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HomeMy WebLinkAboutSWG2022-00549 - SWG Application / Design - 11/2/2022 (2) 415 N 6TH STREET,SHELTON,WA 98584 MASON COUNTY SHELTON:360-427-9670,EXT 400 Mil BELFAIR:360-275-4467,EXT 400 Public Health & Human Services ELMA:360-482-5269,EXT 400 FAX:360-427-7787 ENVIRONMENTAL HEALTH REVIEW OF OSS APPLICATION PAYMENT DEVIN & DANIELLE 7530 W SHELTON MATLOCK RD SHELTON, WA 98584 Applicant: PAYMENT DEVIN & DANIELLE Parcel Owner: PAYMENT DEVIN & DANIELLE Site Address: W Highland Hills Rd Primary Parcel Number: 520243390010 OSS Permit Number: SWG2022-00549 Permit Description: New SFR -4BR Gravity w/class b waiver Permit Submitted Date: 11/02/2022 Permit Review Date: 01/25/2023 The above mentioned Onsite Sewage System Application was reviewed by Environmental Health and found more information is required. revision approved to 4BR 1-25-23 If you have questions or concerns let us know. Sincerely, Jeff Wilmoth 360.427-9670 Ext.543 jwilmoth@masoncountywa.gov .e., LhS i OF, 1 — OFFICIAI USE ONLY DATE RECEIVED. 1 ' . • ,qw > Q MASON COUNTY ,�r�,�� • RECF Co m COMMUNITY SERVICES AA —< N aa - OA 5 o pDylic INeINt(C:mun,ty Heafth/Envlronrnental Health) S W G �O I �ssvease..e•sneRo•.wAsuu Z CO ON-SITE SEWAGE SYSTEM APPLICATION > 7 PH NL r Em P°'' `'''T (360) 463-7537 _ c Devin Payment _ —_ 3 MAILING ADDRESS-STREET.CI-1',$7ATE.ZIP CODE Shelton WA 98584 co 7530 W Shelton Matlock Rd 73 $tTE ADDRESS-STREET CITY ZIP CODE Shelton WA 98584 Cn W Highland Hills Rd I N NAME OF DESIGNER PHONE(360) $98-2255 Arrow Septic Designs - O Cl I C. NAME OF INSTALLER PHONE C I c IV DRINKING WATER SOURCE O I PERQMtT TYPE(seam one) PRIVATE INDIVIDUAL WELL PRIVATE TWO-PARTY WELL Z ,A APE OESIDENTIAL OSS COMMUNITY OSS COMMERCIAL OSS PUBLIC WATER SYSTEM ' TYPE OF WORK(se&e„t one) I I W 'KNEW CONSTRUCTION/UPGRADES REPAIR I REPLACEMENT OTHER DETAILS(s•-teci a that appy) ❑TABLE IX REPAIR SUBMITTALS 0 SURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINE O I CA) LOT SIZE DESIGN FORM(REQUIRED) SEPTIC DESIGN(REQUIRED) BEDROOMS / 2.rj Acres , WAIVERS)(IF APPLICABLE)O. I ICDR FCTIONS TO SITE AND SITE CONDITIONS for ticked paN, • atlock Rd. urn left onto W Turn right onto W Railroad Ave. Continue h Turn Mght onto WTHighland Hills Rd at o I so Rd toward Highland Rd/Panhandle Lake mile marker 2. Turn left at 321/323 on post at driveway. Follow past 2 houses- Yellow sign: "Lot B" I 0 — SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS —— — — OFFICIAL USE ONLY BELOW THIS LINE -- —�-- UPGRADE/FAILURE SOURCE(!or reporbnp purposes) 0 VOLUNTARY 0 MAINTENANCE/PUMPING 0 BUILDING PERMIT ❑HOME SALE ❑COMPLAINTCO COMMENTS,GONd TIONS INSPECTOR SOIL LOGS .3 4>L % 77L / t —..) 