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Goldendale Office 115 W. Court St Box 103 Goldendale, WA 98620 [PHONE REDACTED] Klickitat County Health Department Monday-Friday, 8am to 5pm White Salmon Office 501 NE Washington St/ PO Box 159 White Salmon, WA 98672 [PHONE REDACTED] Gravity Septic Permit Installation Application Washington Administrative Code (WAC) 246-272A and local On-site Sewage Disposal code 8.10 requires individuals to obtain an on-site sewage permit prior to construction. In Klickitat County proof of adequate wastewater disposal is required prior to issuing a building permit with production of wastewater. Local code 8.10.260(F) requires every place where people congregate or reside shall be provided a means of sewage disposal approved by the Local Health Officer. Final designs should be completed in dark ink and legible. Once submitted for review, all fees are non-refundable. If a homeowner chooses to install the system themselves, they will need to pass the WOSSA homeowner installer test to do so. All on-site septic permits are valid for 1 year and will require renewal when expired. The system owner is responsible for operating, monitoring, and maintaining the system to minimize the risk of failure. This includes securing the correct permits prior to construction or repairs and performing system evaluations. During the removal or pumping of solids, the homeowner shall only hire approved pumpers licensed in Klickitat County. System owners are also responsible for protecting the tank, absorption area, and the reserve area from; impervious materials, surface drainage, soil compaction, soil removal, and ensure the flow of sewage does not exceed designed capacity. Owner Information Owner Name: Mailing Address: City: State: Zip: Phone: Email: Site Address: Parcel Number: Parcel Size: Licensed Installer: Permit Proposal ☐ Standard Gravity Installation ($500) ☐ SSAS Replacement with a soil log ($150) ☐ Septic Tank Replacement ($100) ☐ SSAS Replacement with no soil log ($500) ☐ Permit Renewal ($150) ☐ System Expansion with a soil log ($150) ☐ Connection to a Community System ($200) ☐ System Expansion with no soil log ($500) ☐ Waterless toilet permit review ($100) Sewage Source: ☐Residential ☐Other: Drinking Water Source: ☐Private Well ☐Shared Well ☐Public Water Connection For the next section you will need your site evaluation report. ---PAGE BREAK--- SECTION 1: SYSTEM CALCULATIONS Step 1: Per WAC 246-272a & local code 8.10, the system design flow is determined by the number of bedrooms multiplied by 120 gallons. The minimum design flow is 240 gallons per day (gpd). For example; a 3- bedroom home multiplied by 120 gallons per day is 360 gallons per day. Please fill in the shaded area below with your project details. Contact the sanitarian if you are planning connect an ADU in the future. # of bedrooms: multiplied by 120 gpd = gallons per day design flow Step 2: For a home with 4 bedrooms or fewer, the minimum septic tank size is 1000 gallons. For homes with more than 4 bedrooms, an additional 250 gallons per bedroom is required. For example; a 3-bedroom home is required to have a 1000-gallon tank. A 4-bedroom home with a 1-bedroom accessory dwelling unit attached to the septic system must have a minimum of 1250 gallons capacity. Please fill in the shaded table below with your project details. # of bedrooms: = minimum tank volume Step 3: Refer to your site evaluation report to calculate the maximum trench depth. For a gravity dispersal system in Washington State, there must be 36 inches of vertical separation from any restrictive layer or water table. For example; if the depth of the test pit is 54 inches, and we need 36 inches of vertical separation, the trench depth is 18 inches. Please fill in the shaded table below with your project details. Depth of the test pit or restrictive layer minus 36 inches = trench depth Step 4: Refer to your site evaluation report for the “application rate” to calculate the necessary square footage for the infiltration area. To determine the square footage, divide the design flow from Step 1 by the application rate listed in the site evaluation report. For example; 360 gallons per day divided by a .4 application rate equals 900 total square feet. Please fill in the shaded table below with your project details. Design flow divided by the application rate = square footage Step 5: If are not installing pipe and gravel, skip step 5 and proceed to step 6. In Klickitat County the typical design trench width