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HomeMy WebLinkAboutCANCELLED SWG2022-00284 - SWG Inactive - 5/13/2022 • lik MASON COUNTY PUBLIC HEALTH DATE RECEIVED. OFFICIAL USE ONLY• -lib (n D ONSITE SEWAGE SYSTEM APPLICATION AMr�Igi :I CO 415 N 6th Street,(Bldg 8) Shelton WA,98584 < U) Shelton:360-427-9670 ext 400 Belfair.360-275-4467 ext 400 S`n 7 G -øb1 . 4 _!O !V1/ z (n z -U APPLICANT PHONE > > DEAN J E W ETT 360-850-9629 m m MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE r r z 111 E RAILROAD AVE SHELTON WA 98584 > c SITE ADDRESS-STREET,CITY.ZIP CODE m co 30 E GLAMIS CT SHELTON WA 98584 m NAME OF DESIGNER PHONE I (A) Jim Henry 360-507-1267 NAME OF INSTALLER PHONE 5 I N) T CHECK ALL APPLICABLE ITEMS DRINKING WATER SOURCE I ---‘. C ❑ NEW CONSTRUCTION ❑ RV HOLDING TANK ONLY 0 PRIVATE INDIVIDUAL i• (n I N If REPLACEMENT SYSTEM 0 INSTALLATION PERMIT ONLY 0 PRIVATE TWO-PA: EL 0 ❑ TABLE 9 REPAIR a SINGLE FAMILY a COMMUNITY• :LIC , •TE•. • Z I ►v ❑ TANK(S)ONLY ❑ COMMERCIAL SYSTEM NA• : •KE LI CA) I ❑ UPGRADE TO EXISTING ❑ OTHER: BEDROOMS L' S 01 RI EXISTING FAILURE "Record Drawing required for all Installation " 2 •22 W I Q DIRECTIONS TO SITE-BE SPECIFIC AND ADVISE OF ANY NEEDED INFORMATION FOR AC .S I <ed gate g FROM SHELTON, NORTH ON HWY 3, LEF : M` 0 LAKE RD, LE. ON ST I o ANDREWS DR, LEFT ON E SHETLAND R RIG N LAMIS CT T! ITE ON RIGHT. I Q p IN) NIco co 1 SITE MUST FLAGGED FR I D AN ST HOLES MUST BE F •-GED WITH TEST HOLE NUMBERS � Ico FFICIA USE ONLY BELOW T. LINE UPGRADE/FAILURE SOURCE(for reporting oses) ❑VOLUNTARY ❑MAINTENANCE/ MPING UIL NG PERMIT ❑ • •E SALE ❑COMPLAINT ['OTHER: INSPECTOR SOIL LOGS COMMENTS!CONDITIONS • r 6 Al-2-o y MAY 1 3 Z022 111/1 By - ----- SOIL CODES: V=VERY G=GRAVELLY S=SAND L=LOAM Si=SILT C=CLAY E=EXTREMELY R=ROOTS INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED BY DATE 'ORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12/72015 k <:: '" 415 N 6TH STREET,SHELTON,WA 98584 �y MASON COUNTY SHELTON:360-427-9670,EXT 400 MI" ' COMMUNITY SERVICES BELFAIR:360-275-4467,EXT 400 c e ELMA:360-482-5269,EXT 400 ,,ir &Lidding,&Wining,Environs untal Health,Community Health FAX:360427-7787 On-Site Sewage System Permit: SWG2021-00457 APPLICANT Jeff Pritchard Phone: Address: PO Box 10771 BAINBRIDGE ISLAND, WA 98110 OWNER Jeff Pritchard Phone: Address: PO Box 10771 BAINBRIDGE ISLAND, WA 98110 4 SEPTIC DESIGNER Bob Paysse-Pioneer Digging Inc Phone: 360-426-1803 Address: 3083 E Mason Benson Road GRAPEVIEW, WA 98546 Site Address: 13031 NE NORTH SHORE RD Primary Parcel Number: 322345000023 Permit Description: Table 9 repair 2bd ATU to pressure trench on easement, lot 22 Permit Submitted Date: 08/04/2021 Permit Issued Date: 09/23/2021 Issued By: Rhonda Thompson Current Permit Fees Paid: $625.00 (additional fees may be required upon installation of system). Permit Expiration Date: 08/12/2023 (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 ai 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. y r DESIGN FORM—PAGE ONE Assessor's Parcel Number: 3 2 1 2 2 — 5 0 — 0 0 2 9 9 A design will be reviewed when 3 copies of each of the following are submitted: 4 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" CEL IDENTIFICATION ti Permit Number: SWG Designer's Name: JIM HENRY Applicant's Name: DEAN JEWETT Designer's Phone Number: 360-507-1267 Mailing Address: 111 E RAILROAD AVE Designer's Address: PO BOX 14531 SHELTON WA 98584 TUMWATER WA 98511 City State Zip Ci State Zip '" DESIGNORAMETE , . : :.,. �.:._ Treatment Device ❑Glendon Biofilter 0 Sand Filter 0 Mound 0 Sand Lined Drainfield 0 Recirculating Filter,Type: fir Aerobic Unit Make/Model BNR500 0 Disinfection Unit Make/Model Other: Drainfield Type ❑ Gravity 'Pressure 0 Trench 0 Bed 11 Sub Surface Drip Septic Tank/Drainfield Specifications Laterals Number of Bedrooms 2 Schedule/Class NETAFIN BIOLINE Daily Flow:Operating Capacity 180 gpd Length 300 ft Daily Flow: Design Flow 240 gpd Diameter ,,S in Septic Tank Capacity 1100 gal Number 4 Receiving Soil Type(1-6) 4 Separation 2 ft Receiving Soil Appl.Rate .6 gpd/ft2 Orifices Required Primary Area 600 ft2 Total Number of Orifices 322 Designed Primary Area 600 ft2 Diameter NA in Designed Reserve Area NA ft2 Spacing 12 in Trench/Bed Width 14 ft M. +feld- itch)r'' fL'i a e Trench/Bed Length 45 ft Schedule/Class 40 Elevation Measurements Length 24 ft Original Drainfield Area Slope 0 % Diameter 1 in New Slope,If Altered 0 % Preferred manifold configuration used? 0 Yes ❑No Depth of Excavation Up-slope 16-18 in Transport Ripe L;A from Original Grade Down-slope 16-18 in Schedule/Class 40 Designed Vertical Separation 12+ in Length 25 ft Gravelless Chambers Required? 