HomeMy WebLinkAboutSWG2023-00188 - SWG Application / Design - 5/12/2023 1
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3 MASON COUNTY 415 N 6TH STREET,SHELTON, ,E 98584
SHELTON:360 427-9679670 EXT 400
BELFAIR:360-275-4467,EXT 400
Public Health & Human Services ELMA: 360 482-5269,EXT 400
FAX:360-427-7787
On-Site Sewage System Permit: SWG2023-00188
APPLICANT WALLACE BAIDHA DOMINIQUE Phone:
Address: 1509 REDWOOD PL SE OLYMPIA, WA 98501
OWNER WALLACE BAIDHA DOMINIQUE Phone:
Address: 1509 REDWOOD PL SE OLYMPIA, WA 98501
SEPTIC DESIGNER CINDY WAITE-Septic Designer Phone: 3607010205
Address: 80 E PICKERING LANE SHELTON, WA 98584
Site Address: 101 E Mandy Ln
Primary Parcel Number: 120187600020
Permit Description: 4-bedroom pressure system
Permit Submitted Date: 05/12/2023
Permit Issued Date: 05/17/2023
Issued By: David Anderson
Current Permit Fees Paid: $525.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 05/17/2026 (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.
0 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.
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- OFFICIAL USE ONLY �J
DATE RECEIVED,
MASON COUNTY 6- la,-a'
017 COMMUNITY SERVICES AMOUNT RECEIVED, RECENED(BRY: 03 CO
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Public Health(Community Health/Environmental Health) u)
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360-427-9670,ext.{00p 360.215.4467.ext.400 /'` /� G (�)l \) I
415 N 6th Street-Shelton,WA 98584 S`/ / ;0 D �.5 v I X�[ Z m
ON-SITE SEWAGE SYSTEM APPLICATION
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APPLICANT I IUNL m
DOMINIQUE WALLACE 210-843-2963 z
MAILING ADDRESS•STREET.CITY.STATE.ZIP CODE g
1509 REDWOOD PL SE OLYMPIA, WA. 98501 m
X
SITE ADDRESS-STREET,CITY.ZIP CODE
101 E MANDY LANE SHELTON, WA. 98584 (-
NAME OF DESIGNER PHONE
CINDY WAITE 360-701-0205 11,3
NAME OF INSTALLER PHONE
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TBD `�I_
PERMIT TYPE(select one) DRINKING WATER SOURCE 7 I`_
e RESIDENTIAL OSS ri c COMMUNITY OSS 1 I COMMERCIAL OSS ti PRIVATE INDIVIDUAL WELL PRIVATE TWO-PARTY WELL Z pz
TYPE OF WORK(select one) a PUBLIC WATER SYSTEM 1
ff NEW CONSTRUCTION!UPGRADES E REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) ❑ TABLE IX REPAIR I v
SUBMITTALS ElSURFACING SEWAGE ElEXISTING FAILURE 0 SHORELINE
MI I�1�'1 DESIGN FORM(REQUIRED) IA SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE ro
b WAIVER(S)(IF APPLICABLE) 4 611'X334' 0
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DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.locked gate)
GO ACROSS HARSTINE ISLAND BRIDGE, TURN RIGHT AT TEE SIGN, TURN RIGHT
AT NEXT TEE, TURN LEFT ONTO ISLAND SHORES DR, KEEP TO THE LEFT ONTO �l
PLANTATION, TURN LEFT INTO MANDY LANE, TURN LEFT INTO THE CULDESAC. Or
RIBBONS ARE ON THE LEFT SIDE MARKING TRAIL TO SOIL LOGS, IN
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)
0 VOLUNTARY ❑MAINTENANCE/PUMPING ❑BUILDING PERMIT ❑HOME SALE ❑COMPLAINT El OTHER:
INSPECTOR SOILIL/O/GS COMMENTS r 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 FINAL APPROVAL.
INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED/ISSUED BY DATE
ig/ s700 y/IY/z0z‘
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12'7/2015
DESIGN FORM—PAGE ONE Assessor's Parcel Number: 1 -200 g--- 7,‘ —6 OG 2
A design will be reviewed when 3 copies 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.Maximtan paper size: 11"X 17"
PARCEL IDENTIFICATION
Permit Number: SWG I3t3 OC-)1 Designer's Name: CINDY WAITE
Applicant's Name: DOMINIQUE WALLACE Designer's Phone Number: 360-701-0205
Mailing Address: 1509 REDWOOD PL SE Designer's Address: 80 E PICKERING LANE
OLYMPIA WA 98584 SHELTON WA 98584
City State Zip City State Zip
DESIGN PARAMETERS
Treatment Device
❑Glendon Biofilter 0 Sand Filter 0 Mound 0 Sand Lined Drainfield ❑ Recirculating Filter,Type:
❑Aerobic Unit Make/Model 0 Disinfection Unit Make/Model Other:
Drainfield Type
❑Gravity E'Pressure Er 0 Bed 0 Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 4 Schedule/Class SCHEDULE 40
Daily Flow: Operating Capacity 360 gp." Length 50 ft V
Daily Flow: Design Flow 480 gpd '� Diameter 1.25
in
Septic Tank Capacity 1200 gal' Number 4
Receiving Soil Type(1-6) 3 Separation 9 ft
Receiving Soil Appl. Rate .8 gpd/ft21 Orifices
Required Primary Area 600 ft2 U/ Tot,;: umber of-Orifices 52
Designed Primary Area 600 ft2 01
•is 1 Ay 3/16 in
Designed Reserve Area 600 f}2 ,r cif 11 )9 ,�,aa
Trench/Bedin
Width 3 ft v i* •F tts,. Manifold
Trench/Bed Length 200 ft `"$,..:. i..-•1g�\\\ SCHEDULE 40
Elevation Measurements &' Le sN1� 1-2 ft
Original Drainfield Area Slope 5 "'�� St t� ��,�3 2 in
gGI ;{ng1TE
LICENSED DESIGNER 1,
New Slope, If Altered At;aa:��w►' .4„4.`,4i: .i v..,410 Iguration used? 0 Yes 0 No
Depth of Excavation Up-slope 16 in EXPIRES O500,
Transport Pipe
from Original Grade Down-slope 14
in / Schedule/Class SCHEDULE 40
Designed Vertical Separation 24 in Length 60 ft
Gravelless Chambers Required? 0 Yes 0 No 0 Optional Diameter 2 in
Pump Required? ❑Yes ❑ No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day 6
Difference in Elevation Between Pump Shutoff and Uppermost Dose quantity 60 gal
Orifice 10 ft Chamber Capacity 1200 gal
Uppermost Orifice le Higher 0 Lower than Pump Shutoff Pump controls: Please check those required.
Capacity @ Total Pressure Head 30.68 gpm Lo'Timer dirElapse Meter lld'Event Counter
Calculated Total Pressure Head 12.97 ft if Timer: Alp
,ff
CotnmentsprimCONCRETE TANKS REQUIRED, GRAVEL BASED DRAINFIELD REQUIRED, VERIFY PUMP SIZE
AT TIME OF INSTALLATION, PUMP CONTROLS TO BE SET AT , EI0F §TALLATION.
AI—
MASON COUNTY ENVIRONMENTAL HEALTH
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DESIGN FORM—PAGE TWO Assessor's Parcel Number: ( -2 0 le__ -U __ G 0 (jZ0
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
Lot Test hole locations ®' Drainfield orientation and layout Reference depth from original grade:
El Soil logs Lot Trench/bed dimensions and L( Septic tank
121 Property lines critical distances within layout Ea Drainfield cover
lig Existing and proposed wells RI D-Box/Valve box locations Reference depth from original grade
fiWwithin 100 ft of property El Septic tank/pump chamber and restrictive strata:
leasurements to cuts,banks,and locations B Laterals,trench bed,top and
surface water and critical areas Observation port location bottom
01, 'Location and orientation of lE Clean-out location 0 Curtain drain collector
curtain drain and all absorption (.v( Manifold placement 0 Sand augmentation
components ® Orifice placement
El Location and dimension of Other cross-section detail:
primary system and reserve area Ei Lateral placement with distance El' Observation ports/clean-outs
to edge of bed
Lot Buildings Other Information
01 Audible/visual alarm referenced Yes No
0 Direction of slope indicator —/
El Scale of drawing shown on scale 0 I 'Design staked out
Waterlines bar 0 0 Recorded Notices attached
0 Roads, easements,driveways, 0 ❑ Waivers)attached
parking 0 0 Pump curve attached
0 North arrow and scale drawing 0 0 Evaluation of failure
shown on scale bar Non-residential justification
❑ 0 Waste strength
❑ ❑ Flow
DESIGN APPROVAL
The undersigned designer must be notif by instal rat time of installation 0 Yes 0 No
<44 �5./ I Li 2-0 23
Signature Designer Date
The undersigned has reviewed this design on behalf of Mason County Public Health APPROVE
compliance with state and local on-site regulatio . �1
)777(70 Z_3 MAY 1 7 2023
Enviro ental Health Specialist Date
MASON COUNTY ENVIRONMENTAL HEALTH
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDPYJQN:
✓ 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.
