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HomeMy WebLinkAboutSWG2023-00078 - SWG Application / Design - 3/8/2023 MASON CO U NI TY 415 N 6TH STREET,SHELTON,WA 98584 SHELTON:360-427-9670,EXT 400 BELFAIR:360-275-4467,EXT 400 0 Public Health & Human Services ELMA:360-482-5269,EXT 400 'M..M j ylll•^fie FAX:360-427-7787 On-Site Sewage System Permit: SWG2023-00078 APPLICANT MJ SCOTT ENTERPRISES LLC Phone: 360-275-6255 Address: P 0 BOX 1238 BELFAIR, WA 98528 OWNER MJ SCOTT ENTERPRISES LLC Phone: 360-275-6255 Address: P 0 BOX 1238 BELFAIR, WA 98528 SEPTIC DESIGNER FRANKLIN CLARK-A+Onsite Phone: 360-830-4765 Address: PO BOX 1954 SILVERDALE, WA 98383 Site Address: 642 NE Old Belfair Hwy Primary Parcel Number: 123205000004 Permit Description: New SFR -3BR Oxcar X02 Permit Submitted Date: 03/08/2023 Permit Issued Date: 05/09/2023 Issued By: Jeff Wilmoth Current Permit Fees Paid: $525.00 (additional fees may be required upon installation of system). Permit Expiration Date: 03/15/2026 (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 �� DATE RECEIVED: MASON COUNTY _' — 2-3 COMMUNITY SERVICES AMD VE RLCENl C CA 00 CA v_ Public Health(Community Health/Environmental Health) C 360-427-9670,e,t.400 or 360.275.4467,ext.4000 / `/ (� 415 N.6th Street-Shelton.WA 98584 iii SWIG Q - / �/ 'Y-14 2 N Si J v / V\ / V � Z1 Z N ON-SITE SEWAGE SYSTEM APPLICATION m n APPLICANT �/ PHONE I _/` n m t-jai`(�f�I , ./\ C�_1 -5(i-V r 3 b r l� ( 65- Z 1 `� C MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE E 1 70 ca SITE ADDRESS'-STREET,/CITY,ZIPjj CODE 1 (��[l� •• ce NAME OF DESIGNER I NAME OF INSTALLER PHONE v I U3 PERMIT TYPE(select one) DRINKING WATER SOURCE O I� fflizt/S-IDENTIAL OSS UJCOMMUNITY OSS Fi COMMERCIAL OSS uJ PRIVATE INDIVIDUAL WELL hi PRIVATE TWO-PARTY WELL Z I O TYPE OF K(select one) ��'' f)BLIC WATER SYSTEM r LT,EW CONSTRUCTION/UPGRADES REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) ❑TABLE IX REPAIR IU\ SUBMITTAL ❑ SURFACING SEWAGE ❑EXISTING FAILURE ❑SHORELINE SIGN FORM(REQUIRED) 1!,fiSEPTIC DESIGN(REQUIRED) BEDROOMS /�,- LOT SIZE Q I'0 bWAIVER(S)(IF APPLICABLE) 3 n 4 DIRECTIONS TO SITE AND SITE CONDITIONS:(ex./ocked gate) X I., l .iJ2_, at ( I° IC), --, SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. OFFICIAL USE ONLY BELOW THIS LINE UPGRADE I FAILURE SOURCE(for reporting purposes) 0 VOLUNTARY 0 MAINTENANCE/PUMPING ❑BUILDING PERMIT El HOME SALE El COMPLAINT El OTHER: INSPECTOR SOIL LOGS COMMENTS/CONDITIONS MAR U 9 2G?.3 1„2„,,-- f-S✓✓ Y ift JC) /R..4 41,,..5, RECORD DRAWING AND INSTALLATION REPORT SOIL CODES: V=VERY G=GRAVELLY S=SAND L=LOAM Si=SILT C=CLAY E=EXTREMELY R=ROOTS REQUIRED FOR FINAL APPROVAL. ECTOR SIGNATURE 0 DATE APPLICATION EXPIRATION DATE APP CA ION APPROVED/ISSUED BY DATE (A) M "'�- '' 2� , LA) 6,C') T S M MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12/7/2015 ram" DESIGN FORM -PAGE ONE Assessor's Parcel Number: 12320 - 50 -- 00004- A design will be reviewed when 3 copies of each of the following are submitted: ■ Completed design form that has been signed and dated. I Scaled layout sketch,including all applicable items on checklist II Scaled plot plan,including all applicable items on checklist. I 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: 1 1"X 17" PARCEL IDENTIFICATION Permit Number: SWG c -3 — 0e)C) 7 Designer's Name: Franklin J Clark Applicant's Name: Judy Scott Designer's Phone Number: 360.830.4765 Mailing Address: P.O. Box 1238 Designer's Address: P.O. Box 1954 NE 131 McKnight Rd City:Belfair State:WA Zip:98528 City:Silverdale State:WA Zip:98383 DE SIGN PARAMETERS Treatment Device ® Glendon Biofilter Z Sand Filter Z Mound ® Sand Lined Drainfield ® Recirculating Filter,Type: Low Ridge Technologies 111 Aerobic Unit Make/Model OSCAR-X02 ® Disinfection Unit Make/Model 0 Other: Dra infield Type ® Gravity N Pressure ® Trench ® Bed II Sub Surface Drip Septic Tank/Drainfield Specifications Laterals