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Home My WebLink AboutSWG2023-00067 - SWG Application / Design - 3/3/20231�• MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584 SHELTON:360-427-9670,EXT 400 BELFAIR:360-275-4467,EXT 400 e. , , 5. Public Health & Human ServicesELMA:360 482-5269,EXT 400 FAX:360-427-7787 On-Site Sewage System Tank Only Permit: SWG2023-00067 OWNER MCCLEMENTS ET AL COLLEEN P Phone: Address: ELLYN J ERICKSON; NANCY C SHEPARDSON TACOMA, WA 98406 APPLICANT MCCLEMENTS ET AL COLLEEN P Phone: Address: ELLYN J ERICKSON; NANCY C SHEPARDSON TACOMA, WA 98406 SEPTIC INSTALLER MAPLES EXCAVATING Phone: 360-463-8474 Address: 911 SE ARCADIA SHELTON, WA 98584 Site Address: 1451 E Beaver Ave Primary Parcel Number: 320105001027 Permit Description: Tank Replacement Permit Submitted Date: 03/03/2023 Permit Issued Date: 03/13/2023 Issued By: Jeff Wilmoth Current Permit Fees Paid: $255.00 (additional fees may be required upon installation of system). Permit Expiration Date: 03/03/2026 (based on date of inspection) Type of Work OSS New Construction Components being Replaced: Septic Tank Only Surfacing Sewage? No Existing Failure? Yes Shoreline? Yes Horizontal Setbacks Met? Yes Number of Bedrooms: 1 Drinking Water Source: Public Water System Additional Details: 1060 infiltrator Permit Conditions: 3 Mason County Asbuilt Form, Record Drawing, and Installation fee must be submitted for final installation approval. 2 Permit must be installed by a Mason County Certified Installer unless prior written authorization from Mason County is obtained. 1 Horizontal setbacks per WAC246-272A-0210 must be maintained, unless prior approval is obtained 4 Proposed development subject to zoning requirements and approval by the planning department staff per Mason County Title 17. 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/OR 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 RECEIVED: MASON COUNTY 31 I ---7 c N F7COMMUNITY SERVICES AMU R V D. RFCFIVEDBV^ com w Public Health(Community Health/Environmental Health) (n 360-427-9670,ext.400 or 360.275-4467.ext.400 7), • '� 0 41 S N.6th Street•Shelton,WA 98584 S W �a,-3 - 000 l .q- o 73 Z 6 ON-SITE SEWAGE TANK ONLY APPLICATION 3 73 m APPLICANT PHONE m m Colleen McClements 253-381-5342 z MAILING ADDRESS-STREET.CITY.STATE,ZIP CODE 3 2331 N. Highland St. Tacoma, WA 98406 com SITE ADDRESS-SWEET,CITY,ZIP CODE 1451 E. Beaver Ave. NAME OF DESIGNER PHONE I(� NAME OF INSTALLER PHONE 0 10 Maples Excavating 360-463-8474 Z TYPE OF WORK(select one) DRINKING WATER SOURCE O ❑ NEW CONSTRUCTION/UPGRADES II REPAIR/REPLACEMENT ❑ PRIVATE INDIVIDUAL WELL 0 PRIVATE TWO-PARTY WELL Z I° COMPONENT(S)TO BE REPLACED/INSTALLED 0 PUBLIC SYSTEM I 0 SEPTIC TANK 0 PUMP TANK 0 RV HOLDING TANK BEDROOMS LOT SIZE IC51 0 OTHER 1 .15 lO OTHER DETAILS(select all that apply) TANK(S)SETBAC LIST IT O I ❑ SURFACING SEWAGE ®EXISTING FAILURE 0 SHORELINE III 100FT+PUBLIC/COMMUNITY WELLS 0 10 1 SUBMITTALS ND 50FT+PRIVATE WELLS,SURFACE WATERS,STREAMS,RIVERS ® PLOT PLAN(REQUIRED) in TANK CROSS