HomeMy WebLinkAboutSWG2023-00005 - SWG Application / Design - 1/9/2023 MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584
SHELTON:360-427-9670,EXT 400
0411,
BELFAIR:360-275-4467,EXT 400
Public Health & Human Services ELMA:360-482-5269,EXT 400
FAX:360-427-7787
On-Site Sewage System Permit: SWG2023-00005
APPLICANT DEAN MATHEW A Phone:
Address: 444 WALKER RD NE POULSBO, WA 98370
OWNER DEAN MATHEW A Phone:
Address: 444 WALKER RD NE POULSBO, WA 98370
SEPTIC DESIGNER Nathan Cleaver Phone:
Address: 262 NW Thompson Rd POULSBO, WA 98370
Site Address: 1801 E Crestview Dr
Primary Parcel Number: 320227500020
Permit Description: New SFR -4BR Mound
Permit Submitted Date: 01/09/2023
Permit Issued Date: 01/24/2023
Issued By: Jeff Wilmoth
Current Permit Fees Paid: $525.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 01/11/2026 (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/environmental/onsite/oss-inspection-request.php or call:
360-427-9670, extension 400.
1
OFFICIAL USE ONLY
c -
MASON COUNTY DATE RECEIVED: I q
ZS
COMMUNITY SERVICES AMOUNT RECEIVED-. 0r RECEIVED(iv ^ „ v CI m
'I�/�J Public Health(Community Health/Environmental Health) cn
�.27%lo.n � �� 0)
r. a�6�zls..61.. SWG Zp 2� - �
41 S N.6th street-Shelton.WA 9e591 J,0 5- (/� Q
U a �
Z N
-13
ON-SITE SEWAGE SYSTEM APPLICATION D $
APP!(CANT PHONE n
m
Mathew Dean (360) 620-0706 z
c
MAILING ADDRESS-STREET CITY STATE.ZIP CODE
444 Walker Rd NE, Poulsbo, WA 98370 m
SITE ADDRESS-STREET CITY ZIP CODE
xi
1801 E Crestview Dr, Shelton, WA 98584
NAME OF DESIGNER PHONE
Nathan Cleaver (360) 598-6546 kv
NAME OF INSTALLER PHONE 0
PERMIT TYPE(selec!one) DRINKING WATER SOURCE - I�
RESIDENTIAL OSS COMMUNITY OSS F COMMERCIAL OSS tgq PRIVATE INDIVIDUAL WELL PRIVATE TWO-PARTY WELL Z I N
TYPE OF WORK(select one) Q PUBLIC WATER SYSTEM t
R NEW CONSTRUCTION f UPGRADES ft REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) 0 TABLE IX REPAIR
SUBMITTALS ❑ SURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINE W
DESIGN FORM(REQUIRED) SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE O r
5-WAIVER(S)(IF APPLICABLE) 4 ±4.92 acre 0 I
DIRECTIONS TO SITE AND SITE CONDITIONS (ex locked gate)
Head north on Hwy 3, turn right on to E Agate Rd, turn right on to E Crestview Dr, proceed passed
E Cedarshade Ln, property will be on left. Property to the right of subject property is 1881 E O
Crestview Dr. Property to the left of subject property is 1781 E Crestview Dr. o
N
SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. IC)
OFFICIAL USE ONLY BELOW THIS LINE ----
UPGRADE/FAILURE SOURCE(for reporting purposes)
❑VOLUNTARY 0 MAINTENANCE/PUMPING ❑BUILDING PERMIT ❑HOMEE/SALE OCOMPLAINT ❑OTHER:
INSPECTOR SOIL LOGS �� �/I/ COMMENTS I CONDITIONS
; << 03 o"l
-(C �I 1 l,f a mot, 03
c‘- 5,-t i-, LA
g
g
IV
W NI
t, l
SOIL CODES: RECORD DRAWING AND INSTALLATION REPORT
V=VERY G=GRAVELLY S=SAND L=LOAM Si=SILT C=CLAY E=EXTREMELY R=ROOTS REQUIRED FOR FINAL APPROVAL.
INSq TOR SIGNATURE DATE APPLICATION EXPIRATION DATE APP ATIO APPROVED/ISSUED BY DATE
toji(I \ \—\' - )-• (, « — 2
6J'a �,2`�'a3
TH F MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REV( ED t2 72ot5
DESIGN FORM—PAGE ONE Assessor's Parcel Number: 3 2 0 2 2 — 7 5 — 0 0 0 2 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 ?user si:e: 11"X 17"
Permit Number: SWG ZO),3 - OS' Designer's Name: Nathan Cleaver
Applicant's Name: Mathew Dean Designer's Phone Number: (360)598-6546
Mailing Address: 444 Walker Rd NE Designer's Address: 262 NW Thompson Rd
Poulsbo WA 98370 Poulsbo WA 98370
Ci State Zi. Ci State Zi.
