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HomeMy WebLinkAboutSWG2006-00614 - SWG Application / Design / As-Built - 7/20/2006 'sg 4'. .x x firy§� �6777.11 7 MASON COUNTY DEPARTMENT to w Official use only fA OF HEALTH SERVICES � 1 1� a 0 PERMIT NUMBER: SWG 1 z rp 426 W. CEDAR STREET ;y U� o j PO BOX 1666 DATE RECEIVED: 1 p rp SHELTON,WA 98584 RECEIPT NUMBER: S f (360)427-9670, Ext. 352 m APPLICANT `` DATE CHECK [ CHECK APPLICABLE ITEI S131 m o `n �Ae Q'Pt 7-�/U ' b V XNEW SYSTEM m MAILING ADDRES'6 � 1 S DAYTIME PHONE 0 REPAIR SYSTEM 1 ' .: t�A IO n A,'(! l O TABLE 6 REPAIR S CITY STATE ZIP r� ) O SINGLE FAMILY n r t G W A p J 6/ 0 OTHER Please describe m lJ 7 Z SITE ADDRESS �� Alit �I el o� DRINKING WATER SOURCE 3 3 ll Ih � T�If>,Ir..l it 3 PRIVATE INDIVIDUAL WE IL NAME OF DESIGNER PHONE NUMBER m I/ 0 PRIVATE TWO-PARTY WELL G :7 /MCA MIZ1t O COMMUNITY/PUBLIC WA ER NAME OF INSTALLER SYSTEM rp I L)j SYSTEM WFI#: O I 7 NUMBER OF LOT SIZE: ACRES FT X FT SYSTEM NAME: BEDROOMS . 6I • T Jv5 r SPECIFIC DIRECTIONS FOR LOCATING SITE Gv� r/In1 Sw",t� L a,r Avtad#v� R v Mr Ti,rnJ , s This application is for design approval only. 1 6) An installation permit will be required to install the system. • All systems require ongoing Operation and Maintenance as specified in Mason County Onsite Standards. • All ons#e sewage systems must be designed by a Licensed Onsite Wastewater Designer or Professional Engineer,unless pr Dr approval is granted. 0 1 • A Mason County Certified Installer must install all onsite sewage systems, unless prior approval is granted. • Onsite sewage system design approval does not imply other building site approvals. I • Any change from the specified use of the property or any site alteration affecting the system design may invalidate this perm 1'`I/VVII • This permit expires 3 years from the date of site review.Denial of this permit may be appealed to the Health Officer within 10 lays of denial date. Official use only below this line SOIL LOGS COMMENTS/C NDITIONS I -(a rr /0' `f`/ ' �iG5 &_)W, I "' 5� �ir� `_ 10 Z o — EG - 'ED U %-iAb 2) 6 2* CED 426 SOIL TEXTURE CODES: V =very G=gravelly S=sand L—loam Si=silt C=cclay E=extremely INSPECTO SIGNATURE DATE DESIGN APPROV BY DATE DESIGN EXPIRAT N DATE / / 1 Revised 2/23/2005 White Copy—Health Department Yellow Copy—Designer Pink Cop -Applicant MASON COUNTY DEPARTMENT OF HEALTH SERVICES September 26, 2006 PO BOX 1666 5HELTON, WA 8584 SHELTON (360) 427 9670 FAX (360)427 7798 NET Septic ELMA (360)482 5269 p BELFAIR (360) 275 4467 3933 Balsam Ave NE 5EATTLE (206)464 6968 Olympia WA 98506 RE: Design for WHEELER Case No: SWG2006-00614 Parcel No: 320267800050 Your design for the above referenced parcel has been review and is APPROVE D. Please refer to the comments section of this letter for any additional informatio . Please call me at (360) 427-9670, ext. 547 if you have any questions. Sincerely, Penny Ort Environmental Health Mason County Health Services COMMENTS: Installation permit required prior to installation. The owner , Logan Wheeler, will need to call prior to starting installation activity. preliminary inspection is required once trenches are excavated prior to installing infiltrators. With an owner-provided transit, we will check the level of the trenches. Tanks can be installed prior to this inspection, but it is not required. The final inspection will occur when the system is completed prior to cover. At that time we will the* the tank installation, the piping and the pressure test. 912612006 1 of 1 SWG200 -00614 • MASON COUNTY DEPARTMENT OF HEALTH SERVICES September 08, 2006 PO BOX 1666 SHELTON, WA 8584 SHELTON (360)427 9670 FAX (360) 427 7798 NET Septic ELMA (360)482 5269 P BELFAIR (360) 275 4467 3933 Balsam Ave NE SEATTLE (206)464 6968 Olympia WA 98506 RE: Design for WHEELER Case No: SWG2006-00614 Parcel No: 320267800050 Your design for the above referenced parcel has been reviewed and is NOT APPROVED. It does not meet the requirements or needs additional information. Please see the comments section of this letter for more information. Please call me at (360) 427-9670, ext. 547 if you have any questions. Sincerely, Penny Ofth Environmental Health Mason County Health Services COMMENTS: Ken, This design is approvable once I receive a copy of an O&M recording for the reduced-sized drainfield. I will send you a copy of the f rm via email. 918/2006 11 of 1 SWG20 6-00614 MASON COUNTY DEPARTMENT OF HEALTH SERVICES _... �.__ August 02, 2006 PO BOX 1666 SHELTON, WA 8584 SHELTON (360) 427 9670 FAX (360)427 7798 NET Septic ELMA (360) 482 5269 BELFAIR (360) 275 4467 3933 Balsam Ave NE SEATTLE (206)464 6968 Olympia WA 98506 RE: Design for WHEELER Case No: SWG2006-00614 Parcel No: 320267800050 Your design for the above referenced parcel has been reviewed and is NOT APPROVED. It does not meet the requirements or needs additional information. Please see the comments section of this letter for more information. Please call me at (360) 427-9670, ext. 547 if you have any questions. Sincerely, Penny ;rth Environmental Health Mason County Health Services 8/2/2006 1 of 2 SWG20 -00614 Mason County Envinronmental Health I teview 8/2/2006 Case No.:SWG2006-00614 COMMENTS: Ken, You must submit three complete copies of your design paperwc irk including the Mason County Design Page One & Two. You hav only submitted one Design Form. When you resubmit, please includ a a Design form attached to each of the three copies of your desigr 1. The minimum tank size for a three bedroom system in Mason County is 1200 gal. You show a 1000 gal tank. I agree that the soil type is a loamy sand which has a .8 app ra e resulting in 450 sf absorption area. You can use the .6 app rate but the absorption area is 600 sf, not the 200 sf you report on the c esign form for required and designed square footage. You can take a 40% reduction for installation with infiltrators but you must show 100/o primary and 100% reserve. On the design for the trench length indicates total trench length with in your case would be 38X5 = 190 feet. 8/2/2006 2 of 2 SWG20 6-00614 DESIGN FORM—PAGE ONE I' �/� I 'AAesign will be reviewed when 3 copies of each of the following are submitted: FREV Completed design form that has been signed and dated. Scaled layout sketch,including all applicable tems on checklist Scaled lot plan,including all applicable items on checklist. Cross-section sketch,inclM,all applicable tems on checklist. ^.:-,:�. Permit Number: SWG u — yDDesigner's Name: _ Applicant's Name: L W r •+N�r Designer's Phone Number: KLIJ M I � Mailing Address: ^It � wt E Designer's Address: �•� VA 9 5(� _)7y� Ml1MMeitI"&N City State — Zip r ' to Zip Assessor's Parcel Number: 3 __1. 6 -- 7 -- a 0 Q 5 0 Treatment Device ❑ Glendon Biofilter ❑ Sand Filter ❑ Mound ❑ Sand Lined Drainfield ❑Recirculating Filter,Type: ❑ Aerobic Unit Make/Model ❑Disinfection Unit Make/Model Other: Drainfield Type US' tfrka• tJt ar a twa[ ❑ Gravity Pressure 'KTrench ❑Bed 3 Sub Surface Drip Septic Tank/Drainfield Specifications Laterals Number of Bedrooms I Schedule/Class (� Daily Flow 360 gpd LengtjUCEI+ D Qft Septic Tank Capacity D gal Diameter SL, L � ma, in Receiving Soil T O\� Number Receiving Soil LTH,1 EP 6 gpd/ftz Sepai/Bl►SON 11 COUNTY 3 ft Required SqualF ootage 2 6 2006 6 b0 sftz Orifices ;_i Designed Square Footage 0 % ftZ Total Number of Orifices Percent Reduction Taken PJO % Diameter IF in Trench/Bed Width 3 ft Spacing in Trench/Bed Length •,.. ft Manifold ` �a! Elevation Measurements Schedule/Class Ol !4—S! dvc lbr r1t l Original Drainfield Area Slope 0 tp. % Length I � sf�.4+ PVC 7 1 D � ft New Slope,If Altered S 4•y[ % Diameter y in Depth of Excavation (Up-slope) in U Preferred manifold configuration used? ❑ Yes ❑No from Original Grade (Down-slope) in Transport Pip Designed Vertical Separation in Schedule/Class 2 a PA Gravelless Chambers Required? IRYes ❑No ❑ Optional Length X s ft Pump Required? 