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Home My WebLink AboutSEP1978-00066Jefferson County Department of Community Development 621 Sheridan St., Port Townsend WA 98368 (360) 379-4450, Evaluation of an Existing Onsite Sewage System (EES) Draw on the back of this sheet a current plot plan showing location of: Buildings, Drainfields, Septic Tanks, Wells, etc OR attach a current plot plan identifying these items. ALL SPACES MUST BE FILLED IN. If information is not available enter (NV) or not applicable (NA). Type of Evaluation El Evaluation of on-site sewage system ❑ Evaluation of drinking water ❑ ❑ Evaluation of on-site sewage & drinking water ❑ Office Use Only [late Fee 2h.U U Rept 2 Check Case # is - b� _ Reason for Evaluation Routine Operation and Monitoring Inspection Real Estate transaction Complete a Permit # Building Permit Review and/or no septic permit on file Other, explain Date of evaluation n5:�\9�nS Inspected by Dale Wurts6lti (Envkocheck, LLC) Tax Parcel # gSGo oo03o Permitted System yes _ono Permit/case # SEP ZS—(4 Subdivision, Division, Block and Lot(s) �I�.ttidt"Te s rpt e� s. L®'C 1t _t i I .��,E31 7V0�a 3) Lot Size ere or Dimensions X Current Owner �( cwf'EL AuOL� Site Address 40Vitas UCt7a -=;\-. Qv-ji�_CE"E Owner Phone # �V Previous property owner name(s) - (N/V if not known) N- , Directions to Site Ftx Pa. r:S1V—jjk,:,,!4 ac7 _ �S '1 .. lt�l 5� , s�i��'gab ws Date System Installed Age of Dwelling hinj)&= so # Bedrooms W. '3 off symmEs 1�""a�}-,+e; Jaf�[.0 ��1-us 3 ceoAlftektNL House Occupied X yes no, vacant how long? . QEFfca< :,pytes Who installed system? "�l Send completed report to: Owner Name -AS" "" Mailing Address 414 7 i oN� V-kF W L-3. 4�� L�ENE �� 983-16 Phone/email/fa Realtor or Other Representative Name (�cA S)' "ELU- 11A1► % r- n I RS � u rJppTvOoR� Mailing Address. 6. Ph �0-2511�1& _t 'E -V-. �? _nc+,i v�� Include the following items on your plot plan: ❑ Property boundaries ' ❑ Wells ❑ Names of adjacent streets ❑ Septic tank ❑ Driveways and parking spaces ❑ Drainfield (enter NN if unknown) ❑ Surface water (ponds,creeks, etc) ❑ North Arrow ❑ Buildings(residence, sheds, garages, etc) PLOT PLAN -date prepared np� kRos .. V; r p4Q40%. A ;� OF WELL CST 30 -4o'J Q. i .0 ax 7 J NOT TO SCALE 4� EHVIR CHECK, C.L.C. 1612 Hastings Ave. W. Port Townsend, WA 98368 Permit # or Parcel # SE O —1 O—L(a Evaluation of an Existing Sewage System 713010� -pdc e % r ;5 Date of Inspection nskgos Inspected by Dale Wurtsmith (Envirocheck, LLC) Water Supply (fill in only if water supply is being tested in this evaluation) Sample was taken Yes No Sample Results Well casing 12" above ground Yes No Sanitary Seal in place Yes No Public: offsite onsite Name of System Individual: offsite onsite Is well more than 100' to drainfield/disposal component _yes_ no, if not, distance Is well more than 50' to tanks and effluent transport line _yes_ no, if not, distance ONSITE SEWAGE SYSTEM # Bedrooms/gallons per day indicated in County Health Dept. records for this case #1 - Septic Tank Tank size 1 t oo—kl gal. single compartment two compartment CDt aC-e15L material Riser to grade on inlet dyes no. Riser to grade on outlet dyes no Condition of tank )C good needs repair, describe 1st comp. Scum (top layer) in. sludge (bottom layer) s in. 2nd comp. scum n in. sludge d in. Was ground water observed leaking into tank ? yes X— no If yes, where was water observed? Condition of baffles: Inlet: op needs repair materialV oncrete) Outlet: ?Y- ao _needs repair materiaKEO,concrete) Screened Outlet no des, condition clean clogged/dirty Septic tank needs to be pumped (per Jefferson County code 8.15.150 (1) (b)) yes _ono Effluent level at outlet (mark level on circle) If effluent is below the outlet, indicate when tank was last pumped: (eg: 9) 0 Does system include a pump? yes If yes, complete the next section