HomeMy WebLinkAboutSWG2023-00053 - SWG Application / Design - 2/21/2023 C • L.
MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584
SHELTON:360-427-9670,EXT 400
BELFAIR:360-275-4467,EXT 400
47111 1 Public Health & Human Services ELMA:360-482-5269, EXT 400
kaa, FAX:360-427-7787
On-Site Sewage System Permit: SWG2023-00053
APPLICANT Fred Crabtree Phone:
Address: 9101 W Shelton matlock Rd SHELTON, WA 98584
OWNER HICKSON FAMILY REVOCABLE LIVING Phone:
TRUST
Address: A MARIE HICKSON TRUSTEE GRASS VALLEY, OR 97029
SEPTIC DESIGNER CINDY WAITE-Septic Designer Phone: 3607010205
Address: 80 E PICKERING LANE SHELTON, WA 98584
Site Address: 9101 W Shelton Matlock Rd
Primary Parcel Number: 520141100010
Permit Description: 3-bedroom septic system repair for failing drain field
Permit Submitted Date: 02/21/2023
Permit Issued Date: 03/06/2023
Issued By: David Anderson
Current Permit Fees Paid: $780.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 03/03/2026 (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.govlhealth/environmental/onsiteloss-inspection-request.php or call:
360-427-9670, extension 400.
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OFFICIAL USE ONLY
MASON COUNTY PUBLIC HEALTH DATERECEIVED 0 al I . 23
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ONSITE SEWAGE SYSTEM APPLICATION AMOu,,,1, r VED� ` RECEIVES
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415 N 6th Street,(Bldg 8) Shehon WA,98584 • .
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Shelton:360.427-9670 ext 400 Belfair:360-275-4467 ext 400 SWG ZZj _ (n O
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APPLICANT I'- ',= D >
FRED CRABTREE 1 360-490-8543 m m
MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE r
9101 W SHELTON MATLOCK RD SHELTON WA 98584 c
SITE ADDRESS-STREET.CITY.ZIP CODE CO
SAME
NAME OF DESIGNER PHONE I (31
CINDY WAITE 360-701-0205
NAME OF INSTALLER PHONE I N
SCHOENING EXCAVATION LLC 360-742-2982 o I CDCHECK ALL APPLICABLE ITEMS DRINKING WATER SOURCE
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❑J NEW CONSTRUCTION 0 RV HOLDING TANK ONLY Id PRIVATE INDIVIDUAL WELL (n .
E REPLACEMENT SYSTEM ❑ INSTALLATION PERMIT ONLY ❑ PRIVATE TWO-PARTY WELL 0
O TABLE 9 REPAIR 0 SINGLE FAMILY 0 COMMUNITY/PUBLIC WATER SYSTEM z 1 --
❑ TANK(S)ONLY 0 COMMERCIAL SYSTEM NAME:
❑ UPGRADE TO EXISTING ❑ OTHER: BEDROOMS LOT SIZE I —
id EXISTING FAILURE "Record Drawing required for all Installations" r 3 972'X666'(APROX 14 ACRES) W
I
DIRECTIONS TO SITE-BE SPECIFIC AND ADVISE OF ANY NEEDED INFORMATION FOR ACCESS(ex locked gate) 0 r
GO OUT SHELTON MATLOCK ROAD, TURN LEFT ONTO DRIVEWAY, STAY TO THE
Io
RIGHT AFTER GOING OVER THE BRIDGE. DRIVEWAY IS BEFORE HANKS LAKE I o
ROAD.(RIGHT BEFORE THE
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SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS I Ci
OFFICIAL USE ONLY BELOW THIS LINE - — --- -
UPGRADE I FAILURE SOURCE(for reporting purposes)
❑VOLUNTARY ❑MAINTENANCE/PUMPING ❑BUILDING PERMIT ❑HOME SALE ❑COMPLAINT ❑OTHER:
INSPECTOR SOIL LOGS pp COMMENTS/CONDITIONS
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SOIL CODES:
V=VERY G=GRAVELLY S=SAND L=LOAM Si=SILT C=CLAY E=EXTREMELY R=ROOTS
INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED BY DATE
Of/7A,
3/3/20z6
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12/7/2015
DESIGN FORM—PAGE ONE Assessor's Parcel Number: 5 2 0 1 4 — 1 1 — 0 0 0 1 0
A design will be reviewed when 3 copies of each of the following are submitted:
Q 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: /I"X I
PARCEL IDENTIFICATION
_______
Permit Number: SWG Designer's Name: CINDY WAITE
Applicant's Name: FRED CRABTREE Designer's Phone Number: 360-701-0205
Mailing Address: 9101 W SHELTON MATLOCK RD Designer's Address: 80 E PICKERING LANE
SHELTON WA 98584 SHELTON WA 98584
City State Zip City State Zip
