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HomeMy WebLinkAboutSWG2002-00246 - SWG Application / Design / As-Built - 6/21/2002 iASON COUNTY DEPARTMENT OF HEALTH SERVICES PERMIT NO. SWG c v m 426 W. CEDAR/ P.O. BOX 1666/SHELTON, WA 98584, Date �- N o PHONE (360) 427-9670 Receipt No. n 0 Amount$ Z m PROPERTY OWfII�R +�4\ �e DATE, 1 p Z� CHECK APPLICABLE ITEMS 6/ 3 MAILING ADDRESS Y DA I PHO E• NEW SYSTEM o 14-D , REPAIR SYSTEM CITY: STATE: TABLE 6 REPAIR l' w ( 7� MAINTENANCE REVIEW V PROPERTY ADDRESS: SINGLE FAMILY Z L ,001 OTHER: . 3 Srr=CIFIC DIRECTIO14S FOR OCATING SIT PRIVATE WELL COMMUNITY WELL/PUBLIC SYSTEM II.� SYSTEM WFIN SYSTEM NAME APPLICANT V NAME S !,[C'c3u- Name of ��ft.x L1CCj Installer ft, MAILING AD RESSt t Lot S C Size: q-a`� acresNam T HONE � (cR� s of (� Number er o IGNA Designer �t�b Bedrooms OFFICIAL USE ONLY BELOW THIS DEPARTMENTAL SOIL LOGS w A TMENTAL COMMENTS/CONDITIONS I�� w 1 /1 j"VI � /L, taa UV � g M ry 0 SOIL TEXTURE CODES: M V=Very G=gravelly S=sand L=loam Si=silt C=clay E=Extremely IN - OR( int n e) I ECTI SI T RE DATE PERMIT EXPIRATION DATE i AJcl,4 j AJa� I e 7114 6 -7 /o or •All systems reTibire ongoing Operation and Maintenance(O&M)ass ecified in Mason County O -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 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 permit a ires 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. DESIG Et) VIEN/APPRO YI �� DATE: INS LLA I NAPPROLEBCA1 C? DATE: TOPS: Health Dept. Copy MIDr/DLE: Designer's Copy BOTT(QM: Applicant's Copy I MASON COUNTY , DEPARTMENT OF HEALTH SERVICES July 25, 2002 PO BOX 1666 SHELTON, WA 98584 SHELTON (360) 427-9670 FAX (360)427-7798 Robs Excavating ELMA (360) 482-5269 1871 E John's Prairie Rd. BELFAIR (360) 275-4467 Shelton WA 98584 SEATTLE (206)464-6968 RE: Design for FULLER Case No: SWG2002-00246 Parcel No: 321347590143 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: 7/25/2002 1 of 1 SWG2002-00246 MASON COUNTY DEPARTMENT OF HEALTH SERVICES July 10, 2002 PO BOX 1666 SHELTON, WA 98584 SHELTON (360) 427-9670 FAX (360)427-7798 Robs Excavating ELMA (360)482-5269 1871 E John's Prairie Rd. BELFAIR (360) 275-4467 Shelton WA 98584 SEATTLE (206) 464-6968 RE: Design for FULLER Case No: SWG2002-00246 Parcel No: 321347590143 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. 279 if you have any questions. Sincerely, ,Anna Environmental Health Mason County Health Services COMMENTS: Soil depth at 24" and 27". Will need pretreatment or a Class B waiver 7/10/2002 1 of 1 SWG2002-00246 On-Site Sewage Systems (Chapter 246-272 WAC) RECEIVED Request For Waiver From State Regulations SECTION I. r COMPLETED BY APPLICANT To Local Health Department/District(2) Address: �-� ' � y Telephone: Cc— Signature: Property Identification:(3) SECTION IR1.71 COMPIEIF,D BY APPLICANT WAC Number: (4) 3 y Requirement:(5) Waiver Sought:(6) 246-272- (]QQ� cc 11 �c '� Subsection: � 121' V-41C.,l Justification(Mitigation measures to be provided):(7) aS 2 r ''C�a -7�,C t SECTION M. COat MED nY MALTH OFFIM Review Criteria(8) Mitigation Measures(m addition to those proposed):(9) Comments/Conditions:(10) Typeof Waiven(I1) OCI=A assB OCIsssC-Ikquesf DOHmkwT•sf0MVn` V? Yes_ No_ Neighbor Notification: (12) Required? Yes_ No_ [fnee*Amcagreewncx easements,etc properlyAled7 Yes__No_ BECKON N. 1 CoMnMW BY BEALIR OFFMER r 1 i This Request For Waiver From Stale Regulations has been renewed acoordutg W the provisions of Chapter 