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HomeMy WebLinkAboutSWG95-00715 - SWG Application / As-Built - 7/8/1996 �5- 0 7i-9 F�tiJ.l�- / ZOO A5 fro orir T P/T 7/8l s� 9 — 07/5' -7/9 /9e 4 _ 320-0 L...004<I wC,,Z;T f Li r � f ,:tea � • � �� �' , � �` '1 � ,�- Aor � rr 14 ,.Nv j 1 011 toil, 14 , er .- -.-•�__ _ems._ .• ... � S • I� lei r I I' �� rI Septic&Construction Don Woolliscroft i . I 1 �IIILII I I � it?�I11s�:Pi��lAl1e: GARY YANDO,DIRECTOR �oN.STA o M° DEPARTMENT OF COMMUNITY DEVELOPMENT U i N T Z PLANNING -SOLID WASTE-UTILITIES Y y BLDG. I e 411 N. 5TH ST. e P.O. BOX 578 1864_ SHELTON,WA 98584 a (360)427-9670 MEMORANDUM December 19, 1995 TO: Kim Lincoln, Mason County Environmental Health FROM: Allan Borden, Shoreline Planner RE; SEPTIC CASE SWG95-0715 (MIKE DICK/ROBERT SLEE) I have reviewed the site plan for the repair of the sewage disposal and treatment system at NE 24072 State Route 3 in the Belfair Center. The dimensions of the subject parcel (PN: 12328- 32-90050) are clearly shown, and they indicate that the property has little or no area available for parking. The location of the Bio-Max unit, pump tank and drainfield laterals are on the property but in the limited space remaining next to the existing building. The property owner (in this case, Mike Dick) could not reasonably locate parking spaces in the area of the proposed septic system repair. This building appears to be an integral part of the entire Belfair Center. The many parking spaces available to the users of Mike Dick' s building have always been located on the adjacent parcel (PN: 12328-32-90030) . There must have been a verbal understanding or written agreement of the parking spaces provided on these two parcels at the time the buildings composing the Belfair Center were approved for construction. If a subsequent sale of one of the parcels did not involve that agreement of parking spaces provided to Mike Dick' s building, the oversight would be the responsibility of the persons involved in the sale of the property. Recycled " GARY YANDO,DIRECTOR P-0N.STgrFO o A° N u DEPARTMENT OF COMMUNITY DEVELOPMENT i N T Z PLANNING-SOLID WASTE-UTILITIES � Y y BLDG. I 9411 N.5TH ST. • P.O. BOX 578 of o Mesa SHELTON,WA 98584 • (360)427-9670 ME 40RANDUM December 19, 1995 TO: Kim Lincoln, Mason County Environmental Health FROM: Allan Borden, Shoreline Planner RE; SEPTIC CASE SWG95-0715 (MIKE DICK/ROBERT SLEE) I have reviewed the site plan for the repair of the sewage . disposal and treatment system at NE 24072 State Route 3 in 'the Belfair Center. The dimensions of the subject parcel (PN: 12328- 32-90050) are clearly shown, and they indicate that the property has little or no area available for parking. The location of the Bio-Max unit, pump tank and drainfield laterals are on the property but in the limited space remaining next to the existing building. The property owner (in this case, Mike Dick) could not reasonably - locate parking spaces in the area of the proposed septic system repair. This building appears to be an integral part of the entire Belfair Center. The many parking spaces available to the users of Mike Dick's building have always been located on the adjacent parcel (PN: 12328-32-90030) . There must have been a verbal understanding or written agreement of the parking spaces provided on these two parcels at the time the buildings composing the Belfair Center were approved for construction. If a subsequent sale of one of the parcels