HomeMy WebLinkAboutSWG2004-00425 - SWG Application / Design / As-Built - 8/5/2004 a0µ
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MASON COUOY•DEPARTMENT OF HEALTH SERVICES PERMIT NO. SWG
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426 W. CEDAR/P.O. BOX 1666/SHELTON, WA 98584 Date j)(/
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PHONE (360) 427-9670 Receipt No. / ? y
Amount$ fraroo
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PROPERTY OWNER: DATE: m
0 S A N CHECK APPLICABLE ITEM S
MAILING DDRESS: DAYTIME PHONE: NEW SYSTEM p
b• 3 ,. -17_ 0 REPAIR SYSTEM
CITY: STATE: ZIP: TABLE 6REPAIR
/3f2 L'711 TUN WA_ 9r3/ 2- MAINTENANCE REVIEW m
PROPERTY ADDRESS: SINGLE FAMILY Z
aLpc wspitk+aD OTHER: 3
SPECIFIC DIRECTIONS FOR LOCATING SITE: PRIVATE WELL Q
ULh ULT:Xte I L -W r-� d. rb COMMUNITY WELUPUBLICSYSTE
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SYSTEM NAME L72f C 5 uAj /.�.
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Atr+t o //(�,9 ft.x ft. MAILING A DRE
Installer 9
SO• SH-peG CA • Size: /, �ELFkf
Name of,��C e , acres TELEPHONE` -
Designer �U /�u�ON um er o SIGNATURE 2 3U L. ruS L o
Bedrooms X e —
OFFICIAL USE ONLY BELOW THIS LINE
DEPARTMENTAL SOIL LOGS DEPARTMENTAL COMMENTS/CONDITIONS
0
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SOIL TEXTURE CODES:
V
V=Very G=gravelly S=sand L=loam Si=silt C=clay E=Extremely
IN PECTOR(printnme ECTIO I ATURE _6/ D,E PER ITEXPIRATIOND TE
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CC /3/ 2/ . 5.a-- 3 2CO
•All systems require ongoing Op ration and Maintenance(O&M)as specifie in Mason County On-Site Standards.
•All on-site sewage systems must be designed by a Mason County Certifie Designer or a Professional Engineer, unless prior approval is granted otherwise
•All on-site sewage systems must be installed by a Mason County Certified Installer,unless prior approval is granted otherwise. In such cases a preliminary on-site
meeting between health department staff and the homeowner is required.
•On-site sewage system design 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 3 yews from the date of site review.Denial of this oermit may be appealed to the Health Officer within 10 days of denial date.
D REVIEW RO BY: DAyyE: INST TION APPR ED DA E:
TOP: Health Dept. Copy MIDDLE: Designer's Copy BOTTOM: Ap licant's Copy
MASON COUNTY
DEPARTMENT OF HEALTH SERVICES
August 17, 2004 PO BOX 1666 SHELTON, W 98584
SHELTON (360)427-9670
FAX (360)427-7798
Arrow Construction ELMA (360)482-5269
230 E Warren DR BELFAIR (360) Z 5-4467
Union WA 98592 SEATTLE (206) 464-6968
RE: Design for BODDY
Case No: SWG2004-00425
Parcel No: 223047690130
Your design for the above referenced parcel has been review and is APPROVED.
Please refer to the comments section of this letter for any additional informatiorl.
Please call me at (360) 427-9670, ext. 279 if you have any questions.
