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Home My WebLink AboutSWG2022-00582 TANK ONLY - SWG Application / Design / As-Built - 11/18/2022 Y_ s. `S � \ 415 N 6TH STREET,SHELTON,WA 98584 � MASON COUNTY SHELTON:360-427-9670, EXT 400 t iI ,. j COMMUNITY SERVICES BELFAIR:360-275-4467,EXT 400 ELMA:360-482-5269, EXT 400 �•tuM� Budding.Planning,Environmental Health,Community!l ath FAX:360-427-7787 On-Site Sewage System Tank Only Permit: SWG2022-00582 APPLICANT ARNETT CAROL K Phone: Address: 2717 EASTWOOD AVE RICHLAND, WA 99352 OWNER ARNETT CAROL K Phone: Address: 2717 EASTWOOD AVE RICHLAND, WA 99352 SEPTIC INSTALLER Shane Maples- MAPLES EXCAVATING Phone: 360-463-8474 Address: 911 SE Arcadia Road SHELTON, WA 98584 Site Address: 1246 W LAKESIDE DR Primary Parcel Number: 519015001070 Permit Description: Replace septic tank Permit Submitted Date: 11/18/2022 Permit Issued Date: 11/21/2022 Issued By: Rhonda Thompson Current Permit Fees Paid: $240.00 (additional fees may be required upon installation of system). Permit Expiration Date: 11/21/2023 (based on date of inspection) Type of Work OSS Repair Components being Replaced: Septic Tank Only Surfacing Sewage? No Existing Failure? Yes Shoreline? No Horizontal Setbacks Met? Yes Number of Bedrooms: 2 Drinking Water Source: Public Water System Additional Details: IM-1060 Permit Conditions: 1 Horizontal setbacks per WAC246-272A-0210 must be maintained, unless prior approval is obtained 2 Permit must be installed by a Mason County Certified Installer unless prior written authorization from Mason County is obtained. 4 Proposed development subject to zoning requirements and approval by the planning department staff per Mason County Title 17. 3 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/OR 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 I l• l • n ^1� C y MASON COUNTY l//(/fJ .11.lt COMMUNITY SERVICES AMOUNT RECEIVED ' / RECEIVED BY: W Cl) N v m f, - Public Health(Community Health/Environmental Health) A D C u) 415360 N 6:h Street et-400 or n,WA 94584 ext.400 S W G "',V V i -0( /�n O T 41 S N.G:h Nreet.Shelton,0 2 9858d GS//-l)�// /r Z vi ON-SITE SEWAGE TANK ONLY APPLICATION m m> APPLICANT PHONE m Caro► ,AY nett- a53- 3e1-gl80 Z MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE ^ 2 \\I v ` E CO )1I-1 FOS-W.)00d Ave,. 1�tChlonci, WA gg35 - p t 11vw Ilr� �j 111 m SITE ADDRESS-STREET,CITY,ZIP CODE 10\I 1 Q 20ZZ ��• 12 U w• LaK ids Or. She1 i w A q g5 v 10 S. NAME OF DESIGNER PHONE NAME OF INSTALLER PHONE BY v I'-- Shane Mapies (Maples Excavai-im) So0-y(P3- gLI*ILI TYPE OF WORK(select one) DRINKING WATER SOURCE - IO ❑ NEW CONSTRUCTION/UPGRADES REPAIR/REPLACEMENT 0 PRIVATE INDIVIDUAL WELL 0 PRIVATE TWO-PARTY WELL Z COMPONENT(S)TO BE REPLACED!INSTALLED [PUBLIC WATER SYSTEM I dSEPTIC TANK 0 PUMP TANK 0 RV HOLDING TANK BEDROOMS LOT SIZEILit ❑ OTHER a 0.3U W OTHER DETAILS(select all that apply)1 TANKS)SETBACK CHECKLIST O I� El SURFACING SEWAGE C7 EXISTING FAILURE 0 SHORELINE 100FT+PUBLIC/COMMUNITY WELLS n ' ,,/ X 10 SUB ITTALS �/ L�Y/SOFT+PRIVATE WELLS,SURFACE WATERS,STREAMS,RIVERS d PLOT PLAN(REQUIRED) 0 TANK CROSS SECTION(REQUIRED) LW./ DRINKING WATER SUPPLY LINES ❑ PUMP DETAILS(IF APPLICABLE) 0 WAIVER(S)(IF APPLICABLE) lam' 5FT+PROPERTY/EASEMENT LINES,FOUNDATIONS,FOOTINGS PLOT PLAN CHECKLIST 0 r 0 ❑ PROPERTY LINES AND EASEMENTS 0 EXISTING/PROPOSED STRUCTURES 0 EXISTING/PROPOSED OSS COMPONENTS AND LINES —I ❑ WELLS WITHIN 100FT 0 WATER SUPPLY LINES 0 DRIVEWAYS/PARKING 0 