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HomeMy WebLinkAboutSEP2016-00133 Jefferson County Department of Community Development 621 Sheridan St., Port Townsend WA 98368,(360)379-4450 SEPTIC PERMIT APPLICATION PROPERTY OWNER David Garman MAILING ADDRESS P.O.Box 64 Brinnon,WA 98320 PHONE (951)345-3830 SYSTEM DESIGNER: Michael S.Deeney Designer Phone#: ( 800 ) 395-7296 LEGAL DESCRIPTION: Section 16 Township 25 Range 2W PARCEL#502164056 Subdivision Name D ivision Block Lot(s) Site address/Directions to site Head south on Highway 101 past Brinnon, Right on Mt. Jupiter Rd. Subject Property is to west of 291 Mt.Jupiter Rd.Take first access route past access route with cable gate. SOURCE OF SEWAGE/USE TYPE OF WORK WATER SOURCE Residential X New X Tanks(s)only Private X Residential ADU Modification Public Commercial Expansion Community Upgrade Repair SITE SIZE 5.3 acres SYSTEM TYPE Partial Repair-(tank) (drainfield) Previous Evaluation Conventional Designate Reserve Area Yes# Alternative X Redesign No SYSTEM DETAILS Number of Gallons/day 240 Soil type 4 (attach soil eval.) Application Rate 0.6 gal./sq.ft./day Drainfield Length N.A. ft. Trench/Bed Width N.A. ft. Trench/Bed Depth N.A. in. Septic Tank size 1,000 gal. Pump Chamber size 1,000 gal. TYPE OF SYSTEM Glendon Biofilter 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 ,Jt . 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. "00 rte' 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. Gv1,40-1 Cr7.77CZ /906- 2.616 Property Owner Signature Date FOR OFFICE USE ONLY PARTIAL ;') e rfl), /s� ASBUILT �, �. FINAL y AP R Vi ED INSP/PUMP TEST 11/1-- PUD .� ALL HOLD REQ.MET tf /F / Date / /1 '1`� Fee Rec# /Ui ' l Check# 36c Case#SEP / LA;�/. 3 C:\Data\Wpw\County&State Forms\Jefferson\Septic Permit Forms\Glendons\Garman,502164056.Septic Permit Application.wpd JEFFERSON COUNTY PUBLIC HEALTH 615 Sheridan St. Port Townsend, WA 98368 tei 'aso" www.jeffersoncountypublichealth.org Public Heblth Phone 360-385-9444 Fax 360-379-4487 ON-SITE SEWAGE DISPOSAL PERMIT PERMIT #: SEP16-00133 Date Received: 08/15/16 Date Issued: 10/31/16 SITE ADDRESS: 377 MT JUPITER RD Date Expires: 10/31/19 APPLICANT: DAVID&JE GARMAN PHONE: 377 MT JUPITER RD BRINNON WA 98320 LEGAL DESCRIPTION: S16 T25 R2W TAX 41(W OF RD) PARCEL#: 502164056 Section: 16 Township: 25N Range: 2W DESIGNER: MIKE DEENEY PHONE: 360-379-2879 CREATIVE DESIGN SOLUTIONS PO BOX 2787 PORT ANGELES WA 98362 SYSTEM DESCRIPTION: GLENDON BIOFILTER-M31 No. of Gallons per Day: 240 Type of work: NEW Drainfield Trench Septic Tank Length: feet Width: 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 •- JCC 8.15 as amended. This permit may not be renewed. , �/� Jefferson County En onmental 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.: SEP16-00133 1.) 10' separation required between any Water line private or public, and all portions of the onsite sewage system; effluent transport line, tanks, treatment and disposal components. NO EXCEPTIONS. 2.) Septic tank and pump chamber to be water tight. Extra protection (i.e. Bentonite) to be used around inlet, outlet, and risers due to high water table. 3.) Contact designer prior to installation for staking of drainfield area. 4.) 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 246-272A AND 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 5.) This on-site sewage permit shows a possible, future water connection, to a public water supply. No assurance is granted nor implied that water is available to serve this property. Shown to demonstrate that appropriate setbacks could be met should the water purveyor grant a connection to this property. 6.) 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. 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.) 