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HomeMy WebLinkAboutSWG2023-00319 - SWG Application / Design - 8/3/2023 • MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584 v SHELTON:360-427-9670,EXT 400 BELFAIR:360-275-4467,EXT 400 1`' Public Health & Human Services ELMA:360-482-5269,EXT 400 FAX:360-427-7787 On-Site Sewage System Tank Only Permit: SWG2023-00319 APPLICANT PINKERTON SARAH JOY Phone: Address: 11526 EW RAMBLEWOOD AVE MESA, AZ 85212 OWNER PINKERTON SARAH JOY Phone: Address: 11526 EW RAMBLEWOOD AVE MESA, AZ 85212 SEPTIC DESIGNER CHRIS ELSTROTT-Advanced Engineering Phone: 360-561-5000 Address: 128 NORTH RIVER STREET MONTESANO, WA 98563 Site Address: 330 W Little Nahwatzel Dr Primary Parcel Number: 520097500110 Permit Description: Tank only addition to swg2022-00024 Permit Submitted Date: 08/03/2023 Permit Issued Date: 08/16/2023 Issued By: Jeff Wilmoth Current Permit Fees Paid: $255.00 (additional fees may be required upon installation of system). Permit Expiration Date: 08/03/2026 (based on date of inspection) Type of Work OSS New Construction Components being Replaced: Surfacing Sewage? Existing Failure? Shoreline? Horizontal Setbacks Met? Number of Bedrooms: Drinking Water Source: Additional Details: Permit Conditions: 2 Permit must be installed by a Mason County Certified Installer unless prior written authorization from Mason County is obtained. 1 Proposed development subject to zoning requirements and approval by the planning department staff per Mason County Title 17. 5 Installer is responsible for obtaining Septic Designer/Engineer installation approval prior to backfill of system components. 3 Drain field installation not to exceed designed upslope and downslope depth specified on design form. 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/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/onsite/oss-inspection-request.php or call: 360-427-9670, extension 400. OFFICIAL USE ONLY DATE RECEIVED: vi, MASON COUNTY 3 �- D f ! COMMUNITY SERVICES AMOUNT RECEIVED: RECEIVED BY: CO y v_ m Public Health(Community Health/Environmental Health) 360-427-9670,ext 400 or 360-275.4967,ext.400 - Cl) 4 t 5 N.6th Street-Shelton,WA 98584 S n'G ao^ 00 3\.12 Z N ON-SITE SEWAGE TANK ONLY APPLICATION g Ai APPLICANT m n PHONE m r .SA/?i9/-1 Soy /'/y,-0.rim/v 92-B - 2_7 3 -23 6 3 % c MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE n g //SZ6 Rani isec woop ,4v INZMI 71 m SITE ADDRESS-STREET,CITY.ZIP CODE • Pi¢sA, 4 z e s z/ z ) 0 3 2023 "1 NAME OF DESIGNER PHONE BY. l I G/S'1 V- sE[d I' \ NAME OF INSTALLER PHONE I /3a iwslrw 36a — S--” -795' v TYPE OF WORK(select one) DRINKING WATER SOURCE - IO 1:y-1 CONSTRUCTION/UPGRADES 0 REPAIR/REPLACEMENT 0 PRIVATE INDIVIDUAL WELL 0 PRIVATE TWO-PARTY WELL Z 14 COMPONENT(S)TO BE REPLACED/INSTALLED 0 PUBLIC WATER SYSTEM ❑ SEPTIC TANK Q'PUMP TANK ❑RV HOLDING TANK BEDROOMS LOT SIZE I V ❑ OTHER f 4J ►v1 rim,A 4C/ Z Gom,• 3 2.,rs 4c.. W OTHER DETAILS(select all that