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HomeMy WebLinkAboutSWG2022-00357 - SWG Application / Design - 6/21/2022 (2) 415 N 6TH STREET,SHELTON,WA 98584 MASON COUNTY SHELTON:360-427-9670,EXT 400 4111r7111 " COMMUNITY SERVICES BELFAIR:360-275-4467,EXT 400 ELMA:360-482-5269,EXT 400 Buddng,Pbmmng,Environmental Health,Community Health FAX:360-427-7787 On-Site Sewage System Permit: SWG2022-00357 APPLICANT DUMOND STEVE D &JESSICA L Phone: 801-710-4573 Address: 1374 25TH ST OGDEN, UT 84401 OWNER DUMOND STEVE D &JESSICA L Phone: 801-710-4573 Address: 1374 25TH ST OGDEN, UT 84401 SEPTIC DESIGNER MICAH HALVERSON-M. Halverson Phone: 360-490-6365 Design LLC Address: PO BOX 1519 SHELTON, WA 98584 SEPTIC INSTALLER SCOTT JOHNSON-Weather Tight Phone: 360-763-6577 Construction Address: 8639 Salty DR NW OLYMPIA, WA 98502 Site Address: 146 E HARSTINE ISLAND RD SOUTH Primary Parcel Number: 220141190010 Permit Description: New 3bd ATU to pressure trench Permit Submitted Date: 06/21/2022 Permit Issued Date: 07/21/2022 Issued By: Rhonda Thompson Current Permit Fees Paid: $500.00 (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. f OFFICIAL USE ONLY DATE RECEIVED. MASON COUNTY � ' Z� I ZC2�— COMMUNITY SERVICES AMOUNT RECEIVED: 00 RECEMEDB' (n Public Health(Community Health/Environmental Health) C N 360-427-9670,en.aW or 360-275-N67,ern 400 SWG /—' l'�\ (`` Gl (n Q 415 N.6[h Street-Shelton.WA 98589 S Y Y G Z�2 L 1 \ 2,� -1 Z 73 ON-SITE SEWAGE SYSTEM APPLICATION m APPLICANT PHONE m r DUMOND, STEVE 801-710-4573 MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE E 1374 25TH ST OGDEN UT 84401 co SITE ADDRESS-STREET,CITY.ZIP CODE E Harstine Island Rd S IN NAME OF DESIGNER PHONE IN Micah Halverson 360-490-6365 NAME OF INSTALLER PHONE v I Scott Johnson 360-490-5408 <N I� PERMIT TYPE(select one) DRINKING WATER SOURCE (75 Or RESIDENTIAL OSS 1"1 COMMUNITY OSS 'r]COMMERCIAL OSS * PRIVATE INDIVIDUAL WELL ❑ PRIVATE TWO-PARTY WELL Z I TYPE OF WORK(select one) 0 PUBLIC WATER SYSTEM , lit NEW CONSTRUCTION/UPGRADES h REPAIR I REPLACEMENT OTHER DETAILS(select all that apply) 0 TABLE IX REPAIR SUBMITTALS 0 SURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINE W 4 R.DESIGN FORM(REQUIRED) SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE r- I/ ffWAIVER(S)(IF APPLICABLE) 3 2.5 Ac o I DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.locked gate) From Hwy 3 turn onto E pickering Rd, travel to harstine island, after harstine bridge take I 0 right, travel to stop sign and turn right (south) driveway easement is on your right in about I 1/4 mi. Drainfield area is marked with pink ribbon o 0 (— SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. I 0 OFFICIAL USE ONLY BELOW THIS LINE UPGRADE/FAILURE SOURCE(for reporting purposes) 0 VOLUNTARY 0 MAINTENANCE/PUMPING 0 BUILDING PERMIT ['HOME SALE ['COMPLAINT ❑OTHER: INSPECTOR SOIL LOGS COMMENTS I CONDITIONS GI ` �'Y 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 APPLICATION APPROVED/ISSUED BY DATE P—y\-- cOl 1`zo1-z2, '7 ( z-oLz-r S iIZi ( ZZ- THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12/7/2015 DESIGN FORM—PAGE ONE Assessor's Parcel Number: t 2. 