Loading...
HomeMy WebLinkAboutSWG2022-00356 - SWG Application / Design - 6/21/2022 1 415 N 6TH STREET,SHELTON,WA 98584 MASON COUNTY SHELTON:360-427-9670,EXT 400 COMMUNITY S E,,T7 VICE BELFAIR:360-275-4467,EXT 400 COMMUNITY 1�l 1 1 i 1\ ELMA:360-482-5269,EXT 400 \''' •-a 1 Bu;fding,Planning,Environmental Health,Community I lealtft FAX:360-427-7787 On-Site Sewage System Tank Only Permit: SWG2022-00356 OWNER BARKER JEFFREY D Phone: Address: 8762 W CLOQUALLUM RD SHELTON, WA 98584 APPLICANT BARKER JEFFREY D Phone: Address: 8762 W CLOQUALLUM RD SHELTON, WA 98584 SEPTIC INSTALLER Shane Maples- MAPLES EXCAVATING Phone: 360-463-8474 Address: 911 SE Arcadia Road SHELTON, WA 98584 Site Address: 8762 W CLOQUALLUM RD Primary Parcel Number: 419064400020 Permit Description: Lift station Permit Submitted Date: 06/21/2022 Permit Issued Date: 06/24/2022 Issued By: Luke Cencula Current Permit Fees Paid: $2 40.00 (additional fees may be required upon installation of system). Permit Expiration Date: 06/24/2023 (based on date of inspection) Type of Work Other Components being Replaced: Other Surfacing Sewage? No Existing Failure? No Shoreline? No Horizontal Setbacks Met? No Number of Bedrooms: 3 Drinking Water Source: Private Well/Spring Additional Details: Permit Conditions: 2 Permit must be installed by a Mason County Certified Installer unless prior written authorization from Mason County is obtained. 3 Mason County Asbuilt Form, Record Drawing, and Installation fee must be submitted for final installation approval. 4 Proposed development subject to zoning requirements and approval by the planning department staff per Mason County Title 17. 1 Horizontal setbacks per WAC246-272A-0210 must be maintained, unless prior approval is obtained 5 After installation, full inspection by certified O&M Specialist required. THIS PERMIT MUST BE ONSITE DURING INSTALLATION OF OSS. PROPERTY OWNERS RESPONSIBLE O PROPERTY THIS PERMIT MAY BE REVOKED IF THE SITE CONDITIONS HAVE CHANGED SINCE THE SITE WAS INSPECTED AND/OR 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/heal thlenvironmentallonsite/oss-inspection-request.php or call: 360-427-9670, extension 400. .a► OFFICIAL USE ONLY DATE RECEIVED: ` ' MASON COUNTY Z\ �-�L1 cn x. CCOMMUNITY SERVICES AMO N RECEIIV v0 RECEIVED BY: v C Ca - Public Health(Community Health/EnvironmentalHealth) N O 360-427-9670,exc.400 or 360-275-467,ext.400 (/�� /� 7.1 415 N.6th Street-Shelton,WA 98584 S W V Lu,:2.. - ( 5 ON-SITE SEWAGE TANK ONLY APPLICATION E om m m APPLICANT PHONE Teffrel asrlur /barbaxa DeanS °I12.-322-I80 z MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE cog1in W clop a►lum R-d . Shelton , WA 61g58-1 co SITE ADDRESS-STREET,CITY,ZIP CODE 21C412 w CIOGlUallUr 1 Rd. ShelivhIWA 014'69`-1 F. NAME OF DESIGNER PHONE I.