HomeMy WebLinkAboutSWG2023-00012 - SWG Application / Design - 1/18/2023 10
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MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584
SHELTON:360-427-9670,EXT 400
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BELFAIR:360-275-4467,EXT 400
Public Health & Human Services ELMA:360-482-5269,EXT400
FAX:360-427-7787
On-Site Sewage System Permit: SWG2023-00012
APPLICANT KEMMAN ET AL RICHARD PAUL Phone:
Address: KAY FRANCES KEMMAN BUCKLEY, WA 98321
OWNER KEMMAN ET AL RICHARD PAUL Phone:
Address: KAY FRANCES KEMMAN BUCKLEY, WA 98321
SEPTIC DESIGNER CINDY WAITE-Septic Designer Phone: 3607010205
Address: 80 E PICKERING LANE SHELTON, WA 98584
Site Address: 1130 E Island Lake Dr
Primary Parcel Number: 320065002001
Permit Description: New SFR -4BR Gravity
Permit Submitted Date: 01/18/2023
Permit Issued Date: 01/30/2023
Issued By: Jeff Wilmoth
Current Permit Fees Paid: $780.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 01/26/2026 (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.
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. 4( OFFICIAL USE ONLY
MASON COUNTY PUBLIC HEALTH DATERECENED: i Ca
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ONSITE SEWAGE SYSTEM APPLICATION AMO�ED�D� sib RECEIVE C Cn
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415 N 6th Street,(Bldg 8) Shelton WA,98584 • R- �
Shelton:360-427-9670 ext 400 Belfair:360.275-4467 ext 400 S` \I G ) 3 - ( O0
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APPLICANT PHCN > >
RICK KEMMAN 253-350-5498 m m
MAILING ADDRESS-STREET.CITY.STATE.ZIP CODE r
PO BOX 750 BUCKLEY WA 98321 c
SITE ADDRESS-STREET.CITY.ZIP CODE CO
1130 3 ISLAND LAKE DR SHELTON WA 98584 m
NAME OF DESIGNER PHONE I C,J
CINDY WAITE 360-701-0205
NAME OF INSTALLER PHONE I N
TBD I CDCHECK ALL APPLICABLE ITEMS DRINKING WATER SOURCE
0
NEW CONSTRUCTION 0 RV HOLDING TANK ONLY lif PRIVATE INDIVIDUAL WELL (n I O
lr REPLACEMENT SYSTEM 0 INSTALLATION PERMIT ONLY 0 PRIVATE TWO-PARTY WELL 0
❑ TABLE 9 REPAIR 0 SINGLE FAMILY 0 COMMUNITY/PUBLIC WATER SYSTEM Z 10)
❑ TANK(S)ONLY 0 COMMERCIAL SYSTEM NAME: 1
❑ UPGRADE TO EXISTING 0 OTHER: BEDROOMS LOT SIZE I C.71
gr EXISTING FAILURE "Record Drawing required
for all Installations" 4 76 X324 X40 X315 W I o
II DIRECTIONS TO SITE-BE SPECIFIC AND ADVISE OF ANY NEEDED INFORMATION FOR ACCESS(ex.locked gate) ^ 0 t
X IID
GO NORTH ON US HOGHWAY 101, TURN RIGHT ONTO SHELTON SPRINGS RD,
TURN LEFT ONTO ISLAND LAKE RD, TURN LEFT ONTO ISLAND LAKE DR. LOT IS ON I N
THE RIGHT SIDE OF ROAD, RIGHT NEXT TO THE BOAT ACCESS PARK. GATE CODE
IS 4449. HOLES ARE BETWEEN RESIDENCE AND LAKE. o IQ
ICD
SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS I
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE/FAILURE SOURCE(for reporting purposes)
❑VOLUNTARY 0 MAINTENANCE/PUMPING ❑BUILDING PERMIT ❑HOME SALE ['COMPLAINT ❑OTHER:
INSPECTOR SOIL LOGS COMMENTS/CONDITIONS
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SOIL CODES:
V=VERY G=GRAVELLY S=SAND L=LOAM Si=SILT C=CLAY E=EXTREMELY R=ROOTS
TO'SIGNATURE DATE APPLICATION EXPIRATION DATE cc)LI FATION APPROVED BY DATE
0
OLcil i -.21-2-3
T IS rl MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSIT REVISED 12/72015
. DESIGN FORM—PAGE ONE Assessor's Parcel Number: 3 2 0 0 6 — 5 0 — 0 2 0 0 1
A design will be reviewed when 3 copies of each of the following are submitted:
Completed desiga 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: 41•',Y 1?"
PARCEL IDENTIFICATION
Permit Number: SWG 2023--QOCVR_ Designer's Name: CINDY WAITE
Applicant's Name: RICK KEMMAN Designer's Phone Number: 360-701-0205
Mailing Address: PO BOX 750 80 E PICKERING LANE
Designer's Address:
SHELTON WA 98584 SHELTON WA 98584
City State Zip City State Zip
DESIGN PARAMETERS
Treatment Device
❑Glendon Ilioliltcr 0 Sand Filler 0 Mound 0 Sand l.incd Draintield 0 Recirculating Filter,Type:
❑Aerobic Unit Make/Model ❑ Disinfection Unit Make/Model
Other:
Drainfield Type
('Gravity 0 Pressure 0 Trench G 'Bed
0 Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 4 Schedule/Class 480
Daily Flow: Operating Capacity 360 gpd Length : 30 ft E
Daily Flow: Design Flow 480 gpd Di tp R0V 4
in
Septic Tank Capacity 1530 INFILTRATOR gal umber s...
i'` 6
Receiving Soil Type(1-6) 3 arat4N 27 2023
Receiving Soil Appl. Rate .8
gpd/ft' coop(ENVIRONMENTALHEAl1H 3 ft
p� sot,1 Orifices
7fif
Required Primary Area 600 ft' Total Numbeices 2729 PERF
Designed Primary Area 600 ft2 Diameter 4
in
Designed Reserve Area TABLE 9 ft2 Spacing
in
Trench/Bed Width ( BEDS) -
10 TWOft i �` Manifold
Trench/Bed Length 30(TWO BEDS) ft Sch-„Ple/C 4.
fi
Elevation Measurements L-�;� �' I ft
Original Drainfield Area Slope <1 % .* F's" 9' '�
New Slope, If Altered % i T ;" `I► In
e -'; • - f iv$I figuration used? 0 Yes 0 No
Depth of Excavation tip-slope 18 in i y �� TF 1
from Original Grade +P� DYE AITE %,Si Transport Pipe
Do„„-slope in
Designed Vertical Separation 36 via". tom���0�� wroloo 1, 3034
.�v. in tT:^rt. osno, 5-8 ft
Gravelless Chambers Required? 0 Yes 0 No lirOptional Diameter 4
in
Pump Required? ❑ Yes R1No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day
Difference in Elevation Between Pump Shutoff and Uppermost Dose quantity '
Orifice ft gal
Chamber Capacity gal
Uppermost Orifice 0 Higher 0 Lower than Pump Shutoff Pump controls: Please check those required.
Capacity @ Total Pressure Head gpm ❑Timer ❑Elapse Meter 0 Event Counter
Calculated Total Pressure Head ft If Timer: Pump on Pumpoff
y� Comments
MAY NEED TO RAISE PLUMBING COMING OUT OF HOUSE
AND GRAVITY TO DRAINFIELD TO KEEP 36" OF VS. TO MAINTAIN GRAVITY TO TANK
DESIGN FORM—PAGE TWO Assessor's Parcel Number: 3 2 0 0 6 -- 5 0 -- 0 2 0 0 1
Permit Number: SWG
' DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
66 Test hole locations li! Drainfield orientation and layout Reference depth from original grade:
10 Soil logs 64 Trench/bed dimensions and
El Septic tank
0 Property lines critical distances within layout
lZ Drainfield cover
lid Existing and proposed wells lg D-Box/Valve box locations
within 100 ft of property lid Septic tank/pump chamber Reference depth from original grade
and restrictive strata:
t Measurements to cuts, banks,and locations
filf
surface water and critical areas Fig Observation port location Laterals,trench/bed, top and
bottom
4Location and orientation of ri�.,/oetQ'lean-out location ❑ Curtain drain collector
curtain drain and all absorption Icifjlanifold placement 0 Sand augmentation
components
/�rifice placement Other cross-section detail:
lid Location and dimension of /`7
primary system and reserve area liff Lateral placement with distance Cif Observation ports/clean-outs
Buildings
to edge of bed Other Information
41L,Pli Audible/visual alarm referenced Yes No
Direction of slope indicator
lif EZI Scale of drawing shown on scale It 0 Design staked out
Waterlines bar
0 0 Recorded Notices attached
Itil Roads,easements,driveways, 0 0 Waiver(s)attached
parking 1 1 e �^ 0 0 Pump curve attached
. ./Yam, so ye„,, - — Q( ❑ Evaluation of failure
21 liviititaWati‘r te /�ph Csu caaf�s<�<<. Non-residential justification
JAN21t3,\I-rpoEo"
Di
r0 0 Waste strength
❑ ❑ Flow
W,/,sO COUNTYJ�W
DESIGN APPROVAL
The undersigned designer must be notifie y installer at time of installation-Yes 0 No
C�cJ r
Signature o esigner Date
The undersigned has reviewed this ign on behalf of Mason County Public Health and determined it to be in
compliance with state and local -si real
/
E iroeal Health Specialist Date
CAUTION: DESIGN APP OVAL 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 - --'.Z
V 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. '2-\C(
This form may be scanned and available for public view on the Mason County Web site.
