HomeMy WebLinkAboutSWG2023-00224 - SWG Application / Design - 6/14/2023 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,EXT400
FAX:360-427-7787
On-Site Sewage System Permit: SWG2023-00224
APPLICANT TREVOR TURNBULL Phone:
Address: PO BOX 376 OLALLA, WA 98359
OWNER TREVOR TURNBULL Phone:
Address: PO BOX 376 OLALLA, WA 98359
SEPTIC DESIGNER Jim Zimny -Advantage Perc & Design Phone: 360-516-7287
Address: 7178 WINDFLOWER PL NW SEABECK, WA 98380
Site Address: E Anderson Ln
Primary Parcel Number: 220197600020
Permit Description: New SFR -3BR Pump to Gravity w/class B waiver
Permit Submitted Date: 06/06/2023
Permit Issued Date: 06/27/2023
Issued By: Jeff Wilmoth
Current Permit Fees Paid: $525.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 06/13/2026 (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 CDATE RECEIVED:
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MASON COUNTY ( r C / .P-3 IC N
ICI COMMUNITY SERVICES AMD T k c6 ��^�� 1 o m
, � Public Health(Community Health/Environmental Health) �� �
360d27-9670,ect 400 or 360 775-M67,ext.400 r��
415 N.6th Sheet-5belton,WA 98564 S\/V G 1�TS
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CI FAR FORM ON-SITE SEWAGE SYSTEM APPLICATION z 13
APPLICANT PHONE Rt m
TREVOR TURNBULL 253-549-8700 Z
c
MAILING ADDRESS-STREET,CITY,STATE.ZIP CODE
PO Box 376, Olalla WA 98359 m
73
SITE ADDRESS•STREET,CITY,ZIP CODE
E Anderson Ln, Shelton WA 98584 I(\j
NAME OF DESIGNER PHONE
Jim Zimny 360-516-7287 I fJ
NAME OF INSTALLER PHONE a I O
C _
PERMIT TYPE(select one) DRINKING WATER SOURCE En I
or RESIDENTIAL OSS n COMMUNITY OSS Fl COMMERCIAL OSS F1 PRIVATE INDIVIDUAL WELL ❑ PRIVATE TWO-PARTY WELL 2 I
TYPE OF WORK(select cne) 3 PUBUC WATER SYSTEM ___ t
h NEW CONSTRUCTION/UPGRADES rl REPAIR/REPLACEMENT OTHER DETAILS(soled ali that apply) ❑ TABLE IX REPAIR I
SUBMITTALS 0 SURFACING SEWAGE CI EXISTING FAILURE El SHORELINE
DESIGN FORM(REQUIRED) PI SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE r I
C WAIVER(S)(IF APPLICABLE) 3 2 acres I O
DIRECTIONS TO SITE AND SITE CONDITIONS'.(ex locked gale)
From Shelton Take hwy 3 to E Agate Rd - Go Rt.Tavel for 3.8 Miles to stop sign and take
left on E Agate rd.Go 1,2 miles to Old Farm Rd and take Rt. In .7 miles vert at fork . Travel a
.2 Mi on E Anderson Rd to site on left (Marked in Pink Ribbons). Test holes are across rd o
350 up the hill. Trail is marked in pink ribbons. I N
SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED MTN TEST HOLE NUMBERS I 0
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE!FAILURE SOURCE(for reporting purposes)
0 VOLUNTARY 0 MAINTENANCE/PUMPING 0 BUILDING PERMIT ❑HOME SALE ❑COMPLAINT El OTHER:
INSPECTOR SOIL LOGS COMMENTS1 CONDITIONS
L7L 33cL
, ,
— ' -1
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.
• -ECTOR SIGNATURE I q DATE APPLICATION EXPIRATION DATA,/ A ICA PPROVEDI ISSUED BY DATE
q 1 ( l
it s- l,./I\,M9'`' .n..lC ':2-3 -ii.1• � L \ L:5 .\ff (9"�"��
�IS *M MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12fI2O15
.
1`)ESIGN FORM—PAGE ONE Assessor's Parcel Number L :1•g- -7,(p-- 0 QQ 2 0
A design will be reviewed when 3 conies of each of the following are submitted:
'0 Completed design form that has been signed and dated. i#Scaled layout sketch,including all applicable items on checklist
'1 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 2) 0 O 22 A Designer's Name: Jim Zimny
Trevor Turnbull Designer's Phone Number. 360-516-7287
Applicant's Name:
PO Box 376 Designer's Address: 7178 Windflower pL NW
ner
Mailing Address: g
Olalla WA 98359 Seabeds Wa 98380
CLEAR FORM
City State Zip City State Zip
DESIGN PARAMETERS
Treatment Device
❑Glendon Biofilter 0 Sand Filter 0 Mound 0 Sand Lined Di airfield 0 Recirculating Filter,Type:
❑Aerobic Unit Make/Model 0 Disinfection Unit Make/Model Other.
Drainfield Type
"Gravity 0 Pressure L'Trench 0 Bed 0 Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
d Number of Bedrooms 3 Schedule/Class 3034
Daily Flow:Operating Capacity 360 gpd Length 50 ft
Daily Flow: Design Flow 270 gpd Diameter 4 in
Septic Tank Capacity(working) 1200 gal Number 4
Receiving Soil Type(1-6) 4 Separation 5 ft
Receiving Soil Appl.Rate 0.6 gpd/ft2 Orifices
Required Primary Area 600 fe Total Number of Orifices NA
Designed Primary Area 600 ft2 Diameter in
Designed Reserve Area 600 ft2 Spacing �, in
Trench/Bed Width 3 ft ii Manifold
Trench/Bed Length 200 ft Schedule/ %..: .�D, NA
i. e:e(:t .
Elevation Measurements Len: ,: ft
Dia;;' Al ' .4tt in
Original Drainfield Area Slope 10 �cev;eo �°"'
c s!oNER 1.
New Slope,If Altered 10 % Pre' +'' '`-it.' , . _gration used? ❑ Yes ❑No
Depth of Excavation up-slope 10 in Transport Pipe
from Original Grade Doun-slope 12 in Schedule/Class SCh 40
Designed Vertical Separation 18 in Length 4/Z5- ft-
Gravelless Chambers Required? 0 Yes 0 No le Optional Diameter 1 1/2 in
Pump Required? re Yes 0 No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day 6
Diff. in Elevation Between Pump&Uppermost Orifice 35' ft Dose quantity 45 gal
Drainfield Squirt Height/Selected Residual(head) I ft Chamber Capacity(flood) 1200 gal
Uppermost Orifice ErHigher 0 Lower thanPump Shutoff
Pump controls:Please check those required.
Capacity @ Total Pressure Head 5 gpm F1`Timer IlirElapse Meter ®'Event Counter
Calculated Total Pressure Head 35' ftIf T.: r. ;.sc; ,,� o 1 min��30 sec . off 4 his
,
Comments '' Y;
JUN 2 2 2023 ti.,40
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DESIGN FORM—PAGE TWO Assessor's Parcel Number 22_l l'( -22 6 - 0 O 0 Ze-
Permit Number. SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
✓ Test hole locations Drainfield orientation and layout Reference depth from original grade:
El Soil logs Lot Trench/bed dimensions and Er Septic tank
El Property lines critical distances within layout 8' Drainfield cover
✓ Existing and proposed wells Er 0-Box/Valve box locations Reference depth from original grade
within 100 ft of property El Septic tank/pump chamber and restrictive strata:
0 Measurements to cuts, banks,and locations l0' Laterals,trench/bed,top and
surface water and critical areas VI Observation port location bottom
fa Location and orientation of E Clean-out location 0 Curtain drain collector
curtain drain and all absorption 0 Manifold placement 0 Sand augmentation
components 0 Orifice placement Other cross-section detail:
P1 Location and dimension of El Lateral placement with distance El Observation ports/clean-outs
primary system and reserve area to edge of bed
Buildings g Other Information
le 0 Audible/visual alarm referenced Yes No
el Direction of slope indicator Er Scale of drawing shown on scale 0 0 Design staked out
El Waterlines bar 0 0 Recorded Notices attached
El Roads,easements,driveways, ## 0 0 Waiver(s)attached
parking so, 0 0 Pump curve attached
El North arrow and scale drawing :, ,%������ ❑ ❑ Evaluation of failure
shown on scale bar
�' � �� Non-residential justification
2 �m�i ❑ ❑Waste strength
r O � .33 ��
s u i &�`.�.= 'y"^ ' ❑ 0 Flow
,,« tis:cnEH
ekpmaz;
D SIGN AP T
OVAL
The undersigned designer must be notified b 'n ller at time of installation Er Yes 0 No
Signatur esigner Date
The undersigned has reviewed this des. on behalf of Mason County Public Health and determined it to be in
compliance with state and local on- to gul 'ons:
C - Ilk i Inn,c(On 6 - _,2_,-2_ 3
Envir ealth Specialist Date
CAUTION: DESIGN APPRO AL 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: / `�
/ 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.
1�
�t p
pROVE 47.1
An Installation Fee is required. {{,,''AA`` a
This form may be scanned and available for public vie thL`M� �duty $ite.
..ti ON COUNTY ENVIRONNIENTAI h'EALTH Updated Date: 12/7/2015
11)
Advantage Perc & Design
T;mely•Reasonabfe•30 Years of Local Experience
il
Construction Notes for Pump to gravity 3 Bedroom System:
Install 4-50' laterals w/graveless chambers (Rock and pipe may be substituted)
Install on 5'foot centers.
Install max 12"trench depth on low side of trench and maintain 18" of vertical separation
Install level and along contours.
Install in dry weather only.
Install 425' of 1 A"sch 40 transport line. Keep Transport line and tanks at least 50'from all wells.
Use 1200-Gallon septic and 1200 gallon pump tank.
See pump Chart for Pump Specs
Use Rhombus SJE Control Panel or equivalent w/audible and visual alarms for low and high water.
System designed for typical residential waste strength sewage only.
System designed for 360 Gallons Per Day
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