EXISTING SEPTIC SYSTEM VERIFICATION APPLICATION INTAKE CHECKLIST

Transcription

1 Skamania County Community Development Department Building/Fire Marshal Environmental Health Planning Skamania County Courthouse Annex Post Office Box 1009 Stevenson, Washington Phone: Inspection Line: EXISTING SEPTIC SYSTEM VERIFICATION APPLICATION INTAKE CHECKLIST (This Checklist must be completed and submitted with all required documents for the application to be considered complete. Review will not begin on the project until all of the requirements below are submitted.) STAFF APPLICANT Complete Existing Septic System Verification Application and non-refundable fee(s) (payable to Skamania County Treasurer). Fees are subject to change by resolution of the County Commissioners. < 1,000 gallon per day system - $210non-refundable fee > 1,000 gallon per day system - $265 non-refundable fee (not exceeding 3,500 gpd) O&M Review for Existing Systems - $105 non-refundable fee Septic tank and distribution box access points are uncovered and accessible. Yes No Reviewed by Complete: Yes No Date:

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3 Skamania County Community Development Department Building/Fire Marshal Environmental Health Planning Skamania County Courthouse Annex Post Office Box 1009 Stevenson, Washington Phone: Inspection Line: Existing Septic System Verification Application and Informational Packet An Existing System Verification application is needed when changes are proposed to a building or property served by an existing onsite sewage system, such as when changing the size, location or intended use of a building served by an existing onsite sewage system, or when connecting a new building to an existing onsite sewage system. The Skamania County Community Development Department (SCCDD) will review the application to verify that there are adequate permit records of the on-site sewage system to support the proposed change to the building or property, or connection to an existing on-site sewage system. The evaluation is also intended to help determine that proposed changes will not impair the operation of the on-site sewage system and to verify that the system is in full compliance with current regulations. APPLYING FOR AN EXISTING SYSTEM VERIFICATION 1. Existing System Verification Application a. You will need to submit the form titled EXISTING SYSTEM VERIFICATION APPLICATION along with a current Site Plan. See 2 for Site Plan requirements. b. The completed application must be submitted to SCCDD by mail or hand delivery. c. The non-refundable Existing System Verification fee must accompany the completed application. Fees are subject to change by resolution of County Commissioners. d. A site visit will not be scheduled unless a complete application and site plan is submitted and the required non-refundable fee has been paid. 2. Site Plan For An Individual Lot a. A site plan is an accurate and detailed map of your property that illustrates existing and proposed structures, land features, etc. The site plan shall be clearly and accurately drawn to a suitable scale, (such as 1 inch = 30 inches), on paper no larger than 11 X 17 and must indicate all of the information listed on the Site Plan Checklist. b. The processing and issuance of your on-site sewage, building, or land-use permit is often delayed because the site plan is incomplete and/or illegible. Please review the site plan checklist to ensure the drawing is complete. c. Provide SCCDD with a copy of the site plan and keep a copy with your permanent records. 3. System Verification Preparation To prepare for the inspection, you must do the following: a. The entire top of the septic tank and the distribution box must be uncovered and accessible for the Environmental Health Specialist to complete the review; b. The drainfield must be left untouched;

4 4. Key elements of existing system evaluation and approval for continued or re-use: a. The system is properly functioning as designed. b. Site development meets all required setbacks to existing OSS components. c. Adequately sized and designated reserve OSS area existing on parcel that meets setbacks. 5. If Problems Are Identified During The Inspection a. Repairs or modifications that are noted on the report are not generally required to be completed prior to release of the Existing System Verification Results. The repairs/modifications are the responsibility of the property owner. b. If the drainfield is found to be failing or sewage surfacing on the ground a Notice of Violation will be sent and corrections or replacement will be required as determined by the Environmental Health Specialist. The Existing System Verification file will be closed with the Notice of Violation attached and comments regarding the system status as failed will be included in the database records. A separate OSS repair permit application and fee may then be required. c. Other items that may result in recommended or required corrections are observation of structures, parking or driving over the drainfield or designated reserve area, increase of the number of bedrooms over what was permitted. These items are a violation of state and local regulations and are likely to result in premature failure of the system but may not be immediately harmful to the system operation. d. Access risers will be required to be installed on the septic tank and distribution box if those existing system components are below grade.

5 Existing Septic System Verification Application (ALL SPACES MUST BE FILLED IN. IF INFORMATION IS NOT APPLICABLE PLEASE INDICATE N/A. Please complete in ink) Applicant: Address: Home: ( ) Work: ( ) Property Owner: Address: Home: ( ) Work: ( ) Site Address: Tax Lot/Parcel # Zoning: House Occupied: Yes No If Vacant, how long? Age of dwelling: Number of bedrooms: PURPOSE OF EVALUATION New Residential Dwelling Placement New Commercial Use or Structure Placement of an Accessory Building Residential or Commercial Remodel Changes to the Building Site (addition of a Other pool, relocation of a driveway, etc.) Description of Proposal: EXISTING ON-SITE SEWAGE SYSTEM INFORMATION Existing system OSS records? If yes, attached? Yes Yes No No Most recent date the system was pumped: Inspection/Pumper Report attached: Yes No If no, why: I certify that the information provided is true and accurate to the best of my knowledge. Applicant Signature Date Property Owner Signature Date Signature of the property owner(s) authorizes the Community Development Department and other Agency personnel reasonable access to the site in order to evaluate the application. For Department Use Only: Date received: File No.: Fee: Receipt #: System type: Test type: Application

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7 SEPTIC SYSTEM PUMPERS LICENSED BY SKAMANIA COUNTY COMMUNITY DEVELOPMENT DEPARTMENT This list represents septic system pumpers who are licensed to work in Skamania County as of the date this list was printed. The list is not meant to serve as a recommendation, endorsement, or guarantee of workmanship. A-1 Septic Tank Service Contact: Glenn Gregory PO Box 386 Parkdale, OR Affordable Septic PO Box Portland, OR Bishop Sanitation Contact: Edgar Holbrook PO Box West Main Goldendale, WA Fax: Vickie@bishopholdings.biz Bob s Septic Service Contact: Bob Comeau 5112 NE 119 th Street Vancouver, WA Fax: River City Environmental Mailing: PO Box Portland, OR Physical: NE Marx Street Portland, OR Fax: michellem@rivercityusa.com Ted-Dee Bear Septic Contact: Teddy Gibson 8905 NE 115 th Street Vancouver, WA (360) Webster s Septic Tank Service PO Box 1006 The Dalles, OR (541) Application