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HomeMy WebLinkAboutSEP2016-00064 r Jefferson County Public Health `, 615 Sheridan St., Port Townsend WA 98368, (360)385-9444 o !1#1 9-004P"' '0,,PERMIT APPLICATION :w+4 �� •. 1 PROPERTY OWNER _SidorieAMorse&Benjamin Tansey er, ovwnr ti•r4 MAILING ADDRESS _401 Otto Street i"...'�0.d ..411 .• port townsend,WA 98368 sidonie<mail@sidonie.com> r, : 1 PHONE L608_.)_556-3878 .if Su51-03342 '':`I1 SYSTEM DESIGNER _Suzanne Martin Designer Phone# (360)990-3304 '"'o '41w ►r► 44.:4144 .,.w�►;, 1) -- ;rt /1.4, LEGAL DESCRIPTION: Section_21_ Township_30N_ Range_1W PARCEL#_001 212 007 Subdivision Name _Tax 2 Division Block Lot(s) Site address/Directions to site_401 Otto Street-port townsend, WA 98368 JQ 3928? Po SOURCE OF SEWAGE/USE TYPE OF WORK WATER S x'10,, O4 Residential yes New__ Tank/s only Private_e0,, COV Residential ADU Modification Public_ t`�/h,�4, Commercial Expansion Community a7�h Repair_Yes SITE SIZE_460612sf SYSTEM TYPE Partial Repair- (tank)_Yes_ Previous Evaluation Conventional (drainfield)_Yes Yes#_SEP77-00329 Alternative yes_ Designate Reserve Area_Yes No SYSTEM DETAILS Number of Gallons/day_360 Soil type_4 (attach soil eval.) Application Rate 0.60 gal./sq.ft./day Drainfield Length 16.5 ft. Trench Width_17.5_ft. Trench/Bed Depth_n/a in. Septic Tank size_1000 gal. Pump Chamber size 1000 gal. TYPE OF SYSTEM Glendon Biofilter slopes less than 5% M31 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 SC:(44.,1_ 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. C--`ok - ----. ,/t^ - i-►/16/(6, Property Owner Signature Date FOR OFFICE USE ONLY i r I, ' PARTIAL L,I �J / k- V ASBUILT 14 7 FINAL 3 I E ., f7 � A 'RAVED �- INSP/PUMP TEST 1_A ( Monitoring Agreement *A_11-' r ALL HOLD REQ. MET ) j ,r Date of Zg J f to Fee ILf q-r��Rec# t & 3.73 Check# 5 Y u-7 Case#SEP 16 �'O b 9 C:\Users\Suzanne\Desktop\Morse & Tansey 001212007\la SPA Morse & Tansey.doc JEFFERSON COUNTY PUBLIC HEALTH 615 Sheridan S, Port Townsend, WA 98368 www.jeffersoncountypublichealth.org Public He(Git Phone 360-385-9444 Fax 360-379-4487 ON-SITE SEWAGE DISPOSAL PERMIT PERMIT #: SEP16-00064 Date Received: 04/28/16 Date Issued: 07/11/16 SITE ADDRESS: 401 OTTO ST Date Expires: 10/11/16 PORT TOWNSEND, WA 98368 APPLICANT: SIDONIE STRAUGHN MORSE PHONE: BENJAMIN K TANSEY 401 OTTO ST PORT TOWNSEND WA 98368-9392 LEGAL DESCRIPTION: S21 T30 R1W TAX 2 PARCEL#: 001212007 Section: 21 Township: 30N Range: 1W DESIGNER: SUZANNE L MARTIN PHONE: 360-990-3304 PO BOX 125 CHIMACUM WA 98325 SYSTEM DESCRIPTION: GLENDON BIOFILTER-M31 No. of Gallons per Day: 360 Type of work: REP Drainfield Trench Septic Tank Length: 16 feet Width: 17 feet Depth: inches Size: 1,000 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 Environmental 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 REVERSE & ADDITIONAL PAGES CONDITIONS OF APPROVAL- PERMIT NO.: SEP16-00064 1.) This permit was issued to correct a violation of WAC 246-272A for a system that backs-up seasonally . The permit must be completed within 90 days of the date of issuance. 2.) 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. 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.) Health Dept. required to observe pressure test with system designer when system fully installed/complete, 48 hours notice to be provided for scheduling. 5.) 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 6.) 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. 7.) Notification of the start of construction shall be faxed or emailed to Jefferson County Public Health ONE WORKING DAY prior to start. 8.) H - An asbuilt drawing and certification of completion by the designer is required prior to final approval. 9.) 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. 10.) Dry season installation required. 11.) 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. 12.) This system as designed and approved is sized for only one single family residence. It is not sized for an Accessory Dwelling Unit (ADU). The minimum daily design flow per residence is 240 GPD. 13.) 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. 14.) 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. SEP16-00064 Page 2 of 2 \\tidemark\data\forms\FS EP_Perm itm od.rpt 7/11/2016 I CERTIFICATION OF TANK ABANDONMENT Parcel number 001 212 007 Address 401 Otto Street-Port Townsend, WA 98368 Property Owner Name Sidonie Straughn Morse & Benjamin Tansey Septic Permit # (if applicable) SEP 16-00064 Individual/Company Certifying Abandonment Marty Kithcart(Landmark Excavating) Phone Number (360) 379-6652 t` certify that the septic tank and/or pump chamber on the above referenced site has been abandoned to Washington State and Jefferson County Public Health Requirements. Signature : _ Date F.:-C-10I L.f Print Name MOx--\. 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' H _. = 3 o a) East Property Line ±North ±625' . * 0 /10 00,:<<,:b System Owner: Sidonie Straughn Morse & Benjamin Tan `�o4 ' $ SEP16-00064; °� �o' �� > Parcel #001 212 007 "'AN Site Address: 401 Otto Street 'Ss Port townsend, WA 98368 Pump Tank Detail-nts 3.5" from top of riser 20"Installed Riser Inlet .75, ,+' ,.,_L 56" _ ±23.1"/500 gallons of storage 'r above high water alarm -not including additional capacity in septic tank and tank risers ?. ii -±15.1"/±330 gallons storage .� Veto set 13.4"from the below invert of inlet of pump tank bottom of the bell alarm set for 13.2"from bottom of the bell -±270 gal working volume }, IR on set 0.9"from bottom of the bell Cotton-1000 gallon pump 1 0 0 f 4 ?: tank;22 gallons per inch 20.75"from bottom of .r :4: -zb-02 Aquaworx IPCS01 — tank to the bottom of the bell iii •/� �l1 i ,wAf , 0,4 ;S or'MA Vi fj i LI i• or Cp* . + y / SUZANNE � MARTIN •. i EXPI' 1 /rl 4#94( ° 0 JEFFERSON COUNTY PUBLIC HEALTH, 615 SHERIDAN, PORT TOWNSEND WA 98368,r�� p� /," ASBUILT INSPECTION REPORT For RECORD DRAWING; o iat- ,"4' '®'gyp 47y Suzanne Martin 16-000607] 0 Designer Permit # SEP p Marty Kithcart/Landmark Excavating Installer Parcel # 001 212 007 'y )�` Electrician Pete's Electric Design Flow 360 gpd peak X44 Property Owner Sidonie Strauqhn Morse&Benjamin Tansey Site Address 401 Otto Street-Port Townsend, WA 98368 Answer all questions or indicate NA DATE Tanks, Pumps and Controls INSP. Tank (manufacturer, size, baffles) 1000 Cotton, risers, baffles&outlet filter installed 2/8/17 Pump chamber (manufacturer, size) 1000gal Cotton, risers installed, 21.4 gal/inch 2/8/17 Screen(s)and/or Pump Shroud (type, location) BioTube in pump chamber 2/9/17 Were Tanks tested onsite for water tightness? es / No Panel Model Infiltrator Timer Model Aquaworx IPC 2/13/17 Pump 1 — Man./Model Orenco P10 Flow Rate n/a qpm 2/13/17 Pump Location (i.e. garage, treatment unit, basement) in pump chamber Float/transducer settings Inches Timer from bottom of tank- On/off - 22.65 in. Functions: On 9 IDmin Veto - 35.15 in. Off- 8:42 sechr Alarm - 34.95 in. Veto On - 9 sec min Storage Above High Water Alarm 330/500 gal. Veto Off- 6:31 sec/ in hr Dose Counter Reading 1 dose/25 veto dose # gallons/dose per gbt gal. Elap. Time Meter Reading 0:05:43 mine Pump Throttled? Yes _No Dose Drawdown (in inches) n/a in. Pump 2 — Man./Model Flow Rate n/a qpm Pump Location (i.e. garage, treatment unit, basement) Float/transducer settings Inches Timer from bottom of basin 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 If additional pumps- complete the info in this table Dose Drawdown (in inches) in. for each and attach. Other Timer functions & settings (e.g. override on/off) ZB-02;Autoclear 22 dose; 77 events; ID=05-08-2013 H:\WEB\ONSITE\Asbuilt_Report_Form.doc 04/28/10page 1 of 2 Pre-Treatment Date Ins') Sandfilter basin high water alarm shuts down pump to Sandfilter Yes / No Sandfilter Basin size/location n/a 9/14/16 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 1" pvc sch 40 Manifold size/schd 1" pvc sch 40 2/8/17 Orifice size n/a Lateral Size/schd n/a Barrier Material jute Cover Material/Depth n/a Residual Head (lat.# & ft. Head) n/a The laterals/pods were balanced Ye / No 2/13/17 Source/Manufacturer of Drainrock/Gravelless chambers n/a Drainrock Clean? Yes / No If no, what action taken? n/a Mound/Glendon Site Prep n/a Drainfield Length 16 ft Width 17 ft Depth n/a inches Caps for measuring residual head stored (location) valve riser COMMENTS (inspection notes, changes from design or deficiencies in installation) Attach additional sheet(s) if necessary system was installed as per plan .3.) Existing tank has been decommissioned; 5.) OM Agreement has been filed at auditor •10.) Soil conditions were suitable for installation of the system .13.) Construction of this system complies with state and county code Health Department Inspection issues resolved Yes / No /0 If yes how? Users Manual Provided to Homeowner mailed Date 14 February 2017 Tank/component Decommissioning Report Attached �e / No / NA Installer Certification attached/signed a/ No ATTACH RECORD DRAWING stamped/signed by Designer or Licensed Professional Engineer a I CEIZTI7Y THE INFORMATION PROVIDED ABOVE WAS VERIFIED BY INSPECTION, THE SYSTEM WAS INSTALLED AS DESIGNED AND APPROVED by JEFFIRSON COUNTY (DATE) OR THAT CHANGES HAVE SEEN NOTED AND THE SY TEM IS IN COMPLIANCE WITH WAC 24'6-2 72. ,Il 14 February 2017 5100342 .... F+ Designer Signature Date License # % 5 sil , ' it, 9 � ��� Suzanne L MaAin 1, • CictusC 5bC NEW- It EXPIRES 2./11MS H:\WEB\ONSITE\Asbuilt_Report_Form.doc 04/28/10page 2 of 2 CO E o a m c m Z I— o W co 2 co ; C a C C N E o aH W v $ c � g E � .; � aCD a- c 2 a 0 = avi N CNI « ? 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TiA2"w Ng' 59' 3'W ID9 9ft '.La.691 3, S—'-S---.9N ' i . a) ..