216-272 WAC On-Site Sewage Sysmeas. The review aitaia applied,and the mitigation measums proposed and/or rrquhed,have been evaluated for dick ability to provide public beilth .p oie tine at least equal to that provided by this chapter WAC. Approved/Granted-Subject to all comments,conditions and requirements noted in Section U and III. 0 Denied Local Health Officer(13) ��/ /�j� �ate: DEPARTMENT COUNTY ' IV 2002 DEPARTtNT OF HEALTH SERVICES .A��]d AR STA *erso ealth Environmental Health Water Quality PO Box r LOCAL(360) 427-9670 Application for Waiver/Appeal BELFAIR(360) 275-4467 &4468 TOLL FREE 1-800-562-5628 FAX (360) 427-7798 Amount Paid.- Receipt Number: L12- Instructions ................. 2. Fens may bebilted .................. ................ .............. ..... 3. mity, 40.0. 00.10NINX 1001ho PART 1: Applicant/Parcel Identification Name of Applicant Yc I A Date Mailing Address Telephone Assessor's Parcel Number C�l C) Subdivision Name and Lot CA- PART 2: Nature of Waiver/Appeal Cl On-Site Sewage Requirements 11 Food Sanitation Requirements 0 Building permit review policies 11 Solid Waste Requirements 13 Location, WAC246-272-09501 0 Group B Water System Requirements c Holding tank WAC 246-2 72-12501 0 Water Adequacy Requirements 13 On-Site Standards 11 Enforcement Timelines C3 Certification contractor(pumper, 13 Departmental Determinations designer, installer, O&Mspec)requirements Other Description Description of Waiver/Appeal(include justification,additional material may be attached): \N0 a \LC 4' �<Appl cant Signature: Date: H KDATAURCHIMWAIVEP WP Update:April 25, 1997 PART 3: Health Department Evaluation (Staff Use Only) IA. Type bf Determination Required: I B. Type of On-Site Waiver(if applicable): ❑ Appeal 9 Waiver ❑ None required ❑ Class A gClassB ❑ Class C 2. Identifrcaton of Specific Code/Standard/Determination(include date of determination or latest code/standard revision): 2y6 -a72- ltsv aF 3. Nature of Appeal: T 4. Hearing Official: ❑ Board of Health Health Officer ❑ Pollution Control Hearing Board ❑ Health Services Director ❑ Certified Contractor Review Board ❑ Environmental Health Manager 5 Mitigating Factors: 3.CX1 U (.j 6. /have reviewed this waiver/variance request. /t is complete, and mitigation required by state and local policy has been submitted. Staff � lA"`� Date: / 0 PART 4: Determination of the Hearing Official The hearing official has determined that approval of this request will not adversely affect public health and is hereby granted. This decision is based on the following findings and conditions: !d ❑ The hearing official has determined that approval of this request could potentially have an adversely affect public health and is hereby denied. This decision is based on the following findings: Hearing Officia Date' H:IWDATAURCHIVEMAIVERWP Update:April 25, 1997 APPENDIX RECEIVED CLASS B WAIVER OF ON-SITE SEWAGE REGULATIONS WAC 246-272 "at 1 b 2002 AND WORKSHEET FOR DETERMINING A REDUCTION IN VERTICAL SEPARqfaNV: CEDAR $Ta This worksheet is used to determine if a site qualifies for a reduction in vertical separation under the Class B Waiver. Please fill out the worksheet in its entirety. Incomplete worksheets are returned to you and will cause delays in your permit application. Part 1:Applicant Information Name of Applicant: �L�� � �� �C ,yam Date: Site Address: �- Mailing Address: 4' �C City:� vvi_ v State: L�, '`' �'\ Zip: c1�1 Assessors Parcel#:��. '�� �c7 t� SWG# CAb c � Part 2: Checklist 1) Sol[Series 3) Cheek the soil structure. 