HomeMy WebLinkAboutSEP1986-00240 615 S dan Street
Port Townsend,WA 9
www-leffersonCountyPublicHeoltrh.org
BRANDON PRZYGOCKI April 20, 2016
381 OLD ANDERSON LAKE RD
CHIMACUM WA 98325-0041
RE: Septic System Monitoring Inspection Report
SITE ADDRESS: 381 OLD ANDERSON LAKE RD
PARCEL#901104009
CASE#: SOM86-00240
Dear: BRANDON PRZYGOCKI
A review of our files for the above referenced property shows that when the title was transferred on or
about October 28, 2015 a monitoring inspection was not on file for the onsite sewage system serving the
residence. Jefferson County Code 8.15.150(7)d.iii. requires that a monitoring inspection in compliance
with the frequency identified in code be on file prior to the sale or transfer of property. There is record of
a tank pumping on February 1, 2016 but pumping the tank does not satisfy the requirement for a complete
inspection of the septic system.
A list of O&M Specialists and a copy of the record for your system, if available, is enclosed for your
convenience.
The purpose of proper maintenance is so the County, for the benefit and protection of the public's health,
is assured by this department that these systems are designed, installed and maintained in a proper
manner. We appreciate your prompt attention to this matter. If you should have further questions
please contact this office at 385-9444. The code sections referenced are attached for your information.
This letter is intended to serve as formal notice that no further approvals shall be granted until a
monitoring inspection is completed and any required corrections are made and approved by Health
Department staff. A permit is required for repair or modification of an onsite sewage system, per
Washington Administrative Code 246-272A and Jefferson County Code 8.15.
Sincerely,
L. 1
Environmental Health Specialist
Jefferson County Public Health
360-385-9444
c: File,
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In 7--rii P-s 1” .S'4 4,,'h 5 s •cg"I/NIC
• . TNISS PERMIT 1A LL EXPPIE ONE YF_AR FROM DATE t! !iED.APPIIC:A TON. `S ✓ ®Q .
• . FOR RENEWEL FOR ONE YEAR WITHIN 30 DAYS WORE EXPIRATION. Cele U..LE
JEFFERSON COUNTI"NEALTH DEPARTMENT 07)1;61'
802 SHERIDAN AVENUE
INSTALLER 'Ov, �x PORT TOWNSEND,WASHINGTON 98368 RECEIPT NO.
(206)385-0722
BUILDERSEWAGE DISPOSAL PERMIT OATS 10/2/86 —
Ron Herms
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InterWest Savings Bank PO Box 1_64_9 Oak Harhnr WA 675-0788 A
Address Phone ,
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: acur Comm Center_ Right 1st road, Left •- 0
0 d Ander on Lake R• Chimacum WA �' Z g•
Directions for locating site on Old Anderson Lake Rd)� N p
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INSTALL NEW SYSTEM 0 REPLACE SYSTEM 0 PARTIAL REPAIR TANK/DRAINFIELDQ• rn 1
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TYPE OF Single NO.OF SITEBASEMENT . . SIZE , , i w
BUILDING . •„ • :_ BEDROOMS 3
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Previous site evaluation by SOIL TYPE DESCRIPTION Oki-07e✓ /o/L Stogy. 9
Health Department x p
Yes x No •� 1) -14 ,lDA/i/ ^'� z
/P-33 mow, orrc� ,� 'n '
Depth to maximum seasonal 33 -� ��,�,�
water table
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Source of potable water supply 2) "k406A4.14,4 �/
Public c., ---- Private
Source type: Drilled well* G-/!o .Cons, 5,7„,,,d
c.:\\--e. •Dug well Zz
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EVERY APPLICANT HAS THE RIGHT OF `- -`{ CNA:Y-6 Ng-.---....:NN, "--..«\A _
APPEAL AS PER JEFFERSON COUNTY - c- I .
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ORDINANCE 2-77. • Q
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• OF OR • • I' DISTURBANCE OF SOIL IN THE PROPOSED OR APPROVED DRAINFIELD r
AREA MAY CRATE SITE CONDITIONS THAT ARE !ACCEPTABLE FOR THE INSTALLATION OF A 8
SEWAGE DISPOSAL SYSTEM. ANY CHANGE IN BUILDING OR SEWAGE DISPOSAL PLANS tINCLUDING
PLUMBING STUBOUT LOCATION) AND/OR LOCATION OF HOUSE OR DRAINFIELD INVALIDATESaTHISDe t
PERMIT UNLESS PRIOR APPROVAL IS OBTAINED FROM THE HEALTH DEPARTMENT• p
for final inspection). STS OUT PLUIMBING ABOVE FOUVDATIlt FOOTING, Fausn O
Drainfield Length /5V Trench width 3` Trench depth a"'Ro.lines 3' Tank size"' `�,/ >
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Soil type and application rate used for design 3 GPD/ft2= , p c 1
COMMENTS: > // T.t'E,re,i/es, Aro ziee eie 740,4kf 32”
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I certif at this system w Cn d in a manner approved by the Health Department r-
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INSTALLER'S SIGNATURE DATE DATE INSTALLED " '
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y`d 903 E. Caro140x OLYMPIC HEALTH`DISTRICT Permit No. � S U
Port Angeles SEWAGE .DISPOSAL PERMIT APPLICATION
Submit in Duplicate Builder
Court House
Port Townsend Date ctill��l
OWNER ,0 C..i\ _ ADDRESS `o , Q o a`1 l ,��,;,,.c,. PHONE
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DIRECTIONS FOR LOCATING-SITE ������. C .�
APPLICATION IS HEREBY MADE TO: INSTALL Nola SYSTEMR EXISTING SYSTEM
,>S J i r}cc-ie. L:.-gin" Tc(c. ->k b - - \
P'YP OF NO. OF BEDROOMS , BASEIENT I SITE SIZI NAME OF INSTALLER
DRAINFIELD LENGTH t 36 ,+rnTH z( DEPTHo1'Y.
4," ,_,.., \-1-2.. --SEPTIC AA SIZE �.C��
DRAW A DETAILED PLOT PLAN BELOW. SEE INSTRUCTIONS. SOIL TYPE Si ..4%-, k.\\-.1.-,Ir\-.-r�,C-.:e.*
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C-HANGE IN BUITDING OR SE'AGE DISPOSAL PLANS, LOCATION OR SITE, INVALIDATES THIS
P T UNLESS PRIOR APPRCV AL OBTAINED FROM THE HEALTH DEPARTMENT.
DATE OF INSTALLATION SIGNATURE OF APPL NT
APP OVID DATE cJ/?W-7i INSPECTED BY ��` )` DATE id 1 7 3
SANITARIAN IS COI iN'.ENTSs
I CERTIFY THAT THIS SYSTEM YAS INSTALLED IN THE MANNER APPROVED BY THE
HEALTH DEAPRTMriT DATE
INSTALLERS NAME
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