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HomeMy WebLinkAboutSWG2016-00267 - SWG Application / Design / As-Built - 9/8/2016 OFF:C:A- SE ONLY MASON COUNTY PUBLIC HEALTH DATE ROZENED: CA ) —� "t f CO ONSITE SEWAGE SYSTEM APPLICATION AMOUKTNEC@VEO: _ _Let ; C CM 415 N 6th Street,(Bldg 8) Shelton WA,98584 -kS ?� Co Shelton:360-427-9670 ezt 400 Belfair 360-275-4467 at 400 C w V ( r - •( 7 j 53 J o�,�' �i V _l Z W APPLICANT PHONE SG.DT NAY VS _ � II.•2SS• i9to0 m m HALING ADDRESS-STREET.CITY.sum,ZIP CODE r rN z 39¢ IRvI`qe../sc0/lam. Rd. Qusfe> 1 La—• - 'viO o 3 SITE AODRESB-STREET,c Y 2TP CODE - Q I I A). Su vex. L///,%(.a.v/p Ccie►. 4 YSs'S` 7 p NAME OF srtp.� Suv.cc 360 • 490 .22c1 NAME OF INSTALLER PHONE 1 I CHECK ALL APPLICABLE ITEMS DRINKING WATER SOURCE 2 • rk NEW CONSTRUCTION CI RV HOLDING TANK ONLY 0 PRIVATE INDIVIDUAL WELL < OD IO ❑ REPLACEMENT SYSTEM ❑ INSTALLATION PERMIT ONLY ❑ PRIVATE TWO-PARTY WELL Z 0 TABLE 9 REPAIR $ SINGLE FAMILY fti COMMUN(TY/PUBUC WATER SYSTEM F ❑ TANNS)ONLY ❑ COMMERCIAL SYSTEM NAME: e p/C,h 5Z. N a ❑ UPGRADE TO EXISTING CI OTHER: eEOROOMS LOTS ` ❑ EXISTING FAILURE _/4 Q,C.re. Oar NI komMAMMoss" 'N DIRECTIONS TO!IRE-BE SPECIFIC AND ADVISE OF ANY NEEDED INFORMATION FOR ACCESS(a.b&.d gum) g . Iv l „�C-oloYNN( Sorg u%/,1 I I to L fez. Top, 10 L x I-- f A 9 'r- c et 1-,-t- 0. I 13(oL.,Gc I CD Cor% L IS— iu o o IQ IV, !I-) SITE MST . MAWI ROAD AI TEET HOLES OUST FlAOOED bWTH TEST HOLEma<n I-r- ,OFFI CIA-USE ONLY BELOWThIS_:NE •UPGRADE I FMLURE SOURCE(1Or ieporthp pvpoaw) ❑VOLUNTARY 0 MAINTENANCERUMPING 0 BUILDING PERMIT ❑HOME SALE ❑COMPLAINT ❑OTHER: INSPECTOR SOn,LOGS COMMENTS/CONDITIONS 0 O. _- GLS , © -I lg. Cak-- %kk Co+-Q- . 143 7.... o S ,....,, e ©- .e 6,k3 a o -V-k Co 1-S -i 2�+ C9► - SEP 0 8 2016 w ttepte6\ tA0(-MilAILk Ok\\k4 BY: _Ok"-'). SOIL COM: fr V.VERY G-GRAVELLY S•SAND L=LOAM SI•SILT C-CLAY E•EXTREMELY R.ROOTS I INS 1 1 []ATE APPI lC/VTION EXPIRATION DATEIertTNED BY ii s.i DATE :La THIS FORM MAY SCANNED AND V an Aw t<FOR PUBLIC VIEW ON THE MASON COUNTY YYEt3EfTE REVISED unrtots printed mead From Mason County ... M Punted from. Mason County DttflS t oNcOUv Public Health Always working for a , healthier Mason County September 21, 2016 Brian Sund PO Box 477 Hoodsport WA 98548 RE: Design for HAYES Case No: SWG2016-00267 Parcel No: 323095110024 Your on-site sewage system design for the above referenced parcel has been reviewed and is APPROVED. The system must be installed by a Mason County Certified Installer. A list of installers is available on the Mason County Public Health WEB page at www.HealthyMasonCounty.org Select Environmental Health, then On-site Sewage Systems. In some cases, homeowners may be allowed to install their own system. Prior approval by Mason County Public Health is required. Please refer to the comments section of this letter for any additional information. Please call me at (360) 427-9670, ext. 279 if you have any questions. Sincerely, -jj%-ffi-) Alex Paysse Environmental Health Mason County Public Health COMMENTS: 9/21/2016 Page 1 of 1 SWG2016-00267 printed From Mason County , Printed from Mason County MIS DESIGN FORM-PAGE ONE Assessor's Parcel Number: 2 r3 Oct - ../_ - ( o Al- 4_ A design will be reviewed when asggigg of each of the following are submitted: '0 Completed design form that has beat signed and dated. '1 Scaled layout sketch,including all applicable items on checklist 1 Scaled plot plan,including all applicable items on cher-WV Cross-section sketch,including all applicable items on checklist. Ws form may be scanned and available for public view en the Mason • Web stem.Maximum lel;,,•• size 11"X 17" II] t~ .5-.• . . . - . '• ` Permit Number. SWG 2-01 Le -E')Q�i Designer's Name: a r; --- 0.- -. / Applicant's Name: Sc_olf 46..,V-e,S Designer's Phone Number. "16 U - •et40- 7-2.Si Mailing Address: 3 et 4 of-/ ..s sun t tN_ PI• Designer's Address: I c>c. 4'1"t R U s ityv, L . "it 1.10 1-4 o cx'�S por7r.bdet• frog' State i. ; State _ ; • . -ii..k.-.-ln:/.':i. is i'1 .t. i`: Treatment Device ❑Glendon Biofilter 0 Sand Filter 0 Mound 0 Sand Lined Drainfield C]Recirculating Filter,Type: C]Aerobic Unit MakelModel 0 Disinfection Unit MakeiModel Other Drainfield Type ❑Gravity Iit.Pressure 0 Trench 0 Bed C]Sub Surface Drip Septic Tank/Drainfield Specifications Laterals Number of Bairboms 2. Schedule/Class 200 Daily Flow:Operating arty 1 g O gpd Length S' - 14 ft Daily Flow:Design Flow -7 -40 gpd Diameter I in 7 Septic Tank Capacity I o c o gal Number ,i- 7. Recciying Soil Type(1-6) 3 '� • Separation (9 ft RaxivingSoil-AppL Rate .q ---gpd/ft- -- --- Orifices Required Square Footage o ft 7 Total • �*•-• • ,.. 4 Designed Square Footage -3 Q o ft a', i�i,- =:„~� 3 Yg in f . n � „I' 36. in Percent Reduction Taken - % ��G- 'i*1+� Trench/Bed Width ft ' ` . Manifold Trench/Bed ••;�' - =w Q Elevation Measurements LedelbREs c-/-/c I ft Original Drainfield Area Slope 1 % Diameter 7-- in New Slope,If Altered % Preferred manifold configuration used? fit Yes ❑No Depth of Excavation up4uope 1 0 in Transport Pipe frog Ongtnal llrada_. pOa^'snOP° 1. S in / Schedule/Class 4-0 D Vertical 4 in Length -c o ft Graveness Chambers Required? CI Yes 0 No .81 Optional Diameter ,�•, in Pump Required? 13 Yes 0 No Dosing and Pump Chamber Pump/Siphon Specifications Number of doses/day 4 Difference in Elevation Between Pump Shutoff and Uppermost. Dose quantity (o 0 gal .✓ Orifice . (o ft Chamber Capacity 1 U Uo gal Uppermost OrificeiViigher 0 Lower than Pump Shutoff Pump controls:Please chock those required. Capacity(41 Total Pressure Head •1 S.3 glsrn f Winer 11f Elapse Meter B Event Counter Calculated Total Pressure Head 12.1 Z ft ✓ If Timer: Pump o 4- 1/s•+J ,Pump off ( 11 f S Comments L-)2 a-V Mc, 4- -r r-ve>+ L. /e f ="tr., j . f.et„!i G 1 e.6 t' TRENCHES NO DEEPER THAN: UPSLOPE 't 0 DFinted FromW ,, : . UMM Printed from Mason Gclur1y DMS ' DESIGN FORM-PAGE TWO Assessor's Parcel Number:? 1- ? J 3 -- - - 1 Q o J fr Permit Number. SWG �'`� X ��s: f q _"'ti..: � :.r�•; ,..� r.1 .� Rt'-i' � G ..•-r.�� `''S _: - 4_. .•r4:4'•.4: '44-7,0:006 * . ~ , .. 342N},f f:r;,sHj+r` + -li yi -� 2i'a i� is fi��}!p�:'..FZ':! �4 �L..e h���6��:'�r�.