- NAME OF INSTALLER PHONE 0 I-9 rnapies xcavatinal (sham Mapicf) 3u70- 40-2q1L1 ` fst TYPE OF WORK(select one) DRI ING WATER SOURCE O ❑ NEW CONSTRUCTION/UPGRADES ❑ REPAIR/REPLACEMENT PRIVATE INDIVIDUAL WELL 0 PRIVATE TWO-PARTY WELL Z F ❑ PUBLIC WATER SYSTEM t COMPONENT(S)TO BE REPLACED/INSTALLED lot SEPTIC TANK ❑nP,UMP TANK1 0 RVnHOLDING TANK BEDROOMS LOT SIZE yQ LEA OTHER ��tt�C/� LIT` station UVI vJ cci OTHER DETAILS(select all that apply) TANK(S)SETBACK CHECKLIST O 0 ❑ SURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINE 0 100FT+PUBLIC/COMMUNITY WELLS SUBMITTALS � 0 50FT+PRIVATE WELLS,SURFACE WATERS,STREAMS,RIVERS I�❑ PLOT PLAN(REQUIRED) 0 TANK CROSS SECTION(REQUIRED) ❑ 10FT+DRINKING WATER SUPPLY LINES ❑ PUMP DETAILS(IF APPLICABLE) ❑ WAIVER(S)(IF APPLICABLE) 0 5FT+PROPERTY/EASEMENT LINES,FOUNDATIONS,FOOTINGS PLOT PLAN CHECKLIST O ❑ PROPERTY LINES AND EASEMENTS 0 EXISTING/PROPOSED STRUCTURES 0 EXISTING/PROPOSED OSS COMPONENTS AND LINES -'I ❑ WELLS WITHIN 100FT 0 WATER SUPPLY LINES 0 DRIVEWAYS/PARKING 0 SURFACE WATERS,STREAMS,RIVERS,ETC... ❑ DIRECTION OF SLOPE/CONTOURS 0 PERIMETER/CURTAIN DRAINS 0 NORTH ARROW 0 SCALE BAR I(S) DIRECTIONS TO SITE AND SITE CONDITIONS:e, 0OI locked gate) Of - C P roper ) has no dl rai nfi e l d - we)a�Ott line, sysrte1m on -t-Y UpQ�r nveirfy• We U 'tt PQ.,rfornn raw up an , cA kex tYL , -OCA- CAC I bvli 1F • a�nn olv�d GI I uc, a Zo�Ite�Ir tuft sfialti on . Plc.': ;e infix �p?e�' sous- we, wI 1 toe, OFFICIAL USE ONLY BELOW THIS LINE UPGRADE/FAILURE SOURCE(for reporting purposes) m m ❑VOLUNTARY 0 MAINTENANCE/PUMPING 0 BUILDING PERMIT 0 HOME SALE ❑COMPLAINT,ER: COMMENTS!CONDITIONS SEWAGE TANKS MUST BE LISTED UNDER DOH"LIST OF REGISTERED SEWAGE TANKS". TANKS MUST MEET CURRENT MINIMUM SIZE REQUIREMENTS,EQUIPPED WITH RISERS AND LIDS TO SURFACE,AND INCLUDE AN EFFLUENT FILTER(IF APPLICABLE). RECORD DRAWING AND INSTALLATION REPORT REQUIRED FOR FINAL APPROVAL. INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED!ISSUED BY DATE Co\74tre'r THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB REVISED 12/7/2015 IIMI Mel • ` ; }a:. : ' h Health hepartment •,..,,m: •`/E :off,: : Co-laxity M'' '„..,.. ' '.'"+N. Y •.'. '• John V. Butler, M.D. ENVVRONMENTAL HEALTH SECTION ' • •' .NURSING SECTION" •Ir, :'. County Health ON'cer303 N. 4th. •1, 428 West Birch Street ,I' ". ,s e' ;?lnAf�4f t'.K"Stmat Shelton,Woshington 98584 �.ic1;l'•. ''' '•-'i:vee•• f 1Noshingtpn.98$d4" , 11-25-81 Phone 426556I • ',�, .:gip.•. �. ' y.:.,.,,{�r. ' F. f';. • ,• qt,. ;,, ';as'yi:�14i:-.3.. Roberts 4:45p .1:•• ,•, 2;:Montclair•Dr. . ' P ':: • • , of. SEA ? bar .. 47.•.y�f1;,. !` :: • a Re: Site at" W1•, SEA ftY;:-aa,,4'i:;C --z.-:=;'ti.' • '; • Sec-6, T-19., R-4 D '-• r.: : beets: `6s'.T a`above.referenced lot was inspected on • ':,,, ;�' '' that the following features of your lot. . �' ' : '4. inspegion revealed • ty '' gravel over compact sand and. .` a3i :' '.;; 'omit 4::.:to 24 inches clayey sand, f ,, ���.��;--t t��`'gavel: '.•., . .ter. itary Code l • ..�•;''' sues whichon yhave, less than fourifeet, butsnotzlessythang to be two feet of d r. .,' ' for i permeable,:Boil. Y1ti '-... '.. :• ,:Special systems may be designed by a Professional Engineer, Registered San- ;'=Marian; or`.designer licensed by Mason County. This requirement can be •,: : waiived for single family residences if aMdesign n nois stsuy bmitted o edlby yltheso iprope'rty ,; ' .. , 4oiwp r .or.a .system installer licensed by ' '�<• , consideration, �!'" .'. ':' `• '1,'p stem 'The 'forms.are•enclosed to expedite further rI.•4.I.' �•, +,'. �. fig • . ��:}��`,•-�,��": •.i::...:.: install • .3'. ,• letter', is not a guarantee that the lot will receive approval-to ~ *ssthat the features noted during the site .•:•.'�;; ; • .:. ;:.. � t,�. It is notification.only .i -``��``. ��• �' � 3,�pection� would require a special design. When a special design is submitted . ' • ., be installed :'.f,�-°: .,.'. ' ; ,approved, the application will be approved and the system may `,''3, ': :r' "'; designed 'and in accordance with the Sanitary Code. i: ; f..:r.;.,,:•te:,*: ontact his offige. • }';}; :_.,, ;: . f . ou have.`questions or comments, please feel free to to.contact t.. •i�•i-aye: ".,:':! -:. ;,s. >?Y_Y;:.x.;-.: ;; •• Sincerely, . `{A,NRI.;a - ? '►;.,'; Butler M D •''v t •F ..:•:•..5. ..;:,`;f t., John V. , r;,° e a" County health Officer • pa_ Ray llins• . `' ` Environmental Health Specialist , OM ' . lOaure ' • • L S • ` y + • - Equp� rt _E.-..Alove • . . n : : g „ l M in 2 ¢� j - ( r t ,�,A .._ +. . • � � ,, v a...« • q t ef . 3 SITE INSPECTION CHECK LIST - NO Check every acceptable feature. Leave every questionable or unacceptable feature blank. Explain every blank in the space for remarks. Item Applicable Regulations 1. Soil in holes-describe layers & depth Art. VI Sec. 3.5 (a) VII 3.3, 3.7, 10.2 -. 2. Existing sewage systems VII 4.1, 4.2 -' 3. Existing structures - check use VI 3.5 4. Existing wells - check construction VI 2.1 (b) VII 4.1 5. Presence of fill VI 1.8 VII 3.6 6. Has soil been removed VI 2.1 (c), 2.4, 3.5(f) VII4.1 ft -- 7. Salt water It8. Lake „ 9. River II10. Creek „ -11. Stream „ -` 12. Pond „ 1- 3. Swamp .. - 14. Misc. Surface water -- 15. Property VI 3.5 (f) VII 4.1 16. Banks or cuts VI 3.5 VII 4.1, 3.7 17. Distance to public sewer VI 3.5 (g) , 9.2, 10.2, 10.3 & .� 10.4 18. Water table - Record depth VT 3.5 (d) VII 1.4 19. Slopes VI 3.5 (e) VII 3.7,4.1 - 20. Driveways and roads VII 4.2 21. Drainage patterns VI 3.5 (e) VII 4.1 22. Interceptor drains VII 3.8 - 23. Culverts VII 2.6, 4.1 -' 24. Water lines .4 - 25. Flood control zones VII VII 23.4 26. Roof drains VII 3.2 27. Vegetation REMARKS / c;:r , , S ! N. 0-Z-Dr ‘....) - a -c- " ' I s( 9,4A ' ' .N &atmti►-� LA {cam I1•a ‘1? 1.A)L& IL4 OS %1 \VAL'S ( :? L.9, S vA,Ny- ce,:_ , ,0 Li- so./ ----,k u..J ,y -7 V\ Y ', f . 1 C }- z.d t \)ctab. Vpil li.,---Ak ,,Ve.