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HomeMy WebLinkAboutSWG2021-00223 - SWG Application / Design - 4/26/2021 (2) • RECEIVED t*'-'4444tW MASON COUNTY n 415 N 6TH STREET,SHELTON,WA 98584 J A N 3 0 'I] SHELTON:360-427-9670,EXT 400 COMMUNITY SERVICES BELFAIR:360-275-4467,EXT 400 `:-�:> auidn9,Pannin9,_nv a-unenlal lloa th,GommunityHaal(h ELMA:360-482-5269,EXT 400 615 W. indoor Street FAX:360-427-7787 On-Site Sewage System Permit: SWG2021-00223 APPLICANT TURGEON ET AL MARK ROBERT Phone: Address: DAVID &CYNTHIA SLAWSON BUCKLEY,WA 98321 OWNER TURGEON ET AL MARK ROBERT Phone: Address: DAVID&CYNTHIA SLAWSON BUCKLEY,WA 98321 SEPTIC DESIGNER BRIAN SUND -Brian Sund Designs Phone: 360-490-2257 Address: PO BOX 1186 HOODSPORT,WA 98548 Site Address: 121 N BROOK LN Primary Parcel Number: 422165200122 Permit Description: New two bdrm-above grade sand filter Permit Submitted Date: 04/26/2021 Permit Issued Date: 05/10/2021 Issued By: Luke Cencula Current Permit Fees Paid: $705.00 (additional fees may be required upon installation of system). Permit Expiration Date: 05/04/2024 (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. 7 Cleanout to grade required between structure&septic tank. 8 Pump tanks with capacity> 1,000 gallons require two 24"risers to grade per county standards. 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: www.co.mason.wa.us/healthlenvironmental/onsiteloss-inspection-request.php or call: 360-427-9670, extension 400. Printed From Mason County DMS Printed from Mason County DMS OFFICIAL USE ONLY— �.. DATE RECEIVED: ,• -'` �•� MASON COUNTY y \C_ (cs cn > .x . ; CO SERVICES AMOUNT RECEIVED v rn CS ti ,,.-.+�- Public Health(Community Health/Environmental Health) G S3 -- auxemsa'.r-s>,.leonwasasao SWG / - M^ z fR ON-SITE SEWAGE SYSTEM APPLICATION E xi m n APPUCANT PHONE in ,�n v i c.(' Stitt)w S Z 5-3• L 6;4• S`b,:i'g c MAILING ADDRESS-STREET.CITY.STATE.ZIP CODE E P ,S30x 1 C06 - I 'a'-&Iej GL/a... 9g311 • 03 SITE ADDRESS-STREET.CITY.ZIP CODE - / I N. 6:'t-00 k /n , /odsjOc),--t GLia.. qff-4-8 14. NAME OF DESIGNER PHONE IST- la,e— Sur.( -360- 4 1v ''22,S -1 10 NAME OF INSTALLER I PHONE CI 1 cS. 5 E ce av J/,--j, 360 . 4.1,0•o '-/ i < I_ PERMIT TYPE(soled one) DRINKING WATER SOURCE CA ff RESIDENTIAL OSS bCOMMUNIIY OSS COMMERCIAL OSS b"PRIVATE INDIVIDUAL WELL ff PRIVATE TWO-PARTY WELL Z I C TYPE OF WORK(select ono) 0.PUBLIC WATER SYSTEM C(rT L/►'L a..--- ( t i�_ NEW CONSTRUCTION I UPGRADES 5-REPAIR/REPLACEMENT OTHER DETAILS(select aU that apply) ❑TABLE IX REPAIR I Imo\ SUBMITTALS 0 SURFACING SEWAGE ❑EXISTING FAILURE ❑SHORELINE W DESIGN FORM(REQUIRED) SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE Q- i,9- r I -WAIVER(S)(IF APPLICABLE) AL l e 0 I C DIRECTIONS TO STTE AND SITE CONDmONs:(ex.tacked gate) r 1 1 / �6 I /41,,Y / l q /U -t Poi lac fL L. us/,,, e,.., kei 7 0 I Q g,a t... 60,,-' �'Y ,a CZ......)CZ......) -to4 ervo A. //n. �G/ 7`v C.- v/-JC 6. O l- icit n,fi e P•d f0 5 c1I/,+iy L -I It- SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. I 7-1 OFFICIAL USE ONLY BELOWTHIS LINE UPGRADE/FAILURE SOURCE(Tor reporting purposes) ' ❑VOLUNTARY ❑MAINTENANCE/PUMPING ❑BUILDING PERMIT ❑HOME SALE'['COMPLAINT ❑OTHER: I INSPECTOR SOIL LOGS COMMENTS tCONDm 00 - 2y'' GSL , s.