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HomeMy WebLinkAboutSWG94-0089 - SWG Application / Design / As-Built - 2/4/1994 MASON COUNTY DEPARTMENT OFF HEALTH SERVICES ' PERMIT NO. SWG — y �- - _ V Date `- y 426 EDAR/ BO 16 HELTON, WA 98584 ° Receipt No. PHONE (206)427-9670 Amount$ Z SD 3 m } �� • r , 4 CHECK APPLICABLE ITEMS ✓ m MAILING R DAYTIME HONE: INSTALLING NEW SYSTEM qB!� REPAIRING OLD SYSTEM (]r EXPANDING SYSTEM w CITY: STATE: ZIP: CJ �' SINGLE FAMILY ER Z PRf PERTY A DRESS: .SU 5-40Nt rr o r I OTM SPECIFY: 3 ( A �' PRIVATE WELL m SPEC C DIRECTIO S VOR LOCATING SITE- PUBLIC PUBLIC SYSTEM SYSTEM ID NUMBE TQ4 i I�lek rt u, , t �' .F SYSTEM NAME r I� APPLICANT h NAME I C Name of Lot 1 L 5��� ft.x 3l ft. MAILING AD ESS U -C Iw Installer J) S— �' Size: . �9 acres TELE HONE V 1 X D I� Name of um er o SIGNA E o O Designer Ao �. Bedrooms X PLOT PLAN lqcck 'I Q Draw a dimensional plot plan, ii including: m U Precise location of test 3a+'t A holes,showing JA I -tj measured distances to property boundaries. (� ❑Entry road;other roads, driveways. FEB 41994 NOTE: DO NOT DRAW IN SYSTEM DESIGN qp OFFICIAL USE ONLY. DO N RITE BELOW DOUBLE LINE. I SOIL LOGS ,----- VA Ui I � � L S-z R� 0-fB ��y sawb � 0- 55 e � � s`a Caen —111 v co"U4 Depth from Original Grade to Restrictive Layer or Water Table: 3q'` In. DESIGNER DESIGNATION SCORES MINIMUM SLXT—W-0�) UIREMENTS Finding Score Designer Level: ❑OneSoil Type 3 wtr t _—� Vertical Separation in. Septic Tan Daily 3(OC) GPD P t Ca acft : I Gal. Flow: Slope (-I ci % Appl. Infilt. Parcel Size 2 Ac. ( S Rate GPD/FT' Area �10() FT' Distance to Shoreline ft. Total Ins actor Date o-6, 2- ^4 COMMENTS/CONDITIONS FOR APPROVAL -Type., l soil "Uir`ca 3�" �-VbL4\ 3-T*L6� a-4 L4 C-33 5,qd 14W 6 �ypr 1 bet o w jA-Q- S tq�b• D"io7A �w e\P-6^ lj S H�1bw 11I, r t�eS/ S. r.cl n w r v4�n�i oh M� )v�esav �t� it��1an _ -t `fir �' I bt 14 2UO is `�4Y -fU I'vrss d So sk ww - IA i �irM Arl �e 3� 4Z n't l4er,4 o•Fhvt, A k- VaEIA ►wof L 4,4 Any chan a from the specified use of the property or any site alteration affecting the system design may invalidate this permit. This Permit expires 3 years from date of she Inspection.Denial of this permit may be appealed to the Health Officer within 10 days of denial date. SITE: q�1,`',ed Design Required ❑Not Approved DESIGN: I*Approved ❑Not Approved INSTALLATION: Approved U Not Approved BY: �j7 DATE:2_fp_gy BY: s� DATE:3�-1 BY. DATE-,?4tYr TOP: Health Dept. Copy MIDDLE: Designer's Copy BOTTOM: A plicanYs Cop MASON COUNTY DEPARTMENT of HEALTH SERVICES Shelton,Washington 98584 (206)427-9670• Belfalr. 275-4467 ENVIRONMENTAL HEALTH PERSONAL HEALTH WATER QUALITY P.O. BOX 1666 303 N. FOURTH P.O. BOX 1666 r MEMORANDUM DATE: �"� " _ 1 TO: l, FROM: RE: Design for Parcel # 321�2-32 -C CR }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} Your design for the above referenced parcel has been reviewed and is APPROVED. 1KYour design for the above referenced lot is NOT APPROVED. It does not meet the requirements or yneed1s- additional information. 'p,Z1 Sol v�eq✓� �-�+ y'�/-I-uc-q �w� — �2 . sit 1 f4 _a A -4 SUr a a 1 DESIGN FORM' - PAGE ONE Rev ie ad 12/283- A design will be reviewed when 3 co `•4 pies of each of the following items are submitted: • Completed design form that has been signed and dated • Completed Resource Lands and Critical Areas Che k`UsE' t • Scaled plot plan, including all applicable items on'checklist } • Scaled layout sketch, including all applicable g'r� �ck�l' • Cross-section sketch, including all applicabl ' •'!L',Ji(J '`p'�j,`•ni nn PARCEL IDENTIFICATION 8 9 4 _ �/ Permit Number c1 °" 'p'u r. Ryl 511�i. lil- DOf%9 �• )`1J Designer' s Name �y QES [Applicant's Name MKkiN)�tS ce�):ST iA Prop. Owner' s Name <tlrue A1 , 4-ptailing Address Tr . (3coi '3S(;, Mailing Address S�iF.l,i(a.) W f151a lit: 4 C lty Bcsca 21p city Sc.+c® zlp Assessor' s Parcel No. •3.1. - `iooc( I Subdivision S'TUNi,P�R)r42 tOr�' 1 S(' N3�u'3 DESIGN PARAMETERS J J / Initials-J . ��-- " pa4Cs 19R'e�-0`t�r t i c a 1 Separation Mound Subsurface Pressure Gravity Bed Trench Septic Tank/Drainfield Specifications No. Bedrooms 3 Pressure Distribution? Yes No Daily Flow (ao gpd iiii ': ii ii ii (If yes, proceed. . . ) Septic Tank Capacity z4a gal Receiving Soil Type (1-6) ( Receiving Soil App1. Rate ( • L gpd/ft2 Laterals Trench/Bed Bottom Area 3 oo ft° Schedule/class 2.UO Trench/Bed Width ,'3 ft Length $I ft Diameter I '/2 in Elevation Measurements Number 2 Orig. Drainfield Area Slope % Separation Final Drainfield Area Slope a $ Orifices Depth of Bottom of Trench/Bed Total Number of Orifices 3 y from Original Grade in Diameter tz 3b%,, in o v.,iope Spacing in Manifold Schedule/Class 2O✓ Length ip ft Pump Required? Yes No Diameter Z•' in (If Y proceed. . . es, ) Transport Pipe Schedule/Class -2c,a Pump/Siphon Specifications Length ft Difference in Elevation Between Pump Shutoff Diameter p in and Uppermost Orifice '�.5� ft Dosing and Pump Chamber k Doses/Day Uppermost Orifice is higher, lower Dose Quantity 180 gal than Pump Shutoff Chamber Capacity ?,0 O gal Capacity @ Tot. Pres. Head '2(�_p(r qpm I Calculated Tot. Pres. Head Ci $' ft j (Attach Pump Curve) DESIGN FORM - PAGE TWO � i, 12/28/93 DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch fJi Reference depth from orig- s�-� Test hole locations l�l Drainfield orientation inal grade: I�rl and layout W Property lines Septic tank lid and I�1 Trench/bed dimensions and drainfield cover depth �A.1 Existing and proposed critical distances within wells within 100 ft layout Reference depth from orig- of property lines inal grade and restrictive ® OV D-Box/"T"/"L" locations strata: Critical distance measurements to cuts, 4a Septic tank/pump chamber ® Laterals, trench/bed banks, surface water locationSa-6 VLvf pLA-0 top and bottom Location and orientation Observation port location w Curtain drain collector of curtain drain and all absorption area ® Cleanout location 91 Sand augmentation components Manifold placement No external reference needed: Location and dimension of primary system and Orifice placement Observation ports and reserve area ® � Lateral placement, with cleanouts Buildings distances to edge of bed Additional mound information: © Direction of slope � Audible/visual alarm El_ Upslope and downslope indicator