SECTION(REQUIRED) MI 10FT+DRINKING WATER SUPPLY LINES I ❑ PUMP DETAILS(IF APPLICABLE) 0 WAIVER(S)(IF APPLICABLE) I 5FT+PROPERTY/EASEMENT LINES,FOUNDATIONS,FOOTINGS PLOT PLAN CHECKLIST Q Ie ❑ PROPERTY LINES AND EASEMENTS 0 EXISTING/PROPOSED STRUCTURES 0 EXISTING/PROPOSED OSS COMPONENTS AND LINES -I ❑ WELLS WITHIN 100FT 0 WATER SUPPLY LINES ❑ DRIVEWAYS/PARKING 0 SURFACE WATERS,STREAMS,RIVERS,ETC... ^j IN ❑ DIRECTION OF SLOPE/CONTOURS 0 PERIMETER/CURTAIN DRAINS 0 NORTH ARROW 0 SCALE BAR I J DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.locked gate) r v\acQ, C ant irn Sae.m 10 Co i-ion w tA-h a 1000 1 cxt 5Y Se,Q c emu-. TC e_ tS \ ' 15 V 50 Ck• -rc)rr, Wo,'teN. OFFICIAL USE ONLY BELOWTHIS LINE UPGRADE/FAILURE SOURCE(for reporting purposes) 0 VOLUNTARY ❑MAINTENANCE/PUMPING 0 BUILDING PERMIT ❑HOME SALE ❑COMPLAINT ❑OTHER: COMMENTS I CONDITIONS SEWAGE TANKS MUST BE LISTED UNDER DOH'LIST OF REGISTERED SEWAGE TANKS'. TANKS MUST MEET CURRENT MINIMUM SIZE REQUIREMENTS,EQUIPPED WITH RISERS A DS TO SURFACE,AND INCLUDE AN EFFLUENT FILTER(IF APPLICABLE). RECORD DRAWING AND INSTALLATION REPORT REQUIRED FOR FINAL APPROVAL. SPE TOR SIGNATURE DATE APPLICATION EXPIRATION DATE THI 4A(Ah'aika LIGATION APP''RwwOV^^EDD;ISSUED BY 3- 13 . 2, REVISED 12/7/2015-3 -(3-29 DATE AVAILABLE FOR PUBLIC VIEW ON THE MASON COU TY WEBSITE Y BE SCANNE AND .._+we.A..... - _ • at y + 5th & Masi lliewsissoalassa Neal* trier No. �iQ 7Ater, Washington �IriM ill w ill Courthouse Annex Phone: 426-4407 M.._� �A Olympia, Washington Phone: 352-485�1 / SITE APPLICATION g Date 3/8- /? / SEWAGE APPLICATION 5 Date 3 /0. / ( / Owner M y g 0 im l^ 1 A y L o Phone S tt - / S1 Mailing Address 3 S 3 1 c O { City ( PeCII Mate L4/ /V Builder Address Sewage Contractor Address Legal Description C. A.D AP-- 6R.nl/ A b b / /,b A..) -/I z A. T D^ �j Parcel No. Lot Size3a$)cl5 Intended use of Buildings A. /j" /Ai G Directions to Property A61� Tc L.r 7 s bA-iV 1 c L s i2.1 , A /1 o 1-4-- to C6--1)4Q -'Qvv A-b15, i, o I lol10 % 7 No. of Bedrooms 3 No. of Bathrooms ! Basement Water System: PUBLIC PRIVATE DRAW SKETCH in blank space: 1. Property lines and location of house on lot and dimensions of lot. 2. Location of house and sewage disposal system in relation to streams, lakes, wells, patios, driveways, underground tanks, water supply lines and easements. 3. Proposed fill, including depth, area, porosity and amount plus location of drains. 1 DRAINFIELD LENGTH 4- SEPTIC TANK SIZE L b 0 D v'Alij r TO u s E D¢., y t.'--6// . 4 -.Jyu4 /9 ' se-- • ge 1 ,\\ r 1 b -,, \Faird-ranK,,PlacC With IO(PO I n el(tralotc i �= -T 6 1 , *AA k 6aXY1 C 3 A 1Def \ l ocafinn �` tecii.. a, ,t) A 4 3 The septic system is an approved temporary method of sewage disposal until sanitary sewers are available. SITE APPLICATION L DATE ? // APPLICANT'S SIGNATURE Site inspecti fe Approved Receipt No. BY Not Approved By Da Date Sanitari SEWAGE APPLICATION w Alter / 3 / )i APPLICANT l,� , " .. 'S SIGNATURE �... ...- . .� /. DA PlrffW7Fee p,b . 0 C) Receipt 1. militi 1 . F : O - Permit No. L{-1 ►. 