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Home My WebLink AboutSWG2022-00301 TANK ONLY - SWG Application / Design / As-Built - 5/23/2022 p111111111111m 1 ' 415 N 6TH STREET,SHELTON,WA 98584 MASON COUNTY SHELTON:360-427-9670,EXT 400 r COMMUNITY SERVICES BELFAIR:360-275-4467,EXT 400 ELMA:360-482-5269,EXT 400 Building,Planning,Environmental Ilcvlth,Community Health FAX:360-427-7787 On-Site Sewage System Tank Only Permit: SWG2022-00301 APPLICANT NAU RICHARD C Phone: Address: PO BOX 773 LONGVIEW, WA 98632 OWNER NAU RICHARD C Phone: Address: PO BOX 773 LONGVIEW, WA 98632 SEPTIC INSTALLER SCHOENING EXCAVATING LLC Phone: 360-742-2982 Address: 121 W GRIZDALE DRIVE SHELTON, WA 98584 Site Address: 22010 N US HIGHWAY 101 Primary Parcel Number: 422235000103 Permit Description: Replace septic tank Permit Submitted Date: 05/23/2022 Permit Issued Date: 05/24/2022 Issued By: Rhonda Thompson Current Permit Fees Paid: $240.00 (additional fees may be required upon installation of system). Permit Expiration Date: 05/24/2023 (based on date of inspection) Type of Work OSS Repair Components being Replaced: Septic Tank Only Surfacing Sewage? No Existing Failure? Yes Shoreline? Yes Horizontal Setbacks Met? Yes Number of Bedrooms: 2 Drinking Water Source: Public Water System Additional Details: IM-1060 Permit Conditions: 4 Proposed development subject to zoning requirements and approval by the planning department staff per Mason County Title 17. 1 Horizontal setbacks per WAC246-272A-0210 must be maintained, unless prior approval is obtained 2 Permit must be installed by a Mason County Certified Installer unless prior written authorization from Mason County is obtained. 3 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/OR 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/health/environmental/onsiteloss-inspection-request.php or call: 360-427-9670, extension 400. Alb- i . , OFFICIAL USE ONLY MASON COUNTY DATERECENED Sbl)oa w 7;:. COMMUNITY SERVICES y .� RECEIVED BY: ^A CO 0 0 Public Health(Community Health/Environmental Health) SWG �L < (n 360427 9670,ed.400 a wo-275-4467,ext.400 S V V V N) \�� W O 415 N.6th Street-Shelton,WA Se5B4 _1 a a - J tcj 1 lam`/ 1 Z cn i ON-SITE SEWAGE TANK ONLY APPLICATION m rn APPLICANT PHONE tk Jn 411. Nuw 360- 412,-3011 c MAIUNG ADDRESS-STREET,CITY,STATE,ZIP CODE g ¶. o• Qok 773 Lon v►CIO 1,(_9 6 %.630- co 73 SITE ADDRESS-STREET,CITY,ZIP CODE tot A o�1 a `� W�� , _ ?.u;)to N V►S tAi51,.way 'ram'\ NAME OF DESIGNER PHONE Ps-)NAME OF INSTALLER PHONE 'Sc,1,O•eh...1 Ex(AV 0o 441N. Lt.L %60.142.294Z TYPE OF WORK(select one) DRINKING WATER SOURCE o I'U ❑ NEW CONSTRUCTION/UPGRADES REPAIR/REPLACEMENT ❑ PRIVATE INDIVIDUAL WELLS�l❑l PRIVATE TWO-PARTY WELL Z I- ) se CO,MPONENT(S)TO BE REPLACED/INSTALLED PUBLIC WATER SYSTEM `�� I m PO SEPTIC TANK ❑ PUMP TANK ❑RV HOLDING TANK BEDROOMS LOT SIZE Ir n ❑ OTHER � k e S IO, OTHER DETAILS(select all that apply) TANK(S)SETBACK CHECKLIST r 0 t El SEWAGE EXISTING FAILURE 0 SHORELINE Er 100FT+PUBLIC/COMMUNITY WELLS 0 ID I SUBMITTALS ffi SOFT+PRIVATE WELLS,SURFACE WATERS,STREAMS,RIVERS PLOT PLAN(REQUIRED) TANK CROSS SECTION(REQUIRED) le 10FT+DRINKING WATER SUPPLY LINES I O ❑ PUMP DETAILS(IF APPLICABLE) ❑ WAIVER(S)(IF APPLICABLE) "5FT+PROPERTY/EASEMENT LINES,FOUNDATIONS,FOOTINGS PLOT PLAN CHECKLIST 1 O I.r-1 PROPERTY LINES AND EASEMENTS firEXISTING/PROPOSED STRUCTURES ® EXISTING/PROPOSED OSS COMPONENTS AND LINES • I nl CI WELLS WITHIN 100FT CI WATER SUPPLY LINES 0 DRIVEWAYS/PARKING / SURFACE WATERS,STREAMS,RIVERS,ETC.. v ❑ DIRECTION OF SLOPE/CONTOURS 0 PERIMETER/CURTAIN DRAINS E NORTHARROW 0 SCALE BAR I`W , DIRECTIONS TO SITE AND SITE CONDITIONS:(ex locked gate) `_OAK �� C�� 1 ��,• '0 in t, 0•1 I S%S �C'Yuw w ► Qv►O 43.