--,.. ro0.1's APR 26 2021 i I ?Ai4' 6.4_4,t.Y614s( By — 7 r I J 69 s 1 tel.i '`-'' -� � Yk" RECORD DRAWING AND INSTALLATION REPORT SOIL CODES: V=VERY G=GRAVELLY S=SAND L=LOAM SI=SILT C a CLAY E a EXTREMELY R=ROOTS REQUIRED FOR FINAL APPROVAL INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED!ISSUED BY DATE °. f,gge* J°i l7'1 Ha 1-1 , W>7 f 611. Ji es P'( FFO BE sCAr 1c A"P__-=_=, UGL!C Yaw ON aUiti;r Y.'LMSTTE ; ISEn.1anrzB1s P nfe5 roni ason -;oun'(y � Printed trom Mason County DMS , DESIGN FORM-PAGE ONE Assessor's Parcel Number: 4 �z. I (D — .S z — v a / 2. Z- 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" t '? 1� :l.• :':W:• ti -F ...:t„" ,f;?-1"+?c,3 7f R •.;gii:ti ..••i• ly: •�;;���c},� ;,. ,= .,PARCEL-ID��'rIFIGATION':�� .. � .��. x. �.. u:�.�::�' •. ..--. Permit Number:' SWG O'}1 - 0 6 7'1'3 Designer's Name: .67riet. r. 54/4 / Applicant's Name: iDcr.l/1 d ' I Q.uw S o ri Designer's Phone Number. 3 C6 O.44D-7 2-S7 Mailing Address: P D.jo,c live,.Z C. Designer's Address: J/R'•O.3o< //g,Co/ �7 p �1 . C j tJ u 1-ey ..utt.. •1 d.iZ/ ii,)041/ i- A A.. e 0 rie 11City State Zip City State Zip T, .. y. },. :'y!'_;.�, .h..M t 1R :fir ?- ,'". r,,.:k } y ,:vi ;_2S4bS.'Y1�f'.A..-.� .�. . :�.;,�chr� -� ,( t4�?�1yi :•:r....s'.: . L�;'1��.���::�•�DESIGN:PARAMETERS:�.,.�, :�.. ;.r,., :s�' . Treatment Device • ❑Glendon Biofi r�[1 id FIIlter ❑Mound $.Sand Lined Drainfield 0 Recirculating Filter,Type: ❑Aerobic Unit Make/Model 0 Disinfection Unit Make/Model Other: Drainfield Type ❑Gravity Jg Pressure l2t Trench 0 Bed ❑Sub Surface Drip Septic Tank/Drainfield Specifications Laterals Number of Bedrooms '2.. Schedule/ 7-0(0 Daily Flow:Operating Capacity / Grp gpd Length �/, ? Z, c 37•S' a k3U ft �.4 .. •�.. I i n Daily Flow:Design Flow 2-q•O gpd Dia..y ?r cok: -�1}, J 4 N .�; m - . Septic Tank Capacity /20G gal i y: ' Receiving Soil Type(1-6) 4 • S:``? jjst u'::--uo (, ft Receiving Soil AppL Rate (rz gpd/ft rxemes S—/-2 , Orifices Required Primary Area 4e,b ft2 Total Number of Orifices 3 S^ Designed Primary Area 40 c ft' Diameter 7 ' in - Designed Reserve Area 4o e) ft2 Spacing 4./ in Trench/Bed Width 3 ft Manifold Trench/Bed Length i 3 3.3 ft Schedule/Class 9U Elevation Measurements Length / ft Original Drainfield Area Slope 0 -"Z- % Diameter 2- in New Slope,If Altered % Preferred manifold configuration used?)2.3 Yes ❑No Depth of Excavation Up-st0pc g in Transport Pipe from Original Grade Down-slopc 1. 3g in Schedule/Class 4- Designed Vertical Separation / Z. in Length Z ft Gravelless Chambers Required? 0 Yes No 0 Optional Diameter .2- in Pump Required? VI Yes D No Dosing and Pump Chamber Pump/Siphon Specifications Number of doses/day . - • Difference in Elevation Between Pump Shutoff and Uppermost Dose quantity 4,0 0 gal Orifice S ft Chamber Capacity /.2a0 gal Uppermost Orifice 0 Higher 0 Lower than Pump Shutoff Pump controls:Please check those required. Capacity @ Total Pressure Head 15•'1 S gpm ®Timer l2Elapsc Meter D` vent Counter Calculated Total Pressure Head 1.1.`1 I. ft If s wp ,7 r'',^. ,Pump off Co fin/S CommentsAV ''S;pp� pp�.�rV1/ tg' MAI 10 2021 Panted rrUm Mdsuri Count c:., R461ROPMENTALHEALTP Printed from Mason County DIM-- 1VC DESIGN FORM—PAGE TWO Assessor's Parcel Number. 4 i.