4 Approved „x "4.-J1-., By . • 112. a Sanitarian INFILTRATOR` 1 IM-1060---- septic tanks Features&Benefits • Strong injection molded polypropylene construction f • Lightweight plastic construction and inboard lifting lugs allow for easy � r( delivery and handling • Integral heavy-duty green lids that tilti( ' `I 1 I I interconnect with TWTM risers and pipe riser solutions EtritKwcitt[K�ttIt It It it it K IC ill y ■ .� )•• • Structurally reinforced access ports eliminate distortion during installation and pump-outs A • Reinforced structural ribbing and fiberglass bulkheads offer additional strength • Can be installed with 6"to 48" of cover The Infiltrator IM-1060 is a lightweight strong and durable septic tank. • Can be pumped dry during This watertight tank design is offered with Infiltrator's line of custom-fit pump-outs risers and heavy-duty lids. Infiltrator injection molded tanks provide a • Suitable for use as a septic tank, pump revolutionary improvement in plastic septic tank design, offering long-term tank, or rainwater(non-potable)tank exceptional strength and watertightness. • No special water filling requirements Inlet Side are necessary • The tank may be backfilled with suitable TANK CUTAWAY Infiltrator - native soil. See installation instructions TW Riser ` for guidance. System J is- Partition , r - baffle wall' HEAVY DUTY LID • CUTAWAY . Reinforced 1 : 24" structural % "' > access port f`, Nilt N `\�. Structural I 4 -- bulkheads MID-SEAM CUTAWAY • Reinforced water tight mid-seam 7• ` gasketed connection ir INFILTRATOR` Protecting the Environment with Innovative Wastewater Treatment Solutions water technologies IM-1060 General Specifications and Illustrations LIFTING STRAP LIF TING LUG RISER CONNECTION (TYPICAL) (4 TOTAL) (TYPICAL) The IM-1060 is an injection molded two piece mid-seam ��y"�* plastic tank. The IM-1060 injection molded plastic design � ��I I��rlll�I DTI- niiiprererarek I�Ifi11lll�l��'allows for a mid seam joint that has precise dimensions A ri �!1III , I1 i!I' r�.i',, A ay■.. o ■ ■ 0 .f�sy�� for accepting an engineered EPDM gasket. Infiltrators ,fir.- --- o ■ ■ ; o —�) B gasket design utilizes technology from the water industry ,;=11__ o •I. ■ • o �_• n562.2 to deliver proven means of maintaining a watertight seal. °.�' �, r It. ° "ale ExTERKR j, ■f 4■_ till �`_�•' WIDTH The two-piece design is permanentlyfastened usinga �►,�':�"i'fE i �_��iseries of pon corrosive pastic alignment dowels and '�111101�~/III I-� I 1 I�L /1.ti��' 1 locking seam clips. The IM-1060 is assembled and sold through a network of certified Infiltrator distributors. r _ 1270(32261EXTERIOR LENGTH TOP VIEW Must be backfilled and installed in accordance with Infiltrator Water Technologies, Infiltrator IM-Series Septic OUTLET — Tank General Installation Instructions and for shallow _=IIground water conditions reference the Infiltrator IM- l �Series Tank Buoyancy Control Guidance. 