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HomeMy WebLinkAboutSWG2023-00302 TANK ONLY - SWG Application / Design - 7/17/2023 1 MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584 • SHELTON:360-427-9670,EXT 400 dita BELFAIR:360-275-4467,EXT 400 Public Health & Human Services ELMA:360-482-5269,EXT 400 FAX:360-427-7787 On-Site Sewage System Tank Only Permit: SWG2023-00302 OWNER DONOVAN GEORGE W Phone: Address: PO BOX 33 HOQUIAM, WA 98550 APPLICANT DONOVAN GEORGE W Phone: Address: PO BOX 33 HOQUIAM, WA 98550 SEPTIC INSTALLER MAPLES EXCAVATING Phone: 360-463-8474 Address: 911 SE ARCADIA SHELTON, WA 98584 Site Address: 17251 E State Route 106 Primary Parcel Number: 222125900036 Permit Description: pump basin replacement Permit Submitted Date: 07/17/2023 Permit Issued Date: 07/27/2023 Issued By: Jeff Wilmoth Current Permit Fees Paid: $255.00 (additional fees may be required upon installation of system). Permit Expiration Date: 07/17/2023 (based on date of inspection) Type of Work OSS New Construction Components being Replaced: Other Surfacing Sewage? No Existing Failure? Yes Shoreline? Yes Horizontal Setbacks Met? Yes Number of Bedrooms: 2 Drinking Water Source: Public Water System Additional Details: pump basin only Permit Conditions: 3 Mason County Asbuilt Form, Record Drawing, and Installation fee must be submitted for final installation approval. 1 Horizontal setbacks per WAC246-272A-0210 must be maintained, unless prior approval is obtained 4 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. 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/OR 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. t /Vali/ OFFICIAL USE ONLY CV • MASON CO 1 N U L 1 �3 DATE RECEIVED \ ` _ �� D I I. - COMMUNI 1 S . 1 VICES _ 1`y` �j/\ C CD AMOK RECEIVED !�,+' JiJ ` 03 to 1 v m '� Public Health (Community Healt' in4 , D Z N 360-427-%70.ext.4%or 360-27S-4467,ext.400 /^ /� /^ / j� O415 N.6th Street-Shelton,WA 98584 S /,,1 ' / \ T3 _ On U✓VY \.1V �1 0 Z N ON-SITE SEWAGE TANK ONLY APPLICATION m n APPLICANT PHONE I Helen Donovan 3(i/0-Zl0-tier' Z MAILING ADDRESS-STREET,CITY.STATE,ZIP CODE i CO r1161 E. s-rq-t-6 Route lei" 6elfoiir1 WA flt6Z m SITE ADDRESS-STREET,CITY,ZIP CODE ' lR 2S e E- statfi ZotAt--t. i btp belfair, W A ol g2g NAME OF DESIGNER PHONE " NAME OF INSTALLER PHONE v IN Maples Exca vli t-ini 310 0- -i - SU *1 4 z (- TYPE OF WORK(select one) DRINKING WATER SOURCE ❑ NEW CONSTRUCTION/UPGRADES REPAIR/REPLACEMENT ❑f PRIVATE INDIVIDUAL WELL 0 PRIVATE TWO-PARTY WELL Z plif COMPONENT(S)TO BE REPLACED/INSTALLED PUBLIC WATER SYSTEM ' ❑ SEPTIC TANK 0 PUMP TANK 0 RV HOLDING TANK BEDROOMS LOT SIZE 10 BOTHERAtMeA261 sin 1, 3.91 o cra W OTHER DETAILS(select all that apply) TAN S)SETBACK CHECKLIST Q ❑ SURFACING SEWAGE EXISTING FAILURE 0 SHORELINE 100FT+PUBLIC/COMMUNITY WELLS n ' SUBMI7ALS / In 5OFT+PRIVATE WELLS,SURFACE WATERS,STREAMS,RIVERS LS P OT PLAN(REQUIRED) {�TANK CROSS SECTION(REQUIRED) ad 10FT+DRINKING WATER SUPPLY LINES PUMP DETAILS(IF APPLICABLE) 0 WAIVER(S)(IF APPLICABLE) 5FT+PROPERTY/EASEMENT LINES,FOUNDATIONS,FOOTINGS PLOT PLAN CHECKLIST r la ❑ PROPERTY LINES AND EASEMENTS 0 EXISTING/PROPOSED STRUCTURES 0 EXISTING!PROPOSED OSS COMPONENTS AND LINES —I ❑ WELLS WITHIN 100FT 0 WATER SUPPLY LINES 0 DRIVEWAYS/PARKING ❑ SURFACE WATERS,STREAMS,RIVERS,ETC... ❑ DIRECTION OF SLOPE/CONTOURS 0 PERIMETER/CURTAIN DRAINS 0 NORTH ARROW 0 SCALE BAR DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.locked gate) IC Install new zoellex p basin with flDais and c t nyi bOX- OFFICIAL USE ONLY BELOWTHIS LINE UPGRADE/FAILURE SOURCE(tor reporting purposes) ❑VOLUNTARY ❑MAINTENANCE/PUMPING ❑BUILDING PERMIT ['HOME SALE ['COMPLAINT ❑OTHER: COMMENTS I CONDITIONS SEWAGE TANKS MUST BE LISTED UNDER DOH'LIST OF REGISTERED SEWAGE TANKS'. TANKS MUST MEET CURRENT MINIMUM SIZE REQUIREMENTS,EQUIPPED WITH RISERS AND LIDS TO SURFACE,AND INCLUDE AN EFFLUENT FILTER(IF APPLICABLE). RECORD DRAWING AND INSTALLATION REPORT REQUIRED FOR FINAL APPROVAL. INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLI ON APPROVED!ISSUED BY DATE THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12/7/2015 • .. � �7p , SECTION:3.10.015 at&/TY PUMPS 4//NCE 5,_7, — FM2164 ; ` 0208 Product information presentedo Supersedes here reflects conditions at time Pilitt UMP 1—0. 0507 of publication.Consult factory regarding discrepancies or inconsistencies. MAIL TO: P0.BOX 16347•Louisville.KY 40256-0347 visit our web site: SHIP TO: 3649 Cane Run Road •Louisville,KY 40211-1961 www.zoeller.com (502)778-2731.1(800)928-PUMP•FAX(502)774-3624 912 - SIMPLEX SEWAGE PACKAGE SYSTEMS (JOB READY/ASSEMBLED) Zoeller Preassembled Sewage Systems More Choices Easier Installation Fast Delivery Saves Labor • Reduces Installation Errors SOLUTIONS \ _ 912-0 .S i P R 0 V E 912-0017 Poly Molded Basir F cySischa 2-0056 (Top Discharge) ,JUL 2 12023 Discharge) 1" :fv COUNTY ENVIRONMENTAL , JBW me'ill 912-0063 912-0082 Deluxe Basin 912-0088 (Side Discharge) (Top Discharge) Premium Basin (Top Discharge) JP,'�TY4,_,0 SYSTEMS INCLUDE: m2 • 2"solids handling pump. 'GS , • 2"PVC discharge pipe, 30"long(24"long on 24"X 24")and(36" long on 24"X 36"). • Basins-polyethylene, poly-foam or fiberglass construction with TOTAL DYNAMIC HEAD/FLOW PER MINUTE poly or solid steel covers and 4"pipe seal hub,4"PVC hub (Deluxe)or 4"cast iron hub on L.A. Code Systems. MODELS 211 264 266 Check valve options-30-0151,30-0020,30-0021, 30-0101 or Feet Meters Gal. Liters Gal. Liters Gal. Liters 30-0103(Not Included). 5 1.5 82 310 90 341 128 484 Systems available with alarms and preinstalled alarm float. 10 3.0 53 201 so 227 89 337 4Premium indoor systems have a split cover for easy pump 10 6 3. 1- z3 - 0 189 20 .1 1 10 38 inspection;torque stops and an anti-flotation device. Shut-off head: 19.5 ft.(5.9m) 18 1.(5.5m) 21.5 ft.(6.6m) Side Discharge systems rated for outdoor burial-solid polyethyl- ene structural foam lid and basin with 2"discharge on side. 0C9968B 3/16"vent hole drilled. ©Copyright 2008 Zoeller Co.All rights reserved. ter: miligigli 2"vent 3"vent Weight Order by Item# Order by Item# Pump Basin Type Basin Size Each 912.0073 --- M211 Polyethylene Structural Foam-Standard '8"X 30" 39 912-0112' --- " Poly Molded 24'X 24" 50 912.1112' --- " Poly Molded with Alarm 24"X 24" 54 912.0007 9'2-0021 M264 Polyethylene Structural Foam-Standard '8'X 30- 56 912.1007 --- " Polyethylene Structural Foam-Standard with Alarm 18"X 30" 59 912-0006 -- " Poly-10'stack 18'X 30" 65 912-0061 -- " Polyethylene Structural Foam-Deluxe 18'X 30" 59 912-0069 --- " Poly-with Integral Side Vent 18'X 30" 50 912-0086 -- " Premium Polyethylene Structural Foam w!AFD '8'X 30" 64 912-1086 -.- Premium Polyethylene Structural Foam wl AFD&Alarm 18"X 30" 67 912-0114' -•- - Poly Molded 24'X 24" 73 912.1114* --- Poly Molded with Alarm 24"X 24" 75 912-0078' --- Polyethylene Structural Foam-Deluxe 24"X 36' 82 912-0074 --- BN211 with P.B.V.L.F.S. Polyethylene Structural Foam-Standard 18"X 30" 39 912-0113' --- Poly Molded 24"X 24" 50 912.1113* --- " Poly Molded with Alarm , 24"X 24" 54 912-0005 912-0029 BN264 with P.B. Polyethylene Structural Foam-Standard 18"X 30" 56 912-1005 -.- Variable Level Polyethylene Structural Foam-Standard with Alarm 18"X 30" 59 912-0016" --- Float Switch Fiberglass-10'stack,LA code 18"X 30" 78 912-0055 Poly with Integral Side Vent 18"X 30" 50 912.1055 --- Poly with Integral Side Vent with Alarm 18"X 30" 53 912-0065 -- Polyethylene Structural Foam-Deluxe 18"X 30" 59 912-0087 -•- Premium Polyethylene Structural Foam w/AFD 18"X 30" 64 912.1087 --- " Premium Polyethylene Structural Foam w/AFD&Alarm 18"X 30" 67 912-0115' ..- " Poly Molded 24"X 24" 73 912.1115* --- " Poly Molded with Alarm 24"X 24" 75 912.0080' --- Polyethylene Structural Fcam-Deluxe 24"X 36" 82 912-1080' --- Polyethylene Structural Foam-Deluxe with Alarm 24"X 36" 85 912-0010 912-0025 M266 Polyethylene Structural Foam-Standard 18"X 30" 61 912-1010 --- Polyethylene Structural Foam-Standard with Alarm 18"X 30" 64 912-0012 --- " Fiberglass-Standard 18"X 30" 74 912-0063 ri Polyethylene Structural Foam-Deluxe 18"X 30' 64 912-0070 --- Poly-with Integral Side Vent 18"X 30' 55 912-0088 --- " Premium Polyethylene Structural Foam wl AFD 18"X 30" 69 912-1088 --- Premium Polyethylene Structural Foam wl AFD&Alarm 18"X 30" 72 912-0116' --- " Poly Molded 24"X 24" 76 912.1116* --- " Poly Molded with Alarm 24"X 24" 78 912.0079' --- " Polyethylene Structural Foam-Deluxe 24'X 36" 87 912-0017 912-0033 BN266 with P.B. Polyethylene Structural Foam-Standard 18'X 30" 61 912-1017 --- Variable Level Polyethylene Structural Foam-Standard with Alarm 18"X 30" 64 912-0018 --- Float Switch Poly-10'stack 18'X 30" 67 912-0019 --- " Fiberglass-Standard 18'X 30" 75 912-0020" --. " Fiberglass-10'stack LA code 18'X 30" 79 912-0056 ... ' Poly with Integral Side Vent 18'X 30" 55 912-1056 -.- Poly with Integral Side Vent with Alarm 18"X 30" 58 912-0067 -- " Polyethylene Structural Foam-Deluxe 18'X 30" 64 912.1067 --- " Poly Structural Foam-Deluxe wl Alarm 18"X 30" 67 912.0089 -.- .. Premium Polyethylene Structural Foam w/AFD 18'X 30" 69 912.1089 --- Premium Polyethylene Structural Foam wl AFD&Alarm 18"X 30" 72 912-0117' --- " Poly Molded 24"X 24" 76 912.1117' --- Poly Molded with Alarm 24"X 24" 78 912-0081' --- " Polyethylene S ural F m-Deluxe 24"X 36" 87 1 912.1081* --- " Polyethylene tur arr luRvitoa 24"X 36" 90 Side Discharge Basins : ' V Order by Item# Pump ff��, r Basin Type Basin Size Each 912-0082 Is1264 PolyethylenE,51r'r rat FoanU 18'X 30' 912-1082 v: " Polyethylene StrIi tural Foam w r� LIJ J 18"X 30" 66 912-0090 Premium Poly jy)Btr�Shucturel"Fs� yrfr,����F m D 18"X 30" 61 72 912.1090 --- Premium Polyethylene StructuraW#birir Wll i L. M 18"X 30" 72 912-0083 --- BN264 wl P.B.VLFS Polyethylene Structural Foam �rr pQ H 18"X 30' 62 912.1083 •-• Polyethylene Structural Foam w#R�MAW 18"X 30" 67 912-0091 ... " Premium Polyethylene Structural Foam wf AFD 18'X 30' 72 912.1091 --- " Premium Polyethylene Structural Foam wt AFD&Alarm 18"X 30" 76 912-0084 --- M266 Polyethylene Structural Foam 18'X 30" 62 912.1084 --- Polyethylene Structural Foam with Alarm 18"X 30" 67 912-0092 --- Premium Polyethylene Structural Foam w!AFD 16'X 30' 73 912.1092 --- Premium Polyethylene Structural Foam wl AFD&Alarm 18"X 30" 76 912-0085 --- BN266 w/P.B.VLFS Polyethylene Structural Foam 18'X 30" 63 912-1085 --- Polyethylene Structural Foam with Alarm 18"X 30" 68 912-0093 --- " Premium Polyethylene Structural Foam w!AFD 18"X 30" 73 912-1093 --- " Premium Polyethylene Structural Foam WI AFD&Alarm 18"X 30" 77 '24"X 24"and 24"X 36"shipped individually "4"Cast Iron Hub on L.A.Code Systems. PACKAGING 1 B'X 30"Simplex Systems are shipped four units to a skid.24"X 36"are shipped individually.All units are properly secured OPTIONS: Zoeller recommends a High with a 2"PVC discharge pipe in the basins to avoid shifting or upsetting the pump and switch mechanism,Float switch is Water Alarm for added protection.Systems secured with tape that is easily removed through the inlet hub opening.Premium basins have torque stops for prevention of shown above in bold include Alarm. For shipping damage to the pump.All other systems are packaged with environment safe peanuts that are water soluble.-No other alarm options.see FM0732 need to remove. ©Copyright 2008 Zoeller Co.All rights reserved. ^f . • V�IOI 141)11) do Op CL-10 44" ryF • 10 Nei e3 NQl)1�/ �e`'YN'F,1/T9l y to cJ_ caw ARCiE firs and at�(CW ZoGtItrP�'�i''Pba�,n _ SSG �o ho, ac ;6iled e pumv bad`^ fi-�t7v1 St, E. ktPU , ►(w