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HomeMy WebLinkAboutSWG98-0229 - SWG Application / Design / As-Built - 5/21/1998 MASOWbOUNTY DEPARTMENT OF HEALTH SERVICES PERMIT NO. SWG r n y 426 W. CEDAR/P.O. BOX 1666/SHELTON,WA 98584 Date H: c PHONE (360) 427-9670 Receipt ourd$oSYS z PRY,FlEfff OWNER, w E '�, _ CHECK APPLICABLE ITEMS �/ m m NG RE$S: DAYTIME PHONE: NEW SYSTEM o y� REPAIR SYSTEM CITY S IU MAINTENANCE REVIEW m b q SINGLE FAMILY PROPER SS: OTHER p Z SPECIFY: -1 3 PRATE WELL mECIFIC DI �� .aCTIONaFOR 146 COMMUNITY WELUPUBLIC SYSTEM h 1 L ` SYSTEM WFI# W SYSTEM NAME ® APTkcw NAM Name of O� r S � Lot ft.x ft. I ING DRES v I� Installer LV: '.3�� TELEPHONE a (Mc6 )&*%w;w K _F, Name of " (f Size: cres Number SIGNATURE y'o Designer Bedrooms X PLOT PLAN Draw a dime h{�sih�r¢r I plot pla w I �� IV including: FQa m❑Precise loea�n o t �holes,shogmeasured ii anc o �property bomtdarie6❑Entry road—tFher ro&g,drivewaysr� NOTE: DO9!IuDRAW IN SYST94A• SIGN w 0 CPi OFFICIAL USE ONLY. DO NOT WRITE BELOW DOUBLE LINE. SOIL LOGS f£St I rDLE I r _t kt e 0-2 regr ril e 3 a--la" IraMly tom 0-Z3 "9r0AVjjyLOAM- -24// r Ioa4m - (4-Z )' 5ZO4,aS 44L Z3 -30 V_eQU'VafWeZCA-- slt7�u 20 Hard p'ha,f 0 ut?x�t�rtwQll y gesuAfvF s�rininy ?or (oe" fcau lizo fawn W-37`r a44, AP2A mn Nr obs. 17 cfe*r3 DESIGNER DESIGNATION SCORES MINIMUM SYSTEM REQUIREMENTS Finding/ IV] core Designer Level: ❑One Two Soil Type Soil Depth •'l in. L Septic Tank Daily Capacity: /2OO Gal. Flow: 36 GPD Slope Appl. !- Infih. Parcel Size I� Rate 6 GPD/FT' Area FT- Distance to Shoreline /� �_ Total I 'Tor Date L COMMENTS/CONDITIONS FOR APPROVAL •All on-sits waWe 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 0.e.RLC,Water Adequate have been met. •Any change from the specified use of the property or arty site alteration affecting the system design may Invalidate this permit. •This perm expires 2 years from the dffie of site review.17enial of this permit maybe appealed to the Hearth Olfxx+r within 10 days of denial date. SITE EW: DESIGNREVIEW:�Approved U Not Approved INSTALLATION:�Approved ❑Not Approved BY: MQVJ#bTE: BY: DATE:b_�,Oy IBY. � DATE: 61ZI1Oo TOP: Health Dept.Copy MIDDLE: Designer's Copy BOTTOM:Applicants Copy )F,SiGN Vr RIM - ?AG , O'NIE _ n ( i c �l8, 1998 design will be reviewed when 33 cow of each of the following items are s A:V i Completed design'form that has boon signed and dated e. Scaiod layout sketch,met I A all ap Ic I t slon check Scaled plot plan,Including all applicable Items on chocklist o Cross-section sketch,Inclu g all a lW 1 It�ris;fin checklist p PARCEL IDEN I'iFiCATICN Permit Number: SWG 0Qa Ig Designer's Name: y� Designer's Phone N: t Applicant's is rne: K�1 V l �`t Assessor's Pa;cei No.: Mailing Address: -1 1 z `� (Tweive-Digit Number) �,1' WD tJ �JJAS b10 Subdivision: City State Zip (Namc/Diviision/giockflot) I tDMGN PARAMETERS Treatment Device v Glendon 3iofi;tcr O Sand Filter a Mound O Sand Lined Drainfield XAerobic Unit-Make/Modci: Noewtuo a Disinfection Unit - MakefModel: MC HEAD lei? W Pressure IIed --IIUN 1 3 2006 *rainrock Gravity Trcnc7, ❑Graveiles Chambers Septic Tank/Drainfield Specifications PSD I Laterals /® Number of Bedrooms 3 Schcdui Crass T _Zp -- Dail Flow ,p d engtil Septic Tank Capacity gal Diameter n Receiving Soil Typc(;-G) i Number Receiving Soil Ap pl. Rate Separation ft tcquired Square Footageftz Orifices �7 Designed Square Footage few Total Number of Orifices ereent Rccc;en Taker, rich tied v✓ictit i Dia meter ❑ Spacmg in rent i ed Length Elevation Measurements Manifold j chcuic iass Original Drain:old Area Slope %"'� g` Len by New Slope if Aacred p 3 ;. Diarnc[c: �. in Depth of-xa. :pion from tk• ❑No Original Grade (tjp-slope) Pre ferried Manifold