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Home My WebLink AboutSWG2022-00582 - SWG Application / Design / As-Built - 11/18/2022 t� 415 N 6TH STREET,SHELTON,WA 98584 eri "Tim MASON COUNTY SHELTON:360-427-9670,EXT 400 COMMUNITY SERVICES BELFAIR:360-275-4467,EXT 400 Building. Environmental Health, ELMA:360-482-5269,EXT 400 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. 4 OFFICIAL USE ONLY MASON COUNTY DATERECENED 1 1. I - ZOZZ c U) COMMUNITYSERVICES AMOUNT RECENED/�tiD RECEIVED BY: /� ', Public Health (Community Health/Environmental Health) _v/ /� /�/�'/'f� < (n 4159360-4 6th Street•400 Shell n,W 98584 ext.400 SWG /� I'� -/ —�� /�z Cl) O �t S N.6th Street�Shelton,WA 98584 '/V/(////7 /v/'(/�- /V/y/�7 li Z fn II ON-SITE SEWAGE TANK ONLY APPLICATION 3 APPLICANT PHONE m C r , 53- v - i ;0 I MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE v ` • oOd Ave,. t�•tChl�nd, W A • • a\ ' M SITE ADDRESS-STREET,CITY,ZIP CODE �O\f 1 % 7-1V '^ I7 vv. LaVeide/ Or- sh�itorl, w A g V lV' NAME OF DESIGNER PHONE NAME OF INSTALLER PHONE v� O P Shane Mapes italopics EXca vati - ' - - Q3- gLi I R. TYPE OF WORK(select one) DRINKING WATER SOURCE VI IG ❑ NEW CONSTRUCTION/UPGRADES REPAIR/REPLACEMENT 0 PRIVATE INDIVIDUAL WELL 0 PRIVATE TWO-PARTY WELL Z I_ COMPONENT(S)TO BE REPLACED!INSTALLED PUBLIC WATER SYSTEM l dSEPTIC TANK 0 PUMP TANK 0 RV HOLDING TANK BEDROOMS LOT SIZE ❑ OTHER a- 0.-j(p W I� OTHER DETAILS(select all that apply) TANKS)SETBACK CHECKLIST O 1 n r ❑ SURFACING SEWAGE G EXISTING FAILURE 0 SHORELINE ,_,I/100FT+PUBLIC/COMMUNITY WELLS SUB ITTALS +/ G SOFT+PRIVATE WELLS,SURFACE WATERS,STREAMS,RIVERS bil PLOT PLAN(REQUIRED) L]rTANK CROSS SECTION(REQUIRED) C-7/10FT+DRINKING WATER SUPPLY LINES ❑ PUMP DETAILS(IF APPLICABLE) 0 WAIVER(S)(IF APPLICABLE) d' 5FT+PROPERTY/EASEMENT LINES,FOUNDATIONS,FOOTINGS r PLOT PLAN CHECKLIST O In ❑ PROPERTY LINES AND EASEMENTS 0 EXISTING/PROPOSED STRUCTURES 0 EXISTING/PROPOSED OSS COMPONENTS AND LINES --4 ❑ WELLS WITHIN 100FT 0 WATER SUPPLY LINES ❑ DRIVEWAYS/PARKING 0 SURFACE WATERS,STREAMS.RIVERS,ETC... —Li I- ❑ DIRECTION OF SLOPE/CONTOURS 0 PERIMETER/CURTAIN DRAINS 0 NORTH ARROW 0 SCALE BAR DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.locked gate) IQ Rc I bU i It vv 1I complete of& ( the -fact ohe�n done- DecorAmire, old SQptic,tank and repIcc wib/ new I Dui e 10-6Ital tan , sct,mt, 10aA ti do- OFFICIAL USE ONLY BELOW THIS LINE UPGRADE/FAILURE SOURCE(for reporting purposes) ❑VOLUNTARY MAINTENANCE/PUMPING ❑BUILDING PERMIT ['HOME SALE ['COMPLAINT ❑OTHER: COMMENTS/CONDITIONS 'R-e f Ck LQ C- +-c r V_-- 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 \\Itl Z 3 ,m 5i t4.k ZL THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12/7/2015 I • 3041 De cornm►cs i 4ti e septic„ntw _ o •� 4 Epp R0V Mqs NOV 21 �� h COONr"fti'VjR� F 2022 Rer NMNrAL HEC ry Lost uat, INFILTRATOR ® I M-1060 septic tanks Features&Benefits 'alt • Strong injection molded polypropylene construction • Lightweight plastic construction and `P..