�'`-"4:: Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch O"Test hole locations l2Drainfield orientation and layout Reference depth from original grade: 0r Soil logs Trench/bed dimensions and Septic tank ('Property lines critical distances within layout Drainfield cover f3 Existing and proposed wells 12f D-Box/Valve box locations Reference depth from original grade within 100 ft of property 0'Septic tank/pump chamber and restrictive strain: 127-Measurements to cuts,banks,and locationsEr Laterals,trench/bed,top and surface water and critical areas Observation port location j, bottom. EX Location and orientation of 01"Clean-out location i gh Curtain drain collector curtain drain and all absorption p' Manifold placement ilnik Sand augmentation components U /Orifice placement Other cross-section detail: 12(Location and dimension of r:'Lataal placement with distance 0' Observation ports/clean-outs Erprimary system and reserve areato edge of bed Buildings Other Information Er-Audible/visual alarm referenced Yes No Direction of slope indicator UK-Scale of dra• .•_ : shown on scale -� 0 Design staked out Er Waterlines . bar Roads,easements,driveways, _ ,- ❑ 0 Recorded Notices attached Er ::' ' 0 0 Waiver(s)attached 8 ;,.. '�`' rY , ,. '® 0 Pump curve attached H North arrow and scale drawing ;:= .. ` 0 0 Evaluation of failure. shown on scale bar • Non-residential justification • `' 4 `1. = ❑ ❑waste strength emus's-.1-/ 7.,;y;�.Rl`y-{e "4 F .,, { G �•rt e ,.7F10.s ,:4 1 i',.:1..?�,..., ••1`tit•',4 ! ttS ,G', - nF r.+i�=r ...'i1•r e. .:.ra.>..v..'. _+......a . :.:.�, s. . ... ,5 ..• vvyy .YA: •� • ge Y.. a..�G ++.K.a, .....'s¢•4: ..u�.. t._.�.ra,..r'i."s"•'�...a+♦sY•P.asu«�:Y The undersigned designer must be notified by installer at time of installation tifeYes ❑ No ,,41 ALI--,s." q//://6 - Signature of Designer 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 o ite re "ons: ------- 'Zk \ k ..e Environmental Health Specialist Date CA JTION: DESIGN APPROVAL IS VALID ONLY UNDER TELE FOLLOWING CONDITION: ✓ The design is stamped"Approved"by Mason County Public Health. ✓ . The Onside Sewage Permit has not expired,the Permit Expiration Date is: (>r 2I , 2 D\ck 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: 12/12/2014 printed From Mason County DMS Printed from Mason County OMS A \ �.- .. - __ . . . . . x -.... : _ T • r tw o r •. . o c A�'P ROVED. I �'... I SEPSI2016 - -- �. i St e ut1 .G e ,._ • • ,..t.-Ai : 0 -tl r a Al_ C ,:.•fit ,.. _-.. - __ - -N t, . _- 71'4 ! 1--_ J t vi _ -► ._• .-- "rt\- 3• L : 0 b �.,. l ... . . ... • - . -- .-....._ .. Printed Froma County D . 'rintGz;.!' 1C,.5#'''#/ MasonCounty DMS -. - ` 431 0 At- __-__' ^ — '-- -�—'----'--r--~--�--�--'----'�- ------� �---- - �~"Awoest���''------�----- --�- , ' ^ ' ----r--'------�---�--' --- � ` � ' - -- �_ lop . y4V . . � . � . iLL - _ - � Lo n ' —.... " ' ' � i 0 Som. A b1 -1 v N %* - . ° i:r. ,e--1 -n f- r I , s • C. I ..ZQ`+ o aC 1 P >/-• V Li IT . I • r H — 7 "C J T' c if tk . d 4 Q L A • "''„ Rov. a. r Lp ....., , 1 1C-4"N • • Jrt r. . .' d From Mason n o " D Printed from Mason County Ofyi OSPS0 - Submersible Effluent Pump DETAILS �-Th Pump Characteristics Performance Data Pomp/Moor o oars Simile3z ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ Amlardlcthils OSPSOA1 _ OS?SO*2 ■■■■■■■■■■■■■■■■■■■■■■■■ 1 rii 2s — 11111.