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HomeMy WebLinkAboutSWG2023-00220 - SWG Application / Design - 6/2/2023 .`r, MASON 415 N 6TH STREET,SHELTON,WA 98584 COUNTY SHELTON:360-427-9670,EXT 400 Q BELFAIR:360-275-4467, EXT 400 • r. Public Health & Human Services ELMA:360-482-5269, EXT400 FAX:360-427-7787 On-Site Sewage System Permit: SWG2023-00220 APPLICANT MORRISON ALEKZANDER W P Phone: Address: 1014 BAY STREET#4 PORT ORCHARD, WA 98366 OWNER MORRISON ALEKZANDER W P Phone: Address: 1014 BAY STREET#4 PORT ORCHARD, WA 98366 SEPTIC DESIGNER Tom Purdum Phone: 253-509-02757 Address: PO Box 821 Wauna, WA 98395 Site Address: 90 E Evergreen Rd Primary Parcel Number: 122065100007 Permit Description: 2-bedroom BNR 500 Subsurface Drip System Permit Submitted Date: 06/02/2023 Permit Issued Date: 06/16/2023 Issued By: David Anderson Current Permit Fees Paid: $525.00 (additional fees may be requ.red upon installation of system). Permit Expiration Date: 06/09/2026 (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. r - OFFICIAL USE ONLY �C 0 MASON COUNTY DATE RECEIVED: 7�-'/3- J c › COMMUNITY SERVICES AMOII HMSO RECEIVED BY:AfiomPublic Hellth(Community Health/Environmental Health) — — V) 360-427-9670, 400 a 364 ,art 400 415 H. Sven-Shelton,WA 96564 SWG � a. - OCVON O• Z di CLEAR FORM ON-SITE SEWAGE SYSTEM APPLICATION z zi m n APPLICANT PHC`:F. m Jonathan Morrison (360) 621-8766 �` r C )ZSTM MAILING ADDRESS-STREET,CITY STATE,ZIP CODE 1014 Bay Street #4, Port Orchard, WA 98366 {y23 4L• caxi SITE ADDRESS-STREET.CITY ZIP CODE •• 90 E EVERGREEN RD, BELFAIR 98528 ' S" BY: - NAME OF DESIGNER PHONE R. Thomas Purdum /American Septic Design (253)509-2757 b I NAME OF INSTALLER PHONE v I PERMIT TYPE(select one) DRINKING WATER SOURCE = I Cr W.RESIDENTIAL OSS 1 I COMMUNITY OSS In COMMERCIAL OSS 5- PRIVATE INDIVIDUAL WELL b-PRIVATE TWO-PARTY WELL Z 10-- PUBLIC WATER SYSTEM TYPE OF WORK(select one) — ------- t W NEW CONSTRUCTION 1 UPGRADES iff REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) 0 TABLE IX REPAIR SUBMITTALS 0 SURFACING SEWAGE CIEXISTING FAILURE 0 SHORELINE CO W DESIGN FORM(REQUIRED) Of SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE ("Jr- I WAIVERS)(IF APPLICABLE) 2 .52 acres n t DIRECTIONS TO SITE AND SITE CONDITIONS:(ex locked gate) 0 • I� 00 7IC SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. 1-_1 OFFICIAL USE ONLY BELOW THIS LINE - UPGRADE I FAILURE SOURCE(for reporting purposes) 0 VOLUNTARY 0 MAINTENANCE/PUMPING ❑BUILDING PERMIT ['HOME SALE ❑COMPLAINT 0 OTHER: INSPECTOR SOIL LOGS COMMENTS/CONDITIONS T z ' o -32 l 5,11, Yri, of 0/41 71 0 37 s,tmo a/ b0/01 1-1±9 a- 6 IDS 26- s-i IT.74-,,(4.,t,e SOIL CODES: RECORD DRAWING AND INSTALLATION REPORT V=VERY G=GRAVELLY S=SAND L=LOAM Si=SILT C=CLAY E=EXTREMELY R=ROOTS REQUIRED FOR FINAL APPROVAL ' / INSPE SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED/ISSUED BY DATE I t 6/7AI9i UVZ0ZG 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: 12206-51-0000.7 -- 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. ''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._I1aximum paper size: 11••X 17" PARCEL IDENTIFICATION Permit Number: SWG ((��� R Thomas Purcum/American Septic Design �V - D U Designer's Name: Jonathan Morrison (253)509-2757APPlicant s Name: Designer's Phone Number: Mailing Address: 1014 Bay Street De . .,H.V YV' PO Box 821 Port Orchard WA 98366 WAUNA WA 98395 CLEAR FORM City State Zip JUN 0 2 2023 t=' City State Zip DESIGN PARAMETERS TreatmB Dw4ee- ❑Glendon Biofilter 0 Sand Filter 0 Mound Cl Sand Lined Drainfield 0 Recirculating Filter,Type: lErAerobic Unit Make/Model BN R-500 ❑Disinfection Unit Make/Model Other: Drainfield Type ❑ Gravity 0 Pressure 0 Trench 0 Bed E'Sub Surface Drip Septic Tank/Drainfield Specifications / Laterals ✓ Number of Bedrooms 2 Schedule/Class Netafim Bioline Daily Flow: Operating Capacity Nig0 p"gpd Length 195 ft Daily Flow: Design Flow 240 gpdt7- Diameter in Septic Tank Capacity(working) I()0 0 d R gal Number Receiving Soil Type(1-6) 5 Separation ft Receiving Soil Appl. Rate 0.4 gpd/ft2 Orifices Required Primary Area 1200 ft, Total Number of Orifices 480 Emitters 0,4: Designed Primary Area 1200 ft2 Diameter in Designed Reserve Area 1200 ft2 Spacing 12 in Trench/Bed Width ft Manifold Trench/Bed Length ft Schedule/Class Elevation Measurements Length ft Original Drainfield Area Slope 30 % Diameter in New Slope. If Altered % Preferred manifold configuration used? 0 Yes 0 No Depth of Excavation Up-slope 6 in Transport Pipe from Original Grade Do„„_scope 6 in Schedule/Class Sch 40 Designed Vertical Separation 12 in Length 120 ft Gravelless Chambers Required? 0 Yes No 0 Optional Diameter 1 in Pump Required? e'Yes ❑No Dosing and Pump Chamber Pump/Siphon Specifications Number of doses/day 8 Diff. in Elevation Between Pump&Uppermost Orifice 7 ft Dose quantity 30 gal Drainfield Squirt Height/Selected Residual(head) ft Chamber Capacity(flood) 1128 gal Uppermost Orifice 0 Higher E'Lower that P sip Shutoff Pump controls: Please check those required. Capacity @,Total Pressure Head �• gpm Pu . ® PD Meter fB'Event Counter Calculated Total Pressure Head 78.3 ft If�I`iltibr: ii on ,Pump off TBD Comments JUN 1 6 2023 MASON COUNTY ENVI�:ON/ -AL YEALTI DJA DESIGN FORM—PAGE TWO Assessor's Parcel Number:12206-51-0000Z -- Permit Number: SWG DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch Er Test hole locations E Drainfield orientation and layout Reference depth from original grade: le Soil logs Pl Trench/bed dimensions and !f Septic tank of Property lines critical distances within layout id Drainfield cover 0 Existing and proposed wells D-Box/Valve box locations Reference depth from original grade within 100 ft of property 0 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 0 Observation port location bottom B Location and orientation of 0 Clean-out location ❑ Curtain drain collector curtain drain and all absorption ❑ Manifold placement ❑ Sand augmentation components 0 Orifice placement Other cross-section detail: El Location and dimension of 0 Lateral placement with distance 0 Observation ports/clean-outs primary system and reserve area to edge of bed g Other Information 0 Buildings 0 Audible/visual alarm referenced Yes No e( Direction of slope indicator 0 Scale of drawing shown on scale 0 Er Design staked out 0 Waterlines bar ❑ Er Recorded Notices attached O Roads, easements,driveways, ❑ If Waiver(s)attached parking 0 0 Pump curve attached O North arrow and scale drawing ❑ 0 Evaluation of failure shown on scale bar Non-residential justification ❑ ❑Waste strength O 0 Flow DESIGN APPROVAL The undersigned designer must be noti ed by ' rat time of installation Lot Yes 0 No 5/23/23 igna of Designer Date The undersigned has reviewed this design on behalf of Mason County Public Health and dArprbiRa T compliance with state and local on-site lations: 71'6"7o 3 JUN 1 6 ?^p 1 En r ental Health Specialist Date MASON COUNTY ENVIRONME,; L; CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITISM ✓ 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. 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