HomeMy WebLinkAboutSWG2023-00207 - SWG Application / Design - 5/26/2023 MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584
SHELTON:360-427-9670,EXT 400
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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: SWG2023-00207
APPLICANT Rick & Gina Phillips Phone:
Address: 4111 NE 92ndSt VANCOUVER, WA 98665
OWNER W. CARL MILLER Phone:
Address: 1933 NW CIRCLE DR NORTH POULSBO, WA 98370
SEPTIC DESIGNER PAULA JOHNSON -Arrow Septic Phone: 360-898-2255
Designs Inc.
Address: 171 E VUECREST DRIVE UNION, WA 98592
Site Address: 490 w clear lake
Primary Parcel Number: 421355000025
Permit Description: New SFR -3BR Pressure Bed
Permit Submitted Date: 05/26/2023
Permit Issued Date: 07/12/2023
Issued By: Jeff Wilmoth
Current Permit Fees Paid: $525.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 06/01/2026 (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
DATE RECEIVED: m • NINII N D
C N
MASON COUNTY ,i RECel, �� o N
MI r. COMMUNITY SERVICES AMO "R_
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publkFI••krr(Communityor3607S- 67,ert/ErnirorlmentalHealth) ��G 0 74
400
415N.5t0 Sb«t-ShehaLWA96584 Z N
ON-SITE SEWAGE SYSTEM APPLICATION > 73
m
PHONE ^ r
(360)607-0719 `
APPLICANT (
Rick & Gina Phillips �, zC
MAILING ADDRESS-STREET.CITY,STATE,ZIP CODE Vancouver WA 98665
4111 NE 92nd St 77 •.
73
SITE ADDRESS•STREET.CITY.ZIP CODE Shelton WA 98584 — �'
490 W Clear Lake Dr
F,ONE I N
NAME OF DESIGNER ell
Arrow Septic Designs (360)898-2255 nI
PHONE
NAME OF INSTALLER C
CIw
DRINKING WATER SOURCE Q
PERM�IT TYPE(select one) � F CC
110lp RESIDENTIAL OSS I_h COMMUNITY OSs COMMERCIAL OSS pr.PRIVATE INDIVIDUAL WELLb1 PRIVATE TWO-PARTY WELL Z
IS PUBLIC WATER SYSTEM
TYPE OF WORK(self one) pp all thatI (.11
ENEW CONSTRUCTION/UPGRADES Pr REPAIR/REPLACEMENT OTHER DETAILS(select a apply) 0 TABLE IX REPAIR
0 SURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINE
SUBMITTALS
DESIGN FORM(REQUIRED) IaSEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE r I O
o
0 I CD
(IF APPLICABLE) 4 BR 2.44 acres
DIRECTIONS TO SITE AND SITE CONDITIONS.(ex locked gate) I I
Take Hwy 101 N toward Port Angeles. Turn (L) into Clear Lake neighborhood. Go through
gate. Destination on (R). Yellow sign: "Phillips" o I o
IN
SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. I
Crl
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE/FAILURE SOURCE(for reporting purposes;
❑VOLUNTARY 0 MAINTENANCE/PUMPING 0 BUILDING PERMIT 0 HOME SALE ❑COMPLAINT 0 OTHER:
INSPECTOR SO � (1 I V rE 0 (�j7 ' _ �� / COMMENTS!CONDITIONS
iiG
MAY YtJi i i li 267 — (5 Yo 7' , G e> 4l
By _ 6O /_ g r'< v l
RECORD DRAWING AND INSTALLATION REPORT
SOIL CODES: = R ••IRED FOR FINAL APPROVAL.
