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HomeMy WebLinkAboutSEP2013-00074 Jefferson County Department of Community Development 621 Sheridan St., Port Townsend WA 98368, (360)379-4450 SEPTIC PERMIT APPLICATION A. Mary Hjelvik (for Elvind Hjelvik) '�'+; PROPERTY OWNER 1% MAILING ADDRESS 251 Hjelvicks Road ;F�+, i Brinnon,WA 98320 . 5 a A s+,+ ''. Suzanne L Mart n \--+ PHONE ( 360 ) 796-4720 •• . ebr N a•'• h, errr.�vivo SYSTEM DESIGNER Suzanne Martin Designer Phone# (360)554-0224 LEGAL DESCRIPTION: Section 24 Township 26N Range 2W PARCEL# 602 242 003 Subdivision Name NW NW less r/w Division Block Lot(s) Site address/Directions to site 251 Hjelvicks Road-Brinnon SOURCE OF SEWAGE/USE TYPE OF WORK WATER SOURCE Residential _ New Tank/s only Private O Residential ADU Modification_ ,/ _ Public Commercial ✓ Expansion_,/ Community Upgrade. ✓, Repair SITE SIZE +/-884543sf SYSTEM TYPE Partial Repair-(tank) (drainfield) Previous Evaluation Conventional Designate RPGPrve Area Yes# 73-00226 i 3"-- C3 '-11 Alternative ✓ Redesign ✓ No SYSTEM DETAILS Number of Gallons/day 582 Soil type 4 (attach soil eval.) Application Rate 0.60 gal./sq.ft./day Drainfield Length 324 ft. Trench Width 3' ft. Trench/Bed Depth 24" in. Septic Tank size 1250 min gal. Pump Chamber size 1500 min gal. TYPE OF Pressure trench system By signing the application form, the applicant/owner attests that the information provided herein is true and correct to the best of their knowledge. Any material falsehood or any omission of a material fact made by the applicant/owner with respect to this application packet may result in this permit being null and void. I further agree to save, indemnify and hold harmless Jefferson County against all liabilities,judgments, court costs, reasonable attorney's fees and expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit. I further agree to provide access and right of entry to Jefferson County and its employees, representatives or agents for the sole purpose of application review and any required later inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the application that he or she requires prior notice. Inspections shall occur during regular business hours. Initial here if you require notification before entry Appeal -A person aggrieved of a decision of the Health Officer may appeal. Appeals shall be submitted to the Health Division in writing within fifteen days after receiving written notice of the decision. DISCLAIMER-This application is for an on-site sewage system that meets the state and county standards in effect on the date of application. This application for an onsite sewage system DOES NOT assure you of any other County approvals. For example, it DOES NOT GUARANTEE that you will later obtain permission to build a permanent residence or other structure on this parcel. Any future application will be separately judged by the rules and laws in effect at that time. sg2- 5(\-vp ,, Property Owner Signature CitlrPdI�1 / J/ Date FOR OFFICE USE ONLYC�p Q fel -e i /(0(1S /7 jo_illi . PARTIAL C V I f/ �A � ASBUILT I /J Fp FINAIOM �6 APPROV D INSP/PUMP TEST 1b/./I a GDS CI ��j 10-ALL HOLD REQ. MET Date Fee Rec# Check# Case#SEP /3 `7(/ c•\Docvme*i*s and Settirvis\gtza^^e Mart,\My DQ,,,me'ts\my documents 7a^ne\mhh9Q\Jaffo- r, rn,,,,ty\Jeffco forms\Suz\2008 SPA.DOC 1- JEFFERSON COUNTY PUBLIC HEALTH 615 Sheridan Street •Port Townsend•Washington •98368 www.jefferson countyp ub lichealth.o rg I'hone MU-in-9444 Fax 360-319-4461 ON-SITE SEWAGE DISPOSAL PERMIT PERMIT #: SEP13-00074 Date Received: 06/19/13 SITE ADDRESS: 251 HJELVICK RD Date Issued: 06/11/14 Date Expires: 09/11/14 APPLICANT: EIVIND H HJELVIK PHONE: 251 HJELVICKS RD BRINNON WA 983209789 LEGAL DESCRIPTION: S24 T26 R2W NW NW LESS R OF W PARCEL#: 602242003 DESIGNER: SUZANNE L MARTIN PHONE: PO BOX 179 PORT HADLOCK WA 98339 SYSTEM DESCRIPTION: PRESSURIZED TRENCH No. of Gallons per Day: 582 