DESIGN PARAMETERS
Treatment Device
0 Glendon Biolilter 0 Sand Filter ❑ Mound 0 Sand Lined Drainfield 0 Recirculating Filter.hype:
0 Aerobic Unit Make/Model 0 Disinfection Unit Make/Model Other:
Drainfield Type
0 Gravity l 'Pressure G'Trench 0 Bed 0 Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 3 Schedule/Class SCHEDULE 40 '
Daily Flow: Operating Capacity 270 gpd Length 50 it
Daily Flow: Design Flow 360 gpd Diameter 1.25
in
Septic Tank Capacity 1200 gal Number 4
Receiving Soil Type(1-6) 4 Separation 2 ft
Receiving Soil Appl. Rate .6 gpd/ft2 Orifices
Required Primary Area 600 ft2 Total Number of Orifices 40
Designed Primary Area 600 ft2 Diameter 3/16
in
Designed Reserve Area 600+ ft2 Spacing 60 in
Trench/Bed Width 3 ft Manifold
Trench/Bed Length 200 ft Schedule/Class SCHEDULE 40
Elevation Measurements *II �,h - 2 it
Air Original Drainfield Area Slope <1 % '%ian R+er 2 in
New Slope, If Altered % , refer,manifold configuration used? 0 Yes 0 No
Depth of Excavation Up-slope 16 in i'� ,wAS `�7��1 t Transport Pipe
from Original Grade p p
Down-slo p��/�, 1
rx 15 ior„...P ;; . it is 1) SCHEDULE 40
Designed Vertical Separation 24 .' J• N S 60
j c2• n N 5 ram;. ' ft
Gravelless Chambers Required? ❑ Yes 0 No /•Ftrct . , ft: . t i 2
GNE d in
Air
Pump Required? En Yes 0 No megiom gookvioublawk ift. �AMNOlieP,sing and Pump Chamber
EXPiRI s 05n0t
Pump/Siphon Specifications Number of doses/day 6
Difference in Elevation Between Pump Shutoff and Uppermost Dose quantity 45 gal
Orifice 5 ft Chamber Capacity 1200 gal
Uppermost Orifice 0 Higher 0 Lower than Pump Shutoff Pump controls: Please check those required.
Capacity @ Total Pressure Head 23.6 gpm C'Timer l 'Elapse Meter fit Event Counter
Calculated Total Pressure Head 7.59 ft If Timer: Pump on A P PRQ
VEMComments VI/
ACONCRETE TANKS REQUIRED, SET PUMP CONTROLS AT TIME OF INSTAIRLaiI
MASON COUNTY ENVIKONMENTAL HEALTH
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DESIGN FORM—PAGE TWO Assessor's Parcel Number: 5 2 0 1 4 — 1 1 -- 0 0 0 1 0
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
lid Test hole locations 21 Drainfield orientation and layout Reference depth from original grade:
21 Soil logs 2 Trench/bed dimensions and 2 Septic tank
21 Property lines critical distances within layout Q( Drainfield cover
Bj Existing and proposed wells 2 D-Box/Valve box locations Reference depth from original grade
4easurernents
thin 100 ft of property 2 Septic tank/pump chamber and restrictive strata:
to cuts,banks,and locations 11 Lateral
surface water and critical areas 21 Observation port location s,trench/bed,top and
bottom
,Location and orientation of 2 Clean-out location 0 Curtain drain collector
curtain drain and all absorption 2 Manifold placement 0 Sand augmentation
components
lifi 6d Orifice placement Other cross-section detail:
Location and dimension of
primary system and reserve area 21 Lateral placement with distance 2 Observation ports/clean-outs
to edge of bed
66 Buildings Other Information
g Audible/visual alarm referenced Yes No
El Direction of slope indicator
El Scale of drawing shown on scale d 0 Design staked out
e1 Waterlines bar 0 0 Recorded Notices attached
lid Roads,easements,driveways, 0 0 Waiver(s)attached
parking 21 0 Pump curve attached
0 North arrow and scale drawing 21 0 Evaluation of failure
shown on scale bar
Non-residential justification
❑ 0 Waste strength
❑ ❑ Flow
DESIGN APPROVAL
The undersigned designer must be no ' d by installer at time of installation 'Yes 0 No
Lk-)44 2 20 24 2-3
Signa a of Designer Date
The undersigned has reviewed this design on behalf of Mason County Public Health and d r i
compliance with state and local on-site reg ations:
_37J/2,, MAR 0 6 2023
r
nmen al Health Specialist Date qg ����y E
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING O��NDITIC ONMENTAL HEAVE.
