HomeMy WebLinkAboutSWG2022-00391 - SWG Application / Design - 7/8/2022 415 N 6TH STREET,SHELTON,WA 98584
/12ria it MASON COUNTY SHELTON:360-427-9670, EXT 400
,_ . ) COMMUNITY SERVICES BELFAIR:360-275-4467, EXT 400
ELMA:360-482-5269, EXT 400
v' Building.Planning,£rrvironmental Health,Community I ienttli
FAX:360-427-7787
On-Site Sewage System Permit: SWG2022-00391
APPLICANT BAKKEN TODD R& BRENDA L Phone: 253.355.0440
Address: 221 E BALLANTRAE DR SHELTON, WA 98584
APPLICANT RUSSELL ERIC Phone:
Address: 5015 N 26TH ST TACOMA, WA 98407
OWNER RUSSELL ERIC Phone:
Address: 5015 N 26TH ST TACOMA, WA 98407
Site Address: UNKNOWN
Primary Parcel Number: 320215502030
Permit Description: New 2bd pressure trench
Permit Submitted Date: 07/08/2022
Permit Issued Date: 08/04/2022
Issued By: Rhonda Thompson
Current Permit Fees Paid: $740.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 07/20/2025 (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
DATE RECEIVED:
MASON COUNTY , " Z C
( COMMUNITY SERVICES A E V0.I. RECEI °4) U) >
Cn
Wo m
14, `"�_ Public Health(Community Health/Environmental Health) Q y
5•HitygN', 360-427-9670,ext.400 or 360-275-4467,ext.400 �� II I 0 Q
415 N.6th Street-Shelton,WA 98584 S W G _7��� /n
Z
ON-SITE SEWAGE SYSTEM APPLICATION
APPLICANT ll PHONE ,^ M
ESN j/‘ E=N --1Go - ztot — O\4O g- c
MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE q
�—�A 'cA '` gUli'� WE �i�J6 SwEL-vote I%C ' m
SITE ADDRESS-STREET,CITY,ZIP CODE I'\),
NAME OF DESIGNER\//�(�/ `�'\ �y PHONE
f- '^� ^y / o^ AI 9
I0
I
NAME OF INSTALLER PHONE 0
PERMIT PE(select one) DRINKING WATER SOURCE -
RESIDENTIAL OSS COMMUNITY OSS El:COMMERCIAL OSS b-PRIVATE INDIVIDUAL WELL 0 PRIVATE TWO-PARTY WELL Z I
TYPE O ORK(select one) LPUBLIC WATER SYSTEM J rC )—cF--6 AR i Z 1
NEW CONSTRUCTION/UPGRADES 5-REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) 0 TABLE IX REPAIR ICE
SUBM-ITT�LS
0 SURFACING SEWAGE ❑EXISTING FAILURE 0 SHORELINE
10DESIGN FORM(REQUIRED) ' SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE WB I UN
Co0- I
WAIVER(S)(IF APPLICABLE) -2- '�R-6 � O.\C AGF- o
DIRECTIONS TO SITE AND SITE CONDITIONS:(ex-locked gate)
%41c-i7 Qq-e5r1)Kv,) `Pti "to f-RS--r- l Q-1F-vl q y QvJD r Co JCt^ 60 4 i‘E 1A y N 10
--r- EN-VC, S S-r Sa t c ( S a TA T- (gay 1 ea—r VIA M,n/taRlb '1-Alm o 10
( 0Iw
0
SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. I
OFFICIAL USE ONLY BELOW THIS LINE -
UPGRADE/FAILURE SOURCE(for reporting purposes)
❑VOLUNTARY ❑MAINTENANCE/PUMPING 0 BUILDING PERMIT 0 HOME SALE ['COMPLAINT 0 OTHER:
INSPECTOR SOIL LOGS COMMENTS/CONDITIONS
' ° .' L Cl Lr HOW 1EF!
pS
JUL 0 8 2022 ts11)1
By _—
RECORD DRAWING AND INSTALLATION REPORT
SOIL CODES:
V=VERY G=GRAVELLY S=SAND L=LOAM Si=SILT C=CLAY E=EXTREMELY R=ROOTS REQUIRED FOR FINAL APPROVAL.
INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE AP LIGATION APPROVED/ISSUED BY DATE
gitl 7tUrv,__ -7 (-1_0(.15- . vi\ (6/4(7_-_--L
THIS FORM MAYBE CANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12/7/2015
t DESIGN FORM-PAGE ONE Assessor's Parcel Number:3 G-d `-- ( -- 5'b -- d Z 0 3 D
A design will be reviewed when 3 copies of each of the following are submitted:
°Completed design form that has been signed and dated. 0 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 paper size: 11"X 17"
PARCEL IDENTIFICATION
Permit Number: SWG <OZ QD5c1i Designer's Name: 16)i-a,G IWSvtL,
`�)'(L .N �jA11-4--C� Designer's 'S� 1,$g ` a7
Applicant's Name: � A g er's Phone Number:
Mailing Address: 'IS l eA - ' ,111.4..e.*4T¢I -Designer's Address: JSO'S L)+ 21;146 s-'
s A erN-00 VWA et@ 4 -Tht+vA,vt WA eibia1
City State Zip City State Zip
DESIGN PARAMETER
T J
❑ Glendon Biofilter ❑ Sand Filter ❑ Mound ❑ S.1' i fined�Drfaiinfield El circulating Filter,Type: _
❑ Aerobic Unit Make/Model El Disinfe .s U 1GAQk3/1 o 1 Other: !J/�
D rki,ii field Tje_„_.
❑ Gravity ;}Pressure 14/Tre 0 Bed 0 Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms Z Schedule/Class 0
Daily Flow: Operating Capacity 24 J gpd Length v?(Z. e ft
Daily Flow: Design Flow z-4 0 gpd Diameter 1, . 2>S- in
Septic Tank Capacity(working) 1,Oct r.7 gal Number c3
Receiving Soil Type(1-6) 4 Separation 01 ft
Receiving Soil Appl. Rate CD . fa gpd/ft2 Orifices
Required Primary Area OJ ft2 Total Number of Orifices
Designed Primary Area AC>o ft2 Diameter 3l4 in
Designed Reserve Area )(-, ft2 Spacing 3 C in
Trench/Bed Width "3 ft Manifold
Trench/Bed Length VS-3. - •a t, ft Schedule/Class 4 v
Elevation Measurements Length �,AI .-1 e5 ft
Original Drainfield Area Slope 0 - 2._ % Diameter 1, 'J in
New Slope, If Altered fJ /.i % Preferred manifold configuration used: =es 0 No
Depth of Excavation Up-slope 1 . in Transport Pipe
from Original Grade Down-slope
} 5 in Schedule/Class D
Designed Vertical Separation Z in Length IN p ft
Gravelless Chambers Required? 0 Yes 0 NoOptional Diameter 'C in
Pump Required? s es 0 No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day 4
Diff. in Elevation Between Pump&Uppermost Orifice�`eft Dose quantity (0c.7 gal
Drainfield Squirt Height/Selected Residual(head) `- ft Chamber Capacity(flood) \ � gal
Uppermost Orifi Higher 0 Lower than Pump Shutoff Pump controls: Please check those required.
