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Home My WebLink AboutSEP1973-00009JEFFERSON COUNTY PUBLIC HEALTH 615 She ridan Street • Port Townsend • Washington • 98368 wvm jeffersonr-ountypu blichoatftorig MARY ZELLMER April 21, 2014 PO BOX 306 BRINNON WA 983200306 RE: Septic System Monitoring Inspection Report SITE ADDRESS: 561 APPALOOSA DR PARCEL # 966900088 CASE #: SOM73-00009 Dear: MARY ZELLMER A review of our files for the above referenced property shows that when you purchased the property on or about March 13, 2014 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. 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, % Environmental Health Specialist Jefferson County Public Health 360-385-9444 c: File, O&M Specialist Code References 8.15.150 OPERATION, MAINTENANCE AND MONITORING (1) Responsibility of Owner(s). The owner of every residence, business, or other place where persons congregate, reside or are employed that is served by an OSS, and each person with access to deposit materials in the OSS shall use, operate, and maintain the system to eliminate the risk to the public associated with improperly treated sewage. Owners' duties are included, without limitation, in the following list: a. They shall comply with the conditions stated on the on-site sewage permit. b. They shall employ an approved pumper to remove the septage from the tank(s) when the level of solids and scum indicates that removal is necessary. The septic tank shall be pumped when the total amount of solids equals or exceeds one-third (1/3) the volume of the tank. The pump and/or siphon chamber(s) shall be pumped when solids are observed. c. They shall not use water in quantities that exceed the OSS's designed capacity for treatment and disposal. d. They shall not deposit solid, hazardous waste, or chemicals other than household cleaners in the OSS. e. They shall not deposit waste or other material that causes the effluent entering the drainfield to exceed the parameters of residential/household waste strength. f. They shall not build any structure in the OSS area or reserve area without express, prior consent of the Health Officer. g. They shall neither place nor remove fill over the OSS or reserve area without express, prior consent of the Health Officer. h. They shall not pave or place other impervious cover over the OSS or reserve area. L They shall divert drains, such as footing or roof drains away from the area of the OSS. j. They shall comply with inspection requirements in JCC 8.15.150 and WAC 246-272A k. They shall complete maintenance and repair of the OSS as recommended by the monitoring entity. 1. They should not dispose of excess food waste via a garbage disposal. m. They should not drive, park or store vehicles or equipment over the drainfield or reserve area. n. They should not allow livestock access to the OSS area or reserve area. o. They shall comply with WAC 246-272A-270. (2) Breach of Owner's Responsibilities. An owner's or occupier's failure to fulfill any of the responsibilities in 8.15.150 (1) shall be a basis for a Notice of Violation and for the Health Officer to decline to issue approval for further development on the parcel. \\tidemark\data\forms\F_SOM_no_inspection.rpt 4/21/2014 Jefferson County Permit Center '621 Sheridan St Port Townsend WA 98368 360-379-4450 RECEIVE® MAR 1 81996 JEFFERSON COUNTY PERMIT CENTER FOR OFFICE SE Date Fee Rec if Check # OTH # O (EES) EVALUATION OF EXISTING SYSTEM INDIVIDUAL SEWAGE DISPOSAL AND/OR WATER SUPPLY SYSTEM