HomeMy WebLinkAboutSWG2023-00024 - SWG Application / Design - 1/31/2023 eligNI MASON COUNTY 415 N 6TH STREET, 0427-9SHELTON,WA 98 400
584
SHELTON: , 42 ,EXT584
BELFAIR:360-275-4467,EXT 400
f ELMA:360-482-5269,EXT 400
Public Health & Human Services FAX:360-427-7787
On-Site Sewage System Permit: SWG2023-00024
APPLICANT NORRIS NICOLE M Phone:
Address: P 0 BOX 3137 SHELTON, WA 98584
OWNER NORRIS NICOLE M Phone:
Address: P 0 BOX 3137 SHELTON, WA 98584
SEPTIC DESIGNER Paysse, Alex L Phone:
Address: 3083 E Mason Benson Rd GRAPEVIEW, WA 98546
Site Address: 101 E Scarlet Rd
Primary Parcel Number: 320012100000
Permit Description: New SFR -3BR Pressure w/class b waiver
Permit Submitted Date: 01/31/2023
Permit Issued Date: 02/16/2023
Issued By: Jeff Wilmoth
Current Permit Fees Paid: $780.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 02/14/2026 (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
4 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/onsiteloss-inspection-request.php or call:
360-427-9670, extension 400.
OFFICIAL USE ONLY
DATE RECEIVED. V 1/�. �74., � D
MASON COUNTY �V/� _
OW COMMUNITY SERVICES AMI TRIES - RECEI CO m
Public Health(Community Health/Environmental Health) CO
415 N.6th 70,Street
.40 SOf helton.
0 WA rat.400 SWG A N�% — 40C�ZA Cl) 2
615 N.6th Street•Shelton.WA 98584 v Q
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ON-SITE SEWAGE SYSTEM APPLICATION
m n
APPLICANT PHONE mr
NICOLE NORRIS c
MAILING ADDRESS-STREET,CITY,STATE.ZIP CODE
PO BOX 3137 SHELTON WA 98584 03
SITE ADDRESS-STREET,CITY,ZIP CODE SHELTON WA 98584 (`'
101 E SCARLET ROAD
NAME OF DESIGNER PHONE I N.)ALEX L. PAYSSE 360-426-1803
PHONE I C)NAME OF INSTALLER
TBD I o
PERMIT TYPE(select one) DRINKING WATER SOURCE
kir RESIDENTIAL OSS COMMUNITY OSS COMMERCIAL OSS 17 PRIVATE INDIVIDUAL WELL ff PRIVATE TWO-PARTY WELL Z I
rr PUBLIC WATER SYSTEM 1
TYPE OF WORK(select one) I
t N
it NEW CONSTRUCTION/UPGRADES n-REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) 0 TABLE IX REPAIR
0 SURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINE COSUBMITTALS r �
MrDESIGN FORM(REQUIRED) oaf SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE
V WAIVER(S)(IF APPLICABLE) 3 2.0 ACRE 0 o
DIRECTIONS TO SITE AND SITE CONDITIONS'(ex.locked gate)
NORTH HWY 3. RIGHT ON AGATE ROAD. JUST PASSED PIONEER SCHOOL TURN o
LEFT ON SCARLET RD. FOLLOW A FEW HUNDRED FEET TO NEW DRIVEWAY ON r o
LEFT. SITE ADDRESS POSTED ON GATE. FOLLOW DRIVEWAY THRU WOODS TO o
SITE. PARK ON TOP AND WALK DOWN TO TEST HOLE AREA. SEE SITE PLAN. I o
SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. O
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE/FAILURE SOURCE(for reporting purposes)
0 VOLUNTARY 0 MAINTENANCE/PUMPING 0 BUILDING PERMIT ❑HOME SALE ['COMPLAINT ❑OTHER.
COMMENTS/CONDITIONS
INSPECTOR SOIL LOGS
.30f i `2L .1, ) 6.4,(1 11 l[ 1-- N
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By
RECORD DRAWING AND INSTALLATION REPORT
SOIL CODES: REQUIRED FOR FINAL APPROVAL.
