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SWG2023-00241 - SWG Application / Design - 6/12/2023
MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584 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: SWG2023-00241 APPLICANT EARL IDDINGS Phone: (360)275-2454 Address: PO BOX 2755 BELFAIR, WA 98528 OWNER EARL IDDINGS Phone: (360)275-2454 Address: PO BOX 2755 BELFAIR, WA 98528 SEWAGE DESIGNER ANTHONY DEMIERO Phone: 360-877-5200 Address: PO BOX 1174 HOODSPORT, WA 98548 Site Address: XX NE Klahowya Rd Primary Parcel Number: 322237590022 Permit Description: 3-bedroom pressure system Permit Submitted Date: 06/12/2023 Permit Issued Date: 08/07/2023 Issued By: David Anderson Current Permit Fees Paid: $780.00 (additional fees may be required upon installation of system). Permit Expiration Date: 06/27/2026 (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/environmentallonsiteloss-inspection-request.php or call: 360-427-9670, extension 400. MASON COUNTY DATE RECEIVED: I ,, `� .. - . i{I- "� COMMUNITYSERVICES AN.OUI,ITRE F \ RECEIVEDo C m r. !v\ Public Health(CommuniryHeaith/EnvironmenialHealth) • M •1,, 350417.3570.es.40.3m 364275•C467,tat 4C0 C7341;it fi:h Strer;-;h;(tpn.t::.S6;8: V\V/\r, A 'G � — Gc � 1 Q m z cn ON SITE SEWAGE SYSTEM APPLICATION z APPLICANT —S• r7 PHONE M n m E4 7?1 Tyr _:. ,,, G6 f- " a -391-7so z MAILING ADDRESS-STREET.CITY,STATE.ZIP CODE �� CO ?a l�o -i55 ' ` .\-V• 1 SITE ADDRESS-STREET,CITY.ZIP CODE - t ,.= �5.:� NAME OF DESIGNER ., 3 � •;j•� PHONE '✓e.ffic.ro 1. r. IP •= 4�r st 3G0- 77 -5; NAME OF INSTALLER r 5t -'. �� Ei.I KO'• 4\ PHONE • • i '15 FG PERMIT TYPE(select cne) ,� 26t-YDRINKING WATER SOURCE i N sop 10-08 RESIDENTIAL OSS (1 COMMUNITY OSS f=1 COMMERCIAL OSS ❑ PRIVATE INDIVIDUAL WELL 0 PRIVATE TWO-PARTY WELL k TYPE OF WORK(select eno)it z {}� PUBLIC WATER SYSTEM (- NEW CONSTRUCTION/UPGRADES a REPAIR/REPLACEMENT OTHER DETAILS(Select afl that apply) ❑TABLE IX REPAIR kl SUBMITTALS s 0 SURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINE a'OESIGN LOT FORM(REQUIRED) **SEPTIC DESIGN(REQUIRED) BEDROOMS b j SIZE P. j WAIVER(S)(IF APPLICABLE) O t DIRECTIONS TO SITE AND SITE CONDITIONS:(er.lacked gate) -. I,_,� i �d ?�rn� iy p l��T4d ;.t ql -(oP0� ,Col N,5hdre R . l-err. P.4•. 0,-, Gc,r,vyon -Dr. ='f'•a,,J.�^e ac 1=^(ay9�. G?t•1 LPre-1 cja 10 [::/ L S,t!1 F.at c���o tJ v (�hCllnoWta �d, �k,ci t in th s La S I J�I ` Kte a 3 ,rat le c�cne,', ^.�, � I` i`0 \ o incya PC aor Ft,rrd P.d, O x c/ SITE MUST SE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST SE FLAGGED WITH TEST HOLE NUMBERS. 90 2 Z f .. UPGRADE!FAILURE SOURCE(for reporting purposes) � � VOLUNTARY 0 MAINTENANCE/PUMPING 0 BUILDING PERMIT ❑HOME SALE ❑COMPLAINT ❑OTHER: IN PECTOR SOIL LOGS COMMENTS I CONDITIONS Tifl:0- L{Z" I/6 cm S Cr/poc14 w/ )-(I at ill/ 7ffz , 5`4nKrz' Trf3 . f SOIL CODES: RECORD DRAWING AND INSTALLATION REPORT `!=LCRY G=GRAVELLY S=SAND L=LOAM Si=SILT C=CLAY E=EXTREMELY R=ROOTS REQUIRED FOR FINAL APPROVAL. INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED/ISSUED BY DATE 4%)i, - 6/?7471 6•/Z 7/zo 26 Vw?oa3 THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 1217/2015 DESIGN FORM—PAGE ONE Assessor's Parcel Number:- ;--,:. 3,3 .- __ -- 9_( m l. 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.Maxinutmnaper size: 11"X 17" PARCEL IDENTIFICATION Permit Number SWG �(2) e' colat4,1 Designer's Name: A- ,7 r.