referenced TJ (^~G{% fill width ® Waterlines Scale of drawing shown Settled cap depth at on scale bar center and edge of bed Roads/easements/ driveways/parking Additional Mound Information: El Sidewall slope Critical resource lands Endslope width 1:1Up/downslope bed elevat. (if applicable) ❑ J'1 overall fill dimensions Completed Resource Lands and 1�1 North arrow and scale of Critical Areas Checklist drawing shown on bar Megnn County Delpt, Health SerVICeS DESIGN APPROVAL The undersigned designer /'does, does not, waive the reqirement to be notified b7the installer of the installation and given 48 hours to perform a final inspection prior cover. 1g^ec�+ra o� D�alg Oscr The undersigned has reviewed and approved this design on behalf of Mason County of Health Services. 1ChYyoctor `�— �� �� o vc. CAUTION: THIS DESIGN IS ONLY VALID IF STAMPED "APPROVED" BY MASON CO. DEPT. OF HEALTH i I� �r -285 2S V � I, PUMP RISER✓E C HpM3tY< (, $1 RESEKVE Ip ot. ru I 4NE F-- 35 -- 7Rv�o5ED µok 5a I 3 GARAGE / E<< I 'r_a I I 3 1, o OJ rl I I A I I � O GoM hurnTy � I I / WECC S�ie i � L/ Mason Couniy ;'.ept. Heult'Serv� es j iu E APPRJVLD� Initials 0. Date 3---'r—� - I I W I I I C. SO v1 570,VE BN.aR P4..4 c£ it PDPT 3 Rom\ — � 1 ,/ KESE1tVE , `150 ELL � THREr1J e`D TfyrUSPaRT 10 O.C. / CAP TyPt-AL o6 F SCA Le' ® NOTE 4LL- 06 PO(<'(5 L GLe"0,,T3 10 YO 316 MWF.KEU L✓TTN Lo:xa'oaC rNre � NO SCAi.e ortiv�rJgL C-,BADE _ EL4-E L MAX �qv �o �— Trte-k%-4 14� fiCiEn Fq(5k�(. Toe Izoo GAL. O pRgjv 9 i LARM FLpa1T TkNCN u fan A!nK}• UZ4gWWervices Lon�LR[Te j APP'1 VED M� FLogT} 24 TPrJK E 33 Sre1Als Pv P Date C LAS5 1 l� sotL o 6 ' Performance Data Pump Characteristics 12 35 Pump/Motor Unit Submersible 10 Manual Models SHEF33MI SHEF33M2 30 Automatic Models SHEF33Al SHEF33A2 m 6 25 -- 'o Horsepower 1/3 E on a Full Load Amps 11.2 5.5 6 =20 Motor Type Shaded Pole(4 Pole) 15 R.P.M. 4 1550 0 Phase 10 2 Voltage 115 230 - Hertz 60 0 0 Temperature 120'F Max.Fluid Temp. Capacity,US GPM 0 5 10 15 20 25 30 NEMA Design A liters/second 0.0 0.5 1.0 1.5 —0 Insulation (lass A cu meters/hr 0 1 2 3 4 5 6 7 Discharge Size II/2"NPT Total Head (feet) 70 15 20 25 30 35 36 Solids Noodling 3/4" 1 33 1 29 25 20 1 15 1 3 1 0 Weight 28 tbs. Power Cord 18/3,S1TW, 10'std. (30'optional) Dimensional Data 3 7/6—'1_____6 518--_ Materials of Construction L All dimensions in inches — `N. 2. Component dimensions Handle Rainless Steal a z/6 may vary+/- 1/8 inch. " 3. Not for construction — Labdcariag Oil Dielectric Oil --- I — purposes unless cendied Motor Housing Cast Iron 3 7/8 DISCHARGE 1 112 NPT 4. Dimensions and weights v`Ii are approximate. Pump Casing Cast Iran 5. We reserve the ngot to Shalt Steel make revtsrons to our - FLOAT products and their spec, Mechanical Seal Faces:Carbon/Ceramic SWITCH - Shalt Seal Seal Body:Anodised Steel flotations without notice 8 r. Floo switch autoina4lC;,tlFVI es Spring:Stainless Steel --�-- — ( Bellows:Bumi models only) (] D m Impeller Engineered Thermoplastiz `/ 1 Initials Upper Bearing Bronze Sleeve Bearing ta 3ns E Lower Bearing Single Row Boll Bearing D,i" Bottom Plate Polyester Coated Steel i 3-96 Fasteners Stainless Steel z Legs Engineered Thermoplastic _ b AURORA/HYDROMATIC Pumps, Inc. 1840 Baney Road, Ashland, Ohio 44805 (419)289-3042 P. O. Box 2003 Shelton, Wash. 98584 -75 " INSTALLATION / MAINTENANCE Pressure Distrisution Systems 1. Install laterals with contour of the ground. 