V=VERY G=GRAVELLY S=SAND L=LOAM Si=SILT C=CLAY EXTREMELY R=ROOTS
DATE APPLICATION EXPIRATION DATE AT�rN APPROVED!ISSUED BY DOTE
TO/�GNATUR ////nn I( 3 irti Et
ili,
T IS-•••• •Y BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12/7/2015
DESIGN FORM—PAGE ONE Assessor's Parcel Number: 4 2 1 3 5 — 5 0 — 0 0 0 2 5
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. ;llax/mum paper size: II /
Permit Number: SWG 2023-00207 Designer's Name: Arrow Septic Designs, Inc
Applicant's Name: Rick&Gina Phillips Designer's Phone Number: (360)898-2255
Mailing Address: 4111 NE 92nd St Designer's Address: 171 E Vuecrest Dr
,‘ a City Vancouver, WA 98665
Union, WA 98592
y kv �'� State Zip City State Zip
Treatment Device
❑Glendon Biofilter 0 Sand Filter 0 Mound C'Sand Lined Drainficld 0 Recirculating Filter.Type:
❑Aerobic Unit Make/Model 0 Disinfection Unit Make:Model Other:
Drainfield Type
0 Gravity li 'Pressure 0 Trench C 'Bed 0 Sub Surface Drip
Septic Tank/DrainfieId Specifications Laterals
Number of Bedrooms 4 Schedule.Class 40
Daily Flow: Operating Capacity 360 gpd Length 60 ft
Daily Flow:Design Flow 480 gpd Diameter 1.25 in
Septic Tank Capacity(working) 1,200 gal Number 4
Receiving Soil Type(l-6) 3 Separation 2.5 ft
Receiving Soil Appl. Rate 0.8 2pd/ft2 Orifices
Required Primary Area 600 ft2 Total Number of Orifices 120
Designed Primary Area 600 ft2 Diameter ** 1/8"** in
Designed Reserve Area 600 ft2 Spacing 24 in
Trench.Bed Width 10 ft Manifold
Trench/Bed Length 60 ft Schedule/Class 40
Elevation Measurements Length 7.5 ft
Original Drainfield Area Slope 3 % Diameter 1.25
in
New Slope,If Altered 3 �% Preferred manifold configuration used? gYes 0 No
Depth of Excavation lip-slope 9+24=33 in vTransport Pipe
from Original Grade Down-scope 6+24=30
in Schedule/Class 40
Designed Vertical Separation 12+ in Length 180 ft
Gravelless Chambers Required? 0 Yes El No 0 Optional Diameter 2 in
Pump Required? Ii6Yes 0 No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day 4
Diff. in Elevation Between Pump& Uppermost Orifice 25 ft Dose quantity 120 gal
Drainfield Squirt Height'Selected Residual (head) 5 ft Chamber Capacity(flood) 1,200 gal
Uppermost Orifice Higher 0 Lower than Pump Shutoff Pump controls: Please check those required.
Capacity @ Total Pressure Head 49.20 gpm ErTimer gElapse Meter 1 (Event Counter
42.14w —
Calculated Total Pressure HeadIII ft If Timer: P o t u .� 6 hours
Comments '
r
JUL 1 2 2023
MASON COUNTY ENVIRONMENTAL HEALTH
,p8 1 o-c-B JBW
DESIGN FORM—PAGE TWO Assessor's Parcel Number:4 2 1 3 5 — 5 0 -- 0 0 0 2 5
Permit Number: SWG 2023-00207
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
rid Test hole locations Q1 Drainfield orientation and layout Reference depth from original grade:
g Soil logs g Trench./bed dimensions and Ig Septic tank
Property lines critical distances within layout Pi Drainfield cover
Et D-Box/Valvebox locations
g Existing and proposed wellsReference depth from original grade
within 100 ft of property g Septic tank/pump chamber and restrictive strata:
id Measurements to cuts.banks,and locations 6d Laterals,trench/bed,top and
surface water and critical areas Ig Observation port location bottom
O Location and orientation of It Clean-out location 0 Curtain drain collector
curtain drain and all absorption g Manifold placement lit Sand augmentation
components Z Orifice placement Other cross-section detail:
lg Location and dimension of Lateral placement with distance g Observation ports/clean-outs
primary system and reserve area to edge of be.
gOther Information
11 Buildings g Audible.'vi IV a referenced Yes No
• Direction of slope indicator RI Scale of t;'"v" •n on scale Ef 0 Design staked out
g Waterlines bar i -, 0 g Recorded Notices attached
g Roads,easements.driveways, (141.7.4yo'•' •c�!'a. ❑ g Waiver(s)attached
^h 11 0 Pumpcurve attached
parking
� .. , •.i,,./. 0 l�Evaluation of failure
[� North arrow and scale drawing s,oc3s� •.� �}
shown on scale bar - • PAULA JOY JOHNSCN • ‘` Non-residential justification
it' 'n iGNEft' ❑ gWaste strength
❑ gFlow
DESIGN APPROVAL
The undersigned designer must be no fa)by ins3 er a time of installation Et Yes 0 No
(o Z2—Z1
Signature of.Designer Date
The undersigned has reviewed this design on behalf of Mason County Public Health and determined it to be in
compliance with state and local on- • e regulations:
Az
E virs�ntal Health Specialist Date
CAUTION: DESIGN APPROVAL 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: /-,2_6
✓ 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
•
•
RECORD OF SURVEY FOR THE PURPOSE OF A BOUNDARY LINE ADJUSTMENT
A PORTION OF NORTHWEST QUARTER OF THE SOUTHWEST QUARTER AND BLA No.
tef•r am NORTHEAST QUARTER OF THE SOUTHWEST QUARTER OF ,1444.0
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' MASON COUNTY.WASHINGTON
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: MASON COUNTY ENVIRONMENTAL HEALTI ,
• 5 DEGREE ELBOW OR JBVI►
TERM,SWEEPING 90 NOTE, r.., `.
