Loading...
HomeMy WebLinkAboutSWG2022-00072 - SWG Application / Design - 2/22/2022 MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584 SHELTON:360-427-9670,EXT 400 COMMUNITY SERVICES BELFAIR:360-275-4467,EXT 400 n 9, ELMA:360-482-5269,EXT 400 No 4,v/ suilding,Plannu oy,Environmental Health,Community Health FAX:360-427-7787 On-Site Sewage System Permit: SWG2022-00072 APPLICANT GOULD TRENT V Phone: 360-490-6480 Address: 1123 E MALANEY CREEK RD SHELTON, WA 98584 OWNER GOULD TRENT V Phone: 360-490-6480 Address: 1123 E MALANEY CREEK RD SHELTON, WA 98584 SEPTIC DESIGNER DALE TAHJA-Septic Designer Phone: 360-426-5940 Address: 2450 W DEEGAN ROAD WEST SHELTON, WA 98584 Site Address: UNKNOWN Primary Parcel Number: 220063490003 Permit Description: New four bdrm-gravity trench with Class B waiver Permit Submitted Date: 02/22/2022 Permit Issued Date: 07/13/2022 Issued By: Luke Cencula Current Permit Fees Paid: $740.00 (additional fees may be required upon installation of system). Permit Expiration Date: 03/03/2025 (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(12') and downslope (10') 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. 7 Double sleeve transport line under any driveways. 8 Horizontal setbacks per WAC246-272A-0210 must be maintained, unless prior approval is obtained 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/onsite/oss-inspection-request.php or call: 360-427-9670, extension 400. OFFICIAL USE ONLY _ DATE RECEIVED: MASON COUNTY �'• ?'� ' c a) COMMUNITY SERVICES AM1E� • RECEIVED , 03 m ,..,.. - _„., Public Health(Community Health/Environmental Health) C V) #5 24 4'.' 360-427-9670,ext.400 or 360-275-4467,ext.400 415 N.6th Street-Shelton,WA 98584 : SVVG 20UL0 ° VtIV �<.�.��-mom. Z di ON-SITE SEWAGE SYSTEM APPLICATION m n APPLICANT PHONE Cm� Trent V. Gould (360) 490-6480 c MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE c 1123 E. Malaney Creek Rd. Shelton WA 98584 m 73 SITE ADDRESS-STREET,CITY,ZIP CODE E. Malaney Creek Rd. Shelton WA 98584 I N NAME OF DESIGNER PHONE I N Dale L. Tahja (360) 426-5940 NAME OF INSTALLER PHONE v I CI R. IPERMIT TYPE(select one) DRINKING WATER SOURCE T'RESIDENTIAL OSS )1 COMMUNITY OSS rl COMMERCIAL OSS I41f PRIVATE INDIVIDUAL WELL L7 PRIVATE TWO-PARTY WELL Z I TYPE OF WORK(select one) a PUBLIC WATER SYSTEM t if NEW CONSTRUCTION/UPGRADES ' REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) 0 TABLE IX REPAIR I W SUBMITTALS ❑ SURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINE 03 Fir DESIGN FORM(REQUIRED) il SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE r0 I 'p' I�WAIVER(S)(IF APPLICABLE) 4 13.52 acres o ' 7 co DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.locked gate) East on Hwy 3, right on Agate Rd., left on Spencer Lake Rd., right on Malaney Creek Rd. I I o go to Y with signs for (1123, 1251, 1300, 1301) stay to the right, property first driveway on r I o the left. -{ Io SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. I (A) OFFICIAL USE ONLY BELOW THIS LINE -- UPGRADE/FAILURE SOURCE(for reporting purposes) 0 VOLUNTARY 0 MAINTENANCE/PUMPING ❑BUILDING PERMIT ❑HOME SALE ['COMPLAINT ❑OTHER: , INSPECTOR SOIL LOGS COMMENTS/CONDITIONS n IF C�-3a �5L + S� �. Uri t (2 - r 5 c- +, +=�. ,., -n" /lg n y LE *' ; Y U1 l I ,1 tIt ,iS '-- v - w 22 % ��3b t- Co w RECORD DRAWING AND INSTALLATION SOIL CODES: • —_�""- =VERY G=GRAVELLY S=SAND L=LOAM SI=SILT C=CLAY E=EXTREMELY R=ROOTS �y��"`r V REQUIRED FOR FINAL APPROVAL. ,�[,�J( INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED/ISSUED BY " 11"(SATE ' 4 3 f-s1y- THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 1217/2015 c °� DESIGN FORM—PAGE ONE V.CU 1 `c� Assessor's Parcel Number: 2 2 0 0 6 — 3 4 — 9 0 0 0 3 A design will be reviewed when 3 conies of each of the following are submitted: ''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. This form may be scanned and available for public view on the Mason County Web site.Maximum a r size: 11' X 17" : _:;% PAi iO O ASO ._i.