HomeMy WebLinkAboutSWG2023-00182 - SWG Application / Design - 5/10/2023 i-2a). MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584
SHELTON:360-427-9670,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: SWG2023-00182
APPLICANT DORCY BERNARD T& CHARLENE M Phone:
Address: C/O BARB SMITH SHELTON, WA 98584
APPLICANT ESTATE OF BERNARD DORCY Phone:
Address: 9 CHRISTMAS TREE LANE SHELTON, WA 98584
OWNER DORCY BERNARD T& CHARLENE M Phone:
Address: C/O BARB SMITH SHELTON, WA 98584
SEPTIC DESIGNER CINDY WAITE-Septic Designer Phone: 3607010205
Address: 80 E PICKERING LANE SHELTON, WA 98584
Site Address: 1734 E Spencer Lake Rd
Primary Parcel Number: 221323300030
Permit Description: Repair-2BR Pressure Bed
Permit Submitted Date: 05/10/2023
Permit Issued Date: 05/24/2023
Issued By: Jeff Wilmoth
Current Permit Fees Paid: $780.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 05/11/2026 (based on date of inspection)
Permit Conditions:
1 Proposed development subject to zoning requirements and approval by the planning
department staff per Mason County Title 17.
2 Permit must be installed by a Mason County Certified Installer unless prior written
authorization from Mason County is obtained.
3 Drain field installation not to exceed designed upslope and downslope depth specified on
design form.
4 Installer is responsible for obtaining Mason County installation approval prior to backfill of
sysoms.
5 Installertemc is responsible for obtaining Septic Designer/Engineer installation approval prior to
backfill of system components.
6 Mason County Asbuilt Form, Record Drawing, and Installation fee must be submitted for
final installation approval.
THIS PERMIT MUST BE ONSITE DURING INSTALLATION OF OSS.
PROPERTY OWNERS ARE RESPONSIBLE FOR DETERMINING AND MARKING ALL PROPERTY LINE AND EASEMENT LOCATIONS.
THIS PERMIT MAY BE REVOKED IF THE SITE CONDITIONS HAVE CHANGED SINCE THE SITE WAS INSPECTED AND DESIGN APPROVED.
FINAL INSTALLATION APPROVAL IS REQUIRED PRIOR TO TEMPORARY OR FINAL OCCUPANCY OF ANY RELATED STRUCTURES.
For Final Inspection visit: masoncountywa.gov/health/environmental/onsiteloss-inspection-request.php or call:
360-427-9670, extension 400.
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0 OFFICIAL USE ONLY �-
MASON COUNTY PUBLIC HEALTH DATE RECEIVED
ONSITE SEWAGE SYSTEM APPLICATION AMOUNTENED C'` REt:ENED$Y�
CO cn
415 N 6th Street,(Bldg 8) Shelton WA,98584 < cn
Shelton:360-427-9670 ext 400 Belfair:360-275-4467 ext 400 S W G � _ O o L3 O 2
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APPLICANT PHONE > D
ESTATE OF BERNARD DORCY 360-701-8049 m m
MAILING ADDRESS•STREET.CITY.STATE.ZIP CODE r
9 CHRISTMAS TREE LANE - SHELTON WA 98584 z
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SITE ADDRESS-STREET.CITY.ZIP CODE co
1734 E SPENCER LAKE RD SHELTON WA 98584 m
NAME OF DESIGNER F'.iONI- I N
CINDY WAITE 360-701-0205 NAME OF INSTALLER PHONE I/ ')
TBD o I.,
':HECK ALL APPLICABLE ITEMS DRINKING WATER SOURCE
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❑ NEW CONSTRUCTION 0 RV HOLDING TANK ONLY Q It-,
PRIVATE INDIVIDUAL WELL (p
Er REPLACEMENT SYSTEM 0 INSTALLATION PERMIT ONLY 0 PRIVATE TWO-PARTY WELL Z N
❑ TABLE 9 REPAIR 0 SINGLE FAMILY ElCOMMUNITY/PUBLIC WATER SYSTEM I
❑ TANK(S)ONLY ❑ COMMERCIAL SYSTEM NAME: r
1
❑ UPGRADE TO EXISTING 0 OTHER: BEDROOMS LOT SIZE I `Av
❑ EXISTING FAILURE "Record Drawing required 728 68'277tXX
for all Installations" 2 68'X277'X68'X287 8 r-
DIRECTIONS TO SITE-BE SPECIFIC AND ADVISE OF ANY NEEDED INFORMATION FOR ACCESS(ex.locked gate) Q I
GO NORTH ON HIGHWAY E, TURN RIGHT ONTO PICKERING ROAD, TURN RIGHT IQ
ONTO SPENCER LAKE ROAD, TURN LEFT ONTO DRIVEWAY. DRIVEWAY IS RIGHT I�
NEXT TO THE BOAT LAUNCH, IT FOLLOWS THE FENCE, PARCEL IS ON THE LEFT
SIDE OF ROAD o 10
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SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS I O
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/CONDITIONS
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SOIL CODES:
V=VERY G=GRAVELLY S=SAND L=LOAM Si=SILT C=CLAY E=EXTREMELY R=ROOTS
I S CTOR SIGNATURE DATE APPLICATION EXPIRATION DATE APB ATION APPROVED BY DATE
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T S MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSIT REVISED 12/1/2015
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DESIGN FORM—PAGE ONE Assessor's Parcel Number: -?-2 / .7 2-..73 _- 0 G 03
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: SWGC • CC j �I$ CINDY WAITE- Designer's Name:
Applicant's Name: ESTATE OF BERNARD DORCY 360-701-0205
Designer's Phone Number:
Mailing Address: 9 CHRISTMAS TREE LANE
Designer's Address: 80 E PICKERING LANE
SHELTON,WA.
