HomeMy WebLinkAboutSWG2023-00079 - SWG Application / Design - 3/8/2023 MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584
SHELTON:360-427-9670,EXT 400
BELFAIR:360-275-4467,EXT 400
y Public Health & Human Services ELMA:360-482-5269,EXT 400
, FAX:360-427-7787
On-Site Sewage System Permit: SWG2023-00079
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: 640 NE Old Belfair Hwy
Primary Parcel Number: 123205000003
Permit Description: NEW 4BR-OSCAR X02
Permit Submitted Date: 03/08/2023
Permit Issued Date: 03/23/2023
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.
7 Payment of the Belfair sewer Capital Facilities Charge (CFC) required before final
approval of the septic system. See Mason Chapter 17.03.030.
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 C
DATE RECEIVED: —% —a
MASON COUNTY
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COMMUNITY SERVICES AMOUCL RECEIVED 03 N
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ON-SITE SEWAGE SYSTEM APPLICATION
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APPLICANT PHONE ` m
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MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE g
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SITE ADDRESS-STREET,CITY,ZIP CODE
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NAME OF DESIGNER PHONE 1
1-,`01,,n1c (P n OAU6' 3(n , !o a G, 865
NAME OF INSTALLER PHONE v 1 w
PERMIT TYPE(select one) DRINKING WATER SOURCE N ' v
RESIDENTIAL OSS 5]COMMUNITY OSS I��-COMMERCIAL OSS E PRI ATE INDIVIDUAL WELL Il PRIVATE TWO-PARTY WELL Z 1C)
TYPE OF WORK(select one) UBLIC WATER SYSTEM r
FegrN CONSTRUCTION/UPGRADES EREPAIR/REPLACEMENT OTHER DETAILS(select all that apply) ElTABLE IX REPAIR
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SUBMITTA El SURFACING SEWAGE El EXISTING FAILURE CI SHORELINE
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ESIGN FORM(REQUIRED) r I�
SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE 0
b]WAIVER(S)(IFAPPLICABLE) 0 O
DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.locked gate)
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SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. IW
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE!FAILURE SOURCE(for reporting purposes)
❑VOLUNTARY 0 MAINTENANCE/PUMPING 0 BUILDING PERMIT ['HOME SALE 0 COMPLAINT 0 OTHER:
INSPECTOR SOIL LOGS COMMENTS/CONDITIONS
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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 FINALAPPROVAL.
I URE CT�R SIGNAT .; �( ..��DATE APPLICATION EXPIRATION DATE APP CAT)ON APPROVED/ISSUED BY DATE
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T.IS••)I AY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12/7l2015
DESIGN FORM -PAGE ONE Assessor's Parcel Number: 1 2320 -- 50 -- 00003
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
■ Scaled plot plan,including all applicable items on checklist. III) 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 2° -.77- O ,/ 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
El Glendon Biofilter Z Sand Filter ® Mound 0 Sand Lined Drainfield 0 Recirculating Filter,Type:
Low Ridge Technologies
I Aerobic Unit Make/Model OSCAR-X02 Z Disinfection Unit Make/Model 0 Other:
Drainfield Type
Z Gravity ® Pressure El Trench Z Bed I Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 4 Schedule/Class Custom Netafim Bioline
Daily Flow: Operating Capacity 480 gpd Length (2)25'Coils connected together,50'Total ft
Daily Flow: Design Flow 480 gpd Diameter 1/2 in
Septic Tank Capacity 1,200 •al u er 4
Receiving Soil Typ a(1-6) 4 p tip tvi V E .5 ft
Receiving Soil Appl.Rate Pri: .6/ Res: .6 .ii ft 2 3 Orifices
�i MeR L(J 3 OS-50 Coils have 50 emitters,
Required Primary Area 800 lit ' O I umber of Ori (8)Coils=400 emitters total
*EON CO J6 41/�0NMENTALHEALTH o.a gphemi)) s in
DesignedPrimary Area 800 W
Designed Reserve Area 800 ft2 Spa 6 in
Trench/Bed Width 44.5' ft Manifold
Trench/Bed Length 18' ft Schedule/Class Low Ridge Technologies provided Headworks Assy.
Elevation Measurements Length ft
Original Drainfield Area Slope 0- 1 % Diameter in
New Slope,If Altered N/A % Preferred manifold configuration usedll 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? ® Yes I No ® Optional Diameter 1.0 in
Pump Required? ■ Yes 0 No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day 360
Difference in Elevation Between Pump Shutoff and Uppermost Dose quantity 1.33 gal
Orifice 8 ft Chamber Capacity 1,200 gal
Uppermost Orifice I Higher ® Lower than Pump Shutoff Pump controls:Please check those required.
Capacity @ Total Pressure Head 2.1 gpm I Timer I Elapse Meter U Event Counter
Calculated Total Pressure Head 50' ft If Timer: Pump on 22Seconds , Pump off 3 minutes38Seconds
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 0550 coils.
DESIGN FORM- PAGE TWO Assessor's Parcel Number: 12320 -- 5O -- QQQQ3
Permit Number: SWG
DESIGN CHECK LISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
■ Test hole locations ■ Drainfield orientation and layout Reference depth from original grade:
■ Soil logs I Trench/bed dimensions and � Septic tank
■ Property lines critical distances within layout ■ Drainfield cover
■ Existing and proposed wells ■ D-BoxNalve box locations Reference depth from original grade
within 100 ft of property ■ Septic tank/pump chamber and restrictive strata:
■ Measurements to cuts,banks,and locations
I Laterals,trench/bed,top and
surface water and critical areas ■ Observation port location bottom
■ Clean-out location ® Curtain drain collector- N/A
® Location and orientation of I Manifold placement I Sand augmentation
curtain drain and all absorption 51 Orifice placement -N/A Other cross-section detail:
components
■ Lateral placement with distance I Observation ports/clean-outs
I Location and dimension of to edge of bed
primary system and reserve area Other Information
• Audible/visual alarm referenced Yes No
Buildings
■ le cpvgOoyI E ® ■ Design staked out
■ Direction of slope indicator �+ ■ ® Recorded Notices attached
I Waterlines ® I Waiver(s)attached
■ Roads,easements,driveways, MAR 2 3 2023 ® ■ Pump curve attached
parking MASON COUNTY ENVIRONMENTAL HEALTH N ■ Evaluation of failure
■ North arrow and scale drawing JBW Non-residential justification
shown on scale bar X I Waste strength
XI ■ Flow
DESIGN APPROVAL
The undersigned designer must be notified by installer at time of installation ■ Yes NI No
01/23/2023
Signature of esigner Date
The undersigned has reviewed this design on behait of ,.._. County Public Health and determined it to be in
compliance with state and loc. ons. e regulations:
'n)t mental Health Specalist Date
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
The design is stamped "Approved"by Mason County Public Health.
N The Onsite Sewage Permit has not expired,the Permit Expiration Date:s: 3 ----/$'
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.
Updated Date:12/7/2015
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