411. _hI— �ilra cs4.7Please visit www.infiltratorwater.com/images/pdf/ _ o_, b (1389I r EXTERIOR ManualsGuides/TANK01.pdf for the latest information. SEAM CLIP 111111111111pHEIGHT (TYPICAL) /IN TRAP 4. I IM-1060 LIFT G S _ ._ _. (TYPICAL) Working Capacity 1094 gal(4141 L) Total Capacity 1287 gal(4872 L) END VIEW Airspace 16.5% Length 127"(3226 mm) PVC 00R4(11 521 / 0 24(610)ACCESS OPENINGS WITH LOCKING LIDS(2) 10.2(2601 FREEBOARD 04 I1021 PVC OR Width 62.2"(1580 mm) INLET TEE ABS OUTLET VCO ,.■ disitaile■e• Length-to-Width Ratio 2.3 to 1 OUTLET 3.0 Height 54.7"(1389 mm) PER I 1761COr COEORE Liquid Level 44"(1118 mm) I µ•0 + 111181 FIBERGLASS FIBERGLASS LORD SUPPORT Invert Drop 3"(76 mm) SUPPORT DEPTH (TYPICAL) WITH BAFFLE Fiberglass Supports 2 EQUl WHERE Compartments 1 or 2 Maximum Burial Depth 48"(1219 mm) SIDE VIEW Minimum Burial Depth 6"(152 mm) Maximum Pipe Diameter 6"(152 mm) TANK TOP CONTINUOUS Weight 320 lbs(145 kg) HALF GASKET TANK j� INTERIOR v.'aaaJJJ �-- SEAM CLIPF —J ALIGNMENT DOWEL TANK BOTTOM HALF ��!!! 4 Business Park Road P.O.Box768 Old Saybrook,CT 06475 INFILTRATOR; 860 577 7000•Fax 860-577-7001 MID-HEIGHT SEAM SECTION 1-800-221-4436 water technologies w1Mw,infeltratorawater.com U.S.Patents:4,759,661;5,017,041;5,156,488:5,336,017;5,401,116;5,401,459;5,511,903;5,716,163;5,588,778;5,839,844 Canadian Patents:1.329,959;2,004,564 Other patents pending.Infiltrator,Equalizer, Quick4,and SldeWinder are registered trademarks of Infiltrator Water Technologies.Infiltrator is a registered trademark in France.Infiltrator Water Technologies is a registered trademark in Mexico. Contour,MicroLeaching,PolyTuff,ChamberSpacer,MUftiPort,PosiLock,QwckCut,QulckPlay,SnapLock and StraightLock are trademarks of Infiltrator Water Technologies. PolyLok Is a trademark of PolyLok,Inc.TUF-TITE Is a registered trademark of TUF-TITE,INC.Ultra-Rib lea trademark of IPEX Inc. ®2016 Infittrator Water Technologies,LLC.All rights reserved.Printed In U.SA. IM02 1116 Contact Infiltrator Water Technologies' Technical Services Department for assistance at 1-800-221-4436 Pow • �w Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG2.823 -00an Parcel # 3 0I0"50-®I0a Applicant Name CC)I it CO M co elmei-1-s Subdivision (Name/Div/Block/Lot) Applicant Address Ellin 3"Coa<0n; NOM1f.y Cs. (Max &`JY-INC 61 K" Z Le F-- 2 y� r san Installer Name Ma 1C< EK , vC t nCJ City, State, Zip i a LD 17'��,\�IA cte�#�to `'� � JJ Site Address 1 W5 1 E 13eovcl Pa/G .Shl°rtvl Designer Name INSTALLATION CHECKLIST ❑ Full System Installation [iTank(s)Only ❑ Drainfield Only ❑ Repair ❑Other System Type 6111.1 VI M Pretreatment Type >5 ft.from foundation? - - ❑ N/A BYES ❑ NO >50 ft.from wells? - - ❑ ❑ Z >50 ft.from surface water? - - 0 ,.g ❑ H Cleanout between building and tank? - - CI Di Tank baffles present? - - ❑ B�.,( CId 24" access risers over each compartment?- - ElE CI W Effluent filter installed?- - ❑ u El 0 gal10fil tYalvv Septic tank size toy � Manufacturer 0 D-box water level and speed levelers used? - - El N/A El YES E] NO J oO Manifold/D-box accessible from surface?- - CI CI CI mZ Check valves installed? - - ❑ ❑ ❑ oQ 2 Transport Line Size Schedule/Class Bedrooms installed (check one ❑ 2 ❑3 ❑4 ❑ 5 ❑6 El Commercial/Other >10 ft.from foundation?