SHELTON WA 98584
City State Zip
City State Zip
DESIGN PARAMETERS
Treatment Device
❑ Glendon Biofilter 0 Sand Filter 0 Mound ❑Sand Lined Drainfield ❑ Recirculating Filter,Type:
❑Aerobic Unit Make/Model ❑Disinfection Unit Make./Model
Other:
❑GravityDrainfield Type
Er Pressure 0 Trench OYBcd
0 Sub Surface Drip
Septic Tank/Drainfield Specifications
Laterals
Number of Bedrooms 2
Schedule/Class SCHEDULE 40
Daily Flow: Operating Capacity 180 gpd Length
ft
Daily Flow: Design Flow 240 gpd Diameter15 in
1.25
Septic Tank Capacity 1200 in
gal Number 8
Receiving Soil Type(1-6) 3
Separation 2 ft
Receiving Soil Appl. Rate .8 gpd/ft2
Orifices
Required Primary Area 300 ftZ Total Number of Orifices
60
Designed Primary Area 300 ft2 30 Diameter
3/16 in
Designed Reserve Area LIMITED ft2 • S i
Trench/Bed Width /0 10 sR il 1„ c a. 36 in
Trench/Bed Length 1 ft ? ifold
57 ft 'eir Sch Cl , . SCHEDULE 40
Elevation Measurements MASC.ffd 'TY ENVIRONMENTAL HEALTH 1-2 ft
Original Drainfield Area Slope 10 % Diameter JBW 2 to New Slope, If Altered
Preferred manifold configuration used? ❑ Yes 0 No
Depth of Excavation Up-slope p , ( 27
from Original Grade ' in Transport Pipe
Down-sIopTTpq ii 12 in Sc ule •ss SCHEDULE 40
Designed Vertical Separation 9e 21-36
in h '� 25-30 ft
Gravelless Chambers Required? 0 YesP i
q �No 0Optional ��t��ti..�� 2 in
Pump Required? El Yes ❑No to4 $ Z
osir „ Pump Chamber
Pump/Siphon Specifications yes4� se , 6
Difference in Elevation Between Pump Shutoff and Upper_ t° t�e : �ER 30 Orifice io ft gal
expIRLs °soot 1200 gal
Uppermost Orifice P'Higher 0 Lower than Pump Shutoff Pump controls: Please cheek those required.
f Capacity @ Total Pressure Head 23.6 gpm ❑Timer
DElapse Meter 0 Event Counter
Calculated Total Pressure Head 12.59 ft If Timer: Pump on Pumpoff
Comments
} CONCRETE TANKS REQUIRED, GRAVEL BASED DRAINFIELD REQUIRED,PUMP TANK \\—c—/
REQUIRED TO HAVE TWO RISERS, CONTROLS TO BE SET AT TIME OF INSTALATION.