apply) TANK(S)SETBACK CHECKLIST r El SURFACING SEWAGE 0 EXISTING FAILURE El SHORELINE 100FT+PUBLIC/COMMUNITY WELLS C) SUBMITTALS u-FT+PRIVATE WELLS,SURFACE WATERS,STREAMS,RIVERS 1 Et LOT PLAN(REQUIRED) ANK CROSS SECTION(REQUIRED) LOFT+DRINKING WATER SUPPLY LINES P DETAILS(IF APPLICABLE) 0 WAIVER(S)(IF APPLICABLE) FT+PROPERTY/EASEMENT LINES,FOUNDATIONS,FOOTINGS PLOT PLAN CHECKLIST r IN al OPERTY LINES AND EASEMENTS XISTING/PROPOSED STRUCTURES STING/PROPOSED OSS COMPONENTS AND LINES -I ` G"°gE1 WITHIN 100FT [VEER SUPPLY LINES D- RIRIVEWAYS/PARKING SURFACE WATER -STREAMS,RIVERS,ETC... k IRECTION OF SLOPE/CONTOURS PERIMETER/CURTAIN DRAINS ORTH ARROW SCALE BAR DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.locked gate) 33 0 w. ', l r/Al A w at 71- Z./ 0 Si )fie, i.Y /s c a ) I 4'74' eef t 1 .�r/� /1/4 `mow Obi-0— 7'. C/V AV A"-C— CL /l' �vy 44.'/4J OFFICIAL USE ONLY BELOWTHIS LINE -- UPGRADE/FAILURE SOURCE(for reporting purposes) 0 VOLUNTARY 0 MAINTENANCE/PUMPIN BPDP FRAC EVOES COMPLAINT 0 OTHER: COMMENTS/CONDITIONS AUG 1 6 2023 MASON COUNTY ENV'IRONENTAL HEALTH JBW 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. DATE APPLICATION EXPIRATION DATE AP !CATION APPROVED!;SSUED BY DATE 7 ---, ----3-.74 t-D"y-1,-, -x--23 THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12/7/2015 ill wGI ; • rays - • /3 . : a; nib .. . Performance Data 32 Pump Characteristics Pump/Motor Unit Submersible Pump Models SD25A1 SD33A1 i 24 11111111 Full Load Amps 8.0 10.0 ill 2 16 Motor Type Shaded Pole(4 pole) z 1/4 HP ' ,, R.P.M. 1550rn Phase 0a I 6r 0 Voltage 115 III Hertz 60 0 Operation Intermittent 0 10 20 30 40 50 60 Temperature 120°F Ambient CAPACRV-U.S.G.P.M. NLMA Design A Total Head(feet) 4 6 8 10 12 14 16 18 20 22 24 Insulation Class A 1/4 HP 44 41 36 33 29 26 23 18 12 6 0 Discharge Size 1-1/2"NPT GPM 1/3 HP 47 45 43 40 37 34 30 26 22 16 10 Solids Handling 1/2" Unit Weight 30 lbs. Dimensional Data Power Cord 18/3,S1TW,10'std. I AgaTemicers kin thes (20'optional) 1 e ndmemkn, . 3-1/2 5.78 - ^ our, -1/2 weY!I/6 Inch 3.Mot la ewntrufian purpose r.r..+ e;,,,e 1.1/2 NPT adn+eM�red ,.. - ' 4.cp rrnkrc,and of01 ore Materials of Construction 3'n - i f/� ro,f0eim.,e Handle Steel 'S(F 'Jf _ } — 5.On/aBk.elodoabk 5,.- - 6 We mime the right k lubricating Oil 31Q mdorrriian to or 9 Dielectric 01 // r Motor Housing +1�� / 4-1/2 Pader�swith Cast /Isp«fakn.uhoutaN.r Pump Casing Cast Iron I`5-3/4' Shaft Steel Mechanical Seal Faces:Carbon/Ceramic Shaft Seal Seal Body:Anodized Steel Spring:Stainless Steel Bellows:Buns-N Pi n 1 e Impeller Thermoplastic 101m 7ortr Bearinga Sw''rr♦ PUMP Upper Bronze Sleeve Bearing 1 DISCHARGE ON Lower Bearing Single Row Ball Bearing i HEIGHT Strainer/Base Plastic -": • .; 3 PUMP e .t F.�. : t i :JAW - Orr toFasteners Stainless Steel 1 z 0 w z a AURORA/RYDROMATIC Pumps, Inc. 1840 Raney Road,Ashland,Ohio 44805 ,, (419)289-3042 NI • co • ::zr .. O Titin ' �\ I . 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