✓ The design is stamped"Approved" by Mason County Public Health. °�
✓ 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.
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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# (Feet) (Inches) Spacing " Orifices feeder line of end of lateral
1 50 600 60 10 2.5 2.5
2 50 600 60 10 2.5 2.5
3 50 600 60 10 2.5 2.5
4 50 600 60 10 2.5 2.5
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6 0 0 60 0
7 0 0 60 0
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TRANS LENGTH 60 �s,�o4uAs,Fy,
GPM 23.6 P F � �i
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FRICTION LOSS 0.599772094 �o is
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Trench Depth
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THREADED CAP OR PLUG
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LAST ORIFICE;WITH
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Pump Specifications
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LITERS PER MINUTE
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Installation Notes M .u4NCO ENVIRONMENTAL HEALTH
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Pressure Distribution S i�� �° As 9� � a}1�i
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52014-11-00010 9101 W Shelton Matlock ��
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1. The prepared site plan is not a survey. It's the owner's re:9'®n sYooa,a `p
,, sil did E*pro. dy
lines, utility lines (water, sewer, power, phone and gas) . �� - 44%74; ��:•s �����1,
2. This is a repair. Existing system is at least 60 years old. S siLCifiTS°boncrete tiles
that some are crushed full of roots and solid.
3. Concrete tanks required
4. Pump controls to be set at time of installation .
5. Install system during dry weather with acceptable soil conditions
6. The tanks may be moved as necessary to accommodate building requirements. Septic
tank location must meet all required setbacks.
7. Keep wheeled vehicles off the drainfield area before, during and after installation.
Tracked equipment only,
8. All ground, surface water and roof drains must be diverted away from the septic
and drainfield. Ensure the final grade slopes away from these areas and water doesn't
collect on or around them. Use swales, berms, catch basin and tight lines, curtain drains,
etc. to divert all waters.
9. Curtain drains can be no closer than 10' upgradient and 30' down gradient of the
drainfield
10. Exposed restrictive layers, cuts, banks, etc. can be no closer than 50' downhill from the
drainfield.
11. Install access risers on the septic tanks, valve box and ends of laterals.
12. Make sure septic tank risers are epoxied or caulked to cast in riser rings on tank.
13. Lids must form a water and gas tight seal with the access risers
14. Install effluent filter specified in this design at the septic tank outlet.
15. This system must be installed by a Mason County Certified installer.
16. Self-install systems must meet Mason County procedures.
17. Deviation from this design without prior approval from the designer and Mason County
Health Department will make this design null and void.
18. This design was sized per Washington Administrative CodeWAC246-272A-0230. The
operating capacity is based on 45 gallons per day per capita with two persons per
bedroom. The minimum design flow per bedroom per day is the operating capacity of
ninety gallons multiplied by 1.33. This results in a minimum design flow of one hundred
twenty gallons per day. This creates a surge factor of 33% but anticipated flow is ninety
gallons per bedroom per day.
19. Install laterals with contour of the ground
20. Install trench bottoms level and always maintain a minimum of six inches into native soil
21. Install locator tape on top of all drainfield laterals.
22. Install threaded clean outs at the ends of all laterals (caps must extend to within six
inches of finish grade and be in a valve box as shown on diagram.
23. Install audio/visual alarm
24. Filter fabric required over drain rock prior to backfilling. If the drain rock extends above
the original grade, run the filter fabric at least 2 inches down the trench wall.
ROVE,
MAR 0 6 2023
TY ENVIRONMENTAL HEALTH
System Owner Responsibilities: DJA
1. Operation and Maintenance is required by Washington State Department of Health and
Mason County Health Department.
2. The septic tank and pump tank should be pumped every three to five years or as
needed.
3. System owners are responsible for having maintenance performed annually.
4. System owners are responsible for responding to septic issues in a timely manner.
5. System owners shall not at any time change or alter settings in the control box.
6. System owner agrees to read and abide by information regarding their system in the
User Manual provided by Mason County Public Health.
7. Keep the flow of sewage at or below the approved
8. Keep waste strength at residential waste strength parrameterrs operating capacity.
9. Spread loads of laundry through the week.
10. Do not use excessive bleach or detergents with added whiteners.
11. Do not shower, do laundry and dishwasher at the same time
12. Antibiotics can kill or impair the biological process in the septic tank.
13. Leaky plumbing can hydraulic overload your on-site septic system.
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