V=VERY G=GRAVELLY S=SAND L=LOAM Si=SILT C=CLAY E=EXTREMELY R=ROOTS
th
APP AT ION APPROVED/SSUED BY DATE
IN TOR SIGNATURE .��jr�-�.x DATE APPLICATION EXPIRATION DATE r '
L. 1 tili:LA 4444 ...-'. 14 — ?4•49
T Fs AY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE
REVISED 12I712015
` DESIGN FORM—PAGE ONE Assessor's Parcel Number: 3 2 0 0 1 — 2 1 — 0 0 0 0 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 paper size: 11"X 17"
' ' 'PARCEL IDENTIFICATION
`� — i2 Designer's Name: ALEX L. PAYSSE
Permit Number: SWG v�.� ( g
NICOLE NORRIS Desi ner's Phone Number: 360-426-1803
Applicant's Name: g
Mailing Address:
PO BOX 3137 Designer's Address: 3083 E MASON BENSON RD
SHELTON WA 98584 GRAPEVIEW WA 98546
City State Zip City State Zip
DESIGN,PAc TERS'
Treatment Device
Cl Glendon Biofilter 0 Sand Filter ❑Mound 0 Sand Lined Drainfield 0 Recirculating Filter,Type:
❑Aerobic Unit Make/Model 0 Disinfection Unit Make/Model Other:
Drainfield Type
❑Gravity lif Pressure Its Trench 0 Bed 0 Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 3 Schedule/Class SCH.40
Daily Flow:Operating Capacity 270 gpd Length 50 ft
Daily Flow:Design Flow 360 gpd Diameter 1.25 in
Septic Tank Capacity(working) 1500 gal Number 4
Receiving Soil Type(1-6) 4 Separation 10 ft
Receiving Soil Appl.Rate 0.6 gpd/ft2 Orifices
Required Primary Area 600 ft2 Total Number of Orifices 52
Designed Primary Area 600 ft2 Diameter 3/16 in
Designed Reserve Area 600 ft2 Spacing 48 in
Trench/Bed Width 3 ft Manifold
Trench/Bed Length 200 ft Schedule/Class SCH.40
Elevation Measurements Length 30 ft
Original Drainfield Area Slope 5 % Diameter 1.25 in
New Slope,If Altered 5 % Preferred manifold configuration used? GliYes 0 No
Depth of Excavation Up-slope 12 in Transport Pipe
from Original Grade Down-slope 10 in Schedule/Class SCH.40
Designed Vertical Separation 12+ in Length <100 ft
Gravelless Chambers Required? 0 Yes Id No 0 Optional Diameter 2 in
Pump Required? 56 Yes 0 No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day 6
Diff.in Elevation Between Pump&Uppermost Orifice 5 ft Dose quantity 60 gal
Drainfield Squirt Height/Selected Residual(head) 2 ft Chamber Capacity(flood) 1500 gal
Pump controls: Please check those required.