did not involve that agreement of parking spaces provided to Mike Dick's building, the oversight would be the responsibility of the persons involved in the sale of the property. i I i 1 ON-SITE SEWAGE INSTALLATION FINAL INSPECTION ...N.............1.....11.1...1..1.........1..1.N.1.....................................1...................N.1.:.....1................. ......................................................................................................................................................................... xi3sii:s:::3:ii:::::s..................................................................................................•.,,,.,................................................................. DATE CALLED IN: IA// TIME: INSTALLER: ✓/�[ �' APPLICANT/OWNER: CALLER: PHONE # OF CALLER: SWG #: 15— o 716- V PARCEL NUMBER: /9" �0 53 l SUBDIVISION: 1 DIVISION: LOT: �R 5-cf � � ......1.................N.1N......N....................1........-.... .N..................NNNN...... NNNN NNNN...N.N. i..N..N.NN.N..N1..N.NNN...NN.....NN......N.N.NN.NNN....N.... .....NNN...NIN....... .N N.N.NNNNN......N.N.1 .N..NNN..NN...N....N ....N. .........N.N......N...N..N 1..NN.......1N....N........N 1NN...N...NN...N.1.N1.N..N.N.NN.(,...N........... NN SYSTEM TYPE (CHECK ONE) : _. _ ....... ..P SURE- GRAVITY . INSPECTION SCHEDULE (CHECK ONE) : u AP INTMENT PLUG IN � AS-BUILT ON-SITE? (CHECK ONE) : u S NO 1NNN...tN.............11....N11 N..N.N........1N.N.N1....IN...N... 1N...N...NNNa UN..NNNN....N......NN..................... .NN11.N. .N.N.NNNNN....1.. .I.NN. ...........................:.i........................i::..:•......:i::.N:�:isii:iii:i��i��iii:iiii�i:i....................... ��..... NNiii�.M�ii�ii1��N:� STAFF INITIALS: h:callin.0 Revised 02/01/95 ON-SITE SEWAGE INSTALLATION STAFF INSPECTION REPORT ..........................................................................................................................................................................:::::::::::::::::::::: STAFF CBSCXLIST 1 I � 1 CONFIRMED BY INSPECTOR? 1 I � I I. SEPTIC TANK Yes Ho Comments 1 A) >5 ft from foundation? E) Bldg stubout to septic tank: cleanout if not 1-2%? c) Baffles intact and clean? _ D) Dividing wall intact? ✓_ zx. D-sox leveled with water or speed leveler (circle ane)? / G} III. DRx.narmcm 1 A) >10 ft from foundation and >5 ft from property lines? _ 1 a) laterals level to s1 inch & end caps present if not looped? _ c) system dimensions the same as shown on the design? _ D) Gravel clean, properly sized, and proper depth? �_ a) PRESSURE SYSTWI i) sand quality ASTM'C-33? a) Bead height uniform and t24 inches? _ I 3) Cleanouts and observation ports present? _ 4) Hound: Side slope 3:1? _ I 5) owner informed electrical connections exist be made by owner or licensed electrician and inspected by DI.I? _ I ! rv. POTAwz warm LINES I A) >10ft from drainfield, transport line, and septic tank? _ a) Wells 1-100ft from drainfield? — V. PMW TAKE 04 V Screen basket or fluent filter ircle one) installed? a) Riser installed access _ c) Alarm installed? _ 'AAT VI. AS WMT REQunm? .va ";-ze"Q viz. OTHER ao:aDa 1 I I jde I pobrA I I a r ale The unde iidi revi this i l Pttn and rifieshese finding on beh f of Mason County of Health Services. _g . tn or a e h:callin_N Revised 02/01/95 ON-SITE SEWAGE INSTALLATION PRE-INSPECTION DATE CALLED IN: TIME: 3 l t r" ,r INSTALLER: 1 _, APPLICANT OWNER: �C �`I cuj CALLER: i PHONE # OF CALLER: SWG . r PARCEL NUMBER: SUBDIVISION: DIVISION: LOT: ................................. � .......... .... �,: ... (: ... .. ...: ....... �.f..7�{ ................................ ............................................................................................................................................................ ................................ ................................................................................................................................................................................................ SYSTEM TYPE (CHECK ONE) ld PRESSURE GRAVITY INSPECTION SCHEDULE (CHECK ONE) : c-Cti t OJT,C ' u u APPOINTMENT PLUG IN AS-BUILT ON-SITE? (CHECK ONE) : u u YES NO STAFF INITIALS: h:callin.w Revised 04/09/96 A , ORSA VO - PAGE ONE Revised 07/28/95 ed when 3 copies of each of the following items are submitted: Complet esign form that has been signed and dated MAY 1. Gammleted Resource Lands and Critical Areas Checklist attached �lJMd plot plan, including all applicable items on checklist Scaled layout sketch, including all applicable items on checklist aFALTH 4on sketch, including all applicable items on checklist it PARCEL IDENTIFICATION II II Permit Number 57W C2 d 7/ 5- Designer's Name z2d k PLG / II #, WV-T s< G tt II Applicant's Name R/¢S /'"/'�. S�� . Prop. Owner's Name �lli•/CL� f/sG![ II II Mailing Address / 3 7 IM /A th 2UG S40 Mailing Address II II II i y State Zip City state zip II Assessor's Parcel No. 3Melve3�_ 3 9Do50 Subdivision II 1E Number) � Yi @NIC@S II II Pr II DESIGN PARAMETERS II II ✓ ✓ ✓ Date % II r-�� Designed II rL, ��-/ vertical II II u u u u Separation II it Mound Subsurface Pressure Gravity Bed Trench 3 to in II II Septic Tank/Drainfield Specific II II No. $edxnouis eYSO�f/G! L S- ..� I Pressure Distribution'. u Yes No (I II Daily Flow, Q Ve rc e- qpd I:....................... (If yes, proceed. . .) .......................:II ....................... II Septic Tank Cap&Cit /5 gal I II II Receiving Soil Type (1-6) r'3 I II II Receiving Soil Appl. Rate d ft' w Laterals II Trench/Bed Bottom preaLLU4�41 1 ft° Sc edule/Class -a�i�Ga-1 V0.ri S ft Length 2`I 3di �Z '3so ft II Trench/Bed Width � g i i II Trench/Bed Length (tt4.v��`�.s ft II A1,0 /PG�k�%�'I A/ I Diameter ��l in II II Elevation Measurements I Number _ II Original Drainfield Area Slope _�— / V I Separation 6 als ft II II Drainfield Area Slope if Altered ft/ V I Orifices II I Total Number of Orifices Ma-L II ^, II Depth of Bottom of Trench/Bed in l Diameter I/S in 11 II from Original Grade P e I Spacing II in I Manifold o o II II e I Schedule/Class y r-1 I Length ZO.ZS .1 7 ft Yes II l._J No I Diameter 2 in II Infiltrator Used? II Pu� ,'N Q,c.,l,►`S��phB•u `o,14 r-1 I Transport Pipe II II Pump Required Yes u No I Schedule/Class 40 II II ....................: (If yes, proceed. . . Length lo3,S ft::.................... II I Diameter Z.�� in II II Pump/Siphon Specifications Dosing and Pump Chamber g II II Difference in Elevation Between Pump Shutoff I # Doses/Day II Uppermost Orifice 1 ft I Dose Quantity /D 2- aa1 II and pp � al n Chamber CapacityII C II ,oL II Uppermost Orifice is higher, U lower I� than Pump Shutoff // I Check the following components if they drain II II crpm between doses: Capacity 0 Tot. Pres. Head a.