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HomeMy WebLinkAboutSWG2005-00172 - SWG Application / Design / As-Built - 3/28/2005 MASON COUNTY DEPARTMENT D Rif l�i�—cPFHEALTHSERVICES Official use only 0 L ..��—t L PERMIT NUMBER: SWG oZ(]C�5 Ob I Z G m 426 W. CEDAR STREET O �:knw •) j..,�,� PO BOX 1666 DATE RECEIVED: 2. SHELTON,WA 98584 RECEIPT NUMBER: —0 426 W# CE jjp,;, i-(360)427-9670, Ext. 352 m m APPLICANT DATE CHECK APPLICABLE ITEMS m o NEW SYSTEM m MAILING ADDRESS DAYTIME PHONE 0 REPAIR SYSTEM w 0 TABLE 6 REPAIR CITY ( STATE ZIP - 0 SINGLE FAMILY S •/ O OTHER Please describe 5 Z SITE ADDRESS c DRINKING WATER SOURCE 3 NAME OF DESIGNER �C. PHONE NUMBER 0 PRIVATE INDIVIDUAL WELL .PRIVATE TWO-PARTY WELL 0 COMMUNITY/PUBLIC WATER ^; NAME OF INSTALLER ^ r SYSTEM I'�v SYSTEM WFI#: O NUMBER OF LOT SIZE: CACRES FT X FT r BEDROOMS SYSTEM NAME: i SPECIFIC DIRECTIONS FOR LOCATING SITE A 44" cr._ This application is for design approval only. I� An installation permit will be required to install the system. RECENtD • All systems require ongoing Operation and Maintenance as specified in Mason County Onsite Standards. • All onsite sewage systems must be designed by a Licensed Onsite Wastewater Designer or Professional Engineer,unless plr1K 23, 2 5 I r++ approval Is granted. 0 • A Mason County Certified Installer must install all onsile sewage systems, unless prior approval is granted. .. • IB Onsite sewage system design approval does not imply other building site approvals. 426 W. CEDIR S • 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 years from the date of site review.Denial of this permit may be appealed to the Health Officer within 10 days of denial date. Official use only below this line SOIL LOGS COMMENTS/CONDITIONS CA-U SOIL TEXTURE CODES: V =very G=gravelly S=sand L—loam Si=silt C=clay E=extremely TORS NATURE DATE Inon" DATE DESIGN EXPIRATION DATE 7 V ?G L/ OJT Revised 2/2 312 0 0 5 White Copy—Health Department Yellow Copy—Designer Pink Copy-Applicant v MASON COUNTY DEPARTMENT OF HEALTH SERVICES D 426 W. CEDAR ♦ PO BOX 1666 ♦ SHELTON,WA 98584 N (360)427-9670, Ext. 352 N SYSTEM INSTALLATION CD ❑TANK REPLACEMENT ONLY(Attach Supplemental Tank Replacement Form) N � W •Q CERTIFIED INSTALLER Official use only C) ❑ HOMEOWNER ' a�J — �C� I 7 APPLICANT NAME PERMIT NO SWG Vr t ISSUE DATE I I `Q APPLICANT ADDRESS f \ '� !--+y� _ al// N JLAJV' RECEIPT NUMBER } tC�� AS4 CITY p STATE ZIPq'.S r� 0 VL � Jr FINAL INSPECTION (�]� INSTALLER NAME AND BUSINESS NA CALL-IN DATE MAILING ADDRESS n' C DAYTIME PHONE INSPECTION APPOINTMENT Z `M `( DATE/TIME / CITY STATE ZIIPP f 6�Y ASBUILT ON SITE? O YES ONO PROPERTY ADDRESS 9 -b .a.tUw_sue-•- - CD I hereby agree to comply with all requirements of the Mason County Department of Health I W Services Onsite Regulations and Standards. Upon completion of the work, the Health Department and the Designer shall be notified. All work shall be left open and uncovered until inspected. A completed asbuilt from the installer or designer must be provided at the time of final inspection. The applicant has the right to appeal decisions of the Health Department. IVv This permit is valid for one year from the issue date or the 1 expiration date of the septic design, which ever occurs first. Iw SIGNATURE OF JCFIED INSTALLER OR HOMEOWNER INSTALLER DATE �) Official use only below this line I(')k FINAL INSPECTION COMMENTS NQ �.