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HomeMy WebLinkAboutSEP2014-00148 Jefferson County Department of Community Development 621 Sheridan St., Port Townsend WA 98368,(360)379-4450 SEPTIC PERMIT APPLICATION PROPERTY OWNER JODI HOLT MAILING ADDRESS P.O. BOX 532 CHIMACUM, WASHINGTON 98325 PHONE ( 206 ) 393-8640 SYSTEM DESIGNER NATHAN N. CLEAVER Designer Phone# 360-598-6546 LEGAL DESCRIPTION: Section 09 Township 28N Range 1W PARCEL# 801-091-002 Subdivision Name Division Block Lot(s) A Site address/Directions to site 5030 EAGLEMOUNT ROAD, CHIMACUM SOURCE OF SEyVAGE/USE TYPE OF WORK WATER SOU CE Residential V New Tank/s only Private_fResidential ADU/ Modification Public Commercial b Expansion Community Upgrade Repair SITE SIZE 2,743,408+/- SYSTEM TYPE Partial Repair-(tank) (drainfield) Previou vat do Conventional_ ✓ Designate Reserve Area Yes#°FP�` Alternative Redesign V No 1 6a SYSTEM DETAILS Number of Gallons/day (DOD Soil type 4 (attach soil eval.) Application Rate 0.6 gal./sq.ft./day Drainfield Length 335 ft. Trench Width 3 ft. Trench/Bed Depth 18 in. Septic Tank size (2) 1,000 gal. Pump Chamber size 1:3(31)x tsObgal. TYPE of system — SIMPLE PRESSURE 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,jucgments, 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 wiAl be separately jt4dgedby the rules and laws in effect at that time. Property Owner Signature Date FOR OFFICE USE ONLY !(f /c/ r C(J PARTIAL Cr 1 J+5 ASBUILT t 4f- FINA�> `hoN- APPROVED _ `��.r \ lA\ INSP/PUMP TEST J z/3XS CC DP''? �1�` ALL HOLD REQ.MET / 0 Date. 7 k5 Fee l Rec# l-5 -R Check# Case#SEP l �� :i: :.,_�\l'UL ...,✓l L. m..1..:. Ytft r�r. JEFFERSON COUNTY PUBLIC HEALTH * � 615 Sheridan Street•Port Townsend•Washington •98368 www.jefferson countyp ub licheakh.org Phone 360-:tib-9444 rax 3bU-319-44131 ON-SITE SEWAGE DISPOSAL PERMIT PERMIT #: SEP14-00148 Date Received: 12/22/14 Date Issued: 04/22/15 SITE ADDRESS: 5030 EAGLEMOUNT RD Date Expires: 07/22/15 PORT TOWNSEND, WA 98368 APPLICANT: JODI HOLT PHONE: PO BOX 532 CHIMACUM WA 98325-0532 LEGAL DESCRIPTION: S9 T28 R1W TAX 13-PARCELA V33/P75 BND TGTH THRU BLA#110949 PARCEL#: 801091002 Section: 9 Township: 28N Range: 1W DESIGNER: NATHAN CLEAVER PHONE: 360-598-6546 NATHAN CLEAVER SEPTIC DESIGN 262 NW THOMPSON RD POULSBO WA 98370 SYSTEM DESCRIPTION: PRESSURIZED TRENCH No. of Gallons per Day: 600 Type of work: NEW Drainfield Trench Septic Tank Length: 335 feet Width: 3 feet Depth: 18 inches Size: 2,000 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. Jefferson County Enviro mental Health Specialist This permit with conditions must be onsite during I phases of construction HEALTH DEPARTMENT MUST BE CONTACTED FOR FINAL INSPECTION. SPECIAL CONDITIONS APPLY - SEE ADDITIONAL PAGES CONDITIONS OF APPROVAL - PERMIT NO.: SEP14-00148 1.) This permit was issued to correct a violation of WAC 246-272A for septic system components installed w/o a permit. The permit must be completed within 90 days of the date of issuance. 2.) Keep the primary and reserve drainfield areas 100' from the low area near the 32" culvert just west of the approved drainfield area. Seasonal standing water this area. 3.) 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. 4.) Any portion of transport line under a driven way is to be sleeved/cased or equivalent. See detail sheet 5.) This septic system is designed and approved for a single family residence with 7 additional employees. No business or other activities on this property, currently or in the future, are allowed to dispose of waste water into this septic system with out obtaining additional permits from this office. 