� I II II Calculated Tot. Pres. Head / ': ft I r1 '� II (Attach Pump Curve) � ".x/ � Laterals Manifo ld Tran sport Port II �I L DESIGN FORM - PAGE TWO Revised 07/28/95 it DESIGN CHECKLISTS Q Scaled Plot Plan I Scaled Layout Sketch I Cross-Section Sketch II II I I Reference depth from orig- II II I__I Test hole locations IEg Drainfield orientation l i^nal�gr de: II II i and layout I r II II P perty lines l ��� I Septic tank lid and II II i U Trench/bed dimensions and l ra le cover dept II Existing and proposed l critical distances within ( II II wells within 100 ft i layout I Reference depth from orig- II it of property lines l I inal grade and restrictive II v- x "T"/"L' .locations I strata: II II Critical distance ��-- ,� II II measurements to cuts, ( u Septic tank pump chamber I Laterals, trench/� II II banks, surface water l locati l top and bottom II II I I r-i II Location and orientation l Observation port location l u Curtain drain collector II II of curtain drain and all l /" I n II II absorption area ( Cleanout location l U sand augmentation II II components Manifold placement I No external reference needed: ll II �' Location and dimension II of primary system and l orifice placement l u Observation ports and II II reserve area i F;;I� I cleanouts II II I u Lateral placement, with I II II �- Buildings l dunces to' edge of bed I Additional mound informational) j, ll U Direction of slope l L, Audible/visual alarm l U Upslope and downslope II II indicator l ref -enced l fill width II II �' � 1 Waterlines l U Scale of drawing shown I U Settled cap depth at / I on scale bar l center and edge of bed Il II jam' Roads/easements/ I I n II II driveways/parking- i Additional Mound Information: l U Sidewall slope II II Critical resource lands l U Endslope width i U Up/downslope bed elevat. (i applicable) l u I II II ( overall fill dimensions l Completed Resource Lands and13" II II I North arrow and scale of l I Critical Areas Checklist ll ll drawing shown on bar I Macr►n cAlIntv ne + u i+a Izapl A PPR OyFn DESIG APPROVAL it Initials II Date II II The undersigned designer u does, U does not, waive the reqirement to be notified by the II installer of the installation and given 48 hour to perform a final inspection prior to ll Q cover. — II II s II II II The undersigned has reviewe and app d this design on behalf of Mason County of Health II II services. II pcor II II CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITIONS:vf II THE DESIGN IS STAMPED -APPROVED" BY MASON COUNTY DEPAARTMENT OF HEALTH SERVICES ll II �/ THE ON-SITE SEWAGE PERMIT HAS NOT EXPIRED; EXPIRATION OF SAID PERMIT IS BASED ON Il THE DATE OF INITIAL SITE INSPECTION, NOT ON THE DATE OF DESIGN APPROVAL ll I) ✓ THE SYSTEM IS INSTALLED BY A CERTIFIED INSTALLER, UNLESS PRIOR AUTHORIZATION IS II II OBTAINED FROM MASON COUNTY DEPARTMENT OF HEALTH SERVICES W 5� -4510 r-)PA1N )1::7f 1,0 :D FOPEPr SLCIE PPOPE TY ADDPE55, PAKGEL PAS GOM111,-15EP NE 24012 MY 3 *12328-32-900f50 13140 /67-/1 AIT 5W ;AELPAIP, WA 98528 5EATTLF,WA 98166 'PrO DETAIL ORl61NAL C-RADt FlNl5/1 GRADt !O' i R�SERD W/6Rh55 � SGftL� 12V"LATtRhL5 GTF)IN VARIOUS LPNGT/i5, lNFlLTRATOR5 24" O O /ZV" l29' iPIPt PIPt INFILTRATORS 3'W/Dt M(P), 24" G`" SffiNU r^ Z"MANIFOLD NOf I SGALt /Z" G, BOTTOM OF BCD BALL VALVt IN PCSTRK;TNt LAYL'R Ih tAGli LATGRAL GI,EANOLT5/N ALL LA7-tRA45 4-/2V'BALL VALVCS i POWtR I-Wr 8-4"OBStRVATION PORr5 1`PROM BUILDING. 