Configuration USed? Yes Designed Vertical Separation, i it Transport Pipe (�(Dorn-sloipe) Sc x•d i,ic. Class n Len Gth 6,10 Ft Diai,lctcr in Graveliess Cha nibers Required? + Yes %No L ) Opt o ri,LI Pump Required? Yes a No Dosing and Pump Chamber Pump/Siphon Specifications Number of Doses/Day / i e Dose Quantity ai Difference in Cievation Between Pump Shutoff and Upp• 1 ost i Chamber Capacity al Orifice: ft Pump Controls: Timer(or) Flapse Time Meter(circle if required) _ If Tuner. Pump On Pmnp Off Uppermost Orifice is Higher, _/ i.ower than, Pump Snutofv/ — — Capacity @ Tota' Pressure Head. ° U I Z, m Check the following components if they drain between doses: Calculated Total Press„-e Head: IG a ; '1 Laterals 7J Manifold ❑ Transport (Attach, Pump Curve) l l9 DESIG.N FORM - TWO Revised February ia, 1 DES:Gib CHECKLISTS Scaled Plot Plan j Scaled Layout Sketch Cross -Section Sketch T"" '. locations - �I Urainficld orientation and layout � Referenced depth from oriRinnl grade: 1 Property lines - �j Trench/bed dimensions and critical 171 Septic tank lid and drainfield cover Ex is, and nroposed wd!: ti n distances wrthm layout depth 100 ii of prn,-rr;y lines �0 D-[toxr.T"P'I:' locations u"7 Critical distance measurements to cuts, M Septic tank/pump chamber location Reference depth from or�ninnl grade banks, mid surface water Observation port location j\and restrictive strata: I 0 LocaLon and orientation curtain 0 Clean-out location M Laterals,trench bed top and bottom drain and all absorption connponents .�O Manifold placement 0 Curtain drain collector so Lowe;,� arrl dimension or.[. '\I0 0"it7cc placement I O Sand augmentation System and reserve area 7 Lateral placement,with distances to I ! Buildings edge of bed ?Other cross-section detail: f �� Dirrr?l­, of slope indc ' 0 iible/visual alarm referenced ! C7 Observation ports and clean-outs !"`S Roads/ncs wsemcnh/dri y Layout information for mound system:Sc� e of diawmg shown on scale bar 1 vcwn -c/ �.C,W section information for mound parka: system: Critical resource lands(if applicable) 0 Overall fill dimensions j O Settled cap depth at center and edge o '!�e North arrow and scale of drawmr ,d . r t`--- I t Ln slop c down.slop c and ends one she.. ❑scale bar r width _7� D Sidewall slope All F 10 Up-slope and downslope bed elevatio i Mc HF'Ain -- - iJUN ' Additional In`orrnaton 13 Gl Dcsig,n staked out f1 L+� O Operation and Maintenance Notice 1�v7 Attached f 1 0 Wmver(s)Attached JESIC-N APPROVAL The undersigned designer does, does not, waive the requirement to be notified by the installer of the installation and given 48 hours to pci'om ".ra: rspectiw-, p cov� Signature of Designer Date The undersigned has reviewed this deign on behalf of Mama County Department of I Icallh Services and determined it to be in compliance w t v i•e and oc d -churations: 1 Environmental health Specialist Date Caution: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION: I ✓ The design is stamped "approved" by Mason County Department of I-Ieelth services. Tlac On-sic oewagc perm;;has not expired, the Permit Expiration Date is: 5-2q -Q ✓ The system is insta!;ed by a certified installer, unless prior authnrmrltion is ohtained from Mason County Dcpanmorit oft-lealth Services. ✓ D; ;,e:d site conditions liavc not been altered to adversely affect conditions of design approval k� I'- 1 " 77) C) z I ✓ � III II APPROVED MC HEM TH EPT JUN 1 .1 2000 Ih _ ' e��,Q PSD,V C. I i itAi1 � I I i I I i I I I � I j � I i a .v ar�UTd 3 M�fp /isa UUN , PSO i I � 3 ' uy 1"•YrJ rl **;z hill'$ N l Y/ Yµ-' 'K YT Y •i iA rv.Y I �g � � M r I 4 ^41 1 • • e e r . • 11 !7 p•. ■ I n f • • i t ' I � f Ile, /�AIlnC.