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HomeMy WebLinkAboutSWG2001-00300 - SWG Application / Design / As-Built - 8/14/2001 N-SITE SEWAGE SYSTEM PERMIT i PERMIT NO. SWG - MASON T LTH SERVICES 426 W. CEDAR/P.O. BOX 1666/SHELTON, WA 98584 Date / o Receipt No. Amount$ m m PROPER NE DAT _3U- D CHECK APPLICABLE ITEMS �/ MAILING ADDRESS: (},I DAYTIME PHONE: NEW SYSTEM REPAIR SYSTEM v CITY: 1 J Z p: TABLE 6 REPAIR d STATE: MAINTENANCE REVIEW m PROPERTY AD�DRES (O SINGLE FAMILY Z OTHER: a SPECIFIC DIRECTIONS FOR LOCATING SITE: PRIVATE WELL v COMMUNITY WELtJPUBLICSYSTEM h\SYSTEM WFI p Fmii�rDy.it 3 -/ QO�ts�r SYSTEM NAME t Ct APPLICANT IO' Dfl�✓K/ fir/ Ses� f iyw�,o '-w(L NAMEVRv_UjdrWA Name of s(AjsV(A Lot _4C) ft.x ( f- ft. MAILING ADDRESSZ,3EOW h/ I„- Installer ro•" Size: acres TELEPHONE `�..1 Name of um er o SIGN E Designer Bedrooms 3 X OFFICIAL USE ONLY BELOW THIS LINE � DEPARTMENTAL SOIL LOGS DEPARTMENTAL COMMENTS/CONDITIONS I�' m s I� poc,�eok5 0� loc�.w� 10 IO IrN PoCNN&V5 o!;� \0CW-n• Test �ole,s were. ��ot�ti,�n� • �1n G b��-. �es LSv� t�orwsu,re.� �,l�n o.�C• Cq0 ivy • SOIL TEXTURE CODES: V=Very G=gravelly S=sand L=loam Si=silt C=clay E=Extremely I (pdnt na e) IN CTION SI ATU TE PERMIT EXPIRATION DATE SPECTOR SPECTOR /3 #o u,&V 13. 2c04 •All systems require ongoing Operation and Maintenance(0&M)as specified in MaAn County On-She Standards. •All on-site sewage systems must be designed by a Mason County Certfied Designer or a Professional Engineer,unless prior approval is granted otherwise •All on-she 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 she requirements(i.e.RLC,Water Adequacy)have been met. •Any change from the specified use of the property or any she alteration affecting the system design may invalidate this permit. •Thus Permit expires 3 years from the date of she review.Denial of this permit may be appealed to the Health Officer within 10 days of denial date. DE N REVIEW ROV BY: / DATA: IN CATION PROV BY: ATE: OP: Health Dept. Copy MIDDLE: Designer's Copy BOTT : Applicant's Copy MASON COUNTY DEPARTMENT OF HEALTH SERVICES August 20, 2001 PO BOX 1666 SHELTON,WA 98584 g SHELTON (360)427-9670 FAX (360)427-7798 ELMAPeninsula Excavating LFAI (360) 275-4469 BELFAIR (360)275-4467 2380 W Highland Road SEATTLE (206)464-6968 Shelton WA 98584 RE: Design for DIERKER Case No: SWG2001-00300 Parcel No: 620243300000 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. 279 if you have any questions. Sincerelly�,� .' Q ate%"'._ 410 -' Amanda Reynolds Environmental Health Mason County Health Services COMMENTS: 8/20/01 1 of 1 SWG2001-00300 i MEMO *DESIGN FORM-PAGE ONE Ada design Will be mvwwed when lof each of the tmw"it"O lef1"I�R�.'���Q tF •EN ER�C�� ��.... ssrwSaai�sa�!ed z, peM�R�.�IWY�Y�=fit 1=.on �MYvs ry¢='1 � � .,-a'mR�2mm30 .yy MI.�$�i �yj��{y.. r+{ 1' it f .y� .S r..3iG'JL✓h .a Fz't ��L(.Yr��Fi�u�ri Ke •�Vl {{ ! Dea)gns's Name: pemtWuwben nDesignees Phone/ 3ro �uy3 �— Awasear's Parcel Now Appliaet'aNama: kHaaead Manors Aadeaa: 1?,o a oy M A'fLBr.