7 ON TOTAL#OF OR/Mf-`5 46 GPM 0-3g rlNl.5"GRADE ' INSTALL tFFLLtNT F1LTtRW/IT1 R/StR, I O,PIG/NhL GRhDP O OB5tRVArlm PORr5 SURFhGt RISC RI5tR RCOUIPM PLMP >� ason County Dept. Health Services TNJK OW DING /N57'ALLtR Rt5PON5I9Lt � ED 455 rOP 5?rJ/17/N6 051IR lin5 I98 ON:.St Prr-TN MDPUM PTMK, Initial s ALL r/ 5 I R/5tR5 TO Bt POWtR Wnr,rF!r Date FrrRthrtD 4x6 PoSr use -R 2"rRNSPORr ALL OPfArOu LOW rl-U5t7IN6 T01LfT5 L—T -f .5hn�LLD Of INS77AL4-rt) 6X9 IN A -INRIFOOP'15, �- 7-ANX p 4- 1� �� r 1�'Ot3�1C 1"SL�� JP�15 GOMM.5 1', , 1, -10, 5F/fiTTLE,WA 98/66 � Pl.'O> fpT Y/V pp 55; 125"LRTC,PitL5 CIYP)IN Nf 24012 MY 3 VACIOU5 LC1167ri5. Dlffl-FAIP,WA 98�19-8 I'Ak`G,EL #1Z328 3Z-900�0 r2�"BNB co55 5�cr/oN o�r�Io-MAX. � C>z� INSrN.�CrFwCNr PINl5t16PAPIr A Opl(51NAI C-CAD�iP�SC SCffiIGRCOUIR�D Pullp TA14K rANK TOrAl-#OP OPIMCNor TOScnLt 6PM 2 . IN577N.4CR Pff5PON501.,f rO P 5rWrIN61P15CP UD5 OBSCiPVi1rIDN POiPTS Z"MNJII:Ot D ON 5CPr1G r/WX AND PUMP rN�K. 2O2y /fLL rMIKS 8 n-6MS7-0 BC WAMPrl6rtt: 2"T1PNJ5POK'T P/PC.114.5` GOMM, 55 BUILDING GX9 98 )17r. ` g� PUT rPfA7-CD 4XG P05r FOP OFrNGO BOX W17W TIMfP$COUNTCPP. U5C ALL-OPfNCO � � MitTC1P�N,5 LOW FL U51'IIN6 TOlLfTS 5HOULD Of IN57"f1LLED 7-ANK IN f11-1-PA7-H OO/'75, 0051N I-CWAC)f P1N15116RAVC O,P161N&C7p,4DC iPCSCCDWAX 55 Maso Coun`y GeA. Flea,w Aru+ces IZ„ APPROVED INFILTiP'fioRS 2411 Initials Date IZ„ mr ; O O O O O I2„ 12S" U2 $. I2�" 2'3" P1PC PIPC PIPC PII'C PIPE 611 7 5ANO V NOT ro--XALf GrCNVOUTS IN N L L,hrCPI 5 I2-9"OBSfRVA 1ON POltfi5 jBDTTOMOPBCD PCSrPPK:rNC LAYM * ,DOCT0P5 CLINIC MOVED x�on��T SL�� PI�oP�i�(Y Az�p1� 55, OUT OF PfL- AIP GtfN7,EP PA5 COMM.5jff1P, Nff 24072 HWY 5 1574016771 AVP.5W PfLPAIP,WA 98528 IN AUGU57" 5rAT7-1-P, WA 96166 PA�'G�L #125Z8 3Z-90050 MONTM WA7-f'UStfiGf (CU"'IC FfEr) FEPPUAP' 5862 mlwctl 5741 PUILDING OCCUPANCY APP/L 6204 Cftr Tt115 T/M�> MAY 6145 JUNP 4068 6 PULL T/1"1F fMPL0YfF5 DULY 5207 5 PtiJPr T/M��MPLOYPS AUC-7U5T 2951 5PPT Iff/lo 1;' 2040 OG7-00FP 5445 NOV,ffMnPp 2426 TOrAL-58087 GP 5INGjE AUGUST X 1,48 284890,16 4a1, 7-07-itL-10862 GP X 1,48 254890,76/10-28489,08 gallmonth 8124776 qal 28489,08/50-949,64 4d/day 81247,76/4-20511,94 40070nth 7-07 AL-- 20311,94/-50s6-77,06 oVday TOTAL— 677,06 qal/day 7-MT UOCTOPS CLINIC WI5 USING A1-07-OF ffXTPA WATEP WITM 7"MTIP X-PAY MAGMINf, TMjffS,ff WA7-,EP USING MAGMINr5 WILL NOT Of APL TO Of U5ETU AGAIN AT-TM1513UILUING WITMOUT PiffP1155/ON OF OfSIG EP AND MA-,50N COUNTY 11,EAL7-M 7-t1fPf WILL Of N GOOKING OF F00P5 OIL PPffPAPING OF ANY F00C,)5 IN 7-Ml5PUILUING Af ANY 7-111E 07-HE '7 AN PF 50NAL- U5f FPOM EMPLOYEES, MANAGEP l5 TO ttSX jfACM TENANT APOU7-AW WA7-jffP U5/NG MftCMIN,ES WMEN PEN7-IN6, F TMEIPE APE ANY QUE57-ION5 TMAN TMT Df5IGNEP OP MA50N COUNTY MEtfLTM UEPAP7"MENTSMOUk O GONT/�G7" U, ason County Deft. Hea'th `'ert,'res APPROVED Initials_ Date f�OD J�r SL PPOf FPTY ADDJCjff55; PA5 COMM,51ffP Nf 24072 t A/Vy 3 13740167 tt AVE 5W DEL1=A/F,WA 98528 StfATrL ,WA 98/66 PA�i'G�L -#J2328-32-90050 24 MOUp PEP100 DAY WA7-fP USAGE WED 1124196 175 GF X 1,48 - 1309 qal rt9UJP 1/25/96 136 G>"X 7,48 - 1017.28 qal rp/ 1126196 112 GP X 1,48 =837,76 al NSW WAr,EP 5AVIN6 MON 2/12/96 53 GF X 1,48 -396,44 qal >=IXrUPE IN5rAL1-rD rUf 2/13/96 64 GP X 748 =478,72 qal wro 2/14/96 79 GP x 1,48 - 590,92 qaf 1�UILDINC� OGGU�ffiNGY r1lv1C' 2/15/96 67 GFX 7,48 = 501,16 CIO/ (Ar r17`l5 TIM�� MON 2/19/96 43 G1=x 7,48 -321,64 qal rUf 2/20/96 67 GP X 1,48 501,16 qa/ 6 FULL rll"lf ffMPL.OYlfffS WED 2121196 95 GP X 1,48 710,6 qal 5 PAIPr rIMff 1-lPL.0YffES rt>UP 9/22196 83 GP X 7,48 -62084 qal FP/ 2125196 101 G1=X 7,48 -755,48 gol 7-07-AL- 1075 GP 8041 qa/ 804/qal oU5INjff55 MOUpS f99484 qal 0AY WA7-f U-,5AGf 9053 84 qa/ MON 2/I2/96 47 GP X 7,48 =351,56 al rUf 2/13/96 59 GP x 1,48 -44132 al 905384 qal \ 13 days 695,06 gal/day WED 2/14/96 77 GF x 1,48 - 575,96 a/ 2/l5/96 65 GF X 1,48 -411,24 gal *FPI 2/16/96 133 GI'x 1,48 =994,84 401 rOrAL=379 G>= 2834,92 qal MUST Of ADDED 7-0 24 t>OUP PE1'100 7-0 GOMPLfrff rnAr WjfffK DAY TIME WATEP PEADING (GU3IG FEET) rUf //23/96 6;00 PM 221221 WED 1/24/96 8;00 PM 221402 r19U1Z 1/25/96 7;00 PM 227538 PPP 1/26/96 7:30 PM 221650 MON 2/12/96 8;00 AM 228750 MON 2112196 8;50 PM 228197 rUE 2/13/96 8;00 AM 228803 TUf 2/13/96 7;45 PM 228862 WfO 2114196 8,40 AM 228861 PU51NE55110UiP WtfD 2114196 8;01 PM 228944 K�ADlN65 7-hU3P 2/15/96 8;00 AM 228946 771UP 2/15/96 8;00 PM 229009 FP/ 2/16/96 8;00 AM 229013 2/16/96 9;00 PM ZZ 4 MON 2/19/96 8;00 AM 229174 rUF 2120196 6;30 AM 229217 WED 2/21/96 8;00 AM 229284 T»UlP 2/22-/96 8,00 AM 229379 FP1 2/23/96 7;30 AM 229462 5Ar 2-/24/96 8;00 AM 229563 o� PODFPT SLFF PPOPFP'T)'AtDD3�'F55: 1ZA15 G0/ 5FP, NF 24072/1WY 3 13 I4o 167-tl/tViff,5W WA 98528 / 5FA I TLF,WA 98/66 PA k'GFL i P/Rr WhTrR MrrfP #1Z3Z8-3Z-90050 mDRhNr Pox ttr PFc P' -20' Z'l ROM 1 GAI� PROP. 0` �4 UNC, 1/8 OPIFlGFS AT 12 O'CLOCK n'S0U1PT DAYUGIfi GFPTIFIFD INSTAtLLFP ONLY, 4"DOWN SPOUT . O 1FR0/M 99 GZ� UNr 12�' rhFPF 15 ro or No w11FFL PROP, VFP1/GLF 771VTIG ON OPIt1N UNC, FIFLD MTA OfFOPF OP D /tPTFP INSTA l-f-ArloN, TRrCs INRILMArORs AU L TANK5 ff Pl5FP5 TO PC PC Cxlt wroc MP) WhrFP TI611T. DOWN lNf ILTKitT'OR'5 3 W/Dr mr) \\\\\\ I I v Ala C�Or s)IN VAOO sc��rn P'1 1 I I I Fill N PPOPFPTY OWNFP PF5PON51PLF 25- �"DOWN SPOUT ' V P N FOP PPOPFPTY UNFS,DF5/CGNFP Vcn l5 NOT h GFPTIFIFD SUPVFYOP. l2 ��rLL I III I Z"MANIPOL, O I vnLvr IN Z0 1 F15FP TO Of 1N5TAtLl.,FD ON PUMP C \\\,� I I I TANK UP TO 5U9FiiGF I O I L Z"M�vv�roLD '!�c 1`W/DF 7-PFNG11 ON FAST 51DE LDlNC6 GONTAUNlN6 OF DUI \\ DOWN SPOUT LINF g TPAtNSPOPT LINF, 1NPI1.7'Rh7'OR5 DO NOT,PFMOVF ANY 501L FPOM I OPIVN FIFLD IWM, 2"rRNVSPORr WATER'LINF TO Pf AT LFAtSr/0' FPOM DPAVN FIFLD TPFNGt1F5, lF NOT MUST PF DOUPLF 5LFFVFD. rw r wror rR s� c^' FX15TlNG SFPTIG TANK GLFAtNO � ��'1� � TO Pr PFMOVFD, 100,00 Z"rRNvsPORr ° 50/L 1-065 P,T, PIPL 163,�' 3200 GAL_ 4"DOWN SPOUT"5 SFPTIG ° PIPS TANK o 0P5FPVA7-)ON POPrS 1600 6AL, POWER PDX i �� 1�0l�E1PT SLEE PJPOPEIPTY/iDD1PE55: RffiS GOMM.5EP NE 24072 MY 3 13740 /6TYl AVE,5W DELFAIR, WA 98528 �j 5EATTLE,WA 98/66 t'fiRGEL FIRe wnreR MereR #1Z328-32-90050 i rnDRNVT\ /� PDX ' �0) PIPC PRO OM f— SCALE 1/8 O P1F1GE5 AT 12 O'CLOCK D P Ll6r1T G2� \ \ \\ \ \\\ GEKTIFIED lNSTALLEI.'ONLY, 2'FROM 9.7, \\ \, \\`\ 4 1 C. 25 OUT �' T�EPE l5 7-0 DE NO Wt1EEL NO �`: \\ \\\\ VE17/GLE TIPAFFIG ON D1PIVN APEA DEPOPE OAP AFTEP INSTALLATION. INPILTRi MPR 5 AL L 7ANK5 ff�P15EIP5 TO bE of cijr � \.\� \\\\�\�. � �'wipe mP� WATEiP TIQ�4 D INFILTRATORS\ ounty NO, Health Services �\ I y`\ \.` ` ,\, :\\` i I I I!I _ I2V"LnrrPAL5(-aP)/N�►PP p ED 1 , . I,: I f I VARIOU5 LeN6Tl75. I( I \ I2S°LhrMAI-5(TYP)I Ip I m I I I I I Initials 4 VV/OUS LeN6rl75. . . Date FPOPEKTY OWNER 1'E5PON5/DLE 12S"PALL -4 T DOWN 5POL ( VALve/N FOP PiPOPEIPT) UNE5.DE5/6NEP uNe.14���'\ I I I I I I eAcn L nreR _ l5 NOT ACERTIFIED 5Ul'VEY01P, o ! I I \\ ill I 2„MMUFOLD z TAB i I vALVe/N \ i zo2n' P15 TEP PEE INSrAI-LED ONE U' I'1P 'X, \encn 1--7rTFAL\ TANK P TO SURFACE, O P WIDE 7-PENCh ON EA57-510f OF OUILDING CONTIJININ6 x �- \ DOWN SPOUT LINE T-PAM5POPT LINE, DO NOT REMOVE ANY 501L FROM DRAIN FIELD AREA. 2'rRNJ5PORr�` Wl1TER LINE TO PEE�iT LE�iST 10' i 7 \PIPe./63.