6.) H - AS PER WAC 246-272A AND JEFFERSON COUNTY CODE 8.15 ALL ONSITE SEWAGE SYSTEMS REQUIRE THAT A 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 7.) Health Dept. required to observe pressure test with system designer when system fully installed/complete, 48 hours notice to be provided for scheduling. 8.) H - Permanent barriers are required around Septic and Pump Tanks to protect from vehicular dammage. 9.) Approval/issuance of a sewage disposal permit or installation of a septic system does not guarantee the approval of other development or a building permit on this site. Future buildings that require connection to an on-site sewage system (OSS) shall only be approved if the OSS meets the current standards and codes in effect at the time of the building application. 10.) 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. 11.) 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. 12.) Notification of the start of construction shall be faxed or emailed to Jefferson County Public Health ONE WORKING DAY prior to start. 13.) H - An asbuilt drawing and certification of completion by the designer is required prior to final approval. 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.) This onsite sewage system is designed for domestic strength wastewater only. Disposal of any other waste strength is considered a violation of this permit. 16.) 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. SEP14-00148 Page 2 of 3 \\tidemark\data\forms\F_SE P_Perm itm od.rpt 4/22/2015 17.) Approval of this permit does not assure the existing septic system has capacity for all uses allowed by current code. 18.) Setbacks to all existing wells- 100' required from drainfield and reserve areas. 50' required from tanks and effluent transport lines. 19.) 10' separation required between a Water line and all portions of the onsite sewage system; effluent transport line, tanks, treatment and disposal components. No crossing permitted here. 20.) When/if designated reserve area is utilized an alternative system providing an additional level of treatment may be required and must comply with code at the time of application for use. 21.) 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. 22.) 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. 23.) This approval is for a new septic system permit only. Any future permits on this site are subject to review for consistency with applicable codes and ordinances and does not preclude review and conditions which may be placed on future permits. 24.) The site plan as submitted with the septic system permit application on December 22, 2014 has been reviewed for consistency under the UDC, and has been approved by Jefferson County Department of Community Development. Any modifications, changes, and/or additions to the approved site plan shall be resubmitted for review and approval by Jefferson County Department of Community Development. 25.) Aquifer Recharge Areas in Jefferson County are characterized by porous geological formations that allow percolation of the surface water into the soils and the underlying zone of saturation. Aquifers are geologic formations that contain sufficient saturated permeable material to yield significant quantities of water to wells and springs. Aquifers serve as the source of drinking water within most of the rural portions of Jefferson County. 