•f)ow," ky;vuw+i `1 W OFFICIAL USE ONLY BELOWTHIS LINE UPGRADE I FAILURE SOURCE(for reporting purposes) ❑VOLUNTARY.AINTENANCE/PUMPING ❑BUILDING PERMIT OHOME SALE ['COMPLAINT 0 OTHER: COMMENTS/CONDITIONS 'aM\c4 Q C C. () c SEWAGE TANKS MUST BE LISTED UNDER DOH"LIST OF REGISTERED SEWAGE TANKS". TANKS MUST MEET CURRENT MINIMUM SIZE REQUIREMENTS,EQUIPPED WITH RISERS AND LIDS TO SURFACE,AND INCLUDE AN EFFLUENT FILTER(IF APPUCABLE). RECORD DRAWING AND INSTALLATION REPORT REQUIRED FOR FINAL APPROVAL. INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED!ISSUED BY DATE cEVISN.21/1\i2VYA. VIVI 11,-1.. THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12/7/2015 dill •rog;piotl• _1, o'•' . 45) • • -- . •� r. tJ;; :(.1 ' • •z. ,.. •± .:z10, ,J;:...•xc 7- y -. . ., 3771.ti. • vier. • �� 1 � � `) :•:?..: L»t'.a .1c.4 -.. _ i • •:F • • i. ', .... • .) • . 1 „o`i• 1. '�j'•: .•.•.i� iJ'.r? •.L ,- as .",s'.i i:_'. .' . .i _ . - t _ a / .1:iY!••1.1i' •-,'.l�A i' -T• •.n.t . $... Jl17 ? "—t$T` .,.A 7 . 1 • • :} r• f . • • -r APPROVED MAY 2 4 2022 ` MASON COUN1 ENVIRONMENTAL kEALTk RED M-1060----- INFILTRATOR® septic tanks Features&Benefits • Strong injection molded polypropylene construction f • Lightweight plastic construction and inboard lifting lugs allow for easy i • delivery and handling f;i /� /;I~ . '((11\ • Integral heavy-duty green lids that #( interconnect with TWT"^ risers and pipe riser solutions Its NNW K rri at fit it IC Ft wit of IC gi It Ot Mil * * a.r i. • Structurally reinforced access ports eliminate distortion during installation and pump-outs r • Reinforced structural ribbing and fiberglass bulkheads offer additional •., strength • Can be installed with 6"to 48" of cover The Infiltrator IM-1060 is a lightweight strong and durable septic tank. • Can be pumped dry during This watertight tank design is offered with Infiltrator's line of custom-fit pump-outs risers and heavy-duty lids. Infiltrator injection molded tanks provide a • Suitable for use as a septic tank, pump revolutionary improvement in plastic septic tank design, offering long-term tank,or rainwater(non-potable)tank exceptional strength and watertightness. • No special water filling requirements Inlet Side are necessary • The tank may be backfilled with suitable TANK CUTAWAY Infiltrator _ native soil.See installation instructions TW Riser ' ; for guidance. -- • =h System - '� 'f Partition . baffle wall `- •'- r HEAVY DUTY LID \'` CUTAWAY • Reinforced • 24" structural • 'I access port a Structural -- bulkheads APPROVED MID-SEAM CUTA X, ii Inl, f,e Reinforced water ti 1 rii�s ahi' `' R gaskete 0A901f0enTY ENVIRONMENTAL HEALTH ,A, RET Protecting , Ilkir I the Environment with Innovative Wastewater Treatment Solutions N F I LT RATO R® water technologies IM-1060 General Specifications and Illustrations LFTMIG SNAP LFTRIG LUG RISERRCONNEC110N (TYPICAL) (4TOTAL) (TYPICAL) The IM-1060 is an injection molded two piece mid-seam � � �, plastic tank. The IM-1060 injection molded plastic design iiil� li �) I�=/1�11�� allows for a mid seam joint that has precise dimensions A ii r! I i 1 1 1,7 r�.i, A for accepting an engineered EPDM gasket. Infiltrator's A i'; Qo ;�r oo � �) ) - gasket design utilizes technology from the water industry ' -- ,1-_I` °o,%ar, • s °°o.l pm to deliver proven means of maintaining a watertight seal. ,� i 1 1 r r 16, _`�i, orreleorr The two-piece design is permanently fastened using a -ii. "`� ! tS"`^.."e� series of non-corrosive plastic alignment dowels and `�,1R^ I A I �"JIi locking seam clips. The IM-1060 is assembled and sold 1 through a network of certified Infiltrator distributors. 