Sincerely,
la' 4�
Amanda Reynolds
Environmental Health
Mason County Health Services
COMMENTS:
8/17/2004 1 of 1 SWG200 -00425
pESIGN FORM- PAGE ONE
4,1999
A designWill be reviewed when$mjgg of each of the following Rams are submitted: '1S bV 3:) - VTr
aowaWntwi� ms�on�e t VAL s�� Nwi�P s an
M3a
7thWftAddrew:
r: SWI) 2c" -po 1}2- Designar's Name:
Designees Phone M: -
e: Da/cs!y/ Assessor's Petrel No.: ,7a VA1 7G O
/ / 9*dve-)i tNmmber)
/ 7 Subdivision:
CRY sea ZIP (N
Roam
/' Treatment Device
O (i On.BioBka Copy O Sand Filter O Mound O Sa=Linedld
ice+,A/anbic Unit-MakeJMod1el:/ d A2 krL: =_%L— TQj EMisinfection Unit - MaketModel:
Drainfield Type
Praaem e
IIIci<avity WTreench p
Septic TanWDreinflekl Specficatlons pR�i � I s
N1mberofBedrooms 3 Schedule/Class{,G �i 04
Daffy Flow Length
�o
Septic Tank Capacity NJ = 9 0 — O Diameter
Ratbivlsg Soil Type(1-6) c� Number
Receiving SOB Appl.Rate _ �— Separation
Raptired Square Footage UIR
(coo ft2
Designed Square Footage 600 ftr Orifices
Parent Reduction Taken _ e/, Total Numbe of orifices #6
Trench/Bed Width 3 ft Diameter bin
Tranch/Bed Length A nil ft Spacing e
Elevation Measurements Manifold
Original Drainfi Area Slope sy Sche�e/C�
Now Slope Allesed
/ Length CA F5L
Diameter Va in
—
Depth of Excavation from 1.2 in Preferrod Manifold Configuration Used? ®Yes ❑No
Original tirade (U"f?pe)
�/ ;a Transport Pip$
(Down-slope) Sqffeduleglass +f 0
Designed Vertical Separation / in _
Diameter
Uravellew Chambers Required? O Yes Mo ❑Optional Dosing and Pump Chamber
Pump Required? 0 Yes ❑No Number of Dosesmay
Pump/Siphon Specifications Dose Quantity
Chamber Capecity /Doc.
Orifice: gal
Diffumce in Elevation Between Pump Shutoff and Uppermost ft Pump Controls: Timer(or)Elapse Time Meta /I Nrequirod)
If Thow. Pump On .Pump
Uppamoat Orifice is❑Highs, O Lower than Shutoff Check me following ponents if may drain een doses:
Capadty®Torsi Pressure Head o2 0 �Letatals RManifold ❑Thaspoll
Qsla��0ed Total Pressure Headld'.3,5j 2./8 ft
Attach Pump Curve)
aS a2 E1?6( a Pam
PAc r OFJ--PA(;RS AUG 05 20
DESIGN FORM-PAGE TWO Revhea A4ra 24,1998
7ZScaledot Plan Scaled Layout Sketch Cross-Section 3 etch
locations I�Drainfield orientation and layout Refe��'enced depth firom original grade:
Imes if iQ /bed dimensions and critical 0--Septic tank lid and infield cover
O Existing and proposed wells within distances within layout depth
00 R of property lines O D-Hoxf'TY"L"locations
El Critical distance measurements to cuts, /Septic tank/pump chamber location Reference depth from riginal grade
banks,and surface water iJ Observation port location and restrictive strata:
O'Lecadon and orientation of curtain Gr�Cleaa-out location 0"Laterals,trench/bed I Dp and bottom
drain and all absorption components d Manifold placement O Curtain dram toll r
O"Location and dimension of primary Cr Orifice placement O Sand augmentation
,,system and reserve area 0�Lateral placcment,with distances to
13 uiidings edge of bed Other cross-section de
Direction of slope indicator �/�udibldvisual alarm referenced O Observation ports clean-outs
0'Waterlines : Scate of drawing shown on scale bar
t(Roads/easements/driveways/
parking s e
f xmcal resource lends(if applicable)
Ir North arrow and scale of drawing i w
shown on scale bar
�' tp Additional information
t rgn staked out o
�' o, �•C. 0 SON,;y SOperation and Maim ance Notice
ED DE GNER . Attached
RES O Waiver(s)Attached
The undersigned designer does, ❑does not,waive the requirement to be notified by the installer of the installatioi and given 48
hours to perform a final inspection prior to cover
v fj
i fIginer,the undersigned has reviewed this design half of Mepartmen f Health Services and determined't to be in
compliance with state and local on-site regulations: /
`6!/6(oy
Environmental Health S ist Date
Caution: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING ODNDMON:
d The design is stamped*Approved*by Mason County Department of Health S ices.
d The On-site Sewage Permit has not expired,the Permit Expiration Date Is: u u5-� 13 Zco 7
./ The system is installed by a certified installer,unless prior authorization is obtain from Mason County .
Department of Health Services.