((- 9�Sri4 . subdivision: - 23 - Treabrient Devkx O Saud Filer . O Mound O sand Lined DraioBald r(03 Giondenit-MAIMIUM & — ODisintactleaUmt - Malce/Model: Drairfield Type ck praame �lteaeh GtaveIIes Chambers (Im'lY SeptleTanW inn DreeldBpecMications LateralsSchedui lu �- - S' it Number of Bedrm Length oos goyFlOwv DiameterSeptic Teak Capacity ' L t Receiving SouType(l� LL'' sep�u�don AUG .2 0 2001Rueddug Soil Appl.Rate —T g Required square Footage o �q ces Deed square Footage Toral Number of Orl" parent Red ctimTaken Diameter Tree bead Width �[n ft spacing Trmdt/Bed Length sys .-Manifold""r 4"` . +-- Elevation Sched Measurements __ . . u - G uldChus �p IfA aid Area slope Diameter l eopsU f�DS ""�-- Naw pop if Alered - C��a U es ❑No ZrL to preferred Manifold u sed? p 1 Depth ofGrade fiom Zy Nv ) Transport PipeOrightel �7=_ (pawe.abpe) Length � Deslgaed vertical separation 3(o isDWactwN Gr aveness Chambers Required? O Yesallo ❑Optional Dosing and Pump Chamber 0Yes,'19'No Number ofDwwV*y Pump mp(Siphon Specifications ChamberCapaCitY —�i p Uppap�st� � Commh: Timer(w) Mess(oYeM IrregWnd) DiffaeacefrmElevauanl3dwaw Shutoff and POmP T �_ IfT6ax. PUMP on Orifice. Check Are AallovvIRS OOMPOOma If they drda between doses: Upper y4 Tolde is Q Ni[ha. I owertlm PmOP m (3 Latersh (3 Manifold . ,;0 Transport �c�p..ae�py�®rowPreeameHad: /r�� a�bmadTa t PanpCurve> DESIGN FORM:d F1. o a ,,. ..a, a -. :, .ter r �. .Y:a .c, H!4?4�sss Soeled Plot Plan '" Scaled Cayou`t Sketch ` Crosd 41ection Sk Test hob locations fir D�Id akomion and layout Rahn . from urtjiii giade. pity Boas - - (; 7Ymeh/bed dimensions and attieel k hoe lid dea(ofieW Bova »sod proposed wells within / distances w"layout _. _ depth ... 1008of property Liam jdSEPWMIOcadon locations Critical distance measurements to am, rhumba location Rafenance depth from original`rude banl�and sit water and restrictive stmts: Location and adaoMion of waste O I MWA s, 1 tap and bottom drain and all absorption components 1lfadmid p O Q r ta8n P I,oatton and dimension of primary O OriflcaItf-F P`Y``' O system and reserve area Latordplaoemen4 with distances to Buildmgf ,..„.. edge of bed IL Direction of slope lodicaW O AodibWvisaal��� OMervalon and clan outs D Watalhra Stab of draahng on sale bar Roaddea'' //,mmems/driveways/ O =item lands(if applicable) North arrow and scale of drawing shown on scale bar IM Additional Information O Design staled out O Operation and Maintenance Notice Attached O Welver(s)Attached The undersigned designer 0 does, not,waive the requirement to be notified by the installer of the huialbation and given 49 hours to perform a final inspectio&psdoa prW to cover•. -01 Si of igaer Date The undersigned has reviewed this design on behalf of Mason County Department of Hean Services and determined it to be in compliance with state and local on-site regulations: / se B��Zd101 Pavhonmental Haltlr Sp ist Date Citation: DESIGN ArmoveL 13 VAUD ONLY UNDER THE FOLLOWING CONDrrroN: d The desigt is atamped'Approver by Masco Caudy Deparmrent of italtlt // The ooike sewage Permtrhas not esi f the Permit 6 pk*Vcn Dab : /8!O W V The aystsr a is installed by acatiHed 1nstanX melm prior auhorinian Is obtained from Moon County aIEWMtservioes. _ ' d Draletfield Me aood1doos have sat becs aioaad lo affixtmddoi3iofdesivWpmlW - -- -�- ' f . Mc 6 AUG 2 0 700 ADR - a v t -- .- --� r CPR d • uD wrr"OAS TNMIT SEAL .owrgm . FINI GRADE TD.O-W FROM SEWAGE FLOATING MAT SOURCE APPROVED EFFLUENT FILTER SEDIMENTS dxEWAU A PID mc KS -a AUG 2 0 2n01 ADR Pure Performance The OSI Siotube'Effluent Filter is the most advanced in the industry, engineered to provide maximum protection for your septic system. Features and Benefits • Improves effluent quality. Average Total Suspended Solids (TSS)is less than 30 PPM,nearly 2-1/2 times lowertnan a non- screened system! • Allows for smaller diameter drainfield pipe. Lowers drainfield material costs • Superior patented design. Extends drainfield life. Reliable, corrosion-proof construction. • Easy installation. Installs in minutes in new or existing tanks. f I MC rfr.b�� Ivl L32;;PT • Simple,hassle free AUG 2 0 2001 >. maintenance. • Available alarm. ADR Indicates when maintenance is needed. ` • Ideal for variable-grade sewers. Allows reduction of the transport line size and associated cosh • Custom sizes. Call for availability. r INsTA-L— A, COV Ir Dw-) OF v! o,.•.P. of neEF�N -r•ENk - I _. FA -_-_ i" Xm _a-- LO AUG 2 ONOqD ij ADS - _ Q - -rl 0 it _ _ T A 3 � - •a © m o _. - _p O _ � a § o _ _ __ ron_amction Notes 1. If dry. The soil MUST be s���installation mars proc noteed. Do no Install until it is property end an field while the sods are wet Re 2. Use UMEME care In site Preparation- removal. -No-top soils. Use ore in tree and stump removal. Leave root systems intact 3. Trenc�h bottoms must be level. follow contours of the slopes. 4. V a%Dw bar is used,speed levelers are required. S. &ush piles and debris are not to be burned on top of the proposed drain fields sites. 6. Do not use the drain field areas for storage of excavated dirt, parking areas, lumber packages,or anytidng that will disturb or destroy the ar the designer. 7. Do not deviate from this design without permission 8. Drain fields sites are to be roped off,for the protection of the sites, prior to and during the construction of the horse. No traffic of any type is allowed on top of the drain field sites. Soils can be damaged easily and the infiltration rate can be lost,making the proposed sites unusable for a drain field. 9. Once the trenches are excavated,the sidewalls and bottoms are to be raked to open the Infiltration surfaces. 10. Cleanable effluent screens are to be used. 11. Construction and materkals for this system shall conform to the latest regulatlons and requirements of the County Health Departrnent 12. Topography, benchmark,stub-out and Invert elevations are based on assumed data. 13. Ascertain location of underground utilities before digging. 14. Edge of drain field trenches to be a mnknum of 5 feet from any property and/or easement 15. Encroachment of house and/or driveway Into drain fleld or reserve area may render the site unusable, requiring a redesign at additional costs, or even totally unusable. 16. All roof drains and surface water run off shall be directed away form the drain field. 17. Sewer lines under roadways shall be encased In pipe rated at 1000 lb.crush strength. 18. This system is not designed for use of a garbage disposal. Use of such may cause system failure. cross, above 19. where sewer lip and��d water lines in anot her pipe for lines nim m of 20 be a minimum feet Crossing muusst be at center of encasement pipe. 20. Where a good off site sandy cover Is placed over an installed drain field,the sandy soil shall extend ten feet beyond drain field and be feathered to match adstirg terrain. 21. Installation and use of this septic system without a tee filter seated in the outlet side of the septic tank may cancel any warranty,expressed or implied. 22. This system requires a proper degree of maintenance. Certification of the design and R khstapation does riot Insure trouble free service. 23. Keep septic components a minimum of 10 feet from any water line under pressure, unless sleeving of water one is provided, per codes. 24. 8laa s"more compeonn ar d tight lined dayllghdy meemtingt)all county cooddes aDo n s opecf side Is to be lined with black plastic. 1 MC i'sr`. E)E?- T AUG 2 0 9001 ADR ,I ON-SITE SEWAGE INSTALLATION FINAL INSPECTION DATE CALL$D IN: y : 3o pen►nbu.l4 t=�ccaya��n� TNsrAu.s2: Q ApMCAM/OWMR: DIQrK R- CALLER: PHONE#OF CALLER: 9O Ot,\a SWG#: &0�0/�1^ oo3od PARCELNUMBER: SUBDIVISION: Div: Lot SYSTEM TYPE(CHECK ONE): ® ❑ PRESSURE GRAVITY IlrpBanON SCHEDULE(CHECK ONE)• ® ❑ APPORTI'Mun PLUDIN - AS-BUILT ON-snE(CF 'EM ONE): ® ❑ YES No STAFF banAIS: ApponnUENT DATE: 1u: • OOMl�l1'1'S: ON-SUE SEWAGE INSTALLATION STAFF INSPECTION REPORT Yes No C�meafa I. SEPnC TANK / A) >5 R from foundation? •^ t/ B) >50ftfftW4ts'a '6dAc2iefiti!? t.•, t •� ) r ` _JG — C) Bldg sm6-01A to septic tank:clean-out if not 1-2Ye? ✓ _ D) Baffles intact and clean? E) Dividing wall intact? _— F) Risers installed for access? i .•�• ' v - 11 D-Box Leveled with`wat�end/or speed leveler(cNc)l EL DRAVOTEEZ) J. A) >10 ft from foundation and>5 ft from pemdvedprcpertypgps?� n/ B) >100 ft fium wells and surface water/ '. t ��• — C) >10 R from potable water lines? _— D) Laterals level to±T iOh do eddl:a&prest4ifnot 1ooped7i' . E) Gravelless chambers utilized? �G F) System dimensions the same as shown on the design? O) Gravel clean.properly sized,and proper depth? H) PRESSURE SYSTE sc — 1) Sand qualityASTMG33? -/14 2) Head height uniform and x24 inches? _ 3) Clean-outs and observation ports present? _ 4) hfound Side Slope 3:1? _ 5) Owner informed electrical connections must be made _ by owner or licensed electrician and inspected by 1AI? IV. PUMP/PEW CHAMBER A) Screen basld or eft1 t fil". le one)installed? B) Riser installed for ae:o _�• — C) Alarm installed? D) Pump on timer or demand(circle)? _ V. As-Burrs ReQumm? _3L RCQV VL 07nER C0mM Nrs/ons=vATfoNS 9 The undersigned has reviewed this installation and verifies these findings an behalf of Mason County D a:tmeat of Heal Services. 71 Sanitarian Date • - Itavlaed9/16/9? Rcv,,ed,.ouay. lass AS BUILT FORM Iwo x s x :L s ka.:,v . .....:. i .. Applicant � EL (�/r2�t✓l� Assessor'sParcel# Gaoay' 33-oo,dn O3� (Twelve-0gR Numhar) Permit Number SWC,��- C9 Installer 76rJ/tiCSr/�a Subdivision � , Blocwtot) Designer S*74sr ?" It#S)fA CHICKLI3T ,, i ,x , NIA Yes Prior to completion 1. SEPTIC TANK ❑ A) >5 R.From foundation? .. ...... ........... ...... .. .. .. . ........ .. ❑ ❑ B) >50 R 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: 17,,02 _gal.;Manufacture Z&9:S II. D-Box ❑ ❑ A) Leveled with water? . .. . . . . .. .. .. .. . . . .. . . . . . . . .. . .. . . . . . . . .... .. Pr� ❑ ❑ B) Speed leveler used? . . . . ... .. ... . . .. . . .. . . . . . .. . . . .. .. . .. . . . . .... 111. DRAINFIELD lnes7 ❑ A) >10 ft from foundation and>5 ft from property ' •••• •• •• • ❑❑ ❑ B) >I00 ft from wells and surface water? .... . .. . .. . ... .. .... . ... .. .. ... ❑ C) >IO R from potable water lines? ........ ...... . .. ... .. .. ...... .... . ❑ ❑ D) Lsterals level to±1 inch&end caps present if not looped? ... . . ❑ ❑ E) Gmvelless chambers utilized? 1" ❑ F) System dimensions the same as shown on the design?.. . .. .. ... .... ... .. ❑❑ ❑ G) Gravel clean,groperI and proper depth? .. . .. . .. .......... .. . . .y sized H) PRESSURE SYSTEMS ❑ ❑ 1) Sand quality ASTM C-33? . ••• ❑ ❑ 2) Head height uniform and a24 inches? Actual head height ❑ ❑ 3) Clean outs and observation polls present? 4) Mound: Side Slope 3:1? . .. .... ....I .. .. . .. . .. . . .. . 5) owner informed electrical connections must be made ❑ ❑ ❑ by owner or licensed electrician and inspected by L&I7 . .. . . . I... . . .. IV. PUMP/PUMP CH ..awn=.Zsco- b c^"P� "^'e T or ❑ A) Screen basket a uen�fi-1 uole one)installed? ..... .. ........ .... ❑ B) Riser installed or ••••••••...... .. ...................... ❑ ❑ C) Alarm installed? .. ........... ..... .. .......... ump model D) pump make E) Chamber size gal; V' t; ether Manufacture F) pump chamber draw down in es minute; Height of pump off bottom of pun H n er inches G) pump controls:Timer(or)Elapsed Time Meter (Circle if Installed): if tinier is used:Pump On_,pump Off n 77777777 7'1 CHIECKLIIST a Drainfield&manifold t orientation &layout Af, C) Trench/bed dimensions oil and critical distances within layout 6 0 Septic/pump tank placement C) Location of buildings. 13 Observation port&clean- out location. A)ST-A • Location of wells& roads. • Undisturbed native soil h6e 60 between trenches. • North arrow xeo CALMON:Minor adjustments to septic tank location and dramficid orientation made in the field by the installer aregrly acceptable to bodl ft J=t km compromise the viability Of the System- it is the installer's responsibty to mior aten appro"I from c and the dosiper.but could in camin viability. Any devissions from the appruved design must be =!sent or the designer=Malang any deviation$firmn the design dw affect dw systan tiE 77710,ii- installer Check a box from Row-A"and"B",sign and date the certification A. 13 1 certify that I installed the system without any / I certify that all deviations from the design stamped from om the design stamped"APPROVED"by I --APPROVED"by MCDHS are shown above. MCDHS B. ID i certify that I contacted the designer and left the Q 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. rover. I further certify that all information contained on this form is accurate; I understand that if the information contained herein is not accurate,them will be just cause for immediate suspension of my installer cation. blignaIre staIer Vale The undersigned approves this installation on behalf of Mason County Sanitartan Date