127.0.32261ExTTRIORI MGM Must be backfilled and installed in accordance with TOP VIEW Infiltrator Water Technologies, Infiltrator IM-Series Septic OUTLET Tank General Installation Instructions and for shallow -••-•;r* ground water conditions reference the Infiltrator IM- V! Series Tank Buoyancy Control Guidance. 1111 c 1111 s.7 Please visit www.infiltratorwater.com/images/pdf/ nBR1 1 v EXTERIOR ManualsGuides/TANK01.pdf for the latest information. tIisijJIr HEIGHTSEAM(TYPCALmPluuIM-1060 (TYPICAL) Working Capacity 1094 gal(4141 L) Total Capacity 1287 gal(4872 L) END VIEW Airspace 16.5% Length 127"(3226 mm) 04(102) 024t610)ACCESS OPENINGS WITH LOCKING UDS(2) PVC OR ABS 0 4(102)PVC OR Width 62.2"(1580 mm) INLET TEE —101(2601 FREEBOARD ABS OUTLET TEE Length-to-Width Ratio 2.3 to 1 1 INLET \' -' '.4-Nirr‘L/-1.\1171659 R AIRSMCE OUtlET S Height 54.7"(1389 mm) v�l I PE aD�EL R L� c� Liquid Level 44"(1118 mm) 44.0 �$ num FIBERGLASS —�i FIBERGLASS UQUIDt—SUPPORT Invert Drop 3"(76 mm) SUPPORT 069TH1 (TYPICAL) L (TYPICAL) WITH BAFFLE - Fiberglass Supports 2 wALL WHERE REQUIRED Compartments 1 or 2 Maximum Burial Depth 48"(1219 mm) SIDE VIEW Minimum Burial Depth 6"(152 mm) Maximum Pipe Diameter 6"(152 mm) TANK TOP CONTINUOUS Weight 320 lbs(145 kg) HALF GASKET --r APp R Ov E INTERIOR ` Olt SEAM CLIP MAY 2 4 2022 ALIGNMENTii—h. P , TANK BOTTOM MASON COUNTS ENVIRONMENTAL HALF r 4 Busines7 Park Road RET P.O.Box 768 Oki Saybrook,CT 06475 INFILTRATOR` 860-577-7000•Fax 860-577-7001 MID-HEIGHT SEAM SECTION 1-800-221-4436 water technologies www•I nil ltratorswater.com U.S.Patents:4.759,661;5,017.041;5,156,488;5,336.017;5.401,116;5,401,459;5,511,903;5,716.163;5,588,778;5,839,844 Canadian Patents:1,329,959;2.004,564 Other patents pending.Infiltrator.Equalizer, Qulck4,and SideW index are registered traderTLa'ks of Infiltrator Water Technologies.Infiltrator is a registered Trademark in France.Infiltrator Water Technologies is a registered trademark in Mexico. Contour.MicroLeaching,PoyTuff,Chan ilAASpacer,MuttiPort,PoslLodc,QuickCut,QuickPlay,SnapLock and StralghtLock are trader'elks of Infiltrator Water Technologies. PolyLok Is a traderrerk of PolyLok,Inc.TUF-TITE Is a registered trademark of TUF-TITE,INC.Ultra-Rib is a trademark of IPEX Inc. *2016 Infiltrator Water Technologies.LLC.All rights reserved.Printed in USA 1M02 1116 Contact Infiltrator Water Technologies' Technical Services Department for assistance at 1-800-221-4436 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION - Permit Number SWGZL2.1-to os OI Parcel# Z113.' 5 t— C.C. 3 Applicant Name 9.�c .4 Pkw► Subdivision (Name/Div/Block/Lot) Applicant Address /able, N VAS 1-)604 tbl City, State, Zip S\4„1. vvr Wu 418%4- Installer Name 5c ouniny Extava�i•,y Site Address 22.Q10 N us Hv.A/ to% Designer Name J �J INSTALLATION CHECKLIST ❑ Full System Installation [17"Tanks)Only ❑ Drainfield Only 'Repair 0 Other System Type G► ONif/ Pretreatment Type >5 ft.from foundation? - - ❑ N/A 'YES ❑ NO >50 ft. from wells? - - •- 0 d 0 Z >50ft.from surface water? 01E4 484 Cr- - - - ❑ [� 0 < Cleanout between building and tank? - --- 0 [ ❑ ✓ Tank baffles present? - MAR-0.1 2Q23- --- ❑ LJ ❑ d24" access risers over each compsrtm nt. -- - t�'� - ❑ [ ❑ W Effluent filter installed?- � --- ---- - - ❑ 0 Septic tank capacity (working)_ laa4' gal Manufacturer Tv‘ tkra►}vr 0 D-box water level and speed levelers used? - - [ 'N/A ElYES ❑ NO OO Manifold/D-box accessible from surface?