HomeMy WebLinkAboutSWG2023-00069 - SWG Application / Design - 3/6/2023 4* •:. 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,EXT400
FAX:360-427-7787
On-Site Sewage System Permit: SWG2023-00069
APPLICANT THANEM TYSON Phone:
Address: 81 NE LENNIES LOOP BELFAIR, WA 98528
OWNER THANEM TYSON Phone:
Address: 81 NE LENNIES LOOP BELFAIR, WA 98528
SEPTIC DESIGNER Lawrence Purdum-Apex Septic Design Phone: 253-509-9922
Address: 5711 34th AVE GIG HARBOR, WA 98335
Site Address: 81 NE LENNIES LOOP
Primary Parcel Number: 223365600014
Permit Description: Repair/Upgrade to 4bd pressure sandlined bed with location waiver
Permit Submitted Date: 03/06/2023
Permit Issued Date: 04/19/2023
Issued By: Rhonda Thompson
Current Permit Fees Paid: $525.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 01/03/2024 (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/onsite/oss-inspection-request.php or call:
360-427-9670, extension 400.
OFFICIAL USE ONLY Cr P
MASON COUNTY DATERECENED 3 /, ,,,,
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COMMUNITYS AMOUNT �. RECEIVED BY: .Ntt COv C m
j' Public Health(Commun I It '' Z
360427-9670,ert.400«36P27 7,ert.400
415 N.6th Street-Shelton,WA S W G 3 — 0,039 o 53
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CLEAR FORM ON—SffiE SEWAGE SYSTEM APPLICATION z
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APPLICANT PHONE m
Stephanie Thanem (602) 575-1399 / r
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MAILING ADDRESS-STREET CITY,STATE,ZIP CODE 7, g
81 NE Lennie's Loop Rd, Belfair, 98528 co
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SITE ADDRESS-STREET,CITY,ZIP CODE
81 NE Lennie's Loop Rd, Belfair, 98528 IN
NAME OF DESIGNER PHONE
Lawrence Purdum 253-509-2579
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NAME OF INSTALLER PHONE D 100
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PERMIT TYPE(select one) DRINKING WATER SOURCE
OT RESIDENTIAL OSS fl COMMUNITY OSS fl COMMERCIAL OSS h- PRIVATE INDIVIDUAL WELL inPRIVATE TWO-PARTY WELL Z IS
TYPE OF WORK(select one) la
PUBLIC WATER SYSTEM
h- NEW CONSTRUCTION/UPGRADES RI REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) 0 TABLE IX REPAIR E(J1
SUBMITTALS 0 SURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINE co
DESIGN FORM(REQUIRED) FI SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE 17,859 sq ft r r
4
W WAIVER(S)(IF APPLICABLE) O I
7 IC'
DIRECTIONS TO SITE AND SITE CONDITIONS:(ex locked gate)
Rhonda Thompson met designer onsite for soils evaluation 1/31/23. lc)
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SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. I
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE I FAILURE SOURCE(for reporting purposes)
0 VOLUNTARY ❑MAINTENANCE/PUMPING 0 BUILDING PERMIT OHOME SALE OCOMPLAINT ['OTHER:
INSPECTOR SOIL LOGS COMMENTS I CONDITIONS
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kAnSut S•FrA►AL .ter Q s S
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SOIL CODES: RECORD DRAWING AND INSTALLATION REPORT
V=VERY G=GRAVELLY S=SAND L=LOAM Si=SILT C=CLAY E=EXTREMELY R=ROOTS REQUIRED FOR FINAL APPROVAL
INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED)ISSUED BY DATE
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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: 1 2321-51-000 1 7
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. y 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..11aximum paper size: 11"I'17"
PARCEL IDENTIFICATION
Permit Number: SWG ?02 3-0 pobq Designer's Name: Lawrence Purdum
Applicant's Name: Stephanie Thanem D . ,-r •,. - ' .,. (253) 509-9922
Mailing Address: 81 NE Lennie's Loop Rd D F (,•1 , " PO Box 801
Beltair, WA 98528 11
MAR 0 6 2023 Gig Harbor, WA 98335
City State Zip _ City State Zip
lt�'i DESIGN P-tAETERS
TreatmentiTevice
❑Glendon Biofilter 0 Sand Filter 0 Mound 'Sand Lined Drainfield 0 Recirculating Filter,Type:
❑Aerobic Unit Make/Model 0 Disinfection Unit Make/Model Other:
Drainfield Type
❑ Gravity E'Pressure 0 Trench 0 Bed 0 Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 44 Schedule/Class 40
Daily Flow:Operating Capacity '200 gpd Length 48 ft
Daily Flow:Design Flow 480 gpd Diameter 1.25 in
Septic Tank Capacity 1205 gal Number 3
Receiving Soil Type(1-6) 1 Separation 3 ft
Receiving Soil Appl.Rate 1.0 gpd/ft` Orifices
Required Primary Area 480 ft2 Total Number of Orifices 80
Designed Primary Area 480 ft2 Diameter 1/8" in
Designed Reserve Area 480 ft2 Spacing 21.6" in
Trench/Bed Width 10 ft Manifold
Trench/Bed Length 48 ft Schedule/Class 40
Elevation Measurements Length 5' ft
Original Drainfield Area Slope 0 % Diameter 1.5 in
New Slope,If Altered N/A % Preferred manifold configuration used? ❑ Yes ❑ No
Depth of Excavation Up-slope 44 in Transport Pipe
from Original Grade I)o\Nn-slope 44 in Schedule/Class 40 _
Designed Vertical Separation 12 in Length 181 ft
Gravelless Chambers Required? 0 Ycs P1 No 0 Optional Diameter 1.5 in
Pump Required? if 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 80 gal
Orifice 5 ft Chamber Capacity 1,250 gal
Uppermost Orifice 'Higher 0 Lower than Pump Shutoff Pump controls:Please check those required.
Capacity @ Total Pressure Head 32.7 gpm IofTimer Eft:lapse Meter Ila'Event Counter
Calculated Total Pressure Head 29.3 ft If Timer: Pump on 146 sec ,pump off 4 hrs
Comments
System failure is likely caused by an unregulated sewage flow to a gravity bed and poor effluent
distibution in the bed.
DESIGN FORM—PAGE TWO Assessor's Parcel Number: 12321-51-00017
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
E1 Test hole locations F1 Drainfield orientation and layout Reference depth from original grade:
El Soil logs E1 Trench/bed dimensions and Ear Septic tank
El Property lines critical distances within layout fa Drainfield cover
❑ Existing and proposed wells ❑ D-Box/Valve box locations Reference depth from original grade
within 100 ft of property El Septic tank/pump chamber and restrictive strata:
❑ Measurements to cuts,banks,and locations Iff Laterals,trench/bed,top and
surface water and critical areas El Observation port location bottom
❑ Location and orientation of 0 Clean-out location 0 Curtain drain collector
curtain drain and all absorption Ef Manifold placement El Sand augmentation
components ❑ Orifice placement Other cross-section detail:
El Location and dimension of El Lateral placement with distance Er Observation ports/clean-outs
primary system and reserve area to edge of bed
El Buildings Other Information
E'1 Audible/visual alarm referenced Yes No
El Direction of slope indicator Ef Scale of drawing shown on scale ❑ EI Design staked out
El Waterlines bar 0 Ef Recorded Notices attached
E+1 Roads,easements,driveways, Iff ❑Waiver(s)attached
parking ET ❑ Pump curve attached
El North arrow and scale drawing Ef 0 Evaluation of failure
shown on scale bar Non-residential justification
❑ El Waste strength
O Er Flow
DESIGN APPROVAL
The undersigned designer must notifibby installer at time of installation EYes 0 No
2/10/23
Signature of Designer 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 on-site regulations:
(0,1A kit(lq Iz- 3
Environmental Health Sikecialist Date
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
✓ The design is stamped"Approved"by Mason County Public Health.V The Onsite Sewage Permit has not expired,the Permit Expiration Date is: (S I 12-1
✓ 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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