Drainfleld site conditions have not been altered to adversely affect conditions of design vat
Jul 19 04 06: 16a Richard Moore 360-426-9673 P. 1
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--��� - FKL S DITCH o
O=OBSERVATION PORTS--TO BE 4 " G' DETAIL
PVC PIPE FROM BOTTOM OF TRENCH CLEAN OUT
TO FINISHED GRADE. REMOVABLE •
CAP SHALL BE INSTALLED ON NOTE, CLEANOUT TO BE FROM 0 TO 6
OBSERVATION PORT PIPE. GLUED ON INCHES BELOW FINISHED GRADE.
TEE AT BOTTOM. MARK ENDS WITH REBAR. LEAN OUT
MINIMUM OF `� IN SYSTEM. REQUIRED AT END OF EACH LATERAL. ,
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,/ 5 2004 PIPE 5
PAGE nr PACES
DETERMINE THE TOTAL DYNAMIC HEAD:
Selected residual pressum: 2.00 R.
"4-'TranaP0rl PiPe friction losscss: .7S n•
Line# I S"a n. ......... AVn.
Line#2 6/' n,,,,,,,••,• 3, it.
Line w3`76 _n........... .3g n.
Line Ay_ 7 9 n............ n.
Line k3VE
fl............. n,
Tolal elevation li ................
TOTAL DYNAMIC HEAD:...... 9,/k rr• 4
� ; bZD
SECURED LID WIT"OAS TION7 SEAL
xA lTER THRE40 DED UNION
FINISH OMAN RISER
u 4wo SERVICE
VALVE
FROM C {A K
a e�
• �y TO ORAINFIELO
"EMENCY STORAGE
WON WATER AuKM LEVEL -- ANTI SIPHON
VALVE
NORMAL TIMER OFF WMKINO VOLUME
LEVEL — — — INCEPENOENT
FLOAT STEM
f R FLOAT
db M UNTINO
CHE K VALVE
aEDIMENTa
SUB ERSIBLE
CE IFUOAL
PUMP` [�rau � I lump
,1�•,Y mceica� p�a�►� ot�
AS NEEDED
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I 1 ENGINEERING DETAILS -
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,PAGE 7OFrpwps AUG' 0 ZU04
d'' C*Aq&WL Add jI!W
NORWECO Pretreatment with Chlorination & De-Chlorinatio
INSTALLATION/MAINTENAN C E
Pressure Distribution Systems
I. Instal Laterals with contour of the ground.
2. Instal bench bottoms level.
3. Instal bcelm tape or rabar on top of all drainfield laterals.
,. Install observation polls as Indicated on.the plot plan (minimum-two per
drakNkld with bottom extending to the drainrock/native soil interface). Glue "T'
to bottom a removable cap.
5. Install drainfield during dry weather and soil conditions, any soil smearing must
be elmbeled by hand raking.
6. Instal threaded dean-outs at the end of all laterals (cap must exter d to within
six Inches of finished grade and be marked with locator tape or reb r).
7. Install audiovisual high water alarm. Redundant off switch not r quired.
9. Instal check vaMe in pump outlet line to prevent system from drainii ig back into
the chamber.
10. Tee to Tee constnktlon between laterals and manifold with orifices oriented at
6 O'clock. Install laterals to the manifold with the orifices at 12 O'clock, (do not
glue), after pressure test and Health Dept. approval, turn orifices down (6
O'clock) and glue laterals to manifold.
11. Filter fabric required over drain rock prior to backfilling. If the drain lock
extends above natural grade, run the filter fabric at least 2 inches dc wn the
trench wall.
12. Encase all water lines within 10' of drainfield area.
13. Div" aN storm water run-off away from on-site sewage system.
14. No crsW drains allowed within I of the up-slope edge or 30' of th a down-
s" edge of the drainfield and reserve area.
15. No vehicular trait over draintleid area.
16. Norweco Guidance Manual has been provided for the owner.
17. Inspect floats and test high water alarm every 6-12,months as needed.
18. All materials and workmanship must meet County and state regulatio s.
19. Deviation from this design without prior approval from the Designer a id Mason
County Health Department will make this design null and void.
20. All manhole lids and access, sampling, or inspection ports must have locking
covers and located at ground level.