Type of work: EXP Drainfield Trench Septic Tank Length: 324 feet Width: 3 feet Depth: 24 inches Size: 1,250 gallons DISCLAIMER-This approval is for an on-site sewage system that meets the state and county standards in effect on the date of application. This approval for an on-site sewage system DOES NOT assure you of any other County approvals. For example, it DOES NOT GUARANTEE that you will later obtain permission to build a permanent residence or other structure on this parcel. Any future application will be separately judged by the rules and laws in effect at that time. All construction and development activities must comply with all permit conditions, state and local codes, and Recommended Standards and Guidance documents in effect when the permit is issued. The property owner is responsible for the accurate location of all property lines.Any removal of or major disturbance of soil in the primary or reserve drainfield area may create site conditions that are unacceptable for the installation of a sewage disposal system. Any change in drainfield or tank location may invalidate this permit unless prior approval is obtained from the Jefferson County Environmental Health Division. If during excavation or development of the site an area of potential archeological significance is uncovered,all activity in the immediate area shall be halted, and the UDC Administrator shall be notified at once. Permit issued to CONSTRUCT, ALTER, REPAIR OR MODIFY AN INDIVIDUAL SEWAGE DISPOSAL SYSTEM IN JEFFERSON COUNTY, WASHINGTON This permit is issued for a period of three years (unless otherwise stated above) in accordance with Jefferson County Rules and Regulations for On-Site Sewage Systems, codified in JCC 8.15 as amended. This permit may not be renewed. / ,,Z2 Jefferson County vironmental Health Specialist This permit with conditions must be onsite during all phases of construction HEALTH DEPARTMENT MUST BE CONTACTED FOR FINAL INSPECTION. SPECIAL CONDITIONS APPLY - SEE ADDITIONAL PAGES CONDITIONS OF APPROVAL - PERMIT NO.: SEP13-00074 1.) This permit was issued to correct a violation of WAC 246-272A for installation of a septic system with a permit. This permit must be completed within 90 days of the date of issuance. 2.) The existing water line along Hjelvik Rd. must be re-located if drainfield is installed closer than 10'. As per design. Verrification of water line is required. 3.) H - Existing tank shall be properly abandoned. It shall be pumped and filled with clean fill. Documentation to be provided to Health Dept. prior to final. 4.) H - Permanent barriers are required along/around primary and reserve drainfield areas to protect from parking, driving, and other land disturbing activities prior to final. 5.) The current permitted food service level is for a limited grocery store selling only prepackaged food. There is not any food prep or food handling. No coffee etc. Any changes to this current level of service/permitting will require additional review and may require the following testing of the waste water: Waste Strength (BOD, TSS, Grease and oils) is to be monitored quarterly for the first year of operation and annually thereafter. Responsibility is that of the owner. Results are to be submitted to the Jefferson County Health Dept. 6.) Any portion of transport line under a driven way is to be sleeved/cased or equivalent. 7.) WAC 246-272A REQUIRES ANNUAL MONITORING OF THE ONSITE SEWAGE SYSTEM WHEN IT IS SERVING A FOOD SERVICE ESTABLISHMENT. 8.) Health Dept. required to observe pressure test with system designer when system fully installed/complete, 48 hours notice to be provided for scheduling. 9.) Designer must be contacted prior to start of construction and for inspections during installation. DESIGNER IS REQUIRED TO DO A PRECOVER INSPECTION ON ALL TYPES OF SYSTEMS. 10.) Notification of the start of construction shall be faxed or emailed to Jefferson County Public Health ONE WORKING DAY prior to start. 