175tbeski ld t�iitt allies::mu;tk/klQarviadtl,. ifiarSbtl0;., n! # )Iramedo[weatu �halrorl chit' te�teily5anrlyoatpr > indt"cefeT �Y� Let Single Grained or Weak ........................ . `.';:�& k �'a: a7F'�3Fr. :k:'x.efi�xFt.:s;.$ ;'y.��' :: ❑ .l❑... w. SJ Well structured ............................... Alderwood Gravelly Sand Loam .................� Other ❑ Harstine Gravelly Sand Loam ................... Cl 4) Cheek percent slope of the primary/reserve drainfietd Roodsport Gravelly Sand Loam.................. ❑ a0m Shelton Gravelly Sand Loam .................... ❑ a a&<.. tveiI Sinclair Gravelly Sand Loam .................... ❑ >' `° 00 s ALA 2) Cheek the soli type: Less than3% ............................... 3%- 5% . ••UK t.:.. 16Y.-30Y• ........................... ❑ Greater than 30% ............................. ❑ ❑ S) Check then slope vertl aration. Loam ...................................... p fl 0 Loamy Sand ................................. 09 % ti r k Sandy Loam ...................... 8A a rp,z•. R n., Peroent Gravel by Volume: x Less than or equal to 60% ..............••.• ❑ Less than 12" ................................ Greater dm60%......................... ❑ :.. .:: Greater then 18" ............................. ❑ Determined by: Depth lOHardpan ......................... 0 ,.,. Depth to Motteling ❑ Both .................................... ❑ ......... l , 6) Check the drainage of the■oil. 101) Check Horizontal Attenuation Zane. Soils must be rrrotlaratety web drained to well A 60 foot horjXtlntai a[tentiatlon zone Is (aGulred drained. down 9radiento"ilia atlb sittface system. Is there less than 50 feet between the down gradient side of Well Drained ... . . . . the proposed primary and reserve drainfield areas and the . . . . . . . . . .. . . . . . . . . . .. . property boundary? Moderately Well Drained . . .. . . . . . . . . . . . . . .. .. ❑ © ��`y'/ Yes .. . . . . . . . . . . . . . .. . . .. . . . . . . . . . Other ❑ Q 7a)Check water table level. if yes,the applicant will need to provide a recorded If a seasonal water table ex)sts above 36", final then a-. covenant or easement prior to acceptance of the on- cudain drain is required. Water tables shallower site sewage application. than 12"are not allowed 10b) Record 50 foot zone on deed. _ m The 60foot hot9Xonfat attehydtion zone IS Tequired Is the water table: It be.recu>st?;d an the aeed,;sf{}�rcpenv as Above 36" ❑ f uobtriwlabfe r s r#:apprpval, Tha owner b ... ..... . ...... .... ... . . . . ........ m must agree that this area will not be used Sor the w Above 24" .. ........... ......... . ........... ❑ Q consbactianof:roads,decks:Wos.yaikfng Above 12.. . . . .. . . ❑ (] j vehiwtartraffc.or other simiiarsuchases. a 7b) Is a curtain drain proposed up slope of the primary -C drainfield area? C Is the owner aware and in agreement with these terms? m (home owner initial ) Yes . . ... . . ... . . ... ........... . . . . .... . .... ❑ Q ' - o Yes . ...... .... . . ................. .. . . .. . . . � — No . . . . . . . . ... . . ... . . . . .... . ... . . . . .... .... .. _. No . .......... .......... .... ...... .. . . . . . . .. ❑ 8) Is the property on marine shoreline? .�•' Is the 50 zone recorded on the deed? Sites'wlthin 200 Jeot 9k mar ne stwraGnes must H ... . . mmplywithstandardreqrtts Yes ......................... ... ... No ...... .... ..... . ..... . ... . ... . .. ... . . . ❑ ❑ uireme Yes .. .... .......... ......... ............... ❑ Q 11) Check proximity to welts No.. ....................................... 