SURFACE WATERS,STREAMS,RIVERS,ETC... I-' ❑ DIRECTION OF SLOPE/CONTOURS 0 PERIMETER/CURTAIN DRAINS ❑ NORTH ARROW 0 SCALE BAR DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.locked gate) NO Rc I 191,1i it WI 11 COm piete after the -NG{ Whenclone- DecOmmion ad ce c-tank and rep tact with new Lao in.61t a.ny -ran , Sct,my, 1ocatlor- OFFICIAL USE ONLY BELOWTHIS LINE UPGRADE/FAILURE SOURCE(for reporting purposes) ❑VOLUNTARY MAINTENANCE/PUMPING 0 BUILDING PERMIT ❑HOME SALE ['COMPLAINT 0 OTHER: yt COMMENTS I CONDITIONS n SEWAGE TANKS MUST BE LISTED UNDER DOH-LIST OF REGISTERED SEWAGE TANKS'. TANKS MUST MEET CURRENT MINIMUM SIZE REQUIREMENTS,EQUIPPED WITH RISERS AND LIDS TO SURFACE.AND INCLUDE AN EFFLUENT FILTER(IF APPLICABLE). RECORD DRAWING AND INSTALLATION REPORT REQUIRED FOR FINAL APPROVAL. INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED/ISSUED BY DATE \\\-Lt I 2 3 4..A-1,,,,,„„vo,$),A (1/2_,t 4.L THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12/7/2015 l � ,l�oc,IC�P �,LY• 30 r` I �Oe C011+mi(S i� i0OVI11fiIP<Y n • pp R0V RASONcDUNryk. 2022 Rer 4L HEALTH M-1060 / FILTRATOR septic tanks Features&Benefits 111 • Strong injection molded polypropylene construction I , • Lightweight plastic construction and ' i inboard lifting lugs allow for easy ( delivery and handling 4frfrn /24 (/ (I41\ interconnect with TWTM risers and pipe ti fr riser solutions Kr clew[ t K t t it of >ar Ile 1[ K K IN MA 111 a I•t • Structurally reinforced access ports eliminate distortion during installation and pump-outs • Reinforced structural ribbing and k. fiberglass bulkheads offer additional strength • Can be installed with 6"to 48" of cover The Infiltrator IM-1060 is a lightweight strong and durable septic tank. • Can be pumped dry during This watertight tank design is offered with Infiltrator's line of custom-fit pump-outs risers and heavy-duty lids. Infiltrator injection molded tanks provide a • Suitable for use as a septic tank, pump revolutionary improvement in plastic septic tank design, offering long-term tank, or rainwater(non-potable)tank exceptional strength and watertightness. • No special water filling requirements Inlet Side are necessary • The tank may be backfilled with suitable TANK CUTAWAY Infiltrator native soil. See installation instructions TW Riser , < « for guidance. System-- -----_. -r --- Partition baffle wall 14' • 1 - r HEAVY DUTY LID CUTAWAY - - Reinforced • 24" structural access port Structural APPROVED V bulkheads (�' 1/ r• � MID-SEAM C AY M • �, ' f41P�tG�{ ��h��ROtiMEIvTAI HEALTH �' lit Reinforced wa i y gasketed connection REr r L Protectingthe Environment with Innovative Wastewater Treatment Solutions (------- INFILTRATOR' eswater technologies IM-1060 General Specifications and Illustrations LIFTING STRAP LIFTING LUG RISER CONNECTION (TYPICAL) (4 TOTAL) / (TYPICAL) The IM-1060 is an injection molded two piece mid-seam :. ______ ________ •��s., � Ilia Yil plastic tank. The IM-1060 injection molded plastic design liplik �� I�j, allows for a mid-seam joint that has precise dimensions A -i�pligi �'��l It I I r,/ re;: A for accepting an engineered EPDM gasket. Infiltrators 1 r,: - °/ o �� / oo�L:� t B gasket design utilizes technology from the water industry �_!I °o� b °o��;,, 62.2 e_ . o o 1q1I 05801 to deliver proven means of maintaining a watertight seal. ,, -� .