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SWG2022-00296 - SWG Application / Design - 5/20/2022
(gZPOP MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584 j 3 SHELTON:360-427-9670, EXT 400 - .. COMMUNITY SERVICES BELFAIR:360-275-4467,EXT 400 1 ELMA:360-482-5269, EXT 400 / Building,Ruining.Environmental l leul lh.Community l lealth FAX:360-427-7787 On-Site Sewage System Permit: SWG2022-00296 APPLICANT BOUSHLEY CURTIS AARON & ELENA CASTILLO Phone: Address: 370 MT KENYA DR ISSAQUAH, WA 98027 SEPTIC DESIGNER TOBY SYRETT- B-Line Construction Phone: 360-426-4221 INC. Address: 2971 E Phillips Lake Rd SHELTON, WA 98584 SEPTIC INSTALLER B-LINE CONSTRUCTION Phone: (360)426-4221 Address: 2971 E PHILLIPS LAKE LOOP RD SHELTON, WA 98584 Site Address: 301 E WILLCHAR BLVD Primary Parcel Number: 220047500160 Permit Description: New 4bd pressure trench Permit Submitted Date: 05/20/2022 Permit Issued Date: 05/31/2022 Issued By: Rhonda Thompson Current Permit Fees Paid: $740.00 (additional fees may be required upon installation of system). Permit Expiration Date: 05/31/2025 (based on date of inspection) Permit Conditions: 1 Proposed development subject to zoning requirements and approval by the planning department staff per Mason County Title 17. 2 Permit must be installed by a Mason County Certified Installer unless prior written authorization from Mason County is obtained. 3 Drain field installation not to exceed designed upslope and downslope depth specified on design form. 4 Installer is responsible for obtaining Mason County installation approval prior to backfill of system components. 5 Installer is responsible for obtaining Septic Designer/Engineer installation approval prior to backfill of system components. 6 Mason County Asbuilt Form, Record Drawing, and Installation fee must be submitted for final installation approval. THIS PERMIT MUST BE ONSITE DURING INSTALLATION OF OSS. PROPERTY OWNERS ARE RESPONSIBLE FOR DETERMINING AND MARKING ALL PROPERTY LINE AND EASEMENT LOCATIONS. THIS PERMIT MAY BE REVOKED IF THE SITE CONDITIONS HAVE CHANGED SINCE THE SITE WAS INSPECTED AND DESIGN APPROVED. FINAL INSTALLATION APPROVAL IS REQUIRED PRIOR TO TEMPORARY OR FINAL OCCUPANCY OF ANY RELATED STRUCTURES. For Final Inspection visit: www.co.mason.wa.us/health/environmental/onsiteloss-inspection-request.php or call: 360-427-9670, extension 400. -- OFFICIAL USE ONLY MASON COUNTY PUBLIC HEALTH DATE RECEIVED Z ONSITE SEWAGE SYSTEM APPLICATION AM UNT qE IV 0: RECEIVE N D • c cn cn PO Box 1666,415 N 6th Street,(Bldg 8) Shelton WA,98584 O CON Shelton:360 427 9670 ext 400 Belfair:360 275 4467 ext 400 S\VV G 0 0 0�C( to O Z Cl) APPLICANT PHONE D D oi)si{t.cY G4 1-L°� CoNS(-• =a.,� • 360 . t{Z I, . K2= ( m MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE (71 Z P S LK • S Ms �-roNt w h 9 t�5�s P SITE ADDRESS-STREET,CITY•ZIP CODE - CO 30 ( E (4i•1clis► IL GI.-it Sste-C.-7 j ins ? 5g`�f Ti NAME OF DESIGNER PHONE g� sy i-r e g-L;tiF CuNsr�a„ ,c r~ Lr.t 3 b a • 4.(2104 YZ z' 1 N NAME OF INSTALLER PHONE w` Oat,i Weolkarr k 41.54- Cor-slgau c w . +c , 36a • `(Z (a• YZ-t( p CHECK ALL APPLICABLE ITEMS DRINKING WATER SOURCE 0 le KNEW CONSTRUCTION • G ❑ RV HOLDING TANK ONLY �PRIVATE INDIVIDUAL WELL � ElREPLACEMENT SYSTEM ElINSTALLATION PERMIT ONLY 0 PRIVATE TWO-PARTY WELL 0 i 0 TABLE 9 REPAIR le SINGLE FAMILY 0 COMMUNITY/PUBLIC WATER SYSTEM Z ❑ TANK(S)ONLY 0 COMMERCIAL SYSTEM NAME: 1 ❑ UPGRADE TO EXISTING 0 OTHER: BEDROOMS �.