HomeMy WebLinkAboutSWG2023-00169 - SWG Application / Design - 5/3/2023 MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584
SHELTON:360-427-9670, EXT 400
BELFAIR:360-275-4467,EXT 400
-, .,,L Public Health & Human Services ELMA:360 482-5269,EXT 400
FAX:360-427-7787
On-Site Sewage System Permit: SWG2023-00169
APPLICANT HOYT STEVEN &JANNAE Phone:
Address: 1240 NE TEE LAKE RD TAHUYA, WA 98588
OWNER HOYT STEVEN & JANNAE Phone:
Address: 1240 NE TEE LAKE RD TAHUYA, WA 98588
SEPTIC DESIGNER Bob Paysse - Pioneer Digging Inc Phone: 360-426-1803
IAddress: 3083 E Mason Benson Road GRAPEVIEW, WA 98546
Site Address: 641 NE Tee Lake Rd
il Primary Parcel Number: 323355000904
Permit Description: 2-bedroom NuWater BNR 500
Permit Submitted Date: 05/03/2023
Permit Issued Date: 05/12/2023
Issued By: David Anderson
Current Permit Fees Paid: $525.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 05/05/2026 (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 C `'
MASON COUNTY DATERECENEO: �_� ' 2 u, D
07 COMMUNITY SERVICES AMOUNTRECENED: RtLti
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Public Health(Community Health/Environmental Health) C U)
360 427 9670,ext.400.360 275 4467.net.400 (p U)
415 N.6th Street Shelton.WA 98584 SVVG 20 , Geo I (A0
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ON-SITE SEWAGE SYSTEM APPLICATION
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APPLICANT PONE
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STEVE & JANNAE HOYT z
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MAILING ADDRESS-STREET.CITY.STATE.ZIP CODE 3
1240 NE TEE LAKE ROAD TAHUYA WA 98588 co
SITE
STREET,CITY,
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641 NE TEE LAKE ROAD TAHUYA WA 98588 I w
NAME OF DESIGNER PHONE I\D
ROBERT H. PAYSSE 360-426-1803
NAME OF INSTALLER PHONE 0 OD
TBD
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PERMIT TYPE(select one) DRINKING WATER SOURCE O
Pr RESIDENTIAL OSS (COMMUNITY OSS (COMMERCIAL OSS In PRIVATE INDIVIDUAL WELL 5 PRIVATE TWO-PARTY WELL Z 01
TYPE OF WORK(se)ect one) {-.l PUBLIC WATER SYSTEM 1
aJ NEW CONSTRUCTION/UPGRADES FREPAIR/REPLACEMENT OTHER DETAILS(select all that apply) 0 TABLE IX REPAIR 01
SUBMITTALS 0 SURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINE
LvMIt DESIGN FORM(REQUIRED) SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE W I CD
gWAIVER(S)(IF APPLICABLE) 2 0.53 0 1
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DIRECTIONS TO SITE AND SITE CONDITIONS (ex locked gate)
WEST ON NORTH SHORE FROM BELFAIR. RIGHT ON BELFAIR TAHUYA RD. RIGHT I o
ON DEWATTO ROAD. RIGHT ON TEE LAKE ROAD. SITE ADDRESS 641 ON LEFT o
(LAKESIDE), SEE SITE PLAN. -I
Ico
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(for reporting purposes)
❑VOLUNTARY ❑MAINTENANCE/PUMPING ❑BUILDING PERMIT ['HOME SALE ['COMPLAINT ['OTHER.
INSPECTOR SOIL LOGS COMMENTS I CONDITIONS
Ttl/< 6L015 0- y:��
MT: (iL1 0-5/„
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4 T N T �S tom tie- hih,j �J MAY 02
2023
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RECORD DRAWING �51 I - • . . •RT
SOIL CODES:
V=VERY G=GRAVELLY S=SAND L=LOAM Si=SILT C=CLAY E=EXTREMELY R=ROOTS REQUIRED FOR FINAL APPROVAL.
