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HomeMy WebLinkAboutSEP2007-00266 Jefferson County Department of Community Development 621 Sheridan St., Port Townsend WA 98368, (360)379-4450 ? SEPTIC PERMIT APPLICATION ����p PROPERTY OWNER Sea Crest Land Development Inc. V MAILING ADDRESS 223 Hardwick Point Rd Sequim,WA 98382 ,.,,r 2008 < PHONE L360_)457 5422 � P !p ' SYSTEM DESIGNER Ken Warren Designer Phone#_(360)683-6300 ®CD LEGAL DESCRIPTION: Section_27 Township 24N Range_13W PARCEL# 413-273-00X,Li Subdivision Name Division Block Lot(s) � `� Site address/Directions to site_153573 Hwy 101 S. 31/2 miles S of Claylock Lodge '�'—T- SOURCE OF SEWAGE/USE TYPE OF WORK WATER SOURCE Residential_X New Private X Residential ADU Modification Public Commercial Expansion Community Upgrade SYSTEM TYPE Repair SITE SIZE_24.04 Conventional Partial Repair- (tank) (drainfield) Acres Alternative X Designate Reserve Area Previous Evaluation Redesign X Yes#_07-00266 SYSTEM DETAILS Number of Gallons/day_720 Soil type 1 (attach soil eval.) Application_1.0 .. sq.ft./day Drainfield Length_240 ft. Trench Width 3 ft. Trench/Bed Depth Septic Tank size_1000 gal. Pump Chamber size 2000 gal. TYPE OF SYSTEM Deep Trench Pressure System — 50pA/ 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. Staff's 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 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. _ C1 _ Z0C`� Property Owner Signature Date FOR OFFICE USE ONLY /festive, LOT G�vE fcs 6 I Z., PARTIAL ASBUILT L (� ,{� FINAL tzJ (t° APPROVED I e INSP/PUMP TEST t C.� PUD �``���Q ct, ALL HOLD REQ. MET /// Date 1 r I')101 Fee i OCp o o Rec# q 57(4-a, Check# 1006 Case#SEP 01 D CO 3, 0 l l .Ct5 SEWAGE DISPOSAL PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend WA 98368 (360) 379-4450 (800) 831-2678 PERMIT #: SEP07-00266 Date Received: 07/18/07 SITE ADDRESS: 153573 HWY 101 Date Issued: 01/15/08 FORKS, WA 98331 Date Expires: 01/15/11 APPLICANT: SEA CREST LAND DEVELOPMENT INC PHONE: 360-457-5422 223 HARDWICK POINT RD SEQUIM WA 98382 SUBDIVISION: BLOCK: LOT: 7 PARCEL#: 41327300'X1/ Section: 27 Township: 24N Range: 13 W DESIGNER: KEN E WARREN PHONE: (360) 683-6300 SOILS APPLICATION INC PO BOX 387 CARLSBORG WA 98324 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. Permit issued to CONSTRUCT,ALTER, REPAIR OR MODIFY AN INDIVIDUAL SEWAGE DISPOSAL SYSTEM IN JEFFERSON COUNTY, WASHINGTON Thls permit is issued for a period of three years (unless oth-rwise stated above) in accordance with Jefferson County Rules and regulations for on-site sewage syste ' codified 8.15 amended per ordinance no. 08-0921-00. This permit may not be renewed. , Jefferson o %bnmental Health Specialist 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. HEALTH DEPARTMENT MUST BE CALLED FOR FINAL INSPECTION. SYSTEM DESCRIPTION: 150-SAND LINED TRENCH No. of Gallons per Day: 720 Type of work: NEW Drainfield Trench Septic Tank Length: 240 feet Width: 3 feet Depth: 24 inches Size: 1,000 gallons SPECIAL CONDITIONS APPLY - SEE REVERSE CONDITIONS OF APPROVAL- PERMIT NO.: SEP07-00266 1.) ALL CONSTRUCTION AND DEVELOPMENT ACTIVITIES MUST COMPLY WITH ALL DESIGN SPECIFICATIONS, PERMIT CONDITIONS, STATE AND LOCAL CODES, AND RECOMMENDED STANDARDS AND GUIDANCE DOCUMENTS IN EFFECT WHEN THE PERMIT IS ISSUED. 2.) This issuance of this septic permit requires compliance with all building setbacks and code requirements. 3.) Approval/issuance of a sewage disposal permit does not guarantee the approval of other development or a building permit on this site. Compliance with other Jefferson County and Washington State Codes is required. 4.) H - AS PER WAC 246-272 AND JEFFERSON COUNTY CODE 8.15 ALL SYSTEMS REQUIRE MONITORING. THIS SEWAGE DISPOSAL SYSTEM WILL REQUIRE AN ACTIVE MONITORING AGREEMENT RECORDED TO THE PROPERTY TITLE PRIOR TO FINAL APPROVAL OF THE SEWAGE DISPOSAL SYSTEM. 5.) As per Jefferson County Code 8.15 all onsite sewage systems require monitoring. Monitoring shall be provided by an approved entity. THIS SYSTEM IS REQUIRED TO BE INSPECTED PER JEFFERSON COUNTY CODE 8.15 AS ADOPTED OR AMENDED. 6.) Health Dept. required to observe pressure test with system designer when system fully installed/complete, 48 hours notice to be provided for scheduling. 7.) Designer must be contacted prior to start of construction and for inspections during installation. 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.) Setbacks to all wells- 100' required from drainfield and reserve areas. 50' required from tanks and effluent transport lines. 11.) 10' separation required between a Water line and all portions of the onsite sewage system; effluent transport line, tanks, treatment and disposal components. 12.) Setback to surface waters- 100' required from drainfield and reserve areas. 50' required from tanks. 13.) TRENCH TO BE EXCAVATED TO 48" DEPTH AND THEN BACKFILLED WITH ASTM 33 TYPE SAND TO 24"AND UP SIDE WALLS AS PER DESIGN. 14.) When/if designated reserve area is utilized an alternative system providing an additional level of treatment may be required. 15.) A 30' setback shall be maintained from the disposal component and reserve area to any downslope footing, curtain or interceptor drain or drainage ditch. 16.) All components of the septic system are to be completely protected from vehicular traffic or mechanical disturbance. 2 of 3 11/22/19 I:\F_SEP_Permit.rpt 17.) Drainlines are to be installed along the natural contours. 18.) Contact designer prior to installation for staking of drainfield area. 19.) Divert all sources of drainage, including roof drains away from septic tank and drainfield area. 20.) Any portion of transport line under a driven way is to be sleeved/cased or equivalent. 21.) 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. 22.) Pump chamber shall be water tight and a minimum capacity of 2,000 gallons. It shall be equipped with a control panel outside within line of sight of the pump chamber. The panel shall have an audio and visual alarm, a cycle counter and a riser to grade. It shall be UL listed and meet L&I requirements. 23.) A screen shall be provided either at the outlet of the septic tank or around the pump or at both locations. A pump shroud is required if only an outlet baffle filter is used. 24.) Dose counters are required in the control panel for all system components. 25.) Risers are required to grade with secured lids over both compartments and over the outlet of the septic tank for inspection and maintenance/monitoring. Minimum 20" riser over inlet. 26.) Distribution boxes shall be fitted with a riser to grade, constructed of durable materials and a secured lid, adequately sized to allow visible inspection of the liquid level in the box. 27.) 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. 28.) Approved eagle management plan required. 29.) This onsite sewage system is designed for domestic strength wastewater only. Disposal of any other waste strength is considered a violation of this permit. 30.) 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. 3 of 3 11/22/19 I:\F_SEP_Permit.rpt JEFFERSON COUNTY PUBLIC HEALTH, 615 SHERIDAN, PORT TOWNSEND WA 98368 ASBUILT INSPECTION REPORT For RECORD DRAWING Designer /7773--.7:C- /72736/MAO Permit # SEP 07 - `ZC Installer OW/V.