51..." RECORD DRAWING AND NSTALLATION REPORT SOIL CODES: Y E•EXTREMELY R•ROOTS REQUIRED FOR FINALAFPROVAL V=VERY G•GRAVELLY S=SAND L•LOAM A •SILT C`CLA A•*DON APPROVED ISSUED BY C:.TE '� �I7 DATE APPLICATION EAPI RATION DATE , 'I� i•,1 SIGN/ATURE REVISED 12/7.20iS THIS"ORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE _...a 4,Printed From Mason County DMS 1 4 Printed from Mason County DMS ` DESIGN FORM—PAGE ONE Assessor's Parcel Number: 5 2 0 2 4 — 3 3 — 9 0 0 1 0 A design will be reviewed when 3 conies 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: I "X 17" I EL: I EATI a .. ' gr► Permit Number: SWG 2022-00549 Designer's Name: Arrow Septic Designs,Inc Applicant's Name: Devin Payment Desi er's Phone Number: (360)898-2255 •Olin: 1..1 . S. 7530 W Shelton Matlock Rd Desi er's Address: 171 E Vuecrest Dr '0 cs .a 45 - Shelton, WA 98584 Union, WA 98592 City State Zip City State Zip DESIGN.P AMET'ERt' Treatment Device ❑Glendon Biofilter 0 Sand Filter 0 Mound ❑Sand Lined Drainfield 0 Recirculating Filter,Type: ❑Aerobic Unit Make/Model 0 Disinfection Unit Make/Model Other: 50'Attenuation Zone Drainfield Type 'Gravity ❑Pressure C'Trench 0 Bed ❑Sub Surface Drip Septic Tank/Drainfield Specifications Laterals Number of Bedrooms 4 Schedule/Class 2729 Daily Flow:Operating Capacity 360 gpd Length 54 ft Daily Flow:Design Flow 480 gpd Diameter 4"perf in Septic Tank Capacity(working) 1,200 gal Number 5 Receiving Soil Type(1-6) 4 Separation 9 ft Receiving Soil Appl.Rate 0.6 gpd/ft2 Orifices Required Primary Area 800 ft2otal Number of Orifices — Designed Primary Area 810 ft2 Diameter — in Designed Reserve Area 810 ft2 Spacing — in Trench/Bed Width 3 ft Manifold Trench/Bed Length 270 ft Schedule/Class — Elevation Measurements Length — ft Original Drainfield Area Slope 4 % Diameter — in New Slope,If Altered 4 % Preferred manifold configuration used? 0 Yes 0 No Depth of Excavation up-slope 14 in Tr ipe from Original Grade Down-slope 13 in Schedu it M lE O 034 Designed Vertical Separation 20 in Length 80 ft Gravelless Ghanbe `equited? ❑Yes ❑No 'Optional Diamet 11 JAN 2 0 2 4 in rra'inreie. 1'' ive l (wtt�+ 1 a ump Required? 0 Yes Id No P P ) U Dosing and Pump hamber Pump/Siphon Specifications Number goiipses/ — Diff.in Elevation Between Pump&Uppermost Orifice — ft Dose quantity — gal Drainfield Squirt Height/Selected Residual(head) — ft Chamber Capacity(flood) — gal Pump controls:Please check those required. Uppermost Orifice 0 Higher 0 Lower than Pump Shutoff Capacity na Total Pressure Head — gpm ❑Timer ❑Elapse Meter 0 Event Counter Calculated Total Pressure Head — ft If Timer: Pump on — ,Pump off Comments APPROVE JAN 2 5 1UZ3 pit 0{6 MASON COUNTY ENVIRONMENTAL HEALTH JBW • DESIGN FORM—PAGE TWO Assessor's Parcel Number:5 2 0 2 4 — 3 3 -- 9 0 0 1 0 Permit Number: SWG 2022-00549 DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch lid Test hole locations Drainfield orientation and layout Reference depth from original grade: lig Soil logs 17.1 Trench/bed dimensions and &I Septic tank RI Property lines critical distances within layout la Drainfield cover Existingliol and proposed wells lif D-Box/Valve box locations P P Reference depth from original grade within 100 ft of property lil Septic tank/pump chamber and restrictive strata: GI Measurements to cuts,banks,and locations la Laterals,trench/bed,top