HomeMy WebLinkAboutSWG2023-00014 - SWG Application / Design - 1/24/2023 MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584
SHELTON:360-427-9670,EXT 400
ea:
BELFAIR:360-275-4467,EXT 400
Public Health & Human Services ELMA:360-482-5269,EXT 400
FAX:360-427-7787
On-Site Sewage System Permit: SWG2023-00014
APPLICANT DOVEC PROPERTIES & CONTRACTING Phone:
Address: P 0 BOX 1933 SHELTON, WA 98584
OWNER DOVEC PROPERTIES & CONTRACTING Phone:
LL
Address: P 0 BOX 1933 SHELTON, WA 98584
SEPTIC INSTALLER TJ Goos-TJ's Excavating Phone: 360-490-0217
Address: 150 E MARISA PL SHELTON, WA 98584
SEWAGE DESIGNER DALE TAHJA-Septic Designer Phone: 360-426-5940
Address: 2450 W DEEGAN ROAD WEST SHELTON, WA 98584
Site Address: N Lake Cushman Rd
Primary Parcel Number: 422103290011
Permit Description: New 5BR Pressure
Permit Submitted Date: 01/24/2023
Permit Issued Date: 02/08/2023
Issued By: Jeff Wilmoth
Current Permit Fees Paid: $780.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 02/08/2026 (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 Drainfield 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/onsiteloss-inspection-request.php or call:
360-427-9670, extension 400.
OFFICIAL USE ONLY —
MASON COUNTY DATE RECEIVED: —�� _
COMMUNITY SERVICESc=_Doca3
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AM�RECE RECEIVED BY: COm CA
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Public Health(Community Health/Environmental Health)
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360-427-9670,ext.400 or 360-27SL167,ea.400
476 H.t66 Street-Shelton,WA 98584 S V\l G �-.�r )^ ,i^ -
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ON-SITE SEWAGE SYSTEM APPLICATION a D
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APPLICANT PHONE m m
Dove Properties & Construction LLC (360) 507-3328 z
MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE 3
P.O. Box 1933 Shelton WA 98584 co
SITE ADDRESS-STREET,CITY,ZIP CODE
Lake Cushman Rd. Hoodsport WA 98548 14'
NAME OF DESIGNER PHONE I N
Dale L. Tahja (360) 426-5940
NAME OF INSTALLER PHONE v I N
T.J. Goos (360) 490-0217
PERMIT TYPE(select one) DRINKING WATER SOURCE
Ivl C RESIDENTIAL OSS COMMUNITY OSS P_ :COMMERCIAL OSS 5.'PRIVATE INDIVIDUAL WELL PRIVATE TWO-PARTY WELL Z I c)
TYPE OF WORK(select one) 7 PUBLIC WATER SYSTEM
I
PrNEW CONSTRUCTION/UPGRADES ffREPAIR I REPLACEMENT OTHER DETAILS(select all that apply) 0 TABLE IX REPAIR I CA)
SUBMITTALS � 0 SURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINE
g DESIGN FORM(REQUIRED) giSEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE O I IV
57WAIVER(S)(IF APPLICABLE) 5 2.4 acres Z
DIRECTIONS TO SITE AND SITE CONDITIONS:(ex locked gate)
From Hoodsport, go up Lake Cushman Rd., property just past Realtor Office and before the I 0
Store on the right.
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SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS.
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE I FAILURE SOURCE(for reporting purposes) et
0 VOLUNTARY 0 MAINTENANCE/PUMPING 0 BUILDING PERMIT ['HOME SALE ['COMPLAINT 0 OTHER: aup i
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INSPECTOR SOIL LOGS COMMENTS/CONDITIONS
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RECORD DRAWING AND INSTALLATION REPO
SOIL CODES: l '
V=VERY G=GRAVELLY S=SAND L=LOAM Si=SILT C=CLAY E=EXTREMELY R=ROOTS REQUIRED FOR FINAL APPROVAL.