0 Yes 66 No 0 Optional Diameter 1 in Pump Required? 6d Yes 0 No Dosing and Pump Chamber Pump/Siphon Specifications Number of doses/day 12 Difference in Elevation Between Pump Shutoff and Uppermost Dose quantity 15 gal Orifice NA ft Chamber Capacity 1000 gal Uppermost Orifice 0 Higher 0 Lower than Pump Shutoff Pump controls:Please check those required. Capacity @ Total Pressure Head 2.254 gpm IiiTimer I'Elapse Meter fit Event Counter Calculated Total Pressure Head NA ft If Timer: Pump on 6:30 ,pump off 113:30 Comments r. f DESIGN FORM—PAGE TWO Assessor's Parcel Number: 3 2 1 2 2 -- 5 0 -- 0 0 2 9 9 Permit Number: SWG DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch Ei Test hole locations g Drainfield orientation and layout Reference depth from original grade: 10 Soil logs g Trench/bed dimensions and M( Septic tank g Property lines critical distances within layout g Drainfield cover ❑ Existing and proposed wells Ii4 D-Box/Valve box locations Reference depth from original grade within 100 ft of property Gil Septic tank/pump chamber and restrictive strata: ❑ Measurements to cuts, banks,and locations g Laterals,trench/bed,top and surface water and critical areas 0 Observation port location bottom ❑ Location and orientation of g Clean-out location 0 Curtain drain collector curtain drain and all absorption 0 Manifold placement 0 Sand augmentation components 0 Orifice placement Other cross-section detail: 0 Location and dimension of ❑ Observation primary system and reserve area Lateral placement with distance ports/clean-outs to edge of bed Other Information El Buildings g Audible/visual alarm referenced Yes No ❑ Direction of slope indicator 0 Scale of drawingshown on scale Waterlines d 0 Design staked out bar 0 0 Recorded Notices attached Pi Roads,easements,driveways, ❑ 0 Waiver(s)attached parking 0 0 Pump curve attached 10 North arrow and scale drawing E1 0 Evaluation of failure shown on scale bar Non-residential justification ❑ 0 Waste strength ❑ ❑ Flow DESIGN APPROVAL The undersigned designer must be notified by installer at time of installation . Yes 0 No S' nature of Desi er 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: Environmental Health Specialist Date CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION: ✓ The design is stamped"Approved"by Mason County Public Health. ✓ 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 f r 1 i..r 7 �r> S�1 JIM HENRY DESIGN SERVICES, INC. ON-SITE WASTEWATER DISPOSAL SYSTEM DATE: January 28, 2022 APPLICANT: DEAN JEWETT 111 E RAILROAD AVE SHELTON, WA 98584 PARCEL#: 32122-50-00299 PROJECT #: LEGAL: LOT 299 LAKE LIMERICK 3 DESCRIPTION: REPLACE DRAINFIELD FOUND TO HAVE BEEN SEPARATION WITHOUT A PERMIT AND DOES NOT MEET VERTICAL ;till PROJECT DETAILS: f0• • O.11, 2, 1 Z.L NUMBER OF BEDROOMS 2 GALLONS PER DAY (GPD) FLOW 240 o,�- s r��� •y 51000121 t� �02' JIM HENRY OPERATING CAPACITY (GPD) FLOVN 180 i UCENS��oesicN� �� 0.60 APPLICATION RATE EXPIRES: 081111L2� DRAINFIELD DESIGN PARAMETERS 4 Emitters Required 300 - Soil Type 600 SQ FT - Emitters Designed 322 - Dripfield Area Required 600 SQ FT - Emitter Spacing 1 FT - Dripfield Area Designed-Zones 1 - Dripline Required 300 FT300 FT - Dripline Designed 2 FT - Dripline Spacing Required 2 FT - Dripline Spacing Designed DRAINFIELD CROSS SECTION 8 INCHES - Depth below Original Grade 16-18 INCHES -Vertical Separation SEPTIC TANK 1100 GAL CONCRETE -Size & Composition - New/Existing Existing 0 0 0 o> a a> 1 I Imo_ 1111111 NI m 1� c V 't w N CI,) U O U m j N S',S���n W O N Z a- J8I 0 00 ' ° �� - Z2y.- N y✓ a> 0>1 w 8m.o 0 dn 0w c Sd �-et, is 7, '^ v; =W w O o ':.; 1 o Ls; X tiQ+ W III II1-Iii z a 10 . �.,ac, oe3z I 0 m ZZ 0 ) .'t N O 1 V a 1.1 O r----,---a N rif- 1 • . 0 15'`! 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