HomeMy WebLinkAboutSWG2004-00542 - SWG Application / Design / As-Built - 10/6/2004 MASON COUNTY DEPARTMENT OF HEALTH SERVICES PERMIT NO. SWG
Date O- (�- <)17G y
426 W. CEDAR/P.O. BOX 1666/SHELTON,WA 98584 m o
PHONE (360) 427-9670 Receipt No. (' i U__ J 7 e
mount$ _ Z --
PROPERTY OWNER: DATE: W 9
T6 V A S t S e G(-/(o-C) I CHECK APPLICABLE ITEMS �/ m m
MAILING ADDRESS: DAYTIME PHONE: NEW SYSTEM b
/v�6&,vv LA xic REPAIR SYSTEM
CITY: STATE: ZIP: TABLE 6 REPAIR d
MINT
,S (-� S8cl- 7S MAINTENANCE REVIEW a8 EFANCE PROPERTY ADDRESS: �
OTHER: 1 3
SPECIFIC DIRECTIONS FOR LOCATING SITE: PRIVATE WELL *1
E C�jfZh . COMMUNITY WELUPUBLIC SYSTEM Il
r� SYSTEM WFI A
TQ I� t 6�1 a1Q K cw GF_&U6E SYSTEM NAME I 0 .
APPLICANT N
2A P 1L_ 4*- 4/-4'-& NAME fN
Name of Lot iLCo 7 ' ft.x ESQ` ft. RNG ADDRESS (3� f i 3% L
Installer Size: . (oS acresTELEPHONE 9S f 2
Name of um er o SIGNA RE
Designer ( r hj/2�t Bedrooms3
OFFICIAL USE ONLY BELOW THIS LINE
DEPARTMENTAL SOIL LOGS DEPARTMENTAL COMMENTS/CONDITIONS
co
7` 213
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15 I �o
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SOIL TEXTURE CODES:
V=Very G=gravelly S=sand L=loam Si=sift C=day E=Extremely
INSPE R(print na e / IN ECTIO SIG RE DATE PERMIT EXPIRATION DATE
1 /V re d I16
•All systems require ongog Operation and Maintenance((59M)as spe ed in Mason County On-She StFinddrds.
•All on-site sewage syst ms 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 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 3sm from the date of site review.Denial of this Dennit mav be eat the Health 2U within 10 daysof denial ate.
DESIGN R IEW AP ROV ATE: INS ALLAlt I APP D BY: DATE:
TOP: Health Dept. Copy DDLE: Designer's Copy BOTTOM: Applicant's Copy
/ MASON COUNTY
v DEPARTMENT OF HEALTH SERVICES
October 22, 2004 PO BOX 1666 SHELTON, WA 98584
SHELTON (360)427-9670
FAX (360)427-7798
Jim Henry ELMA (360)482-5269
PO Box 14531 BELFAIR (360) 275-4467
Tumwater WA 98511 SEATTLE (206)464-6968
RE: Design for SETTLE
Case No: SWG2004-00542
Parcel No 9009�
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.
1753
Please call me at (360) 427-9670, ext.2.7-R.if you have any questions.
Sincerely,
A+fertda-REyrtalds
Environmental Health
Mason County Health Services
COMMENTS:
10/22/2004 1 of 1 SWG2004-00542
DESIGN FORM- PAGE ONE ,'1999
A assign will be reviewed when$�14�of each of the following items are submitted: oC C4 i
ttapdd f orm that been dyrwd and dated • ceded 4gwut aicateir,MreludN9•�•pPt�1e ?on n
Ppt y y awPOcebl•Rama on checklat ft Crousaofbn•�et�M N�eN+dlrw •PP�•�0 �'�O O
t'
HEMEM0
�vv�1 0().S-�/ L Designer's Name: J ti 1 °he 'i'
Permit Number. Designer's phone#:
Applicant's Name: -<r dS�'JTL E Assessor's Parcel No.: Ij���h Nam)
Mailing Address: i 7.9 D P-D, [QL
L . , TraeJ �� q g��y Subdivision: (Naneffr4bion/BieddL01)
aty state zip
„.::...,.:..6..,. ...
o?!