INSPECT R SIGNATURE DATE APPLICATION EXPIRATION DATE AP (CATION APPROVED/ISSUED BY DATE
4 („tc,,,-1-, 2._2_,T3
THI F MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12/72015
I
DESIGN FORM—PAGE ONE Assessor's Parcel Number: 4 2 2 1 0 — 3 2 — 9 0 0 1 1
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 Al
Permit Number: SWG U .OcON Designer's Name: Dale Tahja
Applicant's Name: Dove Properties&Contracting LLC Designer's Phone Number: (360)426-5940
Mailing Address: P.O. Box 1933 Designer's Address: 2450 W Deegan Rd W
Shelton WA 98584 Shelton WA 98584
City State Zip City State Zp
DESIGN 'ARAMETERS
Treatment Device
❑Glendon Biofilter 0 Sand Filter 0 Mound 0 Sand Lined Drainfield 0 Recirculating Filter,Type:
❑Aerobic Unit Make/Model Cl Disinfection Unit Make/Model Other: N/A
Drainfield Type
❑ Gravity lI Pressure NCTrench 0 Bed 0 Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 5 Schedule/Class Sch.40
Daily Flow:Operating Capacity 450 gpd Length 67 ft
Daily Flow:Design Flow 600 gpd Diameter 1.25 in
Septic Tank Capacity(working) 1,500 gal Number 5
Receiving Soil Type(1-6) 4 Separation 10 ft
Receiving Soil Appl.Rate 0.6 gpd/ft2 Orifices
Required Primary Area 1,000 ft2 Total Number of Orifices 85
Designed Primary Area 1,000 ft2 Diameter 1/8 in
Designed Reserve Area 1,000 ft2 Spacing 48 in
Trench/Bed Width 3 ft Manifold
Trench/Bed Length 335 ft Schedule/Class Sch.40
Elevation Measurements Length 105 ft
Original Drainfield Area Slope 0 % Diameter 1.25 in
New Slope,If Altered 0 % Preferred manifold configuration used? 0 Yes 6 'No
Depth of Excavation Up-slope 16 in Transport Pipe
from Original Grade Down slope 16 in Schedule/Class Sch.40
Designed Vertical Separation 24 in Length 60 ft
Gravelless Chambers Required? 0 Yes 0 No NS Optional Diameter 2 in
Pump Required? 5t Yes 0 No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day 2
Diff. in Elevation Between Pump&Uppermost Orifice 5 ft Dose quantity 225 gal
Drainfield Squirt Height/Selected Residual(head) 6 ft Chamber Capacity(flood) 1,200 gal
Uppermost Orifice FiHigher 0 Lower than Pump Shutoff Pump controls:Please check those required.
Capacity @ Total Pressure Head 40 gpm Ii 'Timer It�Elapse Meter 1, 'Event Counter
Calculated Total Pressure Head 15_____ ft if Tis u P?r i nP oft 11 hrs 54.4 min.
Comments
<< FEB 0 8 2023 iitii
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ç\\�'` ( 'c W cLti 1cIl i\ ( MASON COUNTY ENVIRONMENTAL HEALTH
JBW
' DESIGN FORM—PAGE TWO Assessor's Parcel Number:4 2 2 1 0 — 3 2 -- 9 0 0 1 1
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
Fti Test hole locations lig Drainfield orientation and layout Reference depth from original grade:
g Soil logs g Trench/bed dimensions and g Septic tank
1 Property lines critical distances within layout 2f Drainfield cover
WI Existing and proposed wells g D-Box/Valve box locations Reference depth from original grade
within 100 ft of property g Septic tank/pump chamber and restrictive strata:
lil Measurements to cuts, banks, and locations 6' Laterals,trench bed,top and
surface water and critical areas g Observation port location bottom
g Location and orientation of 121 Clean-out location 0 Curtain drain collector
curtain drain and all absorption lig Manifold placement 0 Sand augmentation
components
g Orifice placement Other cross-section detail:
Location and dimension of g Lateral placement with distance g Observation ports/clean-outs
primary system and reserve area to edge of bed
g Buildings Other Information
g Audible/visual alarm referenced Yes No
Direction of slope indicator 0 Scale of drawing shown on scale d 0 Design staked out
g Waterlines 0 0 Recorded Notices attached
� Roads,easements,driveways,
y111‘ ROVE 1' ❑ ❑ Waiver(s)attached
parking `.,^ 2( ❑ Pump curve attached
g North arrow and scale drawing -a 4 FEB 0 8 2023 +A '`"` ❑ ❑ Evaluation of failure
shown on scale bar ' ,;.ON COUNTY ENVIRONMENTAL HEALTH Non-residential justification
JBW 0 0 Waste strength
0 ❑ Flow
DESIGN APPROVAL
The undersigned designer st be notified i er at time of installation @1 Yes 0 No
\--W —" 1-\ .-
1 Signature of esigner Date <c.0 •
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Theundersigned this design on behalf of Mason County Public Health and dete nQ'Z '
has reviewedtto
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compliance with state and local on- ' regulations: 'c Is'�O .t Q It',, !
