HomeMy WebLinkAboutSWG2022-00634 - SWG Application / Design - 12/30/2022 OFFICIAL USE ONLY -
MASON COUNTY PUBLIC HEALTH DATE RECEIVED L 1. _ ^ 2
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ONSITE SEWAGE SYSTEM APPLICATION AMDTElED RE• NED ~ . e W u)
6 ,1V' 0 m
415 N 6th Street,(Bldg 8) Shelton WA,98584 i <_
Shelton:360-427-9670 ext 400 Belfair:360-275-4467 ext 400 S W G 22 _a�31 (
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APPLICANT PHONE >
NANETTE TREVINO 11 ��5��'�`i�3® 360-275-4831 m 70 m
MAILING ADDRESS-STREET.CITY.STATE.ZIP CODE \D \W 4-( .✓0 M.
PO BOX 1423 ALLYN WA 98524 c
SITE ADDRESS-STREET,CITY,ZIP CODE CO
422 E LAKE DEVEREAUX RD ALLYN WA 98524 m
NAME OF DESIGNER PHONE I —a
CINDY WAITE 360-701-0205
NAME OF INSTALLER PHONE I N
CHECK ALL APPLICABLE ITEMS DRINKING WATER SOURCE 0 I fV
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❑ NEW CONSTRUCTION 0 RV HOLDING TANK ONLY 0 PRIVATE INDIVIDUAL WELL (n O
❑ REPLACEMENT SYSTEM 0 INSTALLATION PERMIT ONLY 0 PRIVATE TWO-PARTY WELL 0
❑ TABLE 9 REPAIR 0 SINGLE FAMILY I!GJ COMMUNITY/PUBLIC WATER SYSTEM Z I J
O TANK(S)ONLY 0 COMMERCIAL SYSTEM NAME LAKE DEVEREAUX WS I 1
❑ UPGRADE TO EXISTING 0 OTHER BEDROOMS LOT SIZE
EJ EXISTING FAILURE "Record Drawing required
for all Installations" 3 105 coX125 O C)DIRECTIONS TO SITE-BE SPECIFIC AND ADVISE OF ANY NEEDED INFORMATION FOR ACCESS(ex.locked gate) (7 1
X I O
GO OUT HIGHWAY THREE, TURN LEFT ON LAKE DEVEREAUX ROAD, PARCEL IS AT
THE END OF LAKE DEVEREAUX ROAD ON THE RIGHT SIDE. I O
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p e per' it,, ID
SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS 11)
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE/FAILURE SOURCE(for reportng purposes)
O VOLUNTARY 0 MAINTENANCE/PUMPING ❑BUILDING PERMIT 0 HOME SALE ['COMPLAINT 0 OTHER
INSPECTOR SOIL LOGS COMMENTS/CONDITIONS
//
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DEC 3 0 2022
By
SOIL CODES:
V=VERY G=GRAVELLY S=SAND L=LOAM Si=SILT C=CLAY E=EXTREMELY R=ROOTS
CTOR SIGNATURE DATE APPLICATION EXPIRATION DATE AP- ATION AP'ROVED BY DATE
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THI F MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12/7/2015
MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584
SHELTON:360-427-9670,EXT 400
BELFAIR:360-275-4467,EXT 400
P Public Health & Human Services ELMA:360-482-5269,EXT400
FAX:360-427-7787
On-Site Sewage System Permit: SWG2022-00634
APPLICANT TREVINO NANETTE L & ROY V Phone:
Address: PO BOX 1423 ALLYN, WA 98524
OWNER TREVINO NANETTE L& ROY V Phone:
Address: PO BOX 1423 ALLYN, WA 98524
SEPTIC DESIGNER CINDY WAITE-Septic Designer Phone: 3607010205
Address: 80 E PICKERING LANE SHELTON, WA 98584
Site Address: 422 E Lake Devereaux Rd
Primary Parcel Number: 122075000002
Permit Description: Repair-3BR Nuwater
Permit Submitted Date: 12/30/2022
Permit Issued Date: 01/10/2023
Issued By: Jeff Wilmoth
Current Permit Fees Paid: $740.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 01/05/2026 (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: masoncountywa.gov/healthlenvironmental/onsiteloss-inspection-request.php or call:
360-427-9670, extension 400.