�i1a,�.? �f�C,t/l•>�,�•;,o wv K/G c.�c.Irc.L/ Gl�G IN TIp I APPR VED BY DATE '�l„�, Revision Date.6/2/2005 White Copy—Health Department Yellow Copy—Installer Pink Copy—Applicant 6/2/2005 MASON COUNTY DEPARTMENT OF HEALTH SERVICES April 26, 2005 PO BOX 1666 SHELTON, WA 98584 SHELTON (360) 427-9670 FAX (360) 427-7798 Design Systems Northwest ELMA (360) 482-5269 BELFAIR (360) 275-4467 SEATTLE (206) 464-6968 RE: Design for FONTENOT Case No: SWG2005-00172 Parcel No: 321343490032 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. 36U Please call me at (360) 427-9670, a if you have any questions. Sincerely, CLAb Environmental Health Mason County Health Services COMMENTS: 4/26/2005 1 of 1 SWG2005-00172 MASON COUNTY DEPARTMENT OF HEALTH SERVICES April 07, 2005 PO BOX 1666 SHELTON, WA 98584 SHELTON (360) 427-9670 FAX (360) 427-7798 Design Systems Northwest ELMA (360) 482-5269 BELFAIR (360) 275-4467 SEATTLE (206)464-6968 RE: Design for FONTENOT Case No: SWG2005-00172 Parcel No: 321343490032 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. 353 if you have any questions. Sincerely, Cindy Waite Environmental Health Mason County Health Services COMMENTS: Observation ports need to be shown in cross section. You need an observation port to the sand/original soil interface. There are two pages to our design form. You submitted the first one. I need the second with our signature. Also, our design form must be attached to all three copies. Your general notes on the front page are cut off and are hard to read. 4/7/2005 1 of 1 SWG2005-00172 DESIGN FORM - PAGE ONE J„a4'•.t A°�esign will be revlbwed when 3 coQIlLL of each of the following Items are submitted: dealer= that has ltttan and dated % eoakd IaYcut :�a Plan.rbMMpto as m checklist ♦ W. - cro.Nsosone akato ;i d la�lt�. Permit Number. SWG .'1OQ5- DOl7Z Designer's Name: (9, 1 Designer's Phone#: _g'f�=V91.—'063/ Applicant's Name: 4. ,67*&,EE 0 �n e.J�W Assessor's Parcel No.: .3.2/3, ;/-91470.5 L, Mailing Address: & d)• 97,ft Ani- G ryiiGr (r"lvo-Digk Number) iOA Subdivision: Ci Staco Zip (Nanr/DivisfonBloek/I.ot) F(�y�k,1 F Treatment Device 0 Glendon Biofilkr 0 Sand Filter 0 Mound ',Mand Lined Drainfield O Aerobic Unit-Make/Model: O Disinfection Unit - Make/Model: r Grainfield Type Pressured 0 Drainrock Gravity /Q Trench O Gravelles Chambers Septic Tank/Drainfield Specifications Laterals Number of Bedrooms 3 Length Schedule/Class ft — Dail Flow (o Length y Diameter in Septic Tank Capacity gal Number Receiving Soil Type(1-6) Separation ft Receiving Soil Appl.Rate r 0 Yp�L Required Square Footage J12 Orifices Designed Squm Footage JI&0 ft Total Number of Orifices �e) STten t Width uctiTaken Diameter a in 0 ft Spacing Tren Length ft Elevation Measurements ^ ,Maniflold H Schedule/Class M"Cf PR®V Original Drainfield Area Slope '� 1 % Length ---� New Slope if Altered _� % Diameter QQ,�,ALTh/ D Depth of Excavation from Z in Preferred Manifold ConfigllrdTit� 05 ❑Yes No Original Grade (Up-Stope) T ( p•�{Pipe in rl" 19C7 (Dovmalope) Schedule/Class Length f3O ft Designed Vertical Separation /6 in Diameter in Gmvelk ss Chambers Required? ❑Yes YjNo ❑Optional Dosing and Pump Chamber Pump Required? 