Treatment Device
O Glendon Bio5lter
Sand Filter O Mound (3 Sand Lined I)rainfield
(3 Aerobic Unit-Make/ModeL• — O Disinfection Unit - Make/Model:
Drainfield Type
O'beO Gravityd Trench D�� kChambers
Laterals
Septic Tank/Drairdield SpecificationsO SeheduletClass
ofBedrooms 3 Length in
is-
Number ft
Daily Flow 3 U Diameteral
/ y
Septic Tank Capacity Number z.s ft
Receiving Soil Type(1-6) ; � Separation
Receiving Soil Appl.Rate -
Required Square Footage a 1�
Orifices
Designed Square page 3 (0 6 ft' Total Number of Orifices
Percent Reduction Taken /O ft Diameter x�
Trench/Bed Width ft Spacing
Trench/Bed Lent Manifold
Elevation Measurements Schedule/Class ! o 0
Originai Dhainfield Area Slope I Il
' 'W 4111P �n
ft
iameterr'N Ij
New Slope if Altered l;R
4,t S Preferred Manifold Configuration Used? . Yes ❑No
Depth of Excavation from !i O t
Original Grade Np sire) Transport Pipe
3 Zno
(Down-slope) Schedule/Class ft
Length 7 in
Designed Vertical Separation Z f Diameter
Graveness Chambers Required? CI Yes No ❑Optional Dosing and Pump Chamber
$Yes ❑No Number of Doses/Day )
Pump Required? Dose Quantity
pump/Siphon Specifications Clamber Capacity
Difference in Elevation Between Pump Shutoff and UppermostControls: Tuner(or))Elapse Time Meter(circle it required)
ftP Off -!NR s
Orifice: 1 N, If Timer. Fume Oa P.
Higher Pump Shutoff Check the following components if they drain between does:
Capacity®Total Pressure Head:JO
Uppermost orifice
Lower than 4�l.t.Naom ,Laterals Manifold ❑Transport
y y,t ft
Calculated Total Preswr Head:�Aep Curve)
v bs ,��� ><s 4V S�> �1 ,�u-hto s, ; ��q� � G�,�'
DESIGN FORM-PAGE TWO Rewhed Aaraza.IM
<w
Scaled Plot Plan Scaled Layout Sketch Cross-Sectio7drainfield
Test hole locations t3'Drainfield orientation and layout Referenced depth
O 'Property lines Rr Trench/bed dimensions and critical JY Septic tank lid
t'Existing and proposed wells within distances within layout depth
100 ft of property lines I 4a D-Boxt-r/-L"locations
CY"Critical distance measurements to cuts, ,O�Septic tank/pump chamber location Reference depth from original grade
banks,and surface water ,@Observation port location and restrictive strata:
O Location and orientation of curtain t3'Clean-out location ZLaterals,trench/bed top and bottom
drain and all absorption components l"Manifold placement O Curtain drain collector
e'Location and dimension of primary 0" Orifice placement eSand augmentation
system and reserve area P'Lateral placement,with distances to
O"'Buildingse of bed Other cross-section detail:
la' aterl n of slope indicator Audtblemsual alarm referenced El Observation ports and ck�n-outs
A" W Waterlines A'Scale of drawing shown on scale bar
120'Roads/easements/driveways/
C ytiQ
Parking ) a f6r}Ifatrtla fAC�tlOYtdt13F x�Y sus a3 .....
O Critical resource lands(if applicable) : ISiitdfsibn �"� o y'
,W North arrow and scale of drawingx_ ..
shown on scale bar
Additional Information
Design staked out
O Operation and Maintenance Notice
Attached
O Waiver(s)Attached
The undersigned designerodoes, ❑does not,waive the requirement to be notified by the installer of the installation and given 48
hours to perform a final inspection prior to cover: /
�i�- i mil'— /�0"0`"I
S" amre of Desi 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 local on-site regulations:
Ctia& o
Environmental tealth Specialist ate
Caution: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDMON:
01 The design is stamped aApprovecr by Mason County Department of Health Say
✓ The On-site Sewage Permit has not expired,the Permit Expiration Date is: /U 20 In
✓ 'Me system is installed by a certified installer,unless prim authorization is obtained from Mason County
Department of Health Services,
✓ Dramfield site conditions have not been altered to adversely affect conditions of design approval
G�
{
l )1 JIM HENRY DESIGN SERVICES, INC.