- inboard lifting lugs allow for easy delivery and handling /i �/ /ri'ifl �' ifilis � r/ ▪ Integral heavy-duty green lids that t! \ interconnect with TWT^^ risers and pipe + i riser solutions - •ir Mr MO $ 0 r.' l • Structurally reinforced access ports y eliminate distortion during installation and pump-outs • Reinforced structural ribbing and 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-- -- - Partition '(•`''' baffle wall ,,:1111-11 • HEAVY DUTY LID - ..,.)- CUTAWAY Reinforced - , 24" structural access port • .,:.: % :, Structural A P P R O V E D bulkheads r 4 NOV 21 2022 ,, ,. . MID-SEAM CIMAY R - Reinforced wa4 t tG� `�ROhMENTAI HEALTH ' / gasketed connection RET Ifs I A Protectingthe Environment with Innovative Wastewater Treatment Solutions INFILTRATOR water 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 w=gr t ti r-s- -sr-y�,,� %�-w plastic tank. The IM-1060 injection molded plastic design I = I 1 II / II Ore l Ifs�, A allows for a mid-seam joint that has precise dimensions A f�: �� „ „ r1(Nllro ��.� A for accepting an engineered EPDM gasket. Infiltrators 1 ,. o it I —�, B asket desi n utilizes technolo from the water Indust II b -462.2 g g 9Y rY ►= . ° r�'', 1S80) „ o a �nto deliver proven means of maintaining a watertight seal. r�! �' `, E WIDTH The two-piece design is permanently fastened using a ►riej u=r - �je `°'*r; series of non-corrosive plastic alignment dowels and I. ' .'1� Ik _ V -'�JL4 - .`-- ..+. locking seam clips. The IM-1060 is assembled and sold through a network of certified Infiltrator distributors. 127.0132261 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 ground water conditions reference the Infiltrator IM-Series Tank Buoyancy Control Guidance. — C /411rit s4.7 Please visit www.infiltratorwater.com/images/pdf/ irlir-7 n3691 EXTERIOR ManualsGuides/TANK01.pdf for the latest information. EGHTSEAMCLIP(TYPICAL) IM-1060 `� LIRMI(T STRAP `�� I_��.,._I , Working Capacity 1094 gal(4141 L) (TYPICAL) Total Capacity 1287 gal(4872 L) END VIEW Airspace 16.5% Length 127"(3226 mm) 040021 0 24[6101 ACCESS OPENINGSWT'H LOCK/NG UDS(2) PVC OR ABS 0 4(1021 PVC OR Width 62.2"(1580 mm) INLET TEE r10.2[260)FREEBOARD ABS OUTLET TEE Length-to-Width Ratio 2.3 to 1 �� " . OUTLET Height 54.7"(1389 mm) PER 3.0 I C I 1761 PER CODE Liquid Level 44"(1118 mm) 44.0 -1— , FIBERGLASS FIBERGLASS_, [MC Invert Drop 3"(76 mm) LIQUID _—SUPPORT (TVPPK ) DEPTH • (TYPICAL) WITH BAFFLE Fiberglass Supports 2 EQUI RE ED Compartments 1 or 2 Maximum Burial Depth 48"(1219 mm) SIDE VIEW Minimum Burial Depth 6"(152 mm) 1 Maximum Pipe Diameter 6"(152 mm) • TANK TOP CONTINUOUS Weight 320 lbs(145 kg) HALF 0 GASKET TANK to INTERIOR .il'I j- SEAM CLIP APPROVED • LIGNMENT (------ 4 NOV 2 1 2022 DOWEL TANK BOTTOM HALF P.O.Boxs768�Road MASON COUNTY ENVIRONMENTAL HEALTH! Old Saybrook,CT 06475 INFILTRATOR 860-577-7000•Fax 860-577-7001 RET MID-HEIGHT SEAM SECTION 1-800-221-4436 water technologies www•Infiftratorswater.com U.S.Patents:4,759,661;5,017.041;5,156,488;5,336,017;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, Ouick4,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,MuttlPort,PosiLock,QulekCut,OulckPlay,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.Uttra-Rib is a trademark of IPEX Inc. 02016Infittrator Water Technologies,LLC.Al rights reserved.Printed in U.S.A. IM02 1116 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 2.022-005 1 Parcel # 5 j aO i -` ?