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HomeMy WebLinkAboutSWG2020-00532 - SWG Application / Design - 10/12/2020 (2) MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584 SHELTON:360-427-9670,EXT 400 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: SWG2020-00532 APPLICANT Heinlen, Jerry Phone: Address: 19410 HWY 99 LYNNWOOD, WA 98036 OWNER Heinlen, Jerry Phone: Address: 19410 HWY 99 LYNNWOOD, WA 98036 SEPTIC DESIGNER Adam Hunter-Jim Hunter and Phone: 360-753-1226 Associates Address: PO BOX 162 OLYMPIA, WA 98507 Site Address: 590 E ST ANDREWS DR Primary Parcel Number: 321275100274 Permit Description: 3-bedroom OSCAR X02 system Permit Submitted Date: 10/12/2020 Permit Issued Date: 10/27/2020 Issued By: Luke Cencula Current Permit Fees Paid: $850.00 (additional fees maybe required upon installation of system). Permit Expiration Date: 04/12/2026 (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 -- MASON COUNTY PUBLIC HEALTH DATE RECEIVED: 2& ONSITE SEWAGE SYSTEM APPLICATION AMOUNT RECEIVED:/ RECEIVED BY C C m /n cn co 415 N 6th Street,(Bldg 8) Shelton WA,98584 L ca O 0 to U) Shelton:360-427-9670 ext 400 Belfair:360-275-4467 ext 400 S G Zo _ 6 O . z cn z - APPLICANT PHONE > > JERRY HEINLEN 9717322796 m m MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE r 19410 HWY 99 LYNNWOOD WA 98036 c g SITE ADDRESS-STREET.CITY.ZIP CODE co 590 E ST ANDREWS DSC SHELTON WA 98584 m NAME OF DESIGNER PHONE I \('J ADAM HUNTER 3607531226 NAME OF INSTALLER PHONE TBD CHECK ALL APPLICABLE ITEMS DRINKING WATER SOURCE o C I I� Ft) CONSTRUCTION 0 RV HOLDING TANK ONLY 0 PRIVATE INDIVIDUAL WELL ❑ REPLACEMENT SYSTEM 0 INSTALLATION PERMIT ONLY ❑ PRIVATE TWO-PARTY WELL 0 z p ❑ TABLE 9 REPAIR 0 SINGLE FAMILY Er COMMUNITY/PUBLIC WATER SYSTEM ❑ TANK(S)ONLY ❑ COMMERCIAL SYSTEM NAME: LAKE LIMERICK I ❑ UPGRADE TO EXISTING ❑ OTHER: - BEDROOMS LOT SIZE :31i ❑ EXISTING FAILURE "Record Drawing required 3 0.23 Ca I�FSIGN RFVISION (ORIGINAI SV(PG,i1V612O1S2) r ('— DIRECTIONS TO SITE-BE SPECIFIC AND ADVISE OF ANY NEEDED INFORMATION FOR ACCESS(ex.locked ga;e) 0 I GO INTO LAKE LIMERICK PAST THE FIRE STATION, CONTINUE ALONG ST. x b ANDREWS DR. SITE ADDRESS IS 590, PROPERTY IS ON THE RIGHT. IOP � I ' U � -1 D � I-- IN R SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE-I• • -ED WITH TEST HOLE NUMBERS g OFFICIAL USE ONLY BELOW THIS NE - 0 UPGRADE/FAILURE SOURCE(for reporting purposes) ❑VOLUNTARY ❑MAINTENANCE/PUMPING ❑BUILDING PERMIT ['HOME SALE ❑COMPLAINT ❑OTHER: INSPECTOR SOIL LOGS COMMENTS/CONDITIONS •jtl 0-30 5L— Tif110-30" $L SOIL CODES: V=VERY G=GRAVELLY S=SAND L=LOAM Si=SILT C=CLAY E=EXTREMELY R=ROOTS INSPECTO IGNATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED BY DATE 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: 32 i_.1 -- 51 -- Q Q 274 design will be reviewed when 3 copies of each of the following are submitted: Completed design form that has been signed and dated. v Scaled layout sketch,including all applicable items on checklist Scaled plot plan,including all applicable items on checklist. v 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 17" PARCEL IDENTIFICATION Permit Number: SWG 2020-00532 Designer's Name: ADAM HUNTER Applicant's Name: JERRY HEINLEN Designer's Phone Number: 360 753 1226 Mailing Address: 19410 HWY 99 Designer's Address: PO BOX 162 LYNNWOOD WA 98036 OLYMPIA WA 98507 City State Zip City State Zip 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: OSCAR X02 Drainfield Type OSCAR XO2 ❑Gravity 0 Pressure 0 Trench 0 Bed 0 Sub Surface Drip Septic Tank/Drainfield Specifications Laterals