HomeMy WebLinkAboutSWG2004-00041 - SWG Application / Design / As-Built - 1/30/2004 t*ta > ** cTfiAC , t` ,� zwaa xi
MASON COUNTY DEPARTMENT OF HEALTH SERVICES PERMIT NO. SWG a C a
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Date
426 W. CEDAR/P.O. BOX 1666/SHELTON, WA 98584 Receipt No. 0 (IT
PHONE (360) 427-9670 Amount$ z
PROPERTY OWNER: DATE: CHECK APPLICABLE ITEM �/ m m
watt t.46.t (Jvl u✓LJIV J,I A) 1-2— o3
NEW SYSTEM 4
IN A�DDRESZU DAYTIME PHONE: REPAIR SYSTEM
CITY: STATE: ZIP: TABLE REPAIR Z m
Ly /1Xy, WA r'/� ��G c/� MAINTENANCE REVIEW
PROPERTY AD R SS: ' p / SINGLE FAMILY C
�_V_r 1 /�fc7ul.- W4,c ICU s ,SG(�L �� OTHER: 3
SPECIFIC DIRECTIONS FOR LOCATING SITE: PRIVATE WELL
X9LAAbi,& Poo, Y RtN 6 ' p '� COMMUNITYWELUPUBLICSYSTEM @\
SYSTEM WFI H
SYSTEM NAME
M a �A. — r'- APPLICANT V
NAME J, - �1
Name of Lot ft.x ft. MAILING ADDRESS 013c3r 14 3jp
t - 49 11 M
Installer Size: s acres TELEPHONE 3 -2 YZ o
Name of um er o SIGNATURE j
Designer a 1ti. i9ruP_ Bedrooms X
OFFICIAL USE ONLY BELOW THIS LINE
T 4 DEPARTMENTAL SOIL LOGS DEPARTMENTAL COMMENTS/CONDITI NS
m F
/ o
U-36 & SL
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SOIL TEXTURE CODES:
V=Very G=gravelly S=sand L=loam Si=silt C=clay E=Extremely
INSPE OR(print n me) / PECTI N SIG E AT PERMIT EXPIRATION ATE
/ AJ 1�Jw'f a...� � U 2 44L2
•All systems requir66ngoing Operation and Maintenance(O&M)as 4pecified in Mason County On-Site Standards.
•All on-site sewage systems must be designed by a Mason County Certified Designer or a Professional Engineer,unless prior approval is granted otherwise
•All on-site sewage systems must a installed by a Mason County Certified Installer,unless prior approval is granted otherwise.In such cases a preliminary on-site
meeting between health departm�t staff and the homeowner is required.
•On-site sewage system design app oval does not imply other building site requirements(i.e. RLC,Water Adequacy) have been met.
•Any change from the specified use f the property or any site alteration affecting the system design may invalidate this permit.
•This permit expires 3 ears from the ate of site review.Denial of this permit may be appealed IQ the He th Officer within 10 da s of denial date.
DES EW AP L BY: ATE: I STAL TION PPR VEp�Y: DATE:
�� U (� ,�
TOP: Health Dept. Copy MIDDLE: Designer's Copy BOTTOM: Applicant's Copy
MASON COUNTY
DEPARTMENT OF HEALTH SERVICES
l .
February 17, 2004 PO BOX 1666 SHELTON,WA 98584
SHELTON (360)42 -9670
FAX (360)42 -7798
Jim Henry ELMA (360)48 -5269
BELFAIR (360) 27 -4467
SEATTLE (206) 46 -6968
RE: Design for MCTURNAL
Case No: SWG2004-00041
Parcel No: 320267800010
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 information.
Please call me at(360) 427-9670, ext. 353 if you have any questions.