21. All pressure systems with pump chamber higher than drainfield must have a
1/8" hole drilled in the discharge pipe above the pump to prevent siphoning.
22 . All transport lines under driveways must be encased to prevent
crushing.
g� AUG U5 " UU4
PAGF, OF F% PWTS
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3�:(�rD• qi RES. V
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LAK PI0C-1 02 - AUG 0 5 2004
t''C. rS. ..r't.: ��! .e�q1.:n`,mot:'+ r s.: .$t.� 'h•\`. n-'r' �i '.:•l�.e .'��.' ;1 ;t •?.' •.fit
Dom Called In:• is -aa altar:
'5mo: cf.' 'f`1 Swa#:
Ida tTc)hh god,/, P#Ad#:
". 1108 down«: _ h n P(d,� Site Address:1P Gravity --
0 Sand81ter
' I';eaeure 0 ATUftWidary Filter
❑ l� 0 Glet don Bioster
❑ sub-&Ufi a Drip
Impecdon schddnim(check one): YES ❑ N
Oi�fi6aT(dreekoaw): 1.YBS.': ❑ N
• Stafflaitiata: -"., •• ".. '
Date: Tmne:
:.
L batldiag Ixrsent? [] Q NO
Doer memory gaff depth apparrw lava boon alined simc dosiga approval? G ❑ NO
.SyNem appeals to lbooa los6eliaddodor aaitabia iarff aaoo��tme canes? ❑ [1 'NO
System beensiaed/ooasdnctadtnprevaafwrlh6dgrnpmdwateria8ltmtiea? Q. 11 NO
ffgravd andforipeo saod'bas been used,is it dens and of proper zWprada? 11 NO
Bm all horizontal setbul:s been maintained?
Disponrrl 100'f vw well swfaa water? ❑ 4 NO
TW*&Trvvvpwt/Fik=50'from weW urfaoe water?
Rdve waivers been applied fart ❑ t7 Net:
If so,ha*all.wahwoduriabeen met?'
Asstbe system(loyeutA o eta.)been i as••pa design? —0 YJ S 0 NO . .
KNOT,Las designer ooncuffed with d ?- ❑ YM NO
❑ -11 NO.
YIN Tank idet1bud t appear to be vxberd&? YIN Risers to grade&Wear W ?
YIN Lids secomiHoutractor Please aecarre .
lids! -
:wY:.:.. '..w.r..r.y.s ..�. :.� Vr„t'+:nJl.w.0.'J.Nt-. •..:w..:",nr+i...yH.. '.^.;:�
YIN . --Cleanout)nstalled? YIN Pump adblock or is vaiilCl" '"'" "
YIN BaiBes intact with adequate clearance for inlet pipe? Y I.N Discharge'line as per deign( valves,do)?
YIN Outlet filter as per dcdp and aocesslble? YIN Fleet position corM for dosing to preveat hang
Y/N Outlet Piping sufficiently slaAized to prevent ape?
nettling? YIN Floats on separate true,not 9WAea to dischaw?
YIN 'Inner,l?TL►1i,Counter prasart if ' ? .
YIN lino correct It installed
YIN Laftd&orffioe plimno/ebieldiog as per rfsmd Wff I=a Pow Welk
design? Y/N Lid of pmW well rated'!
YIN Sgakt height uni6rm and adagmte for orifice YIN Dieoha fe line m per design(chwk%U vdve%de.)?
do?. YIN Mod poddou owed fordoft&topwWhmg-cps'!
YIN Cbmarts present,amosO.lo and mdmed Y./N Flosls on separate tree,not dMohed to dbchu®e?
propeelyT YIN Find level prevetfe bottom of filter emd fi m fioo&W
Y/N Obmvelon psis to props depths and
YIN Air coil if Wooffied on dWp? L OfPmp Flaat:
Y/N Fsmp floe momded to flod tree Sin below wider drain pipes?
YIN 7Yerdma doa k Fund? YIN DisiofeWm mh pieseat sad as Pet'design 'I I,
YIN wamppaustobeinstalladconvoW
3
YIN D Box aooessffi1e ftm fleshed grade? Y/N ' width&kno owed?
YIN Speed lerda wed? . YIN Latetwnw9&=pareton'adeig"d
YIN g.1azwater4maled?. YIN 1Ye &MW bo#ms appow kwd'vad k coot=?