- - ❑ N/A ❑ YES ❑ NO >100 ft.from wells?- CI CI WCI El>100 ft.from surface water? - LL >10 ft.from potable water lines?- -APR-p- CI �Oc3 �'Q > 5 ft.from property lines and easements?- 0 CI CC > 30 ft.from downgradient curtain/foundation drainsZr� - - - ❑ CI CI -�� - - - • Drainfield level and observation ports present - ❑ ❑ ❑ Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ ❑ ❑ Pump tank setbacks consistant with septic tank?- - ❑ N/A ❑ YES El NO • Pump tank size gal Manufacturer Q 24" access riser(s) and accessible from surfac - - ❑ ❑ El ~ Alarm or Control Panel Installed? - - CI CIa • Control Panel equipped with Timer/ETM /Counter - CI CI CIm a Pump installed in ❑ Bucket or El On Block Other a'• Pump Make/Model ❑ Floats or ❑ Transducer a Tank draw down in/min Pu capacity gpm Squirt Height ft Pump on time Pump off time Daily flow set at gpd Updated 8,21/2018 • M Mason County OSS Installation Report pg. 2 Parcel# 9�0I0" `. " 01029 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - LJ YES ❑ NO If yes, please describe: Were all components pumped out and properly abandoned per WAC246-272A-0300? - - YES NO RECORD DRAWING This is a permanent record and must be accurate and descriptive enough to re-locate in the need of maintenance activities and future development. Typical Record Drawings contain: Drainfield&manifold orientation&layout,Septic/pump tank location,North arrow,reserve drainfield,existing and proposed buildings,location of wells,waterlines, wells,observation ports,cleanouts,and other maintenance access points. Incomplete Record Drawings may create additional delays in final installaton approval and related permits. A 444 o�4/l` �,� 4/7 9ie y �9�Tti [Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ENGINEER I certify that I installed the system in accordance with I certify that the system has been installed in accor- the septic design stamped "APPROVED"by Mason dance with the septic design stamped"APPROVED"by County Public Health and that any deviations shown Mason County Public Health and that any deviations here have been cleared/approved by both the designer shown here have been cleared/approved by both and Mason County Public Health and meet all State myself and Mason County Public Health and meet all and Mason County Codes. State and Mason County Codes I further certify that all information contained on this I further certify that all information contained on this form and attached Record Drawing is accurate. form and attached Record Drawing is accurate. 313)170)5 Signature of Installer Date S ? �.t'14 1 tti Printed Name of Signee MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and Record Drawin on behalf of Mason County Public Health: Signature of vi n ental Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Updated 8/21n018 Y .. RECORD DRAWING (continued) rz_xy-:(ve)( ,rozktircc A, A\*rk'SwAnN et, c rso.t xor 0.(g) 0,, L* PPROVE APR 12 2023 MASON COUNTY ENVIRONMENTAL HEALTH / I JBW • i pa OO(#;33fi1P,- -Ci0ZI