MASON COUNTY DEPARTMENT OF HEALTH SERVICES
ON-SITE WASTEWATER DISPOSAL SYSTEM
DATE: September 9, 2004
APPLICANT: NORTHWEST DEVELOPMENT
5113 PACIFIC HWY E STE 1C
FIFE, WA 98424
LEGAL: LOT D OF SP 785 c
y 51000 21
PARCEL M 321341390090 Or' pM HENRY
LICENSED DESIGNER
PROJECTM ExriRES: 08l1110S
DESCRIPTION: NEW CONSTRUCTION
PROJECT DETAILS:
NUMBER OF BEDROOMS 3
GALLONS PER DAY (GPD) FLOW 360
APPLICATION RATE 1.00
DRAINFIELD
-Absorption Area Required 360 SQ.FT
-Absorption Area Designed 360 SQ.FT
-Trench/Bed Length 36 FT
-Trench/Bed Width 10 FT
DRAINFIELD CROSS SECTION
- Depth below Original Grade 30 INCHES
- Rock Depth below Pipe 6 INCHES
-Vertical Separation 24 INCHES
- Fill Depth 12 INCHES
SEPTIC TANK
-Size&Composition 1125 GAL CONCRETE
-New/Existing New
G�
JIM HENRY DESIGN SERVICES, INC.
APPLICANT: NORTHWEST DEVELOPMENT
DATE: September 9, 2004
PARCEL #: 321341390090 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 140 feet
Orifice Spacing 2 feet Number Orifices Lateral 1 18
Number Orifices Lateral 2 18
Number Laterals 4 Number Orifices Lateral 3 18
Lateral 1 Length 35 feet Number Orifices Lateral 4 18
Lateral 2 Length 35 feet Total Discharge Rate 44.64 gpm
Lateral 3 Length 35 feet
Lateral Length 35 feet Friction Loss
Pipe Class 200 Tightline Fricfion Loss 1.88 feet
Lateral Line Size 1.5 inches Manifold Friction Loss 0.64 feet
Lateral Elevation 100 feel Lateral Friction Loss 0.21 feet
Friction Loss through System 2.73 feel
Manifold Length 8 feet
Manifold Size 1.5 inches Dynamic Head
Risidual Head at Last Orifice 2 feet
Elevation Difference 4.5 feet Add-on Friction Loss 0.2 feet
Elevation Difference 4.5 feet
Tightline Length 70 feet Total Dynamic Head Loss 9.43 feet
Tightline Size 2 inches
Total Discharge Rate 44.64 gpm
Add-on Friction Loss 0.2 feet Total Dynamic Head 9.43 feet
_ vAvokwle Products Pa9c 6280-1 _
Performance t jft scdka Pa6rm Data
Data Dated:lumuary 2001
. RPM:1750 D*dWge:2- Solids: 2-1/4"
9 30
SPSO i SPSM
6 a20
o s
SP40
3 f'10
0 0
(uPodly-ul GYX 0 20 40 60 BO 100 120 140
111az 0 2 4 6 0
The curves reflect maximum performance characteristics without exceeding full load(Nameplate)horsepower. All pumps have a
service factor of 1.2. Operation is recommended in the bounded area with operational point within the curve limit. Performance
curves are based on actual tests with dear water at 70"F.and 1280 feet site elevation.
Conditions of Service:
GPM: TDH:
I� HYDROMATIC'
SEALED RISERS To SURFACE
1WiF/1P11D Flaex
TO ALARM s PavvFtt � It
C.066-u V. VE/OwaR Qvlic,otZr
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AS-BUILT FORM ,evind February 1s.l"s
::ski<>: ...:..:<> <.:. ':.n•:� v.. ......Aw:::v: ...<b.. .5.:a. !e?b Nk;. :e .�
Applicant Assessor's
Parcel# TO
Permit Number SVV,G `f Q�CJ`(2 (Twelve-01gtt Number)
Installer Subdivision
(Name/DivistordSlocIdLot)
Designer
MEMO
N/A Yes Prior to Completion
I. SEPTIC TANK
A) >5 it From foundation?.. . . . . . . . . . ... . . .. . . .. . . ... . . . . .. . . . . . .
