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HomeMy WebLinkAboutSWG2021-00687 - SWG Application / Design - 12/20/2021 (3) 1 ' '11; r ', 415 N 6TH STREET,SHELTON,WA 98584 MASON COUNTY SHELTON:360-427-9670,EXT 400 'y- COMMUNITY iVICES BELFAIR:360-275 4467,EXT 400 • a.1 qw; ELMA:360-482-5269,EXT 400 Bulling,Panning,Em iratmental Health Community Health �> FAX:360-427-7787 On-Site Sewage System Permit: SWG2021-00687 APPLICANT MYERS, STAN Phone: Address: 3064 44TH ST E TACOMA, WA 98443 OWNER NOUM ET UX SOMPHETH (JAI'S) Phone: Address: SOMPHONE PHETSADA AUBURN, WA 98002 SEPTIC DESIGNER JIM HENRY-Jim Henry Design Services Phone: 360-956-7242 Inc Address: PO BOX 14531 TUMWATER, WA 98511 Site Address: UNKNOWN Primary Parcel Number: 323312190030 Permit Description: New SFR -3BR Mound Permit Submitted Date: 12/20/2021 Permit Issued Date: 02/02/2022 Issued By: Jeff Wilmoth Current Permit Fees Paid: $625.00 (additional fees may be required upon installation of system). Permit Expiration Date: 01/28/2025 (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 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: www.co.mason.wa.us/health/environmental/onsiteloss-inspection-request.php or call: 360-427-9670, extension 400. OFFICIAL USE ONLY DATE RECEIVED: MASON COUNTY n COMMUNITYSERVICES AMOUNT RECEIVED: RECEIVED BY: Cl m Public Health(Community Health/Environmental Health) C Cl') 360317-cK/C,rxt.dW or 3642754G67,ext.100 C'� cn Q 415 N.601 Street-Shelton,WA 98586 S W G �1 � \A--� -1)0_0.1 ; Z X ON-SITE SEWAGE SYSTEM APPLICATION m n APPLICANT PHONE m Stan Myers (206) 240-4285 c MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE g 3064 44th St. E. Tacoma WA 98443 cn M SITE ADDRESS-STREET,CITY,ZIP CODE It Hoodsport WA 98584 co I4' co NAME OF DESIGNER PHONE N Dale L. Tahja (360) 426-5940 NAME OF INSTALLER PHONE v I (A) < I co TYPE(select one) DRINKING WATER SOURCE O M RESIDENTIAL OSS rl COMMUNITY OSS (l COMMERCIAL OSS ❑ PRIVATE INDIVIDUAL WELL iii PRIVATE TWO-PARTY WELL Z I TYPE OF WORK(select one) PUBLIC WATER SYSTEM r Pr NEW CONSTRUCTION/UPGRADES FT REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) 0 TABLE IX REPAIR I N SUBMITTALS 0 SURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINE W t.11.-r DESIGN FORM(REQUIRED) gSEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE r I 4 4.32 acres 0 �]WAIVER(S)(IFAPPUCABLE) I co DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.locked gate) Limited access, call Dale Tahja (designer) (360) 426-5940 to schedule a site visit. lc) O la • Iw co 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) el 1 ❑VOLUNTARY 0 MAINTENANCE/PUMPING 0 BUILDING PERMIT ['HOME SALE ['COMPLAINT 0 OTHER: ar / f INSPECTOR SOIL LOGS 3 f COMMENTS/CONDITIONS •,•~ , /V, 'f , 4P1 . tr.; — ._ + 1 N1. ' ' ' ' ' ' \\ JUL 18 2CZZ � , r1%,�3tb: '0.1 �G+•n w,w, ju 3 -32vsa;%% m By----*f:---77---- ------ RECORD DRAWING AND INSTALLATION REP.-•• 0 SOIL CODES: V=VERY G=GRAVELLY S=SAND L=LOAM SI=SILT C=CLAY E=EXTREMELY R=ROOTS REQUIRED FOR FINAL APPROVAL. - I OR SIGNATURE NE DATE APPLICATION EXPIRATION DATE i' y�� PL ATION APPROVED/ISSUED BY DATE I (4):19-)7- Ct- .....1126fe64:6 Z .1 \r/V:i .,.1:tk2-.2., T - FOR AY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12/7/2015 DESIGN FORM—PAGE ONE Assessor's Parcel Number: 3 2 3 3 1 — 2 1 — 9 0 0 3 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. ''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" -- t . 7, . PARCEL IDENTIFICATION ''. ' 7. Permit Number: SWG 2021-00687 Designer's Name: Dale L.Tahja Stan Myers (360)426-5940 Applicant's Name: y Designer's Phone Number: 3064 44th St. E. 2450 W. Deegan Rd.W. Mailing Address: Designer's Address: Tacoma WA 98443 Shelton wa 98584 City State Zip City State Zip DESIGN PARAMETERS -4i Treatment Device ❑Glendon Biofilter 0 Sand Filter 0 Mound 0 Sand Lined Drainfield 0 R. i1 .ulating Filter,Type: ❑Aerobic Unit Make/Model 0 Disinfection Unit Make/Model Other: N/A Drainfield Type 'Gravity 0 Pressure Ih 'Trench 0 Bed 0 Sub Surface Drip Septic Tank/Drainfield Specifications Laterals Number of Bedrooms 4 Schedule/Class 2729 Daily Flow:Operating Capacity 360 gpd Length 90 ft Daily Flow:Design Flow 480 gpd Diameter 4 in Septic Tank Capacity(working) 1,200 gal Number 3 Receiving Soil Type(1-6) 4 Separation 10-15 ft Receiving Soil Appl.Rate 0.6 gpd/ft2 Orifices Required Primary Area 800 ft2 Total Number of Orifices perf. pipe Designed Primary Area 800 ft2 Diameter in Designed Reserve Area 800 ft2 Spacing in Trench/Bed Width 3 ft Manifold Trench/Bed Length 270 ft Schedule/Class 3034 Elevation Measurements Length 30 ft Original Drainfield Area Slope 12 % Diameter 4 in New Slope,If Altered 10 % Preferred manifold configuration used? 0 Yes ii No Depth of Excavation Up-scope 1(.0 in Transport Pipe from Original Grade Do -slope \ in Schedule/Class 3034 Designed Vertical Separation '. in Length 60 ft Gravelless Chambers Required? 0 Yes 0 No lir Optional Diameter 4 in Pump Required? 0 Yes 66 No Dosing and Pump Chamber Pump/Siphon Specifications Number of doses/day Diff.in Elevation Between Pump&Uppermost Orifice ft Dose quantity gal Drainfield Squirt Height/Selected Residual(head) ft Chamber Capacity(flood) gal Uppermost Orifice 0 Higher 0 Lower than Pump Shutoff Pump ctr Pleasch@c�c• • red. . Capacity @ Total Pressure Head gpm .t:.• '' - 0 Event Counter Calculated Total Pressure Head ft I er: Pump on �, . p off Comments u 0 A 28pp 22 .'' �, ^ C�e 3\CNCM HuMASON COUNTY ENVIRONMENTAL HEALTH JBW DESIGN FORM—PAGE TWO Assessor's Parcel Number: 3 2 3 3 1 — 2 1 -- 9 0 0 3 0 Permit Number: SWG 2021-00687 DESIGN CU ECIKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch fii Test hole locations g Drainfield orientation and layout Reference depth from original grade: fii Soil logs g Trench/bed dimensions and El Septic tank g Property lines critical distances within layout Q( Drainfield cover 171 Existing and proposed wells 6l D-Box/Valve box locations Reference depth from original grade within 100 ft of property El Septic tank/pump chamber and restrictive strata: 21 Measurements to cuts,banks,and locations 6i Laterals,trench/bed,top and surface water and critical areas El Observation port location bottom E Location and orientation of 12 1 Clean-out location 0 Curtain drain collector curtain drain and all absorption El Manifold placement 0 Sand augmentation components 0 Orifice placement Other cross-section detail: E Location and dimension of El Lateral placement with distance El Observation ports/clean-outs primary system and reserve area to edge of bed Other Information Buildings 0 Audible/visual alarm referenced Yes No 6g Direction of slope indicator El Scale of drawing shown on scale g 0 Design staked out i� Waterlines 0 0 Recorded Notices attached l Roads,easements,driveways, 0 0 Waiver(s)attached parking ® V E ,. 0 0 Pump curve attached 6l7 North arrow and scale drawing AUG 0 0 Evaluation of failure shown on scale bar +ti1ASQN�pl1NTYENO y ?42z ,,-'` Non-residential justification �iRoNMfNTA, ,„.. 0 0 Wasteow strength JBVy DDSIG$ PROV The undersigned designer m be n tifi 'I Y ,. er at time of installation l6 Yes 0 No „. \\,,, AP'mill" Signature of Designer Date ��•••�� ; ..„. �� The undersigned has reviewed this design on behalf of Mason County Public Health and dete «� 5 . ,; ' z f 1 compliance with state and local ite regulations: ier-• '$.lo.• a.N I L./. aril Lii,t-Pch--?-) n In.. ental Health Specialist Date1. t-et- Q ;Zs,. 1- CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CODE i''14 ::,"J w ✓ The designstamped"Approved" I. ` is by Mason County Public Health. 2� � '' ' ✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: k 4 ✓ Drainfield site conditions have not been altered to adversely affect conditions of design approval. % A 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 1 • •Mh.4' or `+,w el lf -Z4- a ....., 4 q. es �Si 1 SglG� �� t f, 014 iii i ,:: • • %4kt All"* VIP& .'1 rfOlit. ,ti�A�pv AUG 202 r,,,a ' 5sooi1 ' s f or r DALE �q� __ pp�NtVENVIRp�;1�ENr ir .� - -, L TAH • 1 J AC HEAL ry ''.....r+..r►�.��.�►at. ..%AI. '' ---‘(NA Vk T ,\14 Ilk ► •.. i ,a cyl V 't.z. . 4 -t•, .... 4\\( • / 1( • Is ' AlcZet•rk •>t-N . . ' ••._ eor \-0 % At Mt\C' . .0 \(°' •'.::----.4-,i:i; '''' ''-' ,••••-- ‘-.7.,•:-... -,-,,..*.-- .. "t. 0\.\-c\•• lirt._,:,'. ..---... 0.1,,.. , s‘,.•,k, . W� �' 3!0' q`/ Installation/Maintenance Gravity 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. Divert all storm water run-off away from septic system components. 4. No curtain(french) drains allowed within 10ft. of the up-slope edge of the drainfield and reserve area. 5. No curtain(french) drains allowed within 30ft. of the down-slope edge of the drainfield and reserve area. 6. Have the septic tank pumped or inspected every 3 to 5 years. 7. All material and workmanship must meet County and State requirements. 8. Deviation from this approved design without prior approval from the Designer and Mason County Health Department will make this design null and void. 4 9. 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 4 immediately. 10.Locate all utilities prior to starting installation. Anif)R 0 k to SoiCOJNry 04202 Li sv '4�•I 51b)214 0 DAL E. L.. TAH)A L1GF.NSE©o SIGNER R l'-o\C, . 5-0,r1 V‘. (es_rs ' ,(Vo e.,\ -''k-- 3\3.3\ - \ - cx")3O r \\ \___(---,._. \__W sf). A\c --rH, \ -.C \ ,-/-Al. . .C=Sccl\te),,\\ . ;k.'CNc\ \ ' ---3-. A.e-- \( ‘k° _ S\ rk-- \,(7cArr\ ,, _ 1 , --�° t - i ,...37,4,A , . . (.> .- rIL) 'ru\IIA.,5q4< \c)ozrc` ..,-____\AtS. - (,)gl 4:0\-c\ , 7.. 1\ocirc‘\,., .0, _ \1_ -‘‘ '--S (Mt-k- Y...:, ) ar II -- ° $ n \C \I e. ,\ ‘.-.C \A-4 \A 1 , 4. .N4 `P % ' tt - " _' DALE L. TAH)A iI; L" ;.'1 "?£SIGNER _Ives 1a EX ` L.J. �• $ \\ __ � Rcr en � _ � s---- ( C ?i, • -c4Z-- 1 ,,,re , !'r 2 1'.7 __, s__ _ . . c_ _ , c ., . , . _ L , 1 ' ,,d .‘,,,, , , . ., ., IJ ,. � _ I .c• ,- / _ if >c .l (L /7,0 , , .1\ . . „., , c; , _ _____ a, , , ,,, ,,,,-.-_ .- ‘0, , c • , , , /,,, , , _.<-, A ...„, _____ -,,,,.._._ _ . /,‘ , ...,,, s9 '7 i i Jc* \ , i �, +�� 6,- ',cN 0 ' \ A , `\ � / # (.5-\- _,- °Q \.# C?\ --,`:"SCT\lt- ACZ1\1r> ' \e_A 1 ,212• .0a, ,%,et,:),..z.,--, c- ‘,-,,,m,„( . -,c, \ ZN\s _,, ,c, C. ),... co o .Z7 -&- o CO 2 N C a = Nit' ' 1