-2... / ( — �.Z — D b J 2 Permit Number: SWG 20 2-1 - 6 O ?9-3 DE$IG11I d.' t KLiSTs Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch d Test hole locations Er Drainfield orientation and layout Reference depth from original grade: l7 Soil logs 0/Trench/bed dimensions and d Septic tank d Property lines critical distances within layout Dr Drainfield cover II( D Existing and proposed wells D-Box/Valvc box locationsReference depth from original grade within 100 ft of property 17'Septic tank/pump chamber/ and restrictive strata: 0 Measurements to cuts,banks,and locations el Laterals,trench/bed,top and � surface water and critical areas in( Observation port location bottom ©/Location and orientation of El�Clean-out location Curtain drain collector curtain drain and all absorption E Manifold placement BSand augmentation ,components p Orifice placement Other cross-section detail: d Location and dimension of 0/Lateral placement with distance el Observation ports/clean-outs primary system and reserve area to edge of bed Other Information ElBuildings Ef Audible/visual alarm referenced Yes.No d Direction of slope indicator El Scale of I •�'�.7._• shown on scale d 0 Design staked out Er-Waterlinesbar ' I 0 0 Recorded Notices attached / `''' 0 0 Waiver(s)attached i3 Roads,easements,driveways, r' � El' ❑Pump curve attached parking -M`•/w ,� - . / ��f. e 0 ❑Evaluation of failure © North arrow and scale drawing i:' ''u: _ ;a; shown on scale bar /3�y' a,;: . ! Non-residential justification S or:.. ,...91. .k - Uc n DESIGNax . 0 El Waste strength EXPME /--2 3 DESIGN APPROVAL The undersigned designer must be notified by installer at time of installation IE3 Yes 17 No __ 2/� `f/-S-,&f Signature of Designer fiate 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-site regulations: i vivironmental Health Specialist Date CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION: ✓ The design is stamped"Approved"by Mason County Public Health. ,/ 1 I The Onsite Sewage Permit has not expired,the Permit Expiration Date is: / 1 4 `�,,, 6 ✓ Drainfield site conditions have not been altered to adversely affect conditions of dedgn 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 Printed From Mason County DMS Printed from Mason County DMS s S ie....,z-$g..ra La�{.2.7.,-1)xd, tl- . L 0-(C2 Gv5 a.,r ?wIr P1� I = Za' • • ta s. . t I. . _� •t7.-.-.e..„-t -i S i 1�wr•y f ' ��` I I 1 30' �'lr o,!10loPr,G.- L I'',f�• I . .............. / . ‘1 r:e, 1 tYld Of° 1�N / 6 ( ai /i . . !< k fik'rA D\✓�P ' 2 V' S t /----------. t,� G! ''ff p 1. 7�b , \ \ C7 J 1� �3 \ I �. :i• rr- \'c \ 1 / . ///s '. ��,mY L • l , • eXP![ts+r/..2.3 __ .1 ... 1}{ ( 1...s. p Z Ca Cr S L e ro ca I.C. to‘v022.. f2.s. a -1-o Cs-5 L-- TK Z. 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Install 1/8 inch mesh screen around pump not interfering with float operation or use baffle screen as indicated. 7. Always use T to T type construction. 8. Install check valve in pump outlet line to prevent system from draining back. 9. Filter fabric required over drain rock. If drain rock extends above natural grade, run filter fabric at least 2 inches down the trench wall. 10. Install threaded cleanouts at end of all laterals no deeper than 6 inches and mark. • 11. Divert all storm water and-run off away from on-site sewage system. 12. Install drainfield during dry weather conditions. Avoid smearing. Any smearing must be eliminated by hand raking. . 13. Inspect septic and pump chamber every 3-5 years. Pump septic as needed. 14. •Inspect and clean pump screen every 6-12 months. Inspect floats and alarm every 6-12 months. 15. Install septic tank and pump chambers. Risers to surface an all openings. 16. Deviation from this design without prior approval from the Designer and Mason County Health Department will make this design.null_and void. • Nprt Rnv Y' i tv1�Y 1 0 2021 t,t _ viASONCOUN�ENVvRONMENTALHEAIT� • :;, rff„ Printed From Mason G' '°.._r. : fl(PipES Printed from Mason County DMS r"25