21 Yes ❑No Number of Doses/Day Dose Quantity Pump/Siphon Specifications Chamber Capacity LOBO ¢al Difference in Elevation Between Pump Shutoff and Uppermost Pump Controls: Timer(or)Elapse Time Meter(circle if required) Orifice: 10 d ft If Timer. Pump On /6'0.1 Pump Off n ff—AY&L" .us", Uppermost Orifice is�Higher, 0 Lower thpq�irmp Shutoff Check the following components if they drain between doses: Capacity @ Total Pressure Head: V 00 glim ❑Laterals ❑Manifold ❑Transport Calculated Total Pressure Head: sb _Q (Attach Pump Curve) � � ,r D IGN QRM •PAGE TWO Rev6edApa 24,,998 s{ , w s xE a Scaled Plot Plan Scaled Layout Sketch cross-Section Sketch D Test hole locations O Dminfield orientation and layout Referenced depth from original grade: O''-Property limes O Trench/bed dimensions and critical O Septic tank lid and drainfield cover O Existing and proposed wells within distances within layout depth go 1t of property lines O D-Box/"r/"L"locations l Critical distance measurements to cuts, O Septic tank/pump chamber location Reference depth from original grade bra,and surface water O Observation port location and restrictive stets: O Laterals,trench/bed top and bottom D Location and orientation of curtain O Clean-out location O Curtain drain collector drain and all absorption components O Manifold placement O Sand augmentation 17 Location and dimension of primary O Orifice placement system and reserve area O Lateral placement,with distances to O > edge of bed Other cross-sections and c O Dheetion of slope indicator O slam Audible/visual ala referenced O Observation ports and clean outs O waterlines O Scale of drawing shown on scale bar u O Roada/easements/dnvewaysf x�F Pr puking Lsi, orir fmCt!Iatltla ftlrfmtlaa�is�rs ,<aa� .i xx z �.�� �..r> ; O Critical resource lands(if applicable) UAMimengro#s � � t ; D North arrow,and scale of drawing davmstA antiefltisQd t c,. t5g3 diy�p G�shown on scale bar t�! X7p�# ..;afrtd4fa Additional Information O Design staked out 17 Operation and Maintenance Notice Attached O waiver(s)Attached z Q r rESGIV bPP#tC1fACry ME. ... s .. .X ,..,'': The undersigned designerl7does, ❑does not waive requirement to be otified by the installer of the installation and given 48 hours to perform,a final inspection prior to cover: d� r turc of signer ate 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: - 6 C'J' L LCam y u r Environmental Health Specialist Date Caution: DESIGN APPROVAL IS VALID ONLY TINDER THE FOLLOWING CONDRrt ent of Health Services. ,/ The design:is stamped"Approved by Mason County Departm ./ The On-site Sewage Permit has not expired,the Permit Expiration Date is: t The system is installed by a certified installer,unless prior authorization is obtained from Mason County :-Departmem of Health Services. approval .r Drat field site conditions have not been uttered to adversely affect conditions of design p �F—J �!