DESIGN FORM—PAGE ONE Assessor's Parcel Number: 1 2 2 0 7 — 5 0 — 0 0 0 0 2
A design will be reviewed when 3 copies of each of the following are submitted:
Completed design form that has been signed and dated. '1 Scaled layout sketch, including all applicable items on checklist
Scaled plot plan, including all applicable items on checklist. '1 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. L/arimum paper si:e: //"X/7"
PARCEL IDENTIFICATION
Permit Number: SWG �;Z� — 06 e3 LI Designer's Name: CINDY WAITE
Applicant's Name: NANETTE TREVINO Designer's Phone Number: 360-701-0205
Mailing Address: PO BOX 1423 __ Designer's Address: 80 E PICKERING LANE
ALLYN WA 98524 SHELTON WA 98584
City State Zip City State Zip
DESIGN PARAMETERS
Treatment Device
❑Glendon Biofilter ❑ Sand Filter 0 Mound G'Sand Lined Drainfield 0 Recirculating Filter.Type:
❑Aerobic Unit Make/Model 0 Disinfection Unit Make/Model Other:
Drainfield Type
❑ Gravity CiPressure 0 Trench Gfr Bed 0 Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 3 Schedule/Class SCHEDULE 40
Daily Flow:Operating Capacity 270 gpd Length 18
tt
Daily Flow: Design Flow 360 gpd Diameter 1.25
in
Septic Tank Capacity 1200 gal Number 8
Receiving Soil Type(1-6) 2 Separa,i.) 2 ft
s
Receiving Soil Appl. Rate 1 gpd/ft2 Apr I Orifices
Required Primary Area 360 ft2 "T.�4.o • um..0. 'orifices 72
Designed Primary Area 360 ft2 Ai "l1y(<,,,, lift/ 3/16 in
Designed Reserve Area LIMITED ft2 i�.aa�rc` • - . 14.• x 24
4.
in
A.Trench/Bed Width (TWO BEDS)10 ft rye to 1e \ (r�
�Y W ITE `���1 Manifold
Trench/Bed Length 18 ft,�� Li: 4+:'aifvta, ,,h SCHEDULE 40
Elevation Measurements �' ' .��"`��\ ' ' '%%'
°silo, 18 ft
Original Drainfield Area Slope >1 % Diameter 2
in
New Slope, If Altered �,y ? D g % Preferred manifold configuration used? Gif Yes 0 No
Depth of Excavation Up-slope 3 9' 1 S in Transport Pipe
from Original Grade Down slope —,/, /' p
PufiiOaY ESCHEDULE
Designed Vertical Separation 36 Length❑ tt
5-10 It��t�f 1
Gravelless Chambers Required? 0 Yes Ei No al .JAN,eteO 2023 2
in
Pump Required? El Yes 0 No MASON COUNTY ENVIRONMENTAR4Ongpod Pump Chamber
Pump/Siphon Specifications Nu dB Woses/day 6
Difference in Elevation Between Pump Shutoff and Uppermost Dose quantity 45
Orifice s ft gal
Chamber Capacity 1200 gal
Uppermost Orifice RI Higher 0 Lower than Pump Shutoff Pump controls: Please check those required.