Updated Date: 12/7/2015
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INFILTRATOR * IM-1530
tanks
Features & Benefits
The Infiltrator IM-1530 is a lightweight strong and • Strong injection molded
durable septic tank. This watertight tank design is polypropylene construction
offered with Infiltrator's line of custom-fit risers • Lightweight plastic construction
and heavy-duty lids. Infiltrator injection and inboard lifting lugs allow for
molded tanks provide a revolutionary easy deliveryand ha
ndling
improvement in plastic septic �1r�,
tank design, offering long-term ` `�. Integral heavy-duty green lids that
interconnect with TWT"^ risers and
exceptional strength and - �, •NI, pipe riser solutions
watertightness. '�
Structurally reinforced access
ports eliminate distortion during
installation and pump-outs
• Reinforced structural ribbing
and fiberglass bulkheads offer
additional strength
• Can be installed with 6" to 48"
• OVE .. of cover
• Can be pumped dry during
JAN 2 7 20 `. pump-outs
23 ! • Suitable for use as a septic tank,
MASON-COUNTY ENVIRONMENTAL HEALTH pump tank, or rainwater
i• '11 JBW (non-potable) tank
Inlet Side
IT� �s �F9/j, No special water filling
TANK CUTAWAYS;jo"``A°4--I h n�,trat• requirements are necessary
jS,P / r r • The tank may be backfilled with
\vo'l/ suitable native soil. See installation
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instructions for guidance.
�0 LICE SED D SIGNER I/
Partitio --mom womb �0, mL ����m�
ExpiREs 05,10, -
baffle wall - -
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HEAVY DUTY LID
CUTAWAY
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24" structural
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Structural
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bulkheads
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�. I MID-SEAM CUTAWAY CI
I Reinforced water tight mid-seam
I
gasketed connection
Protecting the Environment with Innovative Wastewater Treatment Solutions INFILTRATOR'
water technologies
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IM-1530 General Specifications
and Illustrations
The IM-1530 is an injection molded two piece mid- LIFTING LDG,TVP, RISER CONNECTION(TVP)
-LIFTING STRAP,TVP)
seam plastic tank. The IM-1530 injection molded _ _ _
plastic design allows for a mid seam joint that has
precise dimensions for accepting an engineered %1110411R 1M�c 1 I�I 1I "'�� tom;II r- rjp g eered fi .-_I Ii� ��%11.i ;i,,
EPDM gasket. Infiltrator's gasket design utilizes \PPLR Dt, k"- o �j ��\'°,�technology from the water industry to deliver f , �- ��� o '', 6,7
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proven means of maintaining a watertight seal (\� o 0 ■� D A 1� D ii"arlil WIDTH
The two-piece design is permanently fastened l01~i ipoill
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using a series of non-corrosive plastic alignment
dowels and locking seam clips. The IM-1530 is
assembled and sold through a network of certified — 175 614.4601 EXTERIOR LENGTH
Infiltrator distributors.
Must be backfilled and installed in accordance TOP VIEW
with Infiltrator Water Technologies, Infiltrator OUTLET TEE
IM-Series Septic Tank General Installation TVP)
Instructions and for shallow ground water p P -InfiltratorVE
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Tank Buoyancy Control Guidance. !, j I 54 5
ft.3641
JAN 17 2023 ,1,`IP -�J` EXTERIOR
Please visit www.infiltratorwater.com/im I
pdf/ManualsGuides/TANK01.pdf for the lates �OUNTYENVIRONMENTA�L '�I r
information. JBW IMP . c IL(TVP)
IM-1530
END VIEW
Working Capacity 1537 gal(5818 L)
Total Capacity 1787 gal(6765 L)
024.01610J ACCESS PORT Airspace 0 04 JI02JBS / W TH LOCKING LID(3)
16.9/o OR A\PVCNLET TEE 10 112571 FREEBOARD OUTLET
1
Length 176"(4460 mm)
PVCORAes
OUTLE TEE
r INL T I 16 9%AIR SPACE vm-r YLIL 'r r '
Width 62"(1567 mm) /
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IL 3.6
Length-to-Width Ratio 2.8 to 1 t 176J PER ___0215J WALL
a4 0 CODE
CPER 11 .0 L THICKNESS
Height 55"(1384 mm) coDE LIQUID 2151IX 2I511
`\1 DEPTH FIBERGLASS
Liquid Level 44"(1118 mm) I `Yp ORT(4)
Invert Drop 3"(76 mm)
Fiberglass Supports 4 4,Q- ..,?