2 . Install trench bottoms level. 3 . Install locator tape on top of all drainfield laterals. 4 . Install observation ports as indicated on the plot plan (minimum - one per drainfield with bottom extending to the rainrock \ native soil interface) . 5 . Install drainfield during dry weather and soil conditions, any soil smearing must be eliminated by hand raking. 6 . Install threaded clean-outs at the ends of all laterals (cap must extend to within 6 inches of finished grade and be marked with locator tape) . 7 . Install audio/visual high water alarm. 8 . Install 1/8 inch mesh non-corrosive pump screen (min. 12 sq. ft. surface area, not to interfere with controls or floats) . 9 . Install check valve in pump outlet line to prevent system from draining back into the pump chamber. 10 . Tee to Tee construction 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 rock extends above natural grade, run the filter fabric at least 2 inches down the trench wall. 12 . Divert all storm water run-off away from on-site sewage system. , 13 . No curtain drains allowed within 10 ft. of the up-slope edge of the drainfield and reserve area. 14 . No curtain drains allowed within 30 ft. of the down-slope edge of the drainfield and reserve area. 15. Have the septic tank and pump chamber pumped or inspected every three to five years. 16 . Inspect and clean pump screen every 6 - 12 months as needed. 17 . Inspect floats and test high water alarm every 6 - 12 months as needed. 18 . All materials and workmanship must meet County and State regulations . 19 . Deviation from this design without prior approval from the Designer and Mason County Health Department will make this design null and void. a FINAL INSPECTION - SEPTIC SYSTEM L r DATE CALLED IN TIME• D q2 INSTALLER: GC�V\ V I APPLICANT/OWNER: CALLER• PHONE # OF CALLER: L SWG#: �__ PARCEL NUMBER:S2 1 52 3 2- 1 0 0 9 _ SUBDIVISON• Division Lot PRESSURE or GRAVITY (Circle one) APPOINTME ogGj Staff Initials _ � `J FINAL INSPECTION SEPTIC SYSTEM CHECK LIST I) SYSTEM TYPE YES NO COMMENTS A) CONVENTIONAL: (TREK ) B) ALTERNATIVE: (MOUND UBSURFA ) �L II) SEPTIC TANK A) > Five Ft. from Foundation - _ B) Foundation-Tank Line Slope: Cleanout provided if not 1-2e _ C) Baffles Intact / Clean J Di Dividing Wall Sealed -mil III) D-BOX A) Water Leveled _ B) Speed Levelers Used IV) FIELD — A) > Ten Ft. from Foundation �L B) > Five Ft. from Property Lines _ _ C) Laterals Level to ± 1 inches D) End Caps Present If Not Looped _ E) Square Footage Adequate F) Gravel Depth Adequate G) Gravel Clean �L — H) PRESSURE SYSTEM 1) Sand Quality ASTM C-33 _ 2) MOUND: Sand Slope 3 to 1 _ 3) .Head Height > 24 inches 4) Cleanouts Present _ 5) Observation Ports Present. J _ V) POTABLE WATER LINES A) > Ten Feet From Field Components or Sleeved J _ B) WELL > 100 Ft. from Field VI) PUMP TANK — A) Screen Installed 1�B3�et / Effluent Filter B) Riser For Access