� LOT SIZE ❑ EXISTING FAILURE "Record Drawing required ( G l�� for all Installations" I IyVw'DIRECTIONS TO SITE•BE SPECIFIC AND ADVISE OF ANY NEEDED INFORMATION FOR ACCESS(ex.locked gate) 0 ace P C.t�Y-.W R. 1 - X,(Z-4 cR7-•B oN p 1'. II:p5 LA4 Lope 1?.4 , t %KM%4,n heflr- le Olv Vr• lcX4/4rt. (3Lvr .. ft. I1pw Lu: I n 6.0,A-JN, S4 ' tI r A-NA itito,i N Go (u- R:i\ 1• + . m . S r• :l FT . J L. It .(''1s+ o b5-1-3�1:Stw,tip c -� sS�- v-N o I Mah 1c�. -� R.�• ( f o — l� �'tirS / �/91TE MUST 8 FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS Q Iei ( OFFICIAL USE ONLY BELOW THIS LINE-- T UPGRADE/FAILURE SOURCE(for reporting purposes) (V 0 VOLUNTARY 0 MAINTENANCE/PUMPING 0 BUILDING PERMIT ['HOME SALE ['COMPLAINT ❑OTHER: A INSPECTOR SOIL LOGS COMMENTS/CONDITIONS ` l V IV\714; � \-•- 6. W _ _. PR' 2 11 6 ' 111.-)1 It MAY 2p ?DI SOIL CODES: L; V=VERY G=GRAVELLY S=SAND L=LOAM Si=SILT C=CLAY E=EXTREMELY R=ROOTS INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATrr}NAPPROV-gb-1�,- ----_I DATE S) (1-V, C. J25 , S&ILL THIS FORM MAY B SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 3/2/2015 `N� PAGE ( OF 1� dc RI `� i SEPTIC SYSTEM DESIGN ►-` • A 4.=. -441114, a ' 75 — 0 uo 1 b bo , R ,,- , /y ,1 40 J11.14 _ e . 1. '.,^ . anti' SITE ADDRESS: 301 E Wilchar Blvd. SITE CITY STATE,ZIP• Shelton, WA PARCEL NUMBER: 22004-75-00160 LEGAL DESCRIPTION: T 16 of Survey 5/63 OWNER: Boushley DATE: 16 May 2022 B-LINE CONSTRUCTION, INC. 2971 E PHILLIPS LAKE RD. SHELTON, WA 98584 360.426.4221 office 360.426.0509 fax b-lincconst@msn.com r PAGE t- OF ( ` OWNERSHIP AND USE OF DESIGN DOCUMENTS: 1. This Design Document has been prepared by B-Line Construction, Inc. via its employees, subsidiaries and sub-contractors. 2. This Design Document has been produced in order to attain an on-site septic system installation by B-Line Construction, Inc. for the property indicated herein. 3. This Design Document represents decades of combined experience of B-Line Construction, Inc. its employees, sub-contractors, etc. in construction processes, technical applications and developments as well as interpersonal understandings and relationships with other professionals, manufacturers, suppliers, regulators, and private parties. 4. This Design Document constitutes physical and intellectual property © B-Line Construction, Inc. and may not be used by any other individual, company, contractor, etc. to construct an on-site septic system for this or any other property. 5. This Design Document shall not be construed as a product that stands alone from the achievement of an on-septic system on the specified property for the client by B-Line Construction, Inc. 6. This Design Document remains the sole property of B-Line Construction, Inc. whether the project for which it was made is executed or not. 7. The submission or distribution of this Design Document to meet official regulatory requirements, or for other purposes in connection with the project, shall not be construed as publication in derogation of B-Line Construction, Inc.'s rights regarding this document as physical and © intellectual property. 8. In the event that B-Line Construction, Inc. is not retained for the installation of the system, this Design Document shall not be used by subsequent parties/contractors. 