HomeMy WebLinkAboutSWG2023-00216 - SWG Application / Design - 6/1/2023 584
MASON COUNTY 415 N 6TH STREET, 0427-9 7 ,E 98400
SHELTON:360 427-9670,EXT 400
�r BELFAIR:360-275-4467,EXT 400
un r Public Health & Human Services ELMA:360-482-5269, EXT 400
FAX:360-427-7787
On-Site Sewage System Permit: SWG2023-00216
APPLICANT DAVID STEVENS Phone:
Address: PO Box 2626 BELFAIR, WA 98528
OWNER DAVID STEVENS Phone:
Address: PO Box 2626 BELFAIR, WA 98528
SEPTIC DESIGNER Paysse, Alex L Phone:
Address: 3083 E Mason Benson Rd GRAPEVIEW, WA 98546
Site Address: XXX E April Lane
Primary Parcel Number: 221232200000
Permit Description: 5-bedroom gravity system
Permit Submitted Date: 06/01/2023
Permit Issued Date: 06/14/2023
Issued By: David Anderson
Current Permit Fees Paid: $525.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 06/06/2026 (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 Drainfield 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.
OFFICIAL USE ONLY C`.
DATE RECEIVED: CoMASON COUNTY
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COMMUNITY SERVICES0
AMOUCF � _ RLCE co
Public Health(Community Health/Environmental Health) C w
360.427.9670.70,et-a00lt 360 275 6467,eta 400 ^ — O
415 N.6M Street-Shelton,WA 98584
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ON-SITE SEWAGE SYSTEM APPLICATION z 65
APPLC.ANT PHONE
DAVID STEVENS r c
MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE
, ��r PO BOX 2626 BELFAIR WA 98528 co
Qi\k t-�' SITE ADDRESS
APRIL LANE IP GRAPEVIEWGRAPEVIEW WA 98546
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NAME OF DESIGNER PHONE I n,
ALEX L. PAYSSE 360-426-1803
NAME OF INSTALLER PHONE
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TBD _<
PERMIT TYPE(select one) DRINKING WATER SOURCE - N
Fif RESIDENTIAL OSS 5COMMUNITY OSS FCOMMERCIAL OSS 5 PRIVATE INDIVIDUAL WELL 6 PRIVATE TWO-PARTY WELL Z I CZ
TYPE OF WORK(select one) 7 PUBLIC WATER SYSTEM IN PROGRESS
1
�7
p[t NEW CONSTRUCTION/UPGRADES REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) ❑ TABLE IX REPAIR I N)
SUBMITTALS ❑ SURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINE
IT
DESIGN FORM(REQUIRED) V_SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE CO I N
5WAIVER(S)(IF APPLICABLE) 5 5 ACRES o o
ECTIONS SITE AND SITE CONDITIONS.(ex.locked gate)
' OT 6 F LRG2023-00001 `J
N. HWY 3. RIGHT ON ISLAND VIEW ROAD. LEFT ON THOMAS RD. RIGHT ON APRIL o
LANE. CONTINUE PAST HARD CORNER AND TURN RIGHT INTO NEW DEVELOPMENT I o
ACCESS. SITE ON LEFT JUST BEFORE CULDESAC. PDI SIGN POSTED.
SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. CD
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE I FAILURE SOURCE(for reporting purposes)
0 VOLUNTARY 0 MAINTENANCE/PUMPING ❑BUILDING PERMIT El HOME SALE ❑COMPLAINT ['OTHER:
INSPECTOR SOIL LOGS t COMMENTS/CONDITIONS
Iti-1. o_�y"51.
L5 CGN►PIc4 [DITMTONT .