Information Requested: _, Individual Sewage Disposal System _ Water Supply APPLICANT NAME -��_\IVC` Mailing Address Ir, BE24 14C11 1 Phone 3to4 - 79(o - 20 -31 OWNER Name Cote -vim ��o��s� UM Mailing Address D (I Fi r-Tre� RIS , OlStM210jca Phone 360- 141� 1-'7 31 D Public Private Mail Completed Report To: `T o , day- 49, 1 Pic (Qmcg a , Wr,-A. 9V3,10 Previous Owner Occupied? Yes / No If Vacant, How long? Number of Bedrooms �_ Year Installed Septic Permit Number 35-69, c-� � 7.3' 0 a d 1! SiteAddress: j (o f A �1®0.I S//C� ��aP , �f i a�iNDl�� A� a 9 O 3* 90 Legal Description • Parcel Number �(OQg�� S T N, R q Plat Name: Division Block Lot(s) L Directions to pro arty �U; - lyn� 6m IDi 6m 4,, T6 WQL1l o Qi t0l ons ARM Id%,.�Le4 r® - Ri' Attach plot -plan showing -location _of structures,_drainfield &septic tank. 5 .o� App®fosscDr; 3 4 P P oas FOR HEALTH DEPARTMENT USE ONLY - DO NOT WR/TE BELOW THIS LINE SEWAGE DISPOSAL SY T " Permitted system yes no Installed prior to permit requirement? i` yes nc Sewage noted on group a time of inspection's yes no House is unoccupied therefore an evaluation o rainfield pe ormance is not possible at this time. Health Department records indicate that this system was designed to service a _1__ bedroom residence. Septic tank should be pumped if not done within past 3 - 5 years. Septic tank: '750 volume 1 compartment 2 compartment Baffles:�_ ood condition inlet missing outlet missing Repair area: adequate limited none available WATER SUPPLY Well casing 12" above ground yes no Well 100 ft from drainfield yes no Sanitary seal in place yes no Water sample taken yes no Sample results Comments: S #;hz)' --4 Date Time 00 Environmental Health Specialist ." This report does not constitute a guarantee, either written or implied, that the system dill continue to function properly. This report constitutes a summary of findings only. H:lhomelpinontrlintohlU�leee.fim 2105 Jefferson County Permit Center 621 Sheridan St RECEDE® Port Townsend WA 98368 (360) 379-4450 MAR 18 1996 JEFFERSON COUNTY PERMIT CENTER INSTRUCTIONS FOR EVALUATION OF EXISTING SYSTEM APPLICATION 1. Please complete the information on the top half of the application form. Attach a plot plan and a location map. 2. Uncover the septic tank. Uncover the inlet and outlet inspection ports and be sure the inspection ports are loose, so inspection of the inside of the septic tank can be made. Provide a copy of the pumping receipt if septic tank pumped within the last 5 years. Please do not have the tank pumped immediately prior to this evaluation. If pumping seems necessary, our registered sanitarians will recommend it as part of their evaluation. 3. If a water sample is involved, please allow one week from the time of sampling for results. 4. Unless otherwise noted on the form, all reports will be mailed back to the applicant when completed. 5. Fee schedule: EVALUATION OF EXISTING SYSTEM Without water sample $ 8 Water and septic; OR water only 110.00 The top of the tank may look like one of these: 1 0. ve:•.. To drainfield From house Please make the tank lids (openings marked with an X) available for inspection. H:lhome1pincntr\lnfohlthleeslnetr.frm 2196 LOCATION MAP SAMPLE PLOT PLAN N P Q°P �l DRIVEWAY G °� Abp, tjYF ' Jefferson County Permit Center, 621 Sheridan St. Port Townsend. WA 98368 UNIVERSAL PLOT PLAN �ECEIVQ SETBACKS IN FEET MAR' i8 FII in. the following information as completely as possible. PROPOSED BUILDING 0 ---- Project' Description: CJ LOCATION 9 Digit Parcel