HomeMy WebLinkAboutSWG2022-00188 - SWG Application / Design - 4/7/2022 415 N 6TH STREET,SHELTON,WA 98584
�,, MASON COUNTY SHELTON:360-427-9670,EXT 400
i COMMUNITY SERVICES BELFAIR:360-275-4467,EXT 400
L s ELMA:360-482-5269,EXT 400
�S Boling,Planning.Environmental Health Community Health FAX:360-427-7787
On-Site Sewage System Permit: SWG2022-00188
APPLICANT ZILLYET TAYLOR Phone:
Address: 33 EILEEN LN MONTESANO,WA 98563
OWNER ZILLYET TAYLOR Phone:
Address: 33 EILEEN LN MONTESANO,WA 98563
SEPTIC DESIGNER CHRIS ELSTROTT-Advanced Phone: 360-561-5000
Engineering
Address: 128 NORTH RIVER STREET MONTESANO,WA 98563
Site Address: 50 W LOST LAKE VIEW DR
Primary Parcel Number: 519015202006
Permit Description: New SFR-3BR Nuwater
Permit Submitted Date: 04/07/2022
Permit Issued Date: 05/24/2022
Issued By: Jeff Wilmoth
Current Permit Fees Paid: $740.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 04/14/2025 (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 Drainfield 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.
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COMMUNITY SERVICES AM«,NTI� D. t� q& m ‹
DATE RECEIVED:
Public Health(Community Health/Environmental Health)0
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415 N 366 e St40 or n.WA 9 584 rrt.100 S -,�+ 2_ �� , • 5_ 0.
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ON-SITE SEWAGE SYSTEM APPLICATION
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APPLICANT PHONE m h1
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MAILING ADDRESS-STREET,CITY.STATE,ZIP CODE co
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SITE ADDRESS-STREET.CITY.ZIP CODE I•
SD L.4)sr- .lbx r Y/.a-1 o� .
NAME OF DESIGNER PHONE I"
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6-41,/5 4-7'13T/ao /7— Jd0 - S6 /- rvoo I
NAME OF INSTALLER PHONE 0 1
1./.ri.x44_ /f -fs GO/vsT. !G G 3 6O - S e — 7 9 7 C
PERMIT TYPE(select one) DRINKING WATER SOURCE QrIVII N
E SIDENTIAL OSS Il COMMUNITY OSS f1 COMMERCIAL OSS RIVATE INDIVIDUAL WELL ❑ PRIVATE TWO-PARTY WELL Z I� I
n PUBLIC WATER SYSTEM t J
TYPE OF WORK(select one) I
ri•fiEW CONSTRUCTION/UPGRADES l REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) El TABLE IX REPAIR t.l Q.
0 SURFACING SEWAGE ❑EXISTING FAILURE 0 SHORELINE W
SUBMITTALS __ r I N o
ESIGN FORM(REQUIRED) EPTIC LOT SIZE DESIGN(REQUIRED) BEDROOMS a,./6 G,q,F€rlta.V7- 0 t
El WAIVER(S)(IF APPLICABLE) 0,32 QiG4/�✓F/?t0 GO j 0 I Q
DIRECTIONS TO SITE AND SITE CONDITIONS:(ex locked gale) a
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SITE SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. 14
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1 OFFICIAL USE ONLY BELOW THIS LINE--
UPGRADE I FAILURE SOURCE(for reporting purposes)
0 VOLUNTARY ❑MAINTENANCE/PUMPING 0 BUILDING PERMIT ['HOME SALE ['COMPLAINT 0 OTHER:
COMMENTS/CONDITIONS
INSPECTOR SOIL LOGS
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RECORD DRAWING AND INSTALLATION REPORT
SOIL CODES: REQUIRED FOR FINAL APPROVAL
V=VERY G=GRAVELLY S=SAND L=LOAM Si=SILT C=CLAY E=EXTREMELY R=ROOTS
S CTOR SIGNATURE DATE APPLICATION EXPIRATION DATE
ICATION APPROVED!ISSUED BY DATE
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REVISED 12/T/2015
THI FOitA,k\ok
BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE
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Assessor's Parcel Number: / 9 0 / -- .f 2 -- O .2 G o 6
DESIGN FORM-PAG N � 1 g 2022 .�
A design will be reviewed when 3 copies of each of the following are submitted:
'/ Completed design form that .been lined ar j . Scaled layout sketch,including all applicable items on checklist
Scaled plot plan,including a applicable items on checklist. ''Cross-section sketch,including all applicable items on checklist.
This form may be scanned and available for public view on the Mason County Web site.Maximum paper size: 11"X 17"
PARCEL IDENTIFICATION
Permit Number: SWG 2 22-QO( b d Designer's Name: C6ire/s AEG sTx-Q 7-
Applicant's Name: 129y i_°R 2/1-4)44:' Designer's Phone Number: 3GO - 5-6 1-raoo
Mailing Address: 3.3 C/G .E.,EA/ L I• Designer's Address: /2 S /V- R'P'E'e. tT
/nen,,.rf.r- vv, i✓A 9BS6 3 /210,✓77s fAw v/ 440,1 ?d.113
City State Zip City State Zip
.. - <DESIGN PARAMETERS. -..