✓ -S%1 r)t / of St et Site use E1¢^rations Sepae Systems...where the grass is 9 ver er 3 BDRH.RES- 2� r4mPratoanitwre ) stubout �9� GMPvgeti� HE D aily � (9Fd• 0ympia.WA9 516 Tank Inlet =�`5 (no)4SS4651 ading Rate Tank oU.let a se - 3 t/e/� Dist_ sox =�d— Iz eld Slz Lateral Inlet =P�vo(CFC /e Sv�2oo /,p •-T , _' 1•' pumpTank SizQ pumpchamber =3� 90a3 Z / sand filterZAK.!$ //Mr4 r QENGlopm,*u> LL C, l. 2-eomp- rproof) SAk__x7v� .4 SV amber(waterproof) `� `� .. 9als. min- (aeAfRAL. /yOTES I (lwnedinstaller shall not remove any topsoil in primary t" 003��6 RW-Wp04121 or reserve area. Removal oftopsoil could render site unusnhtc. T/ 2 The installer shell be certified and approved by the county SO/G .0 O¢5 and IXsign Systems North West to install septic Systems •TN,-�+ +`�AW 3 This is a special design due to adverse soil conditions, TP. s ri�1 sYts/ ground water table and/or topography cosign Systems North West has designed this system in accordance with all current suite � and county health department requirements and assumes no T R tespo risibility far its use on longevity. The owner therefore agrees In maintain and make all necessary repairs to the system at no cost to(sign SystcmS Northwest 7` '� 4 The eontmctor shall field verify all contnur%, stub outs elevations D-S Del rK8l'VJJ"0m Se1D and trench depths in drain field area prior to construction. . 6-0" 4/,W CU7fltf�6VV5C_'owfl 5 Drain field setbacks and mcnsurcd from trench cdFc or basal edge. �� /A 0 All construction material and installation shallcnnform to all appl eWe state and,covhty health department requirements. T R 3 7 Existing utilities shown on the plans have been plotted from p !f Z, the best information available to the designer. Accuracy and complete- et ncss are not guamnieed. A locate require by law bdorc digging. /D—G'1 N MCP�RO�/�D A h shall tit:the owners and/or installer's responsibility to notify AVrm t&D 1)asign Systems Northwest at(d the county heath deparuncnt APR-2 6 2005 for required inspections or to beckfilling. 9 It siteli be the installer's responsibility to have a copy of CEw this design On site al ail times during construction. 10 All required teals shall be successfully run prior to calling Design Syslcros Northwest 1'nr final inspection. All components• including all tanks access lids must<hC accessible for inspection.. Corumctor sball he responsible fgt'cnsts of return inspections due Q 9 N to failed tests or inncccssible components. 1 I Any variation to this design shell first be approved by f "ign ,,� f ? Systems Ntxlhwest and the count health dePartment• 12 Water lines mast he sleeved wluun within I0 feet of a septic Raw rN syslem components.SFr# 15 held)+'::: 13()ioner shall he aware of the jtosgihility of boating tanks out Ex 'os-ia of the ground Should the sentic•tenk(s)be pumped empty during sensorial high water table conditions. 14 lnslailer must contact designer print to installation. 15 Water line and sanitary sewer lines shall be constructed in accordance with D.Q.fi. "Criterin for Sewer Works Design Maminl %mlinn C 1-9 of Special Requirements Sheet'. of S Sheets iClient: # of Bedrooms =3 Primary system soil typeC-33 l .r.= 1•0 gpd/sq.ft .@ 120 gpd/bdrm. Reserve system soil typec_33 l .r.= 1.0 gpd/sq.ft. @ 120 gpd/bdrm. i A-1 . Primary Q. = 3(00 - gpd.: I.0 l.r.