• SokOr9 NII-,„', �4.i t""v ;g��'�.,, inert�;r;� (r 1 �w,lw gy sq� i �4 k S 'Wy) i 1 �n t qr '.., t h Ef 4;, _e�wk '],''-L 84� t �' p Al�1, _t k',•�.A` _ ,L f1,_. 1C.t11._il � �_.i�..a:ILi t ,a!'.. BY DATE SITE NO. FOR DEPARTMENT USE ONLY MASON COUNTY HEALTH DEPARTMENT BASIS FOR FEE AMOUNT ENVIRONMENTAL STREETHEALTH• TON, WA. 98584 DATE NEM 428 WEST BIRCH (206) 426-5561 fril V �� APPLICA SIGVATURE NOT ' `l Ip VV.' �' O �. A� APPROVED APPROVED PHONE SITE: ❑ 111111111111111.1.1.1.1 ADDRESS� 1 4 �O�t\Gk l r i�if � .. �-St a"' i����� PROPERTY OWNEg l.'� `k b b"�.`.S Milliii ti 1\1 S W G p DESIGNED SYS M REQUIRED _ ADDRESS- � �� ��� t����ENE�Zb p��v APPROVED ❑ APPROVEDOT - T SEWAGE 111111111 SEWAGE: 0 SEWAGE DESIGNER CONTRACTOR 5-e '� � LEGAL DESrC}t�1PTION , a 4. _e, c`1 {�. 11 /► MIIIIIII1N111111 l SOIL.TYPE r VP _ ` NO.OF 3 LOr'04P acres ` P C.R TA E_ _ ---- TYPE OF oyvL BEDROOMS SIZE s �+� DEPTH TO WATER TABLE BUILDING flbi E. h GAL. PUMP REQ. SINGLE RESIDENCE . PUBLIC WATER ❑ NAME SEPTIC TANK(S) WATER SYSTEM. SYSTEM FEET LIQCOUID ROAST ONLY / 0 r DISTRIBUTION TILE TOTAL SQ. FEET LIQUID WASTE G.P.D. FILTRATION AREA DIRECTIONS TO SITE: ,7 L. QUANTITY OF CU. YD. �� + —2: - I,;1\Eg. APPROVED STONE—.—•--CU• YD. SAND_—_— �h �0 5 �� FILL REQUIRED CU. YDS. ''- • FINAL INSPECTION REQUIRED BEFORE BACKFILLING •c p •per+- �Mo. � �-- <` 60 140.5 i DEPTH OF 49, 1 ---�BACKFILL 1.11 Mil IIII61 11911191111111 II �i 22•.SSTRAAWW IOR PAPER .a%:"�•'•Zil . .t ,�+i F STONE i.,r� 1f ils� yr i� OVER TILE 1111111111111111111111.11111111111111111111 �,,�Nr 6_ �OZs'%aI;y' F11=1 PIPE SIZE IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII f+i� 4-:C4•,i1 '�:;; MIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII OJo� py ----^�{STONE UNDER TILE SITE PLAN AND SPECIAL STIPULATIONS 1 NE ��C OS5 SECTION OF TRENCH �-Z�d } (INDICATE DIRECTION OF DRAINAGE) - .. ,• zSI VAAb; le ko _ 04 ,, 11 . q . ��j 7h �t'Tt:wT1t„id . I got YP Y 'f.l_el ..-. .. ;r- l l.v.a- ., • <- COMMENT w w j. , z•. ,we t� yf e.,fO>:f'"ii:::? ti. :. .. ....:. C t 4.e_ �. „iYrvt _ `Trusted.Tested.Tough.' FM2116 Q 0703 Product information presented ZOE ER Supersedes here reflects conditions at time 0503 of publication.Consult factory regarding discrepancies or PUMP COMPANY inconsistencies. MAIL TO: P.O. BOX 16347•Louisville,KY 40256-0347 Visit our web site: SHIP TO: 3649 Cane Run Road Louisville,KY 40211-1961 zoellerpumps.com TEL:(502)778-2731.1(800)928-PUMP•FAX:(502)774-3624 MODEL: DATE CODE: P REAS S E M B L E D/JOB READY DATE INSTALLED: -p,GNINEO OUTDOOR SEWAGE SYSTEMS 111 MODELS 912-0082, 912-1082, 912-0083, 912-1083, 77IEU99. 912-0084, 912-1084, 912-0085 & 912-1085 INSTALLATION INSTRUCTIONS PREINSTALLATION CHECKLIST Notice to Installer: Leave instructions with homeowner. 