HomeMy WebLinkAboutSWG2023-00041 - SWG Application / Design - 2/13/2023 MASON COUNTY 415 N 6TH STREET,SHELT WA 98584
j SHELTON:360-427-9679670,EXT 400
BELFAIR:360-275-4467,EXT 400
Public Health & Human Services ELMA:360-482-5269,EXT400
FAX:360-427-7787
On-Site Sewage System Permit: SWG2023-00041
APPLICANT HOSS WARREN & MARTHA Phone: 206-979-4604
Address: 35433 26TH AVE S FEDERAL WAY, WA 98003
OWNER HOSS WARREN & MARTHA Phone: 206-979-4604
Address: 35433 26TH AVE S FEDERAL WAY, WA 98003
SEWAGE DESIGNER Jim Zimny -Advantage Perc & Design Phone: 360-516-7287
Address: 7178 WINDFLOWER PL NW SEABECK, WA 98380
Site Address: 860 NE Tahuya River Rd
Primary Parcel Number: 322127600050
Permit Description: New SFR -2BR Gravity W/class b waiver
Permit Submitted Date: 02/13/2023
Permit Issued Date: 03/30/2023
Issued By: Jeff Wilmoth
Current Permit Fees Paid: $525.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 03/08/2026 (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/health/environmental/onsiteloss-inspection-request.php or call:
360-427-9670, extension 400.
OFFICIAL USE ONLY
DATE aEom�
MASON COUNTY o�--C3 ' a 'J
COMMUNITY SERVICES AMOUNT
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Public Health(Community Health/Environmental Health) N N
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CLEAR FORM ON-SITE SEWAGE SYSTEM APPLICATION v v
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APPLICANT PHONE m
Warren Hoss 206-979-4604 c
MAILING ADDRESS-STREET,CITY,STATE.ZIP CODE g
35433 26th Ave, Federal Way WA 98003 m
xi
SITE ADDRESS-STREET,CITY,ZIP CODE I•
•
NE Tahuya River Rd W
NAME OF DESIGNER PHONE I! .Jim Zimny 360-516-7287 �
NAME OF INSTALLER PHONE v I ^)
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DRINKING WATER SOURCE I—
PERMIT TYPE(select one) Q
W RESIDENTIAL OSS fl COMMUNITY OSS I-1 COMMERCIAL OSS W PRIVATE INDIVIDUAL WELL b PRIVATE TWO-PARTY WELL Z I Ni
TYPE OF WORK(select one) 1 ' PUBLIC WATER SYSTEM t
QI NEW CONSTRUCTION/UPGRADES b REPAIR/REPLACEMENT OTHER DETAILS(select all Mat apply) 0 TABLE IX REPAIR
SUBMITTALS ❑SURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINE co
h'f DESIGN FORM(REQUIRED) Pt SEPTIC DESIGN(REQUIRED) BEDROOMS 2 LOT SIZE 5.11 Acres On I
*-WAIVER(S)(IF APPLICABLE) 0-
C
DIRECTIONS TO SITE AND SITE CONDITIONS(ex.locked gate)
From Belfair take St Rte 300 (North shore rd ) 3.1 miles to Belfair Tahuya RD, go Rt . in 8.1 Io
miles take left on NE Tahuya River RD. In .7 miles the lot is on the Rt marked by pink
ribbons. Follow rd up the hill and follow pink ribbons to the test holes. O ID
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SITE MUST BE FLAGGED FROM MAIN ROAD ANO TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. I lam'
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE I FAILURE SOURCE(for reporting purposes)
❑VOLUNTARY 0 MAINTENANCE/PUMPING ❑BUILDING PERMIT ❑HOME SALE ()COMPLAINT ❑OTHER:
INSPECTOR SOIL LOGS COMMENTS 1 CONDITIONS
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RECORD DRAWING AND INSTALLATION REPORT
SOIL CODES:
V=VERY G=GRAVELLY S=SAND L=LOAM Si=SILT C=CLAY E=EXTREMELY R=ROOTS REQUIRED FOR FINAL APPROVAL
IN$•'SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPR DI ISSUED BY DATE
THI • t, •Y BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12T1/2015
DESIGN FORM—PAGE ONE Assessor's Parcel Number. 322127600050— —
A design will be reviewed when 3 copies 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
''Scaled plot plan,including all applicable items on checklist. '1 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.h laximum paper size: 11"X 17" ,
PARCEL IDENTIFICATION
Designer's Name: Jim Zmny
Permit Number: SWG p�p�S • OOQi�)
Warren Noss 360-516-7287
Applicant's Name: Designer's Phone Number:
Mailing Address: 35433 26th Ave S Designer's Address: 7178 Windflower PI NW
Federal Way WA 98003 Seabed(WA 98380
CLEAR FORM City State Zip
City State Zip ty
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
Drainfield Type
❑ Gravity 0 Pressure 0 Trench 0 Bed 0 Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 2 Schedule/Class 3034
Daily Flow:Operating Capacity 180 gpd Length 45 ft
Daily Flow: Design Flow 240 gpd Diameter
4 in
Septic Tank Capacity(working) 1000 gal Number 3
Receiving Soil Type(1-6) 4 Separation
5 ft
Receiving Soil Appl.Rate 0.6 gpd/ft2 Orifices
Required Primary Area 400 ft2 Total Numbe,of Orifices N/A
Designed Primary Area 400 ft2 Diameter ; • in
Designed Reserve Area 400 ft2 Spaci l ►.+r in
Trench/Bed Width 3 ft Al �', Manifold
044,Trench/Bed Length 135 ft Sc • qr.. , •^`Pi N/A
• Jam, Alton= ny
I.r,.S,_o uL:.•!cnER • ft
Elevation Measurements ,',L ts
Original Drainfield Area Slope 8 % Diameter in
New Slope,If Altered 8 % Preferred manifold configuration used? 0 Yes 0 No
Depth of Excavation Up-slope 14 in Transport Pipe
from Original Grade Down-slope 12 in Schedule/Class 3034
Designed Vertical Separation 18 in Length r1)S 1 ft
Gravelless Chambers Required? 0 Yes 0 No 0 Optional Diameter 4 in
Pump Required? 0 Yes 0 No 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
Pump controls:Please check those required.
