HomeMy WebLinkAboutSWG2023-00088 - SWG Application / Design - 3/16/2023 �. 0
MASON COUNTY 415 N 6TH STREET, SHELTON,WA 98584
SHELTON:360427-9670, EXT 400
r� 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: SWG2023-00088
APPLICANT RJ PEABODY Phone: 206-229-5117
Address: PO BOX 565 BURLEY, WA 98322
OWNER WOODIN TERRY R & CHRISTINE D Phone:
Address: 20227 237TH AVE SE MAPLE VALLEY, WA 98038
SEPTIC DESIGNER PAULA JOHNSON -Arrow Septic Phone: 360-898-2255
Designs Inc.
Address: 171 E VUECREST DRIVE UNION, WA 98592
Site Address: 50 NE Katherine Ct
Primary Parcel Number: 223365400065
Permit Description: 3-bedroom gravity system
Permit Submitted Date: 03/16/2023
Permit Issued Date: 03/22/2023
Issued By: David Anderson
Current Permit Fees Paid: $525.00 (additional fees may be requ red upon installation of system).
Permit Expiration Date: 03/21/2026 (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.gov/healthlenvironmental/onsiteloss-inspection-request.php or call:
360-427-9670, extension 400.
4 - _ .
Prl-f c,cr C-C
OFFICIAL USE ONLY
DATE RECEIVED b V.
MASON COUNTY - , tocn
"F COMMUNITY SERVICES .° 5 • 1RECEI co N
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Publk Heath(Community Heahh/Env ronmental Health) ��� —201Z N 0
.. 415 N.Oth St et-Sheet.,
of,WA 9e1a4.<rt 400 06 ` O
415 N.6tA Street-Sl,city WA 96584
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ON-SITE SEWAGE SYSTEM APPLICATION
PHONE m
APPLICANT
RJ Peabody Inc Megan Gjertsen (253)514-3915 c
MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE WA 98322 0 m
P.O. Box 565 Burley
SITE ADDRESS-STREET.CITY.ZIP CODE 98(gyp 528 I N
50 NE Katherine Ct Belfair WA
PHONE (D I N
NAME OF DESIGNER
Arrow Septic Designs (360)898-2255 I
PHONE 0 CA)
OF INSTALLER
Final Vision (360)801-5681 5
cIw
PERMIT TYPE(select one) C DRINKING WATER SOURCE
lil RESIDENTIAL OSS ECOMMUNITY OSS El COMMERCIAL OSS i1 PRIVATE INDIVIDUAL WELL 5 PRIVATE TWO-PARTY WELL Z I a)
7 PUBLIC WATER SYSTEM I
TYPE OF WORK(select one) 'p I 1
�jNEW CONSTRUCTION I UPGRADES REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) 0 TABLE IX REPAIR
0 SURFACING SEWAGE 0 EXISTING FAILURE ❑ SHORELINE co
SUBMITTALS
li��
DESIGN FORM(REQUIRED) hit SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE Q
I
�]WAIVER(S)(IF APPLICABLE) 3 BR .17 acres o t
CD
DIRECTIONS TO SITE AND SITE CONDITIONS-(ex locked gate)
Take Hwy 3 toward Belfair and turn (L) onto Old Belfair Hwy. Turn (L) onto NE State Route
300. Turn (R) onto NE Larson Lake Rd. Turn (R) onto NE Katherine Ct. o I o
Yellow sign: "RJ Peabody" -
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al
I
SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. 101
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE/FAILURE SOURCE(for reporting purposes)
0 VOLUNTARY 0 MAINTENANCEJPUMPING 0 BUILDING PERMIT 0 HOME SALE ❑COMPLAINT 0 OTHER:
INSPECTOR SOIL LOGS COMMENTS!CONDITIONS
lUMN i- fl
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T z: Q-7�' LDS a ,
MAR l s 2023 LJ
iti3; C- ?Z\I //4/6 6 Y ___.