Identification Number (from your tax statement) p� OF SEPTIC 10 Zip Code. AND Subdivision Name Block Lots) DRAINFIE North, Range WM Parcel Size (acres or square footage) ,.. N Y Phone 0 U. a Applicant/Occupant Phone LOCATION OF u, WELL Mailing Address TOP OF BANK (IF APPLICABLE) Authorized Rep Phone ' Jefferson County Permit Center, 621 Sheridan St. Port Townsend. WA 98368 UNIVERSAL PLOT PLAN �ECEIVQ MAR' i8 FII in. the following information as completely as possible. dELFFER Project' Description: CJ 9 Digit Parcel Identification Number (from your tax statement) p� Site Address: 911 # & Road Name Zip Code. Legal Descriptions Subdivision Name Block Lots) Section Township North, Range WM Parcel Size (acres or square footage) .. .............. . ......... Property Owner Phone Mailing Address Applicant/Occupant Phone (if different) Mailing Address Authorized Rep Phone Mailing Address General Contractor Phone Mailing Address Contractor's State License Number Expiration Date Septic Designer - Phone i Mai ling 'Address i Architect Phone Mailing Address Loan lender/General i Phone Contractor's Bond Hoiden I Mailing Address I .FOR,OFFICE USE ONLY .: t Fire bistrict Planning District School District Zone :.:Case N umber i .-MON. . -+ PLOT PLAN INDIGATVA ie'46111owing information. >1 , Draw'lti-scale� Use "1 square to equal i no more #itan` isn ,(.TSO) feet. 13 1. North arrow ❑ 2. Property boundaries and dimensions 0 3. Names of adjacent streets ❑ 4. Driveway/s & Parking spaces - ❑ 5. Major features such as ravines, seasonal creeks, bodies of water, etc. ❑ 6. Septic tank and drainfield location, existing or proposed, and distance to; closest structure ❑ 7. Sewer lines j ❑ 8. Wells and/or water lines i I ❑ 9. Neighboring wells within 150 feet ❑ 10. Paved surfaces (patios) I ❑ 11. Structures, existing or proposed, together ►� . with setbacks (distances to property boundaries) 1 ❑ 12. Easements for access or utilities i Q 13. Arrows showing direction of slope -- assume an elevation of 100 feet at one lot corner and indicate the other lot corner elevations in relation to it For applications adjoining shorelines, INDICATE: ❑ 14. Ordinary high water mark ❑ 15. Top of bank, if over 10 feet high ❑ 16. Slope of bank in degrees Indicate scale of plot plan: One inch equals (Grid is in 1/4 inch squares) �--� 1 ---�—r - -- - �-�- - ---�--- i I - i - i I I -- �- - - 1---�- I - I 1- -� I 4 -- 41, I I I I t I I I- i -� �- ! p - -! - - ; I `- I i r I i r ! I. I --t I -}-- i I i -i--- i j -- , I I r - ---- Jff - T T __T Jefferson County Permit Center RECEIVED 621 Sheridan St FOR OFFICE USE Port Townsend WA 98368 MAR 18 1996 Datear 360-379-4450 JEFFERSON COUNTY Fee PERMIT CE=NTER Ch # Check # (EES) EVALUATION OF EXISTING SYSTEM OTH # INDIVIDUAL SEWAGE DISPOSAL AND/OR WATER SUPPLY SYSTEM Information Requested: Individual Sewage Disposal System _ Water Supply APPLICANT NAME Mailing Address Ire 4,11 Phonef�� — 9 OWNER Name Mailing Address A911 (1 "Pr- r T,p Rd ia,�a Phone 3(0 n _ L j 0 P,2 3 _ Public _ Private Mail �C�ompleted Report To: J fie.- � l til r Kiri ��►;�� W3 Previous Owner Occupied? Yes / No If Vacant, How long? Number of Bedrooms LYear Installed Septic Permit NumberS� SiteAddress: Legal Descriptions Parcel Number Plat Name: Directions to S T N, R Division Block Lots) Attach plot plan showing location of structures, drainfield &septic tank. oN Appolossc�Dr; 3"� prop au FOR HEALTH DEPARTMENT USE ONLY- DO NOT WR/TE BELOW THIS LINE EWA IE DISPOSAL Y TEM• Permitted system 1A yes no Installed prior to permit requirement? Sewage noted on group a time of inspection" Yes no yes no House is unoccupied therefore an evaluation o-f7dramfield pe or rrmance is not possible at this time. Health Department records indicate that this system was designed to service a —I— bedroom residence. Septic tank should be pumped If not done within past 3 - 5 years. Septic tank: '750 volume 1 compartment 2 compartment Baffles: -.)