-'-1;tr p Applicant's Name: r 4 VI: s t to sSoci a)c5 Designer's Phone Number: "',:) • ,-'';•• SG 17 Mailing Address: ,9 Box ,Z75' Designer's Address: p 0 ,.-i-3 Y• ,I,,,,' 6e(Palr waSl- q,52Y C?L,;g[`,,,r-. ,s,Y' City State Zip City State Zip DESIGN PARAMETERS Treatment Dev__iic�ce, ❑ Glendon Biofilter 0 Sand Filter 0 Mound ❑ Sand Lined Drainfield 0 Recirculating Filter,Type: ❑ Aerobic Unit Make/Model 0 Disinfection Unit Make/Model Other: Drainfield Type ❑Gravity 1 Pressure 12 Trench 0 Bed 0 Sub Surface Drip Septic Tank/Drainfield Specifications Laterals Number of Bedrooms Schedule/C A..:'• .,, crV Daily Flow: Operating Capacity •-. :. -Z��"gpd Length , ft Daily Flow:Design Flow 3(b gpd Diamet . ' '`(, , .5 in Septic Tank Capacity(working) /Zoo gal Nun ->' '`"' �� G b qt � `f Receiving Soil Type(1-6) y Sep pp������JJ 032 _ Tj 01 O`. •:Ft.IIERO::. Y I ft Receiving Soil Appl.Rate .6 gpdiftz j"' �t:�: `�. 1� •>ees t 1 :c-CS-'lc- Required Primary Area 6 3,b ft2 Total N..mber of Orifices 7,= Designed Primary Area :^0 ft2 Diameter 3'•- - in Designed Reserve Area D t' ft2 Spacing ;/ in Trench/Bed Width 3 ft Manifold Trench/Bed Length (0 ft Schedule/Class .',•,:) IElevation Measurements Length 4ft Original Drainfield Area Slope % Diameter �,, j in New Slope,If Altered r % Preferred manifold configuration used? CI Yes ❑No Depth of Excavation lip-slope in Transport Pipe from Original Grade Down-slope r in Schedule/Class — Designed Vertical Separation .2 in Length a � -7 ft Gravelless Chambers Required? El Yes 0 No ❑ Optional Diameter ;1,0 in Pump Required? 12 Yes 0 No Dosing and Pump Chamber Pump/Siphon Specifications Number of doses/day Diff. in Elevation Between Pump&Uppermost Orifice ti ft Dose quantity aD gal Drainfield Squirt Height/Selected Residual(head) ft Chamber Capacity(flood) t Zo C eel Uppermost Orifice 0 Higher g Lower than Pump Shutoff Pump controls:Please check those required. Capacity @ Total Pressure Head �$-vF gpm OTimer / ete�ys ' 0 Event Counter Calculated Total Pressure Head 10 ft If Timer: Pump on c--� , �•Jvo Comments '-tie- Si(54$1 niec.d aH a I-t'l i✓15pc-•Novt d00 eucr1 pZ icqr5 cgtl& Sulomi AUG 072023 MASON COUNTY ENVIRn NPAE DJqkTAL NEALT!_• lir.a1UIN r VKM-PAGE TWO Assessor's Parcel Number: 3 — 2. 3 -- /5 -- '® U 2 D Permit Number: SWG _ DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch El Test hole locations M Drainfield orientation and layout Reference depth from original grade: M Soil logs 0 Trench/bed dimensions and ® Septic tank 12 Property lines critical distances within layout Io'd Drainfield cover rd Existing and proposed wells El -1laex!Valve box locations Reference depth from original grade within 100 ft of property Ei Septic tank/pump chamber and restrictive strata: ® Measurements to cuts,banks, and locations 1 Laterals, trench/bed, top and surface water and critical areas El Observation port location bottom &_ 1 Location and orientation of M Clean-out location 0 Curtain drain collector curtain drain and all absorption El Manifold placement 0 Sand augmentation components © Orifice placement Other cross-section detail: Iti Location and dimension ofEii Observation orts/clean-outs primary system and reserve area Lateral placement with distance ports/clean-outs edge of be, "Q1. El Buildings Other Information v 0 Audible/vis a1 *referenced Yes No 6 Direction of slope indicator .121 Scale of drawing s'lii n on scale FEJ 0 Design staked out ft( Waterlines bar -- 1;. 