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25 3' c- c pac
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3 C It?� 35" L S ccmfq ckc/
RECORD DRAWING AND INSTALLATION REPORT
SOIL COD
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
6/6/2oZ? 6/6770Z6
THI FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12/7/2015
• UsT (o
DESIGN FORM—PAGE ONE Assessor's Parcel Number: 2 2 1 2 3 — 2 2 — 0 0 0 0 0
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 Designer's Name: ALEX L. PAYSSE
Applicant's Name: DAVID STEVENS Designer's Phone Number: 360-426-1803
Mailing Address: PO BOX 2626 Designer's Address: 3083 E MASON BENSON RD
BELFAIR WA 98528 GRAPEVIEW WA 98546
City State Zip City State Zip
DESIGN PARAMETERS
Treatment Device
0 Glendon Biofilter 0 Sand Filter 0 Mound 0 Sand Lined Drainfield 0 Recirculating Filter,Type:
-D,Arobic Unit Make/Model 0 Disinfection Unit Make/Model Other:
Drainfield Type
('Gravity 0 Pressure Ii 'Trench 0 Bed 0 Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 5 l Schedule/Class 2729 PERF
Daily Flow:Operating Capacity 450 pd Length 67 ft �'
Daily Flow:Design Flow 600 g1,1 Diameter 4 in /
Septic Tank Capacity(working) 1800 al Number 5 ✓/
Receiving Soil Type(1-6) 4 ✓ Separation 10 ft
Receiving Soil Appl.Rate 0.6 i/ft2 Orifices
Required Primary Area 1000 ft2`-/ Total Number of Orifices -
Designed Primary Area 1005 ft2 Diameter - in
Designed Reserve Area 1005 ft2`/ Spacing - in
Trench/Bed Width 3 ft ✓ Manifold
Trench/Bed Length 335 ft Schedule/Class 3034
Elevation Measurements Length 40 ft
Original Drainfield Area Slope 3 % Diameter 4 in
New Slope,If Altered 3 % Preferred manifold configuration used? fir Yes 0 No
Depth of Excavation Up-slope 13 in Transport Pipe
from Original Grade Down-slope 12 in Schedule/Class 3034
Designed Vertical Separation 36+ in Length <100 ft
Gravelless Chambers Required? 0 Yes le No 0 Optional Diameter 4 in
Pump Required? 0 Yes VINo Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day -
iDiff,in Elevation Between Pump&Uppermost Orifice - ft Dose quantity - gal
Drainfield Squirt Height/Selected Residual(head) - ft Chamber Capacity(flood) - gal
Uppermost Orifice 0 Higher 0 Lower than Pump Shutoff Pump controls:Please check those required.
Capacity @ Total Pressure Head - gpm OTimer ❑Elapse Meter ❑Event Counter
Calculated Total Pressure Head - ft A r o V ,Pump off -
Comments
:10... JUN 1 4 2023
MASON COUNTY ENVIrt.: ,iltti ir- -.:-.LT
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DESIGN FORM—PAGE TWO Assessor's Parcel Number:2 2 1 2 3 — 2 2 -- 0 0 0 0 0
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
lii Test hole locations g Drainfield orientation and layout Reference depth from original grade:
g Soil logs g Trench/bed dimensions and [f Septic tank
g Property lines critical distances within layout 121 Drainfield cover
g Existing and proposed wells g D-Box/Valve box locations Reference depth from original grade
within 100 ft of property g Septic tank/pump chamber and restrictive strata:
g Measurements to cuts,banks,and locations g Laterals,trench/bed,top and
surface water and critical areas 121 Observation port location bottom
0 Location and orientation of fig Clean-out location 0 Curtain drain collector
curtain drain and all absorption g Manifold placement 0 Sand augmentation
components
g Orifice placement Other cross-section detail:
Location and dimension of g Lateral placement with distance g Observation ports/clean-outs
primary system and reserve area to edge of bed
g Other Information
WI Buildings g Audible/visual alarm referenced Yes No
g Direction of slope indicator lid Scale of drawing shown on scale CI 0 Design staked out
ill Waterlines bar ❑ RI Recorded Notices attached
g Roads,easements,driveways, 0 Cif Waiver(s)attached
parking 0 g Pump curve attached
n g North arrow and scale drawing 0 RI Evaluation of failure
shown on scale bar Non-residential justification
❑ it Waste strength
❑ lI Flow
DESIGN APPROVAL
The undersigned designer must otif d installer at time of installation 64 Yes 0 No
51c7 'zo23
Signature of Designer Date
The undersigned has reviewed this design on behalf of Mason County Public Health and c�teprioi
compliance with state and local on- regulations: /� I'' �
s 6//Y/za3
42
Environmental Health Specialist Date£74-
JUN �`
N CCoo
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING
MASO CO v'='y AL f}r"I'
✓ The design is stamped"Approved"by Mason County Public Health. JA
✓ 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: 12/7/2015
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WELL LOCATION SHARED ACCESS
(FROM APRIL LANE)
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JUN 1 4 2023
MASON COUNTY ENVIRONMENT _HEAL'
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AN ASBUILT/INSTALL SIGNOFF FEE WILL
BE CHARGED AT TIME OF INSTALLATION
\r"'"m""m' TEST HOLE I&4 TEST HOLE 2 TEST HOLE 3:
PIONEER DIGGING INC. CUSTOMER: DAVID STEVENS 3ocRAv.LOAM o-zecaAv.t.ontit o-zscRAv.LonAt
PARCEL#:22123-22-00000(LOT 6) 3L>is TINE y1ND 28 55 HNE a�ND 25 55 rlNe SINE)
SOME COMPACTION SOME COMPACTON SOME COMPACTION
SEPTIC DESIGNS ADDRESS: XXX APRIL LANE \ROUND 30• AROUND 2S AROUND 25-
. NTICOUNTY PROVIDED
3083 E MASON BENSON R.D. GRAPEVIEW,WA 98546 DESIGNER ALEX L.PAYSSE DISCLAIMER THIS IS NOT A SURVEY.REFERENCES INCLUDE APPLICA
PUTS OR SURVEYS.FIELD MEASLREMENTS AIO COUNTY GIS.DESIGN INTENDED FOR SEPTIC
OFFICE-360-426-1803 FAX-360-427-2353 PURPOSES IAGEN PROPOSED DEVELOPMENT MAY OR SUBJECT TO TEDOT TO
SHEET: SITE PLAN SCALE 1"-IOU SEPTIC CONTIAGENCY RENEW.CESIWER NOT RESPONSIBLE FOR SETBACKS UNRELATED TO
SEPTIC COAPONENTS.
_ �'// PP�OV��
AN ASBUILT/INSTALL SIGNOFF FEE WILL �
BE CHARGED AT TIME OF INSTALLATION i�� OBSERVATION"
/// JUN 1 L 2023 PORTS (X5)
///
/ 1 SEPTIC TANK
ii/j// MASON COUNTY ENVIRONMENTAL HEALTH
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CONTOURS AND MAINTAIN
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CUSTOMER: DAVID STEVENS ITT HOLE I&4 TEST HOLE 2 TEST HOLE a
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SEPTIC DESIGNS ADDRFSS: XXX APRIL LANE \RoUND�r AROUND 28• AROUND 25' •
3083 E MASON BENSON RD. GRAPEVIEW,WA 98546 DESIGNER: ALEX L.PAYSSE DISCLAIMER MS IS NOT A SURVEY.REFERENCES INCLUDE APPLICANT/COUNTY PROVIDED
PUTS OR SIAtVEYS.FIELD MEASUREMENTS AND COUNTY UGISDE DESIGN INTENDED FOR SEPTIC
OFFICE-364426-1803 FAX 360 427 2353 DEPARTMENTIAGENCY RENEW PLAPOSES ONLY PROPOSED
SIGNER NOOT RESPONSIBLE FOR PMENT MAY BE SSETBACKS UNRELA EUBJECT TO D TO
SHEET: DF DETAIL SCALE I"=2(Y SEPTIC COMPONENTS
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• installation & System Notes
1. Installer must contact designer for final inspection of the installation prior to cover. All components, including tanks, lids,
transport line,drainfield, and water lines must be open for inspection. A$350.00 fee will be charged for time involved with the
inspection of the installation and creation of the record drawing. The designer reserves the right to charge additional fees if
multiple visits are needed due to installation errors or inaccessible components.
2.This septic design must be installed by a certified installer with the local health department. All components shall be installed
according to state, county,and manufacturer requirements. For Homeowner Installs,the owner must get approval from the
designer and local health department prior to attempting installation.
3. Designer is not a surveyor. Installer must familiarize themselves with property line locations prior to installation. Any
confusion or conflicts with line locations should be reported to the property owner. A licensed surveyor may be necessary prior
to installation to confirm all line locations. Any discrepancies found must be reported to the designer immediately.
4. Drainfield area may only be cleared by a licensed installer familiar with sensitive drainfield area preservation. The builder, lot
developer, or property owner shall not clear the drainfield area. Any clearing required for drainfield installation shall not
remove or disturb any top soil in Primary and Reserve areas. Removal or disturbance to drainfield soils could render design
void.
5.The property owner and installer are responsible for locating all underground utilities (ex. water,gas,electric) prior to
installation. Any utility locations shown within design drawings are likely approximate and may not be exact.
6.All proposed tanks must be installed on original soils or compacted gravels. Extend all tank connection lines out onto original
soil to avoid settling issues. Risers and lids must be brought to finished grade and left accessible for future operations and
maintenance. Component manufacturers (ex. ATU,Glendons,) may have other requirements not listed within this design.
7. All electrical wiring shall be done by a licensed electrician or homeowner(if allowed)and must be permitted through Labor
and Industries.
8.The proposed septic system should be installed in dry weather conditions. Any failed attempts at installation during wet
weather conditions may render this design void.
9. Maintain loft to waterlines with all septic components. If less than loft is required,sleeving in sch. 40 pvc is required. I
sewage transport lines and waterlines must cross,waterline must be 18" above sewage line with one of the lines sleeved in sch.
40 pvc 10ft in each direction of crossing.
10. This design may include waiver applications with specific mitigation measures pertaining to installation, operation and
maintenance of the proposed components.
11.Stormwater runoff,footing drains, roof drains must be diverted away from any septic system components. No curtain,
foundation, perimeter drains shall be installed 30ft downslope and 10ft upslope of drainfield areas.
12. This design is site specific and intended to meet state and county requirements that are related to the system components
being proposed. Any placement of proposed buildings, proposed wells or other non-related items on these drawings may or
may not meet other requirements.
13.Al! onsite septic systems require regular maintenance to verify satisfactory operation. The system owner/operator is
responsible for the continuous operation and maintenance of the system per WAC 246-272A. For operation., , ►�ance
information, refer to Mason County Public Health Homeowner's Manual,which should be received Oirlinstal t n oval.
14. System owner should be cautious of landscaping around septic components. Root intrusion-
can cause premature failure of the drainfield area. In addition, bushes and trees should be kept 0 1 4 2023
` away frgm lids and other septic maintenance points. ��, ENTA� ' _
.,.
15. Changes made at time of installation may impact designer calculations, pump sizing, ON COUNT E ;' a"/'
compliance w/county and state requirements. Contact designer prior to install w/any in : �4
iilproposed variations from design. Changes may result in additional fees and permitting. .e • ,�t• �,
PIONEER DIGGING, INC CUSTOMER: llAVID STEVENS •r
. PARCEL#:22123-22-00000(LOT 6) .^h • maxi P,,, ` '.�,SSE �
SEPTIC DESIGNS ADDRESS: XXX APRIL LANE t ' u t N "' `
3083 E MASON BENSON RD. GRAPEVIEW,WA 9854IC• DESIGNER: ALEX L.PAYSSE •NJ-N.,.s
OFFICE-360-426-I803 FAX-360 427-2353 I SHEET: NOTES SCALE NA