1. Inspect your unit. Occasionally, products are damaged during shipment. If the unit is damaged, contact your dealer before using. DO NOT remove the test plugs from the pump. 2. Carefully read the literature provided to familiarize yourself with specific details regarding installation and use. These materials should be retained for future reference. A WARNING A CAUTION SEE BELOW FOR LIST OF WARNINGS SEE BELOW FOR LIST OF CAUTIONS 1. To reduce the risk of electrical shock, a properly grounded 1. Check to be sure your power source is adequate for handling receptacle of grounding type must be installed and protected the voltage requirements of the motor,as indicated on the pump by a ground fault circuit interrupter(GFCI)and in accordance or basin plate. with National Electrical Code and local codes. (SEE WARNING BELOW) 2. Make sure the pump electrical supply circuit is equipped with 2. Make certain that the receptacle is within the reach of the pump's fuses or circuit breakers of proper capacity.A separate branch power supply cord. DO NOT USE AN EXTENSION CORD. circuit is recommended,sized according to the National Electri- Extension cords that are too long or too light do not deliver cal Code for the current shown on the pump name plate. sufficient voltage to the pump motor.But more important,they could present a safety hazard if the insulation were to become 3. All plumbing(discharge and vent lines)must be installed to meet damaged. local codes.Unit must be vented.DO NOT USEANAUTOMATIC 3. Testing for Ground.As a safety measure,each electrical outlet PLUMBING VENT DEVICE SIMILAR TO A "PRO-VENT". should be checked for ground using an Underwriters Laboratory Some states require this product to be installed by a licensed Listed circuit analyzer which will indicate if the power, neutral plumber. and ground wires are correctly connected to your outlet. If they are not, call a qualified electrician. 4. Repair and service should be performed by Zoeller Pump 4. For Added Safety. Pump must be connected to a 3-prong Company Authorized Service Station only. grounded outlet interrupter device (ground fault circuit inter- rupter). 5. CHECK VALVE MUST BE USED TO REDUCE UNNECESSARY 5. FOR YOUR PROTECTION, ALWAYS DISCONNECT PUMP CYCLING OF PUMP. FROM ITS POWER SOURCE BEFORE HANDLING. Single phase pumps are supplied with a 3-prong grounded plug to help 6. This system must be installed above the water table. Ground- protect you against the possibility of electrical shock. DO NOT, water outside the basin will cause it to collapse. UNDER ANY CIRCUMSTANCES, REMOVE THE GROUND PIN. To reduce the risk of electrical shock,a properly grounded NOTE: Pumps with the"UL"mark and pumps with the"US"mark receptacle of grounding type must be installed and protected are tested to UL Standard UL778. CSA Certified pumps are by a ground fault circuit interrupter(GFCI) in accordance with certified to CSA Standard C22.2 No. 108. national electrical code and local codes. 6. Installation and checking of electrical circuits and hardware should only be performed by a qualified licensed electrician. 