Sincerely,
Cindy Waite
Environmental Health
Mason County Health Services
COMMENTS:
2/17/2004 1 of 1 SWG200 -00041
DESIGN FORM- PAGE ONE Re°ised'anua"'`•t9w
A design will be reviewed when a copies of each of the following items are submitted:
g�kd nbt W!n.NwNaNq M nPP1Io'bl° dKems°"�°h°°Wld on k r+M�NWT+11 naa awn d�rod last
Permit Nuhmber. sent _ TI Designer's Name: '
Designers Phone#:
Applicant's Name: G I L L Assessor's Parcel No.: 3 2 0
FlF IASYS m` L rN�aaber)
Mailing Address: 10
2 ov8 Subdivision: Lot m
pLcfn..P�a � `t8,Sa9- (Name/dDi lodd[.ot)
City side zip
Treatment Device
O Glendon BioSher O Sand Filter O Mound O Sand Lined I kainfield
O Aerobic Unit-Make/Modcl• — O Disinfection Unit - Make/Model:
oremfield Type 07D 'JAN 3 0 2004
a Gravity a id, 0 GGra ergs Chambers
Septic Tank/Dreinfield Specifications / Laterals
/ Schedule/Class
Numbs of Bedrooms � Length
Daily Flow BO Diameter Z
Septic Tank Capacity !I Z� cal Number
Receiving Soil Type(1-6) 6p�L Separation
Receiving Soil Appl.Rate 'D2 ft
Required Square Footage Orifices
Designed Square Footage �o ° Total Number of Orifices
Percent Reduction Taken g fft Diameter
Trench/Bed Widtft 7. Cof? ft Spacing
Ttencb/Bed Length
Elevation Measurements Manifold
Schedule/Class
Original Dtainfield Area Slope % Length
New Slope if Altered —__--A* Diameter
Preferred Mani�l 9i
l p Qd V �Yes ❑No
Depth of Excavation from �t
!2 (up-se) MC H� LTi .
Original Grade 10 in re Port Pipe
(Down4tope) Schedule/Class FEB 1 2004
Length
Designed Vertical Separation 2LL Y in Diameter CE'V
Gravelless Chambers Required? ❑Yes ❑No 018ptional Dosing and Pump Chamber
0 Yes ❑No Number of Doses/Day
Pump Required? Dose Quantity
Pump/Siphon Specifications Chamber Capacity cCS
Difference in Elevation Between Pump Shutoff and Uppermost Pump Controls: Timer(or)Elapse Time M (circle If required)
Orifice: 3..!' It If Timer. Pump On Off
uppermost Orifice is , ❑Lower than�iplp Shutoff Check the following components if they between doses:
Capachy®Total presai a Head: V l -WLatenda ❑Manifold
Calculated Total Pressure Head: 1 c°� ft
(Attach Pump Curve)
DESIGN FORM- PAGE TWO F"Ind AMU 24.Ivsa
Scaled Plot Plan Scaled layout Sketch Cross-Seotlor Sketch
e Test hole locations "rainfield orientation and layout Referenced depth f m original grade:
isJ Property lines Sr Trench/bed dimensions and critical ptic tank lid su d drainfield cover
O Existing and proposed wells within distances within layout depth
100 R of property lines (� BoxP`T"PL"locations
13 Critical distance measurements to cuts, ,['J Septic tank/pump chamber location Reference depth from original grade
banks,and surface water j2r/Observation port location and restrictive strati:
l2( Location and orientation of curtain 1�can-out location L�L t3�Caterals,trey top and bottom
in and all absorption componentsanifold placement urtain drain collector
Location and dimension of primary .dice placement O Sand augmentati n
and reserve area t: Lateral placement,with distances to
Huildir edge of bed Othe ross-section etail:
inxxion of slope indicator 8Audible/visual alarm referenced Observation po and clean-outs
aterlines kale of drawing shown on scale bar
Roads/easements/driveways/ C'rus3�ertTon��u". ..�4#►; .,
ttfaEardtioafor�aeaad "'y' 35 •, s.z
trcal resource lands(if applicable)
North arrow and scale of drawing Oa itiWasap acid e
shown on scale bar t •s.: la
f3 ilpstop�atid,�fo. .. c ,:kit..:
Additional Information
Design staked out
Cl Operation and Maintenance Notice
Attached
O Waiver(s)Attach
The undersigned designer-i9rdoes, ❑does not,waive the requirement to be notified by the installer of the instal 3tion and given 48
hours to perform a final inspection prior to cover.
ignature of Designer Date
The undersigned has reviewed this design on behalf of Mason County Department of Health Services and determ' ed it to be in
compliance with state and local on-site reguhuio
:�� cy�" 2-It L11 u
Environmental Health Specialist Date
Gntion: DESIGN APPROVAL IS VAUD ONLY UNDER THE FOLLOWING CONDMON:
✓ The design is stamped"Approved"by Mason County Department of Health Services.
