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SWG2023-00536 - SWG Application / Design - 12/29/2023
MASON COUNTY 415 N 6TH STREET, SHELTON,WA 98584 SHELTON:360-427-9670,EXT 400 BELFAIR:360-275-4467, EXT 400 ELMA:360-482-5269,EXT 400 •.; Public Health & Human Services FAX:360-427-7787 On-Site Sewage System Permit: SWG2023-00536 APPLICANT FRANKLIN CLARK* Phone: 360-830-4765 Address: PO BOX 1954 SILVERDALE, WA 98383 OWNER CANDLER MORIAH Phone: 253-370-0581 Address: 1400 W HURLEY WALDRIP RD SHELTON, WA 98584 SEPTIC INSTALLER FRANK CLARK Phone: 360-830-4765 Address: PO Box 1954 SILVERDALE, WA 98383 Site Address: 1400 W Hurley Waldrip Rd Primary Parcel Number: 319302390030 Permit Description: 5-bedroom gravity system: Replacement Permit Submitted Date: 12/29/2023 Permit Issued Date: 02/05/2024 Issued By: David Anderson Current Permit Fees Paid: $780.00 (additional fees may be required upon installation of system). Permit Expiration Date: 01/03/2027 (based on date of inspection) Permit Conditions: 1 Proposed development subject to zoning requirements and approval by the planning department staff per Mason County Title 17. 2 Permit must be installed by a Mason County Certified Installer unless prior written authorization from Mason County is obtained. 3 Drain field installation not to exceed designed upslope and downslope depth specified on design form. 4 Installer is responsible for obtaining Mason County installation approval prior to backfill of system components. 5 Installer is responsible for obtaining Septic Designer/Engineer installation approval prior to backfill of system components. 6 Mason County Asbuilt Form, Record Drawing, and Installation fee must be submitted for final installation approval. THIS PERMIT MUST BE ONSITE DURING INSTALLATION OF OSS. PROPERTY OWNERS ARE RESPONSIBLE FOR DETERMINING AND MARKING ALL PROPERTY LINE AND EASEMENT LOCATIONS. THIS PERMIT MAY BE REVOKED IF THE SITE CONDITIONS HAVE CHANGED SINCE THE SITE WAS INSPECTED AND DESIGN APPROVED. FINAL INSTALLATION APPROVAL IS REQUIRED PRIOR TO TEMPORARY OR FINAL OCCUPANCY OF ANY RELATED STRUCTURES. For Final Inspection visit: masoncountywa.gov/health/environmental/onsiteloss-inspection-request.php or call: 360-427-9670, extension 400. OFFICIAL USE ONLY DATE RECEIVED: I 467 wr,t. MASON COUNTY — —id D AMO RECE E B �� ' j COMMUNITY SERVICES 0 . - k : rn 44 Public Health(Community Health/Environmental Health) ii 360-415N..6th5reet- �a�z75,467.e,t4� SWG .e02'? cS3t e o 415 N.6th Street-Shehon.WA 98584 Z (n ON-SITE SEWAGE SYSTEM APPLICATION n x. m• n APPLICANT PHONE m Franklin Clark 360-830-4765 Z c MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE g • P.O.Box 1954,Silverdale,WA,98383 m SITE ADDRESS-STREET,CITY ZIP CODE 1400 W Hurley Waldrip Rd,Shelton,WA 98584-8635 W NAME OF DESIGNER PHONE 1.1 Franklin Clark 360-830-4765 � NAME OF INSTALLER PHONE I�/) Franklin Clark 360-830-4765 < IW a PERMIT TYPE(select one) DRINKING WATER SOURCE N ■ RESIDENTIAL OSS 0 COMMUNITY OSS 0 COMMERCIAL OSS ■ PRIVATE Well ❑ PRIVATE TWO-PARTY WELL Z IO TYPE OF WORK(select one) 0 PUBLIC WATER SYSTEM I ❑ NEW CONSTRUCTION/UPGRADES ■ REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) ❑ TABLE IX REPAIR IN SUBMITTALS 0 SURFACING SEWAGE •EXISTING FAILURE •SHORELINE w W ▪ DESIGN FORM(REQUIRED) SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE r t->s,.. 5 ❑ WAIVER(S)(IF APPLICABLE) 1.41 Acres o I• ' DIRECTIONS TO SITE AND SITE CONDITIONS.(ex.locked gate) X Mason County Community Services-415 N 6th St,Shelton,WA 98584>Head south on N 6th St toward W Pine St> IO Turn right at the 1st cross street onto W Pine St>Turn left at the 1st cross street onto N 7th St>Turn right onto W Railroad Ave> Turn left to merge onto US-101 S toward Olympia>Turn right onto W Hurley Waldrip Rd>Destination will be on the right- o IO 1400 W Hurley Waldrip Rd,Shelton,WA 98584 W 4 SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. I O OFFICIAL USE ONLY BELOW THIS LINE UPGRADE/FAILURE SOURCE(for reporting purposes) ❑VOLUNTARY 0 MAINTENANCE/PUMPING 0 BUILDING PERMIT ['HOME SALE ❑COMPLAINT ❑OTHER: TIj COMMENTS/CONDITIONS _ -� •° INSPECTOR SOIL LOGS Jf►Z.O' j��), �f`, ft�-of �H +-� me ;. . .. 