�, \ \\\ FROM DRAIN FIELD TRENGt1E5, S \ \ \ \\o �' � IF NOT MU- P. PE DOUDLE P Taw - 1r.�5' SWrnRr SLEEVED, PROl7f � (o ! I�TP CROP. /I WIDe rReNcrr �-- e^�" EXISTING SEPTIC 7-ANK TO OE REMOVED, 1='�100 00 2"MM5PORr �� SOIL L065 PIPiff, -'Y 4"DOWN SPOUTS hi i `.�it'f�i PIPE#30�4. ,li -�J SEPTIC �I a/ TAN ;`i� '�, O ODSEPVAT/ON PORTS Powell Lu BOX 2 ' �B� 7t`7-L`� (` .t�E i C a t �✓ �} C 1��� '� ti AS-BUILT FORM - PAGE ONE Revised 12/14/94 it PARCEL IDENTIFICATION II II Applicant's Name ( ad SG��, g_CQq,* c II Permit Number SWG9 - 07/S Subdivision N C Z40 W II (Name ivision oc Lot) II Installer's Name -LIW Assessor's Parcel No. �Z32.4- 3Z- 9005*0 II Designer's Name AL $i9:!L$0 -CIwe ve- igi u er II l� I it INSTALLER CHECKLIST II II N/A Yes Prior to I. SEPTIC TANK Completion II II A) >5 ft from foundation? II II B) Bldg stubout to septic tank: cleanout if not 1-29.? II II C) Baffles intact and clean? II D) Dividing wall intact? II II. D-BOX Leveled with water and/or speed leveler (circle) ? I II. DRAINFIELD A) >10 ft from foundation and >5 ft from property lines? II B) Laterals level to ±1 inch & end caps present if not looped? II C) System dimensions the same as shown on the design? II D) Gravel clean, properly sized, and proper depth? II I� E) PRESSURE SYSTEM II 1) Sand quality ASTM C-33? II II 2) Head height uniform and a24 inches? -7 II II 3) Cleanouts and observation ports present? II 4) Mound: Side slope 3:1? II II 5) Owner informed electrical connections must be made by owner or licensed electrician and inspected by DLI? II II IV. POTABLE WATER LINES II A) >10ft from drainfield? II II B) Wells >100ft from drainfield? V. PUMP/PUMP CHAMBER A) ached for equivalent pump? / II II B) creen basket Jr effluent filte (circle one) installed? II II C) Riser in a ss. D) Alarm installed? • � II �I CERTIFICATION OF INSTALLATION II Ii Inst ler: Check box from Row "A," check box from Row "B," sign and date the certification. II � II II A. I certify that I installed the system u I certify that all deviations from II without any deviation from the design the design stamped "APPROVED" by MCDHS are II II stamped "APPROVED" by MCDHS. shown on the reverse side of this form. II B. U I certify that I contacted the U I did not contact the designer prior II I) designer and left the system open for to final cover because the designer II II inspection up to 48 hrs prior to cover. waived the notification requirement. II II I further certify that all 'nf rmation gfca-tion. ed on this form is accurate. I understand II II that if the information con ai ed ereif accurate, there will be just cause for II II immediate suspension of my nst 11 r e 0,,' II II /Va- slignc-Ture ns a a e II II The undersigned approves thi in 1 tionrof behalf of M7 h son County Department of Health II II services. II e s c or �e II `;'' MON...> AS-BUILT FORM - PAGE TWO Revised 12/14/94 II PARCEL IDENTIFICATION II i Applicant's Name �I Permit Number SWG9 - U !l Subdivision N.0 Z40 Z "utt 3 II II —ZName ivision Sick /Lor—� II II Installer's Name {3 - L� N Z� Assessor's Parcel No. /Z3 24? 