✓ The On-site Sewage Permit has not expired,the Pertnit Expiration Date is:
✓ The system is Installed by a certified installer,unless prior authorization is obtained froi a Mason County
Department of Health Services.
✓ Dtainfield site conditions have not been altered to adversely affect conditions of design approval
JIM HENRY DESIGN SERVICES, INC.
MASON COUNTY ENVIRONMENTAL HEALTH DEPT.
ON-SITE WASTEWATER DISPOSAL SYSTEM
DATE: January 26, 2004
APPLICANT: BILL MCTURNAL
PO BOX 12048
OLYMPIA WA 98508-2048
LEGAL: LOT 1 OF SURVEY 22/23
PARCEL M 320267800010 w�o`�^sNiN�r .FiVTS
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PROJECT DETAILS: ,,,,
NUMBER OF BEDROOMS 4
GALLONS PER DAY(GPD) FLOW 480 GFN5L0
APPLICATION RATE 0.60 1 t�xQ`��5; BSI
DRAINFIELD
-Absorption Area Required 800 SQ.FT
-Trench/Bed Length 268 FT
- Trench/Bed Width 3 FT
DRAINFIELD CROSS SECTION
- Depth to Bottom of Rock 12 INCHES
- Rock Depth Below Pipe 6 INCHES
-Vertical Separation 24 INCHES
-Fill Depth 12INCHES FEB 1 LU
SEPTIC TANK CEW
- Size&Composition 1125 GAL CONCRETE
- New/Existing New
G '
JIM HENRY DESIGN SERVICES, INC.
APPLICANT: BILL MCTURNAL
DATE: January 26,2004
PARCEL #: 320267800010 PRESSURE SYSTEM-4 LATERALS
System Parameters Pressure Calculations
Orifice Size 3116 inches Minimum Orifice Discharge Rate 0.62 gpm
Residual Head at last Orifice 2 feet Total Lateral Length 264 feet
Orifice Spacing 3 feet Number Orifices Lateral 1 22
Number Orifices Lateral 2 22
Number Laterals 4 Number Orifices Lateral 3 22
Lateral 1 Length 66 feet Number Orifices Lateral 4 22
Lateral 2 Length 66 feet Total Discharge Rate 54.56 gpm
Lateral 3 Length 66 feet
Lateral 4 Length 66 feet Friction Loss
Pipe Class 200 Tightline Friction Loss 1.42 feet
Lateral Line Size 2 inches Manifold Friction Loss 2 73 feet
Lateral Elevation 93.5 feet Lateral Friction Loss 0.20 feet
Friction Loss through System 4.35 feet
Manifold Length 70 feet
Manifold Size 2 inches Dynamic Head
Risidual Head at Last Orifice feet
Elevation Difference 3.5 feet Add-on Friction Loss 0. feet
Elevation Difference 3. feet
Tightline Length 240 feet Total Dynamic Head Loss 10.0 feet
Tightline Size 3 inches
Total Discharge Rate 54.5, gpm
Add-on Friction Loss 0.2 feet Total Dynamic Head 10.0 feet
FEB I (pZULA
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Wholesale Products Page:6280-1
Performance I ediatu-Performance Data
Data Gated:kmwry 2001
RPM: 1750 Discharge:2w Solids: 1.1/4'
9 30
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6 M 20
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Capadty-OS.G-P.A1.0 20 40 60 BO 100 120 140
uteroemad 0 2 4 6 8
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SEALED RISERS TO SURFACE y$44 r!
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TO ALARM Z POWER
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4"PVC inspection
Fabric wrapped
-1 I Sw*loam,
12" LAY sand •
z1^ —1
E--Original grade
" Filter fabric
. 0 0 0 0 0 2" PVC Pi
9"9i
0 0 0 a 0 0 0 o a —Drain k
HOLES AT&O'CLOCK
CLASS 200 3116"
2—PVC Pip H01458
36"
2" PVC Perf Pipe Dot a 1
• � _ Not to scale
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LENSED DESIGN
EXPIRES:
oanvoy
Qfe VALVE FMjMX wrsN 0=p7 =
MAYMUMMMVALVH81HA7 SK "ALM
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90 degree wall
dean^Yf OF
JIM HENRY DESIGN SE VICES INC.
PO BOX 14531 TUMWATER.WA 98511 1 ii&BiVi� i
kpmysep8Iyo071JeeoMehtj W"ded.op CUSTOMER:
BILL MCTURNAL
TP/ 320267800010 NUMBER
SIM ADDRESS:
LEGAL
LOT I SURV.22123
Ap�iieant .1 add S II u� .ASsemes
Parcel# 1211L Gl�
PemAtNumber SWG Zook bOoul
installer I.,)j �� l ors I Subdivision igec
Designer ge5,�,n
NIA Yes to Completion
1. SEPTICTANK
A) >5&From foundation?............:..........................
B) . >SO S fromweils and swtfw*waled .............................. _T
c) B14g stalroutto septic toga cicaaout if not 1.2%7 .................
D) BaMmimactsndelean? ....................................... L
B) Dividing wall kdacd.......................................... '
F) Riaasivatslledforaooess? ....:................:..
0) Tank Size. 12oo pL;Manufs*n ti � -5«J
11. D-Box
A) Loveledwithwated ................:......................... —
B) Speedlevderused? ..........:.......................:.......
111. DfwNFiaD
A) >10 f3fiom fotmdxdm sad>5 ft Exam ptupaly linos? ............... 7 --
B) >1008 from wells and surtaeewsta? ......................•......
Q I >10 fifcam.potable water ham?
D) peti e ...........
LdOWAS UTd to±1 inch d cad o" aseaf"loopd?........... _
13) Grifreliess dumbecs utilised? .................................. YL -7
F) System dimensd=Ere some as shown on Ow design?................
Q Gmyd clean,property sized,and proper&pdL7 .........:
>� t'aSvsit;us
1) Sand quality ASM C-33?
.
2) Headhd&unifoan24 d: ladies? Actualhead*A&_S' `_
m - �-
3) Clwaooets end obseavatimpottsp ................- ;✓/�
Monad Side Slope 3A? ..
S� ¢xaer-iofamedelecfriealtooaueetlooswdstLemadeby..
oEmer or licensed elacttldaa sod inspected byLdcIt .............
IV. PUMPIPUMP CNAta ER f
A) Pumpmake H. ronIV�L Pump model SPya —
B) chxn ersiae I Zoo gd; Pw
Q Height ofpump dfbottom of pump dumber 3 inches —'
D) Pump chamber draw-down ? y gaUunspe.riach. .
13) Pump cqlacity . gallons per minute
F) Pump emtrols:Tmer.(or)Mgmd Time Meter (oirole if instaned)
a timer isa .P .......................................
: 10,, rip Cw? ................
. I� _
C}) Screen basket e�oast (drele one)installed? ................ ---
H) Riser installed for accom '—
I) Alarm installed? ........:....................................
W Drainfield&manifold ---
—/micatation &layout
td YYeacLlbed dkiensions
and critical distances
wld&layout
l� Sapttdpump tank
placement.
Rs'i.adionofbandmgs
ffd obaecmonpoR&clean- brill
out location.
fy r. Location of wens do -
`vads
Undisdnbcd native son
betwectmaKhes. o
Na9rarmw 9 y t'_ 100 4leanoe}
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CI1bJr10N:1!]mra9vsdeMsba�pnoY/kbe/no/[ilk'/MddwimgBpaatdehtn�2/ 1awdb7t/ wb0LA _ bbaime4erlmr�t. : b/OMV/C/R/lq/�bmb//tris ri/biiyKie Q' 'a Ifb66isnana b /ppowr nov as
tdioaa� k�`0� ealluicawCori/6oefiaabe�atp�WtafixttlaafMea p .taa/gaaoQAeaiQnct►e
lgstaRw ChecY a bos:fiom Row"A"and B",sign and datethe
MCDM d $ome system w�oat saythat all deviations fiom the design stamped
designOw stampod'ett�tovtID"by "Art &MP by MCDFIS ace aiom .
8. 0 Ioadfyd*I contacted it designer and left 9w Q Ididnotcontact.*.a
system open fer i[Moction up to 48 hrs � final tbva because the
per, 1? to. designerwalvedihe cation
I further certify that sll information contained on 9ils farm is socarate..I tmd"and tiiat the hbfounsd mbloed heroin is not
accarste,tiiero wr716e Just cause fa immodiate suspension ofmy installer.
0
taro o a
The undersigned approves dils installation on behalf of Mason County 0 ealth Services.