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WASHINGTON COUNTY
OREGON
-0:-
May 2, 2016
RECEIVED
JULTom Walker 1 3 2017
c/o Coffman Excavation CITY OF TIGARD
PO Box 687 BUILDING DIVISION
Oregon City, OR 97045
RE: ONSITE SEWAGE DISPOSAL SYSTEM
Site Evaluation Approval for Initial and Replacement System
2S1-9AA-300
14165 SW 125th Ave; Tigard
Dear Tom Walker:
The Washington County Environmental Health Program evaluated the above referenced site for the
placement of an onsite sewage disposal system on the property. The site was found to be in compliance
with the Oregon Administrative Rules(OAR Chapter 340-Divisions 71 and 73), and is Approved for the
installation of a Standard serial distribution systems. A minimum 1,000 gallon capacity septic tank is
required. The system must be installed in the .proved identified area and meet specifications detailed in
the enclosed report
The proper operation of your onsite sewage disposal system is dependent on system installation in the
undisturbed approved area. Any alteration of the area approved for your onsite sewage disposal system or
the approved reserve repair area may void your approval. Please keep these areas free of heavy equipment
used in property development. Earth moving in the approval areas is also prohibited.
A Permit Application Packet is enclosed. System construction may not take place until a permit is issued
by this office. Property owners may install their own system. Contracted installers must be licensed with
the Department of Environmental Quality (DEQ). Information on licensed contractors is available at the
DEQ website: http://www.deq.state,or,us/wq/onsite/sdsseareh.asp
If you have any questions related to your approval or permit application for your proposed onsite sewage
disposal system please contact this office at(503)846-8722.
Sincerely,
Larry Fens er, Senior REHS
Environmental Health Program
Enclosures: Site Evaluation Approval Report and Permit Application Packet
Department of Health&Human Services-Environmental Health Program
155 N First Avenue,Suite 160,MS-5,Hillsboro, OR 97124-3072
Phone: (503)848-8722.Fax: (503)846-4490•vvww.co.washington,or,us
Department of Health and Human Services .,G ON
Environmental Health Program 4 ‹�
155 N. First Ave,MS 5, Suite 160
Hillsboro, OR 97124 ""'"
Telephone: 503-846-8722 Fax:503-846-3705
Prdgiclieidth
www.co.washington.or.uslhhs/Environmentaltlealth OG
NON- wraveat.Pronate.rrotzet,
SITE EVALUATION REPORT
(NOT a permit for construction)
CR#: EHA17203 Dates of Inspection: 4124/17
Application Date: 3/30/17
Tax Account#:
Township 2S Range 1Wsection 0AA T.L.# 300
Site Address:: 14165 SW 125th Avenue; Tigard
Applicant: Tom Walker Parcel Size/Dim.:
6:77 Acres
do Coffman ExcavationType of Dwelling:Residential
P.O. Box 687 Public
Water Supply:
Oregon City, OR 97045
An approved site evaluation indicates the above described property is adequate for the installation of one on-site
disposal system in accordance with ORS 454.605 through 454.755,the Administrative Rules of the Environmental
Quality Commission promulgated thereunder,the Washington County Code,Chapters 12.12 and 12.16.
An approved site is given on the basis that the lot or parcel described above will not be further partitioned,divided or
altered in any manner as prohibited by the Statutes,and Ordinances listed above.Any such division, partitioning or
alteration voids this approval.
I;APPROVED
ODENIED
COMMENTS/.CONDITIONS
Initial and Replacement Systems:
Standard serial distribution systems sized at 125'/150gpd (375' of drainline per system);
Trench depth = 30"maximum/24"minimum; System design flow is 450gpd (4-bedrooms);
A minimum 1,000 gallon capacity septic tank is required; See attached field worksheet for
additional information and requirements.
-
NOTE:A plot plan and all required documents must be submitted to this office for approval prior to permit issuance.
v
Sanitarian's Signature ' Y' «> -- Date: 511/17
(......1, --e1/4.4...
Rev.12/2016
Department of Health and Human Services C,TONco ^�
Environmental Health Program �`� G .
155 N. First Ave, MS 5, Suite 160 y* 2 -,
Hillsboro, OR 97124 :
Telephone: 503-846-8722 Fax: 503-846-3705
Public Health
www.co.washington.or.us/hhs/EnvironmentalHealth OREGON Prevent.Promote.Protect.
SITE EVALUATION FIELD WORKSHEET
Tax Reference:2S1-9AA-300 Evaluator: Larry Fenster, RENS
Applicant Walker Date: 4/24/17
Depth Soil Matrix Color and Redox(Notation),Structure, Roots,Pores,Clay Films,%Coarse
(in) Texture Fragments,Layer limiting Effective Soil Depth(Llesd),etc
0 - 10" SiL 7.5YR3/3; 1 F-SBK; FMR,MFR; FMP,MFP; 5%C-FRG
10 -26" SiL 7.5YR4/3; 1F-SOK; FCR,FMR,MFR; FMP,MFP
a.
}- 26 - 37" SiL 7.5YR4/4; 2F-SBK; FCR,FMR,CFR; MFP
37 -48" SiCL 7.5YR4/4 w/FMP-7.5YR5/2+2.5YR5/6+FMP-MNM(39"+); 2M-SBK; FFR; CFP
0 - 7" SIL 7.5YR3/3; 1F-SBK; FMR,MFR; FMP,MFP; 5%C-FRG
N 7 -20" SiL 7.5YR4/3; 1 F-SBK; FCR,FMR,MFR; MFP
20 - 33" SiL 7.5YR4/4; 2F-SBK; FCR,FMR,CFR; MFP
33 - 46" SiCL 7.5YR4/4 w/CMP-7.5YR5/2+FFP-2.5YR4/6(35"+); 2M-SBK; FFR; CFP
SIMILAR TO TP1 & TP2
c,, DEPTH = 43"
wg
0.
RMF @ 30"+
ESD > 43"
Landscape Notes: Upland - Sideslope Llesd:>48"
Slope: 12 - 29% Aspect: W Groundwater: Temporary - RMF @ 30" to 39"+
Other Notes: Proposed new building site to be served by a public water system and an onsite septic
system
SYSTEM SPECIFICATIONS
Facility Type: Residential — Design Units: 4-bedrooms Design Flow: 450gpd
Initial: Standard serial System Sizing: 125' /150 g.Max. Depth Absorption Facility(in): 30"
Replacement: Standard serial System Sizing: 125' /150 g. Max. Depth Absorption Facility(in): 30"
Special Conditions The above noted system(s) must be installed:
1) Within the approved area noted on back.
2) In accordance with DEQ rules.
Rev.03/2017
M ti7"a-o 17— ,O a-76
Sewer Availability Worksheet
DATE: $\8\ton. PERMIT/SERVICE NO.:
SECTION 1
APPLICANT INFORMATION
1.Property Address: /4165' SW tZ' AVE,
City,Zip: 1-kall .i . Qq ZZi4
Township: Range: Section: Tax Lot#: 'Z tO CO
2.Name of Applicant:fAXtRG s«G'S yLe 40MS Telephone#: jog Sb'$ JOK
Mailing Address:` ' t1ttl J qq �T.h,_y�`( MCC>
City,Zip: V{ CAtial t W r ) q UD �..
3Describe type of facility the on-site sewage system will serve(business,residence or other):
**,Single Family ResidenceOBusinessOOther:
4.Type of on-site sewage system permit application being proposed for this property:
Xlew Installation PermitORepair Permit CIAlteration Permit
❑Non water-carried facility requests(pit privy,vault toilets for campgrounds)
SECTION 2
TO BE FILLED OUT BY SEWER DISTRICT,CITY ENGINEERING,PUBLIC WORDS DEPARTMENT OR
OTHER SEWER ADMINISTRATIVE BODY
SANITARY SEWER AVAILABILITY
OAR 340-071-0160 requires a permit application for onsite sewage disposal be denied if
A sewerage system which can serve the proposed sewage flow is both legally and physically available.
*Physical Availability:A sewerage system shall be deemed physically available if its nearest connection
point from the property to be served is:
•For a single family dwelling,or other establishment with a maximum projected daily sewage flow of not •
more than 450 gallons,within 300 feet;
'For a proposed subdivision or group of two to five single family dwellings,or equivalent projected daily
sewage flow,not further than 200 feet multiplied by the number of dwellings or dwelling equivalents;
•For proposed subdivisions or other developments with more than five single family dwellings,or
equivalents,the county agent shall make a case-by-case determination of sewerage availability.
1
H5rao,1-OO a7(
EXCEPTION: A sewerage system shall not be considered available if topographic or man-made features
make connection physically impractical.
*Legal Availability: A sewerage system shall be deemed legally available if the system is not under aDEQ
connection permit moratorium,and the sewerage system owner is willing or obligated to provide sewer
service.
IO.Is a sewerage system physically available and legally available to serve this property?
Physically available: OYES D NO
Legally available: ❑YES\ NO
Distance from property to nearest accessible service line in feet:
Reason sewer is not available(if either"No"is check above):
SEWER ADMINISTRATOR SIGNATURE:
Print name: tfHC?l LE
Title: ' '' k/ 'Al E '. „ V„y u' o tact Number: �7��• f 1 O-2 LJ'4 0
Signature: t . 55
mY Date: R 8[1.T. ,
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