HomeMy WebLinkAboutSWG2023-00224 - SWG Application / Design - 6/6/2023 MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584
J L 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: SWG2023-00224
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/onsiteloss-inspection-request.php or call:
360-427-9670, extension 400.
OFFICIAL USE ONLY CC
MASON COUNTY (0 ( I �a -) I N
COMMUNITY SERVICES AMOUNT RECEIVEDsY: CA
0
e'O�� � m
Publk Health(Community Health/Environmental Health) '�
DATE RECEIVED
360-427-9670,ext 400 of 360-275-4467,ext 400 v,
115 K6tb SbeH-SheLLon,WA 96564 SWG D,).. V DD0,2q itl, Si
z cn
CL FAR FORM ON-SITE SEWAGE SYSTEM APPLICATION z
73
m n
APPLICANT PHONE m
TREVOR TURNBULL 253-549-8700 Z
C
MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE g
PO Box 376, Olalla WA 98359 rn
z
SITE ADDRESS-STREET,CITY,ZIP CODE
E Anderson Ln, Shelton WA 98584 cN\
NAME OF DESIGNER PHONE
Jim Zimny 360-516-7287 ti
NAME OF INSTALLER PHONE
v
PERMIT TYPE(select one) DRINKING WATER SOURCE
W RESIDENTIAL OSS K COMMUNITY OSS h COMMERCIAL OSS Ig PRIVATE INDIVIDUAL WELL b PRIVATE TWO-PARTY WELL Z
TYPE OF VK)RK(select one) Q PUBLIC WATER SYSTEM r
ll9 NEW CONSTRUCTION/UPGRADES fl REPAIR!REPLACEMENT OTHER DETAILS(select all that apply) 0 TABLE IX REPAIRNsj
SUBMITTALS El SURFACING SEWAGE 0 EXISTING FAILURE El SHORELINE W
DESIGN FORM(REQUIRED) 111 SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE r
vVAIVER(S)pFAPPLICABLE) 3 2 acres C) t
X 0
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 0
left on E Agate rd.Go 1,2 miles to Old Farm Rd and take Rt. In .7 miles vert at fork . Travel r 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. N
SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. O
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE/FAILURE SOURCE(for reporting purposes) ----7,
❑VOLUNTARY ❑MAINTENANCE/PUMPING ❑BUILDING PERMIT ❑HOME SALE ❑COMPLAINT ❑OTHER: //� '1 \\
INSPECTOR SOIL LOGS COMMENTS I CONDITIONS V
17t- 3 3 Le' 5L 0 1
P.. ^/ ,
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.
NTECTOR SIGNATURE I q DATE APPLICATION EXPIRATION DAT�,J A ICA PPROV(ED/ISSUED BY DATE
L 1 0 i\l/r � -sue -.2-5 (�-4'4 _l- ZCP L L) \if�' v (i°' -4)
IS M MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12/7T2015
DESIGN FORM—PAGE ONE Assessor's Parcel Number.L L4-- 1_(.0- 0 60 20
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 202:)) C)C)22'\ Designer's Name: Jim Zimny
Applicant's Name:
Trevor Tumbull Designer's Phone Number. 360-516-7287
MailingAddress: PO Box 376 Designer's Address: 7178 Windflower pL NW
Olalta WA 98359 Seabed( Wa 98380
CLEAR FORM
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
Er Cl Pressure NJ'Trench 0 Bed 0 Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
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 ft Total Number of Orifices NA
Designed Primary Area 600 ft Diameter in
Designed Reserve Area 600 ft2 Spacing „�, in
Trench/Bed Width 3 ft ',t Manifold
Trench/Bed Length 200 ft Schedule/ r...: di NA
,0 ft
Elevation Measurements Len.. -
Original Drainfield Area Slope 10 % Dia;;r ,�. •+ in
.. Vs I iEs'AE11 ).
New Slope,If Altered % � '" '' tion used? 0 Yes 0 No
10 Pre , ,�,��. . � •': :�
Depth of Excavation Lip-slope 10 in Transport Pipe
from Original Grade De,,n_slope 12 in Schedule/Class sch 40
Designed Vertical Separation 18 in Length LiZS ft
Gravelless Chambers Required? 0 Yes Cl No Lo'Optional Diameter 1 1/2 in
Pump Required? ( '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) 1 ft Chamber Capacity(flood) 1200 gal
Uppermost Orifice E'Higher 0 Lower than pump Shutoff Pump controls: Please check those required.
Capacity a Total Pressure Head 5 gpm ErTirner gElapse Meter 18'Event Counter
1 min 30 sec 4 hrs
Calculated Total Pressure Head 35' ft. If T...;-r. , , rr,� o , mp off
^'
Comments ;R'f ' ; .
JUN 2 2 2023
MASC^"L rnl iNTv t=nnnRGAwi%PF.TAL;!CAtTM
JBW
DESIGN FORM-PAGE TWO Assessor's Parcel Number. 22, at ei -2 Co - O O 0 -z,,z
Permit Number. SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
Test hole locations El Drainfield orientation and layout Reference depth from original grade:
✓ Soil logs El Trench/bed dimensions and E! Septic tank
El Property lines critical distances within layout V Drainfield cover
e( Existing and proposed wells Er D-Box/Valve box locations Reference depth from original grade
within 100 ft of property V Septic tank/pump chamber and restrictive strata:
El Measurements to cuts,banks,and locations lie Laterals,trench/bed,top and
surface water and critical areas le Observation port location bottom
O Location and orientation of iff 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:
E! Location and dimension of a Lateral placement with distance PI Observation ports/clean-outs
primary system and reserve area to edge of bed
i� g Other Information
Buildings
0 Audible/visual alarm referenced Yes No
▪ Direction of slope indicator V Scale of drawing shown on scale ❑ 0 Design staked out
✓ Waterlines bar 0 0 Recorded Notices attached
E( Roads,easements,driveways, �% 0 0 Waiver(s) attached
parkingA �i, . 0 0 Pump curve attached
V North arrow and scale drawing = y ����ii� 0 0 Evaluation of failure
shown on scale bar -• , , Non-residential justification
R.
,� „ V El El Waste strength
s Li �:,;��„, 0 0 Flow
awrs:ar 7 \XY ti;ti
D SIGN AP�ROYAL
The undersigned designer must be notified b 0 Iler at time of installation Er Yes 0 No
7
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 r gul 'ons:
1/- f t (iA,61c) 6 - ,2_,2--,2._3
rl
Envar ealth Specialist Date
CAUTION: DESIGN APPRO AL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
✓ The design is stamped "Approved"by Mason County Public Health. �n
✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: /v -`' 4.
✓ 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.
ovE r4-N,
An Installation Fee is required. uIA+ 9
`� p p
This form may be scanned and available for public viewvV COUNTY goo didity $'. $l
te.
ENVIRON(L?ENT .,. Updated Date: 12/7/2015
AL HEALTH
JBW
Advantage Perc & Design
Ttmeiy•Reasonabre-30 Years of Local Experience
Construction Notes for Pump to gravity 3 Bedroom System:
4
Install 4-50' laterals w/graveless chambers (Rock and pipe may be substituted)
IInstall on 5'foot centers.
Install max 12"trench depth on low side of trench and maintain 18" of vertical separation
Install level and along contours.
Install in dry weather only.
Install 425' of 1%"sch 40 transport line. Keep Transport line and tanks at least 50'from all wells.
Use 1200-Gallon septic and 1200 gallon pump tank.
See pump Chart for Pump Specs
Use Rhombus SJE Control Panel or equivalent w/audible and visual alarms for low and high water.
System designed for typical residential waste strength sewage only.
System designed for 360 Gallons Per Day
it
,,,,,,,,,..
\.... ..„
____ ,
.....„.., ,....„..., , :,.,,,„
............. . „.. ,
.„..i, _ i, .,, ,, ppROvE,
IF if G
•
N 2 2 2023
MASON COUNTY E�'v1Rol�+�-2347
1NTAL HEALTH
JBW
Advantage Perc&design 0 APDdesigns@icloud.com • (360)516-7287
in
C,a�
E Xm
O N ot o O
owO
Oa) OO II
a ; to .--t
0 ITSrt U
:r 0 d
am __
.. -
- .\
/ ' 'I4.
''O N ,
\\
�/ /4.-- C) \
COcc
a •
4 ! , ' •
g, tn\ E \\
•
\ \ Ups� ��a i `' 3 \
ul
- , \ / 1-1 /
\`
N C)
N 0
N
O 0
O N
" V) N V) to 0
> > > j 0
I a�.a M g g g g C = >✓ Lo
L Q
N Q u u u u ° 3 1
,E p �Lel\ a a`) c rn
O g 2 2 2 Q L Q s N
QMI ft E = _ O O O Qp I - wv) *k
o.
li a
8.
pJ pJ pJ >-
to O N O N O v O w 0 �
s rryn '� s d ct d
Ltrol
_ r-I IN M d' § 3
* M d * M a. * M d * m a. N
CJ C) = I = I = I = I C i 3 '� a�
N ,6tt I- o - -- o � l- o � f-- o � .� A � ,
• PPROVE a _ -1
"� J U N 2 2 2023 - :-774 A.
MASON COUNTY ENVIRONMENTAL HEALTE A-Zi „mot \
-. .:``, gad\
rn
N
M O
N_ N
LA II
aJ aJ a) a
Fs r-4
R$ V
c 0 a N
a1
L
C
in.N
c
fL0
i
G!
c
O
N
C
0
.Y
C
av
Q
0
in
r
a)
a
Ain
c
O
re
LA 1----. i
�► Q o
1
t`n CIA O
F- E-- .4 ,O _ O
xi
I� e 5 0
gt c cQ 'o
in
1—
o°'
Q o oaDpJans ay2 of Jasa /M xoq a � vc_ Q ,..c N I-- wN #
E
—El).-
O 9 oc .()�
`C p C\ CC1
sort A
S • 's i POVE s��
3 M s' ' JUN222023 .- - $"
MASON COUNTY ENVIRONMENTAL HEALTH rn`'��" S;`i
N JgW -
m o `%�
co
y7S`�` J
M
`ea' y .� �Q ,S N
d r
a 0. ,'... ago e �' N
'. IT%^
to Ii V u p_ "E (J
u 8 �N �p if
N
73
2. :Q
5
a
•
r
c
R L
xEll
To
/ la;i 1 4 1 Vit
JO N 2
2
2
02k hp ,ASoN�O�., yFn,,,,A 3;1_
i
1
u 1
a F.s o ;
E el i 1
ii
p.
I > 13 ►
2.
a. 0 1 I e i Ii IA
I it
8 ii1 S F
Ni •Til 1
rl >
N > V
rD
.%
ROUT DLID*THOASTiwfINIAL
/ Ile DIANN=
AOOM:IAi RN=
/ \ 111111111011114111
•
.•+ Ilis -sias Al
1- LPu T _ ��il�y ......Ton ►
a
_ !LOAM,MAT
AIIIWP •
wMMINr
PLUM
SIMINOMI
74-----,....N\N....,....
1200 gallon 111115111331111
03211111,
M IOIAoLoWITHOABTIGHTNAL
MOW
A001111111 MIR Ns... IMAM
VAMP
PINIONIMADI
sM 1 $ Li : TOMRAMMID
1
— INIIIIIMICY_ VO ANTI SIPHON INI*
I WUI�'MMt WANt ''� — —. .— — — —
AXIMICINVICUME
I fIWATIMIll
1 in
Irlo1111rNIn
/
HIRPLOW
VIAL TI MMOPPMAIL. \- �'� a"'"
r113110111111110 rOMMf AI S mosernis
P - lif �I► 0 e
7
PUMP
1200 Gallon EUNIEMININS ='V 1 : :,:, /-1411,
*ammo
PPR
.__..__ _Ov
JUN 2 2 2023 .'
MASON-COUNTY ENVIRONMENTAL HEALTH
JBW