�P�/ S�1SI PM'1 TO DRAINFIELD RHO �AIV�S �O PRESSURE LATERALS At } �AII vAIILS pE �-, JIjN � 2000 psi) I LONG SWEEP 90DEGREE ELBOW , a-- ptil j TRANSPORT PIPE FROM PUMP CHAMBER I I i DRAINFIELD CONTROL BOX (SLOPING GROUND• MANIFOLD BELOW LATERALS) 1 lil I S1 SKHD150 SP40 SP50 1 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 I I I t 'jam . -y ..A t lit • Dual shaft seals standard. Seal • Available in automatic and manual • Availabl n ufomatic and me failure sensor capability available • Oil-filled bail bearing motor • Oil-fillede,�+ ;y all been (to be wired to an alarm device) incorporates automatic reset motor 9 g� /T • 1-1/2 HP, oil-filled motor thermal overload • Enclosed,twoW- - • Rugged cast iron construction • Non-clog, two-vane thermoplastic sewage-ty,)fpp//��,gqelle� j:BF 0 1-1/2•• NPT discharge sewage-type impeller • Auto maticsTe•At2rRo"Matec • Spring loaded mechanical seal • Automatics reature reliable level control diaphragm sJvitch with,carbon and ceramic faces diaphragm switch with piggyback cast iron ho • Non-clogging semi-open plug-in • Rugged cast iro ,tstruction thermoplastic impeller • 2" NPT discharge • Mechanical shaft seal with car • Pump-out vanes on rear shroud of • Rugged cast iron construction and ceramic faces impeller • Stainless steel shaft • 2" NPT discharge(3••flange • For high head septic tank effluent • Completely field serviceable optional) ap„1 ations a Residential sewage ejector or high • Completely field serviceable • 1.1/2 HP, to 230V and 3o 200V, capacity sump pump • All bronze model (SP50AB1)in 230V,460V or 575V • 4/10 HP, 10 1 15V or 230V automatic, to 115V • 1/2 HP, 1 o 115V, 200V, 230V 3e 200V, 230V,460V or 575V 100. u Jz I ` 120 YYY999 i iT� 024 so is � 40 a � i , � . 'J o l- l }� °o t�o z --aoi.. i. " o I-�� a f-� N -r-t-'1_`i I- III ' 1 ' e o ' i 0 so Go 0 20 .0 00 90 100 120 0 32 M 99 119 180 CAPACITY U S G.P.M. CAPACITY.U.S.G.P.M. CAPAWY.U.S.G.P.M. 1871 E Johns Prairie Road Shelton, WA 98584 360-426-6697 Rob's E xcavafing GENERAL NOTES 1. 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 dep'hsin drainfield areas before construction. 4. Ail construction materials and installation shall conform to all applicable state and county Health Department requirements. 9 5. It shall be the 'installer's responsibility to have a copy of this design onsite at all l times during construction. 6. it shall be the owner's and/or installer's responsibility to notify P Rob's , Excavating and the county Health Department for the required inspection q�OV before backfilling. ,SUN 1 �depg 3 zQ�z 7. All required tests shall be successfully run before calling Rob's Excavating�y� 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. I 9. Owner/Installer shall not remove any topsoil in drainfield area. Removal of topsoil could render the site unusable. 10. Existing utilities shown on the plans have been plotted from the best information available to the designer. Accuracy and completeness are not guaranteed. Haut agr&Days ROB'S EXCA VA TING 1871 E JOHNS PRAIRIE RD ,SHELTON, WA 98584 (360-426-6697) INSTALLATION /MAIN'TE.NANCE PRESSURE DISTRIBUTION SYSTEMS Install laterais with contour of the ground. ,2. Install trench bottoms level and at all times a minimum of six inches into the native soii. Install locator tape on top of all drainfield laterals. 4. Install observat is asion po indicated on the plot plan (minimum two per drainfield 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. S. Install 1/8 inch mesh non-corrosive pump screen (min. 12-sq. ft. surface ar at interfere with controls or floats). I/1 L-r 9. Install check valve in pump outlet line to prevent system from draining back i4N* 3 pump chamber. ?OC(; 10. 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. 