HomeMy WebLinkAboutSWG2023-00109 - SWG Application / Design - 3/23/2023 i-rtr• MASON COUNTY 415 N 6TH STREET,SHELTON, E,E 400 98584 SHELTON:360 427-967XT
BELFAIR:360-275-4467,EXT 400
Public Health & Human Services ELMA:360-482-5269,EXT400
FAX:360-427-7787
On-Site Sewage System Permit: SWG2023-00109
APPLICANT NUNLEY ET AL BARBARA Phone:
Address: SHANE ISON BELFAIR, WA 98528
OWNER NUNLEY ET AL BARBARA Phone:
Address: SHANE ISON BELFAIR, WA 98528
SEPTIC DESIGNER Lawrence Purdum-Apex Septic Design Phone: 253-509-9922
Address: 5711 34th AVE GIG HARBOR, WA 98335
Site Address: 160 NE Rainbow Ln
Primary Parcel Number: 223255002006
Permit Description: New SFR -3BR Pressure
Permit Submitted Date: 03/23/2023
Permit Issued Date: 04/03/2023
Issued By: Jeff Wilmoth
Current Permit Fees Paid: $525.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 04/03/2026 (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 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.
OFFICIAL USE ONLY
MASON COUNTY PUBLIC HEALTH DATE RECEIVED: 3 3_1 AL
'
/7 to D
ONSITE SEWAGE SYSTEM APPLICATION AMOUZQ`J RECEIVik0
rn
415 N 6th Street,(Bldg 8) Shelton WA,98584 Z
Shelton:360-427-9670 ext 400 Betfalr.360-275-4467 ext 400 SWG`p G Z6 Ti.1� - c(3t () (� O 53
"`
2 65
z DAPPLICANT PHONE D
Barbara Nunley (360)801-7354 m m
MAILING ADDRESS-STREET.CITY,STATE,ZIP CODE r
2
140 NE Rainbow Ln,Belfair,WA 98628 C
SITE ADDRESS-STREET,CITY,ZIP CODE CI
m
160 NE Rainbow Lane,Belfair,WA 98528
NAME OF DESIGNER PHONE
Lawrence Purdum —Apex Septic Design,LLC (253)509-9922
NAME OF INSTALLER PHONE N
CHECK ALL APPLICABLE ITEMS DRINKING WATER SOURCE
C I0 NEW CONSTRUCTION 0 RV HOLDING TANK ONLY 0 PRIVATE INDIVIDUAL WELL (p
❑ REPLACEMENT SYSTEM 0 INSTALLATION PERMIT ONLY 0 PRIVATE TWO-PARTY WELL z
❑ TABLE 9 REPAIR 0 SINGLE FAMILY 0 COMMUNITY/PUBLIC WATER SYSTEM l
❑ TANK(S)ONLY 0 COMMERCIAL SYSTEM NAME r
❑ UPGRADE TO EXISTING ❑ OTHER BEDROOMS LOT SIZE Ich
❑ EXISTING FAILURE 'Record Drawing required CO
for all Installations" 3 0.36 Acres r- 10
DIRECTIONS TO SITE-BE SPECIFIC AND ADVISE OF ANY NEEDED INFORMATION FOR ACCESS(ex locked gate) 0 1
Directions:Approximately 530 feet north of the intersection of NE Rainbow Ln.and NE Chinook Dr. liNa IN'
Parcel location on the east side of NE Rainbow Lane r
O
la)
SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS 10
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE/FAILURE SOURCE(for reporting purposes)
❑VOLUNTARY 0 MAINTENANCE/PUMPING ❑BUILDING PERMIT OHOME SALE ❑COMPLAINT ❑OTHER
INSPECTOR SOIL LOGS COMMENTS/CONDITIONS
(....... (,-..,
/S - Leo 7 L6 6-C� \\ V ITT)
MAR 2 3 ZU3
1-().\) 0 0 —0-- ip 5 k-I--. c .-B-Y---------0.-
•
-r LC5
SOIL CODES:
V=VERY G=GRAVELLY S=SAND L=LOAM SI=SILT C=CLAY E=EXTREMELY R=ROOTS
INSPECTO SIGNATURE DATE APPLICATION EXPIRATION DATE APPL ON APPROVED BY DATE
1../ 12 " 2(...' ' Pis ( t J,1.0a (i-3-
THIS F gryl MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED t2l7/2015
DESIGN FORM—PAGE ONE Assessor's Parcel Number: 2 2 3 2 5 __ 5 0 _ 0 2 00 6
A design will be reviewed when 3 copies of each of the following are submitted:
Completed design form that has been signed and dated. Sealed 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: 11"X I7"
PARCEL IDENTIFICATION
Permit Number: SWG ?f)Z.3' -Qv of Designer's Name: Larry Purdum—Apex Septic Design,LLC
Applicant's Name: Barbara Nunley Designer's Phone Number: (253)509-9922
Mailing Address: 140 NE Rainbow Ln Designer's Address: PO Box 801
Belfair WA 98528 Gig Harbor WA 98335
City State Zip City State 44
DESIGN PARAMETERS
Treatment Device