Number of Bedrooms 3 Schedule/Class Custom Netafim Bioline Daily Flow: Operating Capacity 360 gpd Length (2)25'Coils connected together,50'Total ft Daily Flow: Design Flow 360 gpd Diameter 1/2 in Septic Tank Capacity 1,200 gal Number 3 Receiving Soil Typ e(1-6) 4 Separation .5 ft Receiving Soil Appl.Rate Pri: .6/Res:.6 gpd/ft 2 Orifices 05-50 Coils have 50 emitters, Required Primary Area 600 ft2 Total Number of Orifices (8)Coils=400 emitters total Designed Primary Area 600 ft2 Di r 0.42gphemitters in Designed Reserve Area 600 ft rs i O V E 6 in Trench/Bed Width 33.5' anifold Y ,. Trench/Bed Length 18' c edu� I23 Lo -'.e Technologies provided Headworks Assy. MASON C RIAtOVIRONMENTAL HEALTH ft Elevation Measurements Original Drainfield Area Slope 0 - 1 % DiarnOW in New Slope,If Altered N/A % Preferred manifold configuration usedi Yes ® No Depth of Excavation Up-slope 0 in Transport Pipe from Original Grade Down-slope 0 in Schedule/Class 40 Designed Vertical Separation 12 in Length 100 ft Gravelless Chambers Required? M Yes I No N Optional Diameter 1.0 in Pump Required? I Yes ® No Dosing and Pu mp Chamber Pump/Siphon Specifications Number of doses/day 360 Difference in Elevation Between Pump Shutoff and Uppermost Dose quantity 1 gal Orifice R ft Chamber Capacity 1,200 gal Uppermost Orifice III Higher ® Lower than Pump Shutoff Pump controls:Please check those required. Capacity @ Total Pressure Head 2.1 gpm ■ Timer ■ Elapse Meter 0 Event Counter Calculated Total Pressure Head 50' ft If Timer: Pump on 22 Seconds , Pump off 3minutes38Seconds Comments Treatment System comes with all required system components,see"System Spectification".The system comes with the Control Panel pre set at the factory, uses one effluent Pump Pump&OSCAR OS50 coils. DESIGN FORM—PAGE TWO Assessor's Parcel Number: 12320 -- SO -- Q0004 Permit Number: SWG DESIGN CHECK LISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch 111 Test hole locations I Drainfield orientation and layout Reference depth from original grade: I Soil logs II Trench/bed dimensions and I Septic tank I Property lines critical distances within layout I Drainfield cover Existing and proposed wells • D-BoxNalve box locations Reference depth from original grade within 100 ft of property O Septic tank/pump chamber and restrictive strata: I Measurements to cuts, banks,anc locations I Laterals,trench/bed,top and surface water and critical areas I Observation port location bottom Clean-out location N Curtain drain collector- N/A N Location and orientation of ! Manifold placement I Sand augmentation curtain drain and all absorption N Orifice placement -N/A components Other cross-section detail: Lateral placement with distance IObservation ports/clean-outs I Location and dimension of to edge of bed primary system and reserve area Other Information f Audible/visual alarm referenced Yes No Buildings II Scale of drawing shown on scale N I Design staked out Direction of slope indicator bar I N Recorded Notices attached Waterlines N I Waiver(s)attached PPRO Roads,easements,driveways, V E El I Pump curve attached parking 1ASONC0UNTYENV!RONME N Evaluation of failure North arrow and scale drawing MAY 092023 Non residential justification shown on scale barNTAL HEALTH I Wowe strength - aw DESIGN APPROVAL The undersigned designer must be notified by installer at time of installation I Yes N No a"-- 01/23/2023 Signature of esigner Date The undersigned has reviewed this design on behaii t". ,.._._ County Public Health and determined it to be in compliance with state and local o i e regulations: Env n I Health Specalist Date CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION: N The design is stamped "Approved"by Mason County Public Health. f ( 5 ,2_,0 N The Onsite Sewage Permit has not expired,the Permit Expiration Date:s: N 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. 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