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SWG2020-00431 - SWG Application / Design - 8/27/2020 (3)
415 N 6TH STREET,SHELTON,WA 98584 MASON COUNTY SHELTON:360-427-9670,EXT 400 COMMUNITY SERVICES BELFAIR:360-275-4467,EXT 400 =, ELMA:360-482-5269,EXT 400 ``S Building,Planning,Environmental Health,Community Health FAX:360-427-7787 On-Site Sewage System Permit: SWG2020-00431 APPLICANT FULLER KEITH D & KATHRYN R Phone: Address: P 0 BOX 714 SHELTON, WA 98584 OWNER FULLER KEITH D & KATHRYN R Phone: Address: P 0 BOX 714 SHELTON, WA 98584 SEPTIC DESIGNER DALE TAHJA-Septic Designer Phone: 360-426-5940 Address: 2450 W DEEGAN ROAD WEST SHELTON, WA 98584 Site Address: UNKNOWN Primary Parcel Number: 421257790021 Permit Description: New four bed SFR- pressure trench Permit Submitted Date: 08/27/2020 Permit Issued Date: 07/21/2022 Issued By: Luke Cencula Current Permit Fees Paid: $840.00 (additional fees may be required upon installation of system). Permit Expiration Date: 09/09/2023 (based on date of inspection) Permit Conditions: 1 Permit must be installed by a Mason County Certified Installer unless prior written authorization from Mason County is obtained. 2 Drain field installation not to exceed designed upslope and downslope depth specified on design form. 3 Installer is responsible for obtaining Mason County installation approval prior to backfill of system components. 4 Installer is responsible for obtaining Septic Designer/Engineer installation approval prior to backfill of system components. 5 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/onsite/oss-inspection-request.php or call: 360-427-9670, extension 400. OFFICIAL USE ONLY DATERECENED: T':'" li„. MASON COUNTY 0) > i Q*, COMMUNITY SERVICES AMOUNT RECEIVED: RECEIVED BY: to 7 p; o m 's-.t',7' Public Health(Community Health/Environmental Health) Q (n 360-427-9670.ext.400 or 360-275-1467,ext.400 ^, O 415 N.6th Street-Sheitnr_ WG WA 98584 C) _ e3 T Q ON-SITE SEWAGE SYSTEM APPLICATION 3 m C) APPLICANT PHONE M Stephen Reynolds (425) 260-0099 c MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE 3 1028 Bayview Dr. Shelton WA 98584 m 73 SITE ADDRESS-STREET,CITY,ZIP CODE Lexington PI. Shelton WA 98584 14-' NAME OF DESIGNER PHONE I N Dale L. Tahja (360) 426-5940 NAME OF INSTALLER PHONE I v PERMIT TYPE(select one) DRINKING WATER SOURCE N N O R RESIDENTIAL OSS ❑ COMMUNITY OSS 'rl COMMERCIAL OSS t7 PRIVATE INDIVIDUAL WELL hid PRIVATE TWO-PARTY WELL Z tl- TYPE OF WORK(select one) PUBLIC WATER SYSTEM f W NEW CONSTRUCTION I UPGRADES el-REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) ❑ TABLE IX REPAIR I �l SUBMITTALS ❑ SURFACING SEWAGE 0 EXISTING FAILURE ❑SHORELINE W t DESIGN FORM(REQUIRED) SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE O 1`J WAIVER(S)(IF APPLICABLE) 4 1.46 acres o 1 DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.locked gale) Go toward Union on the Union Truck Trail, left on Lexington Place, lot's on the left (recently i o cleared). 0 I 0 IN SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WTTN TEST HOLE NUMBERS. I --- — -- OFFICIAL USE ONLY BELOWTHIS LINE x UPGRADE/FAILURE SOURCE(for reporting purposes) 0 VOLUNTARY ❑MAINTENANCE/PUMPING 0 BUILDING PERMIT ['HOME SALE ['COMPLAINT ❑OTHER: l INSPECTOR SOIL LOGS COMMENTS/CONDITIONS a,<<",,- -. $ / 0, 4, ... 4111°G4C. ' ' ,LI/ 1 vevi,40( II, 41.4. ,,,.. c:, ,,. .., „s„, , !JL: i;'Z ',4 P4 4 Ein:1,?~ 1.. is '\� i,,„,,1,1i i,'..0-1-...."IC, Q'. J 'V(3 •Y1 RECORD DRAWING AND INSTALLATION REP 1-. r-r. SOIL CODES: ,S.' 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 THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB REVISED 12/72015 sir 1111., DESIGN FORM—PAGE ONE Assessor's Parcel Number: 4 2 1 2 5 — 7 7 — 9 0 0 2 1 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 '1 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 2020-00431 Designer's Name: Dale L.Tahja Applicant's Name: Stephen Reynolds Designer's Phone Number: (360)426-5940 Mailing Address: 1028 Bayview Drive Designer's Address: 2450 W.Deegan Rd.W. Shelton WA 98584 Shelton WA 98584 City State Zip City State Zip DESIGN PARAMETERS LAD 14.a.� 1-" ' Treatment Device ❑Glendon Bioti r 0 S 1 Filter 0 Mound 0 Sand Lined Drainfreld 0 Recirculating Filter,Type: ❑ Aerobic Unit Make/Model 0 Disinfection Unit Make/Model Other: N/A Drainfield Type 0 Gravity Se Pressure GtfTrench 0 Bed 0 Sub Surface Drip Septic Tank/Drainfield Specifications Laterals Number of Bedrooms 4 Schedule/Class Sch. 40 Daily Flow: Operating Capacity 360 gpd Length 67 ft Daily Flow: Design Flow 480 gpd Diameter 1.25 in Septic Tank Capacity(working) 1,200 gal Number 4 Receiving Soil Type(1-6) 4 Separation 10 ft Receiving Soil Appl.Rate 0.6 gpd/ft2 Orifices Required Primary Area 800 ft2 Total Number of Orifices 68 Designed Primary Area 800 ft2 Diameter 1/8 in Designed Reserve Area 800 ft2 Spacing 48 in Trench/Bed Width 3 ft Manifold Trench/Bed Length 267 ft Schedule/Class Sch. 40 Elevation Measurements Length 70 ft Original Drainfield Area Slope 30 % Diameter 1.25 in New Slope, If Altered 25 % Preferred manifold configuration used? 0 Yes hie No Depth of Excavation Up-slope 26 in Transport Pipe from Original Grade Down-slope 15 in Schedule/Class Sch.40 Designed Vertical Separation 24 in Length 30 ft Gravelless Chambers Required? 0 Yes 0 No Fif Optional Diameter 2 in Pump Required? 111 Yes 0 No Dosing and Pump Chamber Pump/Siphon Specifications Number of doses/day 4 Diff. in Elevation Between Pump&Uppermost Orifice 5 ft Dose quantity 90 gal Drainfield Squirt Height/Selected Residual(head) 6 ft Chamber Capacity(flood) 1,200 gal Uppermost Orifice @''I-Iigher 0 Lower than Pump Shutoff Pump controls:Please check those required. Capacity @ Total Pressure Head 34 gpm l 'Timer l 'Elapse Meter L 'Event Counter Calculated Total Pressure head 20 ft Eb' mp on 2.6 min. ,pump off 5 hrs.57.4 min. Comments AP p R© JUL 2 1 2022 A � 1/4\.: JASON COUNV ENVIRONM� r , _ DESIGN FORM—PAGE TWO Assessor's Parcel Number:4 2 1 2 5 — 7 7 -- 9 0 0 2 1 Permit Number: SWG AM —C' DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch Fli Test hole locations lig Drainfield orientation and layout Reference depth from original grade: EZi Soil logs lig Trench/bed dimensions and It Septic tank It Property lines critical distances within layout Gi1 Drainfield cover It Existing and proposed wells l D-Box/Valve box locations Reference depth from original grade within 100 ft of property B! Septic tank/pump chamber and restrictive strata: 66 Measurements to cuts, banks, and locations G21 Laterals,trench bed,top and surface water and critical areas It Observation port location bottom It Location and orientation of RI Clean-out location 0 Curtain drain collector curtain drain and all absorption rif Manifold placement 0 Sand augmentation components 66 Orifice placement Other cross-section detail: 66 Location and dimension of lt Lateral placement with distance El Observation ports/clean-outs primary system and reserve area to edge of bed 6� Buildings Other Information Audible/visual alarm referenced Yes No Direction of slope indicator It Scale of drawing shown on scale d 0 Design staked out lg Waterlines bar 0 0 Recorded Notices attached It Roads, easements,driveways, 0 0 Waiver(s)attached parking It 0 Pump curve attached 0 North arrow and scale drawing 0 0 Evaluation of failure shown on scale bar Non-residential justification ❑ ❑ Waste strength ❑ ❑ Flow DESIGN APPROVAL The undersigned designer mu e n tified ll at time of installation lI Yes 0 No \ • dpm ry Signature of Designer Date +Ar s"\. , The undersigned has reviewed this design on behalf of Mason County Public Health and dete ,�' ' to' i. '. compliance with state and local on-site regulations: ' ,,- _`«,, 4 , nvironmental Health Specialist , 1 DDate '`,�'(b;,7,Y°''i,.,, ' ` CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CON I t �_ �v" ✓ The design is stamped"Approved"by Mason County Public Health. / 1k 4/ , • ✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: 5 r( 1 t �a�3 ✓ 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 i � � .f-., ��.c )e- `ter `��- --:-. . `c. .\ire Y. �., 9 7--' . Ieo . -71' j t . .i — 'rl ,R2r' • •' •• .4. f •. ` pi x . 4t)�S ,_ y +rL • • i JY! •.a i r. \ 'y» { '0 JI L. ... 9;...,'�val. yp,. ,.+�.-, ., ;" d�+ l�':t'�"��+`..:.a�z� 1 -.ate' .....::;s'x • 1 • i � I ..* '... 4,,.• 1 , -\----r. iN a6 �� _ 6" .._ Sv"\i' 7-.....--\'. . '''' :: , AEI :;:_ 4 !1 u�� iA. A k 1.;;44,-;‘, .?j t1; s ,}. t\I e \ciket 1, 1 .04r......,10P,,0��, s,c) 4 5.4e.SI Fi4. e44APPROVED , Q DALEL. TAMA . , i.b 1. i .UCEN D DESIGNER a1 JUL 2 2022 EXPinES: ' - .y L %SON COMM E t_YG ,...,, O ��,,1 ,,,, 290-SERIES 3/4 hp Submersible E?IfflueritiSump pumps ..- The Liberty 290 series provides a cost effective"mid- perfommusce ' =-290-series range"pump for on-site waste water systems, liquid waste transfer and commercial heavy-duty sump pump so_._. �....-_ . ---,1a applications that require higher head or more flow. .� Iv Designed around Liberty's unique"Uni-Body"casting, 40 , • - �`--' 12 the 290-Series will provide years of reliable performance. Ems' 9 i All Models Feature: 1: •Semi-Open Impeller permitting passage of solids _ I 0up to I" 10 h.. s •416 stainless steel rotor shaft a •Permanently lubricated upper and lower bail bearing 0 0 10 20 zm 0 •Epoxy powder coat finish K ec 7t) 9° •Ail fasteners-corrosion-resistant stainless steel i t f + t 1 i , 1 -1 as re ,t4 list leg ZIT sea 503 341 *1 y:°Discharge Liters Per Mhute •Stainless steel bottom screen-easily removable Dimensional Data: •Maximum fluid temperature: 140'F. Weight 31 lbs. •290r8eries Cord Lengths Height13" Model 10' 2 35'(-3} 50'{-5) Meier Width;10"(model 297) 280 standard Optional .Options+ optana+, AfberrolN1? .Diameters: 291 Standard Optional Optional Optional; Model 291,293...14" 293 Standard Optional Optional N/A Model 297'VMF...10" , 297 Standard Optional N/A N/A • 10'cordIIMF length standard on all models.For optional lengths, Factory switch Model 291,>r MF 247 add-2,-3 or-6"suffix to model number. V Example:for model 290 with 36'cord.Order 290.3 Tern on levet 13" 9.5" Thorn off level 7" 4.06 Afotor Speolflartio►» 'l.hp 6011z 3460 RPM Moral 23s t tauros atilt,•dl�bie moat. Oil oiled,thermally �E o therrr r�t�fflloat m le del P RO 297 la not adjustable. 115 V.Models 10.4 amps Zfl2� 2013/230 V.Models 5.3 amps JUL 2. 1 N�P`NOk` iA50N COON"ENS GN l I r Mallet 290 Model 291 male-'(`-- spit Model 293 Model 297 i i • Manual, Wide angle ( ~ - Wide angle :_ �— VMF Series no swttch Ifir ,0 float switch " --; ,`� float switch �1111A Vertical mag- i� with ,! f with series t netic float for I a fujCiC- .��l ii ' igli disconnect Ali (piggyback) . smaller pits- �iiwi: wii lA s.�.:wi _.:.$ plugill ;11N will operate in 1 ";' 1! ` 1 • ,: a 10"diameter- 0 sump vi w; . t 0 c us Certified $p•ef cellos am subject to change without notice. Llbes yr Pumps•7000 M►Wee Avenue•Bergen,New*de 144111+Phone 80 443-25 O Fax gag 494-11139 wwiscaberlypumpacom Copyright 0 Liberty Puma,tne..2011 MS rlghis resarwd. WT ef51 A09111 Installation/Maintenance Pressure Distribution/Trench Systems 1. Install trench bottom level and in contour with the ground. 2. Install drainfield during dry weather and soil conditions.Any soil smearing must be eliminated by hand raking any areas that get smeared. 3. Install audio/visual high water alarm. 4. Install effluent filter in septic tank outlet or pump vault with 1/16 inch maximum filtration mesh size. 5. Install check valve in pump outlet line to prevent back-flow into the pump chamber. 6. Install 1/8 inch orifices on 4ft. centers. Install the orifices pointing straight up( 12:00 o' clock). 7. Divert all storm water run-off away from septic system components. 8. No curtain (french) drains allowed within l Oft. of the up-slope edge of the drainfield and reserve area. 9. No curtain (french) drains allowed within 30ft. of the down-slope edge of the drainfield and reserve area. 10.Have the septic tank and pump chamber pumped or inspected every 3 to 5 years. 11.Inspect and clean pump screen as needed. 12.Inspect floats and test high water alarm every 6 to 12 months or as needed. 13.All material and workmanship must meet County and State requirements. 14.Install risers on septic tank and pump chamber. 15.Deviation from this approved design without prior approval from the Designer and Mason County Health Department will make this design null and void. 16.The prepared Site Plan is not a survey, it is the owner's responsibility to verify property line locations prior to installation. Any discrepancies must be reported to the Designer immediately. 17. Locate all utilities prior to starting installation. s 11 r owe • • AP ,c PROVED � f �. JUL 2 1 `, I. : � ENVtRONtom'�� • • 9ASON COUNN • �YG 5100214 O DALE L.TA A -L1C NSED DES161ER EXPIRES: - - d • 1 -71 I v_ n 1 1it c r-----------its,‘ ! ice i • t 2fr44 1ll I E1 iK" � 110, A. ,154 64,N:Le' ‘ lic, 1 : i .0 1 IAlIP 1/:i'' Ill -IP '#1 ''.\ . r -- ---i - I ' a.--- . ---- . ,•• i II, 1 - 1 , 1 ., 1/ \ --p`r. .) 1 k -.- - _ _ _ __ _ 1 A , . -A-F--_,3 I 1 ,iii Hill 1 i , i . ,.oti,_\:),17.7\_c3:1 . • L__, .--- , 1 1 -.41 1 1 1 kJ \i Q I 4 N • I to o . � I 33 , ,��% - ' .4 0 !iV \ 106 \ ,,, 1;; I -; \ -1- 1 T f \ 1 t 1 6-4 - _) ��\. • : o g._ \ \ , , ..-;" ,. 1 \ , r —I I:1 t, — . I N.. . I I ;, � ICl �t I I \ ....._ r •• .1 ._ .,. . by 1 1 i '‘ r• \ ---- -.. ..,. I � 1 \ , 3 i • I N• t. 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