Capacity C Total Pressure Head -2. , (e) gpm rter ❑Elapse Meter 0 Event Counter
r E'C-l+Js-61��4 � '7-0/�`Jt/
' S-rif LtNl.-
Calculated Total Pressure Head -7„ ft If Timer: Pump on SE-tat ,Pump off SeR�A'
Comments
DESIGN FORM-PAGE TWO Assessor's Parcel Number:`3 7- 0 Z- 1 -- -- 0 �c, `3 c7
Permit Number: SWG ae...)212.-c.›..)3"t t
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
❑ Test hole locations 0 Drainfield orientation and layout Reference depth from original grade:
❑ Soil logs 0 Trench/bed dimensions and ❑ Septic tank
❑ Property lines critical distances within layout 0 Drainfield cover
❑ Existingand proposed wells 0 D-Box/Valve box locations
p p Reference depth from original grade
within 100 ft of property 0 Septic tank/pump chamber and restrictive strata:
❑ Measurements to cuts,banks, and locations 0 Laterals, trench bed, top and
surface water and critical areas 0 Observation port location bottom
❑ Location and orientation of 0 Clean-out location 0 Curtain drain collector
curtain drain and all absorption ❑ Manifold placement 0 Sand augmentation
components 0 Orifice placement Other cross-section detail:
❑ Location and dimension of 0 Lateral placement with distance 0 Observation ports/clean-outs
primary system and reserve area to edge of bed
0 Buildings Other Information
0 Audible/visual alarm referenced Yes No
❑ Direction of slope indicator 0 Scale of drawing shown on scale 0 veYDesign staked out
❑ Waterlines bar 0 0'Recorded Notices attached
❑ Roads, easements, driveways, 0 I 2Waiver(s) attached
parking 0 Pump curve attached
❑ North arrow and scale drawing ❑ pzx Evaluation of failure
shown on scale bar Non-residential justification
❑p'•Waste strength
❑ Flow
DESIGN APPROVAL
The undersigned designer must be r tified by,installer at time of installation Yes 0 No
C1 i (jam
Signature of Designer Date
The undersigned has reviewed this design on behalf of Mason County Public Health and determined it to be in
compliance with state and local on-site regulations:
‘sqZY\f2A4INtO VY\ iLt I
Environmental Health Specialist Date
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
✓ The design is stamped"Approved" by Mason County Public Health. 12-6
r✓ 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
CA z b v) n
co
p %nmm
amp y zdz
v, O H wCA CA � Or c, 0
v� � mo, � ;� Nm � v,
o ,.._. LA -
r.
O
n CD
0 V) y
ii
NJ
O
"'"
1 �'
4 v. AA 0.1(\ ND G& -GS
/z J // 64
«..• V\
c, � '` ( C" ram- �_)
.A ' o D CO
c7
�, o 0
� % T
K 4 m V
C40
h
CV
,....4 g r _.
)...
�' _ T
v
CJ
—`el ===per -- _. 0
gt 7..
- / N
jCam • op
5:1r�r'r �� sr Pic
Al:- Om X3--"` 1"..-\<,?r, r. ii
le-
•day '
f
l'
