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Home My WebLink AboutSWG2022-00174 TANK ONLY - SWG Application / Design - 4/4/2022 MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584 reei � COMMUNITY SERVICES SHELTON:360-2754467,EXT400 BELFAIR:360-275-4467,EXT 400 ELMA:360-482-5269,EXT 400 / Budding. Emir unmental Health Community Health e fi FAX:360-427-7787 On-Site Sewage System Tank Only Permit: SWG2022-00174 APPLICANT WORKMAN CONTRACTING Phone: 360.463.9573 Address: 170 E TIMBERLAKE DR SHELTON, WA 98584 OWNER HARTER SHARON E Phone: Address: 10210 NW 15TH AVE VANCOUVER, WA 98685 Site Address: 20 N HAMMA HAMMA CT WEST Primary Parcel Number: 422045100069 Permit Description: Tank Replacement Permit Submitted Date: 04/04/2022 Permit Issued Date: 04/06/2022 Issued By: Jeff Wilmoth Current Permit Fees Paid: $240.00 (additional fees may be required upon installation of system). Permit Expiration Date: 04/04/2025 (based on date of inspection) Type of Work OSS Repair Components being Replaced: Pump Tank Only Surfacing Sewage? No Existing Failure? Yes Shoreline? No Horizontal Setbacks Met? Yes Number of Bedrooms: 2 Drinking Water Source: Public Water System Additional Details: Permit Conditions: 4 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. 1 Horizontal setbacks per WAC246-272A-0210 must be maintained, unless prior approval is obtained 3 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/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/onsite/oss-inspection-request.php or call: 360-427-9670, extension 400. L OFFICIAL USE ONLY DATE RECEIVED: Li y_ - D MASON COUNTY COMMUNITY SERVICES AMOUNT c M AA70UNT RECEIVE RECEIVED BY: W (/) 4-' Z/ v Rl Public Health(Community Health/Environmental Health) C (n 360-427-%70,ext.400 or 360-275.4467,ext.400 A /- ^ ' I 415 N.6th Street.Shelton WA 98584 S /►'+ .. `� 17 Li ^ w 1l Y V `—__ C ZZ N ON-SITE SEWAGE TANK ONLY APPLICATION D � g n m APPLICANT PHO 1 kk. ti�91(s,A,�A," y2 3 -,s7 3 z c MAILING ADDRESS-STREET,CITY,STATE.ZIP CODE g I ZO ►_. TO .Pr, m SITETE rADDDRESS SSTREET,CITY,ZIP CODE '"�' 'Q.t Zc l t NA„(lt & f'�C�(•tn tl A ( I i L(�. NAME OF DESIGNER _ PHONE< I1j l_ NAME OF INSTALLER PHONE P tiA -r,/ iAlti WrAtit Cat fa't4, iZC . `/, 3.. 5>75 TYPE OF WORK(select one) DRINKING WATER SOURCE O 10 ❑ NEW CONSTRUCTION/UPGRADES REPAIR/REPLACEMENT 0 PRIVATE INDIVIDUAL WELL 0 PRIVATE TW{{O-PARTY WELL Z '_ COMPONENT(S)TO BE REPLACED/INSTALLED titPUBLIC WATER SYSTEM (_'.(-7`�1/i�nitf:�N Ih El SEPTIC TANK 0 PUMP TANK 0 RV HOLDING TANK BEDROOMS LOT SIZE V'/� ❑ OTHER 4— W ILA._ OTHER DETAILS(select all that apply) TANK(S)SETBACK CHECKLIST Q ❑ SURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINE El100FT+PUBLIC/COMMUNITY WELLS n X to SUBMITTALS ❑ SOFT+PRIVATE WELLS,SURFACE WATERS,STREAMS.RIVERS ❑ PLOT PLAN(REQUIRED) 0 TANK CROSS SECTION(REQUIRED) 0 10FT+DRINKING WATER SUPPLY LINES lO ❑ PUMP DETAILS(IF APPLICABLE) 0 WAIVER(S)(IF APPLICABLE) 0 5FT+PROPERTY/EASEMENT LINES,FOUNDATIONS,FOOTINGS PLOT PLAN CHECKLIST r IC ❑ PROPERTY LINES AND EASEMENTS 0 EXISTING/PROPOSED STRUCTURES 0 EXISTING/PROPOSED OSS COMPONENTS AND LINES —I ❑ WELLS WITHIN 100FT 0 WATER SUPPLY LINES 0 DRIVEWAYS/PARKING 0 SURFACE WATERS,STREAMS,RIVERS,ETC... ❑ DIRECTION OF SLOPE/CONTOURS 0 PERIMETER/CURTAIN DRAINS f❑�� NORTH ARROW 0 1SCALE,BAR { l f DIRECTIONS TO SITE AND SITE CONDITIONS:(Es.locked gate) (d 1 G.(/�c.- (.12..�""Y DI�SQ'(J VJA- 1 I/ �V op l�n��S � C cam, > f 3 ,\ w�l¢s i r.6-e- LO-4- 0,4, (N,( c Ij '5 l, 1n1� , 1-4A42.4, ok col i^d- &v.4-v 4\1tA7 5.,64-akar,1" 1'i -, T1-Q4 a l..s>- �.,4-0 L Jc a✓ •t-i-e.., o. f-Jc,L{ oh1-e, 1,3 �nww,A AtA C1 I/r,, c �Jh/! ' L P4040 v3 Nwv..., vYnviAm Cat. W c%.,,.1 `e,d— J S YJ(Ae__c-I-l GL k.Qc<1. t.-9/ RV U✓t-SDI OFFICIAL USE ONLY BELOW THIS LINE UPGRADE I FAILURE SOURCE(for reporting purposes) ❑VOLUNTARY 0 MAINTENANCE/PUMPING ❑BUILDING PERMIT ❑HOME SALE OCO IN#IpHli 0 v E COMMENTS/CONDITIONS APR 0 5 2022 I/1ASON COUNTY ENVIRONMENTAL HEALTI- SEWAGE TANKS MUST BE LISTED UNDER DOH'LIST OF REGISTERED SEWAGE TANKS'. TANKS MUST MEET CURRENT MINIMUM S� REMENTS.EQUIPPED WTH RISERS AND LIDS TO SURFACE,AND INCLUDE AN EFFLUENT FILTER(IF APPLICABLE). RECORD DRAW NG AND INSTALLATION REPORT REQUIRED FOR FINAL APPROVAL. ( 74 TOR SIGNATURE DATE APPLICATION EXPIRATION DATE APP ION APPROVED/ISSUED BY DATE IS FAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 7/92Dt9 _ i Infiltrator IM-1060 (Add to... 11 . i. if/TN F i LT R AT 0 R- tanks Features & Benefits . • Strong injection molded ,_ • polypropylene construction r t t 1 ,,f1 •� • Lightweight plastic construction • and inboard lifting lugs allow for easy delivery and handling .i ` r f (� ( • Integral heavy-duty green Inds that trittI t • ' , interconnect with TW'Y rises and pipe riser solutions f•l t f I[Vi[e ti 1111•C n. t_':t' t-' I' • Structul ally teinfotced access ports eliminate distorAn during . installation and oump-outs • Reinforced structural oohing and fiberclass oulkneads offer additional strength • Can be installed with 66' to 48" of cove; The Infiltrator 1M-1060 is a lightweight strong and durable septic tank. • Can be pumped dry dam. This watertight tank design is offered with Infiltrator's line of custom-fit pump outs rises and heavy-duty lids. Infiltrator injection molded tanks provide a • Suitable for use as a septic tank. ,evolutionary improvement in plastic septic tank design,offering long-term pump tank.or rainwater exceptional strength and watertightness. ;non-potable)tank !Net S,de • No special installation. backfill or . y water filling procedures are requi,ed TANK CUTAWAY Infotrator - TVl Riser System` • - HEAVY DUTY LID - CUTAWAY Re.ntc"c ed _'4"St a.cu.ral Pall on • \ access port baffle Ewa l' 1 -I / • Structural hulkhesos P P . , MID-S AWAYyq ° E D n ` i, �� Reir to ton t 74f f�trU 5 2022 ADVERTISEMENT MASON COUNTY ENVIRONMENTAL HEALTH JBW 114 f t l 1 ,. , R, , aw,, 0 -r (' g 1 , 1 -fi ct:i 11 S I Lq 4 pal Pi (z: i * 01J woo Too '/ 1c5�y -- �4.11- for oirtV/ PROV A '�l AP -O-o A d k'es4e 14q jN COUNTY71RONMENL O ? � T �! Sc ►/�Q o 1. HEAL rh `�DJS�tJv5 G2)0�rel - �' ,,.�,.� �a cova-"\- I 4 AAA Septic LLC PO Box 1460 360-427-6110 Shelton, WA 98584 PROPERTY INFORMATION Location:20 N HAMMA HAMMA CT WEST HOODSPORT Tax ID:422045100069 mad-To SHARON E HARTER 10210 NW 15TH AVE Use: VANCOUVER,WA 98685 GENERAL SYSTEM TYPE:Conventional (Non-Pressurized) ON ID:422045100069 County Area: Hood Canal Fold ON-SITE WASTEWATER TREATMENT SYSTEM INSPECTION REPORT Fed Here Here Inspected:03/30/2022 - Inspection Type:PROPERTY SALE - Correction Status:No corrections made Company: Work Performed By. Submitted 03/31/2022 by: AAA Septic LLC Debra Lovely Debra Lovely COMMENTS& GENERAL INSPECTION NOTES Deficiencies Noted:deficiencies must be corrected to ensure proper longevity of the Onsite Sewage System. 2nd compartment of tank appears to be cracked,refer to installer.Drainfield tested okay GENERAL SITE&SYSTEM CONDITIONS The General Site and System Conditions were: Fully Inspected Components accessible for service: YES All required service performed(if no-specify omitted inspection items in notes): YES Surfacing effluent from any component(including mound seepage): NO Components appear to be watertight-no visual leaks: NO-Deficient Improper encroachment(structures/impervious surfaces) YES-Deficient All riser lids securely fastened upon departure: YES Electrical repairs needed. If YES describe in comments: NO Root intrusion on any components. If YES describe in comments: NO Settling problems observed. If YES describe in comments: NO The house/structure was vacant or used infrequently,assessment of the drainfield was not possible. NO ONSITE SEWAGE SYSTEM INSPECTION DETAIL •istribution:D-Box This component was: Fully Inspected D-Box in good condition: YES D-Box outlets set to allow equal effluent distribution: YES TANK:Septic Tank-2 Compartment This component was: Fully Inspected Effluent level within operational limits(if NO explain in comments): NO Deficient All required baffles in place(N/A=No baffles required): YES Compartment 1 Scum accumulation(Inches,if other specify): 0 Compartment 1 Sludge accumulation(Inches,if other specify): 4 Compartment 2 Scum accumulation(Inches,if other specify): 0 Compartment 2 Sludge accumulation(Inches,if other specify): 0 Pumping recommended: NO grainfield(disposal):Gravity This component was: Fully Inspected Component appears to be functioning as intended: YES Ponding present?If YES explain in comments: NO Drainfield was vacuumed,flushed or hydro-jetted?(If YES,explain in comments) N/A This report indicates cedan chara°tefStics of the onsite sewage system at the time of wsrt.In no way is this report a guarantee of operation or future performance. ReportiD:1054434 View inspection reports online at www.onlinerme.corn Page 1 of 1