=. . Permit Number: SWGa a-cw7 a Designer's Name: Dale L.Tahja Applicant's Name: Trent V.Gould Designer's Phone Number: (360)426-5940 Mailing Address: 1123 E.Malaney Creek Rd. Designer's Address: 2450 W. Deegan Rd.W. Shelton WA 98584 Shelton WA 98584 City State Zip City State Zip . . _.. - . . ` ES*GN n2,' . 3 Treatment Device ❑Glendon Bi3 0 Sand Filter D Mound 0 Sand Lined Drainfield 0 Recirculating Filter,Type: ❑Aerobic Unit Make/Model ❑Disinfection Unit Make/Model Other: N/A Drainfield Type Ft Gravity 0 Pressure i 1 Trench 0 Bed 0 Sub Surface Drip Septic Tank/Drainfield Specifications Laterals Number of Bedrooms 4 Schedule/Class 2729 Daily Flow:Operating Capacity 360 gpd Length 67 ft Daily Flow:Design Flow 480 gpd Diameter 4 in Septic Tank Capacity(working) 1,200 gal Number 4 Receiving Soil Type(1-6) 4 Separation 10-30 ft Receiving Soil Appl.Rate 0.6 gpd/ft2 Orifices Required Primary Area 800 ft2 Total Number of Orifices Perf. Pipe Designed Primary Area 800 ft2 Diameter in Designed Reserve Area 800 ft2 Spacing in Trench/Bed Width 3 ft Manifold Trench/Bed Length 267 ft Schedule/Class 3034 Elevation Measurements Length 80 ft Original Drainfield Area Slope 6 % Diameter 4 in New Slope,If Altered 4 % Preferred manifold configuration used? ❑Yes 61(No Depth of Excavation Up-slope \_4, in Transport Pipe from Original Grade Down-slope \© in Schedule/Class 3034 Designed Vertical Separation 18 in Length 120 ft Gravelless Chambers Required? 0 Yes 0 No Elf Optional Diameter 4 in Pump Required? 0 Yes li6No Dosing and Pump Chamber Pump/Siphon Specifications Number of doses/day Gravity Diff in Elevation Between Pump&Uppermost Orifice ft Dose quantity gal Drainfield Squirt Height/Selected Residual(head) ft Chamber Capacity(flood) gal Uppermost Orifice 0 Higher 0 Lower than Pump Shutoff Pump controls:Please check those required. Capacity @ Total Pressure Head gpm ❑Timer ❑Elapse Meter 0 Event Counter Calculated Total Pressure Head ft If Timer: Pump on i r.0 F iI55N Ti, 0 Comments I MAR 0 8 I 2022 BY:______„_ DESIGN FORM—PAGE TWO Assessor's Parcel Number:2 2 0 0 6 -- 3 4 -- 9 0 0 0 3 Permit Number: SWG DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch Eli Test hole locations PI Drainfield orientation and layout Reference depth from original grade: FA Soil logs el Trench/bed dimensions and [1 Septic tank lid Property lines critical distances within layout 12f Drainfield cover 171 Existing and proposed wells l D-Box/Valve box locations Reference depth from original grade within 100 ft of property lid Septic tank/pump chamber and restrictive strata: 6d Measurements to cuts, banks,and locations 611 Laterals,trench bed,top and surface water and critical areas 62( Observation port location bottom 0 Location and orientation of GZE Clean-out location ❑ Curtain drain collector curtain drain and all absorption st1 Manifold placement 0 Sand augmentation components ❑ Orifice placement Other cross-section detail: Location and dimension of It Lateral placement with distance g Observation ports/clean-outs primary system and reserve area to edge of bed Buildings Other Information EZi ❑ Audible/visual alarm referenced Yes No Direction of slope indicator g Scale of drawing shown on scale L 0 Design staked out It Waterlines bar 0 0 Recorded Notices attached 1 Roads,easements,driveways, g 0 Waiver(s)attached parking ❑ 0 Pump curve attached lel North arrow and scale drawing 0 0 Evaluation of failure shown on scale bar Non-residential justification ❑ 0 Waste strength ❑ ❑Flow DESIGN APPROVA J , The undersigned designer ust be notified in rat time of installation gYes 0 No Signature of Designer Date ,�.