YIN Lataalpipediemetedola coined? . YIN lapalidepthooaed?
1C/N ae and Y/N "Orave0mclvmbers 'ifreaskedondemlam&
YIN Prdaaedmdfolddooflgareieaneed? YIN Mamadpaelasapar design md"dwred?
TIN Maidfoldlasgthconed? YIN Tmmhmid wim&knoconed?
YIN Vdwbazfu MMUMidaocam ble.8omea&ae? YIN Iaberminim" adeRmalsR . "
YIN LtbaalpipadhmcfimW =coneot? YIN TrmehedBod Wm 1*4mdinaoatom.?
Y/N I Orl6oespaoing/diamMwoonvcV YIN ltmohdv&coned?
YIN I Orffiaodddds if an ? TIN (iYavelles dmobaa iffeaukedan4101W
'. isadd%ttoato ormire daaWA YIN rplinimamfi am. + .gmitibedto. slope
YIN Side elope 3:1 edge?
YIN Asoudd oonshveted papa liculw to slope&m YIN Monitariag poets to,savdt m&mff ide.dm=p wCW
coatour?
YIN co&rol pand a'Gleadon'audwriaed panel? YIN 8tamd pipes pewee an&aoobsdble fiaa[sa&oe?
YIN Shape mdiquotae Oar dedgo? YIN N" >S%is wnon
YIN , Li g=footage of smd areas coned? Do not walk on(Glendad
Comments:
Ire audasigsed honviewedlidsimAMMmandyaMmOmflaftge a belalt'of Masora Couay DgmWient ofHod&Savim:
laitemint slpatmet Dam
AS-B T FORM RsvbW Leug4.1999
Applicant r l k C,s - �� �i#
Permit Number SWW2 i - O
O l ey are unaq
Installer (MarrrslD� ��,
Designer
To✓ T ;In,<ogn
MIA Yes P to Cootple M
I. SEPTICTANK ❑ ❑
A) >5 ft.From famdstiun?.......................................... ❑ ❑
B) >50 ft fttmr wells and surlsce water'l ............................... ❑
C) Bldg stubout to septic tank:clean-out if Mint 1-2a/a? .................... ❑ ❑
D) BatHesintact and ckm? ............................... ----•• O ❑
E) Dividing wall intact?............... .................. ........ ..
.. ❑
F) Risers installed far access? .......... ... - --_---••--- ❑
G) Tank Sin:_ -: _gal.;Manufacture_ —f —
II. A) ix- l/ ❑
A) I.eveld with water? ................ ............ .............. ❑ ❑
B) Speed leveler used? .......... ........ .... ..... .. ....... ...... ...
13
FIELD
III. A) 1 0 ft from foundation and>5 ft from property lines? . ................. 13 ❑
B) >I00 ft from wells and surface water? ............................... ❑ ❑
Q >10 ft tram potable water fires? ................................... ❑ ❑
D) Laterals level to±1 inch&end caps present if sot looped? ............
E) ..
❑
Grsvelkssrhatnbasutthzed? ...............................
F) System dimensions dre same as shown an We design?................... ❑ ❑
G)"Gravel Clan,properly sized,and proper depth? ....................... ❑
H) PaEsarmESmeus ❑ ❑
1) Sand quality ASTM C.33? ............................ ...... (3 ❑
2) Head height uniform and:24 inches? Actual head la:W`-(,r' ... ❑ ❑
3) Clean-0rrts and observation Ports Present? Q ❑
s) IAtieon& side Slope Il? ............ ...............ll.e......
5) owner informed eledrial conMiccfions must be made ... ❑ ❑
by owner or licensed ehxtriciaMi and i by L&I?..... ....
IV. pUllpfP(; IP CHAMBER ❑
A) Sc+gan basket a etHueat filter(Chyle ate)hrsralld? .......... Z ❑❑ 0 .
B) Riser installed for access?.............................. ... 0 O ❑
D) Alarm
installed? ...�................... ........
of Pampmodel
make I/�Ol
t7um6ersize pVb off Flo pump ehm6erdraw-down�_
inches HdghtofPmnP inches .
(1) pump controls Timer(of)Elapsed Time MeW (Circle R knUdledl: lfthma is med:Pomp _—>'�P�—
n, !
16.
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