HomeMy WebLinkAboutSWG2023-00176 - SWG Application / Design - 5/8/2023 MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584
• SHELTON:360-427-9670, EXT 400
BELFAIR:360-275-4467,EXT 400
P Public Health & Human Services ELMA:360-482-5269,EXT 400
FAX:360-427-7787
On-Site Sewage System Permit: SWG2023-00176
APPLICANT HAGSETH EXCAVATING INC Phone:
Address: 1051 BUNKER CREEK RD CHEHALIS, WA 98532
OWNER Thomas Hager Phone: 360-463-7515
Address: 141 E Elk PI SHELTON, WA 98584
SEWAGE DESIGNER Jim Hunter and Associates Phone: 360-753-1226
Address: PO BOX 162 OLYMPIA, WA 98507
Site Address: E Swindler's Cove Rd
Primary Parcel Number: 320103150150
Permit Description: New SFR-4BR Pressure
Permit Submitted Date: 05/08/2023
Permit Issued Date: 05/17/2023
Issued By: Jeff Wilmoth
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.
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/onsite/oss-inspection-request.php or call:
360-427-9670, extension 400.
OFFICIAL USE ONLY_ci_d_
MASON COUNTY PUBLIC HEALTH DATE RECEIVED: 8 ONSITE
SEWAGE SYSTEM APPLICATION AMOUNT RECEIVED RECEIVED BY
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c. �c_C� v cmn
415 N 6th Street,(Bldg 8) Shelton WA,98584 < to
Shelton:360-427-9670 ext 400 Belfair:360-275-4467 ext 400 S G '1,s� „t _03 p O
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APPLICANT PHONE > >
HAGSETH EXCAVATING 3607483471 m 73
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MAILING ADDRESS-STREET,CITY.STATE,ZIP CODE
1051 BUNKER CREEK RD CHEHALIS WA 98532 z
SITE ADDRESS-STREET,CITY,ZIP CODE W
XX SWINDLER'S COVE SHELTON WA }m
NAME OF DESIGNER PHONE 1 �\
ADAM HUNTER 3607531226 t�J"
NAME OF INSTALLER PHONE
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TBD v
CHECK ALL APPLICABLE ITEMS DRINKING WATER SOURCE ID
lr NEW CONSTRUCTION 0 RV HOLDING TANK ONLY 0 PRIVATE INDIVIDUAL WELL (7 I—
❑ REPLACEMENT SYSTEM 0 INSTALLATION PERMIT ONLY 0 PRIVATE TWO-PARTY WELL Z
o TABLE 9 REPAIR ❑ SINGLE FAMILY 0' COMMUNITY/PUBLIC WATER SYSTEM I
El TANK(S)ONLY El COMMERCIAL
SYSTEM NAME: SWINDLER'S COVE I
I
El UPGRADE TO EXISTING 0 OTHER: — BEDROOMS LOT SIZE V
❑ EXISTING FAILURE "Record Drawing required 4 5.00 W �,
for all Installations" r
DIRECTIONS TO SITE-BE SPECIFIC AND ADVISE OF ANY NEEDED INFORMATION FOR ACCESS(ex.locked gate) Q 1
AGATE LOOP TO A RIGHT ON DANIELS RD TO A LEFT AT SWINDLER'S COVE,
THROUGH GATE FOLLOW SIGNS TO LOT 5
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SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS r:-'
OFFICIAL USE ONLY BELOW THIS LINE— -
UPGRADE/FAILURE SOURCE(for reporting purposes)
❑VOLUNTARY 0 MAINTENANCE/PUMPING 0 BUILDING PERMIT ['HOME SALE ['COMPLAINT ['OTHER:
INSPECTOR SOIL LOGS • COMMENTS/CONDITIONS
`l 5
6 0 (
MAY 0 4 202311
Li
By___
SOIL CODES:
V=VERY G=GRAVELLY S=SAND L=LOAM Si=SILT C=CLAY E=EXTREMELY R=ROOTS
IN EC 0 SIGNATURE DATE APPLICATION EXPIRATION DATE PP (CATION APPROVED BY DATE
THIS 0 Y BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12/7/2015
'DESIGN FORM—PAGE ONE Assessor's Parcel Number:3,E Q 1 h -- 3j_ --`� (2)± `J a
r 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.Maximum paper size: 11"X 17"
PARCEL IDENTIFICATION
Permit Number: SWG oX)4'CCin Designer's Name: ADAM HUNTER
nt' Name: HAGSETH EXCAVATING Designer's Phone Number: 360-753-1226
Applicant's g
Mailing Address: 1051 BUNKER CREEK RD PO BOX 162
Designer's Address:
CHEHALIS WA 98532 OLYMPIA WA 98507
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:
❑Aerobic Unit Make/Model 0 Disinfection Unit Make/Model Other:
Drainfield Type
❑Gravity lif Pressure (Trench 0 Bed 0 Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 4 Schedule/Class 40
Daily Flow:Operating Capacity 360 gpd Length 67 ft
Daily Flow: Design Flow 480 gpd Diameter 1.25 in
Septic Tank Capacity 1200 gal Number 4
Receiving Soil Type(1-6) 4 Separation 6 ft
Receiving Soil Appl. Rate 0.6 gpd/ft2 Orifices
Required Primary Area 800 ft2 Total Number of Orifices 92
Designed Primary Area 804 ft2 Diameter 1/8 in
Designed Reserve Area 800 ft2 Spacing 36 in
Trench/Bed Width 3 ft Manifold
Trench/Bed Length 268 ft Schedule/Class 40
Length 24 ft
Elevation Measurements Len g
Original Drainfield Area Slope 15 % Diameter 2 in
New Slope,If Altered N/A % Preferred manifold configuration used? I 'Yes 0 No
Depth of Excavation Up-slope 32 in Transport Pipe
from Original Grade Down-slope 24 in Schedule/Class 40
Designed Vertical Separation >24 in Length 270 ft
Gravelless Chambers Required? 0 Yes 0 No firOptional 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 80 gal
Orifice 3.6 ft Chamber Capacity 1200 gal
Uppermost Orifice eHigher 0 Lower than Pump Shutoff Pump controls:Please check those required.
Capacity @ Total Pressure Head 37.89 !timer elapse Meter 'Event Counter
Calculated Total Pressure Head 16 0 R Oitir: p on 80 GAL ,Pump off 4 HRS
Comments MAY 1 73
MASON COUNTY ENVIRONMENTAL HEALTH
Jaw
. DESIGN FORM—PAGE TWO Assessor's Parcel Number:acs U1 O -- 31 -- O 1Si
Permit Number: SWG
/
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
9' Test hole locations 9' Drainfield orientation and layout Reference depth from original grade:
9' Soil logs 9' Trench/bed dimensions and II Septic tank
9' Property lines critical distances within layout l' Drainfield cover
El Existing and proposed wells Ef D-BoxNalve box locations Reference depth from original grade
within 100 ft of property RC Septic tank/pump chamber and restrictive strata:
9' Measurements to cuts,banks, and locations 9' Laterals,trench/bed,top and
surface water and critical areas a Observation port location bottom
9' Location and orientation of V Clean-out location 0 Curtain drain collector
curtain drain and all absorption 9' Manifold placement 0 Sand augmentation
components a Orifice placement Other cross-section detail:
Ei Location and dimension of 9' Lateral placement with distance 9' Observation ports/clean-outs
primary system and reserve area to edge of bed
g Other Information
9' Buildings 1 Audible/visual alarm referenced Yes No
a Direction of slope indicator 9' Scale of drawing shown on scale et 0 Design staked out
1 Waterlines bar 0 0 Recorded Notices attached
9' Roads,easements,driveways, ❑ 0 Waiver(s)attached
AppRovEDY parking ❑ Pump curve attached
g North arrow and scale drawing
MASON COUNTY ENVIRONMENTAL HEALT, ❑ ❑ Evaluation of failure
shown on scale bar MAY 1 7 2023Non-residential justification
CI ❑ Waste strength
JRW ❑ ❑ Flow
DESIGN APPROVAL
The undersigned designer must be n• . • • - at time of installation lit Yes 0 No
I4/28/23
Sign. . . Designer Date
The undersigned has reviewed this design o behalf of Mason County Public Health and determined it to be in
compliance with state and local on- ite regulations:
,! Wtl S 11 'z,3
En ro i!� tal Health Specia ist Date
.
CAUTION: DESIGN APP' •VAL 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: 54---i I �2`c
/ 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
PROPOSED DRIVE
V PROPOSED 4 BDRM RES
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