�' ; •�. c .ac The undersigned has reviewed this design on behalf of Mason County Public Health and dete ;,0 <,.1 " in . QZ 1 compliance with state and local on-site regulations: „ !'0-,,tam _ „-,,y 1 r sr Environmental Health Specialist Date 'tit_' ,; ,°�s �F"';"7'-.2 `_} 1 CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CON rt y L'V d ' ✓ The design is stamped"Approved"by Mason County Public Health. *t is- , • -� ✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: " g p p � r, ✓ Drainfield site conditions have not been altered to adversely affect conditions of design approval. `f 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 . . • ).... ..............w.... ...-„.... ..........— . .• . . - • . . . _ _..._ . 1—•••••------ II. 1,.._ ,...,--- -....---: la & Nillk ift Illt LI - • I 1 '.''"'.......,.....................___ ' il'il---- : .....___ __..... I il0 .01., ---- 1 4 ______,...........airefts,.................t .r. ,ummun............,,,,...........„ wa......=, I 5 1 -,.. 1 ammilmin* ,ii ' .., a „...„.,...„......,...:.....4 , . . .., • 4 F. - X . ? , c .0441 .0 q ..,4., . ,... 1.7 5 ...,,i. .,,,TO .. ..... - ,8„.7.-...::-.4,...-f... -.....: ,-,..-. -....,..., ... , w Ash ..i..,,.It • . . AO • ,. .:21.9:1*4 51001 ,.,..t. 0" DALE L.TANA . . 'utiNiEbk - - - bt'SIGNER ---\ \1" .._\( A V‘ ' —\1\1 • ........,„ ...,. ',.. .............---.....-.------7......._____ V 1 II 1 8 i ,. r's: —'..2...''.2•7";. ' . Ott -••• A, 1 t Cl 0\ \PN-k\c\, e ' A erk95 / A- i‘ A . , \ol e‘c ,,, Te_< ‘-'.\ctA'\te / Installation/Maintenance Gravity Distribution/Trench Systems 1. Install trench bottom level and in contour with the ground. 2. Install drainfield during dry weather and soil conditions.Any soil smearing must be eliminated by hand raking any areas that get smeared. 3. Divert all storm water run-off away from septic system components. 4. No curtain(french) drains allowed within 10ft. of the up-slope edge of the drainfield and reserve area. 5. No curtain (french) drains allowed within 30ft. of the down-slope edge of the drainfield and reserve area. b. Have the septic tank pumped or inspected every 3 to 5 years. 7. All material and workmanship must meet County and State requirements. 8. Deviation from this approved design without prior approval from the Designer and Mason County Health Department will make this design null and void. 9. The prepared Site Plan is not a survey, it is the owner's responsibility to verify property line locations prior to installation. Any discrepancies must be reported to the Designer immediately. 10.Locate all utilities prior to starting installation. sit si F por • C? DALE L. TANNA _ e 0') 't ,'-4. \ ‘ I , )\N>ek '4I\‘AllID i•tA.,,k.\.S.‘)n) ;'''' . .‘'•,' (t,:..J \ • 7''....* 4) I\ \ . f \ 1 \ \ . \l,/ \( \ \ ' ... \$ 4', ; ,.. \1-,,, , \ ....- \)3 .., ..... \ ...------ . o r.,....' 1' - 0 , , ...".--"" -..-Th ' A 4.- r / ( .-.. ---, r i r/ ..... 4, ., i • , /1:17 13' g i fz, ....,_ _ \\ -, - ......... ....._ ,.....- 3 \ -40 ..---- , -,.. -- ,,, ' 2*.•'Y,3* .1"b• "4""46. 4 2:13NDis•:..., '' ,1 '' 1,, i . — - - . 1.• . .--: _ ,,-- \ No,• ,G,,, ,. t'r. -.9 ‘"c.:::•, \p„.... % Pr 4 . ...., 4 ... 4 401 . 4. .0' ......•....,..,,,,,,,.... .. ...• 11....-*- •-1....‘ I \—kA\09\ It Alk‘C)4:3\ 6V-- 17, I `)S tA '- Q0C)‘o — —/QCS'tst 1z4,\- \z)c .)