no (if no skip to section 3) #2 - Pump Chamber Tank size gal. Material. Riser to grade? yes no Condition of tank good needs repair, describe Solids in Tank (see 8.15.150) yes no scum in. sludge in. Was Ground water observed leaking into tank ? yes no If yes, where was water observed? Screen around pump? _no yes, condition clean dirty/clogged Shroud around pump? no yes Electrical Components Pump operating yes no, describe High water alarm functions yes no, if no, describe Elec. Panel condition good needs repair, describe Pump cycle drawdown inches. Time for pump cycle min/sec.- Timer in/sec. Timer Settings min/sec on min/hrs off Floats secured: _yes no f Permit # or Parcel Evaluation of an Existing O site Sewage System 07'130/04, ,;jai #3 — Drainfield Appropriate Vegetation in area yes no. Describe vegetation Indications of surfacing sewage (check one) ves , if yes, describe and diagram on plot plan XS no Signs of parking/driving in area Ground settling or erosion __yes Monitoring Port Observations (if present): Residual Head yes, Ponding in trench yes, Repair area is? Available as shown on permit ,drainfield area is overgrown and not observable no C drainfield area unknown no overgrown/not observable of inches no _# of inches of ponded effluent no None evaluated or shown on permit Addendum (page 5) is attached for evaluation of Treatment Unit or detailed evaluation of drainfield yes—')!�—no COMMENTS (attach additional sheet if necessary): other Tv 'A% No permit is on file as to size, location or adequacy and it could not be determined SEE ATTACHED ADDENDUM Was a System Problem Identified? Yes if yes, what section #. No This report on the existing onsite sewage system is valid for the permitted or historic (if installed prior to permit requirements) use of the system only and does not constitute assurance of future County approvals (such as building permits) on this parcel. Any future application will be judged separately by the rules and laws in effect at that time. I certify that he information provided is based on a review of County records and my direct observations at the time of inspection. -- v81$o5 Nam&Signature ---- Date No guarantee of future onsite sewage system performance is implied or granted based on -the inforrnatiop,contained in this report. This report constitutes a summary of findings only. Permit # or Parcel # Evaluation of an Existing On ite Sewage System 07/030/,04 ;df AUG 1 911 .; o. ':f ADDENDUM Enviro Cbeck, L.L.C. Company Disclaimer #_+-�� DATE c S \13oS ADDRESS y.r,Lomw 6ia,us1:,C�'tic�� OWNER . \ Based on what we were able to observe and our experience with on-site wastewater technology; we submit this Sewage treatment InspectionfEvaluation Report based on the present condition of the on-site sewage treatment system. Enviro Check, I.I.C. has not been retained to warrant, guarantee, or certify the proper fimctioning of the system for any period of time in the present or future. Because of the numerous factors (usage, soil characteristics, previous failures, etc.) which may affect the proper operation of a septic system, as well as the inability of our company to supervise or monitor the use or none visible areas of the system, this report shall not be construed as a warranty by our company that the system will function properly for any particular buyer or owner. Enviro Check, L.L.C. disclaims any warranty, either expressed or implied, arising from the iutspectionievaluation of the septic system or this report/evaluation. We are also not ascertaining the impact the system is having on the groundwater or environment. Enviro Check,L.L_C. does not make any claim, warranty or guarantee as to where property lines/boundaries of properties are located. And does not warrant or guarantee any encroachments from on site sewage systems on to adjacent properties. Any indications of