� i r n ►. tE EXTERIOR ti��u t41 �r1 4. �l� wiDT The two-piece design is permanently fastened using a nick f series of non-corrosive plastic alignment dowels and \-�I !1 ! I�' locking seam clips. The IM-1060 is assembled and sold - through a network of certified Infiltrator distributors. 121.013226)EXTERIOR LENGTH Must be backfilled and installed in accordance with TOP VIEW Infiltrator Water Technologies, Infiltrator IM-Series Septic OUTLET Tank General Installation Instructions and for shallow mot ground water conditions reference the Infiltrator IM-Series Tank Buoyancy Control Guidance- IFII� 1 e 54.7 Please visit www.infiltratorwater.com/images/pdf/ o-- 113891 EximoR ManualsGuides/TANK01.pdf for the latest information. HEIGHT SEAM CLIP mrily (TYPICAL)IM-1060 LIFTING STRAP -..•-,I Working Capacity 1094 gal(4141 L) (TYPICAL) Total Capacity 1287 gal(4872 L) END VIEW Airspace 16.5% Length 127"(3226 mm) 041102) 024[610]ACCESS OPENINGS WITH LOCKING LIDS(2) PVC OR ABS 0 41102)PVC OR Width 62.2"(1580 mm) INLET TEE -10.2 12601 FREEBOARD / ABS OUTLET TEE 'r Length-to-Width Ratio 2.3 to 1 ? INLET ______L6.5% Y l AIR SPACE --___,..OUTLET S Height 54.7"(1389 mm) CPER nb1 1 ODE Liquid Level 44"(1118 mm) 41i 44.0 L FIBERGLASS [11181 FIBERGLASS Invert Drop 3"(76 mm) SUPPORT LIQUID .4—SUPPORT (TYPICAL) DEPTH (TYPICAL) WITH BAFFLE - Fiberglass Supports 2 i WALL WHERE REQUIRED Compartments 1 or 2 � � „Ai Maximum Burial Depth 48"(1219 mm) SIDE VIEW Minimum Burial Depth 6"(152 mm) I Maximum Pipe Diameter 6"(152 mm) TANK TOP P CONTINUOUS Weight 320 lbs(145 kg) HALF GASKET TANK it t-'• , .^ INTERIOR T j SEAM CLIP APPROVE [ 111. t ALIGNMENT NOVir 2022 DOWEL \ TANK BOTTOM �� HALF Po Box?ess PBark Road MASON COUNTY ENVIRONMENTAL HEALT' Oki Saybrook,CT 06475 RET 860-577-7000•Fax 860-577-7001 MID-HEIGHT SEAM SECTION INFILTRATOR' 1-800-221.4436 water technologies www.lnfiltratorswater.com U.S.Patents:4,759,661:5,017,041;5,1513,488;5,338,017;5,401,116;5,401,459;5,511,903;5,716,163;5,588,778;5,839,844 Canadian Patents:1,329,959;2,004,564 Other patents pending.Infiltrator,Equalizer, Quick4,and SideWinder are registered trademarks of Infiltrator Water Technologies.Infiltrator is a registered trademark in France.Infiltrator Water Technologies is a registered trademark In Mexico. Contour,MicroLeaching,PolyTuff,ChamberSpacer,MultlPort,PoslLock,QuickCut,QuickPlay,SnapLock and StralghtLock are trademarks of Infiltrator Water Technologies. PolyLok Is a trademark of PolyLok,Inc.TUF-TITE is a registered trademark of TUF-TITE,INC.Ultra-Rib is a trademark of IPEX Inc. 0 2018 Infiltrator Water Technologies,LLC.Al rights reserved.Punted in U.S.A. IM02 1118 Contact Infiltrator Water Technologies' Technical Services Department for assistance at 1-800-221-4436 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2-022-005g2- Parcel# 5 jCj(j -‘50-0 10 40 Applicant Name ((('pj Am f.ft Subdivision (Name/Div/Block/Lot) Applicant Address 2-1It ECIStwOOCI AVP, tW -I- l.a..;Ke, v i oCk- 1- l Ot 10 City, State, Zip R-t(fhl(.l.fh1,WA 1955)- Installer Name Hop i eS EXCa VGlt1"Ic Site Address 124L W a, i keside Ix. ;l'1(11-61'1 Designer Name J INSTALLATION CHECKLIST ❑ Full System Installation STank(s)Only El Drainfield Only ❑ Repair ❑ Other System Type (i6iV i ill Pretreatment Type >5 ft. from foundation? - - ❑ N/A BYES El NO >50 ft. from wells? - - 1I-`�-fr�(} fez.r- - - ❑ d ❑ >50 ft. from surface water? - .5 l! ( tf'' '� - ❑ ❑ Z , FQ- Cleanout between building and tank? - JAN-O 8[--.- - ❑ EA ❑ U Tank baffles present? - - - - - -; - ❑ Dr/ ❑ a24" access risers over each compartrn�Y?- - - El [ El W Effluent filter installed?