HomeMy WebLinkAboutSWG2002-00035 - SWG Application / Design / As-Built - 2/1/2002 **t
PERMIT NO. SWG — to D
SO COUNTY DEPARTMENT OF HEALTH SERVICES, Q H
a m
4 W. CEDAR/P.O. BOX 1666/SHELTON, WA 98584 Date
Receipt No. 0y
PHONE (360) 427-9670 Amount$ m
PFPMOW F
G� \ DATE: _ O CHECK APPLICABLE ITEMS �/ m m
1
MAILING ME DAYTIME PHONE: NEW SYSTEM
REPAIR SYSTEM -
OA uNl�(L p TABLE REPAIR obi
CITt `�� STAT O�I L MAINTENANCE REVIEW OR
PROPERTY ADDRESS: `` O SINGLE FAMILY z
N� OTHER: 4 3
S�€CIFIC DIR CTIONAR L TI�N�G SIT PRIVATE WELL
jW 1 COMMUNITY WELL/PUBLIC SYSTEM
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SYSTEM WFIN
0V,-) SYSTEM NAME I�
\� APP T
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Name Lot �33 ft.x $�r ft. MAILINGADDRESS
Installer Sv ^
Size: oL acres TE EPH o � �•-
Name SIG A
Number o o'
Designer p % �) Bedrooms X '
OFFICIAL USE ONLY BELOW THIS LINE I�
DEPARTMENTAL SOIL LOGS DEPARTMENTAL COMMENTS/CONDITIONS
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SOIL TEXTURE CODES:
V=Very G=gravelly S=sand L=loam Si=silt C=clay E=Extremely
INSPECTOR(print name) INSPECTION SIGNATURE DATE PERMIT EXPIRATION DATE
2 1 Z L
•All systems require ongoing Operation and Maintenance(O&M)as specified in Mason Cou ty On-Site Standards.
•All on-site sewage systems must be designed by a Masan 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 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.
DESIGtRnEW APPROVAL BY: DATE: INST TI N AP D BY: DATE:
TOP: Health Dept. Copy MIDDLE: Designer's Copy BOTTOM: Applicant's Copy
MASON COUNTY
DEPARTMENT OF HEALTH SERVICES
February 22, 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
SEATTLE (206)464-6968
Shelton WA 98584
RE: Design for MCNEIL
Case No: SWG2002-00035
Parcel No: 321343400020
Your design for the above referenced parcel has been review and is
APPROVED. Please refer to the comments section of this letter for any
Please call me at (360) 427-9670, ext. 554 if you have any questions.
Sincerely,
Pam Denton
Environmental Health
Mason County Health Services
COMMENTS:
2/22/2002 1 of 1 SWG2002-00035
DESIGN FORM - PAGE ONE Revised February 18, 1998
A design will be reviewed when 33 conies of each of the following items are submitted:
ConspkNed design form that has been signed and dated *A Scaled layout sketch,Including all applicable Items on checklist
Scaled plot plan,Including all applicable Items on checklist % Cross-section sketch,Including all applicable Items on checklist
PARCFt.I[3�NTtFlCli7'�(�N
Permit Number: SiVLQa. Designer's Name:
Designer's Phone#: g I
Applicant's Name: Q�\ ,_ Assessor's Parcel No.: a 13 - 3 - 000 aQ
Mailing Address: `( >J tJQ2 (Twelve-Digit Number)
2 Subdivision:
s1y�s���yyA/�■��1t ��++.�syy (Name/Divisio o 0City State Zip
Treatment Device
O Glendon Biofilter O Sand Filter 0 Mound XSan ed Ds eId
510017
❑Aerobic Unit-Make/Model: 0 Disinfection Unit - Make/Mode ROBERT GO DWIN '•. ! 4
DrainfieldTypeyp�o=
Pressure 4Bed rainrock
Gravity Trench O ravelles Chambers
Septic Tank/Drainfield Specifications Laterals f !_
Number of Bedrooms Schedu /Class
eng
Daily Flow o0 end Diameter
Septic Tank Capacity 1 nr) eal Number
Receiving Soil Type(1-6) I Separation ft
Receiving Soil Appl. Rate l
Required Square Footage fe Orifices
Designed Square Footage ft2
Total Number of Orifices
Percent Reduction Taken n % Diameter
Trench/Bed Width l0 ft Spacing ! in
Trench/Bed Length ft
Elevation Measurements Manifold
c e u Class
Original Drainfield Area Slope ° Length
New Slope if Altered % Diameter e2
Depth of Excavation from m Preferred Manifold Configuration Used? ❑ Yes No
Original Grade (uF-slope>
Designed Vertical Separation in c e Class Transport Pipe t
in Length ft
�^111 (Down-slope)
Diameter 1
Gravelless Chambers Required? ❑ Yes No ❑Optional
Pump Required? I Yes ❑No Dosing and Pump Chamber
Number of Doses/Day ip
Pump/Siphon Specifications Dose Quantity 7U gal
Difference in Elevation Between Pump Shutoff and Uppermost Chamber Capacity al
Orifice: I Pump Controls: Timer(or) Elapse Time Meter(circle If required)
If Timer: Pump On , Pump Off
Uppermost Orifice isX Higher, ❑Lower than Pump Shutoff
Capacity Q Total Pressure Head: 2pmCheck the following components if they drain between doses:
Calculated Total Pressure Head: Laterals ❑ Manifold ❑ Transport
(Attach Pump Curve) ,/O
DESIGN FORM - PAGE TWO Revtred FeWuwy to 19,.