= 3&0 sq.ft. @ (0 ft. wide 0/trench = j(. ln. ft. Reserve Q. = 3(.o gpd.- 1.O l •r•= 3(.o sq.ft. @ /a ft. wide trench = 3(p ln.ft. A-2 . Manifold Lateral length =35 j Lateral spacing = - 5�{ �� i Manifold/ Lat. connection 0+055Gon w Orifices orientation IZ-O �° a 1 A-3 _ Orifices/lateral = 1S i A-4. a. Orifice dia. d. = d. Max. L. for values b. Lateral dia. D. = 1,0" d. ,D. ,Y. /cl . Zoo I C. Orifice spacing Y = 2.4+• pipe = L/p ft. A-5 . a. Orifice discharge rate q. = .}2 b. Lateral discharge - 15 # orifices/lat.x = /0.8" gpd/lat. c. Manifold size = Z" 200 dia. cl, c. i Calculations For Pressure Distribution System4 C-1 . 1 . ) Dosing frequency per soil type 2 . ) Gals . /Dose = 3GO gpd. (D doses 3 . ) Pipe volume a. ) forcemain)30 ft.--�u11 ci .aooVC, �titutne� ` b. ) manifold 4•S ft.- " " cl.ia° pyr j c. ) laterals 140 ft.- ,11 1.o`" cl .suoPYC. - M(),� EPT Dose/pipe volume ratio h05 C-2 . System Discharge = # lat.@ 15 orifices/lat- G' fices C-3. &0•#orifices x q.4Z. = 43.Z tota gpm. Friction Loss- length( vol. gpm) pvc. (pipe) friction loss j AB l90 +' 1C=!# y ,Z � " CG�oO BC LDS it /, �o- u , " _ ©.Od CD 0.00g1 Sg59 i - - i Sheet _?j_._ of .S .Sheets C-4 . Elevations = upper most orifice = 91-5-9 less pump elevation = 925 sv total elevation lift Z:dB r c-s . � Total Dynamic Head = residual pressure3,0 t elevation lift: Z+108 + friction loss H•89�) n° C-6 . Pump effluent type -- `OSQ 50 /1Y000MMMor equal pump, curve - sheet # Sl_ max. capacity, _ ('C•d gpm. max. head = ZSO ;fit. required capacity = N3•Z jp,/.w_ required head =9.9$ 4WIAIWO Ta BW A-bWAr � �CVGENStD 6LEcT5Pic�}N c2 APPfoVEO PERSO� W Irk( .. LyyR6,/povee eK TESA�+'o RtST SECURED LID WITH GAS TIGHT SEAL SECURED LID WITH GAS TIGHT SEAL THREADED UNION 411 prERPfCOf r CCES RISER \\ lA/ 26'DIAMETER J ACCESS RISER \ `E�AAr 1 ACCESS RISER \� �• 1 SERVICE FINISMGRPDE VALVE' ANT SIPHON r�7� VALVE• FLOATING MAT INDEPEDEFOR ft"T TINMOUNNG � CHECK VALVE• SEDIMENTS i F/LIx.0 f I; Dose Vo<aA+c ('0 / �� SEDIYENTS SUBMERSIBLE ENTEIFVOAL •�+ PVMP SEPTIC TANK P PCN EPd (TYPICAL) _ (TYPICAL) _2 6 1?005 -AS NEEDED — NCPIA �/'1 70 R�kIVY'A o6eestxttevl 'R�Ye/l O /� /ncN(tot/AIGEXAL. NeuT F�M� FbrYr Va.it ;v er oVEt r#f'E7f7PV CAP a R vtuy yJRSNEO ROCK� �+j,?,'�s IO Gt/yp$. y1 o+t/8/MNL S!D r"r/LB 3 I PL11G I N S LELavE Q.fADF r m�' /I 1 4TG DAI G • "�.?•7�.. d MAY Cl:200 ;DPW WasN" 11 Q _ /G^ )Cock o,efE,� � o-c�vck nos& o0e A.4A/4 ,yirlos fll G; ARJG 29" RO/+1 NSW C-n A s"T7*\sAmb 6 y n .oa�iee SPAefAq AMrrCeLO "STOAT Frt! ��� � • l�, � si etnfrtasr�N s,,,a.r._� L * \ Zr 10 n �� �� Lf) . co o Oct (DO � � . NJ HCAITH pe© APR 2 g 2005CEW p d� a Fes-p ti ,s za Q _ N � � 1 g Q w Ln N It co In `; 'a FC N E' 3 M33 ti f � n'ro�. i M � a 3003 9 ade ? �,r'61 s g M M o lr� : 1d34 Flllb'3H kroq o P^o Ln 5 � u o t � � � h • c4 � � � h U a O 3 3 /a • a� � j • 3 v y -tP 3" h a R A 1�lill�ll!