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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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APPROVES',
MAY 1 7 2023
MASON COUNTY ENVIRONMENTAL HEAL- 3 ' -
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APPROVED
�„ MAY 1,7 2023
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APPROVED
MAY 1 7 2023
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LICENSED DESIGNER
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Lateral # Length Length Orifice # Distance from Distance from end Length#
# , (Feet) (Inches) Spacing" Orifices feeder line of end of lateral
1� 50
1~ 50 600 48 13 — ___.1 —_-
2 50 600 48 13 __—_1:71 _ — — 1 50
_ __3 50 600 48 13 1' 1I50
4 50 600 48 13 _ 1 1 50
Total 200 52. 200
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TRANS LENGTH 60 --------
GPM , 30.68
K (2" SCHEDULEN 40) 284.5
FRICTION LOSS 0.9744991
Squirt l 2,
Elevation difference 101
TDH 12.974499 i ,
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Ikuf ,i/ Av ,.., .v ta 74/ v tr w v v_., / APPROVED
MAY 1 7 2023
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11 :JASON COUNTY ENVIRONMENTAL HEALTH
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RISER WITH LOCKING LID APPROVED
TO DRAINFIELD
PRESSURE LATERALS
A A MAY 1 7 2023
} !' i}" i MASON COUNTY ENVIRONMENTAL FEALTF
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to pt.
CONTROL VALVE
SLOTS AS
REQUIRED
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FLAP CHECK /\\ \ �'\v
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LONG SWEEP 90 1 \ , •�' ��!r-' '' 0 '���!i=� .•�'�
DEGREE ELBOW \ .;�, D y, ._.. .��� • �y�\
44 '��,t1� SECTION A-A
0 s \ 4 WASHED ROCK
Arlie 4co, �i�,,t' DRAIN SUMP
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040 y 570�• . S� 0` TRANSPORT PIPE FROM
m� C1 W ITE (\ i PUMP CHAMBER
o UCEN DE IGNE#Z" 1I,
EXPIRES OS 10,
DRAINFIELD CONTROL BOX I IU
(SLOPING GROUND: MANIFOLD BELOW LATERALS)
APPROVED
MAY 1 7 2023
MASON COUNTY ENVIRONMENTAL HEALTH
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THREADED CAP OR PLUG
P (4" 6"PVC
LAST ORIFICE;WITH
ORIFICE SHIELDS IF
ORIFICE ORIENTATION IS
BACKFILL UPWARD�1 /
MATERIAL
/ /�//�//� 8"-24")(< // ;\
�\p000° 0000 �-- PRESSURE LATERAL
\� \ j° O AS SPECIFIED
o� ;ono 0
PVC HOSE OR 'bra° o °ago°po
LONG SWEEP / o 0 0 0 0
ELBOW �/ \ DRAIN ROCK;6"MIN.
\ \\, j� BELOW PIPE
UNDISTURBED SOIL
6" PVC WITH DRAIN
HOLES; EXTEND TO
BOTTOM OF GRAVEL TO
i1/1 MONITOR PONDING
of $1 INFILTRATIVE SURFACE
ir .ram~`` � o (i• MaTORING1CLEANOUT PORT 2' ICl/
tea. \ (EXAMPLE)
51004
G LIC IN ED DESIGNER 4
66
EXPIRES 05").
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SECURED LID WITH GAS TIGHT SEAL
i 24"DIAMETER
ACCESS RISER
..a"
— FINISH GRADE
fniiZ ''
TO PUMP
CHAMBER
FROM SEWAGE/ --------7--------, lim.
SOURCE FLOATING MAT
APPROVED
EFFLUENT
FILTER
SEDIMENTS
APPROVED
SEPTIC TANK
(TYPICAL) 1 ? 2020
MASON COUNTY
MAY ENV;RONM_A TAL HEALT!
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SECUREf10 WITH GAS TIGHT SEAL
THREADED UNION DJA
24"DIAMETER
r'ACCESS RISER
FINISH GRADE v -~
SERVICE
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_„1, VALVE*
FROM 3EPTfC • i Z �=, li
TANK \ I� W.
TO DRAINFIELO
1
— EMERGENCY STORAGE
ANTI SIPHON
HIGH WATER ALARM LEVEL VALVE*
WORKING VOLUME ' INDEPENDENT
NORMAL TIMER OFF LEVEL FLOAT STEM
-fl FOR FLOAT
ENCLOSED PUMP \ MOUNTING
d/ SEDIAAENT SHROUD* '� _ CHECK VALVE*
s es
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P ., EDIMEH]� SUBMERSIBLE
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y �n11 �� 2'`O�. PUMP
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Pump Specifications Ill
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280 Series 1 /2 hp it
Submersible Effluent Pump
LITERS PER MINUTE APPROVED
0 50 100 150 200 250
40 1 I I ,1 12 MAY 1 7 2023
MASON COUNTY ENVIRONMENTAL HEALTV
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0 10 20 30 40 50 60 70
GALLONS PER MINUTE
280_PI R010/7/2015 .CCopyright 2015 Liberty Pump%Inc. All rights reserved. Specifications subject to chunge without notice. 1 1 y
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Installation Notes l
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Pressure Distribution System: �r040
���AS�� �it tr , '�'
12108-76-00020 101E Mandy Lane r g \' .\\\\
1. The prepared site plan is not a survey. It's the owner's resp413il ,;Ty, = pro'y
lines, utility lines (water, sewer, power, phone and gas) pry' to ingtfl° 1GNER 1
2. Extreme care to be taken when clearing, remove no t:.‘":"�� ���� 1'1°6.'4
3. Installer and designer to meet on site after clearing to layout drainfiell erals.
4. Concrete tanks required
5. Pump controls to be set at time of installation . R®VE�
6. Install system during dry weather with acceptable soil conditions MAY 7.4 7. Gravel based drainfield required ee��tt1 , 2023
8. The tanks may be moved as necessary to accommodate building regt 0l1?S0,ptic
tank location must meet all required setbacks. vIR°DJA MENTAL HEALTH
9. Keep wheeled vehicles off the drainfield area before, during and after installation.
Tracked equipment only,
10. All ground, surface water and roof drains must be diverted away from the septic tanks
and drainfield. Ensure the final grade slopes away from these areas and water doesn't
collect on or around them. Use swales, berms, catch basin and tight lines, curtain drains,
etc. to divert all waters.
11. Curtain drains can be no closer than 10' upgradient and 30' down gradient of the
drainfield
12. Exposed restrictive layers, cuts, banks, etc. can be no closer than 50' downhill from the
drainfield.
13. Install access risers on the septic tanks, valve box and ends of laterals.
14. Make sure septic tank risers are epoxied or caulked to cast in riser rings on tank.
15. Lids must form a water and gas tight seal with the access risers
16. Install effluent filter specified in this design at the septic tank outlet.
17. This system must be installed by a Mason County Certified installer.
18. Deviation from this design without prior approval from the designer and Mason County
Health Department will make this design null and void.
19. This design was sized per Washington Administrative CodeWAC246-272A-0230. The
operating capacity is based on 45 gallons per day per capita with two persons per
bedroom. The minimum design flow per bedroom per day is the operating capacity of
ninety gallons multiplied by 1.33. This results in a minimum design flow of one hundred
twenty gallons per day. This creates a surge factor of 33% but anticipated flow is ninety
gallons per bedroom per day.
20. Install laterals with contour of the ground
21. Install trench bottoms level and always maintain a minimum of six inches into native soil
22. Install locator tape on top of all drainfield laterals.
23. Install threaded clean outs at the ends of all laterals (caps must extend to within six
inches of finish grade and be in a valve box as shown on diagram. \:\ l�v
24. Install audio/visual alarm
25. Filter fabric required over drain rock prior to backfilling. If the drain rock extends above
the original grade, run the filter fabric at least 2 inches down the trench wall.
System Owner Responsibilities:
1. Operation and Maintenance is required by Washington State Department of Health and
Mason County Health Department.
2. The septic tank and pump tank should be pumped every three to five years or as
needed.
3. System owners are responsible for having maintenance performed annually.
4. System owners are responsible for responding to septic issues in a timely manner.
5. System owners shall not at any time change or alter settings in the control box.
6. System owner agrees to read and abide by information regarding their system in the
User Manual provided by Mason County Public Health.
7. Keep the flow of sewage at or below the approved design operating capacity.
8. Keep waste strength at residential waste strength parameters.
9. Spread loads of laundry through the week.
10. Do not use excessive bleach or detergents with added whiteners.
11. Do not shower, do laundry and dishwasher at the same time
12. Antibiotics can kill or impair the biological process in the septic tank.
13. Leaky plumbing can hydraulic overload your on-site septic system.
APPROVED
MAY 1 7 2023
MASON COUNTY ENVIRONMENTAL HEALTH
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43- ei5,„.. p „Ail,1
04,i ,
51 418
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LICENSED DESIGNER
LXPikes 05:10,