HomeMy WebLinkAboutSWG2023-00120 - SWG Application / Design - 3/31/2023 MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584
eill, % SHELTON:360-427-9670,EXT 400
BELFAIR:360-275-4467,EXT 400
,4 ? : Public Health & Human Services ELMA:360-482-5269,EXT 400
FAX:360-427-7787
On-Site Sewage System Permit: SWG2023-00120
APPLICANT Jenessa Ormdahl Phone:
Address: 4350 E Agate Rd SHELTON, WA 98584
OWNER DAHL Properties LLC Phone: 1.360.740.0345
Address: 261 Hamilton Rd CHEHALIS, WA 98532
SEPTIC DESIGNER CINDY WAITE-Septic Designer Phone: 3607010205
Address: 80 E PICKERING LANE SHELTON, WA 98584
Site Address: 4360 E Agate Rd
Primary Parcel Number: 320241290061
Permit Description: New SFR -3BR Pressure w/class b waiver
Permit Submitted Date: 03/31/2023
Permit Issued Date: 04/27/2023
Issued By: Jeff Wilmoth
Current Permit Fees Paid: $780.00 (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/onsiteloss-inspection-request.php or call:
360-427-9670, extension 400.
OFFICIAL USE ONLY--0,7,-.0,----
MASON COUNTY PUBLIC HEALTH DATE RECEIVED a_3
- 31
ONSITE SEWAGE SYSTEM APPLICATION AMO NT Ey�VED• RECEIV€1D v , 03 cn
415 N 6th Street,(Bldg 8) Shelton WA,98584
cv v 4 0 m
Shelton:360-427-9670 ext 400 Belfair:360-275-4467 ext 400 L o(i p
SWG �j2� - CZ
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APPLICANT PHONE > >
JENESSA OMDAHL 360-338-5792 m m
MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE r
4350 E AGATE RD SHELTON WA 98584 c
SITE ADDRESS-STREET,CITY,ZIP CODE CO
4360 E AGATF RD SHELTON WA 98584 m
NAME OF DESIGNER PHONE I co
CINDY WAITE 360-701-0205
NAME OF INSTALLER PHONE I N
CHECK ALL APPLICABLE ITEMS DRINKING WATER SOURCE 0 I 0
C
lir NEW CONSTRUCTION ❑ RV HOLDING TANK ONLY ❑ PRIVATE INDIVIDUAL WELL I N
❑ REPLACEMENT SYSTEM El INSTALLATION PERMIT ONLY Ed PRIVATE TWO-PARTY WELL O(/�
❑ TABLE 9 REPAIR ❑ SINGLE FAMILY 0 COMMUNITY/PUBLIC WATER SYSTEM Z I
❑ TANK(S)ONLY 0 COMMERCIAL SYSTEM NAME 1
❑ UPGRADE TO EXISTING 0 OTHER BEDROOMS LOT SIZE I
ElEXISTING FAILURE "Record Drawing required 3 2531X2p1� 03
for all Installations" I N
DIRECTIONS TO SITE-BE SPECIFIC AND ADVISE OF ANY NEEDED INFORMATION FOR ACCESS(ex locked gate) g 1
X ICO
TURN ONTO AGATE ROAD AFTER DEER CREEK STORE, TAKE A LEFT AT AGATE
STORE, TURN RIGHT ONTO EMILY LANE, FIRST DRIVEWAY ON THE RIGHT, SOIL I o
LOGS ARE ON THE LEFT SIDE OF THE DRIVEWAY.
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SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE/FAILURE SOURCE(tor reporting purposes)
❑VOLUNTARY ❑MAINTENANCE/PUMPING ❑BUILDING PERMIT El HOME SALE ❑COMPLAINT ❑OTHER:
INSPECTOR SOIL LOGS COMMENTS/CONDITIONS
i--)7 _, ) :,
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SOIL CODES:
V=VERY G=GRAVELLY S=SAND L=LOAM Si=SILT C=CLAY E=EXTREMELY R=ROOTS
IN TOR SIGNATURE DATE APPLICATION EXPIRATION DATE (CATION APPROVED BY DATE
'''' .1. ei tj il LA)'1—) 1
I 4 MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBS( REVISED 12/7/2015
DESIGN FORM-PAGE ONE Assessor's Parcel Number: 3 2 0 2 4 - 1 2 - 9 0 0 6 1
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. '"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 6,2-3 00 C->Q Designer's Name: CINDY WAITE
Applicant's Name: JENESSA OMDAHL ___ _ Designer's Phone Number: 360-701-0205
Mailing Address: 4350 E AGATE RD Designer's Address: 80 E PICKERING LANE
SHELTON WA 98584 SHELTON WA 98584
City State Zip City State Zip
DESIGN PARAMETERS
Treatment Device
d ❑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
0 Gravity Ii21 Pressure RI Trench 0 Bed 0 Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 3 Schedule/Class SCHEDULE 40
Daily Flow:Operating Capacity 270 gpd Length 66,61,38,35
ft
Daily Flow: Design Flow 360 gpd ••i >er 1.25
g R 0 V E D 4 in
Septic Tank Capacity 1200 a1 m
Receiving Soil Type(1-6) 4
Sep�t•�;jpn 6 ft
Receiving Soil Appl. Rate .6 gp t` likes
''K 2 7 2023
ifces
Required Primary Area 600 ft2 MASON ggintiMWeN t. sHEALTH 42
Designed Primary Area 600 ft2 DiatnetA/BW 3/16
in
Designed Reserve Area 600 ft' Spacing 60
in
Trench/Bed Width 3 ft Manifold
Trench/Bed Length 200 ft Schedule/('lass SCHEDULE 40
Elevation Measurements Length 2+/_ ft
Original Drainfield Area Slope 8 % Diameter 2
in
New Slope,If Altered % Preferred manifold configuration used? 0 Yes 0 No
Depth of Excavation Up-slope 20
in Transport Pipe
from Original Grade Do -slope 17
in Schedule/Cla - SCHEDULE 40
Designed Vertical Separation 12 in Length 60+/_
ft
Gravelless Chambers Required? 0 Yes fii No 0 Optional Diameter q- 2
in
Pump Required? VI Yes 0 No .Pof Pump Chamber
Pump/Siphon Specifications Nun : tic s 6
Difference in Elevation Between Pump Shutoff and Uppermost D�*antif�- ON I ip'1/ 12
Orifice 5 ft !�� 5 tw4 i `p�C gal
ternbeticoptc .13 1200 gal
Uppermost Orifice 0 Higher Lower than Pump Shutoff if'um Lcon Sofs: RI.14 eck t e required.
Capacity @ Total Pressure Head 24.78 Amami. ����"` �• %�� --
gpm 7- Nritteps',or F lapse Meter fig Event Counter
Calculated Total Pressure Head _ 7 66 ftIf Timer: Pump on Pump off
��► 1
Comments
✓I�, CONCRETE TANKS REQUIRED, GRAVEL BASED DRAINFIELD REQUIRED. l
MIMIMIIIMPI
DESIGN FORM—PAGE TWO Assessor's Parcel Number: 3 2 0 2 4 -- 1 2 -- 9 0 0 6 1
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
66 Test hole locations lzf Drainfield orientation and layout Reference depth from original grade:
Et Soil logs g Trench/bed dimensions and
64 Septic tank
Ei Property lines critical distances within layout Qf Drainfield cover
It Existing and proposed wells It D-Box/Valve box locations
within 100 ft of property ItSeptic tank/pump chamber Reference depth from original grade
and restrictive strata:
❑ Measurements to cuts, banks, and locations -pia rr ry,
lif
surface water and critical areas It Observation port location Laterals,trench/bed, top and
bottom
❑ Location and orientation of Q1 Clean-out location 0 Curtain drain collector
curtain drain and all absorption g Manifold placement 0 Sand augmentation
components
It Orifice placement Other cross-section detail:
lt Location and dimension of
64
primary system and reserve area Lateral placement with distance l Observation ports/clean-outs
to edge of bed
Iii Buildings Other Information
g Audible/visual alar a erenced Yes No
61 Direction of slope indicator /t •IN
fid g Scale of drawing shown on scale d 0 Design staked out
Waterlines AbPROVED
❑ ❑ Recorded Notices attached
Roads,easements, driveways, RI ❑ Waiver(s)attached
parking ❑ 0 Pump curve attached
It North arrow and scale drawing APR 2 7 2023 o ❑ Evaluation of failure
shown on scale bar
MASON COUNTY ENVIRONMENTAL HEALTH Non-residential justification
LBW ❑ 0 Waste strength
❑ ❑ Flow
DESIGN APPROVAL
The undersigned designer must be notified installer't time of installation 64 Yes 0 No
(by.
dredtSignature of esigner 7 ?1 Date j
The undersigned has reviewed this design on behalf of Mason County Public Health and determined it to be in
compliance with state and local o -sit reg ations:
V-z7-2
Env' on Healt pecialist 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: Y ' ---2-(1
✓ Drainfield site conditions have not been altered to adversely affect conditions of design approval. ^>.-v/
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.
0 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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2 61 732 60 13 0.5 0.5 61
3 38 456 60 8 1.5 1.5 38
35 420 60 7 2.5 2.5 35
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Total 200 42 200
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TRANS LENGTH 60
GPM 24.78
K (2"SCHEDULEN 40) •284.5
FRICTION LOSS 0656427
Squirt 2
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TDH 7.656427
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Pump Specifications Ii ,
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LITERS PER MINUTE
0 20 40 60 80 100 120 140 160 180
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Installation Notes
Pressure Distribution System
4360 E Agate Rd 32024-12-90061
1. The prepared site plan is not a survey. It's the owner's responsibility to verify property
lines, utility lines (water, sewer, power, phone and gas) prior to installation.
2. Gravel based drainfield required.
3. Septic and pump tank must be concrete.
4. The tanks may be moved as necessary to accommodate building requirements. Septic
tank location must meet all required setbacks.
5. Keep wheeled vehicles off the drainfield area before, during and after installation.
Tracked equipment only,
6. All ground, surface water and roof drains must be diverted away from the septic tanks
and drainfield. Ensure the final grade slopes away from these areas and water doesn't
collect on or around them. Use swales, berms, catch basin and tight lines, curtain drains,
etc. to divert all waters.
7. Curtain drains can be no closer than 10' upgradient and 30' down gradient of the
drainfield
8. Exposed restrictive layers, cuts, banks, etc. can be no closer than 50' downhill from the
drainfield.
9. Install access risers on the septic tanks. valve box and ends of laterals.
10. Make sure septic tank risers are epoxied or caulked to cast in riser rings on tank.
11. Lids must form a water and gas tight seal with the access risers
12. Install effluent filter specified in this design at the septic tank outlet.
13. This system must be installed by a Mason County Certified installer.
14. Deviation from this design without prior approval from the designer and Mason County
Health Department will make this design null and void.
15. This design was sized per Washington Administrative CodeWAC246-272A-0230. The
operating capacity is based on 45 gallons per day per capita with two persons per
bedroom. The minimum design flow per bedroom per day is the operating capacity of
ninety gallons multiplied by 1.33. This results in a minimum design flow of one hundred
twenty gallons per day. This creates a surge factor of 33% but anticipated flow is ninety
gallons per bedroom per day.
16. Install laterals with contour of the ground
17. Install trench bottoms level and always maintain a minimum of six inches into native soil
18. Install locator tape on top of all drainfield laterals.
19. Install threaded clean outs at the ends of all laterals (caps must extend to within six
inche of finish grade and be in a valve box as shown on diagram.
20. Inst dio/visual alarm
21. Fil fa 'c required over drain rock prior to backfilling. If the drain rock extends above
t „prigir, grade, run the filter fabric at le t 2pco h w
VEeall.
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System Owner Responsibilities:
1. Operation and Maintenance is required by Washington State Department of Health and
Mason County Health Department.
2. The septic tank and pump tank should be pumped every three to five years or as
needed.
3. System owners are responsible for having maintenance performed annually.
4. System owners are responsible for responding to septic issues in a timely manner.
5. System owners shall not at any time change or alter settings in the control box.
6. System owner agrees to read and abide by information regarding their system in the
User Manual provided by Mason County Public Health.
7. Keep the flow of sewage at or below the approved design operating capacity.
8. Keep waste strength at residential waste strength parameters.
9. Spread loads of laundry through the week.
10. Do not use excessive bleach or detergents with added whiteners.
11. Do not shower, do laundry and dishwasher at the same time
12. Antibiotics can kill or impair the biological process in the septic tank.
13. Leaky plumbing can hydraulic overload your on-site septic system.
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