Capacity @ Total Pressure Head 42.48 gpm 6 'Timer l 'Elapse Meter fir Event Counter
Calculated Total Pressure Head 7.296 ft If Timer: Pump on Pump off
Comments
4- GRAVEL BASED DRAINFIELD REQUIRED, PUMP CONTROLS TO BE SET AT TIME OF \V
INSTALLATION, CONCRETE TANKS REQUIRED. O/cl D, .g< 6.k� ,l
'S'O1 ( /06 IIJlit AlLt1 4 de 4� n✓.„5-yiireJifia„) _ /a/
DESIGN FORM—PAGE TWO Assessor's Parcel Number: 1 2 2 0 7 — 5 0 -- 0 0 0 0 2
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
El Test hole locations 12 Drainfield orientation and layout Reference depth from original grade:
12 Soil logs lif Trench/bed dimensions and g Septic tank
12 Property lines critical distances within layout 12 Drainfield cover
Ey Existing and proposed wells 12 D-Box/Valve box locations Reference depth from original grade
within 100 ft of property E2 Septic tank/pump chamber and restrictive strata:
Crs to c ,and locations p(, „„w i� Measuremaents to cut ban li71 Laterals,trench/bed,top and
surface water and critical areas 12 Observation port location bottom
pg Location and orientadn of Gd Clean-out location 0 Curtain drain collector
00-curtain drain and all absorption 12 Manifold placement 12 Sand augmentation
components
g Orifice placement Other cross-section detail:
l2 Location and dimension of
primary system and reserve area Lateral placement with distance Observation ports/clean-outs
to edge of bed Other Information
Iii Buildings
g Audible/visual alarm referenced Yes No
Iii Direction of slope indicator t'/ " ' 1 0 Design staked out
It Scale of drawingshow on sc e
12 Waterlines bar 0 0 Recorded Notices attached
RI Roads,easements,driveways, 0 0 Waiver(s)attached
parking l2 0 Pump curve attached
Ri North arrow and scale drawing Nit_ l0 �, M , lI 0 Evaluation of failure
shown on scale bar Non-residential justification
❑ 0 Waste strength
❑ ❑ Flow
DESIGN APPROVAL
The undersigned designer must be not' d by insta er at time of installation It Yes 0 No
,.1 iZ/211Zo72
Signatur f Designer Date
The undersigned has reviewed this design on behalf of Mason County Public Health and determined it to be in 7compliance with state and local -s to regulati n :
th �I 1 - /0-- �-3E vintal Health Spec' list Date
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
✓ The design is stamped"Approved"by Mason County Public Health.
I✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: ^�'2
✓ 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 obi fil pfin04ps . I unty Public Health.
JAN 10 2023 11,;VAn Installation Fee is required19,Q ,
This form may be scanned and available for public view Jaw Updated Date: 12/7/2015
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Lateral# Length Length Orifice # Distance from Distance from end Length#
# (Feet) (Inches) Spacing " Orifices feeder line of end of lateral
1 18 216 24 9 1 1 18
2 18 216 24 9 1 1 18
3 18 216 24 9 1 1 18
4 18 216 24 9 1 1 18
5 18 216 24 9 1 1 18
6 18 216 24 9 1 1 18
7 18 216 24 9 1 1 18
8 18 216 24 9 1 1 18
72 72 8
TRANS LENGTH 10
GPM 42.48
K (2" SCHEDULEN 40) 284.5
FRICTION LOSS 0.296544
Squirt 2
Elevation difference 5
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WORKING VOLUME INDEPENDENT
NORMAL TIMER OFF LEVEL i FLOAT STEM
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Il ENCLOSED PUMP MOUNTING
SEDIMENT SHROUD* 'I CHECK VALVE*
APPROVE SEDIMENTS 1B 1=H=. SUBMERSIBLE
CENTRIFUGAL
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ASON COUNTY ENVIRONMENTAL HEALTH *AS NEEDED
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Pump Specifications {
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280 Series 1 /2 hp
Submersible Effluent Pump
LITERS PER MINUTE
0 50 100 150 200 250
40 1 I I 12
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MASON COUNTY ENVIRONMENTAL EALT IIIIIIIII IIIIIIIIL, a \\
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0 10 20 30 40 50 60 70
GALLONS PER MINUTE
2803t R010/7/2015 SX opyright 2015 Liberty Pumps Inc. All rights reserved. Specifications subject to change without nonce l�
Installation Notes
Sand Augmented Pressure Distribution System:
122 07 so 00 002 422 E Lake Devereaux Road
1. This is a failure. Drainfield not taking effluent. May be due to cancer medication.
2. Existing 1200 gallon septic tank may be used if viable, must be retrofitted with
risers and effluent filter.