Co IVO J m DP A Co N _' '
r O 0 x -1 n -1 -Iz c - > o Jcn -i ion w -D -I 'U
O � W > Ti m x O= =0 N= m -[ x Xo > CXM cm �mDAoo-I Z��z co< - I 0 �0�0 'V
m -I C D N N � cnrnn m � pZOcnrn mp � D1 r 0m ccnm Dv�U�C�?m oz �0 �OrD_- Dm - rn -00z
m � rr• N 'O , z 7mr > 11-< zi002p �6Zi) S° o i zrn 10 70 wn 77nm0)* ZCm Om--n mrDmDcn zm77C-i fn
co U O C) -i n� � z � � m0T--I c >mr- G�-I _ m i _� �� DnO� v D �1D <Z 0) z ZHA -C
GO `; m m �Zvim �)m � 00r-23 r- zm mrM
� Zii Uz izm� Dr ' 5 = 2oD xnmzo0 OZMOO fn
a in DCUU D � _ > m mzNw Oarm- ccn�' 71Oin8DmoD mcnD6 000>n2D !"?1,:V:1)
mm j 0 x v Z65z7) OzfnOn z cn 0) c Omo 2 * CDw �7�L„L ���Z 2ZOZDC DZ
m p -i cn p Vm) -0D < -i mr > D mcD01 D-ice,-I 11m rzm�m00 ��mm <-ImO,jj � 0I n
< T m 55 m n 3 z m �xm rnmc < � � r mO �m ��C) o � ---7.0 CmD =rmmm -G OZm. o> I'Tt
m0 v v m > my Mmm), nc_n omco o�trD �zx rrr Dcnz�r> w w >Om in�D7o -� -!17op-Di �1
r m > m m0_ 00 fn r- z H - ZE --. Fr rn r- -i -�-nm mwD n O z '_-{'
w w x -n Omp cz c Ill 1 i m_m- o N z Dcnmz- r-n� cnOcn p Ohm
m cn a� m O �v_ Z Cmam D � - D 7zc')Z nz� oZ Drr-r-mO_1.D -4 . rn 2Z22m.DIO Oct=m� r
cn m v 0 K m D Omx m0 r'- -D -I mm2c mm> m� ADO<rr nD O�mOz <mmO�O 0) J1zrit m
0 Pn _I > z ^\ -irm cnp -i D mx --I cn r mm mw mm -M < nl -zi V' mm < X -0O�z-Icn a
D z Z n D -1 `v O -i CC m n �m mDuwiO �mo° p � Zlr��vo� rzr, mcnD �DwcnoT = � zwcnx G)
x 0 � D c -i D =ZO i(n ° mom mwz -1 pzD o• m mi ��ZO> � cxit2? mmpTrm < OcO�OD Z
m x m w m-{w Zm m zcn mOOm � m �r m o m <m O im mC)C �� CO r
m v � m g m oom NO � �� xmm� *m- rz __I>> m-� xcno_ OOzoOopoz mxmxp O
m -m1z D o ccn u) x mu,> rmz cncn m mom- e
11 71 D4>ocn O Zmm mD m rn mox mm o* �Hmmm mxc z �mv=� ZmDO mwmoC = m�mpp crnn
x me m n O O mlJ�v o iw0� D m 0
Om rD to �D0 �m 02 Dmp OTm �O � p G) m immO�O�p �m� DAD OZC��
7) m 1,i O r z z -10 DC m ,ZDjr= z 7, zz > -n 71 m�7 D -nOmm*� Dp� z7znOcn mDm�n
-i0 D z G> -- r m A mT-i. � m pmOZD > Z�= -.
;i1 o G) r m -i 4� C) m cn cn —I m 0 r
mD O -I In Om� � o mm00 �cnmrrt mRl C)� wri CZ0Co - ,ZD) � Xr- mo��z -IOmyx
cz7m m ^ Zmm m � 3v �� � z � � COT m C)z � zv77�n- mDD uMO wi � 00Um oz��m
xo p m p�Z ZOUm 00,n Zm DO D -i=cn�0 0 m OOrZm ?�5x�
0 m m F z cn m -1 x -1 w- m 1 _ice 0 n m � Z �m Z U(nm < Dv_
mt7n U p o D = mHz -m DX OZc rn GDrwDH -<� 1--Opm > �0 -1
-i p u O= m iZ x0 z0 om mar <_i- D
? m z • Zo = 00 c 0K •
n D -w = rn Z O o
-i m U m -1 =m p z
-i cn
O x m on(n m co co m W N o (0 Co V 0) Cn A W N 'U
\�� � o �m��1Czzi < — m D D D -Irx O 0 o 0_ 1- 0--i 0 --i x0 •n w -i
• -n2,rnrnc) zKK =i XcoT � x m ��D Z� D � D0�m D � Z5DrrO mg w0� DO= fn
m -imw m mm •n � m � D - :r r- m -Iv- rim cn