{1 ),WN � o s r-- 6 W ' lip 11101111111 IN a i 11661 '• �a r Applicant Lam, / /Set -Assessor's Pirml# 11�A q oo . Permit Number SWOP- C9U f ?y t�wetvavtgttN'a'd10d lI1sWer Subdivision Designer WA Yes Prior to Oomptetlon I. SEPTIC TANK A) >3 fr.From foundation?............... ✓ B) . >50 ft fimm wells and surface waW ..... C) Bldg stab-oat to septic tads olmn-oat if not 1-r/i? ................. D) Baffles intact and dow? ...................................... B) Dividing wall intact?.......................................... ✓ F) Risas instilled lbfwcosO ..................:.. • _� O) Tank Size: t?,ADO gal.;Manaf'actare turf — It. D-Box A) Loveted with water? .......................................... B) Speed leveler used? ................... 111. DRAwFIELD A) >10 ft from foundation and>5 ft ficen property lines? ............... B) >100 ft from wells and surface water? ..................... ...... C) >10 ft from.potable water lines? ................................ Y D) Laterals level to±I iaFh do sad caps present if not looped? ........... E) OraivUess chambers utilized? .................................. — F) System dimensions the some as shovm an the design?................ Gravel clean,pvpcdy simd,and ? ...................... — PnEssuttE6Y8`n21t8 1) SandtprdilyASTMG33? ............................... � 2) HeadhoWunifomrmd2-24inches? AdaslheadllwigbLLJf , ... 3) Clean-outs and observation ports p want? — 4) Mound-',Side Slope 3:1? 5) Owner.informed electrical connections mud be made lry owner or licensed electrician and iospocted by L&1? ............ IV. Pumpipump CHAMBER // A) Pump make-CJS 9 Sb : Pump model �Ld F—Ate v B) Chamber size t 2-00 gal; Mmafedare (< a T C) Height of pump off bottom of pump chamber CO inches -� D) Pump chamber draw-down ZS gallons per inch 13) Pump capacity A/9 gallons per minute F) Pump controls:11mm(or)Elapsed Time Meter (circle If Installed) Iftimeris'used:Pun On S Pump Off +14sr ✓ — O) Screen basket or art�ircle one)installed? .. — H) Riser installed for access?...................................... — — I) Alarm installed? ............................................. - PYDra ki"eld der manifold -— orientation do layout �c 4,n h_'° 1 . 064dx.t/Y rts�,. ♦ A'\I YbmchAhed d®iasons � r xr and critical distances °uE rT £. A 'Saco Within layout 3& 9KS�+c(pumP r L ;.� placement 0-�Lockdonofbaildiags 1OA— pod at`tea°"out location. N s7 +�i C31U �Loahtica of wells do tS n roads. �a�hTn ��vi 71aar+ 2 Tx.nn+�POP / h.j NH 17 Undisturbed native soil ` betweentrmcbes. Krow r. r t'AUTKftW=ragmleeshOldAM bseptle6iofcbeatku'adiaio8ddakagtlgaadeY4o 6ymp sny 7 b6oailhe.�Mtoai4ho * ,I,.e=d ft wdVV isbtYrofine nlrieioritlet's�Cil�au p aft =11 dim er6°kdSorr6etwe�Wi6g9�orlationitaa�wagaa6ectmaspline. AhV destgamnAbe Installer Chc&a bmr fiom Row"A"and'%",sign and date&e A. O I certify that I installed the system vdibm any I certify that all deviations fiurn the design stamped deviation from the design stamped"APPROVI3D by "APPROV®"by MCDHS am sholm abet% . MCD11S t3. O I taffy that I contacted the designer and left the I didnot comactthe Systdes prior to final cover because the cover. �fa inspection up to 48 bra prior to. . designer waived then on requirement. I further certify that all infomadon contained on this form is acxwate..I understand that if the information contained hw hi is not accurate,them will be just cause for immediate suspension of my installer cation. er The undersigned approves this installation on behalf of Mason County of tr Savicac. tier