and surface water and critical areas 1g Observation port location bottom Ei Location and orientation of lif Clean-out location 0 Curtain drain collector curtain drain and all absorption ❑ Manifold placement 0 Sand augmentation components 0 Orifice placement Other cross-section detail: Ei Location and dimension ofEid Observation ports/clean-outs primary system and reserve area Lateral placement ��f distance to edge of bed Other Information 10 Buildings 0 Audible/visua ,s'•. enced Yes No ig Direction of slope indicator lif Scale of dra .0): Ihpwi? cale 0 g Design staked out Waterlines bar � "°y.'•���. Of.:-..4.°11 i,- .,�: g ❑ Recorded Notices attachedI Roads,easements,driveways, -.•�,;;, Q( 0 Waiver(s)attached or' 'Ft 1t parking '7` 'ice.* '� _• ,\;;, 0 li 'Pump curve attached .&"f 51b•.349 .�w, Fil North arrow and scale drawing PAULA JOY JOHNSON.•y'/ 0 6d Evaluation of failure shown on scale bar L'iC1rN5>_ ' ESIGlvi:a" J on-residential justification exairn:s �i�z,�.t. . ❑ l Waste strength ❑ el Flow DESIGN APPROVAL The undersigned designer must be ' ied by' taller time of installation ef Yes 0 No I— (1-23 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-sit egulations: �1.� / — ems--9 Env' Health Specialist,t 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: 1 l— q 25 ✓ 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 y t9El 0 • i , CO Pigt . Fii ' d I r-i P!! I gO PIO--1C0-rtt - NI OOitv -� E ZJ .% -\Zn w s o y q ' z OA ;s Z Vl � • CUM\'I NGHAM) �W i $ at e'12' [ 329.60 44.1 A .0 g 0) v- s e ,e•4e' a aso.01 4,td�i „_.._-1 1 PH a 11 rt.', -csq-& 42...'141. Z 0 iiic : 1 I,i '°' . Oy A7 Nr o _ N I`( i f•? a 1 i Plc o h.. rl IA ii . 'N a Z:1 VI "1 i Si� is j "Fill1 vs )rTiz m - Is g2. � R° N ero'as w uo.w t lip i �,i-I Q y \ II! 9 571z Q-- 'Oa -- ./ f/.. N./ iz 1. a' ' ' i s 4 . N i a isi !t,}, ,,,_. „.„,.,. ..,,i.., ,, t.4\r. \ gi' / le4.-- ,. , „ r#, IS M-\I,M,,,, S ---„--''--' t--i- -- ram, , n = ..... , . • .• ''� vc,. a 'as aso.00 c- y i ii F is r " 6 , I ER CO.) 0 o v to � -13 rIN( p: :I • :' ; I.\./ f a r• � c) 2-4w 4-1 w t. 1 Key: 7 ) i C Cleanout 0 1,200 Gallon Septic Tank 2-Compartment with Effluent Filter 33 D-Box with speed-levelers r-T and cover to surface to \'3 a 7\ < ;i2A ) i f \ '�� .f 4' 'O4 / i ' #A k \ 4 \ ),<7/NIn $54 itop 7 G F © ?vote...* 4SR _ 0 (5 3 `x 541 ' 17Y*10,101 D'F. 1r -...0.4esC, a ' D .G. w', 43-1 �� ' it 11 W mil+', c.�tav c 0.1 b^Z4 6 $A4Ad E��: l = ��% �` ; +� d'�s-�.+rb�d!/-fir� > `I` otS 50 gib t v t ✓o o' it 24-3 4.b L ,N.-z5 50.,..t. P -FL 42_ : 5oa.."42. as 41 t „ /v'wA:?'a- .i 4, +-IVa 64,,-10ea / 1t) 0 - 2-4 sa....dy 1eaw,, -Pct - SZb2i-5- - °TOOID -4-t.k-k- s+ tee_ 4tiLLL ed 4: d,s a j A.eb s } UA qe5e4 ii s: . y .:4,, (a; 2. ' d.j 10.4,.—t, 4-111 /.��, :tic•�,.. APPROVE \ S,C:349 `'f' 1� }gagekiMi) 1:01"4 (41V-. PAULA JOY JOHNSO 'om .(' JAN 2 5 2023 `` 'J. MASON COUNTY ENVIRONMENTAL HEALTH l�s ef,gi H:' 1,I.JMY �� 3�f (to �Bw • 4 a ,,,,,.,0, SO 31-k L-�rtSt_9.l`S } �-O�„ - �- fox w� �'�����- ���'�- S cti�s.,c� - � 0 r a, F -A p bSe3C4ct,i•ie4% o Pt,✓k 4 I ow C 7t-esr 3 0 4 `� Z-.7 Zq Lam' r' '. 