7. Risk of electric shock-These pumps have not been investi- gated for use in swimming pool areas. 8. According to the state of California(Prop.65),this product contains chemicals known to the state of California to cause cancer and birth defects or other reproductive harm. ©Copyright 2003 Zoeller Co.All rights reserved. "OUTDOOR" APPLICATION 1. All installations must comply with all applicable electrical and sufficiently locate the basin outside of the loading area of plumbing codes, including but not limited to the National Electrical the adjacent structures. Code,local,regional and/or state plumbing codes,etc. 4. Dig a trench for the discharge and electrical conduit. 2. Dig a hole for the basin. The hole should be at least 24" larger in 5. Thebottom ofthe excavation can nowbe backfilled and compacted. diameter than the basin diameter to provide 12"of backfill all around Set basin in hole and connect the 4"inlet pipe and 2"discharge and deep enough to provide either 12"of compacted backfill or 6" pipe. when a concrete pad is required. Backfill and sub-base should be 6. Run electrical conduit to the power source. 1/8"—3/4"pea gravel or 1/8"—1/2"crushed stone. 7. Backfill around basin with specified media. Care should be used 3. Note: Care must be taken when excavating in order to avoid to avoid damaging components or leaving voids when back filling. underground utilities and disturbance of existing structure 8. Note:Venting can be installed on basin cover as necessary foundations. The hole should be located at least ten feet from according to all applicable National,State,and Local plumbing adjacent structures. Additional distance may be required to codes. WHEN LOCATED BELOW GRADE,A RISER QWIK-BOX IS RECOMMENDED TO BRING THE LID "DISCONNECT MEANS REQUIRED WITHIN SIGHT" TO THE SURFACE FOR EASYACCESS PER NATIONAL ELECTRICAL CODE(NEC) TO THE PUMP AND CHAMBER. r—, (SOLD SEPARATELY) ' QWIK-BOX VENT PER LOCAL CODE rr (SOLD SEPARATELY) l i'—' I nn ,n=rnn=n=nn=nn=n°i n-n_n-n=n"in 'n_n-n; i= n=u=an=nu-n �u=n=u=u=n=u=u=irii=u=m u-i=n=n=n=n—u.-n=n=n n=n=n=u=q=u=n=n=n="=, =ifIrn-n=u-n=n=u=n=n=i n=n=n=n=n—n=n=u—n=u—m —1nil=u=i=u=n=u=n=n ii=n="=n=n=u=n="."=n=n. r'a=WL'TT_-'n'--'n='o°o ir'i *NOTE T=n-n=n=u=n=u=n7=nn =n=n=u=n=u=u=n=n-u=n ,_....n—n_n_.,,..rr, i_n_,_=u-_u-i-i__ MAX.36° n=n=a=n=n=n=u=u=n=n=u, i n=n=n=n—n=n=n=n=n=i ''n°—"prawi'n'--'a°a=��="�_�iiz __=n=a=a=u==a=u= =n=n—nn—n=n=n=nn=n=-, n n=n=n—n=n=n=u=n=i n=n—n=n=n=n=u=n=n=u=a=._ •.`il=ndi=n=n=n=n=n=u=n—n %n=n=u=n=n=n=nu=n n=i;-I:y ;I ....n=n=n=n=n=n=n=i TO ELECTRICAL eoe;oe,aaoe^I , \\\�` -Iili gliggligil °° DISCHARGE ° °I I INLET NEMY a Imo ....... 4 :Eiiiiggaiiii BACKF ILL MATERIAL "ei,e°: %Slam 41,0 legligil -iri, 3/4' 11 4. all COMPACTED SUB-BASE =^_°_°_=�=^"°=^=°=�'°'°'='°�°°°°°°°°° MINIMUM 12"OR 6" PEA GRAVEL CRUSHED ROCK WHEN USED WITH CONCRETE HOLD-DOWN PAD BACKFILL MATERIAL REQUIREMENT SK2253 ©Copyright 2003 Zoeller Co.All rights reserved.