11. Divert all storm water run-off away on-site sewage system. 12. No curtain drains allowed within 10 ft. or the up-slope edge of the drainfield 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. ib. Al; r aiCrla.s and WOrkad'uS:ip :ii7is't i7.ect COuniy and State reguiations. i%. Septic tank risers to be at or above finish grade. .s. ✓cv;dtion from t:.is dCsigr. without prior approvd, from the Designer and Mason County ilca4l-, Depanrnera w", take tais uCs3gn lull and Void. i7. ?Um? d::a:noCr ud i0 be a0ovc ttiit Sl &adc. 2v. he o,-:-S.ic SCID",c sysiCm oWr.C: is iesponsiJ:C Gi properiy operating and maintaining 0 S S aLC Si.ait: d� ✓eiCCLiuIC ti:C iCVe. Oi Soiius and scuw, in :%e septtc tank- Once every .is e yea:S. Jj p;c,y dS 3.�,3:oved j7UnipCr:0 reniove ine scptagc froim the tank Wi.cn t?C :evc. Ot So.lds aid, scr uL". lnu'icates that rernoval is necessary. Cj rG:CCt i.1C VJS a:Ca and tnc is c ve area i707C - Ccwc:by ":lateral 2. w::aCC dCar;io C J. .>GI: cox.pactlon, Gy Vcn:cil.a: t:afilc Or livestock 4. ✓an:ao-C ay soi: rCrnOVii. acid grade alteration dj Keep :;ic flow o;"sewage to t;.e OSS at or below the approved design c'Ganilty ai.d W'IS'iC StrCiigi.:. 2'i. High strengtu Waste W;ii :ncreasc tic 6eptn Of u:e bionat in a dralnficid, causing a dJCrCased "IOW tC::JUga tie biornat and possi ole pondi'r.Z;or fd ooing Of the drainfield. high strength waste in a residence is usaaiiy related to the"iifestyie" or habits of the n0me, generally resuitino' '- i-n one Or 3 oi—c Oi ine foiloW:nS: a% Excessive iisc Ot a ga,!)a3e u:s"JO;a: 3 bj Consecc:ive loads o laundry cone ail on one day c', —Excessive b:cdch of detergents with added whiteners d j viSnWaS :ing sI.OWCiing, arid iaunuC.i:ig ali at !,he 4f tplmg^ C) 'M g;G Ca. ohs a. ..J:ot+Cs car: kiii Or Impair u:C biologicaO �D llw sepuc ",ink. ��'11117777 KEPT iJ Leaky piumbli;g (nyu 11 over;oacing) 1UN 3 2000 PSO I ON-SITE SEWAGE INSTALLATION FINAL INSPECTION DATE CALLED IN: �l T]ME: INSTALLER: OL/7 APPLICANT/OWNER: 9,�:!f I= v=zj CALLER: 0 lL/ / _ PHONE#OF CALLER: 614 SWG#: y A PARCEL NUMBER: �)1X SUBDIVISION: Div: Lot: SYSTEM TYPE(CHECK ONE): 0— PRESSURE GRAVITY INSPECTION SCHEDULE(CHECK ONE): APPOINTMENT PLUG IN AS-BUILT ON-SITE(CHECK ONE): Q El YES No STAFF INrnALS: TSxTis {�NLSe . : APPOINTMENT DATE: 6 )^l TIME: 'COMMENTS: , '^- A �0 x � �✓fO'� 7 NyI`7' uI'pfD�I�A��, 6�.�'�� ON-SITE SEWAGE INSTALLATION STAFF INSPECTION REPORT Yes No Comments I. SEPTIC TANK A) >5 ft.from foundation? _y- N d � o..v�clA3t�ct, B) >50 ft from wells and surface water? C) Bldg stub-out to septic tank:clean-out if not 1-2e/s? D) Baffles intact and clean? _ E) Dividing wall intact? F) Risers installed for access? 11 D-Box Leveled with water and/or speed leveler(circle)? Ll I q III. DRADMEM A) >10 ft from foundation and>5 ft from perceived property lines? >< B) >100 ft fiom wells and surface water? f C) >10 ft from potable water lines? x, D) Laterals level to±I inch&end caps present if not looped? X E) Gravelless chambers utilized? F) System dimensions the same as shown on the design? k G) Gravel clean,properly sized,and proper depth? H) PRESSURE SYSTEMS 1) Sand quality ASTM C-33? 2) Head height uniform and 2:24 inches? 3) Clean-outs and observation ports present? 