■■■■■■■■■■■■■■■■■■ ""*'.' ■■■■1111=1111■■■■■■■■■■■■■■■■ Fstl Leal Arms Ls I 34 6 ■■■■■■■■\i.SO■ ■■■■■■■■ Bow Too. So#Iltrss ■■■■■■■■■■11■OM■■■■EMMI RM. l�so ■■■■■■■■■■■■■■g!1■■■■ 18 ■■■■■■■■■■■■■■►?�■■■■■■ F4ao8 1 g ■■■■■■■■■■■■■■■■■■■11101■■■■ Whip 11s 1 230 4 ■■■■■■■■■■■■11111■■■■■■►N■■■ ■■■■■■■■■■■■■■■■■■■■IK'I■■ Hora 10 r8 ■■■■■■■■■■■■■■■■■■■■■■Ig■ Ot„ens Cool Coorimpos DuiyIdea ■■■■■■■■■■■■■■■■■■■■■■■11 1N'FAiMat ■■li■■■■■■■■■■■■■■■■■■■■■ tir*r•"' u ■■■■■■■■■■■■■■■■■■■■■■■■ IOA ps} I 0 10 20 30 40 50 80 CAPACITY-U.S.GRIM. Widow as F ptstfirr Stec 1-1/2"OPT Dimensional Data Soli Iriy VI' .aa SO is. 1, Prow tiri 1A/3,SAX 10/3.SJ1M sns saatm sewn MAO .� 10's1d.I opt.) 20'' I . AAA Materials of ConMAI SFpt c�`' Fy Nods stool L, I Z� �d atiettric oil �� thotms wedw 'Cad r.s Pour Gift find trio :. r - �t Steil ierdd , : , Sod Fos:(aW/Cwmit I ows mums Sidi nailsSul miss es CMOS • Wow Stsistrss'SW noir ow UO.=f..ri —s impair ' Grlssts{torsion Wain-01111014 t °r 1 *Pot fiery Singh Om Y lory 1 run OFF Lorton Bordog Sfs-s I.,w Barbi Al dratraors In inches.Mitt tog kbrrsdiord use.Component dtenrdom os4rmiry*tl8 Itch Dknsnsisrrl dds rot kr mringlor p.rpose miss artilsd.tliairaiorn Ind stints an sppraodmsle. kg cad i.r 0 Irml odluomble.Ws morn ode rtptt b mils rr Ws to ar product sod their Apodka/lons Fo rsirs Mhos stool ' stiAar orbs. - ` + ivyv i YorA voidtea/Ohrbno.- Ir,° HYDROMATIC' '` -,, Pentair Water 740 East 96 Street Ash ond,Ohio 44805 269 Tarn Drive Wisner,CJNario,Ganda N2G 4W5 Tsk 419-289.3042 Foe 419-2$1 d087 www.hycia math—amn Irk 519-896-2163 Roc 519-896-6337 1+r t 1 li 1„-.)MS dent t:w-024322O 2.515 a 1�:llied iE{ter; mason county ;)ms Construction Notes For Pressure Distribution I. Install drainfield ditches with contour of ground. Keep ends level. 2. Keep IA inch per foot fall from house to septic tank. 3. Keep 1/8 inch to 'A inch per foot fall from tank to pump chamber or drainfield. 4. . Observation ports to extend from final grade to drain rock and original ground interface. 5. Audiovisual alarm required. 6. 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 diy 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 E e41th Department will make this design n41I and void. rc . yEO :.?:- i I sEP a 1 zo E cn♦ i yam' / = • <-: 2)ri t From Masontiii ..,,, , s -} - Printed from Mason County ERAS iRONMENTAE REc E!v:J a a -0d 017 HEALI H RECORD DRAWING (ASBUILT) pg. 1 JAN - 6 202J MASON COUNTY PUBLIC HEALTH t:;::a i s RM erOMI ION .'a .f g1 ;: 1r Y N7 tr Permit Number SWG 2-01 E, —OOZtd 7 Assessor Parcel It 3Z3 Oct -5-1 • / d o 'Z 1 Applicant Name SCrrtt HA 9 e5 Subdivision (Name/Div/Block/Lot) Applicant Address ,ja in EA rgQSUi 11t City, State, Zip (►/S rh L.a, . '7 12 70 Installer Name T3 4 am 3 Site Address /0 5tAVo. L Y\ Designer Name ,.A v: .. I �� tr IN ',ALI AMOH. .F,CLIST`° I K 'f „ ::, .. ;� �z:X.,<w'ti��: H.•u..v fx. ?. /'!1 t lzf=as a_a�r .iY r' '..� k.:�.,:AZ: I $_ MAR 4 2016 [,Full System Installation ❑Tank(s)Only ❑ Drainfeld Only ❑Repair • ❑Otrir �A:k:: System Type• f..: y yp etYf� Pretreatment Type ••R-: >5 ft. from foundation? ❑ NIA ®YES ❑ NO --' >50 ft. from wells? - ❑ [ ❑ ' >50 ft. from surface water? - - ❑ yC� ❑ A.4. Cleanout between building and tank? - - - - - -- -- - ❑ [f� ❑ :.,k" `'C�. Tank baffles present? ❑ ® El F- : 24" access risers over each compartment?