Uppermost Orifice at Higher 0 Lower than Pump Shutoff
Capacity @ Total Pressure Head 30.7 gpm 5fTimer I t I/Event Counter
Calculated Total Pressure Head
16 ft If Time urPoP • I u i.� 4 HRS
Comments
FEB 15 2023 , '
MASON COUNTY ENVIRONMENTAL HEALTH
Jf3
' DESIGN FORM—PAGE TWO Assessor's Parcel Number: 3 2 0 0 1 — 2 1 -- 0 0 0 0 0
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
61 Test hole locations g Drainfield orientation and layout Reference depth from original grade:
g Soil logs g Trench/bed dimensions and i Septic tank
g Property lines critical distances within layout g Drainfield cover
box locationslv/V Box ae
g Existing and proposed wells D- Reference depth from original grade
within 100 ft of property g Septic tank/pump chamber and restrictive strata:
EiZI Measurements to cuts,banks,and locations 21 Laterals,trench/bed,top and
surface water and critical areas g Observation port location bottom
0 Location and orientation of g Clean-out location 0 Curtain drain collector
curtain drain and all absorption l Manifold placement 0 Sand augmentation
components Gd Orifice placement Other cross-section detail:
g Location and dimension of g Lateral placement with distance g Observation ports/clean-outs
primary system and reserve area to edge of bed Other Information
I0 Buildings Iii Audible/visual alarm referenced Yes No
iii Direction of slope indicator 54 Scale of drawing shown on scale g 0 Design staked out
lid Waterlines b ❑ g Recorded Notices attached
g Roads,easements,driveways, R O V E g ❑ Waiver(s)attached
parking g ❑ Pump curve attached
g North arrow and scale drawing
-, FEB 15 2023 ❑ I'Evaluation of failure
shown on scale bar L$S: N COUNTY ENVIRONMENTAL HEALTH Non-residential justification
J B W ❑ t Waste strength
0 g Flow
DESIGN APPROVAL
The undersigned designer must be notified by installer at time of installation g Yes 0 No
Signature of Oesigner 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-si egulations:
Envir nme if'j ealth Specialist Date
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
✓ The design is stamped"Approved"by Mason County Public Health. • 0)--- I c`2 CO
/ 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
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I AN ASBUILTI INSTALL SIGNOFF FEE WILL
•y,,.s BE CHARGED AT TIME OF INSTALLATION
CUSTOMER: NICOLE NORRIS TEST HOLE I: TEST HOLE 2: TEST HOLE 3:
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PIONEER DIGGING, INC. PARCEL# 32001-21-00000 30+ 1 0-2 ,CO1 IA`W' ,02(
SEPTIC DESIGNS ADDRFSS: 101 E SCARLET RD ROOTS TO 30 ROOTS TO 26 ROOIS 10 26
RATS ORS SURVEYS.FIELD
A ASURE REFERENCESINTLUDE'.ASSIGN INTENDED
EDYPROVIDED
3083 E MASON BENSON RD. GRAPEVIEW,WA 98540 DESIGNER: ALEX L.PAYSSE DISCLAIMER:
SUfNES ISN T SURVEY.
RENCO I UOE DESIGNINfENOEDFOR PROVIDED
PUURPOSESNTOILY T RENEW S yCNERELO RESPONSIBLE FOR SETBACKS UNRELATED R
OFFICE 36l}4261803 FAX 36U 427 2353 SHEET: SITE PLAN SCALE: 1"=100' SEPTiC COI.wONENTS.
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O AN ASBUILTI INSTALL SIGNOFF FEE WILL
BE CHARGED AT TIME OF INSTALLATION /%
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RISER OR CLEAN SANDY CLEANOVT
VALVE BOX �� � FILL MATERIAL
FINAL
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ADJUST TO .1 ' li / CHECK ORIGINALI
VALVES :._.._.._.._.._.._..:
# OF LATS \�//. , .-.:�:�:�'i:•- .•• -;-•-.._..._.••
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16" ORIFICES 0 :00 I
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PIONEER DIC�INC, INC. SL
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PARCEL#:3200121-00000 30+Gf 1120 26+.�tOrDi.OAil> 26+.�tOniCOMP
SEPTIC DESIGNS ADDRESS: 101 E SCARLET RD ROOI S'10 30 ROOTS l0 26 ROOT S 10 26
DISCLAIMER THIS IS NOT A SURVEY.REFERENCES INCLUDE'.DESIGN INTENDED
TCOUN,Y PROVIDED
3083 E.MASON BENSON RD. GRAPEVIEW,WA 98546 DESIGNER: ALEX L.PAYSSE PUTS OR RTHISSURVEYS.FIELD MEASUREMENTS AND COUNTY GIS DESIGN IN FOR SEPTIC
PURPOSES ONLY PROPOSED DEVELOPMENT MAY BE SUBJECT TO OTNER
OFFICE-360-426-1803 FAX-360-427-2353 SHEET: DF DETAIL SCALE 1"=10' OEPMTMLT,AGENCY REVIEW DESIGNER NOT RESPONSIBLE FOR SETBACKS UNRELATED TO,
SEPTIC COMPONENTS
24"RIBBED RISERS W/BOLT ON WATER-TIGHT LIDS
USE RISER LID ADAPTERS WITH NO GASKET LIDS
CLEANOU?- A
FINISHED GRADE f i
4 WATER-TIGHT
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WATER-TIGHT .17
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JOINTS — FILTER
1500 GALLON WATER77GHT •: i•�1,
c CONCRETESEP77C TANK
TANKS MUST BE e'� � )• ;•• �.
