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HomeMy WebLinkAboutSEP1975-00026''.?0� 1. Caroliae Port Angeles Court House Port Townsend OLYMPIC HEALTH DISTRICT (' permit No.G^ SEWAGE DISPCSAL'PERMIT APPLICATION Submit in Duplicate Builder Date �- JADDRESS �r� ��k S �N - PHONE DIRECTIONS FOR LOCATING SITES APPLICATION IS HEREBY MADE TO: INSTALL NEW SYSTEM IR EXISTIN SYSTEM DRAINFIELD LENGTH =�j 1IIDTH f0 DEPTH ai`-3#1 Q �K A 5Z -5z�d SEPTIC TANK SIZE lT�O �.:g� va�g Q�s��b\t• rLMvIIT utUZ6 PRIOR APPROVAL OBTAINED FROM THE HEALTH DEPARTMENT. DATE OF INSTALLATION ' SIGNATURE OF APPLICANT ��� 1 APPROVED ✓ DATE-NSPECTED BY'� DATE SANITARIAN'S COMMENTS: r UJ c,, 5'. qb I CERTIFY THAT THIS$ T '.'AS IIST.I IN THE MANNER APPROVED BY THE HEALTH DEAPRTMENT A... IIILAAA{ 11 nAm LF.0 1612 Hastings Ave. Wt9st Port Townsend, WA 98368 "T.: MARK HAMBY TRUSTEEE 7000 52ND AVE NE SEATTLE, WA 981156202 FOU Here House Loosborr. 21 COLMAN PL Port Tommerd PARCEL (APN): 939601439 Use: Resider", Simla Famay GENERAL SYSTEM TYPE: Gravel Bed (M MlNAM! MMYS71! MsPECTWM lllllffisYw• ftVWted 03f I)M2 - kwPeetion Type: ROUnNE - Coneetimr ShOw 066-aeeOMMM ds COMMENTS d GENERAL NWSPEcnoN NOTES !ficiencies Noted., deficiencies must be corrected to ensure proper longevity of the Onsite Sewage System. There was no *Ale1 rise. Outlet new installed by Enviro Chedr, LLC. 2- The outlet batik was deteriorating. A "PVC'type batt daRed by Envino Che:K LLC. A permit had been taken oul but not'Fataled'. Therefore. No pemA is on file as to sae, location or adequacy and 4 could not A revlsed'FU Plan' b erroule to early, Ref- some component klrabons. Inkrmafion is berg subno led to cer+ay asking for a Fnal" on petmtl. Mgr. advised. SfTE 6 SYSTEM CONDIrIONS The General Sse sen Sysiam Cardibars were: AN Carpone. a000ssbbfor rruirtsmrroe, sewsrrn in good mrrdi8on: sadaaq eMuart ham any component (ardudkg mead —0~): Component setlang ptoilerm obaervad: AbnomwA parditg present For ane err mass or the disposal conyonends svbawtace mmPonerrts adequeM, mearad oasrer ampisroe lassies varied '+2vrmz 580.479.9400 M.T NO Odapant mrrtpiarrra Prader (occupant ealaparadrg llre>syslarn PrePerrY1- RYES dasabe of rrWss: NO It aelidnoes ware deotaed m ms erspection were they ooneded before or *mog Ihts arstItAm? (9 YES NO, dsaorhe it notes. NA v m drlitlarrJee m We repod7: _ OSS Coonporarm, structures and appurlarrarram lucaled per asbtirramrd drawing (it NO, describe kr NO- See Gorman notes). r m asbdt Brigs a'tl�sgire made. seeds NO and provkh mood b Health Dept Atdmbfi nmdeto dm OSS (vahre adA=W, timer sabgp modTied, Pots kmmled, ems) OtYES, NO desobe in aroma): -- — The MusersYWtrawas scam Of used inhegltenly, asaaselentaf Ute drainfnld was Ilat Pos9by. YES- See Commei SERVICE INFORMATION Campsy MOrkPartbmftr Sterrtrkd oWWAIW26y: Frniro Check. LLC Imle W XISFA M nranwnawmvs cnron aiaertavetaor"s ss. mars Tar fir's &,ea.xso.,srtrsenaatswenras@&Va nwsasepmmm�. ReportlD: 243126 Vmw impaction reports rnline at wwx.ontimmre.mm Page 1 of 2 ONSITE SEWAGE SYSTEM INSPECTION DETAIL TIIIE/BOMY✓AXbB CB/�NfMBLh'r9aC8 a/fIBpW(B BBNPW iyGBlrlwaBnM O/YiBeNmWyaflwnpar4QIWW89IXOiaI�XlpnCl/BaBltI111B1A9. Ropor'NO: 243126 Prow inspection reports online at vnvw.onibenne.