11.) H - AS PER WAC 246-272AAND JEFFERSON COUNTY CODE 8.15 ALL ONSITE SEWAGE SYSTEMS REQUIRE THATA RESTRICTIVE COVENANT REGARDING THE MONITORING OF THE ONSITE SEPTIC SYSTEM BE RECORDED TO THE PROPERTY TITLE. THE PROPERTY OWNER SHALL ASSURE THAT MONITORING IS PROVIDED BY AN APPROVED ENTITY AT THE FREQUENCY DEFINED PER STATE WAC 246-272AAND JEFFERSON COUNTY CODE 8.15 AS ADOPTED OR AMENDED. A COPY OF THE RECORDED OPERATIONS AND MONITORING AGREEMENT IS REQUIRED PRIOR TO FINAL APPROVAL OF THE SEWAGE DISPOSAL PERMIT 12.) H -An asbuilt drawing and certification of completion by the designer is required prior to final approval. SEP13-00074 Page 2 of 3 \\tidemark\data\forms\F_SEP_Permitmod.rpt 6/11/2014 13.) The site plan received on 6-18-13 was reviewed by the Department of Community Development on 7-10-13 and it was determined the septic permit is exempt from critical area review as it complies with the General Exemption found in JCC 18.22.070 (6) which exempts the following activity: Reconstruction, remodeling, or maintenance of existing structures. This exemption shall not apply to reconstruction which is proposed as a result of structural damage associated with a geologically hazardous area and does not allow further intrusion into a wetland, fish and wildlife habitat conservation area and/or their buffers. Proposed expansion will accommodate existing legal non-conforming use. Proposed use is outside of FEMA flood hazardous area. Any future permits on this site are subject to review for consistency with applicable codes and ordinances and does not preclude review and condition which may be placed on future permits. 14.) Before final approval is given, the designer shall provide an operations and maintenance manual to the property owner and the Health Department. The manual must instruct the owner of the on site sewage system on the ways to properly operate and maintain all components of the system. 15.) All components of the septic system are to be completely protected from vehicular traffic or mechanical disturbance. 16.) Approval of this permit does not assure the existing septic system has capacity for all uses allowed by current code. 17.) All construction and development activities must comply with all permit conditions, Washington State and Jefferson County Codes and Recommended Standards and Guidance documents in effect when the permit is issued. 18.) Approval of this sewage disposal permit does not preclude the permit holder from complying with the Unified Development Code for other/future development on the site. 19.) This onsite sewage system is designed for domestic strength wastewater only. Disposal of any other waste strength is considered a violation of this permit. 20.) The project shall adhere to the Best Management Practices (BMPs) to control stormwater, erosion and sediment during construction. BMPs shall address permanent measures to stabilize soil exposed during construction, and in the design and operation of stormwater and drainage control systems. 21.) Approval/issuance of a sewage disposal permit does not guarantee the approval of other development or a building permit on this site. Compliance with other Jefferson County and Washington State Codes is required. SEP13-00074 Page 3 of 3 \\tidemark\data\forms\F_SEP_Permitmod.rpt 6/11/2014 0 JEFFERSON COUNTY PUBLIC HEALTH, 615 SHERIDAN, PORT TOWNSEND WA 98368 ASBUILT INSPECTION REPORT For RECORD DRAWING Designer Suzanne Martin Permit # SEP 13-00074 Installer Bud Smith Parcel # 602 242 003 Electrician Homeowner Design Flow 582 gpd peak Property Owner Mary Hielvick Site Address 251 Hjelvick Road-Brinnon, WA 98320 %) ?2- qtt Answer all questions or indicate NA /^ o~s S `` -,ijj oi>� 4„ DATE Tanks, Pumps and Controls -gG % INSP. Tank (manufacturer, size, baffles) 1500 Cotton, risers, baffles &outlet filter installed �y 11/10/14 Pump