- - 21 0 0 COE Check valves installed? - - iFr ❑ 0 OQ 2 Transport Line Size 4" Schedule/Class CovIGIrtA^e 4 Bedrooms installed (check one) ❑ 2 ❑3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10 ft. from foundation?- - ❑ N/A ❑ YES ❑ NO O >100 ft.from wells?- - ❑ ❑ 0 W >100 ft. from surface water? - - ❑ 0 ❑ T. >10 ft.from potable water lines?- - ❑ ❑ ❑ Z > 5 ft. from property lines and easements?- - ❑ ❑ ❑ li > 30 ft.from downgradient curtain/foundation drains?- - 0 0 ❑ • Drainfield level and observation ports present - - 0 0 0 ❑ Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?- - 0 ❑ 0 Pump tank setbacks consistent with septic tank? - - ❑ N/A ❑ YES ❑ NO • Pump tank capacity(flood) gal Manufacturer < 24"access riser(s)and accessible from surface?- - ❑ ❑ ❑ I— a. Alarm or Control Panel Installed? - - ❑ 0 0 2 Control Panel equipped with Timer/ ETM /Counter- - ❑ ❑ ❑ m n- Pump installed in ❑ Bucket or ❑ On Block or ❑ Other n'• Pump Make/Model ❑ Floats or ❑ Transducer a Tank draw down in/min Pump capacity gpm Squirt Height ft Pump on time Pump off time Daily flow set at gpd Updated 8/21/2018 Mason County OSS Installation Report pg. 2 Parcel# ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - d YES 0 NO If yes, please describe: EX6Y}11.� 4VO#KI(2) 'St��c.- v' S Were all components pumped out anti'properly abandoned per WAC246-272A-0300? - - YES 0 NO II RECORD DRAWING This Is a permanent record and must be accurate and descriptive enough to re-locate in the need of maintenance activities and future development Typical Record Drawings contain. Drainfield&manifold orientation&layout.Septidpump tank location,North arrow,reserve drainfield.existing and proposed buildings.location of wells,waterlines, wells,observation ports,cleanouts,and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and related permits. Record Drawing Attached CERTIFICATION OF INSTALLATION d INSTALLER DESIGNER/ENGINEER i I certify that I installed the system in accordance with 1 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 attached Record Drawing is accurate. form and attached Record Drawing is accurate. 2.2S•Z'3 Sig-nature of Installer Date FSYuyl.wn SL%o-e lln'l Printed Name of Signee MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and Record Drawing on behalf of Mason County Public Health: Icac-\,, cr 5/6 /z .3 Signature of Environm€ntal Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Updated 8/21/2018 F• •• ......... • -... ..; . . . SKETCH AND 41FASIGNATZ_THE ALLC3ANG: .. .1 • -.•.,:-.,....,;•.„.::.. ! •.:-,- 7. •.•.; ; .7.4 -- -" ,....,. ?,.-, • ,.."; r:1-1, . . - .• L. . Propert3* Liao 'and Flames of .stf,iiett. -- —- --- • ._ . • :-.• ..... . . . . ,. :.. ):; L.... •.: ' -, .. ..:. •.v.::: .•. . . ,-_,... „ • 2.; 1.4cate alland/or building,i driveways, septic tank atail:dieinfreld-; --: • •... _ . .,. .-4. :- : 7 •...... •.:::. • • distribution box and trees.. - . • . -....3".- • • --:-•t - - •-: • 3. frimensions .of •serrt ic tank and Uriiiiifield. . •...,, -• ... . .. ,,. :....,..:;. 1 - .. ../.... :.;,".:.. "••".. -..;.,,.. . ; - . • . 4. Location-of and distance to enrstream, lake, Puget Sound; or other .•1,1w,• --;••:.•- .. bodies of water within loo.;filiqt-of sewage system; - -•11%.'3. ,-”::.• ...":.; • - • ••••• ••;:..f.f k • . . 5. Location and type of-wells or other-werte.r supplies within 100 feei`• of sewage system. . .- . • • .-:-a ..._ • 1 i:. .1 . • A.:1 '1 • • - - -- - --..• • - - - - - • -. . .. . • • •'• • N *-• ..._ _.... . . . .... .. ....... .. _ .... . ... ..._ .. ...... _ 2 ).' th...' - r.f.'. 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