Compartments 1 or 2 4.9rec,v A «, SIDE VIEW
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Maximum Burial Depth 48"(1219 mm) P J• o�S •
T CONTINUOUS
Minimum Burial Depth 6"(152 mm) �`" is) _y ELASTOMERIC
!/� GASKET
Maximum Pipe Diameter 4"(100 mm) of cAl
WAIVLICEDESIG T
Weight 501 lbs(228 kg) .. INTERI ���I
'- �-- SEAM CLIP
EXPIRES 0510, Fill!
ALIGNMENT 0DOWEL TANK BOTTOM HALF
(----'-
4 Business Park Road
P.O.Box 768
Old Saybrook.CT 06475
INFILTRATOR 860-577-7000•Fax 860-577-7001 MID-HEIGHT SEAM SECTION
1-800-221-4436
water technologies www.infiltratorwater.com
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Contact Infiltrator Water Technologies' Technical Services Department for assistance at 6
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Installation Notes
Gravity Distribution System:
1130 E Island Lake Dr 32006-50-02001
1. The original system was installed as a four bedroom in 1973 with a permit and a record
drawing. The system is not accepting effluent. Drainfield was scoped to find root
intrusion and clogged. Proposed may cross part of the old drainfield.
2. The prepared site plan is not a survey. It's the owner's responsibility to verify property
lines, utility lines (water, sewer, power, phone and gas) prior to installation.
3. Interconnect at the ends to form a closed loop.
4. Install observation ports at two corners of bed and one in the middle.
5. Install system during dry weather with acceptable soil conditions
6. Keep wheeled vehicles off the drainfield area before, during and after installation.
Tracked equipment only,
7. All ground, surface water and roof drains must be diverted away from the septic tanks
and drainfield. Ensure the final grade slopes away from these areas and water doesn't
collect on or around them. Use swales, berms, catch basin and tight lines, curtain drains,
etc. to divert all waters.
8. Curtain drains can be no closer than 10' upgradient and 30' down gradient of the
drainfield
9. Exposed restrictive layers, cuts, banks, etc. can be no closer than 50' downhill from the
drainfield.
10. Install access risers on the septic tank, D-box and observation ports.
II 11. Make sure septic tank risers are epoxied or caulked to cast in riser rings on tank.
12. Lids must form a water and gas tight seal with the access risers
13. Install effluent filter at the septic tank outlet.
14. This system must be installed by a Mason County Certified Installer.
15. Deviation from this design without prior approval from the designer and Mason County
Health Department will make this design null and void.
16. This design was sized per Washington Administrative CodeWAC246-272A-0230. The
operating capacity is based on 45 gallons per day per capita with two persons per
bedroom. The minimum design flow per bedroom per day is the operating capacity of
ninety gallons multiplied by 1.33. This results in a minimum design flow of one hundred
twenty gallons per day. This creates a surge factor of 33% but anticipated flow is ninety
gallons per bedroom per day.
17. Install laterals or bed with contour of the ground
18. Install trench bottoms level and always maintain a minimum of six inches into native soil
19. Filter fabric required over drain rock prior to backfilling. I the drain rock extends above
the original grade, run the filter fabric at least 2 inches Oadti the trench wall.
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JAN2 7 2023 '' '
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MASON COUNTY ENVIRONMENTAL HEALTH r�volomLICENSE DES R
- CXPIRES 5 0'
System Owner Responsibilities:
1. Operation and Maintenance is required by Washington State Department of Health and
Mason County Health Department.
2. The septic tank should be pumped every three to five years or as needed.
3. System owners are responsible for having maintenance performed every three years as
per WAC246-272A.
4. System owners are responsible for responding to septic issues in a timely manner.
5. System owner agrees to read and abide by information regarding their system in the
User Manual provided by Mason County Public Health.
6. Keep the flow of sewage at or below the approved design operating capacity.
7. Keep waste strength at residential waste strength parameters.
8. Spread loads of laundry through the week.
9. Do not use excessive bleach or detergents with added whiteners.
10. Do not shower, do laundry and dishwasher at the same time
11. Antibiotics can kill or impair the biological process in the septic tank.
12. Leaky plumbing can hydraulic overload your on-site septic system.
APopRvED
44,4saJAN � 2023
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Je y MENTAL HEALTH
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ExPiRES 05i10,