INSP R SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED(ISSUED BY DATE
// 5jf l2"-0 S[ 5/W
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12T7/2015
DESIGN FORM—PAGE ONE Assessor's Parcel Number: 3 2 3 3 5 — 5 0 — 0 0 9 0 4
A design will be reviewed when 3 conies 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 Designer's Name: ROBERT H.PAYSSE
Applicant's Name: STEVE&JANNAE HOYT Designer's Phone Number: 360-426-1803
Mailing Address: 1240 NE TEE LAKE ROAD Designer's Address: 3083 E MASON BENSON RD
TAHUYA WA 98588 GRAPEVIEW WA 98546
City State Zip City State Zip
DESIGN:PARAMETERS
• Treatment Device
❑Glendon Biofilter 0 Sand Filter 0 Mound 0 Sand Lined Drainfield 0 Recirculating Filter,Type:
It 'Aerobic Unit Make/Model NUWTER BNR500 0 Disinfection Unit Make/Model Other:
Drainfield Type
❑Gravity i1 Pressure I 'Trench 0 Bed 0 Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms \Z OR Schedule/Class SCH.40
Daily Flow:Operating Capacity 21'1 180"gpd Length 25 ft
Daily Flow: Design Flow 3SQ''-(0 Algpd Diameter 1.25 in
Septic Tank Capacity(working) BNR500 gal Number 4
• Receiving Soil Type(1-6) 3 Separation 5.5 ft
Receiving Soil Appl.Rate 0.8 gpd/ft2 Orifices
Required Primary Area 300 ft2 Total Number of Orifices 36
Designed Primary Area 300 ft2 Diameter 3/16 in
Designed Reserve Area 300 ft2 Spacing 36 in
Trench/Bed Width 3 ft Manifold
Trench/Bed Length 100 ft Schedule/Class SCH.40
Elevation Measurements Length 18 ft
j Original Drainfield Area Slope 30 % Diameter 1.25 in
New Slope,If Altered 30 % Preferred manifold configuration used? l 'Yes 0 No
Depth of Excavation Up-slope 23 in Transport Pipe
from Original Grade Down-slope 12 in Schedule/Class SCH.40
Designed Vertical Separation 21+ in Length 350 ft
Gravelless Chambers Required? 0 Yes 1 No 0 Optional Diameter 2 in
Pump Required? 56 Yes 0 No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day 4
Diff.in Elevation Between Pump&Uppermost Orifice 32 ft Dose quantity 60 gal
Drainfield Squirt Height/Selected Residual(head) 2 ft Chamber Clip 1 gal
Uppermost Orifice i1 Higher 0 Lower than Pump Shutoff Pump cun e e s e r
PP
Capacity @ Total Pressure Head 22 gpm gTimer I 'Elapse Meter GiEvent Counter
Calculated Total Pressure Head 43 ft If Timer: Pump onMAY 4 N4N2023,Pump off 6 HRS
Comments MASON COUNTY ENV!RONMENTAL HEALTH
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DESIGN FORM—PAGE TWO Assessor's Parcel Number: 3 2 3 3 5 — 5 0 -- 0 0 9 0 4
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
lid Test hole locations It Drainfield orientation and layout Reference depth from original grade:
It Soil logs 66 Trench/bed dimensions and l Septic tank
B1 Property lines critical distances within layout l' Drainfield cover
e1 Existing and proposed wells lt D-Box/Valve box locations Reference depth from original grade
within 100 ft of property g Septic tank/pump chamber and restrictive strata:
g Measurements to cuts,banks,and locations l2f Laterals,trench/bed,top and
surface water and critical areas g Observation port location bottom
g Location and orientation of 671 Clean-out location 0 Curtain drain collector
curtain drain and all absorption It Manifold placement 0 Sand augmentation
components 121 Orifice placement Other cross-section detail:
• Location and dimension of 64 Lateral placement with distance g Observation ports/clean-outs
primary system and reserve area to edge of bed
g Other Information
Buildings g Audible/visual alarm referenced Yes No
Direction of slope indicator g Scale of drawing shown on scale l 0 Design staked out
Fill Waterlines bar ❑ el Recorded Notices attached
It Roads,easements,driveways, RI 0 Waiver(s)attached
parking L' 0 Pump curve attached
g North arrow and scale drawing 0 g Evaluation of failure
shown on scale bar Non-residential justification
0 RI Waste strength
0 RI Flow
DESIGN APPROVAL
The undersigned designer mus e notified by 'nstaller at time of installation It Yes 0 No
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sly/z-3
Signature of De igner QG,-L Date
The undersigned has reviewed this design on behalf of Mason County Public Health and determAptpft OVE D
compliance with state and local on- • ulations:
V 5784023 MAY 1 1 2023
Environmental Health Specialist Date
MASON COUNTY ENVIRONMENTA.HEALTH
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION: DJA
✓ The design is stamped"Approved"by Mason County Public Health.
✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is:
✓ 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
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AN ASBUILTI INSTALL SIGNOFF FEE WILL
BE CHARGED AT TIME OF INSTALLATION
PIONEER DIGGING INC. CUSTOMER STEVE HOYT PARCEL# 32335 50 00904 0-42 GIS
TEST HOLE I: 048(AS
TEST HOLE 2:
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SEPTIC DESIGNS ADDRFSS: 641 NE TEE LK RD ROOTS-42 1120 @ 53
3083 E MASON BENSON R.D. GRAPEVIEW,WA 98546 DESIGNER ROBERT I-1.PAYSSE DECLAIMER THIS re NOT A SURVEY.REFERENCES INCLUDE APPUCANT/COUNTY PROVIDED
PLATS OR SURVEYS.FIELD MEASUREMENTS AND COUNTY GIS.DESIGN INTENDED FOR SEPTIC
OFFICE 360 4261803 FAX 360 427 2353 SHEET: SITE PLAN SCALE 1"=50' PURPOSES ONLY DEPARTMENT/AGENCY REVIEW DESIGNER NOT R SPPONSIIB MAYNT FOORR SETBACKS UNRELATED TOO
SEPTIC COMPONENTS.
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PIONEER DIGGING, INC. PARCEL# 32335 50-00904 }2+1111. 48-53 TILL
SEPTIC DESIGNS ADDRFSS: 641 NE TEE LK RD ROOTS-42 1 120 @ 53 •
DISCWMERI MS IS NOT A SURVEY.REFERENCES INCLUDE APPLICANT/COUNTY PROVIDED
3083 E MASON BENSON RD. GRAPEVIEW,WA 98546 DESIGNER: ROBERT I L PAYSSE PUTS OR SURVEYS.FIELD MEASUREMENTS AND COUNTY GIS DESIGN INTENDED FOR SEPTIC
OFFICE 36(}4261803 FAX 36(}4272353 SHEET: DF DETAIL SCALE I"=10' PURPOSES AGE PROPOSED oEVNOT MAY BE SUBJECT TO
DURPOTESNT/ONLY REVIEW DESIGNER NOT RESPONSIBLE FOR SETBACKS UNRELATEDTOOD TO
SEPTIC COLFOMENTS.
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Flow/Capacity in Liters Per Minute
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Flow/Capacity in US Gallons Per Minute DJA
LATERAL LATERAL FEEDER TOTAL ORIFICE ORIFICE ORIFICE DIST.TO TOTAL TOTAL
LATERAL St LENGTH PIPE SIZE LENGTH LENGTH SIZE(inch) DISCHARGE SPACING 1ST ORIFICE ORIFICES HEAD
(feet) (inches) (feet) (feet) RATE(gpm) (feet) (inches) (feet)
1 25 1.25 3 28 3/16" 0.59 3 6 9 0.13
2 25 1.25 6 31 3/16" 0.59 3 6 9 0.14
3 25 1.25 12 37 3/16" 0.59 3 6 9 0.17
4 25 1.25 18 43 3/16" 0.59 3 6 9 0.19
DRAINFIELD HEAD(feet) 0.63
TRANSPORT LINE HEAD(feet) 2.88
ELEVATION CHANGE(feet) 32
RESIDUAL/SQUIRT(feet) 2
EXTRA LOSS/FITTINGS(feet) 5
TOTAL DYNAMIC HEAD(feet) 42.51
TOTAL GALLONS PER MINUTE 21.24
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PIONEER DIGGING, INC. AER: STEVE HOYT
RCECUSTOLn#:3233550-0 904r'� ,,- ��
SEPTIC DESIGNS ADDRFSS: 641 NE TEE LK RD 44a.. RCCE................crty`�
3083 E MASON BENSON RD. GRAPEVIEW,WA 98546 DESIGNER: ROBERT H.PAYSSE. exPinEs
OFFICE-360-426-1803 FAX-360-427-2353 SHEET: CALCS SCALE NA
DUAL PORT AERAT,P
6'CLEANpVi3 FT• LID VENT OPTIONAL IN GROUND PLOWER LOCATION
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TANKS MUST BE .f
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APPROVED LIST BNR500 0 0 • •�
OF SEWAGE • DI?FvsERPARs(2) USE RUBBER
TANKS :�••0 / PARALLEL TO TANK WALLSLUDGE RETURN '•, GROMETS FOR
•'. TRANSPORT LINE
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HIGH WATER FLOAT
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PIONEER DIGGING iX T CUSTOMERS STEVE HOYT SCALE:NA
11 . -. PARCEL#32335 50 00904 INSTALL TANKS ON ORIGINAL OR
SEPTIC DESIGNS ADDRESS: 641 NE TEE LK RD COMPACTED LEVEL SOILS. RUN CROSS
3083 E MASON BENSON RD. GR APEVIEW,WA 98546 DESIGNER: ROBERT H. CONNECTIONS INTO ORIGINAL SOILS TO PAYSSE AVOI D SETTLI NG.