3 I}own-gredtenf wells must "lav=1m If yes,Indicate the distance from the shoreline to primaryKtstba.'dt of 2tYQ feet lip-adten drainfield areas feet setback t00feet» 9) Are there any fresh water bodies within,or adjacent to, y ' the roperty boandariest fn a Indicate the smallest distance from existin��of,proposed wells to the c'2 primary or reserve drainfield atcas. _fat A200;toMhonznnta{aeFkadcrtiuslbaitlaintainC4 :: between ffteshoretineandtltCpttmatyandresetve :: Ig 5itrafnfiekfareas. r: s .c< x' k ' Yes ............................. ........... ❑ :<Q� ,�'.h; n a( No . ......................................... ., If yes,indicate distance from shoreline to primary do reserve was: foot. ) Designer Comments: $aItI1T)epaktm #Ctlplmelfl. � • rw' ' 9 z,sy 4SSf ��E.a�$�.'S w�'''�e°$3 I 3 ��xy,°<➢bf�'s bPYuE:s3R ,x f yy�F. .� xY y •�rx'.x&C x'cy .ta �$ r' "hss x r 5�a g 5�,�y'Yljfj,s r�.'y�H2:�X�� htxy �fx rt� C 6 Q Q 3% y� Y iN Part 3: Certification and Approval Applicant Certification: I ify,to the best of my knowledge,that the above information is true and correct. 1 acknowledge that I am solely responsible for maintaining the mtegn of the primary and reserve drainfield areas;and that destruction or damage to the drainfield area may result in immediate rescinding of the onsite se a aplej= Desi� Date Applicant Date Health Department Review: Preliminary Review For Design Submission: ❑Approved ❑ Denied Environmental Health Sanitarian Date Waiver is❑Approved ❑Denied Environmental Health Sanitarian Date Comments: APPENDIX B MASON COUNTY DEPARTMENT OF HEALTH SERVICES CURTAIN DRAIN POLICY DESIGN FORM - PAGE ONE Revised February 18, 1998 4 A d-esIgn will be reviewed when$conies of each of the following Items are submitted: % Completed design form that has been signed and dated % sealed layout sketch.Including all applicable Items on checklist Scaled plot plan,Including all applicable Hems on checklist % Cross-section sketch,Including all applicable items on checklist PAIR IQ1T4Ft+ � (�IN Permit Number: SWG aCO —= igner'sName: Designer's Phone#: Applicant's Name: 11 X _ Assessor's Parcel Mailing Address: 1.7yO et—1 1 Li (Twelve-DigitNumber) ASI Subdivision: City state zip DR;ffi i ) UU aE;31GN P1�l AM- OR0R0 ii Treatment Device Q Glendon Biofilter O Sand Filter O Mound HIN— "DSERVICES 0 Aerobic Unit-Make/Model: --- O Disinfection Unit - Make/Model: Drainfield Type Pressure Bed Drainrock Gravity Trench Gravelles Chambers Septic Tank/Drainfield Specific tions Laterals 1/0 Number of Bedrooms (lass "__ Daily Flow Length I in Septic Tank Capacity Diameter Receiving Soil Type(1-6) 4 Number Receiving Soil Appl.Rate Separation Required Square Footage �g pg®� � p Designed Square Footage Total Numberrt�i PTxL7� DEPT d n Percent Reduction Taken % Diameter Trench/Bed Width ft Spacing JUL 2 5 Naz in Trench/Bed Length Elevation Measurements CEWifold 4/7O Original Drainfield Area Slope ° Len f .12 ft New Slope if Altered 73 % Diameter in Depth of Excavation from inPreferred Manifold Confi¢uration Used? Yes ❑No Original Grade (up-slope) Designed Vertical Separation 10 in -- Transport Pipe (Down-slept) ClassTransport in Length Diameter '1 in Gravelless Chambers Required? ❑ Yes XNo ❑ Optional Pump Required? XYes ❑No Dosing and Pump Chamber Number Doses/Day Pump/Siphon