Onsite_Services_Construction_Installation_Permits.pdf

OSS-16-0~ 9

PERMIT NUMB~R

DOUGLAS COUNTY PLANNING DEPARTMENT

Onsite Services

Construction Installation Permit

S.E. NUMBER FEE

0 NEW CONSTRUCTION ~REPAIR 0 ALTERATION 0 RENEWAL 0 OTHER

PERMIT ISSUED TO: Umpqua National Forest Property Owner's Name

TOKETEE

Nearest City or Community

2/11/2016 Date Issued

Type of Facility Served: ~Single Family Res.# Bdrms.: 3

Township

03W 36 Range Section

Tax Lot

2/11/2017 Expiration Date

D Other:

Specify Type

R32128 Acct.#

ALL WORK IS TO CONFORM TO OREGON ADMINISTRATIVE RULES, CHAPTER 340, DIVISIONS 71 & 73.

__ WQB_lo(__MUST RE_ DQ.NE.BY Jl:lE_.R~RMITTEE_.QRJ3Y ~ Ll<.;:ENSEQ SEWAGt= DIS_eQ_S~L SEB1ftCE_BUS1fiE.SS=_,_·=i"'~~

AKE NO CHA-N'GES I SYSTEM' OC~TION'UR"'SPECIFICATIOf.IS WITffOUT-WRfrTEN APPROVAi: FRCJllll fRe·

PERMIT ISSUING AGENT.

SYSTEM SPECIFICATIONS

~Standard D Capping Fill D Sand Filter D Seepage Trench

D Tile Dewatering DATT - Treatment Level Required: DI or D II

D Seepage Bed D Pressurized Distribution

Max. Peak Design Flow: 375 Gal/Day

Special Tank Requirements:

Media Type:

Trench Spec.:

D Rock/Pipe

Linear Ft.

~Other: bottomless sand filter Specify Type

Min. Septic Tank Volume: 1,000 Gal Min. Dosing Tank Volume: Gal

DRAINFIELD SPECIFICATIONS

[gl Other (Product/Manufacturer): bottomless sand filter 360 sq ft.

Trench Width: feet Undisturbed Soil Between Trenches: feet

Max. Depth: inches Min. Depth: inches Total Rock Depth: inches

Rock Below Pipe: in. Rock Above Pipe: in. . Capping Fills - Min. Depth of Fill Material: in.

Seepage ~ed Specifications: 360 sq. ft bottom

Distribution Method: 0 Equal D Loop D Equal-Hydrosplitter D Serial D Pressurized D Gravelless Half Pipe

~~~~:iim~~~f~.-EfGri>un<:t-Wate 1~pror: epm-: - - mche-S - - molfnCof 5-raln=Meala: - - I nc es 0 DRY SOIL INSTALLATION ONLY 0 Rake Trench Sidewalls 0 Filter Fabric On Top of Drain Media [gJ CONSTRUCTION PLAN MUST BE SUBMITTED AND APPROVED PRIOR TO CONSTRUCTION.

D Other:

Inspection Requirements: For Pressurized, Sand Filters, RGFs, ATTs and Capping Fill systems, there are several inspections required. See inspection requirements specific to each system.

The attached Final Inspection Request And Notice Form must be completed and submitted at time of system completion.

For pre-cover inspection information, contact: LeAnn (541) 440-6183

CERTIFICATE OF SATISFACTORY COMPLETION

D System Inspection D Operation of Law - 7 Days Notice D Pre-Cover Inspection Waived Per 340-071

Authorized Agent -Signature Title

To be valid, this document must be signed by an "Agent" as defined in OAR 240-011..0100.

Douglas County Office

RequiremenlS for this Certificate of satisfactory Completion and addtiooal inspection · ation are attached to · dorunent

Revised 2/4f2008

Date

OSS-16-010

PERMIT NUMBER

DOUGLAS COUNTY PLANNING DEPARTMENT

Onsite Services

Construction Installation Permit

S.E. NUMBER FEE

0 NEW CONSTRUCTION ~REPAIR 0 ALTERATION 0 RENEWAL 0 OTHER

PERMIT ISSUED TO: Umpqua National Forest Property Owner's Name

TOKETEE

Nearest City or Community

2/11/2016 Issued by - Signature Date Issued

Type of Facility Served: 1:8:1 Single Family Res.# Bdrms.: 2

Township

03W 36 Range Section

Tax Lot

2/11/2017 Expiration Date

D Other:

Specify Type

R32128 Acct.#

ALL WORK IS TO CONFORM TO OREGON ADMINISTRATIVE RULES, CHAPTER 340, DIVISIONS 71 & 73.

- :;.WQRK MUSLB~QN~BYJJiE-PERMf[[EE_ QB. BY A -Lic e· .SEO S.EWAG_E_DIS~OSAL SERVICE BUSINESS .. -1~-;;.., MAKE NO CHANGES IN SYSTEM LOCATION OR SPcCIFICATIONS-WITAOUt WR1TTE APPR't>VAL FROM THE

PERMIT ISSUING AGENT.

SYSTEM SPECIFICATIONS

~Standard . D Capping Fill D Sand Filter D Seepage Trench

D Tile Dewatering DATT -Treatment Level Required: DI or D II

D Seepage Bed

~Other:

D Pressurized Distribution

Max. Peak Design Flow: 300 Gal/Day

Special Tank Requirements:

Media Type: D Rock/Pipe

Specify Type

Min. Septic Tank Volume: 1,000 Gal Min. Dosing Tank Volume: Gal

DRAINFIELD SPECIFICATIONS

~ Other (Product/Manufacturer): CHAMBERS

Trench Spec.: 150 Linear Ft. Trench Width: 2 feet Undisturbed Soil Between Trenches: 8 feet

Max. Depth: 30 inches Min. Depth: 20 inches Total Rock Depth: inches

Rock Below Pipe: in. Rock Above Pipe: in. Capping Fills - Min. Depth of Fill Material: in.

Seepage Bed Specifications:

Dist ribut ion Method : 0 Equal r:gj Loop 0 Equal-Hydrosplitter 0 Serial 0 Pressurized 0 Gravelless Half Pipe

--~ p-ecia R~q~i~men~Ef:=r~un~ -.;;~;:;~ptor:--~lJtlT: Amountof=5rain rviea fa: -'"- l-ncnes - 0 DRY SOIL INSTALLATION ONLY 0 Rake Trench Sidewalls 0 Filter Fabric On Top of Drain Media r:gj CONSTRUCTION PLAN MUST BE SUBMITTED AND APPROVED PRIOR TO CONSTRUCTION.

D Other:

Inspection Requirements: For Pressurized, Sand Filters, RGFs, ATTs and Capping Fill systems. there are several inspections required. See inspection requirements specific to each system.

The attached Final Inspection Request And Notice Form must be completed and submitted at time of system completion.

For pre-cover inspection information, contact: LeAnn (541) 440-6183

CERTIFICATE OF SATISFACTORY COMPLETION

D System Inspection D Operation of Law - 7 Days Notice D Pre-Cover Inspection Waived Per 340-071

Authorized Agent -Signature Title

Douglas County Office Date

To be valid, thia document must be sianed by an "Aa~nt" ~~ dQfiMrl in OAO uo._071 _0100.

Requirements for this Certificate of SatisfactOfY Com 'e ·on and adc" · al inspectio · forma · are attached to this document

Revised 21

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BE CAREFUL and BE SAFE - CALL FOR UNDERGROUND UTILITY LOCATIONS BEFORE YOU DIG!

(503) 232-1987 or 1-800-332-2344. . ' • .I

Rules, Approved Material Listing, and Database of Licensed Installers can be accessed at:

http://www.deq.state.or.us/wq/onsite/onsite.htm

General Conditions And Requirements For All Permits Onsite Construction-Installation Permits are valid for one year from the date of issuance. The expiration date is noted on this permit. Renewal or reinstatement of a permit may be granted to the original permittee if an application for permit renewal or reinstatement is filed within one year after the original permit expiration date. The renewal or reinstatement will be issued an expiration date one year after the previous date of expiration. Transfer of a permit from the original permittee to another person may be granted if an application for a permit transfer is filed prior to the original permit expiration date and no other changes to the permit are necessary. Note: The fee for renewal, reinstatement, or transfer of a permit is less than that for a new permit.

ALL WORK IS TO CONFORM TO OREGON ADMINISTRATIVE RULES, CHAPTER 340, DIVISIONS 71 &

73. WORK MUST BE DONE BY THE PERMITTEE OR BY LICENSED SEWAGE DISPOSAL SERVICE

BUSINESS. MAKE NO CHANGES IN SYSTEM LOCATION OR SPECIFICATIONS WITHOUT WRiTTEN

APPROVAL FROM THE PERMIT ISSUING AGENT.

( Installation Requirements: The drainfield is to be installed in undisturbed native soil. There are to be no alterations of the natural site conditions such as soil removal or filling, or slope/topography alterations within the approval areas for both the initial and replacement systems unless otherwise authorized by the Agent.

System installation is not to occur when soil moisture, high groundwater, adverse weather, or other conditions that could affect the quality of installation or reliability of the system are present. If such conditions are present and there is a need for sewage disposal at the site, the septic tank can be utilized as a temporary holding tank as outlined in 340-071-0160(9).

Inspection Requirements: The system installer and/or the permit holder must notify the permitting Agent when the construction, alteration, or repair of a system for which a permit was issued is completed (except for the backfilling or covering of the installation). For Pressurized, Sand Filters, RGFs, ATTs, and Capping Fill systems several inspections are required during the construction process (see inspection requirements specific to each system installation). The permitting agent has 7 days to perform an inspection of the completed construction after the official notice date, unless the permitting agent elects to waive the inspection and authorizes the system to be backfilled earlier. Receipt and acceptance of a completed Final Inspection Request and Notice form by the permitting agent establishes the official notice date of your request for the pre-cover inspection. Faxed copies are acceptable for inspection request purposes only. Originals must be received before a Certificate of Satisfactory Completion can be issued. Please complete all of sections 1 through 4 on the form and return it to the office that issued the permit. Forms determined to be incomplete will be returned.

System Backfill Requirements: The system is to be backfilled or coveredonly after the permitting agent has approved the construction installation, the inspection has been waived, or the Certificate of Satisfactory Completion (CSC) has been issued by operation of law where the inspection has not been conducted within 7 days of notification of completed installation. Unless otherwise required, it is the system installer's responsibility to backfill the system within 10 days after inspection and issuance of the CSC. Backfill must be carefully placed to prevent damage to the system. The backfill must be free of large stones, frozen clumps of earth, masonry, stumps, waste construction materials, or other materials that could damage the system. Be sure that the untreated building paper, filter fabric, or other material approved by the agent is completely covering all drain media where required prior to backfill. The system can be connected to and placed into service once it has been properly backfilled and the CSC has been issued.

Initial and Replacement Areas - Protection: The installed subsurface absorption field and designated replacement areas must be protected and kept free of development such as roadways, covering with asphalt or concrete, filling, cutting, or other soil modifications.

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ONSITE WASTEWATER TREATMENT SYSTEM CONSTRUC'tlON

.1 I • PERMIT ATTACHMENT

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Property Owner: ,,. Permit No. :

BE CAREFUL and BE SAFE - CALL FOR UNDERGROUND UTILITY LOCATIONS BEFORE YOU DIG! (503) 232-1987 or 1-800-332-2344

Special Conditions And Requirements For This Permit Note: Items are signified with a check mark ( v').

ALL WORK IS TO CONFORM TO OREGON ADMINISTRATIVE RULES, CHAPTER 340, DIVISIONS 71 & 73. WORK MUST BE DONE BY THE PERMITTEE OR BY LICENSED SEWAGE DISPOSAL SERVICE BUSINESS. MAKE NO CHANGES IN SYSTEM LOCATION OR SPECIFICATIONS WITHOUT WRITTEN APPROVAL FROM THE PERMIT

ISSUING AGENT.

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D A failing system must be repaired as soon as possible. Should the repair of this system be delayed, the permit holder must notify the agent by phone or in writing the reasons for delay, and propose a different completion date. Delays may be cause for a formal enforcement action which may result in a civil penalty assessment.

D If there are discharges of sewage or septic tank effluent onto the ground surface or into public waters, the permit holder or property owner must take immediate steps to minimize the threat to public health and the environment.

These steps must include at a minimum:

1. Having the existing septic tank pumped, the outlet plugged, and the tank utilized as a temporary holding tank until repair of the system is complete.

2. Securing the area of both contaminated and saturated soils with barricades, roping, caution tape and the posting of warning notices. The notice must read, "Warning - This Area is Contaminated with Sewage - Please Stay Out" or similar language.

3. Treating the affected area of contaminated/saturated soil with either a calcium carbonate compound (lime) or other type of sanitizing compound.

D The approved plans for this system call for septic or dosing tank with a "Limited Approval" in Oregon. They are not to be installed in heavy clay soils or used where a water table would rise above the bottom of the tank. These tanks come with an installation guide from the manufacturer which is to be strictly followed.

D This permit is for the installation of an Alternative Treatment Technology (ATT) system . This system is to be installed only by the property owner that has been certified by the system manufacturer or licensed sewage disposal business (installer) that has been certified in accordance with OAR 340-071-600 and 650.

D This system includes pumps and electrical components . Verification that these components have passed all electrical inspections by a certified electrical inspector is required.

D Other conditions or requirements:

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