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HomeMy WebLinkAboutSWG2022-00625 - SWG Application / Design - 12/27/2022 OFFICIAL USE ONLY DATE RECEIVED: MASON COUNTY IZ 1 21- flc? — c CA II. COMMUNITY SERVICES �' AMOUNT REC•IVED: OO RECEIVED BY _ 5 4�`(� o m -s O N Public Health(Community Health nvironmental Health) / �1 `r� C N 415 N.6th Street ext.400 a 360-175 4467,ext.400' S W G I J�a, — Q r�2,`/ N O 415 N.6th Street-Shelton,WA 985A4 v ��\../// 70 lPI: 2 i 7ii27. z 6 13 ON-SITE SEWAGE SYSTEM APPLICATION a v m n APPLICANT Sy • PHONE m r Juan M Esteban 360-552-8659 z MAILING ADDRESS-STREET.CITY.STATE.ZIP CODE E PO Box 2691 Belfair Wa 98528 03 SITE ADDRESS-STREET.CITY.ZIP CODE 851 E Alta Dr Belfair Wa 98528 I NAME OF DESIGNER PHONE Micah Halverson 360-490-6365 (l�� NAME OF INSTALLER PHONE 0 I 1 `+ Jamie Workman 360-463-9573 z PERMIT TYPE(select one) DRINKING WATER SOURCE O RESIDENTIAL OSS ri COMMUNITY OSS .rl COMMERCIAL OSS r371 PRIVATE INDIVIDUAL WELL In PRIVATE TWO-PARTY WELL Z I TYPE OF WORK(select one) CI PUBLIC WATER SYSTEM 1 WI NEW CONSTRUCTION/UPGRADES rl REPAIR/REPLACEMENT OTHER DETAILS(select ell that apply) ❑ TABLE IX REPAIR I (ii SUBMITTALS 0 SURFACING SEWAGE 121 EXISTING FAILURE 0 SHORELINE COMI Ivl DESIGN FORM(REQUIRED) 171 SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE I- I h WAIVER(S)(IF APPLICABLE) 3 5Ac z . I DIRECTIONS TO SITE AND SITE CONDITIONS.(ex.locked gate) From Hwy 3 turn onto E Alta Drive near North Mason School. Stay on E alta drive to I subject property on left. ( Proposed drainfiled area is staked out) r 1- SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. I O OFFICIAL USE ONLY BELOW THIS LINE - - UPGRADE/FAILURE SOURCE(for reporting purposes) 0 VOLUNTARY ❑MAINTENANCE/PUMPING ❑BUILDING PERMIT ['HOME SALE ['COMPLAINT ['OTHER: INSPECTOR SOIL LOGS COMMENTS/CONDITIONS 1-7 � V-0 6-vl.l 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. I P CTOR SIGNATURE GATE APPLICATION EXPIRATION DATE A •TION APPROVED'ISSUED BY DATE T S 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 ellr041 SHELTON:360-427-9679670,EXT 400 BELFAIR:360-275-4467,EXT 400 . 0' Public Health & Human Services ELMA:360-482-5269,EXT 400 go, FAX:360-427-7787 On-Site Sewage System Permit: SWG2022-00625 APPLICANT ESTEBAN JUAN M Phone: 360-552-8659 Address: 851 E ALTA DR BELFAIR, WA 98528 OWNER ESTEBAN JUAN M Phone: 360-552-8659 Address: 851 E ALTA DR BELFAIR, WA 98528 SEPTIC DESIGNER MICAH HALVERSON-M. Halverson Phone: 360-490-6365 Design LLC Address: PO BOX 1519 SHELTON, WA 98584 SEPTIC INSTALLER JAMIE WORKMAN-Workman Phone: 360-463-9573 Construction LLC Address: 120 E TIMBERLAKE DR SHELTON, WA 98584 Site Address: 851 E Alta Dr Primary Parcel Number: 122053400040 Permit Description: Replacement, 3BR Nuwater+ Pressure Permit Submitted Date: 12/27/2022 Permit Issued Date: 01/09/2023 Issued By: Jeff Wilmoth Current Permit Fees Paid: $500.00 (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 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: masoncountywa.gov/health/environmentallonsiteloss-inspection-request.php or call: 360-427-9670, extension 400. DESIGN FORM—PAGE ONE Assessor's Parcel Number:1 2 1 05 -- 3 L( -- Q 0 Q A 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. 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 20 L' CIS:,a-'p Designer's Name: Micah Halverson Applicant's Name: Juan M Esteban Designer's Phone Number: 360-490-6365 Mailing Address: PO Box 2691 De E s-264 nn �) PO Box 1519 Belfair Wa 98528 „�i Shelton Wa 98584 City State Z� City State Z , , n Treatment Device ❑Glendon Biofilter 0 Sand Filter 0 Mound 0 Sand Lin ElID. i ing Filter,Type: ❑Aerobic Unit Make/Model NuWater BNR-500 ❑ Disinfection Unit Make/Model Other: Drainfield Type ❑Gravity Eif Pressure l 'Trench 0 Bed 0 Sub Surface Drip Septic Tank/Drainfield Specifications Laterals Number of Bedrooms 3 Schedule/Class 40 Daily Flow:Operating Capacity 270 gpd Length 54 ft Daily