Specifications Dose Quantity gal Difference in Elevation Between Pump Shutoff and Uppermost Chamber Capacity /o (3D gal Orifice: it ft Pump Controls: Timer(or) Elapse Time Meter(circle if required) If Timer: Pump On , Pump Off Uppermost Orifice is Higher, ❑ Lower than Pump Shutoff Capacity @ Total Pressure Head: CheFk fhe following components if they drain between doses: Calculated Total Pressure Head: Laterals ❑ Manifold ❑Transport (Attach Pump Curve) Sp qp DESIGN FORM - PAGE TWO Reviud Febnory It, Iq�, R�B�t�Nt R11�C#I1»!S'I9 Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch Test hole locations Drainfield orientation and layout Referenced depth from original grade: Property lines Trench/bed dimensions and critical Septic tank lid and drainfield cover Existing and proposed wells within distances within layout depth 100 It of property lines O D-Bov,r't^V'locations Critical distance measurements to cuts, Septic tank/pump chamber location Reference depth from original grade banks, and surface water )9 Observation port location and restrictive strata: Location and orientation of curtain 17 Clean-out location Laterals,trench/bed top and bottom drain and all absorption components )9 Manifold placement O Curtain drain collector Location and dimension of primary Orifice placement O Sand augmentation system and reserve area Lateral placement,with distances to Buildings edge of bed Other cross-section detail: Direction of slope indicator �9 Audiblelvisual alarm referenced Observation ports and clean-outs Waterlines 'm Scale of drawing shown on scale bar Roads/easements/driveways/ moss section Itttotltlation;or u(tivad parking Layout itfdrmat[ua for monad ystetTts ayaiem: O Critical resource lands(if applicable) Ovetatl fill dimetasipns P Settled cap dilgth lu eamtoi attd adge of North arrow and scale of drawing q Up•stpge,downslige aad eadsloge 6d shown on scale bar flit width f 3Idcwtdistape C7 Up snipe and downslogc tmdievation'. \Additional Information L9 Design staked out O Operation and Maintenance Notice Attached O Waiver(s)Attached D'�SI(3N Ai�PROUAI The undersigned designer❑does, do t waive the requirement to be notified by the installer of the installation and given 48 hours to perform a final inspection prior cover S`)o - o) 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 local on-site regulation Environmentaf Health 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 On-site Sewage Permit has not expired,the Permit Expiration Date Is: -7 11 u 0 S_ ✓ The system is installed by a certified installer, unless prior authorization is obtained Iforn ason County Department of Health Services. ✓ Drainfield site conditions have not been altered to adversely affect conditions of design approval I-T w, 3� 13q- qO i 0 APPP m/ JUL 25200 CEW �, ; c�bs�RviC�olr 'Po�S - )(D .K '�.►Sta�� �,\e,aa -ohs A� Qac�. eQ�aL ZOO I o I I Ii APPROif ` MC HEALTH JUL 2 5 CF S7ARI ,N ��►sf►,11 Clew-ov�s At FAA 44 i1C eND S - lb - o ) r�u,s�, Cjhwue� r_'I �1 u O APP, ;m- MC HLALTE JUL 2 5 2002 CEW SECURED LID WITH OAS TIGHT SEAL 24•DIAMETER ACCESS RISER FINISH GRADE — — — — — TO PUMP CHAMBER FROM SEWAGE SOURCE FLOATING MAT APPROVED EFFLUENT FILTER SEDIMENTS Q SEPTIC TANK WIC HEE1LfF! DEFT (TYPICALI JUL 2 5 2002 SECURED LID WITH GASTIGHT SEAL CEW THREADED UNION 240 DIAMETER ACCESS RISER FINISH GRADE FROM SEPTIC TO DRAINFIELD TANK EMERGENCTSTORAGE HIGH WATER ALARM LEVEL — — — — — — — — i 11 WORKING VOLUME INDEPENDENT W AJ�Ib4. I Vi�J9v FIOATSTEM FOR FLOAT — YOUNTINO CHECK VALVE• ry�,a oF� paten SEDIMENTS SUBMERSIBLE CENTRIFUGAL PUMP PUMP CHAMBER (TYPICAL) •AS NEEDED �R2�C(ZReCX . 1 14"ANi () J—ArtsV-AU S yst� TODRAINFIELD AAo VA Ili iS to PRESSURE LATERALS } 1 yNC.A3l>SL �AI CK••a 1, I �FII yAIJtS B�kFIo� �aluas LONG SWEEP 90 DEGREE �O�ELBOW APPROVED MC HEALTH DEPT JUL 2 5 7007 CEW TRANSPORT PIPE FROM PUMP CHAMBER DRAINFIELD CONTROL BOX (SLOPING GROUND• MANIFOLD SELOW LeTERAL31 . t SI SKHD150 SP40 SP50 MAX. SOLIDS 3/4"SPHERE MAX.SOLIDS 1-1/4"SPHERE MAX.SOUDSI-1/2"SPH 1-1/2 HP 4/10 HP 1 /2 HP 3450 RPM 1750 RPM 1750 RPM a a � .WYYr _i r R� e Duel shah seals standard. Seal a Available in automatic and manual o Available in automatic and ma failure sensor capability available o Oil-filled ball bee ' r t�ra tJ�6J �4�u F Oil-filled, heavy-duty ball bear (to be wired to an alarm device) incorporates sutAr motor e 1-1/2 HP, oil-filled motor thermal overloaMC HEALTH DEP.T Enclosed, two-vane cast iron e Rugged cast iron construction a Non•clog,two•vane t1�pfmQplytic sewage-type impeller 0 1.1/2"NPT discharge sewage-type impell2 L 2002 • Automatics feature oil•isolatec e Spring loaded mechanical seal a Automatics feature reliable level control diaphragm switch with:carbon and ceramic faces diaphragm switch with eir��l cast iron housing 0 Non-clogging semi-open plug-in V a Rugged cast iron construction thermoplastic impeller a 2"NPT discharge a Mechanical shaft seal with cap e Pump-out vanes on rear shroud of a Rugged cast iron construction and ceramic faces Impeller a Stainless steel shaft a 2" NPT discharge(3" flange e For high head septic tank effluent a Completely field serviceable optional) applications a Residential sewage ejector or high a Completely field serviceable e 1.1/2 HP, 10 230V and 30 20OV, capacity sump pump a All bronze model(SP50A61) it 230V,460V or 575V a 4/10 HP, 10 115V or 230V automatic, to 115V e 1/2 HP, to 115V, 20OV, 230V 30 200V, 230V,460V or 575V ,» 32 32 ,rI I T IW rI I to <te so s 1- 1 ,e Eta sM � e l y e o s - - oa WACm• a 20 ee » so IN In a 32 to ,p V.S.a.►.M. CA►ACm-U.S.G.P.M. CA►AWY.U.a.G.F.M. 1871 E Johns Prairie Road Shelton, WA 98584 360-426-6697 Rob's Excavating GENERAL NOTES l. Rob's Excavating has designed this system in accordance with all-current state and county Health Department requirements and assumes no responsibility for its use or longevity. The owner therefore agrees to maintain and make all necessary repairs to the system at no cost to Rob's Excavating. 2. The contractor shall be certified and approved by the county to install septic systems. 3. The contractor shall field verify all contours, stub out elevators, and trench depths in drainfield areas before construction. 4. All construction materials and installation shall conform to all applicable state and county Health Department requirements. 5. It shall be the installer's responsibility to have a copy of this design onsite at all times during construction. 6. It shall be the owner's and/or installer's responsibility to notify Rob's Excavating and the county Health Department for the required inspections before backfilling. 7. All required tests shall be successfully run before calling Rob's Excava ing for final inspection. All components, including all tank access lids must be accessible for inspection. 