&'{ Parcel # J 3 "Z7 3 '-CJO) 1j Electrician ��-/?�r Jwonts-on/ 0yy'G Design Flow 7 2.0 640 Property Owner .S C/3E37 C/9/Z/O 6--z/ Site Address / £ 3 S 7 3 Has /0/ Answer all questions or indicate NA DATE Tanks, Pumps and Controls INSP. Tank (manufacturer, size, baffles) Pe77/11/ 7 i2 * 77t'O /CVO G 7e-- Pump chamber (manufacturer, size) I/ -Z-Cet, 646_ O'136-71-G0 ©G�9L Screen(s)and/or Pump Shroud (type, location) Z,9 t!. ©[ . 774'-,)"5:7 6. SC, 6-n' Tl`" &---ivcO Xv/77P 779/Z6f Were Tanks tested onsite for water tightness? Yes /40, G Panel Model AV(//90../-0734- Timer Model -2-717C---5-07 6X37 Pump 1 - Man./Model O/5t7z0 4 171P Flow Rate 3 Z. qpm Pump Location (i.e. garage, treatment unit, basement) Float/transducer settings Inches Z Q -0 9' Timer p. prom bottom of tank- On/off - /3` in. Functions: On / -/ 4,eivi in Veto - 3 in. Off - 367 sec/ in r Alarm - 3 ' in. Veto On - / / e)min Storage Above High Water Alarm 8-0,"74- gal. Veto Off - sec rir hr Dose Counter Reading g 7 6' # gallons/dose /0 gal. LElap. Time Meter Reading 2-°/t2(>.•i 7 min/hrs Pump Throttled? [Dose Drawdown (in inches) /C/ in. Pump 2 - Man./Model Flow Rate qpm Pump Location (i.e. garage, treatment unit, basement) Float/transducer settings Inches Timer from bottom of tank- 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 Dose Drawdown (in inches) n If additional pumps- complete the info in this table for each and attach. RECEIVE Other Timer functions & settings (e.g. override on/off) SEP 13 2010 H.\WEB\ONSITE\Asbuilt_Report_Form.doc 04/28/10page I of 2 Jefferson County Environmental Health « Y 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, schd, diameter 2-1SCl/ /O Manifold size/schd / - "C./74 ° Orifice size ff • 5 Lateral Size/schd � / ti s�ff Barrier Material � Cover Material/Depth / 2- n Residual Head (lat.# & ft. Head) v�i/ �- The laterals/pods were balanced � ' No - Source/Manufacturer of Drainrock/Gravelless chambers -.- 71/1- 775 Drainrock Clean? Yes / No If no, what action taken? 49;4 Mound/Glendon Site Prep Drainfield Length 2- 90 ft Width -3 ft Depth L inches Caps for measuring residual head stored (location) //1/70 C3Q COMMENTS (inspection notes, changes from design or deficiencies in installation) Attach additional sheet(s) if necessary C)W/7/6 7? /7.0.06--x2 00.273 T Or/tl-3 6.9 7 J4tX 'To ,c 6767.0 7 -----021 F/{Ctm PCm4.0 #06,/72:7-2.6- f3f it P'?Q - orVe7-1.273 orl.Tra--v C T7?/9/>�-,Dc/CE7' —'fix wn.r /WO vv9f ✓s E 'L�9GE�. Health Department Inspection issues resolved Yes / No / NA If yes how? Users Manual Provided to Homeowner 9 _ 9- ao,o Date Tank/component Decommissioning Report Attached Yes / No Installer Certification attached/signed ATTACH RECORD DRAWING stamped/signed by Designer or Licensed Professional Engineer I CERTIFY T}fE INFORMATION PROVIDED ABOVE WAS VERIFIED BY INSPECTION, T]-fE SYSTEM WAS INSTILLED AS DESIGNED AND APPROVED by JEFFERSON COUNTY (DATE) OR TEAT C1-fANES }SAVE BEEN NOTED FIND THE SYSTEM IS IN COMPLIANCE wiry WAC 246-272. e0:£-11 ✓4,0 9"_9_20,0 .5��c0 3Ca RECEIVED Designer Signature Date License # SEP 13 2010 H:\WEB\ONSITE\.Asbuilt_Report_Form.doc 04/28/10page 2 of 2 Jefferson County Environmental Health v ----- ' C4 rpt 12, zj rr*i I Z I 1 / I rn xi o o Z I I ( \ o ' z N o I ; No I J I o Coo o i v Z 0 N g z y m g z ; I r • O N Z • I I , '---- • I I �'- I Or-yf�lCr�y��11r�� •. m : .....R3 /� -0 O O m m Z ' ..F___ ,_,..„, �< ZZOOy O0Z=00Zz1 II 1-Mrn(nVC) • 01 oy� 1*,�, 1,Z I o -1 z-i r il rr y-1Zmu4ON-0� • ' 2 0 Y m i