26.) Jefferson County has determined that the use of real property for agriculture and forestry operations is a high priority and favored use in the county. The county will not consider to be a nuisance those inconveniences or discomforts arising from such operations, if such operations are consistent with commonly accepted best management practices in compliance with local, state, and federal laws. If your real property includes or is within five hundred (500)feet of real property designated as Rural Residential 1:10 or 1:20, Rural Industrial, Rural Commercial, Agriculture, or Forestry, you may be subject to inconveniences or discomforts arising from such farming and forestry operations, including but not limited to noise, tree removal, odors, flies, fumes, dust, smoke, the operation of farm and forestry machinery during any 24-hour period, the storage and disposal or manure, and the application of permitted fertilizers and permitted pesticides. One or more of these inconveniences may occur as a result of agricultural and forestry operations which are in conformance with existing laws and regulations. SEP14-00148 Page 3 of 3 \\tidemark\data\forms\F_SE P_Perm itmod.rpt 4/22/2015 JEFFERSON COUNTY PUBLIC HEALTH, 615 SHERIDAN, PORT TOWNSEND WA 9836E Ii ASBUILT INSPECTION REPORT For RECORD DRAWING Designer NATW kSX N. C EAVES- Permit # SEP 1 --oDl4g Installer Mice iNAORLej Parcel # F;3Q -t I - 00-2-- Electrician 0ZElectrician T)ovB1e X tt EGYCidC_ Design Flow C0O0 Property Owner ADP\ lkcA C Site Address SOW ERyk..eh oui.ir 120A01 Qon r " btor4sc1St• Answer all questions or indicate NA DATE Tanks, Pumos and Controls INSP. Tank (manufacturer, size, baffles) C2-}COTTONIZEOIMIX 1300Dcy4C ► 2 2zS rZokS Pump chamber (manufacturer, size) atOVStr Cornw l2 Olt1A►yc i1 ODD 9+aci 1 2.2. -ZoS- a• Boit/guy OorrbN 2E0l11.vc /,SvO / DN Screen(s)and/or Pump Shroud (type, location) of yD f cr- _!N over Z2 . 1-2CIr of $QT*f- Ssprt c T.4 tJkS, ?Dull, 6t4ftouD is.' eft pump?A1,5 Were Tanks tested onsite for water tightness? CP / No Panel Model l,ZuAwc .)c �+ r01/4)$ 'pi1'46L Model Anw.kWOviX P,13w1bt 4 wok/20/.5'- 1.Pump 1 - Man./Model_s frLI8E127/z$D Flow Rate (o-1s' ter Wmki s Pump Location (i.e. garage, treatment unit, basement) @ IlDu5E Float/transducer settings Inches Timer from bottom of tank- On/off - 20,1 in. Functions: On 2p eta- in Veto - 3-4 in. Off - 2 sec/mine Alarm - 3-3- in. Veto On - 2.71- se min Storage Above High Water Alarm 3i )3 gal. Veto Off - Z. sec/min/el Dose Counter Reading 00O00/00000 # gallons/dose 2,2,,S gal. Elap. Time Meter Reading 000 : 01 40 min/hrs Pump Throttled? Yes ,6o Dose Drawdown (in inches) 3" in. Pump 2 - Man./Model t!�bv(DS/WEA 12.1-1 Flow Rate .ZS qpm '4 n►DV7Dl5 Pump Location (i.e. garage, treatment unit, basement) 13i4L-Dint Float/transducer settings Inches Timer 1 from bottom of tank- On/off - 2D,c' in. Functions: On 40 6e3min Veto - S in. Off - Z sec/mi (' ` Alarm - 35,5 in. Veto On - 54 6-6Dmin Storage Above High Water Alarm 52:3- gal. Veto Off - 2.. sec/mi hr Dose Counter Reading 0000p/p0003 # gallons/dose 33.5 gal. Elap. Time Meter Reading 0000:):10: Oi min/hrs Pump Throttled? Yes / lo) I if additional pumps-complete the info in this table Dose Drawdown (in inches) I ,(o2_S in. I for each and attach. Other Timer functions & settings (e.g. override on/off) ES,—/5B Tr0415 os -1s.1 X4-1 rAv.ks -Airco 0-LEa-12-1 2. "DOSe.S;cacrrIA TAN+r•s 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 Sand Fill met design spec? Yes / No ATU (manufacturer, model) Alarm tested Yes / No Disinfection Unit (manufacturer, type, model) Independent Alarm Yes / No Drainfield Transport Pipe size, schd, diameter MIA. L O Manifold size/schd Z" c & LID 22SFPT?AIS Orifice size Ye" Lateral Size/schd '.SckK L4O 225Epr7,f)ls Barrier Material ARG 3(o 03k% CR. Cover Material/Depth MictWE /t't" Lf NOV Zb1S Residual Head (lat.