� ood condition inlet missing outlet missing Repair area: ix adequate limited none available WATER SUPPLY Well casing 12" above ground yes no Well 100 ft from drainfield Sanitary seal in place yes no Water sample taken Yes no Sample results p Yes no Comments: Date 't Time Environmental Health Specialist " This report does not constitute a guarantee, either written or implied, that the system i/l continue to funct/on proper/y. This report constitutes a summary of findings only. H:Vwm %pknnv*&j lj9W&m =5 �.. , � �.. � � , . .. ... . i :: i n � � ' / ��. t � • i�1 � l � ��/ / i ".:! ' � i � n 01 90� E. Caroline OLYMPIC HEALTH DISTRICT Permit No. Port Angeles SEWAGE DISPOSAL PERMI`.L'.APPLICATION Submit in`Duplicate Builder . Court Housew / Port Townsend G l -C h h ��F04. �� ate ---�d;7 fil,div D T1T]R'F:Q. "—i -----HONE DIRECTIONS FOR LOCATING SITE��+ z��"'e APPLICATION IS HEREBY MADE TO INSTALL N.31 SYSTEM�REPAIR EXISTING SYSTEM DRAINFIELD LENGTH' WIDTH TDEPTH a- #LINES / _ SEPTIC TANK SIZE DRAW A DETAILED PLOT PLAN BELOW SEE INSTRUCTIONS. SOIL TYPE j '1 rpTTr.. urnTmu 1)r.7ADrrTM1I;ATT D OFSTALIATION SIGNATURE OF APPLICANTX APPROVED ef` DATE S/ -73 INSPECTED BY DATE SANITARIAN IS COf1MLNTS I CERTIFY THAT TH HEALTH DEAPRTMENT THE MANNER APPROVED BY THE DATE INX ED 0 MOBILE HOME INSTALLATION APPLICATION Jefferson County Permit Center Castle Hill Mall 621 Sheridan St. Port Townsend, WA 98368 360-379-4450 PERMIT #....:BLD96-0463 DATE RECEIVED.:07/30/96 SITE ADDRESS:561 APPALOOSA DR :BRINNON, WA 98320 ----------------------------- APPLICANT ... :CATHMIA RINARD -------------------------------------------------- PHONE:360-796-2031 MAILING ADDR:JOE RINARD :P O BOX 421 :BRINNON WA 98320 ----------- -------------------------------------------------------------------- INSTALLER... : PHONE: MAILING ADDR: CONTR. LIC #: EXPIRATION DATE: ------------------------------------------------------------------------------- CONTRACTOR..: PHONE: MAILING ADDR: CONTR. LTC #: EXPIRATION DATE: ------------------------------------------------------------------------------- PARCEL NO ... :966900088 � ALT: CON : LEGAL DESC..*STR 34-26-02 WWM, TAX # BY' DATE: . . LOT 95, BLOCK , LAZY Z RANCH DIV 1 WATER: DATE: CAR DATE: DESCRIPTION OF IMPROVEMENT: mobile home replacement ------------------------------------------------------------------------------- BUILDING TYPE ...... :MOB BEDROOMS--- BATHROOMS-- CRPT/GAR..: 0 sf TYPE OF IMPROVEMENT:NEW EXIST.: 0 EXIST.: 0 DECKS.....: 0 sf GARAGE/CARPORT.....: PROP..: PROP..: 1 COMMERCIAL: 0 sf UBC OCCUPANCY GROUP: TOTAL.:TOTAL.: 1 1 INDUSTRIAL: 0 sf EST COST.$: 0 SEWAGE D P..:CON BANK HT...: 0 ft PROJ GRP..: 7654 WATER SUPPLY.:PUD SH SETBACK: 0 ft ------- MOBILE -HOME ------ MAKE:PEERLESS OBILE HOME------ MAKE:PEERLESS YR:80 SIZE:14/60 ------------------------------------------------------------------------------ Owner/agent---------------- FEES -------------- Signature: type amount by date recpt PRMT $ 125.00 EMH 07/30/96 1123805 Date: B.C. $ 4.50 EMH 07/30/96 1123805 Issued By: Date: !v d -------------------------------- $ 129.50 TOTAL 169l