chamber (manufacturer, size) 1500gal Cotton, risers installed, 33.66 gal/inch ;;5 11/10/14 Screen(s)and/or Pump Shroud (type, location) shroud in pump chamber 12/22/14 Were Tanks tested onsite for water tightness? es / No Panel Model Infiltrator Timer Model Aquawon(IPC 7/10/15 Pump 1 — Man./Model Liberty 290 Flow Rate 46 qpm 7/10/15 Pump Location (i.e. garage, treatment unit, basement) in pump chamber Float/transducer settings Inches Timer from bottom of tank- On/off - 21.65 in. Functions: On 1:31 sec 411110 Veto - 34.35 in. Off 288 sec hr N 1�S26 Alarm - 34.15 in. Veto On - 1:31 sec min a Storage Above High Water Alarm 580+300 gal. Veto Off- 180 sec/ in hr Dose Counter Reading1 dose/6 vdose �� # gallons/dose 73+/- gal. Elap. Time Meter Reading 00:09:10 minE4 Pump Throttled? YesNo Dose Drawdown (in inches) 2.25- in. Pump 2 — Man./Model n/a Flow Rate qpm Pump Location (i.e. garage, treatment unit, basement) Float/transducer settings Inches Timer from bottom of tank- On/off - in. Functions: On sec/min Veto - in. Off - sec/min/hr Alarm - in. Veto On - sec/min Storage Above High Water Alarm gal. Veto Off - sec/min/hr Dose Counter Reading # gallons/dose gal. Elap. Time Meter Reading min/hrs Pump Throttled? Yes / No Dose Drawdown (in inches) in. If additional pumps- complete the info in this table for each and attach. Other Timer functions & settings (e.g. override on/off) ZB-OB;Autoclear 1 dose; 59 events; set for 5 doses per day-365 gallons per day 63% capacity(linda atkins wanted 66%) per email sent 10/28/15 H:\WEB\ONSITE\Asbuilt_Report_Form.doc 04/28/10page 1 of 2 Pre-Treatment Date Insp Sandfilter basin high water alarm shuts down pump to Sandfilter Yes / No Sandfilter Basin size/location n/a Sand Fill met design spec? Yes / No ATU (manufacturer, model) n/a Alarm tested Yes / No Disinfection Unit (manufacturer, type, model) n/a Independent Alarm Yes / No Drainfield Transport Pipe size, schd, diameter 2" pvc sch 40 Manifold size/schd 2"pvc sch 40 12/22/14 Orifice size 1/8" Lateral Size/schd 1" pvc sch 40 11/10/14 Barrier Material filter fabric Cover Material/Depth 0 Residual Head (lat.# & ft. Head) 5.5-6' pre cover(12/22/14) 5'with extra orifices 7/10/15 12/22/15 The laterals/pods were balanced 0 / No Source/Manufacturer of Drainrock/Gravelless chambers cotton Drainrock Clean? Ye / No If no, what action taken? Mound/Glendon Site Prep n/a Drainfield Length 335 ft Width 3 ft Depth 24 inches Caps for measuring residual head stored (location) header box COMMENTS (inspection notes, changes from design or deficiencies in installation) Attach additional sheet(s) if necessary 2.) water line along roadway/fence line does not exist, verified at drainfield 3.) tank was properly abandoned by licensed installer, see abandonment form 4.) barriers have been placed around the drainfield area(fencing) 6.) sleeved in driveway as noted; sleeved under water line as noted (2+'separation in addition to sleeve) Health Department Inspection issues resolve Yes No /('y'1 If yes how? l k Sf J/ needneed dOvik` kis (i5 �t'7 t �� �-� �� Lh-y � Ul iLPef ,/ice( / 64 jw•-ecf€ IG /ld L .Tv2 sers Manual Provided to Homeowner ///-(W-05/If frU'ACc/ Date Tank/component Decommissioning Report Attached No / NA Installer Certification attached/signed es / No ATTACH RECORD DRAWING stamped/signed by Designer or Licensed Professional Engineer I CERTIFY THE INFORMATION PROVIDED ABOVE WAS VERIFIED 13Y INSPECTION, THE SYSTEM WAS INSTALLED AS DESIGNED AND APPROVED by JEFFERSON COUNTY (DATE) OR T1- AT CHANGES HAVE 13EEN NOTED AND THE SYSTEM IS IN COMPLIANCE WITH WAC 246-272. far; ft, 5100342 its, .. 