- =� • __.1 _ _ _ ❑ Lid ❑ co Septic tank size I( 90 gal Manufacturer 1t\-F11AY7IV' 0 D-box water level and speed levelers used? - - ❑ N/A ❑ YES ❑ NO DO Manifold/D-box accessible from surface?- - El El El m Z Check valves installed? - - El El El 2 Transport Line Size Schedule/Class Bedrooms installed (check one) �❑ 3 El 4 ❑ 5 El 6 ❑Commercial/Other >10 ft. from foundation?- - ❑ N/A ❑ YES ❑ NO CI >100 ft. from wells?- - ❑ ❑ ❑ W >100 ft. from surface water? - - ❑ El El it >10 ft. from potable water lines?- - El El El Z > 5 ft. from property lines and easements?- - Ill El Eld > 30 ft. from downgradient curtain/foundation drains? - - El ❑ El cl Drainfield level and observation ports present - - El El El ❑ Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?- - El ❑ El Pump tank setbacks consistant with septic tank? - - ❑ N/A ❑ YES ❑ NO Y Pump tank size gal Manufacturer l < 24" access riser(s) and accessible from surface. - El El El ~ Alarm or Control Panel Installed? - - ❑ El El a 2 Control Panel equipped with Timer/ ETM /Counter- - - - El El El D - Pump installed in ❑ Bucket or ❑ On Block r ❑ Ot a' Pump Make/Model oats or ❑ Transducer E a Tank draw down in/min ump capacity gpm Squ Height ft Pump on time Pump off time Daily flow set at gpd Updated 812112018 4.111111111111 Mason County OSS Installation Report pg. 2 Parcel# 5I(1Cb '" -10 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - [ YES ID NO If yes, please describe: ❑ Were all components pumped out and properly abandoned per WAC246-272A-0300? - - YES NO RECORD DRAWING This is a permanent record and must be accurate and descriptive enough to re-locate in the need of maintenance activities and future development. Typical Record Drawings contain: Drainfield&manifold orientation&layout,Septic/pump tank location,North arrow,reserve drainfield,existing and proposed buildings,location of wells,waterlines, wells,observation ports,cleanouts,and other maintenance access points. Incomplete Record Drawings may create additional delays in final installatior approval and related permits. rPR " ' /0172023 N� yTY ENv RoieltNSALHEt�H .0gW Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ ENGINEER I certify that I installed the system in accordance with I certify that the system has been installed in accor- the septic design stamped"APPROVED"by Mason dance with the septic design stamped"APPROVED"by County Public Health and that any deviations shown Mason County Public Health and that any deviations here have been cleared/approved by both the designer shown here have been cleared/approved by both and Mason County Public Health and meet all State myself and Mason County Public Health and meet all and Mason County Codes. State and Mason County Codes 1 further certify that all information contained on this I further certify that all information contained on this form and attached Record Drawing is accurate. form and attached Record Drawing is accurate. 01/QcPIa3 Signature of Installer Date sr cunne 41C1e/D Printed Name of Signee MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and Record Drawing on behalf of Mason County Public Heal 4,1,lam! I '17 z3 Sig ture o Environmental Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Upcated 8f2112018 am RECORD DRAWING (continued) L.<eside pr• — — — — — LP9 __T m 1 y 11 / I to` Pecommiss)oneci °leiTU'\k,('C1A) _ O U� loco infilh'A for camp L► 0 A 5' HOU4e it APPROVE �, JAN 1 7 2023 : :,, MASON COUNTY ENVIRONMENTAL HEALTH JBW L oc1- L'.t