4 3. C-33 or course sand required
44. Concrete tanks required
5. Pump controls to be set at time of installation .
6. Install system during dry weather with acceptable soil conditions
7. The tanks may be moved as necessary to accommodate building requirements. Septic
tank location must meet all required setbacks.
8. Keep wheeled vehicles off the drainfield area before, during and after installation.
Tracked equipment only,
9. All ground, surface water and roof drains must be diverted away from the septic tanks
and drainfield. Ensure the final grade slopes away from these areas and water doesn't
collect on or around them. Use swales, berms, catch basin and tight lines, curtain drains,
etc. to divert all waters.
10. Curtain drains can be no closer than 10' upgradient and 30' down gradient of the
drainfield
11. Exposed restrictive layers, cuts, banks, etc. can be no closer than 50' downhill from the
drainfield.
12. Install access risers on the septic tanks, valve box and ends of laterals.
13. Make sure septic tank risers are epoxied or caulked to cast in riser rings on tank.
14. Lids must form a water and gas tight seal with the access risers
15. Install effluent filter specified in this design at the septic tank outlet.
16. This system must be installed by a Mason County Certified installer.
17. Deviation from this design without prior approval from the designer and Mason County
Health Department will make this design null and void.
18. This design was sized per Washington Administrative CodeWAC246-272A-0230. The
operating capacity is based on 45 gallons per day per capita with two persons per
bedroom. The minimum design flow per bedroom per day is the operating capacity of
ninety gallons multiplied by 1.33. This results in a minimum design flow of one hundred
twenty gallons per day. This creates a surge factor of 33% but anticipated flow is ninety
gallons per bedroom per day.
19. Install laterals with contour of the ground
20. Install trench bottoms level and always maintain a minimum of six inches into native soil
21. Install I;;• ator tape on top of all drainfield laterals.
22. Instal AP t- -ded clean outs at the ends of all laterals (caps must extend to within six
inc .1 of ''t.sh grade and be in a valve box as shown on diagram. \\
23. In '• on l0.ervation port in each bed to the sand/original soil interface.
24. I•I.r 14, ::A ual alarm
25� egf. is r-�itY ed over drain rock prior to backfilf . I r
,the o51�041al grai.!, run the filter fabric at least 2 inc der h n ove
O`er CIND E •ITE ��,'1i„ JAN 10 2023
CENSE i•DE-GN �
"� :'�'S 0 Oi %WOR�. \7c)'1..V MASON COUNTY ENVIRONMENTAL HEALTH
E' 'iHES 0 0
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System Owner Responsibilities:
1. Operation and Maintenance is required by Washington State Department of Health and
Mason County Health Department.
2. The septic tank and pump tank should be pumped every three to five years or as
needed.
3. System owners are responsible for having maintenance performed annually.
4. System owners are responsible for responding to septic issues in a timely manner.
5. System owners shall not at any time change or alter settings in the control box.
6. System owner agrees to read and abide by information regarding their system in the
User Manual provided by Mason County Public Health.
7. Keep the flow of sewage at or below the approved design operating capacity.
8. Keep waste strength at residential waste strength parameters.
9. Spread loads of laundry through the week.
10. Do not use excessive bleach or detergents with added whiteners.
11. Do not shower, do laundry and dishwasher at the same time
12. Antibiotics can kill or impair the biological process in the septic tank.
13. Leaky plumbing can hydraulic overload your on-site septic system.
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