❑Glendon Biofilter ❑ 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 m Pressure 0 Trench 0 Bed 0 Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 3 Schedule/Class
Daily Flow:Operating Capacity 360 gpd Length 37.5 ft
Daily Flow:Design Flow 360 gpd Diameter in
Septic Tank Capacity 1,000 gal Number 4
Receiving Soil Type(1-6) 3 Separation 7 ft
Receiving Soil Appl.Rate 0.8 gpd/ft2 Orifices
Required Square Footage 450 ft2 Total Number of Orifices 40
Designed Square Footage 450 ft2 Diameter 1/8 in
Percent Reduction Taken % Spacing 48 in
Trench/Bed Width 3 ft Manifold
Trench/Bed Length 37.5 ft Schedule/Class SCH 40
Elevation Measurements Length 5 ft
Original Drainfield Area Slope % Diameter 1.5 in
New Slope,If Altered % Preferred manifold configuration used? 0 Yes 0 No
Depth of Excavation UP-slope r / to. in Transport Pipe
from Original Grade Down lope /V in Schedule/Class SCH 40
Designed Vertical Separation 24 in Length 16 ft
Gravelless Chambers Required? 0 Yes 0 No 0 Optional Diameter 2 in
Pump Required? ® Yes 0 No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day 6
Difference in Elevation Between Pump Shutoff and Uppermost Dose quantity 60 gal
Orifice 1.25 ft Chamber Capacity 1.250 gal
Uppermost Orifice 0 Higher m Lower than Pump toff Pump controls:Please check those required.
Capacity @ Total Pressure Head 17.4 0Timer 0Elapse Meter 0 Event Counter
Calculated Total Pressure Head 15.9 p 49f ' : Pump on 2 minutes ,Pump off 4 hours _
Comments
IA iv 'APR p k
couNrye 3 2023
JBHI 74L HEAL ry
DESIGN FORM—PAGE TWO Assessor's Parcel Number: 2 2 3 2 5 -- 5 0 -- 0 2 0 0 6
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
® Test hole locations ® Drainfield orientation and layout Reference depth from original grade:
® Soil logs ® Trench/bed dimensions and ® Septic tank
® Property lines critical distances within layout 10 Drainfield cover
❑ Existing and proposed wells 0 D-Box/Valve box locations Reference depth from original grade
within 100 ft of property ® Septic tank/pump chamber and restrictive strata:
❑ Measurements to cuts,banks,and locations 0 Laterals,trench/bed,top and
surface water and critical areas m Observation port location bottom
m Location and orientation of ® Clean-out location 0 Curtain drain collector
curtain drain and all absorption Q Manifold placement 0 Sand augmentation
components 0 Orifice placement Other cross-section detail:
® Location and dimension of 0 Lateral placement with distance 0 Observation ports/clean-outs
primary system and reserve area to edge of bed
g Other Information
® Buildings 0 Audible/visual alarm e e Yes No
❑ Direction of slope indicator ® anr► ❑ !a Design staked out
pi Waterlines c ■ 0 0 Recorded Notices attached
® Roads,easements,driveways, APR 0 3 2023 ❑ la Wa ver(s)attached
parking 0 ❑ Pump curve attached
® North arrow and scale drawing -COUNTY ENVIRONMENTAL HEALTH 0 m Evaluation of failure
shown on scale bar JBW Non-residential justification
MASON ❑ ❑Waste strength
❑ 0 Flow
DESIGN APPROVAL
The undersigned designer must be notified by installer at time of installation ❑Yes 0 No
4.1. 1 _ 3/22/23
Signature of Designer Date
The undersigned has reviewed this d-:'1 on behalf of Mason County Public Health and determined it to be in
compliance with state and local on :, lations:
'Ark 4 L'-'4 - t/ - 3 - 2 3
En '•.nmlip-a' 7,ecialist Date
CAUTION: DESIGN APPR• AL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
✓ The design is stamped"Ap a oved"by Mason County Public Health.
/ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: _ 3(7—7 cP
✓ 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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