8. Rob's Excavating and the County Health Department shall first approve any variations to this design. AP P "'" ' M r 9. Owner/Installer shall not remove any topsoil n ¢Fain field area. Removal of topsoil could render the site unusable. jet � 10. Existing utilities shown on the plans have been plMutt tom the best information available to the designer. Accuracy and completeness are not guarantecul. . . . . . . . . . . . . . . . . . . . . . . . . Have a good Day! ROB'S EXCAVATING 1871 E JOHNS PRAIRIE RD SHELTON, WA 98584 (360-426-6697) INSTALLATION/MAINTENANCE PRESSURE DISTRIBUTION SYSTEMS 1. Install laterals with contour of the ground. 2. Install trench bottoms level and at all times a minimum of six inches into the native soil. 3. Install locator tape on top of all drainfield laterals. 4. Install observation ports as indicated on the plot plan (minimum two per grainfield with bottom extending to the drain rock/native soil interface). 5. Install drainfield during dry weather and soil conditions, and 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. Filter fabric required over drain rock prior to backfilling. If h i�rock-extends above natural grade, run the filter fabric at least 2 inches WIC PjO, Fench wall. 11. Divert all storm water run-off away on-site sewage system. JUL 2 12. No curtain drains allowed within 10 ft. or the up-slope edge of tfield and reserve area. 13. No curtain drains allowed within 30 ft. of the down-slope edge of the drainfield and reserve area. 14. Have the septic tank and pump chamber pumped or inspected every three to five years. 15. Inspect floats, clean pump screen and test water alarm every 6— 12 months as needed. • I 16. All materials and workmanship must meet County and State regulations. 17. Septic tank risers to be at or above finish grade. 18. Deviation from this design without prior approval from the Designer and Mason County Health Department will make this design null and void. 19. Pump chamber lid to be above finish grade. 20. The on-site septic system owner is responsible for properly operating and maintaining the OSS and shall: a) Determine the level of solids and scum in the septic tank once every three years. b) Employ an approved pumper to remove the septage from the tank when the level of solids and scrum indicates that removal is necessary. c) Protect the OSS area and the reserve area from: 1. Cover by structures or impervious material 2. Surface drainage 3. Soil compaction by vehicular traffic or livestock 4. Damage by soil removal and grade alteration d) Keep the flow of sewage to the OSS at or below the approved design both in quantity and waste strength. 21. High strength waste will increase the depth of the biomat in a drainfield, causing a decreased flow through the biomat and possible ponding or flooding of the drainfield. High strength waste in a residence is usually related to the"lifestyle"or habits of the home, generally resulting from one or more of the following: a) Excessive use of a garbage disposal b) Consecutive loads of laundry done all on one day c) Excessive bleach or detergents with added whiteners d) Dishwashing, showering, and laundering all at the same time e) Medications—antibiotics can kill or impair the biological process in the septic tank. f) Leaky plumbing (hydraulic overloading) APPRMC VEP JUL 2 5 2002 CEW As-BUILT FORM Revised Febmuy ts, 1999 Applicant 1�� ��\4� SEP 05A§seokr's '- oa\ q-11 wL6 Permit Number /SWGa' - OOc')`ftP 426W. CED�°.�� (Twelve-Digit Number) Installer �K�o��\ �n+m�a Subdivision (NemetDw w lslonteloeLot) Designer I#98'I!