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. 9.) Notification of the start of construction shall be faxed or emailed to Jefferson County Public Health ONE WORKING DAY prior to start. 10.) H - An asbuilt drawing and certification of completion by the designer is required prior to final approval. 11.) 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. 12.) Setbacks to all wells- 100' required from drainfield and reserve areas. 50' required from tanks and effluent transport lines. 13.) Dry season installation required. 14.) Divert all sources of drainage, including roof drains away from septic tank and drainfield area. 15.) 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. 16.) 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. SEP16-00133 Page 2 of 4 \\tidemark\data\farms\F_SEP_Permitmod.rpt 10/31/2016 17.) The application was reviewed by the Jefferson County Department of Community Development staff on September 29th, 2016 for the potential presence of Critical Areas under the provisions of the Unified Development Code (UDC). After an initial Geographic Information Systems mapping review and an investigative site inspection, the following Critical Areas were confirmed to be present on the subject property: Unstable old landslide, unstable recent landslide, unstable and intermediate shoreline slope stability, Type F Stream, Fish and Wildlife Habitat Conservation Area, Priority Species Habitat Area (Winter Elk) Wetlands, Landslide Hazard Area, Susceptible Aquifer Recharge Area, Adjoining Forest Lands. 18.) Geologically Hazardous Areas in Jefferson County are characterized by slope, soil type, geologic material, and groundwater that may combine to create problems with slope stability, erosion, and water quality during and after construction or during natural events such as earthquakes or severe rainstorms. 19.) A Geotechnical Report prepared by Zenovic and Associates dated June 13th, 2016 was submitted in conjunction with this application. The report addressed the stability of the geologic hazard area. 20.) Proper maintenance of the existing steep bank to the west is critical to the continued safety of the site and for minimizing damage to the bank. No organic material, including grass clippings and tree or brush trimmings should be thrown over the top of the slope to the east. These materials may help hold water on the slope, thereby reducing slope stability. 21.) If an onsite sewage disposal system is required for this site, the on-site sewage disposal drainfield shall be located as far as practical from the top of the steep slope, but shall be not less than 75 feet from the top of the steep slope. The drainfield shall be installed in accordance with the requirements of the permit for the system, as approved by the Jefferson County Environmental Health Department. Septic tanks, pump chambers and collection and transport piping shall be placed not less than 50 feet from the top of the slope. All system components shall be water tight, piping within recommended setback area shall be tested for leaks prior to cover. 22.) A vegetative buffer of 25 feet shall be permanently maintained from the top or edge of the Landslide Hazard Area. All buffers shall be measured perpendicularly from the top or toe of the Landslide Hazard Area. 23.) Landslide Hazard Areas and their associated buffers shall remain naturally vegetated. Should buffer disturbance occur during construction, the Unified Development Code (UDC) Administrator shall require replanting with native vegetation. No alterations shall be made to the Landslide Hazard Area or its associated buffer without prior authorization by the UDC Administrator. 