OFFICE•360-426.1803 FAX-360-427-2353 DESIGN PAGE TANKS DETAIL
Installation & System Notes
1. Installer must contact designer for final inspection of the installation prior to cover. All components, including tanks, lids,
transport line, drainfield, and water lines must be open for inspection. A$350.00 fee will be charged for time involved with the
inspection of the installation and creation of the record drawing. The designer reserves the right to charge additional fees if
multiple visits are needed due to installation errors or inaccessible components.
2. This septic design must be installed by a certified installer with the local health department. All components shall be installed
according to state,county, and manufacturer requirements. For Homeowner Installs,the owner must get approval from the
designer and local health department prior to attempting installation.
3. Designer is not a surveyor. Installer must familiarize themselves with property line locations prior to installation. Any
confusion or conflicts with line locations should be reported to the property owner. A licensed surveyor may be necessary prior
to installation to confirm all line locations. Any discrepancies found must be reported to the designer immediately.
4. Drainfield area may only be cleared by a licensed installer familiar with sensitive drainfield area preservation. The builder, lot
developer, or property owner shall not clear the drainfield area. Any clearing required for drainfield installation shall not
remove or disturb any top soil in Primary and Reserve areas. Removal or disturbance to drainfield soils could render design
void.
5.The property owner and installer are responsible for locating all underground utilities (ex. water,gas,electric) prior to
installation. Any utility locations shown within design drawings are likely approximate and may not be exact.
6. All proposed tanks must be installed on original soils or compacted gravels. Extend all tank connection lines out onto original
soil to avoid settling issues. Risers and lids must be brought to finished grade and left accessible for future operations and
maintenance. Component manufacturers (ex.ATU, Glendons,) may have other requirements not listed within this design.
7. All electrical wiring shall be done by a licensed electrician or homeowner(if allowed)and must be permitted through Labor
and Industries.
8.The proposed septic system should be installed in dry weather conditions. Any failed attempts at installation during wet
weather conditions may render this design void.
9. Maintain 10ft to waterlines with all septic components. If less than 10ft is required,sleeving in sch. 40 pvc is required. If
sewage transport lines and waterlines must cross,waterline must be 18" above sewage line with one of the lines sleeved in sch.
40 pvc 10ft in each direction of crossing.
10. This design may include waiver applications with specific mitigation measures pertaining to installation,operation and
maintenance of the proposed components.
11. Stormwater runoff,footing drains, roof drains must be diverted away from any septic system components. No curtain,
foundation, perimeter drains shall be installed 30ft downslope and loft upslope of drainfield areas.
12. This design is site specific and intended to meet state and county requirements that are related to the system components
being proposed. Any placement of proposed buildings, proposed wells or other non-related items on these drawings may or
may not meet other requirements.
13. All onsite septic systems require regular maintenance to verify satisfactory operation. The system owner/operator is
responsible for the continuous operation and maintenance of the system per WAC 246-272A. For operation and maintenance
information, refer to Mason County Public Health Homeowner's Manual, which should be received after installation approval.
14. System owner should be cautious of landscaping around septic components. Root intrusion
can cause premature failure of the drainfield area. In addition, bushes and trees should be ke t
away from lids and other septic maintenance points. A r P Rt5V E
MAY 1 12023 z .
F�KiM.
PIONEER DIGGING, INC. CUSTOMER: STEVE HOYT
PARCEL# 32335 50 00904 mRaUn l.1UNTY ENV
�03 5117
RCBEn7 w PAYSSE !L
SEPTIC DESIGNS ADDRESS: 641 NE TEE LK RD "IP "j t
3083 L MASON BENSON R.D. CRAPEVIEw,WA 98546 DESIGNER: ROBERT H.PAYSSE EXPRii5
OFFICE-360-426-I803 FAX-360-427-2353 SHEET: NOTES SCALE NA