# & ft. Head) SQ.utvtt• l+EilNT 'IJDV 2015 The laterals/pods were balanced deb / No /p�,, 4k1DV20(S Source/Manufacturer of Drainrock/Gravelless chambers tk11�r1 1 tYLm-ocz. t�RC kb%.tegrz. Drainrock Clean? Yes / No If no, what action taken? NA Mound/Glendon Site Prep Drainfield Length J 7S ft Width -3 ft Depth kg inches Caps for measuring residual head stored (location) -SPUTTER—IN:x COMMENTS (inspection notes, changes from design or deficiencies in installation) Attach additional sheet(s) if necessary Health Department Inspection issues resolved Yes / No / NA If yes how? Users Manual Provided to Homeowner Date7273— Tank/component Decommissioning Report Attached Yes / No / NA Installer Certification attached/signed Yes / No ATTACH RECORD DRAWING stamped/signed by Designer or Licensed Professional Engineer I CERTIFY THE INFORMATION PROVIDED ABOVE WAS VERIFIED 3Y INSPECTION, THE SYSTEM WAS INSTALLED AS DESIGNED AND APPROVED by JEFFERSON COUNTY 72215 (-DATE) OR THAT CHANGES HAVE BEEN NOTED AND TUE SYST£y�.<.- I .0 PLIANCE WITH WAG 246-272. //270 ,5-/o e,251 Designer Signature Date License # H:\WEB\ONSITE\Asbuilt_Report_Form.doc 04/28/10page 2 of 2 r' r ^ 1 1 1 ! 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(z 1p) ti 73 NC Y \ -' zCA f,', r) Nathan Cleaver Septic Design Inc. Contractor Registration#: NATHACS94002 04/22/15 To: Jefferson County Public Health 615 Sheridan Street Port Townsend,WA 98368SEWAGE DISPOSAL DESIGN Approved f' C� tr . 'on Re: Jodi Holt, 5030 Eaglemount Road, Chimacum, •ate Hi Randy, The attached septic design is to serve the existing house which has been found to have a drain field that is too close to the existing well. It is also intended to serve the proposed Marijuana grow and packaging facility. It is only intended to receive waste from a bathroom that is proposed in the existing building and from a service sink that is proposed in the building. The service sink is proposed only for hand washing, and to fill buckets for occasional hand watering if necessary. The septic system is not designed to handle any waste from any kind of Marijuana processing. No processing is proposed. Water Use Calculations are as follows: Existing 3 bedroom SFR: 360 gpd . 7 employees @ 15gpd: 105 gpd 50%extra capacity for commercial use 52.5 gpd Total Required 517.5 Gallons Total Available 600 Gallons The proposed residential and commercial activities on this site are expected to produce residential waste strength. This system is not designed to handle waste that exceeds residential strength. An aquaworx control panel is required at both the house and commercial building so waste volume can be monitored and distinguished to verify use corn liance. Please feel free;t call with any que tions. Thank You 'r , - —_ '•Ri `� iVj K/' Y -:' 'i, IIYYyy Nathan N. Cleave Licensed Onsite Wastewater Treatment System Designer. Address: Telephone: 360-598-6546 262 NW Thompson Road Fax: 360-598-6548 Poulsbo, WA 98370 Email: nathan@nathancleaver.com Please call ahead to make an appointment if you would like to meet with me. Nathan Cleaver Septic Design Inc. Contractor Registration#: NATHACS94002 Soil Logs Re: JASON OLSEN TREEHAWK FARMS DEC 2 2 2014 Parcel#: 801-091-002 Section: 09,Township: 28N, Range: 1W Soil Logging done on 24TH NOVEMBER 2014 by Nathan N. Cleaver Soil Log#1 (, \ 0 - 2" Duff � tPIIIE/L( 2 -20" Brown Loamy Fine Sand 20-48" Gravelly Fine Sand With Pockets of Compaction l� Soil Log#2 flACIA 1 I V � �.�; () I 0 - 2" Duff 2 - 10" Brown Loamy Fine Sand 10-50" Coarse Sand ©-- 12-2-0 L-5 WV —113 1`r- i � '4- ' ,1, . Soil Log#3 0 - 2" Duff 2 - 50" Brown Loamy Fine SandWith Pockets of Disturbed Soil Fey l Ls tz, Soilsctiv'4- Log#4 0 - 2" Duff 2 -20" Brown Loamy Fine Sand 20-50" Fine Sand 3 Please feel free to call with any questions. Thank you, : a X' ot, NATHAV InEAVER LI NE• • I - , ^r EXPIRE / Nathan N. Cleaver Licensed Onsite Wastewater Treatment System Designer Address: Telephone: 360-598-6546 262 NW Thompson Road Fax: 360-598-6548 Poulsbo, WA 98370 Email: nathan@nathancleaver.com Please call ahead to make an appointment if you would like to meet with me.