24.) Prior to and during approved construction activities, the perimeter of the landslide hazard area buffer shall be marked with a temporary sign. The sign shall be placed in such a manner that it can be directly observed from the construction area. The sign shall contain the following statement: "Landslide Hazard Area and Buffer- Do not Remove or Alter Existing Vegetation." 25.) All construction activities shall not encroach upon the 25 foot Landslide Hazard Area buffer. This includes the storage or preparation of materials. 26.) The applicant shall permanently separate the boundary of the Landslide Hazard Area Buffer from the remainder of the subject property through installing logs, trees, a hedge row, or any other prominent physical marking approved by the UDC Administrator. 27.) A Type F Stream (Fish and Wildlife Habitat Conservation Area) has been identified on the subject property. The stream will require a buffer of 150 feet. The buffer shall be measured horizontally from the Ordinary High Water Mark (OHWM). Fish and Wildlife Habitat Areas shall also have Buffers and Building Setbacks established. 28.) The identified Fish and Wildlife Habitat Area (Type F Stream), shall maintain a vegetative buffer setback of 150 feet. The setback shall be measured horizontally from the Ordinary High Water Mark (OHWM) to the New Septic System. SEP16-00133 Page 3 of 4 \\tidemark\data\forms\F_SE P_Perm itmod.rpt 10/31/2016 29.) 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 of 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. 30.) This approval is for a New Septic System 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. 31.) The site plan as submitted with the New Septic System application on August 15th, 2016 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. 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CC ^ / i M in m a I N I ' W [C i_ a \ I I 1 a II I i::a Pa .t 1 a . ,‘ , ,,, , • , 1 .11101111 I 1 ,‘, ,,, � I, _ I ,, ,, 10 \II, I, , ,I ( sillri � I 0 Ci U W` 38.6 o• I (v J J Q CO �� �Jc( W 10 v I \ �t \ V 411\ 0 \\ \ O Wt?, I \ (1)z cf) Q w WOE V� Q = O 'Q 'Lu �� o \ �f vlJ� (13 OCC O �. W 3 ^. d O / \ o N JW1 �t,W N r. 4.1 J o I mao U W M 4 Q o Z W W Q. � � z a I Hg I N rby 1��� ���b N__ I r - Z m N �o I / N '• wC it g z a N / �cto CC CI VI JEFFERSON COUNTY PUBLIC HEALTH, 615 SHERIDAN, PORT TOWNSEND WA 98368 CONSTRUCTION INSPECTION REPORT For RECORD DRAWING Designer MICHAEL DEENEY Permit # SEP 16-00133 Installer EVAN NEVILLE, SHOLD EXCAVATING Parcel # 502164056 Electrician Design Flow 240 wa, Property Owner DAVID GARMAN Site Address 377 MOUNT JUPITER RD., BRINNON, WA 98320 > `' Answer all questions or indicate NA �/les' Tanks, Pumps and Controls Date Insp. Tank (manufacturer, size, baffles) 1,000 GAL. 2 COMP. W/BAFF & OUTLET FILTER 4/28/17 Pump chamber (manufacturer, size) 1,000 GAL. 4/28/17 Screen(s)and/or Pump Shroud (type, location) PUMP VAULT W/BIOTUBE FILTER 4/28/17 Were Tanks tested onsite for water tightness? Yes / No Panel Model AQUAWORX IPC-SG Timer Model AQUAWORX 4/28/17 Pump 1 — Man./Model PF100511 Flow Rate 19.9 gpm 4/28/17 Pump Location (i.e. garage, treatment unit, basement) Bottom of transducer to bottom of tank 22" Float settings (above bottom of tank) / transducer settings Timer Functions: (above bottom of transducer) On/off - 0.9" On - 5 SEC Veto - 22.8" Off - 14 MIN 55 SEC Alarm - 22.8" Veto On - 5 SEC Storage Above High Water Alarm 329 gal. Veto Off - 14 MIN 55 SEC Dose Counter Reading 20 DOSES, 16 VDOSES Gallons/Dose 1.66 Elap. Time Meter Reading 4 MIN 28 SEC Pump Throttled? Yes / No Dose Drawdown (in inches) 0.08" Pump 2 — Man./Model Flow Rate gpm Pump Location (i.e. garage, treatment unit, basement) Bottom of transducer to bottom of tank Float settings (above bottom of