ON STATE DOH 1�i • 1
APPROVED LIST ;gyp► •��
OF SEWAGE �' f•. >s i . el �1
TANKS �. ,I
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Jr. ALEI LOUR WSW
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PUMP TANKS AQVAWORKS
OVER 1000 GAL. b>ri•i s
REQUIRES TWO CONTROL PANEL
W/TIMER EVENT COUNTER 4• C7RICALWORKDONE 24"RIBBED RISERS
ELE
ACCESS RISERS &HOUR METER BY LICENSED ELECTRICIAN W/WATER TIGHT LIDS
TO GRADE —— 11
a FINISHED GRADE
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ELECTRICAL CONDUIT 1,
-AIM.� I1'1 TRANSPORT LINE
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INLET n UNION& BALL VALVE
1500 GALLON/NATER77GHT
'' R .Ol' V E • CRETE AT TANK
;- (28 GAL./IN.) '
WATER-TIG , 5 ';; "
)OI 1 2023
MASON COU ' ENVIRONMENTAL HEALTIiRESSURE TRANSDUCER CHECK VALVE
(OR FLOATS)
USE TANKS FITTED ..J : A �r
W/CAST IN WATER r USE
TIGHT FITTINGS FORRUBBERRU GROMETS FOR
I NLET/OUTLES AND - PUMP BUCKET: TRANSPORT LINE
CAST IN RISER BUCKET HEIGHT MUST BE . AND ELECTRICAL
ADAPTERS TO AT LEAST HEIGHT OF PUMP !� • ON RISERS. MAKE
ENSURE WATER a , 4 SURE ALL HOLES
TIGHTNESS ARE WATER-TIGHT
CUSTOMER: NICOLE NORRIS SCALE:NA �
PIONEER DIGGING INC. ARCELSS 32001-21-00000C RD INSTALL TANKS ON ORIGINAL OR
SEPTIC DESIGNS COMPACTED LEVEL SOILS. RUN CROSS
CONNECTIONS INTO ORIGINAL SOILS TO
3083 E MASON BENSON RD. GRAPEVIEW,WA 98546 DESIGNER: ALEX L.PAYSSE AVOID SETTLING.
OFFICE-360-426-1803 FAX-360-427-2353 SHEET: TANKS SCALE NA
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Pump Specifications 'If I
280 Series 1/2 hp w
Submersible Effluent Pump
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LATERAL LATERAL FEEDER TOTAL ORIFICE ORIFICE DIST.TO TOTAL TOTAL
ORIFICE
LATERAL# LENGTH PIPE SIZE LENGTH LENGTH SIZE(inch) DISCHARGE SPACING 1ST ORIFICE ORIFICES HEAD
(feet) (inches) (feet) (feet) RATE(gpm) (feet) (inches) (feet)
1 50 1.25 3 53 3/16" 0.59 4 12 13 0.47
2 50 1.25 10 60 3/16" 0.59 4 12 13 0.54
3 50 1.25 20 70 3/16" 0.59 4 12 13 0.62
4 50 1.25 30 80 3/16" 0.59 4 12 13 0.71
DRAINFIELD HEAD(feet) 2.35
100'TRANSPORT LINE HEAD(feet) 1.62
ELEVATION CHANGE(feet) 5
RESIDUAL/SQUIRT(feet) 2
EXTRA LOSS/FITTINGS(feet)I 5
TOTAL DYNAMIC HEAD(feet) 15.97
TOTAL GALLONS PER MINUTE 30.68
PPROVEC
FEB 15
CUSTOMER: NICOLE NORRIS f
COUNTY 2023
PIONEER DIGGING, INC. PARCEL#:32001-21-00000 EN�iRON�4ENTAL HEALTH
SEPTIC DESIGNS ADDR.FSS: 101E SCARLET RD JB W
3083 E MASON BENSON RD. GRAPEVIEW,WA 98540 DESIGNER: ALEX L PAYSSE
OFFICE-36(}426-1803 FAX-360-427-2353 SHEET: CALCS SCALE NA
Installation & System Notes
1. Installer must contact designer for final inspection of the installation prior to cover. All components, including tanks, lids,
transport line, drainfield, and water lines must be open for inspection. A$300.00 fee will be charged for time involved with the
inspection of the installation and creation of the record drawing. The designer reserves the right to charge additional fees if
multiple visits are needed due to installation errors or inaccessible components.