Treatment Device
❑Glendon Biofilter 0 Sand Filter 0 Mound 0 Sand Lined Drainfield 0 Recirculating Filter,Type:
Aerobic Unit Make/Model /i'hJ riza L Disinfection Unit Make/Model Other: PRa-ss uiz.,G rie F4' -i/
� grainfield Type
❑Gravity O'Pressure rench 0 Bed 0 Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 3 Schedule/Class s-/,I y0
Daily Flow: Operating Capacity 76 o gpd Length SO ft
Daily Flow: Design Flow 3G 0 gpd Diameter /fr in
Septic Tank Capacity(working) Nv,,,,q,...,_ 6.p,/t gal Number 4"
996�- so° Se aration !' ft
Receiving Soil Type(1-6) �/ P
Receiving Soil Appl.Rate D• 6 gpd/ft 2 Orifices
Required Primary Area 2-2 ft2 Total Number of Orifices 5/0
Designed Primary Area Zoe) ft2 Diameter .r//` in
Designed Reserve Area 24'.2 ft2 Spacing 4(0 in
Tr ► h/Bed Width 3 ft Manifold
Trench/Bed Length 200 ft Schedule/Class y4
Elevation Measurements Length 2 7 ft
Original Drainfield Area Slope / % Diameter 2 in
New Slope,If Altered / % Preferred manifold configuration used? B 0 No
Depth of Excavation up-Slope /Z in Transport Pipe
from Original Grade Down-slope /cf in Schedule/Class yb
Designed Vertical Separation /y ".. ,2nJ in Length '2-eV ' ft
Gravelless Chambers Required? l31s 0 No 0 Optional Diameter 2. in
Pump Required? es 0 No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day .i
Diff. in Elevation Between Pump&Uppermost Orifice ft Dose quantity /LO gal
Drainfield Squirt Height/Selected Residual(head) ft Chamber Capacity(flood) /d OU gal
Pump controls: ale check those r quired.
Uppermost Orifice 0 Higher 0 Lower than Pump Shutoff
Capacity @ Total Pressure Head gpm imer lJTapse Meter vent Counter
Calculated Total Pressure Head ft If Timer: Pump on 70' "ezeS Ser,Pump off
-.q 7- /vs 77944,9 77 0_
Comments
ill, APR 21 2022
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MASON COUNTY ENVIRONMENTAL HEALTH
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DESIGN FORM-PAGE TWO Assessor's Parcel Number: S I _f o / -- .s 2 -- D 2 0 0 ‘
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Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
1:1-' st edhole locations field orientation and layout Reference pth from original grade:
oil logs re_Jch/bed dimensions and ❑iS5 is tank
13-" roperty lines cri ' i distances within layout rainfield cover
xisting -and proposed wells ll x/Valve box locations Reference depth from original grade
withinw� 100 ft of property Septic tank/pump chamber and restric strata:
G-1 I aaurements to cuts,banks, and loca ions Laterals,trench/bed,top and
surface water and critical areas bse tion port location bottom
ocation and orientation of �l -out location Curtain drain collector
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curtain drain and all absorption j old placement XSand augmentation
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com onents Or' e placement Other cross- ion detail:
ocation and dimension of Lateral placement with distance nervation ports/clean-outs
primary system and reserve area toe e of bed Other Information
uil ings Audible/visual alarm referenced Yes No
ire 'on of slope indicator cale of drawing shown on scale 0 C]-l�e ign staked out
ate lines bar 0 l rded Notices attached
oads, easements,driveways, ❑ aiver(s)attached
parking 0 Ptyrf curve attached
orth arrow and scale drawing ❑ valuation of failure
shown on scale bar Non-r•: 1 ential justification
91 A Waste strength
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DESIGN APPROVAL
The undersigned designer must be notified by installer at time of installation O'Ye��q No,4pill ii' �'"
3-3 I- Z _z ��NTYFNi, <u22 7
Signature of Designer er Date R°N/ NTq/yFykT,,,
The undersigned has reviewed this design on behalf of Mason County Public Health and determined it to be in
compliance with state and local o 'te regulations:
E irS -ntal Health Specialist Date
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
✓ The design is stamped"Approved"by Mason County Public Health. 1���c(�ZS
✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: `
✓ 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.
This form may be scanned and available for public view on the Mason County Web site.Updated Date: 12/7/2015
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GAL PORT AERATOR
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FCOCD CAPACITY:493 GALLONS S ROOD CAPACITY:494 GALLO S 1160 G LLCT6
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INSTALLRi1ON INSTRUCTIONS
1)Bccavdetai<hdevithve ices vndlsto 1 fat laga than
talc m el sides. 4' 9-2'
2)If bottom d hde is story,install 3'd carped said&lave! \
at vJth screed I r , r \ ----'
3)Install ta�tc in cater cf tide,keeping 1 ft.vdd space m I I
all sides.
of' 1�iS( 2:LOMFR
4)Ps talc is filling Wth veer,fill in vdd srPrrmith carped I I 7CPCFUp
c-a-dar(sally)sdl f need large dLrrps cf day. 1.
5)Install rest d system&affix risers to adapters with r I I I ' 4 S
v erp cd ad lesive.
6)Prfamvlaatilrtri test inffieldasr&U red bylcc II
juisddiC7l I I 1T RISER I
7)U{xn c> c r to backfill,c arefilly baddill Wth native I � i i a�.� I,C7Ar R
sale wa'top cf talc
8)Frei gale the suf ace to add chandling suf alp L —J L —J L..---
inEter toned talc
TCPMEW
1"=28 R.
AEROBIC TREATMENT TANK DETAIL FOR t ..;�
NuWATER BNR-500 TREATMENT UNIT
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