Treatment Device
❑Glendon Biofilter 0 Sand Filter I 'Mound 0 Sand Lined Drainfield 0 Recirculating Filter,Type:
❑Aerobic Unit Make/Model 0 Disinfection Unit Make/Model Other:
Drainfield Type
❑ Gravity ('Pressure 0 Trench l 'Bed 0 Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 4 Schedule/Class Schedule 40
Daily Flow:Operating Capacity 360 gpd Length 24 ft
Daily Flow: Design Flow 480 gpd Diameter 1 in
Septic Tank Capacity(working) 1,250 gal Number 8
Receiving Soil Type(1-6) 5 Separation 2 ft
Receiving Soil Appl. Rate 0.4 gpd/ft2 Orifices
Required Primary Area 1,200 ft2 Total Number of Orifices 96
Designed Primary Area 1,244 ft2 Diameter 1/8 in
Designed Reserve Area 2,500 ft2 Spacing 24 in
Trench/Bed Width 10 ft Manifold
Trench/Bed Length 48 ft Schedule/Class Schedule 40
Elevation Measurements Length 6 ft
Original Drainfield Area Slope 6 % Diameter 2 in
New Slope,If Altered 33 % Preferred manifold configuration used? LtifYes 0 No
Depth of Excavation Up-slope +24 in Transport Pipe
from Original Grade Down_slopc +32 in Schedule/Class Schedule 40
Designed Vertical Separation 12 in Length 69 ft
Gravelless Chambers Required? 0 Yes It No 0 Optional Diameter 2 in
Pump Required? lif Yes 0 No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day 12
Diff.in Elevation Between Pump& Uppermost Orifice 17 ft Dose quantity 30 gal
Drainfield Squirt Height/Selected Residual(head) 5 ft Chamber Capacity(flood) 1,250 gal(1,360) gal
Uppermost Orifice ElHigher 51 Lower than Pump Shutoff Pump controls: Please check those required.
Capacity Total Pressure Head 46 gpm gTimer ❑Elapse Meter I 'Event Counter
Calculated Total Pressure Head 31 ft If Timer: Pump 1$91priOuV Eours
Comments
JAN 2 4 2023
tilpSOn1 COUNTY ENVIRONMENTAL HEALTH
JBW
DESIGN FORM—PAGE TWO Assessor's Parcel Number: 3 2 0 2 2 — 7 5 -- 0 0 0 2 0
• Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
lid Test hole locations IZ Drainfield orientation and layout Reference depth from original grade:
66 Soil logs lif Trench/bed dimensions and 121 Septic tank
iii Property lines critical distances within layout I' Drainfield cover
Il Existing and proposed wells 0 D-Box/Valve box locations Reference depth from original grade
within 100 ft of property 0 Septic tank/pump chamber and restrictive strata:
21 Measurements to cuts,banks,and locations 121 Laterals,trench bed,top and
surface water and critical areas 0 Observation port location bottom
0 Location and orientation of 0 Clean-out location 0 Curtain drain collector
curtain drain and all absorption 17.1 Manifold placement 0 Sand augmentation
components
FZI Pi Orifice placement Other cross-section detail:
Location and dimension of liff Lateral placement with distance l Observation ports/clean-outs
primary system and reserve area to edge of bed
gi Buildings Other Information
lid Audible/visual alarm referenced Yes No
lid Direction of slope indicator l Scale of drawing shown on scale 0 0 Design staked out
Pi Waterlines bar 0 0 Recorded Notices attached
0 Roads,easements,driveways,FZi 0 0 Waivers)attached
parking 0 0 Pump curve attached
North arrow and scale drawing ❑ ❑ Evaluation of failure
shown on scale bar Non-residential justification
❑ ❑ Waste strength
❑ ❑ Flow
DESIGN APPROVAL
The undersigned designer must be notifie II r ' e of installation 54 Yes 0 No
/s z3
ignature of Designer D e
The undersigned has reviewed this design on behalf of Mason County Public Health and determined it to be in
compliance with state and local o to regulations:
�/ t�z���3
vir•�� tal Health S ialist Date
CAUTION: DESIGN APP OVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
✓ The design is stamped"Approved"by Mason County Public Health. ( . i(_ ;. c
/ 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
SOIL EVALUATION
Property Owner/s Matthew Dean System Designer Nathan N. Cleaver
Date soils logged: 11/08/2022 Logged by: Nathan N. Cleaver
LEGAL DESCRIPTION:Section 22 Township2ONRange 3W Parcelt#/s 32022-75-00020 `),
Include soil textural characteristics and depths at which significant changes occur. •of ,,tom.1°
Be sure to include depth where mottling or impermeable layers occur. Use additional sheets ne
Nit? s
a) , .I I•l; NATMAN N CLEAVE .7
C t a) y i- Z EXPIRES y'
z Q c 2 i-°- ¢ ce ce w 3
Brown Silt
0-24" Loose Loam
1 24-36" Distinct Loose Gray/Brown 0.4 NA >36"
Silt Loam
36" Compaction
Brown Silt
0-26" Loose Loam
2 26-38" Distinct Loose Gray/Brown 0.4 NA >38"
Silt Loam
38" Compaction
Brown Silt
0-20" Loose Loam
3 20-32" Distinct Loose Gray/Brown 0.4 NA >32"
Silt Loam
32" Compaction
4PPROVE ':..