Uppermost Orifice 0 Higher 0 Lower than Pump Shutoff
Capacity @ Total Pressure Head P R ■l ❑Elapse Meter El Event Counter
Calculated Total Pressure Head �, r ,Pump off
Comments MAR 3 0 2093
MASON COUNTY ENVIRONMENTAL HEALTH
'BW
DESIGN FORM—PAGE TWO Assessor's Parcel Number. 322127600050— —
Permit Number. SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
E1 Test hole locations ie! Drainfield orientation and layout Reference depth from original grade:
Ef Soil logs E1 Trench/bed dimensions and 121 Septic tank
El Property lines critical distances within layout ii ' Drainfield cover
O Existing and proposed wells 0 D-Box/Valve box locations Reference depth from original grade
within 100 ft of property ig Septic tank/pump chamber and restrictive strata:
lid Measurements to cuts,banks,and locations fiff Laterals,trench/bed,top and
surface water and critical areas E( Observation port location bottom
O Location and orientation of 0 Clean-out location 0 Curtain drain collector
curtain drain and all absorption 0 Manifold placement 0 Sand augmentation
components 0 Orifice placement Other cross-section detail:
ig Location and dimension of 0 Lateral placement with distance ig Observation ports/clean-outs
primary system and reserve area to edge of bed
O Buildings Other Information
0 Audible/visual alarm referenced Yes No
▪/Direction of slope indicator El Scale of drawing shown on scale 0 ES Design staked out
d Waterlines bar ► 0 10 Recorded Notices attached
E< Roads,easements,driveways, �b► Ig 0 Waiver(s) attached
parking ;= �'�'►+ 0 0 Pump curve attached
, . �► ❑ ❑ Evaluation of failure
ilt
N4 ;, � t e " I �►
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Non-residential justification
❑ ❑Waste strengthMR 30 2023 .. .;. �.. . - ..,.,. 0 ❑ Flow
MASON COUNTY ENVIRUNNitN IAL ntALTl1 F.SIGN APPROVAL
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The undersigned designer must be notified by ler at .• e of installation ErYes ❑ No
1A. z___ -2_--
Signature of t er
er 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 site regulations:
l'Jrk-, '-; '30 - 3
E it ental Health Specialist Date
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
✓ The design is stamped "Approved"by Mason County Public Health.
✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: 3 $—.2 G
✓ 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 Daic:]2/7/201J
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Advantage Perc & Design
Timely-peasonable-3O Years of Local Experience
Soils Report Ne Tahuya River Rd Belfair, WA 98528
# 322127600050
TH # 1 0-32" med Loamy sand, type 4 soil
TH # 2 0-36" med Loamy sand, type 4 soil
TH # 3 0-32" med Loamy sand, type 4 soil
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MASON CpUNrY tN✓�RONMENTAL HEALTH
Advantage Perc&design • APDdesignsfuicleud.com • (360)516-7287
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Advantage Perc & Design
Timely-Reasonable•30 Years of Local Experience
Construction Notes for 2 Bedroom System equal distribution
Serial distribution w/graveless chambers (Rock and pipe may be substituted)
Install 135' laterals—(3)45'
Use d-box with riser to the surface of the ground for maintenance
Install on 5 foot centers
Install 12"trench depth on low side of trench and maintain 18" of vertical separation
Install level and along contours.
Install in dry weather only.Install 1000 Gallon septic with locking lid riser. ►
System designed for typical residential waste strength sewage only. '
System designed for 240 Gallons Per Day LICENSED lESiGNE ►
ExpiNs;
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MAR 3 0 2023
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