DES1�3N CHQKI„#STS
Scaled Plot Plan Scaled Layout Sketch Cross-SectJofi 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 ft of property lines O D-Boxf'T'P'L" locations
Critical distance measurements to cuts, )S] Septic tank/pump chamber location Reference depth from original grade
banks,and surface water Observation port location and restrictive strata:
Location and orientation of curtain Clean-out location Laterals,trench/bed top and bottom
drain and all absorption components b Manifold placement O Curtain drain collector
Location and dimension of primary Orifice placement Sand augmentation
system and reserve area \10 Lateral placement,with distances to
Buildings edge of bed Other cross-section detail:
Direction of slope indicator Audible/visual alarm referenced Observation ports and clean-outs
Waterlines Scale of drawing shown on scale bar
Roads/easements/driveways/ t�tissm�fiwattttgytjti
parking Layout lnftiirmatioa fAl mou4dsypkwail syataatf
Critical resource lands(if applicable) Overall f#II dlmerlslons £1 Se.... cap dep(Jt arga rtgtd a
North arrow and scale of drawing bed
CI Up•slapo,downslope,and Oro. 1 pe
shown on scale bar fill width Q SidewalJ slaps
Up-slope and downsl J>p41Jtiv@tiPr
Additional information
nr, Design staked out
O Operation and Maintenance Notice
Attached
O Waiver(s)Attached
Q SIC3N APPROV,
The undersigned designer❑does, IEl do waive[he requirement to be notified by the installer of the installation and given 48
hours to perform a final inspection prior o cover.
Signature U Designer Date
The undersigned has reviewed this design on behalf of Mason County Department of Health Services and det
compliance with state and local on-site regulations: 5100,172
ROBERT GOODWIN;.
Environmental Health Specialist Date i' NS ..00
Caution: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION: FXP!RcS OB-03- __
✓ 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:
✓ The system is installed by a certified installer,unless prior authorization is obtained frovii Mdson County
Department of Health Services.
✓ Drainfield site conditions have not been altered to adversely affect conditions of design approval
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SECURED UO WITH OAS TIGHT SEAL
240 DIAMETER
ACCESS RISER
FINISH GRADE
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CHAMBER
FROM SEWAGE
SOURCE FLOATING MAT
APPROVED
EFFLUENT
FILTER
SEDIMENTS
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ROBERTO..DWIN ;. ASEPTIC TANK
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SECURED LID WITH OAS TIGHT SEAL THREADED UNION
240 DIAMETER
ACCESS RISER
FINISH GRADE
FROM SEPTIC TO DRAINFIELD
TANK
EMERGENCY STORAGE
HIGH WATER ALARMJEVEL, - - - - - - - -
` WORKING VOLUME INDEPENDENT
FLOAT STEM
FOR FLOAT- - - - - MOUNTING
CHSOK VALVS
SEDIMENTS SUBMERSIBLE
CENTRIFUGAL
PUMP
PUMP CHAMBER
rNPICALI
•AS NEEDED
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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
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•40 C+
U. ROBERT GOODWIh
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• Dual shaft seals standard. Seal • Available in automatic and manual • Available in automatic and me
failure sensor capability available • Oil-filled ball bearing motor • Oil-filled, heavy-duty bell bear
(to be wired to an alarm device) incorporates automatic reset motor
• 1-1/2 HP, oil-filled motor thermal overload • Enclosed, two-vane cast iron
• Rugged cast iron construction • Non-clog,two-vane thermoplastic sewage-type impeller
• 1-1/2" NPT discharge sewage-type impeller • Automatics feature oil-isolate(
• Spring loaded mechanical seal • Automatics feature reliable level control diaphragm switch
with carbon and ceramic faces diaphragm switch with piggyback cast iron housing
• Non-clogging semi-open plug-in • Rugged cast iron construction
thermoplastic impeller • 2" NPT discharge • Mechanical shaft seal with cat
• 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)
applications • Residential sewage ejector or high • Completely field serviceable
• 1.1/2 HP, 1 a 230V and 3o 20OV, capacity sump pump • All bronze model(SP50A81) it
230V,460V or 575V • 4/10 HP, 1 e 115V or 230V automatic, 1 a 115V
• 1/2 HP, 1e 115V, 20OV, 230V
3o 20OV, 230V,460V or 575V
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CA►AWTV•U.S.G.P.M. CA►AWY•U.S.O.P.M. CA►ACT'-U.S.G.P.M.
