HomeMy WebLinkAboutSWG2023-00007 - SWG Application / Design - 11/16/2022 MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584
SHELTON:360-427-9670,EXT 400
a 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: SWG2023-00007
APPLICANT Bob Bryson Phone:
Address: 819 S Jackson Ave TACOMA, WA 98465
OWNER DEKOKER SASJA&JEREMY Phone: 1.360.569.6700
Address: 320 E FOX RUN LN GRAPEVIEW, WA 98546
SEPTIC DESIGNER DALE TAHJA-Septic Designer Phone: 360-426-5940
Address: 2450 W DEEGAN ROAD WEST SHELTON, WA 98584
Site Address: 31 E IRON WOOD PL
Primary Parcel Number: 220075000020
Permit Description: New SFR -3BR Pressure
Permit Submitted Date: 01/11/2023
Permit Issued Date: 01/30/2023
Issued By: Jeff Wilmoth
Current Permit Fees Paid: $780.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 01/26/2026 (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
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/onsite/oss-inspection-request.php or call:
360-427-9670, extension 400.
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- OFFICIAL USE ONLY
MASON COUNTY DATE RECEIVED: ` v ,
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Il. COMMUNITY SERVICES AMOUNT gill _ _ RECEI
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Public Health(Community Health/Environmental Health) G
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ON-SITE SEWAGE SYSTEM APPLICATION 3 73
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APPLICANT PHONE m
Bob Bryson (360) 620-4489 z
MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE —I E
819 S. Jackson Ave. Tacoma WA 98465 2 Fili
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SITE ADDRESS-STREET,CITY,ZIP CODE CD
31 E. Ironwood Place Shelton WA 98584 I N
NAME OF DESIGNER PHONE •
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Dale L. Tahja (360) 426-5940
NAME OF INSTALLER PHONE I CD
T.J. Goos i (360) 490-0217 '<— I o
PERMIT TYPE(select one) DRINKING WATER SOURCE 0
IF RESIDENTIAL OSS COMMUNITY OSS ICJ COMMERCIAL OSS L.l:PRIVATE INDIVIDUAL WELL E PRIVATE TWO-PARTY WELL Z
TYPE OF WORK(select one)
l ;PUBLIC WATER SYSTEM Timberlake Water System r
tie NEW CONSTRUCTION/UPGRADES E REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) 0 TABLE IX REPAIR I U7
ED
SUBMITTALS CISURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINE
17DESIGN FORM(REQUIRED) I SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE r I CD
5WAIVER(S)(IF APPLICABLE) 3 0.21 acre 0 t
I 0
DIRECTIONS TO SITE AND SITE CONDITIONS.(ex.locked gale)
Enter Timberlake development, left on Timberlake Dr. West, left on Ironwood Place, I o
property on the left.
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oISfTE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS.
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE/FAILURE SOURCE Or reporting purposes)
❑VOLUNTARY ❑MAINTENANCE/PUMPING ❑BUILDING PERMIT ❑HOME SALE ❑COMPLAINT ❑OTHER:
INSPECTOR SOIL LOGS COMMENTS I CONDITIONS
0 0 5(� iu�'1 S 11112-1--?/ (S�l�� ter
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RECORD DRAWING AND INSTALLATION REP (I:SOIL CODES: I.
V=VERY G=GRAVELLY S=SAND L=LOAM Si=SILT C=CLAY E=EXTREMELY R=ROOTS REQUIRED FOR FINAL APPROVAL.
INS- teR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED/ISSUED BY DATE
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/ WEBSITE REVISED 12/7/2015
TH- Fe-� •Y BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY BS
DESIGN FORM—PAGE ONE Assessor's Parcel Number: 2 2 0 0 7 — 5 0 — 0 0 0 2 0
A design will be reviewed when 3 conies of each of the following are submitted:
'1 Completed design form that has been signed and dated. '1 Scaled layout sketch, including all applicable items on checklist
'1 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 .