DESIGN FORM-PAGE TWO Assessor's Parcel Number: 2 2 13 2 -- .7 lir -- 0 0036
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
0 Test hole locations 0 Drainfield orientation and layout
Reference depth from original grade:
Lot Soil logs Lot Trench/bed dimensions and
E!' Septic tank
0 Property lines critical distances within layout la Drainfield cover
0 Existing and proposed wells 0 D-Box/Valve box locations
within 100 ft of property El Septic tank/pump chamber Reference depth from original grade
13'Measurements to cuts, banks, and location
and restrictive strata:
surface water and critical areas ED Observation port location lig Laterals, trench bed, top and
bottom
, y1 ocation and orientation of Er-Clean-out location 0 Curtain drain collector
curtain drain and all absorption E{ Manifold placement 0 Sand augmentation
components
0 Location and dimension of 0 Orifice placement Other cross-section detail:
Ef
primary system and reserve area Lateral placement with distance 0 Observation ports/clean-outs
0 Buildings to edge of bed Other Information
El Audible/visual alarm referenced Yes No
0 Direction of slope indicator l• �n
0 Waterlines 0 Scale otdra\ng shown on scale I!! ❑ Design staked out
bar 0 0 Recorded Notices attached
0 Roads,easements,driveways, 0 0 Waiver(s)attached
parking Sle_f er% 4 S 7 e wv
El 0 Pump curve attached
0 North arrow and scale drawing 011 - Dr itir,1 0 0 Evaluation of failure
shown on scale bar
-{qktAiN t Non-residential justification
i`teAd per ❑ 0 Waste strength
amp'?Pe.4 bI -please 4 0 0 Flow
DESIGN APPROVAL
The undersigned designer must be notified by insta r at time of installation 0 Yes 0 No
6-.6 S q 2- 2....?Signatur of Designer / b 2- 2....?2- 2....?ate
The undersigned has reviewed •"s . sign on behalf of Mason County Public Health and determined it to be in
compliance with state and to :1 on-s e regulations:
(131-iAll'Pa- j 6-- 17— L3
it srr,tal Health Specialist Date
CAUTION: DESIGN APP'OVAL S VALID ONLY UNDER THE FOLLOWING CONDITION:
✓ The design is stamped"' .proved"by Mason County Public Health.
✓ The Onsite Sewage Permit has not expired, the Permit Expiration Date is: 5r`11- Li
✓ 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. `A\V
This form may be scanned and available for public view o Relga3onUtyteg
MAY 17 2023 ted Date: 12/7/2015
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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 15 180 36 5 2 1 15
2 15 180 36 5 1 2. 15
_ 3 15 180 36 5 _1.5 1.5 15
4 15 180 36 5 2 1 15 ,
5 15 180 36 5 1 2 15
6 15 180 36 5 1.5 1.5 15
7.. 15 180 36 5 2 1, 15
8 15. 180 36 5 O. 2 It
Total 120 40 60
TRANS LENGTH
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FRICTION LOSS fi.L ,,,i !, '
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A Family and Employee Owned Company
Pump Specification
FL30-Series - -;.
1/3 HP Submersible Effluent Pumps I��
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Copyright 0 Liberty Pumps,Inc.2019 All rights reserved. Specifications subject to change without notice. FL30-Series P1 R9/27/2079
7000 Apple Tree Avenue Bergen NY 14476 i Phone 800-543-2550 i Fax 585-494-1839 I, Email Liberty@LibertyPumps.com I Web www.LibertyPumps.com
Installation Notes
Pressure Distribution System:
22132-33-00030 1734 E Spencer Lake Rd
1. The prepared site plan is not a survey. It's the owner's responsibility to verify property
lines, utility lines (water, sewer, power, phone and gas) prior to installation.
2. Existing septic tank must be properly decommissioned.
3. Concrete tanks required
4. Pump controls to be set at time of installation .
5. Install system during dry weather with acceptable soil conditions
6. The tanks may be moved as necessary to accommodate building requirements. Septic
tank location must meet all required setbacks.
7. Keep wheeled vehicles off the drainfield area before, during and after installation.
Tracked equipment only,
8. 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.
9. Curtain drains can be no closer than 10' upgradient and 30' down gradient of the
drainfield
10. Exposed restrictive layers, cuts, banks, etc. can be no closer than 50' downhill from the
drainfield.
11. Install access risers on the septic tanks, valve box and ends of laterals.
12. Make sure septic tank risers are epoxied or caulked to cast in riser rings on tank.
13. Lids must form a water and gas tight seal with the access risers
14. Install effluent filter specified in this design at the septic tank outlet.
15. This system must be installed by a Mason County Certified installer.
16. Deviation from this design without prior approval from the designer and Mason County
Health Department will make this design null and void.
17. 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.
18. Install laterals with contour of the ground
19. Install trench bottoms level and always maintain a minimum of six inches into native soil
20. Install locator tape on top of all drainfield laterals.
21. Install threaded clean outs at they GIs of all laterals (caps must extend to within six
inches of finish grade and be in ji, a !i- box as shown on diagram.
22. Install audio/visual alarm /- ,11
23. Filter fabric required over dr., •ck t•fi to backfilling. If the drain rock extends above
the originalgrade, run the f�°� F ;5 1
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t . the •o t t nc wall.
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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.
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