RECORD DRANWG AND INSTALLATION REPORT
SOIL CODES: r REQUIRED FOR FINALAPPROVAL
V=VERY G=GRAVELLY S=SAND L=LOAM Si=SILT C=CLAY E=EXTREMELY R=ROO•S DATE
INSPECT SI NATURE DATE APPLICATION EXPIRATION DATE
APPLICATION APPROVED/ISSUED BY
/21/Xt 3/Z I / 20 l
.:.-,,
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE
REVISED 12/72015
DESIGN FORM—PAGE ONE Assessor's Parcel Number: 2 2 3 3 6 — 5 4 — 0 0 0 6 5
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. 0 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: II"X 17"
- .. _ _ . ; P ,. w- .w>.1 -7 ti t~, - x 8-if_ .. r. - -- : ..._�=+:T.ff.:_.mot,_. <
Designer's Name: Arrow Septic Designs
Permit Number. SWG (360)898-2255
Applicant's Name: Ri Peabody Inc Designer's Phone Number.
Box 565 P.O.
171 E Vuecrest Dr
Mailing Address: Designer's Address:
Burley WA 98322
Union WA 98592
State
City Zip City State Zip
- - ,� �� .,;�`.-�_ —...
...ems,= .�.. �___.� '..J9K3�ti'.-�a' ... ._. ".. s.......,.,.,....,..._.., ._ ...-
.
Treatment Device
0 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:
Drainfield Type
'Gravity 0 Pressure Et Trench 0 Bed ❑Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 3 Schedule/Class 2729
Daily Flow:Operating Capacity 270 gpd Length 50 ft
Daily Flow:Design Flow 360 gpd Diameter 4 in
Septic Tank Capacity(working) 1,200 gal Number 3
Receiving Soil Type(1-6) 3 Separation 5 ft
Receiving Soil Appl.Rate 0-8 gpdif 2 Orifices
Required Primary Area 450 ft2 Total Number of Orifices —
Designed Primary Area 450 ft' Diameter — in
Designed Reserve Area 450 ft2 Spacing — in
Trench/Bed Width 3 ft Manifold
Trench/Bed Length 150 ft Schedule/Class —
Elevation Measurements Length — ft
Original Drainfield Area Slope 12 % Diameter — in
New Slope,If Altered 12 % Preferred manifold configuration used? 0 Yes Cl No
Depth of Excavation Up-slope 30 in Transport Pipe
from Original Grade Down-slope 26 in Schedule/Class 3034
Designed Vertical Separation 36+ in Length 30 ft
Gravelless Chambers Required? 0 Yes id No 0 Optional Diameter 4 in
Pump Required? 0 Yes elNo Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day —
Diff.in Elevation Between Pump&Uppermost Orifice — ft Dose quantity — gal
Drainfield Squirt Height/Selected Residual(head) — ft Chamber Capacity(flood) gal
Uppermost Orifice 0 Higher 0 Lower than Pump Shutoff Pump controls:Please check those required.
Capacity @ Total Pressure Head — gpm ❑Timer ❑Elapse Meter 0 Event Counter
Calculated Total Pressure Head — ft If Timer: Pump on — ,Pump off
Comments APPROVED
MAK 2 1 202i
l t9f-IC "'SON COUNTY ENVIRONMENTAL HEALTF
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DESIGN FORM—PAGE TWO Assessor's Parcel Number:2 2 3 3 6 — 5 4 -- 0 0 0 6 5
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
re Test hole locations 6d Drainfield orientation and layout Reference depth from original grade:
6ti Soil logs It Trench/bed dimensions and ' Septic tank
EZT Property lines critical distances within layout cif Drainfield cover
ElExisting and proposed wells Iii. D-Box/Valve box locations Reference depth from original grade
within 100 ft of property Ei4 Septic tank/pump chamber and restrictive strata:
❑ Measurements to cuts,banks,and locations Pi Laterals,trench/bed,top and
surface water and critical areas 6i Observation port location bottom
❑ Location and orientation of 0 Clean-out location ❑ Curtain drain collector
curtain drain and all absorption 0 Manifold placement 0 Sand augmentation
components 0 Orifice placement Other cross-section detail:
66 Location and dimension of 54 Lateral placement with distance Ei4 Observation ports/clean-outs
primary system and reserve area to edge of bed Other Information
6g Buildings ❑ Audible/visu. : t,yy'i�'j renced Yes No
6� Direction of slope indicator Et Scale of dr •.7i,!1► . cale Iff 0 Design staked out
6i7 Waterlines bar •,'' '•try' U ❑ Et Recorded Notices attached
3 O o Er Waiver(s)attached
64 Roads,easements,driveways, � cc o. ��,
parking 1= ^,.t� ❑ C'Pump curve attached
6� North arrow and scale drawing • ` �^,1.�y. o G�Evaluation of failure
shown on scale bar
ram' s,co as Non-residential justification
"a' PAULA JOY JOHNSON �' 0 (�Waste strength
CiC $>=tilMtlairft'• 0 Flow
e,enarc ,
DESIGN APPROVAL
The undersigned designer must be no i by insta er at time of installation 54 Yes 0 No
3 -1 s-ZN
Signature o Designer Date
p� ,x'
The undersigned has reviewed this design on behalf of Mason County Public Healt R�etERQ -ii.._
compliance with state and local on- ite regu ations:
372("2� ( MAR 2 1 2023
nvironme 1 Health Specialist MR COUNTY ENVIRONMENTAL HEALTI'
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONI4ON:
✓ 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 lated Date: 12/7/2015
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PROVED / / ��'2"s�L,, iMAR 2 12023 "6vOlaild
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SON COUNTY ENVIRONMENTAL HEALTH A
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Kev:
0 Cleanout
O1,200 Gallon Septic Tank
2-Compartment with Effluent Filter
0 D-Box with speed-levelers
and cover to surface ,
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36 lf f'GLA JOY JOHNSON .