Permit Number: SWG 2 0-2.3 ` O0 '0 —7 Designer's Name: Dale Tahja
Applicant's Name: Bob Bryson Designer's Phone Number: (360)426-5940
Mailing Address: 819 S.Jackson Ave. Designer's Address: 2450 W Deegan Rd W
Tacoma WA 98465 Shelton WA 98584
City State Zip City_ State Zip
DESIGN.PARAMETERS
Treatment Device
❑Glendon Biofilter 0 Sand Filter 0 Mound 0 Sand Lined Drainfield 0 Recirculating Filter,Type:
❑Aerobic Unit Make/Model 0 Disinfection Unit Make/Model Other: N/A
Drainfield Type
❑ Gravity 6if Pressure [Trench ❑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) 1,200 gal Number 4
Receiving Soil Type(1-6) 4 Separation 10 ft
Receiving Soil Appl.Rate 0.6 gpdift2 Orifices
Required Primary Area 600 ft2 Total Number of Orifices 48
Designed Primary Area 600 ft2 Diameter 1/8 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 65 ft
Original Drainfield Area Slope 5 % Diameter 1.25 in
New Slope,If Altered 4 % Preferred manifold configuration used? 0 Yes 6'No
Depth of Excavation up-slope 11 in Transport Pipe
from Original Grade Do -slope 9 in Schedule/Class Sch. 40
Designed Vertical Separation 24 in Length 35 ft
Gravelless Chambers Required? 0 Yes 0 No EfOptional Diameter 2 in
Pump Required? fitf Yes 0 No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day 4
Dif ,in Elevation Between Pump& Uppermost Orifice 7 ft Dose quantity 67.5 gal
Drainfield Squirt Height/Selected Residual(head) 6 ft Chamber Capacity(flood) 1,'•I .4: gal
Uppermost Orifice Higher 0 Lower than Pump Shutoff
Pump controls:PI clpk !°I, *t
Capacity @ Total Pressure Head 22 gpm Timer "apse Meter ",li.
t Counter
Calculated Total Pressure Head 17 ft If Timer: Pump 3 rrtt ?, W o'if - 7 min
Comments N'Y E I R'3Nivlt�
Masol C'(3 J BIN
I DESIGN FORM-PAGE TWO Assessor's Parcel Number: 2 2 0 0 7 - 5 0 -- 0 0 0 2 0
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
0 Test hole locations 121 Drainfield orientation and layout Reference depth from original grade:
66 Soil logs fid Trench/bed dimensions and E6 Septic tank
6A Property lines critical distances within layout l;?' Drainfield cover
6d Existing and proposed wells D-Box/Valve box locations Reference depth from original grade
within 100 ft of property 6I Septic tank/pump chamber and restrictive strata:
10 Measurements to cuts, banks,and locations gf Laterals,trench bed,top and
surface water and critical areas B( Observation port location bottom
21 Location and orientation of 121 Clean-out location 0 Curtain drain collector
curtain drain and all absorption Eil Manifold placement 0 Sand augmentation
components
66 Orifice placement Other cross-section detail:
6d Location and dimension of Eli Lateral placement with distance 12i Observation ports/clean-outs
primary system and reserve area to edge of bed
Pi Buildings Other Information
66 Audible/visual alarm referenced Yes No
6il Direction of slope indicator Eli Scale of drawing shown on scale It 0 Design staked out
66 Waterlines bar 0 0 Recorded Notices attached
JO Roads,easements, driveways, 0 0 Waiver(s)attached
parking lif 0 Pump curve attached
66 North arrow and scale drawing 0 0 Evaluation of failure
shown on scale bar Non-residential justification
❑ ❑ Waste strength
❑ ❑Flow
DESIGN APPROVAL
The undersigned designer t be notified b install r t time of installation Yes 0 No
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Signature of Designer Date - ..:: ; yi
The undersigned has reviewed this design on behalf of Mason County Public Health and dete.... tet.or � Z
compliance with state and local o •te regulations: • ;.0. -• ��N f�-116 �-,�,('�'LS-hil �-23 `ili.• �_j %? `�'
E vir ental Health Specialist Date '°tt.b otb v' J ,ti
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CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CON 1 iv ...77
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V The design is stamped"Approved"by Mason County Public Health. s:
•
✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: ��` �2 '�\O
✓ 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. P PFi
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This form may be scanned and available for public on the N oso r� UI1j33 pknty . _ site.
Updated Date: 12/7/2015
MASON COUNTY ENVIRONMENTAL HEALTH
JBW
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Liberty Pumps 280 - 1/2 HP Cast Iron Submersible Sump/Effluent Pump (Non-
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MASON COUNTY ENVIRONMENTAL HEALTH
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Installation/Maintenance
Pressure Distribution/Trench Systems
1. Install trench bottom level and as designed.
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 up ( 12:00 o'
clock).
7. Divert all storm water run-off away from septic system components.
8. No curtain (french) drains allowed within l 0ft. 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.
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