possible property lines/boundaries are approximations and do not indicate legal property lines or boundaries. Enviro Check, L.L.C. will not be held responsible in anyway for information being undisclosed (intentionally or unintentionally) by property owner, representative or other parties of interest. All parties are encourages -to check county records for any information regarding properties. Enviro Check, L.L.C. 1612 Hastings Ave. W Port Townsend, Wa.. 98368 360-379-9400 I acknowledge that I have -studied the information contained herein and that my assessment is honest, done in accordance with Jefferson County Ordinances, and to the best of my ability, correct. Dale R. Wurtsmith Co -Manager Weather Conditions SAMPLING (Septic tank) Date - PH Result - DO Result - Temp. Result - MEASUREMENTS Counter Settinu- Hour Meter - Water Usace (Ave.GPD) Meter - Squirt Height (In feet) - AUG 19 7.005 ,ON JEFFERSON COUNTY PUBLIC HEALTH 1 615 Sheridan Street • Port Townsend • Washington • 98368 r�. 360-385-9400 Fax 360-385-9401 www.jeffersoncountypublichealth.org IM,ao 'IV, 31' jo(p CHARLES BROWN SALLY BROWN 79353 STEWART CREEK RD CLATSKANIE, OR 970162214 February 13, 2006 RE: Evaluation of existing system -40 Washington Street, Quilcene SEP78-00066. System in Violation. Dear Charles and Sally Brown: An evaluation of the existing sewage disposal system was completed on August 19, 2005 by Dale Wurtsmith. Mr. Wurtsmith noted that a new septic tank was installed to the system. No septic permit record could be located for the installation of the newer septic tank. The system has been assigned a number for county records only and does not indicate the system is permitted. If you have documentation indicating the site did receive a permit please contact this office and provide copies of that information. Any installation, repairs, upgrades or alterations made to onsite sewage systems after 1970 require permits. It is a violation of State WAC 246-272 and Jefferson County Code 8.15.080 to install an onsite sewage system or components without a permit. This is intended to serve as formal notice that this site is in violation and no further approvals shall be granted until a permit is obtained for new components. You may choose to have the existing system evaluated to determine if it meets current standards. Please contact a designer to have the system evaluated. A list of designers has been included with this letter. If you have further questions please contact this office at 385-9444. Sincerely Jasmine Fry Environmental Health Specialist cc Dale Wurtsmith, O&M Specialist COMMUNITY HEALTH PUBLIC HEALTH ENVIRONMENTAL HEALTH DEVELOPMENTAL DISABILITIES ALWAYS WORKING FOR A SAFER AND NATURAL RESOURCES 360-385-9400 HEALTHIER COMMUNITY 360-385-9444 JEF7FF_At0N COUNTY HEALTH DEPARTMENT Multi -Service Building - 2nd Floor 802 Sheridan Avenue ��CJ Port Townsend, Washington 98368 385-0722 tot Applicant:_- Lee Yeager 13 Address: Phone: THIS DOES NOT CONSTITUTE APPROVAL OF A BUILDING OR SEWAGE DISPOSAL PERMIT, No.: Fee: Date: Twn. 27 Rg. 2W LEGAL DESCRIPTION (DIV, BLK . LOT) DIRECTIONS FOR LOCATING SITE (DRAW MAP ON BACK) Sears Store - Quilcene Site size A.) Seller _ Buyer _ V, I request this site evaluation for 1 single family residence or Addition for Storage INSTRUCTIONS: A minimum of two soil log holes at least 4 feet deep, 2 feet diameter, and 50 feet apart must be dug in the proposed drainfield area and flagged before the evaluation is made. A site evaluation of the above property was made on and your request has been: 1XI 11 El 12-14-78 by this department \1 APPROVED — Pending submission of a completed sewage disposal permit application. R Building Permit CONDITIONALLY APPROVED — Providing conditions listed below are met and submission of a completed sewage disposal permit application. DENIED. p COMMENTS: On site 12-14-78. Drainfield functioning properly at this time (No - 0 surfacing of effluent noted). The well is positioned approximately cjl 100' from the drainfield on the opposite side of the building. 