Flow:Design Flow 360 gpd Diameter 1 1/4 in Septic Tank Capacity(working) 500+NuWater gal Number 4 Receiving Soil Type(1-6) 4 Separation 9+ ft Receiving Soil Appl. Rate .6 gpd/ft2 Orifices Required Primary Area 600 ft2 Total Number of Orifices 52 Designed Primary Area 648 ft2 Diameter 3/16 in Designed Reserve Area 648 ft2 Spacing 48 in Trench/Bed Width 3 ft Manifold Trench/Bed Length 216 ft Schedule/Class 40 11 Elevation Measurements Length Preferred ft Original Drainfield Area Slope 2 % Diameter 2 in New Slope,If Altered same % Preferred manifold configuration used? l 'Yes 0 No Depth of Excavation Up-slope 13 in Transport Pipe from Original Grade Down-slope 6-12 in Schedule/Class 40 Designed Vertical Separation 12+ in Length 180 ft Gravelless Chambers Required? 0 Yes 0 No 19iOptional Diameter 2 in Pump Required? if Yes 0 No Dosing and Pump Chamber Pump/Siphon Specifications Number of doses/day 6 Diff.in Elevation Between Pump&Uppermost Orifice 5 ft Dose quantity 45 gal Drainfield Squirt Height/Selected Residual(head) 2+ ft Chamber Capacity(flood) 1233 gal Pump controls:Please the . tho re uir . Uppermost Orifice re Higher 0 Lower than Pump Shutoff ;; �sy �:Tt q;" Capacity @ Total Pressure Head 37.43 gpm liTimer •'• .la� en tiii if 1 Cp. ter Calculated Total Pressure Head 10.44 ft If Timer: Pump onr Pump off `+" i, Comments "'t `JAN 0 y 20Z3 e 1) Must use Approved NuWater Products and Procedures MASON COUNTY ENVIRONMENTAL HEALTH 2) Set dosing to Operating Capacity 3)Contractor to get All undergound Utilities Located before construction JBW 4 . DESIGN FORM—PAGE TWO Assessor's Parcel Number:1 Z 2 O S -- 3 -- 0 0 / 0 Permit Number: SWG DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch EA Test hole locations 6d Drainfield orientation and layout Reference depth from original grade: g Soil logs g Trench/bed dimensions and Q' Septic tank O Property lines critical distances within layout V Drainfield cover Existingand proposed wells g D-Box/Valve box locations t Reference depth from original grade within 100 ft of property g Septic tank/pump chamber and restrictive strata: RI Measurements to cuts, banks,and locations 121 Laterals,trench bed,top and surface water and critical areas 12i Observation port location bottom g Location and orientation of 6d Clean-out location 0 Curtain drain collector curtain drain and all absorption Eid Manifold placement 0 Sand augmentation components g Orifice placement Other cross-section detail: • Location and dimension of g Lateral placement with distance l Observation ports/clean-outs primary system and reserve area to edge of bed FZ1Buildings Other Information g Audible/visual alarm referenced Yes No FA Direction of slope indicator j g Scale of drawing shown on scale g 0 Design staked out Waterlines bar 0 g Recorded Notices attached g Roads,easements,driveways, 0 [f Waiver(s)attached i parking 21 ❑ Pump curve attached g North arrow and scale drawing ❑ gf Evaluation of failure shown on scale bar Non-resident'.I justification O ❑ Was e, . h O ❑ Fl•I . 18, pie "> DESIGN APPROVAL ' . The undersigned designer must be no ' ed by installer at time of installation g Yes 0 MCOUNTYFN O y 20, ,,Q�. ie.7 /zot a ���,,o/vr ENT I 1 Signature of Designer 111 Date �1r '�(/y�,41(1/3,1 The undersigned has reviewed this design on behalf of Mason County Public Health and determined it to be in compliance with state and local j e regulations: (,)1(.0 -vm 1---- -."2--3 En ir¢1,�J ntal Health Specialist Date CAUTION: DESIGN APPR I VAL IS VALID ONLY UNDER THE FOLLOWING CONDITION: ✓ The design is stamped"Approved"by Mason County Public Health. A_�2 ✓ 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. 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M.Halverson Design LLC o �d�pl'cant ESTEBAN+ JUAN M Site info' Parcel# 12205-34-00040 �N R PO Box 1519 Shelton Wa 98584 PO Box 2691 851 E Alta Drive5 Halversondesignllc(c�outlook.com Belfair, Wa 98528 Belfair, Wa REVISION#: