HomeMy WebLinkAboutSWG2023-00163 - SWG Application / Design - 5/1/2023 ON,
584
MASON COUNTY 415 N 6TH STREET,SHELT967 ,E 98400
SHELTON:360-427-9670,EXT 400
OIL, BELFAIR:360-275-4467,EXT 400
`11 .4P Public Health & Human Services ELMA:360-482-5269,EXT 400
FAX:360-427-7787
On-Site Sewage System Permit: SWG2023-00163
APPLICANT HEBLICH JOSHUA CHARLES & DEBRA Phone:
JEAN
Address: PO BOX 706 BELFAIR, WA 98528
OWNER HEBLICH JOSHUA CHARLES & DEBRA Phone:
JEAN
Address: PO BOX 706 BELFAIR, WA 98528
SEPTIC DESIGNER Jim Zimny -Advantage Perc & Design Phone: 360-516-7287
Address: 7178 WINDFLOWER PL NW SEABECK, WA 98380
Site Address: 2705 NE Dewatto Rd
Primary Parcel Number: 323347500131
Permit Description: 2-bedroom gravity system
Permit Submitted Date: 05/01/2023
Permit Issued Date: 05/22/2023
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.
,s, OFFICIAL USE ONLY "C
I* DATE
MASON COUNTY �ozivax �- (- (9-Caz ) c
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COMMUNITY SERVICES AMOuNTI€cE WIIYEDl3Y CA
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Public Health(Community Heaith/Environmental Health) L X PublicPublicC Cl)
360-427-9670,eat 400 a 360-275-4467,eat 400 N
415 316th Street-Shelton,WA 98584 SWG -) a CiZ t Lo3 0 Si
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CLEAR FORM ON-SITE SEWAGE SYSTEM APPLICATION -0
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APPLICANT PHONE mm
Josh & Debra Heblich 253-320-0053 Z
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MAILING ADDRESS-STREET,CITY.STATE,ZIP CODE g
PO Box 706, Belfair WA 98528 m
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SITE ADDRESS-STREET.CITY.ZIP CODE
2705 Dewattowa Rd,Tahuya Wa 98528 It,v
ESI NAME OF DGNERS p(r PHONE
Jim Zimny ('J 1 360-516-7287 IN
NAME OF INSTALLER PHONE v I c AV 1
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PERMIT TYPE(select one) DRINKING WATER SOURCE
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G
In RESIDENTIAL OSS h COMMUNITY OSS 11 COMMERCIAL OSS W PRIVATE INDIVIDUAL WELL ❑ PRIVATE TWO-PARTY WELL Z I c
TYPE OF VK)RK(select one) Q PUBLIC WATER SYSTEM___
IA NEW CONSTRUCTION/UPGRADES ❑ REPAIR/REPLACEMENT OTHER DETAILS(select at!that apply) ❑ TABLE IX REPAIR ki
SUBMITTALS 0 SURFACING SEWAGE 8 EXISTING FAILURE 0 SHORELINE !A
W.DESIGN FORM(REQUIRED) PI SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE r
*WAIVER(S)(IF APPLICABLE) 2 1.60 Acres '
DIRECTIONS TO SITE AND SITE CONDITIONS(ex ticked gate) 7 b
From Belfair travel down Northshore rd 5.4 miles to Belfair Tahuya Rd take rt . Go 7.5
Miles and Take Right onto Dewatto Rd go 2.6 Miles and lot is on left. Marked with Pink r
ribbons and Address. . 6 I
Test Holes on o the north and marked w/ Pink Ribbons. I U
SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS I--
OFFICIAL USE ONLY BELOW THIS LINE -
UPGRADE I FAILURE SOURCE(tor reporting purposes)
❑VOLUNTARY 0 MAINTENANCE/PUMPING 0 BUILDING PERMIT ❑HOME SALE ❑COMPLAINT ❑OTHER:
INSPECTOR SOIL LOGS COMMENTS I CONDITIONS
TFf1 :0-3V ` CBI-
L/glV 41 3((I') U&ity Phi// 4m0/►1 f
Tff 1: 0-31 (5L
Th3= 0- 2?'` (a
RECORD ORAWNG 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.
INSPECTO NATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED/ISSUED BY DATE
5/5/ o 575/70 Z&
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12/I12015
DESIGN FORM—PAGE ONE Assessor's Parcel Number. 323347500131- --
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 '0 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"I'17"
PARCEL IDENTIFICATION
Permit Number. SWG 0.(t3-0CL(43 Designer's Name: Jim Zrmny
Josh&Debra Heblich 360-516-7287
Applicant's Name: Designer's Phone Number:
PO Box 706 7178 Windflower PI NW
Mailing Address: Designer's Address:
Belfair WA 98528 Seabed< Wa 98380
CLEAR FORM
City State Zip City Slate Zip
DESIGN PARAMETERS
Treatment Device
❑Glendon Biofilter 0 Sand Filter 0 Mound 0 Sand Lined Drainfield 0 Recirculating Filter,Type:
❑Aerobic Unit Make/Model 0 Disinfection Unit Make/Model Other.
Drainfield Type
lh'Gravity 0 Pressure ErTrench 0 Bed 0 Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 2 Schedule/Class 3034
Daily Flow:Operating Capacity 180 gpd Length 45 ft,----
Daily Flow:Design Flow 240 gpd Diameter
4" in
Septic Tank Capacity (working) 1200 gal Number 3
Receiving Soil Type(1-6) 4 Separation 5' CTC ft
Receiving Soil Appl.Rate 0.6 gpd/ft2/ Orifices
Required Primary Area 400 Total Number • -,srifices NA
Designed Primary Area 400 f / Diameter ,'3- site in
Designed Reserve Area 400 ft2 Spacing r.1 . s. in
J g,_ ' , -
Trench/Bed Width 3 f - /4.� 4 - `�,. Manifold
4
Trench/Bed Length135 ft L ,n j Sche• ¢'It _?' •t. •: ' k NA
Elevation Measurements Len='',... ..:-;tr
Original Drainfield Area Slope 8 % Diameter in
New Slope,If Altered 8 % Preferred manifold configuration used? 0 Yes Er No
Depth of Excavation up-slope 10 in Transport Pipe
from Original Grade Down_stope 8 in Schedule/Class 3034
Designed Vertical Separation 18 in Length 15' ft
Gravelless Chambers Required? 0 Yes 0 No 0 Optional Diameter 4"
in
Pump Required? 0 Yes 'No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day
Diff.in Elevation Between Pump&Uppermost Orifice ft Dose quantity `' �''� gal
Drainfield Squirt Height/Selected Residual(head) ft Chamber Capacity:a psfR o �!' E�..,_ gal
Uppermost Orifice 0 Higher 0 Lower than Pump Shutoff Pump controls: PI ck o required.
Capacity @ Total Pressure Head gum ❑Timer ❑)Yl 1 eA23 0 Event Counter
Calculated Total Pressure Head ft If Tuner: Pump on �1A1 , p off
Comments MASON COUNTY ENVIRONMENTAL HEALTH'
DJA
DESIGN FORM—PAGE TWO Assessor's Parcel Number.323347500131— —
Permit Number. SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
El Test hole locations IZ Drainfield orientation and layout Reference depth from original grade:
El Soil logs Ef Trench/bed dimensions and g Septic tank
Er Property lines critical distances within layout V Drainfield cover
O Existing and proposed wells Ef D-Box/Valvc box locations Reference depth from original grade
within 100 ft of property E! Septic tank/pump chamber and restrictive strata:
O Measurements to cuts,banks,and locations 0 Laterals,trench/bed,top and
surface water and critical areas Ef Observation port location bottom
0 Location and orientation of 0 Clean-out location 0 Curtain drain collector
curtain drain and all absorption 0 Manifold placement 0 Sand augmentation
components 0 Orifice placement Other cross-section detail:
Ei Location and dimension of Er Observation ports/clean-outs
system and reserve area 0 Lateral placement with distance
to edge of bed Other Information
0 Buildings 0 Audible/visual alarm referenced Yes No
d Direction of slope indicator re Scale of drawing shown on scale ❑ 0 Design staked out
O Waterlines bar 0 0 Recorded Notices attached
El Roads,easements,driveways, stt iff 0 Waiver(s) attached
parking r +it 0 ❑ Pump curve attached
El North arrow and scale drawing l,4, 0 0 Evaluation of failure
shown on scale bar i'�rq ��� Non-residential justification
%? ���t 0 0 Waste strength
a r .ry 0 ❑ Flow
UCErSF OEs;cr
ESi'X ROVAL
The undersigned designer must be notifie staller time of installation S.-Yes 0 No
ii Izetiz,
Sign of signer Date APPROVED
The undersigned has reviewed this design on behalf of Mason County Public Health and determined it to be in
compliance with state and local on-site regulations: MAY 2 2 2023
_ 5/2 Z/7Q Z MASON COUNTY ENVIRONMENTAL NEALTP
Environmental Health Specialist Date DJA
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
✓ 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: 12i7n015
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IEEE Property Line
Advantage Perc & Design
Timely-Reasonable-30 Years of Local Experience
•
Construction Notes for 2 Bedroom Gravity System
Gravity w/graveless chambers (Rock and pipe may be substituted)
Install 3-45' laterals.
Use a 4 hole d-box and speed levelers/with riser to the surface
Install 10"trench depth on low side of trench and maintain 18" of vertical separation
Install level and along contours.
Install in dry weather only. APPROVE `
Use 1200-Gallon 2 compartment septic tank with risers to the surface MAY 2 2 2023
System designed for typical residential waste strength sewage only. MASON COUNTY ENVIRONMENTAL REALM'
System designed for 240 Gallons Per Day DJA
114
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LICE. D •SIGNER •
Expiro. .,1Z-4.)
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Advantage Perc&design ,♦ APPDdesigns@icloud.com (360) 516-7287
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