Number of Bedrooms 3 Schedule/Class PER OSCAR Daily Flow: Operating Capacity 270 gpd Length PER OSCAR ft Daily Flow: Design Flow 360 gpd Diameter PER OSCAR in Septic Tank Capacity 1200 gal Number 3 Receiving Soil Type(l-6) 4 _ Separation PER OSCAR ft Receiving Soil Appl.Rate 0.6 gpd/ft2 Orifices Required Primary Area 600 ft2 Total Number of Orifices PER OSCAR Designed Primary Area 600 ft2 Diameter PER OSCAR in Designed Reserve Area 600 ft2 Spacing PER OSCAR in Trench/Bed Width 22.4 ft Manifold Trench/Bed Length 26.8 ft Schedule/Class 40 Elevation Measurements Length 22.4 ft Original Drainfield Area Slope 0 % Diameter 1 in New Slope,If Altered N/A % Preferred manifold configuration used? 'Yes 0 No Depth of Excavation Up-slope 6 in Transport Pipe from Original Grade Down-slope 0 in Schedule/Class 40 Designed Vertical Separation 24 in Length 90 ft Gravelless Chambers Required? 0 Yes iifNo 0 Optional Diameter 1 in Pump Required? EYes 0 No Dosing and Pump Chamber Pump/Siphon Specifications Number of doses/day 412 Difference in Elevation Between Pump Shutoff and Uppermost Dose quantity 0.87 gal Orifice 10.5 ft Chamber CapaA p p ROVED gal Uppermost Orifice IeHigher 0 Lower than Pump Shutoff Pump controls:Please check those required. Capacity @ Total Pressure Head 50 gpm Vrimer A. t ej ter Et Event Counter Calculated Total Pressure Head 30.681 ft If Timer: Pump on ' ,E ,Pump off 3 MIN Comments ITA6UN COUNTY ENVIRONMENTAL HEALTH' REVISED DESIGN FROM ORIGINAL TAJA PERMIT - SWG2020-00532 DJA DESIGN FORM—PAGE TWO Assessor's Parcel Number: j `7 -- _j 1 -- LI f _7 L. Permit Number: SWG 2020-00532 DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch 6a1 Test hole locations la Drainfield orientation and layout Reference depth from original grade: 62< Soil logs El Trench/bed dimensions and NI Septic tank 12f Property lines critical distances within layout ®' Drainfield cover 621 Existingand proposed wells 62l D-Box/Valve box locations Reference depth from original grade within 100 ft of property 62' Septic tank/pump chamber and restrictive strata: 121 Measurements to cuts,banks,and locations 63' Laterals,trench/bed,top and surface water and critical areas 12' Observation port location bottom 12i Location and orientation of 6' Clean-out location 0 Curtain drain collector curtain drain and all absorption tif Manifold placement 9' Sand augmentation components 61 Orifice placement Other cross-section detail: 62( Location and dimension of 621 Lateral placement with distance a Observation ports/clean-outs primary system and reserve area to edge of bed g Buildings Other Information Ei Audible/visual alarm referenced Yes No 621 Direction of slope indicator 9' Scale of drawing shown on scale l' 0 Design staked out El Waterlines bar 0 0 Recorded Notices attached 9' Roads,easements,driveways, 0 0 Waiver(s)attached parking 0 0 Pump curve attached 62l North arrow and scale drawing 0 0 Evaluation of failure shown on scale bar Non-residential justification ❑ ❑ Waste strength ❑ ❑ Flow DESIGN APPROVAL The undersigned designer must be i otifi,d by in er at time of installation Nr Yes 0 No 4/7/23 Signa .t f esigner Date Ap -- .""" The undersigned has reviewed this desi: n behalf of Mason County Public Health and determine it to be in :�I) compliance with state and local on- --,' • ations: 7 APR 2 ; 1,• ON COUts; En fOnmental Health Specialist Date - L HAT 1-,,,f5 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: ✓ 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 Si, /4NO • >' W O R �S sSl j. 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