4 w
JAN 2 4 2023T .I
",—
.!Tv ENVIRONM
ENAL HEALTH
Mound Systems-Recommended Standards and Guidance
Effective Date:Ma 1,2020
Appendix D—Mound Worksheet/Checklist
—__ A. DAILY DESIGN FLOW
Daily Design Flow= # Bedrooms x 120 gal/day/bedroom (minimum)
mum)
4
x 120
_ ..
480
gal/day
B. DESIGN OF THE INFILTRATION AREA
Y
r\,'
1. Size the Infiltration Area 5'�25'
NATHAN N CLEAVER +f
c6-741
a. Infiltration Rate of Filter Media: 1.0 gal/ft2/day ExP'RErt 711
b. Infiltrative Surface Area(Bed)= Daily Design Flow(gal/day)
1.0 gal/ft2/day(maximum)
480
1.0 gal/ft2/day(maximum)
_ 480
feet2
2. Bed Configuration
a. Bed Width (A)
_ io
Table 2) ft(Dependent on Soil Depth. See
Required Bottom Infiltrative Surface Area
b. Bed Length (B)=
Bed Width (A)
480 ft 2
48 feet
C. DESIGN THE ENTIRE MOUND
1. Filter Media Height
a. Filter Media Depth (D+ E)
DOH 337-008
Page 58 of 66
Mound Systems-Recommended Standards and Guidance
Effective Date:Ma 1,2020
1) Depth Below Upslope Edge of Bed(D)
for dispersal l =2 feet or 1 foot if mound is only
persa! following Treatment Level B.
= 2
feet
2) Depth at Downslope Edge of Bed (E)
Filter Media Depth Below Downslope Edge of Bed(E)=D+[%Natural
Slope as a Decimal x
Width of Bed (A)]
= 2
ft+ 0.06 x 10
?ft
= 2.6
feet
b. Bed depth(F)=9 inches(minimum for 1-inch lateral) in gravel.
Other dispersal technologies can be considered, which haveg varyin heights.
0.75 g
feet
c. Cap and Topsoil
1) Depth at Bed Center(H)= 18 inches
2) Depth at Bed Edges(G)= 12 inches
2. Filter Media Length
a. End Slope Width (K)=Total Filter Media Depth at Bed Center x Horizontal
Gradient of Side Slope.
K= rrD+E\ 2 J +F+H x Selected Horizontal Gradient of Side Slope(3 if 3:1)
K= Cl2 ft+2.6 ft
Ll 2 J+0.75 ft+ 1.5 ftJ x 3
K= 13.65
DOH 337-008
Page 59 of 66
Mound Systems-Recommended Standards and Guidance
Effective Date:May 1,2020
b. Filter Media Length (L)= Bed Length + [2 x End Slope Width]
L=B+2K
L=48 ft+(2x 13.65 ft)
L= 753 feet
3. Filter media width
a. Upslope Width(J)=Filter media Depth at Upslope Edge of Bed(D+F+G)x
Horizontal
•
Gradient of Side Slope(3 if 3:1)x Slope Correction Factor(see Table 3)
J=(D+ F+G)x Horizontal Gradient x Slope Correction
Factor
J=(2 ft+ 0.75 ft+ 1 ft)x 3 x 0.85
J= 3.75 ftx3 x 0.85
J= 9.5625 feet
b. Downslope Width (I)=Filter Media Depth at Downslope Edge of Bed (E+F+G)
x
Horizontal Gradient of Side Slope(3 if 3:1)x Slope Correction Factor(See
Table 3).
I =(2.6 ft+ 0.75 ft+1 ft)x 3 x1.22
I= 4.35 ft x 3 x 1.22
I= 15.921 feet
c. Filter Media Width(W)= Upslope Width + Bed Width + Downslope Width
W=J+A+ l
W= 9.5625 ft+ 10 ft+ 15.921 ft
W= 35.4835 feet
DOH 337-008
Page 60 of 66
Mound Systems-Recommended Standards and Guidance
Effective Date:May 1,2020
4. Check the Basal Area
a. Basal Area Required = Daily Design Flow
Infiltration Rate of Original Soil
480 gal/day
0.4 gal/ft2/day
= 1,200 feet2
b. Basal Area Available=B x(A+I)
1) Sloping Site=Bed Length x(Bed Width +Downslope Width)
=Bx(A +I)
= 48 ftx(10 f}+ 15.921 ft)
= 48 ft x 25.921 ft
= 1,244.a feet2
2) Level Site=Filter Media Length x Fill Width
=LxW
ftx ft
= feet2
Compare basal area available with the basal area required. Is there sufficient basal area?
YES X NO
DOH 337-008
Page 61 of 66
I [ I
I 177
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