is 3 feet. You may opt for a 2-foot-wide trench, but the total square footage will still need to be shown in the design and constructed during the installation. In this step we divide the total square footage from step 4 by the typical trench width of 3 feet. For example; the square footage from step 4 is 900 square feet, dividing that by a 3-foot-wide trench, is 300 linear feet of pipe and gravel. If you are planning to install drain rock, please fill in the shaded table below with your calculations. Square footage divided by the trench width = linear feet of gravel ---PAGE BREAK--- Goldendale Office 115 W. Court St Box 103 Goldendale, WA 98620 [PHONE REDACTED] Klickitat County Health Department Monday-Friday, 8am to 5pm White Salmon Office 501 NE Washington St/ PO Box 159 White Salmon, WA 98672 [PHONE REDACTED] Step 6: If you plan to use gravel-less product, like EZflow™ (peanuts) or Infiltrator Chambers™ (domes), you may reduce the total square footage by a percent based on your soil type. Refer to your site evaluation report for the soil type. For soil types 3 through 6, there is a 40% reduction. In soil type 2, there is only a 20% reduction. For example; if the soil type is 5, we multiply the total square footage from step 4 by .6 (60%) to get the remaining square footage given by a 40% reduction. Please fill in the shaded table below with your project details. Square footage multiplied by .6 = reduced infiltration area Reduced infiltration area divided by a 3-foot trench = linear feet of gravel-less Please note, when considering gravel-less products there are additional manufacturer requirements for installation. We encourage the homeowner to discuss these products with the installer and we encourage the homeowner to fully understand costs associated with the product installation. Final Design Calculations Number of Bedrooms: Design Flow: Application Rate: Maximum Trench Depth: Linear Feet of Drain Rock: Septic Tank Volume: Linear Feet of Gravel-less: Pump Tank Volume (if required): Continue to the next page ---PAGE BREAK--- Goldendale Office 115 W. Court St Box 103 Goldendale, WA 98620 [PHONE REDACTED] Klickitat County Health Department Monday-Friday, 8am to 5pm White Salmon Office 501 NE Washington St/ PO Box 159 White Salmon, WA 98672 [PHONE REDACTED] SECTION 2: DETAILED SITE PLAN CHECK LIST (example on the next page) ☐ Show property lines & dimensions ☐ Label the building sewer out ☐ General topography (slope direction & ☐ Show all buildings, roads, driveways, or parking ☐ Show length & location of transport lines ☐ Show location of all trenched utilities ☐ Show location of the initial area and the reserve area ☐ Show the location of all test pits ☐ Show any sewer lines under roads & driveway(s) ☐ Show observation ports, clean outs, & risers ☐ Show location of all other trenched utilities ☐ Show North arrow ☐ Label setback distances from any surface water ☐ Show & label setback from any well or spring ☐ List the pipe material used and diameter ☐ Show the location of any drinking water source ☐ Show length and width for the trench ☐ Show material used for infiltration (drain rock etc…) ---PAGE BREAK--- Goldendale Office 115 W. Court St Box 103 Goldendale, WA 98620 [PHONE REDACTED] Klickitat County Health Department Monday-Friday, 8am to 5pm White Salmon Office 501 NE Washington St/ PO Box 159 White Salmon, WA 98672 [PHONE REDACTED] ---PAGE BREAK--- Goldendale Office 115 W. Court St Box 103 Goldendale, WA 98620 [PHONE REDACTED] Klickitat County Health Department Monday-Friday, 8am to 5pm White Salmon Office 501 NE Washington St/ PO Box 159 White Salmon, WA 98672 [PHONE REDACTED] SECTION 3: VERTICAL CROSS SECTIONS Vertical cross sections are required per WAC 246-272a & Local code 8.10 design criteria. Please provide the required information below in the shaded area. You may also substitute any cross section below with the manufacturer’s tech sheets. Trench Cross Section Septic Tank Cross Section Owner or Authorized Agent: I, the undersigned, hereby certify that the information provided is true and accurate to the best of my knowledge. I hereby assume all responsibility for the accuracy of the information contained herein and grant Klickitat County Health Department staff permission to enter the above listed property for the purpose of this application. Homeowner Signature Date Native soil cover Trench Width _ Depth of Material Used (e.g. pipe & gravel, EZ Flow, Chambers) Tank Model: Tank Manufacturer: Effluent Filter Model: Cover Material Depth: