HomeMy WebLinkAboutSWG2022-00414 - SWG Application / Design - 7/20/2022 klc \ MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584
0 3: .. SHELTON:360-427-9670,EXT 400
•?- '��'�' •9l COMMUNITY SERVICES BELFAIR:360-275-4467,EXT 400
ELMA:360-482-5269,EXT 400
ry tttyv Budding.Pla may,ErrvuonmantalHealth,CommunilyHealth/ FAX:360-427-7787
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On-Site Sewage System Tank Only Permit: SWG2022-00414
OWNER MILLS MATTHEW B & DENISE Phone:
Address: 7521 ANDREWS BEACH RD NE OLYMPIA, WA 98516
APPLICANT MILLS MATTHEW B & DENISE Phone:
Address: 7521 ANDREWS BEACH RD NE OLYMPIA, WA 98516
SEPTIC INSTALLER TESSA HOLT- Dodge Excavation Phone: 360-349-5333
Address: 4225 BLACK LAKE BLVD SW OLYMPIA, WA 98512
Site Address: 121 E FRANJO BEACH DR
Primary Parcel Number: 220165001010
Permit Description: Replace septic tank
Permit Submitted Date: 07/20/2022
Permit Issued Date: 07/26/2022
Issued By: Rhonda Thompson
Current Permit Fees Paid: $240.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 07/26/2023 (based on date of inspection)
Type of Work OSS Repair
Components being Replaced: Septic Tank Only
Surfacing Sewage? No Existing Failure? Yes
Shoreline? No Horizontal Setbacks Met? Yes
Number of Bedrooms: 2 Drinking Water Source: Private Two-Party Well
Additional Details: Sound Placement 1200 gallon cement
Permit Conditions:
1 Horizontal setbacks per WAC246-272A-0210 must be maintained, unless prior approval is
obtained
2 Permit must be installed by a Mason County Certified Installer unless prior written
authorization from Mason County is obtained.
3 Mason County Asbuilt Form, Record Drawing, and Installation fee must be submitted for
final installation approval.
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: www.co.mason.wa.us/health/environmental/onsite/oss-inspection-request.php or call:
360-427-9670, extension 400.
\ M 11.E _5\c-k 13' -f< �� t-.\- A OFFICIAL USE ONLY
MASON COUNTY DATE RECEIVED: -7 -
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COMMUNITY SERVICES AMDUN _ RECEIVED W N IV :
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I Public Health(Community Health/Environmental Health) ! C CO
415 427th St•et .400 or n,WA 9 584 ext.400 S W G f1 ^ /� 6 \
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a15 t:.bth 5t•eet Shelton,WA 98584 — O 70
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ON-SITE SEWAGE TANK ONLY APPLICATION
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APPLICANT PHONE IT1
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MAILING ADDRESS-STREET.CITY,STATE,ZIP CODE g
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SITE ADDRESS-STREET.CITY,ZIP CODE
NAME OF DESIGNER PHONE
.. -----
NAME OF INSTALLER PHONE —� 0 I
TYPE OF WORK(select one) DRINKING WATER SOURCE O I 'c---
❑ NEW CONSTRUCTION/UPGRADES IKREPAIR)REPLACEMENT 0 PRIVATE INDIVIDUAL WELL A PRIVATE TWO-PARTY WELL Z I
COMPONENT(S)TO BE REPLACED/INSTALLED 0 PUBLIC WATER SYSTEM 1
SEPTIC TANK ❑ PUMP TANK 0 RV HOLDING TANK BEDROOMS LOT SIZE I CIOTHER o '%3 W C
OTHER DETAILS(select all that apply) TANK(S)SETBACK CHECKLIST r
f
❑ SURFACING SEWAGE 3,EXISTING FAILURE 0 SHORELINE 0 100FT+PUBLIC/COMMUNITY WELLS 0
SUBMITTALS 0 50FT+PRIVATE WELLS,SURFACE WATERS,STREAMS,RIVERS
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❑ PLOT PLAN(REQUIRED) 0 TANK CROSS SECTION(REQUIRED) 0 10FT+DRINKING WATER SUPPLY LINES I
❑ PUMP DETAILS(IF APPLICABLE) 0 WAIVER(S)(IF APPLICABLE) 0 5FT+PROPERTY!EASEMENT LINES,FOUNDATIONS,FOOTINGS
SLOT PLAN CHECKLIST 0 I
❑ PROPERTY LINES AND EASEMENTS ElEXISTING/PROPOSED STRUCTURES 0 EXISTING/PROPOSED OSS COMPONENTS AND LINES I 0
❑ WELLS WITHIN 100FT 0 WATER SUPPLY LINES 0 DRIVEWAYS/PARKING 0 SURFACE WATERS,STREAMS,RIVERS,ETC...
❑ DIRECTION OF SLOPE/CONTOURS ❑ PERIMETER/CURTAIN DRAINS 0 NORTH ARROW 0 SCALE BAR 1
0 DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.locked gate) —' 7 1
Ce�c � I�
L JUL 2 U 2022 ;
By \
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE!FAILURE SOURCE(for reporting purposes)
❑VOLUNTARY MAINTENANCE/PUMPING ❑BUILDING PERMIT ❑HOME SALE ['COMPLAINT ❑OTHER:
COMMENTS i CONDITIONS
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SEWAGE TANKS MUST BE LISTED UNDER DOH"LIST OF REGISTERED SEWAGE TANKS'. TANKS MUST MEET CURRENT MINIMUM SIZE REQUIREMENTS,EQUIPPED WITH RISERS
AND LIDS TO SURFACE,AND INCLUDE AN EFFLUENT FILTER(IF APPLICABLE). RECORD DRAWING AND INSTALLATION REPORT REQUIRED FOR FINAL APPROVAL.
INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED'ISSUED BY DATE
1 J7—( [iE ' 1 I-Lq1-Z.
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12/7l2015
—
MASON COUNTY HEALTH DEPARTMENT SEWAGE SYSTEM
DESIGN
_ ENVIRONMENTAL HEALTH SECTION C� DEPTH OF
303 NORTH 4th STREET • SHELTON, WA 98584 'DEPTH
PHONE (206) 426-5561 (- 2"STRAW OR PAPER
DATE SU MITT D ,�'�"'`., r: �1J;�''- r
P}�pPERTV OWNER ;�,•.•, 'J•.'
u ti M' (R c i s ,.. ,.:r_.. . l v STONE
N' DESI NED K•,��'. •;., OVER TILE
AQQR£SS A Sip�� •r e.
g.brroaJ it./4S N SOIL LOG DATA ,,.`o'y. .0,,,. �pt•."iri
LEGAL DESCRI TION 41�xiti1C4..`i6.! +�5 �' STONE
.4 O i /0 g, C,OC1< / I<- I I'^S ?r > ^ JNDER TILE
Depth to
1'-'
r ie 4 10 IS C 3 C r-! CROSS SECTION OF TRENCH '4 17, Restrictive
l�h► lJ`� v Layer
CALCULATIONS: GPD if other SHOW THE FOLLOWING ITEMS IN GRID BELOW:
No. Bedrooms 7 than residence _ A. Horizontal system plan and, if mound system is proposed or
slopes exceeding 15%provide cross section.
Application Rate:gal./sq.ft./day B. Scale •
Drainfield Sizing:Absorption Area 4 .O 5(*aFt.2 Total Length / 5 °___-Ft. C. Benchmark A ,stubout elevation, took outlet elevation, (bot-
tom of pipe), elevation at finish grade at center of drainfield.
Pump Specifications:High level alarm Elevation Difference-v...____.—Ft. D. Property lines,building,trees,slopes i'i excess of 5%,driveway.
GPM Discharge Volume — E. All wells or drinking water supplies Within 100 ft.,water lines.
Volume of sump F. Drainage system detail (i.e.curtain drain).
iOa.) b t/�4 Cr4—S( G. Replacement area. .
Septic Tank Size and Manufacturer j
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NOTARY PUBLIC
•
I L)Oit -I5 M ()C./4 /ff/fe .'e agree not to hold the Health Department responsible in
the event that the special system as proposed by 6- ,I f u el c_ .
fails to operate as required by Articles VI and VII, of the Mason County Health partment Code.
•
Signature+v L��4 S l l • 2Link1•J/.e. ' -
Subscribed and sworn before me this 43 VCL day otary u lc for the State of Washings
Of u,��v 9 ' *• - A3„`residing at P.)..te '`-)
rOrfl mason. fa.
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AIM&ASSOC!ATE$'S,1'`q`Iiirrpr3,t' r/t�"za. Ofk L.•OU'rRY r_)ivro !
• ' MASON COUNTY HEALTH DEPARTMENT
• 428 WEST BIRCH STREET
• SHELTON, WASHINGTON 98584
PHONE (206) 426-5561
RECORD OF FINAL INSPECTION OF YOUR SEWAGE DISPOSAL SYSTEM ` /
OWNER
1/. 1. Dolt) t~� ADDRESS '$l�et'7LytJ ( i{�,G lei �.r 2-1 .a�v,�� ��ra�cc D
THIS RECORD IS NOT A GUARANTEE OF PERFORMANCE. LEGAL .-(71(to , r pc&'i -
A SEPTIC SYSTEM IS NOT A MUNICIPAL SEWER. HOWEVER DESCRIPTION ‘C�4 a ei4cr-t,
WITH PROPER MAINTENANCE AND CAREFUL USE OF
WATER IT CAN GIVE MANY YEARS OF TROUBLE FREE SER- —
VICE. MANY PROBLEMS WITH SEPTIC TANKS ARE CAUSED SOIL
BY FLUSHING EXCESSIVE AMOUNTS OF PAPER, CLOTH COMMENTS
AND PLASTIC MATERIALS DOWN THE DRAIN, OR BY SITE F ELD /8 X 4d
LARGE AMOUNTS OF WATER FROM LEAKY FAUCETS OR NO.
FAULTY FIXTURES. DEPTH TO MONTH J(' L y�
THE SEPTIC TANK ITSELF SHOULD BE CLEANED EVERY WATER TABLE OF YEAR !
TWO OR THREE YEARS DEPENDING ON THE HABITS OF THE INSTALLER
FAMILY, THE NUMBER OF FIXTURES IN THE HOUSE, AND Ge;ebo-4. 8 . fri-ooSeSIZE
THE AMOUNT THAT A GARBAGE DISPOSAL IS USED. CLEAN- SEPTIC TANK (S) /OOa 4.4
ING AT THE RIGHT TIME WILL AVOID THE RISK OF INJUR-
ING OR DESTROYING THE DRAINFIELD DUE TO SOLIDS DRAINFIELD i 40
LENGTH
CARRYING OVER INTO THE DRAINFIELD. CALL THE TRENCH AREA SQ. FT.
MASON COUNTY HEALTH DEPARTMENT FOR A LIST OF 4 48
LICENSED SEPTIC TANK CLEANERS IN YOUR AREA. THE
CLEANER CAN SERVE YOU BEST IF YOU SHOW HIM THIS TILE DEPTH _, r� ❑ CORRUGATED RIGID ❑ CEMENT
RECORD WHEN HE COMES. ROCK it r�DEPTH �� TOTAL
HEAVY TRUCKS OR EQUIPMENT SHOULD NEVER BE CU. YDS. (7 6rS BELOW
PIPE r S DEPTH
DRIVEN OVER THE TANK OR DRAINFIELD. CONSULT THIS SPACE RESERVED FOR
i RECORD IN CASE OF ANY BUILDINGS, DRIVEWAYS, REPLACEMENT DISTRIBUTION HELD: ' SQ. FT.
SWIMMING POOLS, OR EXTENSIVE GRADING OR FILLING NORTH
ARE LATER CONTEMPLATED.
SHRUBS OR TREES SHOULD NOT BE PLANTED CLOSE TO
THE SEPTIC TANK AS THEY WOULD INTERFERE WITH %
CLEANING OF THE TANK. THEY CAN BE PLANTED IN THE 1p
DRAINFIELD AREA PROVIDING WILLOWS ARE NOT USED. ' ` X
THE YARD GRADE IN THE DISPOSAL AREA SHOULD BE
SUCH THAT SURFACE WATER IS NOT POCKETED ON THE i
DRAINFIELD. ANY SETTLING OF THE GROUND OVER THE K.
TRENCHES SHOULD BE FILLED IN WITH SOIL. DO NOT EX-
CESSIVELY WATER THE LAWN IN THE DRAINFIELD AREA. Nye
WATER EVAPORATION FROM THE DRAINFIELD IS ABOUT
EQUAL TO ONE HALF INCH OF RAIN PER DAY. k.
FOOTING DRAINAGE, DOWNSPOUTS AND WATER
SOFTENER RECHARGE WATER SHOULD NOT BE CON-
NECTED TO THE SEPTIC SYSTEM OR DISCHARGED INTO THE IP
DRAINFIELD AREA. •
THE TYPES OF BACTERIA NEEDED IN A SEPTIC TANK ARE ��
ALWAYS FOUND IN SEWAGE. THERE IS NO NEED TO ADD
YEAST OR OTHER STARTERS TO A SYSTEM. THE USE OF RE-
JUVENATORS OR CHEMICALS TO CLEAN A SEPTIC TANK
HAVE NOT BEEN PROVEN TO BE BENEFICIAL AND MAY BE e
HARMFUL BY FLUSHING SOLIDS OUT OF THE TANK OR BY
•
CHANGING THE CHARACTERISTICS OF THE SOIL. THE 'i
NORMAL USE OF BOWL CLEANERS OR CLEANING COM- • I• SOUTH
POUNDS WILL NOT KILL THE BACTERIAL ACTION OR SLOW ---------
DOWN THE OPERATION OF THE SEPTIC TANK.
2 2—`Q2 APPROVED BY
THIS IS AN IMPORTANT DOCUMENT
Printed Fi Pg IT' � H ur ty/ •
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SS,' ATE 'CERTIFIED BY ao
PrinnEE e ram aso RGounty DMS 1
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