7Nt:b.. Lid" r-SSc,_ , , �`''' tLcS} u 4 wl ^� " ,„ v5,„ �� �92t23 ` ' ` A,e)� G� 3`� wlntlt ,2, _,x. S ____________, : Tiy:U - 19 r`5c- Z9-9SN' fSL 'cam C el "41 1 • � to triAnl RECORD DRAWING AND INSTALLATION REPORT 4 SOIL CODES: li t V=VERY G=GRAVELLY S=SAND L=LOAM Si=SILT C=CLAY E=EXTREMELY R=ROOTS REQUIRED FOR FINAL APPROVAL INSPEC OR SIGNATURE ATE APPLICATION EXPIRATION DATE APPLIC (ON APPROVED/ISSUED BY DATE I/3/20? i l3 i ?o7,7 Z/s/zo z ti. THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12/7/2015 4I_ DESIGN FORM -PAGE ONE Assessor's Parcel Number: 3 1 930 — 23 -- 90030 A design will be reviewed when 3 copies of each of the following are submitted: ■ Completed design form that has been signed and dated. I Scaled layout sketch,including all applicable items on checklist ill Scaled plot plan,including all applicable items on checklist. C Cross-section sketch,including all applicable items on checklist This form may be scanned and available for public view on the Mason County Web site. Maximum paper size: 1 1"X 17" PARCEL IDENTIFICATION Permit Number: SWG W 23 -Oa% Designer's Name: Franklin J Clark Applicant's Name: Kristi Candler Designer's Phone Number: 360.830.4765 ►UtniliGdresr.—� 1400 W HURLEY WALDRIP RD Designer's Address: P.O.Box 1954 !AN 2 9 2G'Z4 City:Shelton State:WA Zip:98584 City:Silverdale State:WA Zip:98383 DE SIGN PARAMETERS RECEIVED__ Treatment Device DI Glendon Biofilter N Sand Filter ® Mound El Sand Lined Drainfield N Recirculating Filter,Type: ® Aerobic Unit Make/Model N Disinfection Unit Make/Model Other: Drainfield Type I Gravity 0 Pressure ® Trench ® Bed El Sub Surface Drip Septic Tank/Drainfield Specifications Laterals Number of Bedrooms 5 ' Schedule/Class 3034 Daily Flow: Operating Capacity 600 gpd Length 85 ft Daily Flow: Design Flow 600 / gpd Diameter 4 in Septic Tank Capacity (2)1,200 ' gal Number JAN 2 4 2024 4 Receiving Soil Typ e(1-6) 4 Separation , 5'On Center. ft eg- Receiving Soil Appl.Rate Pri: .6/ Res: .6 gpd/ft2 Orifices - N/A Required Primary Area 1000 - ft2 Total Number of Orifices DesignedPrimary Area 1000 - ft2 Diameter in Designed Reserve Area 1 000 ft2 Spacing in Trench/Bed Width 3 `- ft Manifold - N/A Trench/Bed Length 85 i ft Schedule/Class Elevation Measurements Length ft Original Drainfield Area Slope 1 - 2 % Diameter in New Slope,If Altered N/A % Preferred manifold configuration used?® Yes ® No Depth of Excavation Up-slope 8 in Transport Pipe Ili from Original Grade Down-slope 8 in Schedule/Class 3039 40, Designed Vertical Separation 36 in Length 85 ft Gravelless Chambers Required? 0 Yes I No 0 Optional Diameter 1.25 in Pump Required? I Yes 0 No Dosing and Pu mp Chamber Pump/Siphon Specifications Number of doses/day Be naiad I'' Difference in Elevation Between Pump Shutoff and Uppermost Dose quantity gal Orifice N/A ft Chamber Capacity *17500 gal Uppermost Orifice M Higher M Lower than Pump Shutoff Pump controls:Please check those required. Capacity @ Total Pressure Head 1.3 gpm )If Elapse Meter 0 Event Counter Calculated Total Pressure Head 15' ft Timer: Pump on , Pump off Comments FEB U 5 2024 MASON COUNTY ENVIRONMENTAL HEALTF n IA DESIGN FORM —PAGE TWO Assessor's Parcel Number: 3 1 930 — 2 3 — 90030 Permit Number: SWG DESIGN CHECK LISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch 1 Test hole locations I Drainfield orientation and layout Reference depth from original grade: Soil logs 1 Trench/bed dimensions and I Septic tank I Property lines critical distances within layout I Drainfield cover Existing and proposed wells 1 D-BoxNalve box locations Reference depth from original grade within 100 ft of property I Septic tank/pump chamber and restrictive strata: ❑ Measurements to cuts, banks,and locations I Laterals,trench/bed,top and surface water and critical areas I Observation port location bottom - N/A I Clean-out location ❑ Curtain drain collector- N/A ❑ Location and orientation of I Manifold placement ❑ Sand augmentation - N/A curtain drain and all absorption 0 Orifice placement - N/A Other cross-section detail: components _ N/A Lateral placement with distance I Observation ports/clean-outs I Location and dimension of to edge of bed primary system and reserve area Other Information • Audible/visual alarm referenced Yes No I Buildings 1 Scale of drawing shown on scale 0 I Design staked out I Direction of slope indicator bar ❑ I Recorded Notices attached 1 Waterlines ❑ I Waiver(s) attached 1 Roads,easements,driveways, I ❑ Pump curve attached parking ❑ 1 Evaluation of failure 1 North arrow and scale drawing Non-residential justification shown on scale bar ❑ I Waste strength p 1 Flow DESIGN APPROVAL The undersigned has reviewed this design on behalf of Mason County Public Health and determined it to be in compliance with state and local onsite regulations: 01/25/2024 A�pNVRIRpNMENTAi7� L HEA Signature of Designer Date FEB 0 5 2024 1)N- 7 /c/7° c./ MASON COUNTY E Environmental Health Specalist l Date DJA L ' CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION: ❑ The design is stamped "Approved" by Mason County Public Health. /3 / �V�/�The Onsite Sewage Permit has not expired,the Permit Expiration Date:s: ( ❑ 7- Drainfield site conditions have not been altered to adversely affect conditions of design approval. 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