__,----_ X95' • 1`%.'3\ 3 5`" , ti N� I:1 _0. r ko N15' 22'8"W AA• 91 I +, {, cn N5' 30'25"\N 85.13' 0 0 u u II '0 -1 1 page 4 of 8;Morse/Tansey; Tank Cross Section - Not To Scale parcel#001 212 007 (For illustrative purposes only, actual tank configuration may vary, tanks must be on list of approved products.) SECURED LID WITH GAS TIGHT SEAL ACCESS RISER -0 rimmi / \ I FINISH Glc' ® _ / \ I - - \SCC y : ,,. 1 r ti r 0 '} �� , ^, � 1 TO PUM�� --_ J I 1 l 1 ‘) ® + CHAMBER / FROM SEWAGE / 1 SOURCE FLOATING MAT I APPROVED EFFLUENT FILTER SEDIMENTS 1/16"filter must / be installed SEPTIC TANK (TYPICAL) SECURED LID WITH GAS TIGHT SEAL THREADED UNION ACCESS RISER NN SERVICE FINISH GRADE ®_ VALVE I4---: r , FROM SEPTIC e —►TO DRAINFIELD TANK ri j ■ 270 \ '�� 1 — EMERGENCY STORAGE ANTI SIPHON HIGH WATER ALARM LEVEL VALVE* 270 NORMAL TIMER OFF LEVEL WORKING VOLUME I Aquaworx Transducer ENCLOSED PUMP /� SEDIMENT SHROUD* , CHECK VALVE* 18" - SEDIMENTS , ® SUBMERSIBLE R CENTRIFUGAL PUMP PUMP CHAMBER (TYPICAL) *AS NEEDED co I R _, ._.— CCS Page 5 of 8;Morse/Tansey; Parcel#001 212 007 Effluent Pumps OrencoSysteme' Incorporated 1-800-348-9843 100 • Effluent Pumps 90 PEF150 PEF, PKP Series 1/3 hp to 1-1/2 hp BO PEF 1001 70 wm 60 PEF75 •= 50 PEF 50 p 40 Ts to 30 effluent pump 20'of head 10 PKP 35D PEF 3311 0 • I r 1 • 1 t 0 10 gpm 20 30 40 50 60 70 80 90 Net Discharge,gpm N D W-PC-PEF-1 Rev.5.0,©9/04 Page 1 of 1 Page 1 of 8; Morse/Tansey; Parcel#001 212 007 JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT I 621 SHERIDAN ST.,PORT TOWNSEND ,WA 98368, (360) 379-4450 t Hand dug holes "FP+'+ SOIL EVALUATION : ` '`�''ya PROPERTY OWNER Sidonie Morse & Benjamin Tansey '+, h 512 •..' �� Suzanne L Marlin -0, ,S ` i N.WISE'I N€R"" ++, SYSTEM DESIGNER Suzanne Martin EXPIRES2/11/17 LEGAL DESCRIPTION: Section 21 Township 30N Range 1W Parcel # 001 212 007 Tax 2 401 Otto Street-port townsend Date Logged: 4 March 2016 Logged By: Suzanne Martin Include soil textural characteristics and the depths at which significant changes occur. Be sure to include depth where mottling or impermeable layers occur. SOIL LOG #1 SOIL LOG #2 0-6" Dark brown sandy loam 0-4"dark brown sandy loam .,J '9,O `,. 6-24+"Yellow brown gravelly sandy loam 4-36 Yellow brown gravelly sandy toa t ' 27+" mottled soils 6 0^s v9� o 1 �o, >-'0 'e-,-;" '4%.:C1) Anticipated water table 24 in. Anticipated water table in. (z)./ Roots to inches Roots to 27 inches e=3 Health Dept. Comments Health Dept. Comments , SOIL LOG #3 SOIL LOG #4 0-3" dark brown sandy loam 0-6"dark brown gravelly sandy loam 3-25"yellow brown gravelly sandy loam 6-30" olive brown gravelly sandy loam 25" restrictive 30-32" gley loam with mottles r d1- 2 +I -- 32" hardpan d-5 '�-/'� �, UJt Z L Anticipated water table in. Anticipated water table in. Roots to 25 inches Roots to 32 inches Health Dept. Comments Health Dept. Comments SOIL LOG #5 SOIL LOG #6 0-5" dark brown gravelly sandy loam 5-32" yellow brown gravelly sandy loam 32" hardpan some compact soils on the East side Anticipated water table in. Anticipated water table in. Roots to 32 inches Roots to inches Health Dept. Comments Health Dept. Comments H:\INFOHLTH\SOIL.FRM 1100