0 I q -- / / -- _i © 0 L 0 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 0 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 2 C2.2"' ---1 Designer's Name: Micah Halverson Applicant's Name: Steve Dumond Designer's Phone Number: 360 490 6365 Mailing Address: 1374 25th St Designer's Address: PO Box 1519 Ogden UT 84401 Shelton Wa 98584 City State Zip City State Zip ... . RESIGN PARAMETERS Treatment Device 0 Glendon Biofilter 0 Sand Filter 0 Mound ❑ Sand Lined Drainfield 0 Recirculating Filter,Type: 'Aerobic Unit Make/Model NuWater BNR-500 0 Disinfection Unit Make/Model Other: Drainfield Type ❑ Gravity Er Pressure '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 50 ft Daily Flow: Design Flow 360 gpd Diameter 1 1/4 in Septic Tank Capacity(working) 500+ NuWater gal Number 3 Receiving Soil Type(1-6) 3 Separation 9 ft Receiving Soil Appl. Rate .8 gpd/ft2 Orifices Required Primary Area 450 ft2 Total Number of Orifices 30 Designed Primary Area 450 ft2 Diameter 3/16 in Designed Reserve Area 450 ft2 Spacing 60 in Trench/Bed Width 3 ft Manifold Trench/Bed Length 150 ft Schedule/Class 40 Elevation Measurements Length preferred ft Original Drainfield Area Slope <1% % Diameter 2 in New Slope,If Altered same % Preferred manifold configuration used? FrYes 0 No Depth of Excavation Up-slope 13 in Transport Pipe from Original Grade Down-slope 12.64 in Schedule/Class 40 Designed Vertical Separation 12+ in Length 30 ft Gravelless Chambers Required? 0 Yes E'No 0 Optional Diameter 2 in Pump Required? 12i Yes 0 No Dosing and Pump Chamber Pump/Siphon Specifications Number of doses/day 6 Diff. in Elevation Between Pump&Uppermost Orifice 10 ft Dose quantity 45 gal Drainfield Squirt Height/Selected Residual(head) 2'+ ft Chamber Capacity(flood) 1233 gal le than PumpShutoff Pump controls:Please check those required. Uppermost Orifice 0 Higher Capacity @ Total Pressure Head 21.59 gpm le Timer IiirElapse Meter gig Event Counter Calculated Total Pressure Head 10.76 ft If Timer: Pump on TBD ,Pump off 4 Comments 1) Must Use approved products and methods by NuWater 2) Set Dosing to operating capacity 3) Must be certified NuWater installer miimak DESIGN FORM-PAGE TWO Assessor's Parcel Number: Z Z.O I 1 -- 1 L -- 0 0 1 0 Permit Number: SWG DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch li Test hole locations IV/Drainfield orientation and layout Refireyice depth from original grade: VI/zSoil logs ta/ Trench bed dimensions andSeptic tank 0 Property lines ,�, i critical distances within layout Drainfield cover Id Existing and proposed wells 4J D-BoxNalve box locations Reference depth from original grade within 100 ft of property 12/ Septic tank/pump chamber and restrictive strata: M)3(.k. easurements to cuts,banks, and , /locations t5' Laterals,trench bed,top and urface water and critical areas U Observation port location bottom 0 Location and orientation of E Clean-out location 0 oerttriii-dfa+n-and all absorption D" � Manifold placement 0 e � components Orifice placement Other c oss-section detail: Location and dimension of LI/ Observation ports/clean-outs Lateral placement with distance primary system and reserve area to edge of bed Other Information Audible/vis.:• alarm referenced Yes No Gal Direction of slope indicator b/Scale of I .,+'l� shown on scale 0 l Design staked out lei Waterlines bar •• 1 0 IZf.Recorded Notices attached AI/Roads, easements,driveways, ` 1►I 0 QWaiver(s) attached 2 fig_parking �!� I, 0 Pump curve attached fo f,„ s ;, +INO: 0 evaluation of failure North arrow and scale drawing .:y� r shown on scale bar �� �' stogy I Non-residential justification of ,haw T1W&L r LVE ON 0 ❑ S to aEs► R i, � 0 ❑ }evr-- The undersigned designer must be ''fied by installer at time of installation -Yes 0 No _..0.)- 0/7? I-k. 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: 1z► Iz— Environmental Health pecialist 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: I ( oiz ✓ 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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