9. If B-Line Construction, Inc. is not retained for completion of this septic system installation project, subsequent parties/contractors wishing to install an on-site septic system on this property must produce their own design documents for use in a separate research/development/design/permitting/installation process. 10. If B-Line Construction, Inc. is not retained for completion of this septic system installation project, client shall be liable to subsequent parties/contractors for new design documents and additional permit fees as required in pursuit of re-inspection, re-design and installation. B-Line Construction, Inc. 2971 E Phillips Lake Rd., Shelton, WA 98584 360.426.4221 (office) 360.426.0509 (fax) b-lineconstmsn.com PAGE 3 OF 1 I DESIGN FORM—PACE ONE Assessor's Parcel Number: 22004 __ 75 __ 00160 A design will be reviewed when 3 conies,of each of the following are submitted: "I Completed design form that has been signed and dated. 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. Maximum paper.see: 1/"X/7" PARCEL IDENTIFICATION Permit Number: SWG 1-D2 -- 0029 b _ Designer's Name: TOBY SYRETT @ B-LINE CONST. INC. Applicant's Name: BOUSHLEY C/O B-LINE CONST. INCsigner's Phone Number: 360.426.4221 Mailing Address: 2971 E PHILLIPS LAKE RD. Designer's Address: 2971 E PHILLIPS LAKE RD. SHELTON, WA 98584 SHELTON, WA 98584 City State Zip City State Zip DESIGN PARAMETERS Treatment Device PRESSURE DISTRIBUTION WITH 30"+VERTICAL SEPARATION Drainfield Type 0 Gravity IX Pressure Z "French 0 Bed 0 Sub Surface Drip Septic Tank/Drainfield Specifications Laterals Number of Bedrooms 4 Schedule/Class y'a321-+ SU+t..1,O Daily Flow:Operating Capacity 360 AVG gpd Length 33' -80' It Daily Flow: Design Flow 480 MAX gpd Diameter 1.25" ill Septic Tank Capacity 1200 gal Number ..eii Receiving Soil Type(1-6) 4 Separation 10' + ON CENTER It Receiving Soil Appl.Rate 0.6 gpd/ft2 Orifices Required Square Footage 800 ft2 Total Number of Orifices 44 Designed Square Footage 819 tt` Diameter 3/16" in Percent Reduction Taken 0 % Spacing 72" in TrenchlIt'd Width 3' ft Manifold Trench/1E1 11 Length 273' It Schedule/Class 40 Elevation Measurements Length 12" It Original Drainfield Area Slope 5-15% MAX % Diameter 1.25" in New Slope.If Altered SAME % Preferred manifold configuration used? CS[Yes 0 No Depth of Excavation UP-slope 18" MAX in Transport Pipe from Original Grade D,'n-sl„pe 12" in ScheduleiClass SCH 40 Designed Vertical Separation 30"+ MIN in Length 100' MAX ft Gravelless Chambers Required? gliiiiiiirs OKNo 1947!13,1" Diameter 2" in Pump Required? Yes 0 No Dosing and Pump Chamber Pump/Siphon Specifications Number of doses/day 6 Difference in Elevation Between Pump ShutolT and Uppermost Dose quantity 60 gal Orifice 35' MAX I1 Chamber Capacity 1200 gal Uppermost Orifice 14 Higher 0 Lower than Pump Shutoff e_, Pump controls: Please check those required. Capacity`i;Total Pressure Head 25.96 gpm [Xtimet. MElapse Meter Of Event Counter Calculated Total Pressure Head 75 11 �""- ',I timer: Pump on 2min 19sec ,Pump off 3 hr 57min 41 sec Comments r1 s_. 22 41(0?: rf, .)-`.7;',':!-I f SQUIRT= 3 f= 1.19 FITTINGS LOSS 5 EILEVATION:DI EkE4E = 20 TOTAL= 29.19 = 35 EXPi Es: 06/07/L2 PAGE q OF 0! DESIGN FORM—PAGE TWO Assessor's Parcel Number: 22004 -- 75 -- 0016 Permit Number: SWG DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch XI Test hole locations Drainfield orientation and layout Reference depth from original grade: Soil logs PS) Trench/feed dimensions and / IX Septic tank [gl Property lines critical distances within layout Drainfield cover Xl Existing proposed wells /Valve box locations andP ro p Reference depth from original grade within 100 11.of property N Septic tank/pump chamber and restrictive strata: M Measurements to cuts, banks, and locations IV Laterals, trenched, top and surface water and critical areas lgl Observation port location bottom ❑ L.,s_au.ni di id Vi{linaljVi Vr X1 Clean-out location ❑ (l„ia„i di aii,.A,ll....i.,i l Ui lcln1 .Bain dn.l all dlnui tniU"' M Manifold placement Li JdIIU cugmciacalOII ...ersitrorstem444— IA Orifice placement Other cross-section detail: IX] Location and dimension of 1,54 Lateral placement •r Observation >rts/clean-outs primary system and reserve area Other Information N Buildings IV Audible/visual alarm referenced' Yes \o M Direction of slope indicator IN Scale of drawing shown on scale ❑ Design staked out f4.4 Waterlines bar f4 ❑ Recorded Notices attached X1 Roads,easements, driveways, X1 ❑ Waiver(s)attached parking IX ❑ Pump curve attached ] North arrow and scale drawing CK ❑ Lvaluation of failure shown on scale bar Non-residential justification u u waste suenelil u u I uIw i DESIC���►,lE''t'OVAL i:C, t' The undersigned designer must be notified by instal.'.- yaw . ` %tallation I1 Yes ❑ No �� �11 Signature of er 1. . RETT` � /,'t� Da • The undersigned has reviewed this design 6 u....,,,:.•: y°�� mE�.,•.a'" t F{calth and determined it to be in • compliance with state and local on-site regulations: EXPIRES: 06/07/ Environmental Health Specialist Date CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION: ✓ The design is stamped "Approved"by Mason County Public Health. ✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: 573I I?A-- ✓ Drainfield site conditions have not been altered to adversely affect conditions of design approval. Please Note: The system must be installed by a certified installer, unless prior authorization is obtained from Mason County Public Health. An.Installation Fee is required. Revision Date:8/18/07 Pr et" S or...4L ,4117- --,e --j• , e2.L-cX./ - el r - - ,:A'7*.:Cd/.-- - - &tr-Y6,/ - -,, '- 4 r/ C6,/ - r ------ -/I I' , , i 11, I --v—-- - -- - - - --- . - --:c ))- - - - -- - - -1 \ ! 5) a : , 0..... S ii i ,,,4i \ � , ,,„ \:,,,,_ v\ t, . ,,..i , 1„,,e, „ , ',1 \, \i \\\ \ ,.„ ,. ,. ki . k , ,: k1/4, .:,,.,,, .., „ N%‘, .*:\k N :.4t, '.4:t,. .;Z ( \ .1/441 \I 1) ( • ,, tt.*� , . , ( , I ` P MAY 3 1 2022 S i MASON OUNTY ENVIRONMENTAL HEALTH RET 1 t k \... I,i( i Cr° * r/ ,. " - t i am,,-, J - r _cd,/ -z^_ e5, " - 1, . _ ►, 0 N e- v O 1 W (SD " CV N Z W p 0 J CD N < > W O 2 Q cod z LLI U O Q W -) o 0 z p ��` J O a o W p �\`�� —ice/ ~ —— r L J O W NDC c, APP a OVER D CC o _, Q z U Cl] W 0 _ cc MA 3 1 2022 a GC us Y < MASON COUNTY NVIRONMENTAL HEALTH W W Q } o cn � � mz cc + z Lis �-id w Q w Q Q ET w 0 w � / cc CC D Q Q O. W e 0 v` i'a. / `cam a h.- 11110 mz Lo Lujt i CL 1/40 N Ci) , '\ ''. ... .'- -- - -* -- ''. ' ''. N \ w w ` w U v w _ c\� — J �p (./) _ _ i w o OVR' J�� I R� I Z 0ch W 1 0 o u) O i map 4 b op 7CL: \‘ cc / J w0 , o p F \ (n 2 i Z u)v \ o p 2E J .� a o U u w O/178 2/IYH07IM a W Nvo8 cc f lf— 966 ON(ONH s _ - - m O