- - ❑ ® El LL W Effluent filter installed?- -- -• ❑ 8 LI ,(A Septic tank size 1OCO gal Manufacturer (trY�tavS C.], D-box water level and speed levelers used? - - - tIK N/A ❑YES ❑ NO �, J 440 Manifold/D-box accessible from surface?- - - - - - El RI ❑ .Oti.. ;msZ;: Check valves installed? - - - - -- -- - ❑ r� ❑ :-"glit Transport Line Size l'iSchedule/Class ft 9 0 .!-1:., Bedrooms installed (check one) IA 2 ❑ 3 ❑4 ❑ 5 ❑6 ['Commercial/Other >10 ft. from foundation?- -- - ❑ N/A ®YES ❑ NO b >100 ft. from wells?- - El I ❑ "a >100 ft. from surface water? - - ❑ ® ❑ ':.W_ u_ >10 ft.from potable water lines?- - ] ❑ . 4 . > 5 ft. from property lines and easements?- - El El > 30 ft. from downgradient curtain/foundation drains?- - ❑ ® ❑ 0- Drainfield level and observation ports present - - - . - ❑ [r ❑ • ❑ Graveless chambers or LK Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ IR ❑ Pump tank setbacks consistant with septic tank? - - ❑ N/A [,YES ❑ NO Pump tank size /00O gal Manufacturer e°roW\ Z al • Q.' 24" access riser(s)and accessible from surface?- - - - ❑ 13 ❑ H Alarm or Control Panel Installed? - - ❑ ® ❑ 2 Control Panel equipped with Timer/ETM /Counter- - ❑ ® ❑ D '_a .'Pump installed in ❑ Buuckket or ® On Block or ❑ Other Q. Pump Make/Model 13yd bSp 1 6-0 ❑ Floats or ® Transducer Tank draw down I in/min Pump capacity _2_ gpm Squirt Height /L - ft Pump on time ef'1 n 06sec- Pump off time 36 0 Daily flow set at Qi D gpd 1 Updated 12/7/2015 inted From Mason County i Printed from Mason County DMS MCPH RECORD DRAWING (ASBUILT) pg. 2 Assessor Parcel,# :3-g3tI9 -SI 4cC -41 - • :RECORD D RAM NG: :K. ''.,:','t.U✓oh5r4g4r , .>6= -wr. irir<_'. B Drainfield&manifold t 1 j/ ,.ni )I orientation&layout /V �`ef" w/dimensions for _ ___ re-location. oaIltifs Trench/bed Ir � ` dimensions and ‘1\ d���t Lik. ray,' 0 eb critical distances ‘ � li a within layout x [51'4A rr Septidpump tank ♦ q placement '— col g Location of building existing/proposed //1/V * ( \ i4 Observation ports, i -x4- or, 0 clean-out locations, b I J &manifolds/d-box-: J R -4 Location of wells, " ' surface water,mad-, (� &waterlines. ` ��� �e� w S 1t.€'fed Reserve area(s) LA)h en. Zn c to"{,e ri7) North Arrow _ ——_— — --- — If the designer or instal:er feel the need for additional information/comments, it may be attached. Record drawing may also be on a separate page attached. No. Pages Attached CERTIFICATIO i 0P.INSTALLATIOW M gr INSTALLER DESIGNER 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 attache Record Drawing is accurate, form and attached Record Drawing is ac urate. —11--171 .. Signature fin taller Date Sr Printed Name of Signee %-a'. MASON COUNTY PUBLIC HEALTH `�•'' ` The undersigned approves this Installation Report and / - `: Record Drawing on behalf of Mason County Public %0.1 -'."o VO 'S c Health: `/-y4 (k-) 3127111 - Signature of nvironmental Health Specialist Date (designer's stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Updated 127/2015 printed From Mason Cuny� M Printed troutMason County DW.S