,� o DZzzrO„�� z amc m p D �y� �� 0) mi � � -1�x � czit C)D1 � Zmm py � C
z - z � rev, ��1r * P c v m G)-�' m zcn mn z m
Z _ > Z _ __I7C mr- -i m 0,,,- xr 0 FA m m Fill D (n DO - m
�, <TpMp2Cr� g M r - m 0 z n [n __ A rn mr0 -I ZO r *t1n n�
\, X1- I,—, Jy wcn cn � -��7I7c -I i, = Na_ o � mm � � r � D � -G
�o r- -1 c m m I c D rnn w 01 z _ r- ;) z c) m...- m mm�
m c w m D n z� 3 D v, D r- film D Z r to
i -12C) cn-1 � z rn zrr- 2 --I zm -cOn WI r- IJmp OH _..1
-i
.s• �11a aD^ D � w C) mOO rDp z = w =mXZ =� x [7 •cncn C _
i \\\ � •'y O a p >c � z m• v oA6 m c) m m Dp m = " m O mDm �D
:: I:.;,:;.• ,. :. l30 +� s � G mTo = n �� � � vi � � m oo rD O = m ow•v 77Aw
Q C -4 -< -I cO � � - m � r 0 zm mD cn mD = may fn
um) N -1 m C r- +!� nm c)0 0OrDD O � r -i nDm �O= (_�
J -i Ql x O OK D -1 m -i _ --i 0 I- M N -I-I m -1 m Z m ,t m ?1
/ .. 3: ZCm n � D Z rO X T, 7 1Cww i= D O n0 � pnD n
TOTAL DYNAMIC HEAD-FEET w r- 0 _i rD -i:r-1 Z Z < £0 <D m m D i a D C D O 2 >
o m m A N m 0 n mp on r S^,' �7rn�� O In 0m Ono 6
m � Z c or m cn m m m_ m
1` j -4p � cn Dv m� •Wo Tm mD �z N G a mW� mmm Z
O C T m -1 --4 G znl m . - rzm m < 0 C) gym= �Fill D (�
r- I Ii Ni z (np o 0 -1� m mi mwDm mn .< -iDD 23
•
C � � D m_ m rnmcn < -i � t70 �� � mD�
O � O rmTt -2w -I mtnn-DI m � D m wgm ccZz
a �o xcn x cn 0-I O �� cp OO m zOo -i
n m 3 � m o c)D m zpmz ZZ m m{m m-D
p (J C Dr mw m mwo o -im
�� \ \�`Al hV � � p D � < �Z o °m-I >73
mm -fl 1 n ni Z < -mcn C0 H
m_ 7Z r ��m v
z OG mm A r-s z C m m o= • m 0 cn m om
m -1 o 0/ m m
--1 =
A 1 D
/ *♦
C < DD
H
US n Z i(R�
f Ill c kJ 1
i\\iv-\ /•/ — __�,� G -r �'Z , I �. c
0
e.
n •/I \ %\ E� [( // o o mco
� q �rdie A
us Ul Cp1 T'O ,.h4� U.
-ri ''� ..bo c�OO �= U�C.Oqt:
./////
/ n n -[%1%c+'{i,.,i,r,..,rrta. {}{} cilit ..,,...a : At. .w t. A j�. c�S4 .//\ 1 o Q = �. r• . i i I-I,I.1 r r 4::tf„1,. itT >.». a
3 c sa 1 y o0 oc� �-�II��,I�l�� /� < ""+
eV fit . 4" ' ,%5, " 0 0°O C % ' J" (�1'j) • //` Q O
-J. . . -1-1,,,,„..- ( ( ?KW",
o Z 9 IIII I 8 0V RI-C/ //� / m Fn 4
yAy O.U., f n T Clq 1
F
O�Z V: mM�
- z
N >ioo Z Aa
� 8
'cn b � n r- _
�\• ] a % ii '%�/%� �\
• • CD 7 IT ri7 - D O c ��� m
� Z J
6. i 1i,(` ' • / /L•//
x rn ' ` O _ mobG
Cl c/ O o O
t11 :-iqv ^'3N ZdZ Z mZm SO m y
-I �i H X OVo n < Z -
n b
Z ` v' fiC -Ic 3 { •, at ,'1,;,:
;� - `
om ,, 1,
a )
"'IL
!11
1 w
• ozd n ] D po
1 ,i . 1 , •i •) C o ;UZCst w w- U �- A_ 44J j 1 } ' AmA
O 07 '�' om � It 3wO � w- r• ow � 0 z \ °
„ti ' 1 z
/ _ Cn D N O O
m Or- rZit,, 1:, f () A [ 1T- _ im Z
00 L tt m = p CP oma ® � m 0C C7 , � C7 r"j1,..) oO 1cc0o /, rC ,p F." o w O / Om w
ipiO {] / m
w rT1 S
0 Ln m n n r r _P
Y z Z "= o
J m F c 3a 1 c
O o
II
s<iN
O