E it tal Health Spec alist Date � •
`'�`( Q L:
Sa 1:1'C
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CON ,� w
✓ The design is stamped"Approved" by Mason County Public Health. �s11;
✓ , _ � _ D
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.
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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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FEB 0 8 2023
'ASON COUNTY ENVIRONMENTAL HEALTH f
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290-SERIES
3/4 hp Submerseile Effluent/Sump
The Liberty 290 series provides a coat effective"mid- porfiDrmance - 290-Series
range"pump for waste water systems,liquid
waste transfer and commercial heavy-duty sump pump 1°' - -.-,—.-.--,.._. --1s
applications that requirehigher head or more flow. '°•
Ad around unique" 4° ' 12
Design Liberty's ll -Body casting, 35 „ - , . - o.
the 290-Series will provide years of reliable performance. l
AUModek Featured
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a Semi-Open impeller permitting passage of solids is, - - ' 4- NihN
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•416 stainless steel rotor shaft a. _ ,
•Permanently lubricated upper and lower ball bearing o.- - • °
•Epoxy powder coat finish ° /0 20 so »orbs '0 7° �° BD
•All fasteners-corroslon-reslstant stainless steel f OS iI .1 t, Rio ter ► SOB tea+,
•1 W'Discharge um P—Minute
•Stainless steel bottom screen-easily removable Dimensional
•Maximum fluid temperature:140"F. Weight 31 lbs.
•29043eriesCordLengthsHeigh 13"
Model 10' 2614) 35' 1 501.8l Major Wide 10"(model 297)
200 Standard Optional .Optional firm Sump.E eneetais:
�l Standard Optional Optional Optional Model 291,293...14•
293 Standard Optional Optional N/A Model 297 VMF...117 •--•
297 Standard Optional WA N/A Ply switch Model 291,293 -Model 297
10'cord length standard on ell models.Roroptional settings WM
Add"-2.'3 or-ri"sufg r to model numbs: ,
Example:for model 290 with S6'cord.Order 290-3 Um on fevvet 13" 9 S"
Morn off level r 4.0"
Motor Specification
'/e hp 60 Hz 3450 RPM The Model 293 failures a fully adjustable wide-angle float.
Oil filled,thermallyprotectedbnents can be node eery t y tethering the boat
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pptivpi4.,,,,z pipe or Mho'mounting point 1r l float model
115 V.Models 10.4 amps °-. FEB 0 8 2023
208/230 V.Models 5.3 amps �'
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. . ' Modell 290 .�•• Model 291 /'�r Model 293 idtode1297
;��_ Manual, - - Wide angle I _:`�- Wide angle WY F-Series(
! ino switch i l# float switch `-- 1 1,�.f float switch i Vertical(nag-
i Ai, with q� 1 ; with series •U!�I , relic float for
iiiiiliao. .aral!
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sump
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ttasoleoescrisN> to chime without roll.
Liberty Pumps•7o000Apple Wee Avenue•Barger;New 16.*14416•Phone 800-543.2660 Pis WO
copyrtatitetiberty Pane,.too.2211
AU rights'e.ry d. llrr 08131 11o2/11
Installation/Maintenance
Pressure Distribution/Trench Systems
1. Install trench bottom level and in contour with the ground.
2. Install drainfield during dry weather and soil conditions.Any soil smearing must be
eliminated by hand raking any areas that get smeared.
3. Install audio/visual high water alarm.
4. Install effluent filter in septic tank outlet or pump vault with 1/16 inch maximum
filtration mesh size.
5. Install check valve in pump outlet line to prevent back-flow into the pump chamber.
6. Install 1/8 inch orifices on 4ft. Centers. Install the orifices pointing straight down ( 6:00
o' clock).
7. Divert all storm water run-off away from septic system components.
8. No curtain (french) drains allowed within 10ft. of the up-slope edge of the drainfield and
reserve area.
9. No curtain(french) drains allowed within 30ft. of the down-slope edge of the drainfield
and reserve area.
10.Have the septic tank and pump chamber pumped or inspected every 3 to 5 years.
11.Inspect and clean pump screen as needed.
12.Inspect floats and test high water alarm every 6 to 12 months or as needed.
13.All material and workmanship must meet County and State requirements.
14.Install risers on septic tank and pump chamber.
15.Deviation from this approved design without prior approval from the Designer and
Mason County Health Department will make this design null and void.
16.The prepared Site Plan is not a survey, it is the owner's responsibility to verify property
line locations prior to installation. Any discrepancies must be reported to the Designer
immediately.
17. Locate all utilities prior to starting installation. P p b
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