15kYes ❑No Diameter Z in Pump/Siphon Specifications Dosing and Pum tuber Difference in Elevation Between Pump Sh toff and Uppermost Number of doses/day Orifice � Ft Dose quantity 15 gal Uppermost Orifice"AHigher ❑ Lower than Pump Shutoff Chamber Capacity 7, gal Capacity @ Total Pressure Head �— gpm Pump controls: Timer(or) Elapse Time Meter Circle if required Calculated Total Pressure Head •L ; ft If Timer: Pump on L41 A ,Purrq. off Comments Vf+ bly�•/I 'f 6 isdaJ�flt�) dir t � n FORM „l �(T i Assessor's Parcel Number:3 L S L ` __7 $ __ O C O s O_ No Permit Number: SWG 'I)ESIF��l`C�E�IQ)43T1, r Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch Test hole locations 1b Drainfield orientation and layout Reference depth from original grade: Soil logs Trenchlbed dimensions and Septic tank Eh critical distances within la out Property lines Y Drainfield cover Vb Existing and proposed wells D-Box/Valve box locations Reference depth from original grade within 100 fit of property Septic tank/pump chamber and restrictive strata: !� Measurements to cuts,banks, and l locations p Laterals,trenchlbed, top and surface water and critical areas l7 Observation port location bottom f Location and orientation of LiJ Clean-out location ��f❑ Curtain drain collector curtain drain and all absorption Manifold placement Z❑ Sand augmentation components GA Orifice placement Other cross-section detail: [M Location and dimension of ib Lateral placement with distance Observation ports/clean-outs primary system and reserve area to edge of bed 14 Buildings Other Information 2 Direction of slope indicator Audible/visual alarm referenced Yes No 1 Scale of drawing shown on scale CJ ❑ Design staked out [A Waterlines bar ❑ &Recorded Notices attached 9 Roads, easements,driveways, ❑ EY Waiver(s) attached JJ parking Cy ❑ Pump curve attached 1S North arrow and scale drawing ❑ WEvaluation of failure shown on scale bar Non-residential justification ❑ It Waste strength ❑ ['1 Flow The undersigned designer ❑ does, does not,waive the requirement to be notified by the installer at time of installation. Signature of Designer Date The undersigned has reviewed this design on behalf of Mason County Department of Health Services and determined it to be in compliance with state and to al on-site regulations: EnvironmFOalVrealth Specialist Date CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION: ✓ The design is stamped "Approved"by Mason County Department of Health Services. ✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: Z/ dN / ✓ Drainfield site conditions have not been altered to adversely affect conditions of design approval. Please Note: The system must be installed by a certified installer, unless prior authorization is obtained from Mason County Department of Health Services. An Installation Permit is required. 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S G.s_ `�.Q.C`. $ 7 5 c a s ^o � � v �� c �n OP• �^ n m 'c' y� � �+ COti � m'�� � � � S rn m rn cd � n ,I`„] A v Ym^ c 01 CM d Sir. c OR F n o 9 N '< 3 R m. m ° c Y ..�. o S 7 o a T 3 m y two A. p D 5'� " , S '+f E4 ^ " 05v3 ke{N 2 no 3 � m E.� � $ e cm rtnH'm •'•,'`9D ao^' ^ ♦ ID �i• .J p �'� �1 v A T M • C � r ' A ' /O A . APPRO ED MC HEALTH' PT - �7 � SEP26206 Z n M r , n NO ori M r *T � • A 00 V OL 'O r 3 • a on AI rn Q n � � ^RJ g V mason uoungruaticmeattn > / Assessor's Parcel# 3Z0z,6 7�� ©r 00�L Permit Number SWG D (Twelve-Digit N unber) Applicant's Name (�cik � Subdivision oc I (Na me/Division/B ock/Lot) Applicant Address 31( installer's Name Ci , State,ZipS E ZY� t, J A,gKw Debi er's Name N/A Yes Pri r to Completion I. SEPTIC TANK >5 ft. From foundation?............................................................. ❑ .g" ❑ >50 ft from wells? ......................................................_........... ❑ g ❑ >50 ft surface water? ............................................................... ❑ ❑ Building stubout to septic tank: cleanout if not 1-2%? ................... ❑ p ❑ Baffles intact and clean?............................................................ ❑ 8 ❑ Dividing wall intact?...............................................................- ❑ ffi ❑ Risers installed for access?....................................................... ❑ Er- ❑ Screen basket or errrac--circle one) ❑ ❑ ❑ Tank size: I Zov gal.; Manufacture: k: s; 11. D-BOX Leveled with water? ........................................................... ©' ❑ ❑ Speed leveler used? ............................................................ H' ❑ ❑ I L DRAINFIELD >10 ft from foundation?....................................................... ❑ �� ❑ >5 ft from property lines and easement lines? ............................ ❑ ❑ > 100 ft from wells?............................................................ ❑ $ ❑ > 100 ft from surface water? ................................................. ❑ -8 ❑ >I0 ft from potable water lines? ............................................. ❑ �' ❑ Laterals level to+1 inch&end caps present if not looped? .............. ❑ ❑ Gravelless chambers utilized? ................................................ ❑ C Gravel clean,properly sized,and proper depth?........................... ❑ j PRESSURE SYSTEMS a� -S� Sand quality ASTM C-33?.......................................... E� ❑ ❑ OP Head height uniform >24 inches? Actual head height ❑ Clean-outs and observation ports present?......................... ❑ ❑ Mound: Side Slope 3:1?............................................. -B' ❑ ❑ Owner informed electrical connections must be made by owner or licensed electrician and inspected by L&I?.............. ❑ IV. PUMP/PUMP CHAMBER Pump make OSQ -0 ; Pump model P t64.-,uQ�zc- ❑ Chamber size (ZOD gal; Manufacture vR 1 S ❑ ❑ ❑ Height of pump off bottom of pump chamber inches Pump chamber draw-down 2,S gallons per inch per tkiwA@ Pump capacity 30 - gallons per minute Pump controls:Timer,Elapsed Ti a Meter,Counter?(Circle all that ,�� �— ❑ apply). If timer: Pump Pump Off Riser installed for access?......................................................... ❑ 'Er ❑ Alarminstalled?........................................................................ ❑ .0� 0 CHECKLIST .; t ,' rr .B"Drainfield& L - 3l Lu ots TrarH,4(ljrS manifold orientation &layout 1�Trench/bed dimensions and S�- --W critical distances within layout 4 peptic/pump tank larsr placement b o.C . a 1:1-10cation of buildings r port cjean-EY—Observatio cation � 2` �e.�spotir clean-out location Location of wells& 1 roads ti`Undisturbed native soil between trenches 1zaa 5At North arrow O 'Lou JAI ���~ t�lTI��R IN Si'LCt.tlYJ y� 1-AT-erCA CP to QG. So* 40 A��tPA�A1d I$ 36 :C9ug 9F. ML,BW. F ?W-A CAUTION"Minor adjustments to septic tank location and drainfield orientation made in the field by the installer are ggenerally acceptable to both the department and the designer but could in certain cases compromise the viability ofthe system. It al the rnsttller's responsibility to obtain prior written approval from either the health department or the designer before making any deviations from the design that affect the system viability. Any deviations from the approved design must be shown above. Installer: Check a box from Row"A"and`B", sign and to the fication A. ❑ I certify that I installed the system without any I certify that all deviations from the design stamped deviation from the design stamped"APPROVED"by 'APPROVED"by MCPH are shown above. B. I certify that I contacted the designer and left the ❑ I did not contact the designer prior to final cover because the system open for inspection up to 48 his prior to cover. designer waived the notification requirement. I further certify that all information contained on this form is accurate. I understand that if the information contained herein is not accurate, there will be just cause for immediate suspension of my installer certification. Si rH Da e The undersigned approves this installation on behalf of Mason County Public Health. Revised January 2008 Environmeecialist Date