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Home My WebLink AboutSWG2020-00617 - SWG Application / Design - 11/23/2020r : MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584 A SHELTON:360-427-9670,EXT 400 F' '1 COMMUNITY SERVICES BELFAIR:360-275-4467,EXT 400 ' Building.Planning,Environmental Health,Community Health ELMA:360-482-5269,EXT 400 FAX:360-427-7787 On-Site Sewage System Tank Only Permit: SWG2020-00617 APPLICANT GONZALEZ ERNESTO Phone: 253-327-0367 Address: 6213 52ND AVE W UNIVERSITY PLACE, WA 98467 OWNER GONZALEZ ERNESTO Phone: 253-327-0367 Address: 6213 52ND AVE W UNIVERSITY PLACE, WA 98467 SEPTIC DESIGNER Jim Hunter-Jim Hunter and Associates Phone: JIM 360-507-1265 Address: PO BOX 162 OLYMPIA, WA 98507 Site Address: 291 SE ARCADIA RD Primary Parcel Number: 320291200300 Permit Description: Septic tank replacement Permit Submitted Date: 11/23/2020 Permit Issued Date: 11/25/2020 Issued By: Luke Cencula Current Permit Fees Paid: $225.00 (additional fees may be requ red upon installation of system). Permit Expiration Date: 11/25/2021 (based on date of inspection) Type of Work OSS Repair Components being Replaced: Septic Tank Only Surfacing Sewage? No Existing Failure? No Shoreline? No Horizontal Setbacks Met? Yes Number of Bedrooms: 3 Drinking Water Source: Public Water System Additional Details: Septic tank replacement Permit Conditions: 4 Proposed development subject to zoning requirements and approval by the planning department staff per Mason County Title 17. 1 Permit must be installed by a Mason County Certified Installer unless prior written authorization from Mason County is obtained. 2 Horizontal setbacks per WAC246-272A-0210 must be maintained, unless prior approval is obtained 3 Mason County As-built Form & Record Drawing 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/OR DESIGN APPROVED. FINAL INSTALLATION APPROVAL IS REQUIRED PRIOR TO TEMPORARY OR FINAL OCCUPANCY OF ANY RELATED STRUCTURES. For Final Inspection visit: www.co.mason.wa.us/health/environmental/onsiteloss-inspection-request.php or call: 360-427-9670, extension 400. I OFFICIAL USE ONLY MASON COUNTY PUBLIC HEALTH DATERECENED: ^ ONSITE SEWAGE SYSTEM APPLICATION AMOUNT RECEIVED RECEIVED W Cl) 415 N 6th Street,(Bldg 8) Shelton WA,98584 CPC9 t7 m Shelton:360-427-9670 ext 400 Belfair:360-275-4467 ext 400 SWG � — Call—] 5 xi z 6 ,10 APPLICANT PHONE Z ERNESTO GONZALEZ D 253 327-0367 m m MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE r 291 SE ARCADIA RD SHELTON WA 98584 E SITE ADDRESS-STREET,CITY,ZIP CODE SAME m 73 NAME OF DESIGNER PHONE JIM HUNTER 360-753-1226 ICY NAME OF INSTALLER PHONE IL CHECK ALL APPLICABLE ITEMS DRINKING WATER SOURCE v Io' ❑ NEW CONSTRUCTION ❑ RV HOLDING TANK ONLY ❑ PRIVATE INDIVIDUAL WELL C I4 N, y ❑ REPLACEMENT SYSTEM ❑ INSTALLATION PERMIT ONLY 0 PRIVATE TWO-PARTY WELL ❑ TABLE 9 REPAIR 0 SINGLE FAMILY OMMUNITY/PUBLIC WATER SYSTEM Z St TANK(S)ONLY ❑ COMMERCIAL SYSTEM NAME: 1 1 ❑ UPGRADE TO EXISTING ❑ OTHER: BEDROOMS LOT SIZE ❑ EXISTING FAILURE "Record Drawing required 3 Pfor all Installations" r_93 DIRECTIONS TO SITE-BE SPECIFIC AND ADVISE OF ANY NEEDED INFORMATION FOR ACCESS(ex.locked gate) O n I 1 ID r 104 ICI SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS I d OFFICIAL USE ONLY BELOW THIS LINE UPGRADE/FAILURE SOURCE(for reporting purposes) • ❑VOLUNTARY ❑MAINTENANCE/PUMPING 0 BUILDING PERMIT 0 HOME SALE ❑COMPLAINT ❑OTHER: INSPECTOR SOIL LOGS COMMENTS/CONDITIONS FRI CD GB Co.., 0 N tC \, r/ • SOIL CODES: V=VERY G=GRAVELLY S=SAND L=LOAM SI=SILT C=CLAY E=EXTREMELY R=ROOTS INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED BY DATE • NCIs)-4•.-+Q •?-5 I ,. 1 4- _ 111 J707.O THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBS!1 REVISED 12/7/2015 DESIGN FORM—PAGE ONE Assessor's Parcel Number:a at O an -- L -- c7 15_6 O 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 X,^O e to 11 Designer's Name: JIM HUNTER Applicant's Name: ERNESTO GONZALEZ Designer's Phone Number: 360-753-1226 Mailing Address: 291 SE ARCADIA RD PO BOX 162 Designer's Address: SHELTON WA 98584 OLYMPIA WA 98507 City State Zip City State Zip . DESIGN PARAMETERS �M, .. 0�vTreatment 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 0 Pressure 0 Trench ❑Bed ❑ Sub Surface Drip Septic Tank/Drainfield Specifications Laterals Number of Bedrooms 3 Schedule/Class -- Daily Flow:Operating Capacity 2.1 C gpd Length ft Daily Flow:Design Flow .'? (p C gpd Diameter in Septic Tank Capacity 1,200 gal Number Receiving Soil Type(1-6) Separation ft { Receiving Soil Appl.Rate gpd/ft2 Orifices Required Primary Area ft2 Total Number of Orifices Designed Primary Area - ft2 Diameter — in Designed Reserve Area ft2 Spacing in Trench/Bed Width ft Manifold Trench/Bed Length — ft Schedule/Class Elevation Measurements Length ft Original Drainfield Area Slope % Diameter — in New Slope,If Altered % Preferred manifold configuration used? 0 Yes 0 No Depth of Excavation Up-slope --- in Transport Pipe from Original Grade Down-slope in Schedule/Class Designed Vertical Separation in Length :` ft Gravelless Chambers Required? 0 Yes 5Io l 0 Optional Diameter in Pump Required? 0 Yes E No Dosing and Pump Chamber Pump/Siphon Specifications Number of doses/day _ Difference in Elevation Between Pump Shutoff and Uppermost Dose quantity gal Orifice ft Chamber Capacity gal Uppermost Orifice 0 Higher 0 Lower than Pump Shutoff Pump controls:Please check those required. Capacity @ Total Pressure Head _ gpm ❑Timer ❑Elapse Meter 0 Event Counter Calculated Total Pressure Head — ft If Timer: Pump on ,Pump off Comments , DESIGN FORM—PAGE TWO Assessor's Parcel Number: 32 O -- 1 -- (13 0 Permit Number: SWG -O c (. vl DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch ❑ Test hole locations 0 Drainfield orientation and layout Reference depth from original grade: ❑ Soil logs 0 Trench/bed dimensions and 0 Septic tank ❑ Property lines critical distances within layout 0 Drainfield cover ❑ Existing and proposed wells 0 D-Box/Valve box locations Reference depth from original grade within 100 ft of property 0 Septic tank/pump chamber and restrictive strata: ❑ Measurements to cuts,banks,and locations 0 Laterals,trench bed,top and surface water and critical areas 0 Observation port location bottom ❑ Location and orientation of 0 Clean-out location 0 Curtain drain collector curtain drain and all absorption 0 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 referenced Yes No ❑ Direction of slope indicator 0 Scale of drawing shown on scale 0 0 Design staked out ❑ Waterlines bar 0 0 Recorded Notices attached ❑ Roads,easements,driveways, 0 0 Waiver(s)attached parking 0 0 Pump curve attached ❑ 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 notified by'ins a31 ,i,,l,="/- �/installation 0 Yes lid No 41,,, Signature(0- igner 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: E ronmental Health Specialist 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: N 6 U -t'--u sv '1-6 >13'}-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 I • (..,,t '4' - . i i • . ...j,r- 1 J i it o , r • 1 + N. liJ i , • i i • i H I fOil I 1 il'!111 i illgi l trY :.'I k w It,,. ;ya :rr, U lii I IC , . I 1P , • ,�?�b rip.. . 11 , , , , , 11 s...1a r ; A iI ' i� s j I. • I I?lilt a C v,.. m f i i x m1 " t' C gip • m gl # s ir. to L a d m i` ' Mit b a i `� , f U� > ,� 3 ,, ift•t- L y m o ! v LA 10 11, 4. III a. !� si 7 Z ri1 —+ „Q y i 1 i i .'fir,:. 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