9 5 Soil Log: Respectfully, O I U SANITARIAN Larry Anderson �culations: Lump sum (Sprinklers, eievotors, etc.) A - ,- I n A r3 --•r d"b 32 .............................. ............................Total Insurance Exclusions (Section 96) 33, Basement excavation ............ . ... . . . 34. Foundation below ground ......... , .. . . 35. Piping below ground ....... ...... . .... . 35. Architects plans and specifications..... - .. . SK. �qq J1 .J T J I 0 0 �culations: Lump sum (Sprinklers, eievotors, etc.) A - ,- I n A r3 --•r d"b 32 .............................. ............................Total Insurance Exclusions (Section 96) 33, Basement excavation ............ . ... . . . 34. Foundation below ground ......... , .. . . 35. Piping below ground ....... ...... . .... . 35. Architects plans and specifications..... - .. . SK. p P A > O z `756/600, wner ......... I eAl ............................ COMMERCIAL APPRAISAL ............. Building Roll No— .......... Page No .......................... Address,_ .... /Y.�. 1.-------• ........ ....... MapNo—____------- Photo No.---------------------------- --------- ----------------- --- Addition ----- Remodeled 19--------------- Cost $ ---- -------------•---..._.__....,._.................. Sold 191.1-1-11 Arnaunt SoldC h _1Amount Appy, ................ .. i V 2 7 ApprY_,.I.,'P�5 Date . .......... _ Appr. Val. it v J,•7e, X-1 A, Remarks: m /VJ BUIRDIING —[CONSTRUCTION PARTITICNS Class 40 VU Typz Condition All.: Apartment Single No. Units 1 Backed Detached Araitment Hotel Double Drywall Sq, Feet Stories Wall H=;I1�,t Auto Solas Block Compis.H.'n Year Built t Construction Cost $ Bank Wood Frame Contrite Block Court 'I:eel Frame Brick Dental P" Insulation Steel D,,parfrnent I Square "cot % dj. vasa Rate Adj, Garage ROOF CEILING Items + + Gas Station Arch Flat AcouiticGreenhouseGrcnhouse Com'-30sition ': Hotel GoHe Drywall T!> z, Hip L,` Plaster S'.od S. spanded -AAeralBldg. I ac"arn Motel S f, 21 Truss INTERIOR Store C)"F're Waod Truss Market P,)s1au.:;nt Auto Show Total .Adj._ e,- Store Aluminum Restaurants Theatre Built-up O,flce Warehouse Composition Theatres Adj. 3.1se Cost Concrete ADDED FEATURES + Golv. Iron ELECTRICAL Basement Rock Minimum Heating FOUNDATION Shake iI ;VAverage Concrete 'Shingle Good _Plumbing Electrical Concrete Block Steel E.' av!:f,rs Stone Tar and Gravel FLOOR Stoirvoy Brick Single Wood Frame L_ Double S.Prinkkcri _HEATING Fluor -Wall Fir 0-mcloy Forced Air Hc3rd%vc,,d EXT. WALLS Gravity Concrete Aluminum Brick Hot Air No. Units Grade Elevated ig Brick Veneer Space Heat Concrete Block BASEMEN Concrete Reinf. Hot Water Finished ADJ. TOTAL Curtain _Steum Utility '12 Arert - ------ --------- x - ---- ----------- P. S. F. Galt'. Iron Full 'A Ad Jed Features Shakes ELECTRIC To,a't 3-jse Cost Shingle Baseboard PLUMBING 19 Cost Index x Base Colt Siding neat Pump ToiletI I -- ---- Adjusts -.eat Steel Panel Urinal -'Iay. I Cost Stucco AIR COND. Fouwuin Sink Deprec,orion Thy-F-inc.-Econ, Depr.-Repl. Cost /910 Tile Evaporative Shower Tub Tilt -up Ed Rafrigernnon Other improvements_ Custom To'ol 7'.q-nl. (71)s' it v J,•7e, X-1 A, Remarks: m /VJ ■■ -- _ reaMrrerrris - - ■ a■■gl��a�wafw� OMEN ■■ !/! ■.■■ mm I, Liii !! N IC .■ _ " ■■CC : ■■��. C■�C� 011 =x%11 S IO ::C■':: : MR �: :� !. _ ■.� ■ ! . ■ .. EleclricoI Foymb+ng Q I� CeiIinrs i d C 4 ^ ar 1 _ _ -- II M,isc. Ccrstrurion Exlerior Wolls Interior ConstructionI i f�r 0 a Ila, lej.ttlb S r-tc,alff I Total Y F � Bose COO i < , �, l �.� (, , '"' • ; ? is=� �. 19 - _ _Cect Index _- --------- x Bcse Cost 1 --- -- `ib Quolity Acl;ustment Rep!ocement Ccst FIZ� Dep.. °4 Phy.•Fu. c Econ. c� �ep'ec ole d��Seplocemenr Ccs? C