`.0 I. Z ' , :� APPROVED
1 MAR 2 1 2023
MASON COUNTY ENVIRONMENTAL HEALTH
NOTE; DJA
. - O=OBSERVATION PORTS TOBE 4" PERI'•
PVC PIPE FROM BOTTOM OF TRENCH TO '
FINISHED GRADE. REMOVABLE CAP
SHALL BE INSTALLED ON OBSERVATION
PORT PIPE. Glue 'Ttt ON BOTTOM SO
PIPE CANT BE REMOVED. NEED ONE
AT DISTAL END OF EA. LAT. LATERALS. -
ARE • TO BE CENTERED IN TRENCHES.
SECURED LID WITH GAS TIGHT SEAL
i 24'DIAMETER
ACCESS OSIER \ . •
ILI* \_P 11
7". i Ir - TO PUNP
_ai
SouRCE FLOATING MAT
s—
_. EFFLUENT
FILTER
•
SEDIMENTS
SEPTIC TANK •
.
v,, ,f\e.,,.,,,,\ APPROVED
MAR 2 1 2023
afr,ce--47 (`Do aatc1--(-;•-\13
MASON COUNTY ENVIRONMENTAL HEALTH
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5 "Note: Septic Tanks must meet standards required by WAC chapter 246-272C
and manufacturer must be on the Dept of Heatth list of registered sewage tanks.**
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Clueut Septic De/sign/3
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INSTALLATION & MAINTENANCE � `� " ��' �
Gravity Distribution Systems x' 51:Z;<3 1
PAULA JOY JOHNSON
1. Install Laterals with contour of the ground. s/
2. Install trench bottoms level.
3. Install locator tape or rebar at each end of all drainfield laterals.
4. Install observation ports as indicated on the detailed drainfield layout. One required at
distal end of each lateral in drainfield with bottom extending to the drainrock/native soil
interface. Glue "T" to bottom so Observation Port cannot be easily removed from
ground. Install removable cap on top of port at final grade level.
5. Install drainfield during dry weather and soil conditions; any soil smearing must be
eliminated by hand raking.
6. Use distribution box with speed levelers and cover to surface. Divert incoming pipe
down with 90-degree angle to prevent short-circuiting.
7. Filter fabric required over drain rock prior to back filling. If the drain rock extends above
natural grade, run the filter fabric at least 2 inches down the trench wall.
8. Encase all water lines within 10' of drainfield and under any driveway,/parking areas.
9. Divert all storm water runoff away from on-site sewage system.
10. No curtain drains allowed within 10' of the up-slope edge or 30' of the down-slope edge
of the drainfield and reserve area.
11.No vehicular traffic over drainfield area.
12. Install Bio-Tube or equivalent effluent filter at outlet end of septic tank.
13. All manhole lids and access, sampling or inspection ports must have locking covers and
be located at ground level.
14. Inspect tank and clean filters every 6-12 months as needed.
15. Have the septic tank pumped or professionally inspected every 3 to 5 years.
16. All materials and workmanship must meet County and State regulations.
17. Deviation from this design without prior approval from the Designer and Mason County
Environmental Health Department will make this design null and void.
18. All transport lines under driveways or parking areas must be encased to prevent crushing.
19. Homeowner is responsible for all property lines.
PRovEf
MAR 2 12023
,30N COUNTY ENVIRONMENTAL! .'
n.JA.