B) >50 ft from wells and surface water? .. . . . .. . ... . . .... . . ... . . . . . .
C) Bldg stub-out to septic tank:clean-out if not 1-2%? .. .. .. . ..... . . . . .
D) Baffles intact and clean? . ..... .. ... . .. .. . . ..... . ... ...... . ... .
E) Dividing wall intact?.. . . . .. ........ . ...... .. . . . .. ..F) Risers installed for access? . . . . .. ..... ...
G) Tank Size: 1(W gal.;Manufacture
II. D-Box
A) Leveled with water? .. .. . . . . .. . . . ... ....... .. . . ... .. . . .. . . .. . .
B) Speed leveler used? . . ... . . . .. . . .... . . . . . . ... . . . . . . . .. .. . . . . . .
III. DRAINFIELD
A) >10 It from foundation and>5 ft from property lines? . .. . .. . . . .. .. . . —
B) >100 It from wells and surface water? ...... . .... ..... ... . . ..... . .
C) >10 it from potable water lines? . . .... . . . . ..... . . .. .. . . . .... .. . .
D) Laterals level to±1 inch&end caps present if not looped? ..... .. .. . .
E) Gmvelless chambers utilized? .. .. ........ . .... .. . .. ...... . ..... _
F) System dimensions the same as shown on the design?. ... ... . . . .... . .
G) Gravel clean,properly sized,and proper depth? ..... ... ... . ...... . .
H) PRESSURE SYSTEMS
1) Sand quality ASTM C-33? ................ .. ...... ......... JL
2) Head height uniform and z24 inches? Actual head height ..
3) Clean-outs and observation ports present? -�
4) Mound: Side Slope 3:1? ... ........ ...... .. . ..............
5) Owner informed electrical connections must be made by
owner or licensed electrician and inspected by L&I? ..... . ..... . .
IV. PUMPIPUMP CHAMBER
A) Pump make Pinup model SP�(� — JIn-
B) Chamber size ( gal; Manufacture C-�e`P
C) Height of pump off bottom of pump chamber g inches
D)"Pump chamber draw-down gallons per inch
E) Pump capacity gallons per minute
F) Pump controls im or)Elapsed Time Meter (circle if Installed)
If timer is us :Pump OnIAjn Pump Off q V
G) Screen basket or effluent filter(circle one)installed? . ..... .. . .. .... . —
H) Riser installed for access? . ......... ... .. . ..... . . . . . .. . .. . . . .. . .
-
I) Alarm installed? .. . . . .. . ............ . . . ..... . . . . .. . .... . ... ..
:¢:.:i:<:a.:' [:£'< '.GP`
❑ Drainfield&manifold
orientation &layout
❑ Thach/bed dimensions
and critical distances
within layout t�
❑ Septidpump tank t
placement. o c 1 / �S
f�
❑ Location of buildings.
`I 7
❑ Observation port&clean- /
out location. Vo 7 /
❑ Location of wells&
roads.
❑ Undisturbed native soil
{ between trenches.
❑ North arrow
9
I
i
i
CAUTION:Moor adjustments to septic tack location and drainfield orientation made in the field by dw tostdler tie�o�ally c�pmble b both the depedmcut
and the ,Ma eotdd in certain cases compromise the viability of the ryst m. It Is the installer's slily to obfaia prta wrtaw approval 8om ehtier the
health or dw designer before making any deviations from the design dad affect the system vLbi Its y. Any deviations linen dw approved design must be
shows .
.:;:..`... "H:.::
Installer Check a box from Row"A"and`S",sign and date the certification
A. El certify that I installed the system without any ❑ I certify that all deviations from the design stamped
ai deviation from the design stamped"APPRDvED"by "APPROVED"by MCDHS are shown above.
MCDHS
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 bra prior to designer waived the notification requiremeat
cover.
I flasher certify that all information contained on this form is accurate. I and d if the' rm contained herein is not
accurate,there will be just cause for immediate suspension of my installer catio .
Wre o to
The undersigned approves this installation on behalf of Mason County-Hpepattat It or Services.
�
tanDate