2.This septic design must be installed by a certified installer with the local health department. All components shall be installed
according to state, county, and manufacturer requirements. For Homeowner Installs,the owner must get approval from the
designer and local health department prior to attempting installation.
3. Designer is not a surveyor. Installer must familiarize themselves with property line locations prior to installation. Any
confusion or conflicts with line locations should be reported to the property owner. A licensed surveyor may be necessary prior
to installation to confirm all line locations. Any discrepancies found must be reported to the designer immediately.
4. Drainfield area may only be cleared by a licensed installer familiar with sensitive drainfield area preservation. The builder, lot
developer, or property owner shall not clear the drainfield area. Any clearing required for drainfield installation shall not
remove or disturb any top soil in Primary and Reserve areas. Removal or disturbance to drainfield soils could render design
void.
5. The property owner and installer are responsible for locating all underground utilities (ex.water,gas,electric) prior to
installation. Any utility locations shown within design drawings are likely approximate and may not be exact.
6. All proposed tanks must be installed on original soils or compacted gravels. Extend all tank connection lines out onto original
soil to avoid settling issues. Risers and lids must be brought to finished grade and left accessible for future operations and
maintenance. Component manufacturers (ex. ATU,Glendons,) may have other requirements not listed within this design.
7. All electrical wiring shall be done by a licensed electrician or homeowner(if allowed) and must be permitted through Labor
and Industries.
8. The proposed septic system should be installed in dry weather conditions. Any failed attempts at installation during wet
weather conditions may render this design void.
9. Maintain 10ft to waterlines with all septic components. If less than 10ft is required, sleeving in sch. 40 pvc is required. If
sewage transport lines and waterlines must cross,waterline must be 18" above sewage line with one of the lines sleeved in sch.
40 pvc loft in each direction of crossing.
10.This design may include waiver applications with specific mitigation measures pertaining to installation,operation and
maintenance of the proposed components.
11. Stormwater runoff,footing drains, roof drains must be diverted away from any septic system components. No curtain,
foundation, perimeter drains shall be installed 30ft downslope and 10ft upslope of drainfield areas.
12.This design is site specific and intended to meet state and county requirements that are related to the system components
being proposed. Any placement of proposed buildings, proposed wells or other non-related items on these drawings may or
may not meet other requirements.
13. All onsite septic systems require regular maintenance to verify satisfactory operation. The system owner/operator is
responsible for the continuous operation and maintenance of the system per WAC 246-272A. For operation and maintenance
information, refer to Mason County Public Health Homeowner's Manual,which should be received after installation approval.
14.System owner should be cautious of landscaping around septic components. Root intrusion
can cause premature failure of the drainfield area. In ditp,psns°direr • be kept ;v.::,
away from lids and other septic maintenance points. . � t.
FEB 15 2023 let
,.
MASON COUNTYEN!�!RON""ENTALI EALTH :'e ;mot ' ' rig
CUSTOMER: NICOLRIS10
PIONEER DIGGING, INC. PARCEL#:32001-21-00000 f- • ALEX LOUR PA. `\
SEPTIC DESIGNS ADDRESS: 101 E SCARLET RD - . }
S ,J 4.3
1083 E MASON BENSON RD. GRAPEVIEW,WA 98546 DESIGNER: ALEX L.PAYSSE
OFFICE-36(-426-1803 FAX-36(1-427-2353 SHEET: NOTES SCALE NA