tank) / transducer settings Timer Functions: (above bottom of transducer) On/off - On - Veto - Off- Alarm - Veto On - Storage Above High Water Alarm gal. Veto Off - Dose Counter Reading: Gallons/Dose: Elap. Time Meter Reading: Pump Throttled? Yes / No Dose Drawdown: If additional pumps complete this info for each \\LENOV02016DEC\Data\WpwlCounty&State FormsJefferson\Construction Rpts\Glendon\Garman,502164056,Alternative sys ASBUILT 2010-21 FRM wpd 05/03/17 Page 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/Sch. 1" SCH 40 PVC Feeder Size/Sch. *1" SCH. 40 PVC 4/14/17 Orifice Diameter Lateral Size/Sch. Barrier Material Cover Material/Depth Residual Head (lat.# & ft. Head) Source/Manufacturer of Drainrock/Gravelless chambers Drainrock Clean? Yes / No If no, what action taken? Mound/Glendon Site Prep. Drainfield Length ft Width ft Depth inches Caps for measuring residual head stored (location) COMMENTS (inspection notes, changes from design or deficiencies in installation) Attach additional sheet(s) if necessary Other Aquaworx panel settings: Swarn: , Zbios: 09 , Autoclear: 25 doses min-sec. *BACKFILLED PRIOR TO INSPECTION, SIZE & LOCATION PER INSTALLER Health Department Inspection issues resolved Yes / No / NA If yes how? Users Manual Provided to Homeowner WITH RECORD DRAWING Date 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 by inspection (with exceptions as noted, if any). I also certify that this on-site system was installed in accordance with the approved design and verified through periodic observations of construction such as site plowing for mounds, pressure testing with all system components exposed (no backfill, except over transport pipes), and final inspection of the completed system (with exceptions as noted, if any). To the extent revealed by these periodic inspections, the system complies with all the conditions noted in the permit as approved by Jefferson County 10/31/16 (Permit Approval Date) or that changes have been noted and the system is in compliance with WAC 246-272. 5100110 Designer Signatur, Date License # t1LENUVU2U1bULC1UataWVpwlUounty&State I ormsJettersonlConstruction Rpts1Glentlon\Garman,502164050,Alternative sys ASBUILT 2010-21 FRM.wpd 05/03/17 Page 2 of 2 vivXI 0" m a < n �_ s ti� i I 4' Z 0 )N ,/ ' 1 1 i p Z v 1) a g per, O i �oo ro ^ic)C l spry ' °1 P. _ n N O I' N P c --.---1_ Erna N I I T -$ g ; i i iP' v n ° ..D -< � on S s -1 0z I < �2 i �� t1„ to Amminuelmir -- r ` . ,,, dm:. / /-5.VE, / 1 A ++'ii t..- +e'J' S . . �'"- • ���r -+ "504,"• +�+- \ / $ y� J_ 1 "..�.` j . 1, ZS 3 ,,' 'a3, 'k 1f 1 g ..- •,...:,,.., 4 p. ______ ________ , \ , _ 40...... _ i \ , :b,iz:(.0 Acn con m il ;1;4., ., _„,., g , ... 1 _-,5._. ___ E \ r ) . - 7 .6 -------- tU3 �• r VIJ 711 �`�� �l j�"'� Q 0 X•UO til .� g, � %Qb i › . zed `= G . 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ITER RD" cn r Cr) zoo 70 Do z v4� �Zo IA A COmzo CO r Zoon \ mo- o co m C CO n c m z CO SOIL HOLE LOGS AUG 15 2C13 Page of / Jefferson County Designer ,/'.-7/� " --°' e f�'n"�'sta y_'th .( Property Owner/Buyer i=7,7\.71 2 4" . e- `•s,"/ Parcel# 2 /6 4- 'S�' Project C//t/lrG .47,4e-rfz 4)e-*-:-'---f -> ,-ve-4 Sec(Twp-Rng) SEA-r-- ,( /2 —2w) I HOLE NO. w z IllatG o TYPE w ,Zu OFDEPTH Q w Oz SYSTEM (Inches) U TEXTURE APPL. u) r o 0 H H z RATE cc w 0 O DATE (gpd/sq. ft.) u- Q a OBSERVED G \ ~ V 0 U \ o rx z i ,e'l� vZ, t- S PG < L. 63, ` L > `7 t� ? 2 SL ems'/' ,9-a Wp, L C D• �c 41 LF L, p- tlz, /-71y. /--.7..;. Q. c 0-0 LOP , 4`-''3 p/2--Y 1• F.M r s 4 ii":Or 34-- ak , 7-1,-.:. /4- e 1,6 5-4, \i):,:- - ,y3 (eiyvt c(4,2_„r5,fr-7 /-2-G- 4 5- ,,,,‘3- ,2 "*.c-1-' p, '7-e' /`-r- G F /_S q _.,-- 7-7e /' ' >- -240 k,j‘)1/4,1\4s. (P';.. 5 .", CliiNt,_,), .40)1/41- - 0911 " , , 4 V ' u ,, 3 \