-0 10.40 Applicant Name CAA O AI'Y1fft Subdivision (Name/Div/Block/Lot) Applicant Address 11I9 ECIStvvUGC1 Ave, LOst i c(Y I Pock- 2 tot 90 City, State, Zip R-1ChIatld,1A1A 111 5)- Installer Name H6119(t°S iXGa O-h( Site Address 124-KP Iry> i_ake'irae I)'. 6;hC1110,Designer Name INSTALLATION CHECKLIST ❑ Full System Installation STank(s)Only ❑ Drainfield Only ❑ Repair ❑ Other System Type (-Ink'all Pretreatment Type >5 ft. from foundation? - - ❑ N/A EYES ❑ NO >50 ft. from wells? -f 7 - - Ill II Z >50 ft. from surface water? - - - - - F4) - -- CI [TI ❑ H Cleanout between building and tank? e sev ,4 . -- - ❑ 71 CI U Tank baffles present? - - - - - I 11 ❑ (,- - - e CId 24" access risers over each compart wit?- - - ❑ L1 ❑ W Effluent filter installed?- ----.i--- ❑ Li" ❑ co Septic tank size I G') gal Manufacturer 1E1f1lt((t Y 9 D-box water level and speed levelers used? - - ❑ N/A ElYES ❑ NO OO Manifold/D-box accessible from surface?- - El El El mZ Check valves installed? - - ❑ ❑ ❑ 0< 2 Transport Line Size Schedule/Class Bedrooms installed (check one) 10 3 ❑4 ❑ 5 1116 El Commercial/Other >10 ft. from foundation?- - ❑ N/A ❑ YES ❑ NO O >100 ft. from wells?- - ❑ ❑ ❑ W >100 ft. from surface water? - - ❑ ❑ CI LL >10 ft. from potable water lines?- - ❑ ❑ ❑ Z a > 5 ft. from property lines and easements?- - CI CI cc > 30 ft. from downgradient curtain/foundation drains? - - ❑ ❑ ❑ Drainfield level and observation ports present - - ❑ ❑ ❑ ❑ Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ ❑ ❑ Pump tank setbacks consistant with septic tank? - - ❑ N/A ❑ YES ❑ NO • Pump tank size gal Manufacturer Q24" access riser(s) and accessible from surface. - ❑ ❑ ❑ a Alarm or Control Panel Installed? - - ❑ CI CI E Control Panel equipped with Timer/ETM /Counter- - - - ❑ ❑ ❑ - Pump installed in ❑ Bucket or ❑ On Block r El Ot d• Pump Make/Model loats or ❑ Transducer CL a Tank draw down in/min ump capacity gpm Squ Height ft Pump on time Pump off time Daily flow set at gpd Undated 82212018 • Mason County OSS Installation Report pg. 2 Parcel# 51c10I - .N "010-10 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - [(YES [] No If yes, please describe: Were all components pumped out and properly abandoned per WAC246-272A-0300? - - BYES 0 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 installation approval and related permits. rPR " 'D BAN17202, �4�y'Y ENVIRONti1ENTALNEAtSH 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 I 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. Of/QUO-3 Signature of Installer Date Sncune M iCS Printed Name of Signee MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and Record Drawing on behalf of Mason County Public Heal a 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 Updated 8/21/2018 RECORD DRAWING (continued) LaiKesidt Dr. cog, T pe comrn issi o neci 011 T \Ic,oak) _ a a� cotpo inhtb'ator camp L, 0i 5' House I=� PPROVE .IAN 1 7 2023 bp MASON COUNTY ENVIRONMENTAL HEALTH JBW i05' L OSt- LAG