0 o S ( o /S Zo . 1 Pr—LA f i 1 G r cJ1 e CI '-12��e,✓ Zn o ri ', ct,1 (�✓ode YL- Zt h;�.�. (r-Z'1 z1 c. -, �� err Ai A ,. r 'T.' s ks, Cie) t( • )1 2-L e, W r S tg-Q.D_ -: k "z; ( r ,-.z.lirvkil -, ..P. _ ..%,i, N� PAULA JOY JOHNSON •:r�\ '� z _ • PPROVE %ra\SE1, 42,.-N N -- -.' `U 'lam �i �►�•�► - '; EXPIRE$ 9T1 JAN 2 5 2023 ' Fa Ll Gt r MASON COUNTY ENVIRONMENTAL HEALTH J `P • JBW . SECURED LID WITN GAS TIGHT SEAL ACCESS mos \ . . � -_ . 7ibummilv .... 1._ TO PUMP 111 li j .i1111" FftoM�M�AA6F ,t FLOATING MAT 1 SOURCE --' APPROVE — EPFLUENT NOIR • TIC TANK PPROVE JAN25 , r�IASGN OOUNTY ENVIRON JR Kt HEALTH **Note: Septic Tanks must m et standards required by WAC chapter 246-272C the Dept of Health list of registered sewage tanks.** and manufacturer must be on p 5 Qf (o . • A • ;r. INSTALLATION & MAINTENANCE 5t 349 Gravity Distribution Systems • PAULA JOY JOHNSON 4.( ▪ ..MENSE 'ri1=SiGN R� ExPiaEs 1 1. Install Laterals with contour of the ground. 2. Install trench bottoms level. 3. Install locator tape or rebar at each end of all drainfield laterals. 4. Install observation ports as indicated on the detailed drainfield layout. One required at distal end of each lateral in drainfield with bottom extending to the drainrock/native soil interface. Glue"T"to bottom so Observation Port cannot be easily removed from ground. Install removable cap on top of port at final grade level. 5. Install drainfield during dry weather and soil conditions; any soil smearing must be eliminated by hand raking. 6. Use distribution box with speed levelers and cover to surface. Divert incoming pipe down with 90-degree angle to prevent short-circuiting. 7. Filter fabric required over drain rock prior to back filling. If the drain rock extends above natural grade,run the filter fabric at least 2 inches down the trench wall. 8. Encase all water lines within 10' of drainfield and under any driveway/parking areas. 9. Divert all storm water runoff away from on-site sewage system. 10.No curtain drains allowed within 10' of the up-slope edge or 30' of the down-slope edge of the drainfield and reserve area. 11. No vehicular traffic over drainfield area. 12. Install Bio-Tube or equivalent effluent filter at outlet end of septic tank. 13. All manhole lids and access, sampling or inspection ports must have locking covers and be located at ground level. 14. Inspect tank and clean filters every 6-12 months as needed. 15. Have the septic tank pumped or professionally inspected every 3 to 5 years. 16. All materials and workmanship must meet County and State regulations. 17. Deviation from this design without prior approval from the Designer and Mason County Environmental Health Department will make this design null and void. 18. All transport lines under driveways or parking areas must be encased to prevent crushing. 19. Homeowner is responsible for all property lines. PP ROVE JAN 2 5 2023D MASON OuuNTY ENV1R JB �NME' TAL W HEALTH