Present — C) Alarm Installed VII) AS BUILT REQUIRED COMMENTS G �ti /7 gnature Of S nitarian Date vised: 10/20/92 �-,a-5--BUILT FORM - PAGE ONE Rw Saod 07/12 PARCEL IDENTIFICATION Permit Number SWG9 Subdivision Installer's Name /ylm. -a Assessor's Parcel No. Designer's Name INSTALLER CHECKLIST I. SEPTIC TANK Yes No N/A A) >5 ft from foundation? n B) Building stubout to septic tank: cleanout provided if not 1-2% C) Baffles intact and clean? D) Dividing wall intact? II_ D-BOX A) Water leveled? x B) Speed levelers used? III. DRAINFI%LD A) >10 ft from foundation and >5 ft from property lines? � B) Laterals level to tl inch? C) End caps present if not looped? �- D) System dimensions the same as shown on the design? X _ E) Gravel clean, properly sized, and proper depth? Jc F) PRESSURE SYSTEM 1) Sand quality ASTM C-33? 2) Head height uniform and 2-24 inches? 3) Cleanouts and observation ports present? X 4) Mound: Side slope 3:1? _ IV. POTABLE WATER LINES A) >10ft from field or double sleeved? B) Wells >100ft from drainfield? V. PUMP TANK -� A) Screen basks or effluent filter .(circle one) installed? B) Riser installed for access? C) Alarm installed? CERTIFICATION OF INSTALLATION Installer: Check box from Raw "A," check box from Now "B," sign.and date the certification_ A. 0 I certify that I installed the system I certify that all deviations from without any deviation from the design the design stamped "APPROVED" by MCDHS are stamped "APPROVED" by MCDHS. shown on the reverse side of this form. B.El I certify that I contacted the 0 I did not contact the designer prior designer and left the system open for to final cover because the designer inspection up to 48 bra prior to cover. 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. The undersigned approves thi inst llation of behalf of Mason County Department of Health Services. R'-UU1L1 PV1uvi - Plildl5 YWtI Awleoa 07/11 PARCEL IDENTIFICATION Permit Number SWG9 [� - x Suhdl vi Dion / \ t Installer's Name rY)r, KP >� Assessor's Parcel No. Designer's Name �n �--f-fp • :uQ./',f <=...a�,.e-nicer ea.....nat� AS-BUILT DRAWING y� �. ;Z-k air-7f CAU7106z Moor adjustments to septic tank location and drainfield orientation ride in the field by the installer axe generally acr ceptebls to both The department and the designer, but could in certain caeas coaprodw the viability of the system. It is the in Stallsr•s responsibility to obtain prior written approval fors either the health department or the designer before making any devi &time from the design that affect system viability. Any deviations fron the approved design aunt be shown above. AS-BUILT CHECKLIST ® Drainfield orientation © Observation port location ❑ Undisturbed native soil and layout © between trenches Cleanout location ❑ 59 Trench/bed dimensions and North arrow critical distances within Manifold placement ❑ layout Scale of drawing shown 10 Orifice placement on scale bar D-Box/"T"/"L" location ❑ Lateral placement, with Additional Mound Information Septic tank/pump chamber distances to edge of bed ❑ location ❑ Endslope width 1-1 Location of wells, roads ❑ t�Sl Location of buildings Overall fill dimensions