`AIRI. �*rH�GKWST !. N/A Yes Prior to Completion 1. SEPTIC TANK A) >5 ft,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? . . . . . . . . 4 . . . . . . Y. . . . G) Tank Size:�—gal.; Manufacture .�xz`CS 11. ) Lev ox A) Leveled with water? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B) Speed leveler used? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . — 111. DRAINFIELD A) >10 ft from foundation and>5 ft from property lines? . . . . . . . . . . . . . . . B) >100 ft from wells and surface water? . . . . . . . . . . . . . . . . . . . . . . . . . . . . C) >10 ft from potable water lines? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D) Laterals level to± 1 inch&end caps present if not looped? . . . . . . . . : E) Gravelless chambers utilized? . . . . . . . . . . . . . . . . . . ./ r ' � h p 7� F) System dimensions the same as shown on the design? . . "(. .�.l . . . .7. r� G) Gravel clean,properly sized, and proper depth? : : H) PRESSURE SYSTEMS -/ 1) Sand quality ASTM C-337 . . . . . . . . . . . . . . . . . Y 2) Head height uniform and z24 inches? Actual head height 3) Clean-outs and observation ports present? . . . . . . . . . . . . . . . . . . . . . 4) Mound: Side Slope3:17 . .. . .... . . . . . . . . . . . . . . .. . . . . . . . . . . 5) Owner informed electrical connections must be made by owner or licensed electrician and inspected by L&I? . . . . . . . . . . . . . —L�(Zawavw rl i a rQ C IV. PUMPIPUMP CHAMBER A) Pump make \k, &orn ;� ; Pump model sp�� — B) Chamber size gal; Manufacture �,AS C) Height of pump off bottom of pump chamber 4 inches D) Pump chamber draw-down gallons per inch E) Pump capacity 0j(3 .L.p% gallons per minute F) Pump controls:Timer(or)Elapsed Time Meter (circle If Installed) If timer is used: Pump On Pump Off — G) Screen basket o e nt fil (circle one)installed? — H) Riser installed for access? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 . . . . . . . . — I) Alarm installed? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ' f A&-BUIt.T I�fiAYY1.N4'� ,. CHECKLIST n c - ElDrainfield&manifold Cv(�Nq l b VtiSJ orientation & layout ❑ Trenchlbed dimensions and critical distances within layout ❑ Septic/pump tank placement. 1 'Av �ifi� i ❑ Location of buildings. ❑ Observation port&clean- out location. ❑ Location of wells& roads. 1 ❑ Undisturbed native soil between trenches. O North arrow CAUTION:Minor adjustments to septic tank location and drainfield orientation made in the field by the installer are generally acceptable to both the department and the designer,but could in certain cases compromise the viability of the system. It is the installer'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. �iERTIFIQ4TIQN�F:1NI�'#`{lt.fTli'J�1 Installer Check a box from Row"A"and'B",sign and date the certification 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 MCDHS are shown above. MCDHS B. ❑ I certify that I contacted the designer and left the ❑ I did not contact the designer prior to frial cover because the system open for inspection up to 48 hrs prior to designer waived the notification requirement. cover. I further certify that all information contained on this form is a orate.iiaNturen hat if the information contained herein is not accurate,there will be just cause for immediate suspension of m 'nstansta a ate The undersigned approves this installation on behalf of Mason County Dee of H �ices. C— �ipZ/ Sanitarian I Date,[