4) Mound: Side Slope 3:l? x N A 5) Owner informed electrical connections must be made _ by owner or licensed electrician and inspected by L&V 1V. Pu irAhmEte A) or effluent filter(circle one)installed? B) Riser installed for access? C) Alarm installed? D) Pump on timer or d4 (nan le)7 V. As-BOILIrREQvmED? — — VL OTTIER CohmmiWOBSERVATIONS � Lod z s-i7�i I The undersigned has reviewed this installation and verifies these findings on behalf of Mason County Department of Health Services. Sanitarian Date Q WyFilesVuudchedcwpd Revised 9/26/97 AMALT ]PORM � ROE 0 WI&WIS.19" Al*libant �e ;'c�, �v\�f a^` Assessor's PERNUT SlSTANC CE Efrj Parcel # Q) PeiilitNtmlber SWG (Twe1ve01gnNumber) ' In§tallet o�JS � � Subdivision (NameroMsionlelocWtot) D69igner xrKv INSTALL �,`1iEt:KLIST NNW— NIA Yes Prior to Completion L `SEPTICTANK % 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) Battles intact and clean? . . . . . . ... . . . . . . .. . . :. . . . . . . . . . . . . . .. . . — E) Dividing wall intact?... . . . .. . . . . .... .. . . . . . . . . . . . . . . . . . . . . . . . . F) Risers installed for access? .. . . . . . ...... . . . . . . ° G) Tank Size: gal.;Manufacture K� di D-BOX A) Leveled with water? . . . . . .. . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . B) Speed leveler used? . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . �— — III. DRAINFIELD / A) >10 ft from foundation and>5 ft from property lines? .. ..'. . . . . . . . . . . — B) >100 It from wells and surface water? . . . . . . . . . . . . ... . . . . . . . . . . . . . C) >10 ft from potable water lines? . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . D) Laterals level to±1 inch&end caps present if not looped? . . . . . . . . . . . B) Gravelless chambers utilized? . . . .... ... . . .. . . . . . . . . . . . . . . . . . . . . F) System dimensions the same as shown on the design? . . . . . . . . . . . . . . . . G) Gravel clean,properly sized,and proper depth? PRESSURE SYSTEMS err . 1) Sand quality ASTM C-33? 2) Head height uniform and x U 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? . . . . . . . . . . . . . �L 1*: PUMP/PUMP CHAMBER A) Pump make Pump model SP go .• B) Chamber size gal; Manufacture — }: ,C) Height of pump off bottom of pump chamber inches — i Pump chamber draw-down aQ_ gallons per inch E) Pump capacity y0, f'Z, gallons per minute Pomp controls:Timer(or)Elapsed Time Meter (circle if installed) / If timer is used:Pump On Pump Off — G) Scroen baske r effluent filter(circle one)installed? . . . . . . ... ... . . . . Riser installed for access? . . .. . . . . . . . . ...... . . . . . . . . . . . . . . . . . . . . J) Alarm installed? . . . . . . . . . . . .. . . . ....... . . .. .. . . . . . . . .. . . . . . . . 1l,T[�111WiQ!. i mar,•: CHECKLIST W ❑ Drainfield&manifold orientation &layout a p ❑ Trench/beddimensions A* and critical distances within layout ❑ Septic/pump tank placement. ❑ Location of buildings. ❑ observation port&clean- out location. t „ ❑ Location of wells& roads. o�l� ❑ Undisturbed native soil between trenches. 1 r, ❑ North arrow 3 Q�z CAUTION:Minor adjustments to septic tank location and drainfield orientation made in the field by the installer are GBenerally acceptable w both4he t and she deiigner,but could m attain eases compromise the viability of the system. It is the installer's responsibility to obtain prior written approval Rpm. aril e health department or the designer before making any deviations fan the design that affect the system viability. Any deviations from the approved detipR�paut be shown above. � RT[FtCATiQN©F I Niht.Y A EiOht 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 `AppRov6D"by "APPROVED"by MCDHS are shown above. MCDHS B. �1 I certify that I contacted the designer and left the ❑ I did not contact the designer prior to final cover becapfe 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 ace e. derstand that if the information contained hgrpin is not accurate,there will be just cause for immediate suspension of m ' staller ificetiq�. tgna of Installer Date The undersigned approves this installation on behalf of Mason County Department of Health Services. W L( Lb sanitarian te