=n Page 2 of 2 Tris vas: FlIy YNpxbd Component appears, to be funcbpnffig asi tended: YES Effluerd level unlit fndts NO WOW in Camnaris YES Htl powered baiffresb Place A=Nobs_'rescrQ NO S.ComMeOs Mmand Rkr Oemod –Not ___.. -... WA Connparknent Baan aooaxiEdim ifoYret S EMkwdlibdaaeen needed damning m arrival w 1 SkKkF amaaiation Nolherspeciryx 4 Purokwo Is~ NO Apprownala GaYnmm be f Calibd This coff4ronent rose: FWf kq—%d ConVonent appears to be AmmocimmraV as insendect vE5 Pon&V Present TIIIE/BOMY✓AXbB CB/�NfMBLh'r9aC8 a/fIBpW(B BBNPW iyGBlrlwaBnM O/YiBeNmWyaflwnpar4QIWW89IXOiaI�XlpnCl/BaBltI111B1A9. Ropor'NO: 243126 Prow inspection reports online at vnvw.onibenne.=n Page 2 of 2 Y4 Ftoo ,„cm&,w�� ��: C) Props" boufwlm%s a of a�ON Pw*k* Vaose a (Ponaicre" e4c) a aaftmoomerm staft go, pws 1u / !7 i (� i IvtA4 '--A D 6U* * [,Ztj Qvti T tIL NOT TO SCALE Ib'b Q Wells O septic tw* { WVW ) a Mod, Arrow 11s Z4k ENVIROVtHECKs LLC. lalpOTtTowr�end, AsaSM (Z l i Orpvmd# SAO �S^�� ftP204 `/ 5otv�-7S-voba.�o ON-SITE SEWAGE DISPOSAL SURVEY OF Street Or n4v4c4nn R1nrb Int Iandmark Lot Size I. Location, Lot Size7 if II. System Owner Address Q� 63 Telephone Number 3 ��r Zi 77 Permit M I (Previous Owner) 6 Date Issued III. Installer C.P Average Number of People Served Date Installed / 9-(a 5 Numbier of Bedrooms Time In -Service (years). /J Clothes Washer Septic 'Tank Pumped YES NO S NO H W Dishwasher OFTEN YES NO # of Months/Years Residence Occupied? Garbage Disposal YES NO I11. Type of cover over'drainfie.ld. (i.e. grass, landscaping, etc.) f V. Repairs (when, wh `, who) Cause of Failure VI. Comments (Over for Sketch) VII. Action Taken x I. Location, Lot Size7 if II. System Owner Address Q� 63 Telephone Number 3 ��r Zi 77 Permit M I (Previous Owner) 6 Date Issued III. Installer C.P Average Number of People Served Date Installed / 9-(a 5 Numbier of Bedrooms Time In -Service (years). /J Clothes Washer Septic 'Tank Pumped YES NO S NO H W Dishwasher OFTEN YES NO # of Months/Years Residence Occupied? Garbage Disposal YES NO I11. Type of cover over'drainfie.ld. (i.e. grass, landscaping, etc.) f V. Repairs (when, wh `, who) Cause of Failure VI. Comments (Over for Sketch) VII. Action Taken Incluft the fb#wwkW Rom on your plot plan: © Pmpecty botmda a o Nmm of a D>i veways and pig Spaces a Surbee Water 3 o , sheds. , mac; C1 Wens a septic tw* a (firWV ffurJuvm) - -- . . 11�� N r ps CSC 9 Pel ,7dC rr �'/j j SSS r0i1 lSE 0'`` ! j NO s F PrP �4°' Af i IV LL.C. NOT TO SCALE IST Hastings Ave. w nsend, WA 98M1 Plot plan submitted by AAf6A/U+� e � Orpamm *SE o —L _ as a part of a Monitoring Inspection aaee z oto Not reviewed or approved by JCPH.