3�_7 Cj06rOil it Designer's Name _y, S/" Mwe ve- git Number) l I) AS-BUILT DRAWING II I' 'I II II it AS l'iRL �;CS15tj II it II it Zc" II II 3 ji II jj II II II II II II II II II II II II II j II �I I� CAUTION: Minor adjustments to septic tank location and drainfield orientation made in the field by the installer are generally ac- ceptable to both the department and the designer, but could in certain cases compromise the viability of the system. It is the installer's'responsibility to obtain prior written approval from either the health department or the designer before making any deviations from the design that affect system viability. Any deviations from the approved design must be shown above. it AS-BUILT CHECKLIST l II F , II U Drainfield orientation " Observation port location I__I Undisturbed native soil II II and layout n between trenches II II n u Cleanout location n II u Trench/bed dimensions and I-1 U North arrow II II critical distances within U Manifold placement n II II layout n U Scale of drawing shown II orifice placement on scale bar II LJ D-Box/"T"/"L" location f-1 Lateral placement, with Additional Mound Information II II u Septic tank/pump chamber distances to edge of bed F--i II I) location n U Endslope width �I II u U Location of wells, roads n �� II Location of buildings U overall fill dimensions I� �I ON-SITE SEWAGE SYSTEM SITE EVALUATION AND DISPOSAL PERMIT PERMIT NO. SWG 95- I o7 y MASON'CGUNTY DEPARTMENT OF HEALTH SERVICES C U) i Q m 426 W. CEDAR/ P.O. BOX 1666/SHELTON, WA 98584 Date l l — <_ PHONE (360) 427-9670 Receipt �; Z Amount$ ��l]�9 • U�) � g PHOPERTY �4;G� 1 _�', CHECK APPLICABLE ITEMS �/ CK MAILING ADDRESS: V DAYTIME PHONE: NEW SYSTEM o �(_ l-1�A !t A T F1t2 P X SO SD A L!b w(!4 U M REPAIR SYSTEM � `:; CITY: STATE: ZIP: MAINTENANCE REVIEW LA�� 03 SINGLE FAMILY m PROPERTY ADDRESS: OTHER SPECIFY: � Z SPECIFIC DIRECTIONS F R LOCATING SI PRIVATE WELL (E m COMMUNITY WELL/PUBLIC SYSTEM SYSTEM WFI# _r SYSTEM NAME 5 APPLICANT NAME f A f S Sr-ro'ce-s- Name of Lot 1y5,21 X 80 ft. x I ZoiX 160�ft. MAILINGADDRESS,25G wtil< (ill Installer i C-11 fi'o Size: acres TELEPHONE 83 o Name of Number of SIGNATURE o Desigae Bedrooms 0 ix I PLOT PLAN gE A7rAC4A C_:D (_t93C 0_I71 I Iul IN Draw a dimensional plot plan, including: W xrA � 2 0 w Precise location of test D holes,showing T 0 6 J — (© measured distances to property boundaries. IC) gEntry road;` _driveways. other roads, HEALTH SERVICES ; I�' NOTE: DO NOT DRAW IN 1 SYSTEM DESIGN OFFICIAL USE ONLY. DO NOT WRITE BELOW_P9K L1 1_-�__t SOIL LO C� wed. r V6 f3 s � 3q- 4 W_�r 0` from Orig a[ 5 . Gra a to Restrictive p Layer or Water Table: In. DESIGNER DESIGNATION SCORES MINIMUM SY EM REQUIREMENTS Finding FS—co-r-e-1 Designer Level: ❑One Qi?wo Soil Type ( tom. Septic Tank Daily Vertical Separation in. Capacity: Gal. Flow: GPD Slope 0 Appl. Infilt. Parcel Size Ac. Rate �.O? GPD/FTZ Area FT2 Distance to Shoreline t. Q Total Insp for Date Mj 1� Y ` - CO ENTS/CONDI FOR APPROVAL ' )t am 0 a i ' ^ -M I Ij- A 6�w, •All septic systems must be designed and installed by contractors certified by Mason County Department of Health Services, les nor raapproval is granted by the department,or the design is by a professional engineer. �c1 •Septic permit approval does not imply other building site requirements (i.e. RLC,Water Adequacy) have been met. •Any change from the specified use of the property or any site alteration affecting the system design may invalidate this permit. •This permit expires 2 years from the date of site review. Denial of this permit may be appealed to the Health Officer within 10 days of denial date. SITE R VI - ESIGP RftlEW:Li Approved _j Not A'ppro`�d INSTALLATION:❑Ap oved% ❑Not Approved BY: DATE: BY:c DATE:J' BY: DAT gG TOP: Health Dept. Copy DLE: Designer's Copy BOTTOM: Applicant's Copy � �. 1 \ "! f .. .. ., . 4 .