0 f7 Recorded Notices attached ® Roads, easements,driveways, r. ? �`, ."....o, 0 Ill Waiver(s)attached parking '� ;25 F. El 0 Pumpcurve attached 1 ei North arrow and scale drawing %:;.r?A,t:TI;o,y oV:N Cr;.1:mRo t 0 0 Evaluation of failure shown on scale bar �•`� -L' •�....`I Non-residential justification `'p "'"tig- ��� ❑ ❑ Waste strength ❑ ❑ Flow DESIGN APPROVAL The undersigned designer must be notified by ins ,Iler at time of installation Yes 0 No Si�e of Designer Date The undersigned has reviewed this design on behalf of Mason County Public Health and de o be in 4compliance with state and local on •• e regulations: W7 / 'oz3M q� V�� nvironmental Health Specialist Da��CpUNTr��✓/ 2023 CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING COI9gC ✓ The design is stamped"Approved"by Mason County Public Health. / 7/' ii,,, ✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: 6/Z 7/7O z ✓ 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 • � a'o Ji�2. `�A ! GII i s _ PRESSUR2 DSi`'RIBu'l'?� P . AE r7 EJEH{}7Q l o ifsta?'2 tl' nch bottoms level 2 =�en trenches d,,v�d without zs�y s1o�= . v s are being used on different elevation,, CheC.,, valves are eCk ate was to be used between laterals wi�'I1.-. - 30�anif- trt 14-eep�manifold Primed at all times. a _�nsta?l ?_... • with,th, the cantOUi• of the grour_d o - acator. tape to surface to locate laterals if ever needed 'S a�.11s'�ls Or.�E@r va'�ion' r � ' f7 .i s'�''.-a�.,�f ea pot_ within 4 0� ends of au Tenches. contact trenches during dry conditions. If smearing occurs, designer or the hea1t`l do at, official- who signed design. =hs.is must o desianer is not responsibl efo, failure caused--by smearing of the trench walls 7=1nsta}? a check valve in the ?-a chamb-ar, t. nspart line within the uu o b. o install either a pump chamher screen or an effluent filter to-protect- -the p solid t P ' and the dw ai�nfiel f m, s0 matter, � ' =a -COS-i`Lct=1?i13iC_iZC� • naslls ? i �7 �euC:? - + pump failure. water alaru system. to warn owners of - P ai_u_e, lDo I1Zsta31 ?aura? cle finish -grade.l enouts, screw fittings five up forty to 5 Risars are to be ;installed ' grade level f at the pump tank to the finish or tease in pump removal° if baffle type filter •• �.s �ic�c'. used x'-js�c•rs must b? Iistael . also be brought to the surface filter- fab i,c• over trenches completely over • • trenches. + ' • 7 .D q vert ail home and storm drains away from e drai.nfield o 13t�s y tom is to bs {nspectod, and or serviced every o e_ to 71 o s ears tank should he pumped at a minimum of every , ;ilO years - 15.,i%ny deyiatiors from-this design without prior approval with • - Designer br Health Deota official will make this design, voids as well as the- responsi b ri-tj- of=--the .Designer. _ - t d-:- Install audio and v suer alarm 5.4 PLm'a ''chamber. - - - _ f . _ -- --_ • ..,fit - 'y: 1 ;f-y.- -4. . ., I� ^h ', y ITO ii''• 5100325 �� VTi-fUt:Y U::'EY.OEfa(ERU'. Trip is-08 2-'o z 7 Y RCNM�JFNT• - i yo .a,? KI F,:>:riyA, ta. 1 \--\\s, 1 I i . ,,,,-I d<I 8 eJ A p ° R0VED Gann 4 I AU: U7202 3 K . 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NPS, NRCAN, GeoBase, 1GN, Kadaster NL, Ordnance Survey, Esri Japan,METI.Esri China(Hong Kong),(c)OpenStreetMap contributors,and the GIS User Community Contours 5 ft Mason County WA GIS Web Map Application Bureau of Land Management.Esri Canada.Esri,HERE.Garmin.INCREMENT P.USGS.EPA.USDA