END OEO=OBSBRVATION PORTS--TO SE 4' SNWIL
PVC PIPE FROM BOTTOM OF TRENCH
DIT •J TO FINISHED GRADE. REMOVABLE
3 DETAIL CAP SHALL BE INSTALLED •
CLEAN OUT ON OBSERVATION PORT PIPE.
' T" A-r iaotti t of ofisegvomoti po.1' •
NOTE, CLEANOUT TO BE PROM 0 TO 6 TOTAL OF IN SYSTEM.
INCHES BELOW FINISHED GRADE. (2.)4T6 WWWSTAd. AT'8ortoc't aV C•33 SAt-.
NARK ENDS WITH- REBAR. CLEAN OUT **LATERALS ARE TO BE CENTERED
REQUIRED AT END OF EACH LATERAL. - IN TRENCHES.
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Length Length Orifice # Distance from Distance from
Lateral# (In.) (Ft.) Spacing Orifices Feeder Line (In.) Cleanout (In.)
1 720 60 24 30 12 12
2 720 60 24 30 12 12
3 720 60 24 30 12 12
4 720 60 24 30 12 12
'Total Lateral Length 240
Total#Orifices 120 I GPM = 49.2
(with 1/8" orifices)
Dynamic Head Calculations
Selected residual pressure: 5 ft.
Length (Ft.) #Orifices
Transport Pipe 180 120 7.00 ft.
Feeder Total
Lateral Line Length
Lateral#1 60 4 64 30 1.28 ft.
Lateral#2 60 2 62 30 1.28 ft.
Lateral#3 60 2 62 30 1.28 ft.
Lateral#4 60 4 64 30 1.28 ft.
Total Elevation Lift 25.00 ft.
'Total Dynamic Head 42.14 ft. I
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Flow(GPM)
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Septic Tanks must meet standards required by WAC chapter 246-272C and
manufacturer must be on Dept of health list of registered sewage tanks. FIGURE.2'
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((view Septic Deesigvs
•
INSTALLATION & MAINTENANCE cor
Pressure Distribution Systems— Sand Lined Bed
51 03 g .•
1. Install Laterals with contour of the ground. PA OY JOHNSON
2. Install bed bottom level. IES< l►CEXIS=b nS►'GNI= �
3. Install locator tape or rebar at each end of all drainfield laterals. "`P" ' '
4. Install observation ports as indicated on the plot plan. One required in each corner of the
bed. Two with bottom extending to the bottom of the drainrock and two extending to the
sand/native soil interface. Glue "T"to bottom so Observation Port cannot be easily
removed from ground. Install removable cap on top of port at final grade level.
5. Install drainfield during thy weather and soil conditions; any soil smearing must be
eliminated by hand raking.
6. Install threaded clean-outs at the end of all laterals (cap must extend to within six inches
of finished grade and be marked with locator tape or rebar).
7. Install audio/visual high water level alarm. Redundant off switch required.
8. Install 1/8"mesh non-corrosive pump screen(min. 12 sq. ft. surface area, not to interfere
with controls or floats) Or pump screen may be substituted with Bio-Tube in septic tank.
Pull bio-tube every 6-12 months and flush back into tank.
9. Install check valve in pump outlet line to prevent system from draining back into the
pump chamber.
10. Tee to Tee construction between laterals and manifold with orifices oriented at 6 o'clock.
Install laterals to the manifold with the orifices at 12 o'clock, (do not glue), after pressure
test and Environmental Health Dept. approval, turn orifices down(6 o'clock) and glue
laterals to manifold. Orifice shields may be used with orifices in the 12 o'clock position
in lieu of turning the orifices down to the 6 o'clock position.
11. Filter fabric required over drain rock prior to back filling. If the drain rock extends above
natural grade, run the filter fabric at least 2 inches down the trench wall.
12. Encase all water lines within 10' of drainfield and under any driveway/parking areas.
13. Divert all storm water runoff away from on-site sewage system.
14. No curtain drains allowed within 10' of the up-slope edge or 30' of the down-slope edge
of the drainfield and reserve area
15. Have the septic tank and pump chamber pumped or inspected every 3 to 5 years.
16. No vehicular traffic over drainfield area.
17. Inspect floats, clean filters, and test high water level alarm every 6-12 months as needed.
18. AlI materials and workmanship must meet County and State regulations.
19. Deviation from this design without prior approval from the Designer and Mason County
Environmental Health Department will make this design null and void.
20. All manhole lids and access, sampling or inspection ports must have locking covers and
be located at ground level.
21. All pressure systems with a pump chamber outlet higher than the drainfield must have a
1/8"hole drilled in the discharge pipe above the pump to prevent siphoning.
22. All transport lines under driveways or parking areas must be encased to prevent crushing.
23. Homeowner is responsible for all property lines. p
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, � $ JUL 122023
0 MASON COUNTY ENVIRONMENTAL HEALTH
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