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NORMAL TIMER OFF I , ANTI SIPHON LEVEL WORKING VOLUME VALVE 11111111 A4uaworx Transducer ENCLOSED PUMP if Assembly SEDIMENT SHROUD CHECK VALVE SEDIMENTS SUBMERSIBLE CENTRIFUGAL PUMP CHAMBER PUMP TYPICAL *AS NEEDED Page 5 of 6;Hjelvik; Parcel#602 242 003 Effluent Pumps itzz, Systems. Incorporated 100 1-800-348-9843 on iir ___ 90 PEF 150 Effluent Pumps • PEF, PKP Seris 111 al on m 1/3 hp to 1-1/2 hill 80 PEF 100 Nina 70 +r d inne mil i 60 Nal I 11111111 I In = 50 s I ihisilinia 4a • -4,41,4r1 effluent pump Elli 3a 25'of ' `. head 1111111ihhimm- `� �a1i 20 2111111111111i WIN N ali 101111111 ihqpiLbnillihh, 11011111111111110.11-.41111111111111111:11111: a IIIIIIIIIIIIIII i 0 PKP 350 10 20 30 40 gpm 50 60 70 Net Discharge,gpm 80 90 NDW_PC-PEF-1 Rev.5.0,©9/04 Page 1 of 1 Page 2 of 6; Hjelvik; Parcel#602 242 003 ONSITE SEWAGE DISPOSAL SYSTEM DESIGN l?'f K5 0 2 kF',I 3 Date 16 April 2013 °tiSuzanne 613gl Martin-" 2,,1,15 Property Owner Mary Hjelvik(for Elvind Hjelvik) 27 February 2014 System Designer Suzanne Martin Legal Description: Section 24 Township 26N Range 2W Subdivision Name NW NW less r/w Division Block Lot(s) 2 I. CALCULATIONS If for residential use: Number of Bedrooms: see calculation x 120 G.P.D.. 582 total G.P.D. • If for non-residential use, attach calculations used to determine G.P.D. Soil texture waste water application rate 0.60 G.P.D./ft. squared (see page 214 of the EPA Design Manual) DRAINFIELD SIZING: Absorption area: 970 square feet (total G.P.D. _G.P.D./ft. squared) Trench or bed width 3' feet Trench or bed length 324 lineal feet (sq. ft.+trench or bed width) II. APPURTENANCES Septic Tank Size 1250 min gallons Pump Requirements (If Necessary) Elevation difference in feet 5 Friction loss 9.5 Pump capacity should be 40 G.P.M. at 25 T.D.H. Number of doses per day 6/9 Dosing volume 65 gallons Pump chamber size 1500 min gallons H:\homelpIncnnAinfohlth\sewdsn page 3 of 6; Hjelvik; Parcel#602 242 003 III. DRAINFIELD CROSS SECTION f4 '�+4 =�2" Suzanne L Maninr'+1+ D mcg 27 February 2014 NATIVE SOIL A IMPERMEABLE MATERIAL/ SEASONAL SATURATION A. Trench Depth 24" inches B. 6-8" inches of drainrock below pipe C. 36+ inches of vertical separation from trench bottom to impermeable material/seasonal saturation D. 0" inches of fill (if needed) E. Trench width 36" inches NOTES: Reserve area may require additional treatment ATTACH DETAILED DESIGN OF SYSTEM Page 6 of 6; Hjelvik; Parcel#602 242 003 Pressure Distribution On-Site Sewaj a Disposal System Work Sheet Name of Applicant Mary Hjelvik Site Address or Location 251 Hjelvicks Road Tax Assessors# 602 242 003 Date 16 April 2013 Designer's Name Suzanne Martin Company Name none Phone# 360-554-0224 Property Information: Number of Bedrooms - Maximum Daily Flow 582 Total Absorption Area Required(Sq.Ft.) 970 Trench Information: Trench Width 3' Trench Depth 24 Total Lineal Trench Length 324 Total Washed Drain Rock Under Lateral 6-8" TDH=19.5(25)feet Gravelless Chamber Drainfield(Yes-No) no -Residual-5' -Friction loss-9.5' Manifold. Lateral& Transport Information: --Transport line+/-7' Total Lateral Pipe Length 324 --Manifold&Lateral-+/-2.5' Lateral Spacing 9'oc El. Difference-+/-5' -Pump On-+/-30' Transport line Length +/_500' -D/F ie elevation-+/-29" Transport Line Pipe(Schedule) sch 40 Manifold& Laterals Pipe (Schedule) sch 40 Lateral Line Diameter • 1" Manifold Line Diameter 2" Transport Line Diameter 2" Pump Information: -4'spacing-16 per lateral x Residual Lateral Head(Squirt Height) 5' 5=80 orifices Pump Size 40gpm@ 25'head -80 orifices @ 0.41 gpm =32.80(40 gpm) Dosinj'Information: Orifice Spacing(inches)- 48" Total Orifices 80 Orifice Diameter • 1/8" Total Dose Volume 65 %y Number of Doses Per Day 6/9 ok A � ,�' Size of Pump Tank(gallons) 1500 m , if, 4 �4 5tdra2 06 'fit Control Panel Information „re Suzanne L Martin '�tl `1 .fJS@tib@r N@-.. .t• Ewu�-vnns Aquaworx IPC-1 Other Information: ^ - `_ \ter , .'` / ( $ % f ;` --- \, .� f t / t a '\so �\tNORTH -::::::::::,::::::::::::f11,.. ,0,,,0' `' _ __ ,, ``" ^ 7 )Ill,/,„------ --,,,,......,, - I ti9 a t- ......'N...4__,,— „ \` _` ,_ ' ' a._.; . 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