1871 E Johns Prairie Road
Shelton, WA 98584
360-426-6697
10
G00DWIN
Rob'sExcavai�ngNE4,
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
depths in drainfield areas before construction.
4. All construction materials and installation shall conform to all applicable state. ! J
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 Excavating 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.
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.
Ft'1,y � 1 i II'i.rr4�lii
Hoved j d Day!
ROB'S EXCAVATING e
1871 E JOHNS PRAIRIE RD SHELTON, WA 98584 (360-426-669
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INSTALLATION /MAINTENANCE 51oo172
.'ROBE GOOD WIN
PRESSURE DISTRIBUTION SYSTEMS "'b6t Js@ b sicyEP
CF•grncr: - -.:-or.
t. 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 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.
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 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.
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.
os
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)
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'�ICENSCD DESIGNED
AS-BUILT FORM Revbed Febnuvy 18, 1998
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Applicant \` ,G 1���� Assessor's / }
l Parcel#
Permit Number SWGc�,- a (Twelve-01gRNumber)
Installer Subdivision (Name/01vlslon/B1ock/Lot)
Designers
y.
4x'
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N/A Yes Prior to Completion
I. SEPTIC TANK
A) >5 ft.From foundation? . water?
B) >50 ft from wells and surface aca water? . . .. . . . .. . . . . . . . . . . .. . . .
C) Bldg stub-out to septic tank:clean-out if not 1-2%? . . . . . . . . . . . . . . . . .
D) Baffles intact and clean? . . . . .. . . ........ . . . . . . . . . . . . . . . . . . . . . .
E) Dividing wall intact?.. . . . . . . . . . . . . . . . .. ... . . . .-.q.-. . . . . . . . . . . . . . —
F) Risers installed for access? . . . . . . . . . . . . . . . .../ fLt . . . . . . . . . . . . —
G) Tank Size: " 00 gal.;Manufacture fw
II. )ALev
A) Leveled with water? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . —
B) Speed leveler used? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . —
III. IELD A) >10
A) >10 ft from foundation and>5 ft from property lines? • • • • • • • • • • • • • • • --�
B) >I00 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? . ... . . .... . . . . . . . . . . . . . . . . . . . . . . . . —
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? . . .; •• • — V
2) Head height uniform and z24 incites? Actual head height=. . .
3) Clean-outs and observation ports present? .... . . .... . . . . ... ... .
4) Mound: Side Slope3:1? .. . . .. . . ......... ....... . . ... . . . . .
5) Owner informed electrical connections must be made by
owner or licensed electrician and inspected by L&I? . . . . . . . . . . . . . —
IV. CHAMBER
A) Pump
make
A) Pump make ('nCr�Z&1 ; Pump model L N I
B) Chamber size W03 gal; Manufacture L2 RTS
C) Height of pump off bottom of pump chamber U ZA% 1' inches
D) Pump chamber draw-down_ gallons per inch
E) Pump capacity 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 eftluent fit circle one)installed? . . . . . . .. . . . . . . . .
H) Riser installed for access? . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . —
I) Alarm installed? . .. . . . . . . . . . . . . .. . . . .. . . . . . . . . . . .. . . . . . . . . . . .
OW
❑ Dreintleld&manifold
orientation &layout
❑ Trench/bed dimensions .
and critical distances
within layout
❑ Septic/pump tank
placement.
❑ Location of buildings.
❑ Observation port&clean• \S
out location.
❑ Location of wells&
roads.
❑ Undisturbed native soil n
between trenches. v
❑ North arrow
CAUTION:Minor sdiusImew to septic unk ieeaion and drab6eld orkmutioa made In the bald by dw Installer ere amxally siapn6le b both the doRanmwt
and the ddea�aaa.but aouW b tastab am oampromlae the gem ryas #d hatativ a nerpgrAi ity a obtala par wrinem approvai 8om a Cher the
haM dep=l or tla dealper bef m maths any day�tioas�the tb�4�at��>Y� OW. the appoved design must be
viab Any daviatloma Cram
shown above. I,71?tl
Installer Check a box from stow"A"and"B",sign and date lie � „ ,.,,.oP
A. ❑ 1 certify that I installed the system without any ❑ 1 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 final 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,f0m'is
aco I and d th if the information contained herein is not
accurate,there will be just cause for immediate sus Qenstonof my er on.
a t acvin r $
! a ti j
alarm of Installer ate
The undersigned approves this installation on behalf of Mason County De t of Services.
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