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HomeMy WebLinkAboutSWG2023-00239 - SWG Application / Design - 6/12/2023 MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584 OW 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: SWG2023-00239 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: 10 NE Klahowya Rd Primary Parcel Number: 322237590021 Permit Description: 3-bedroom pressure system Permit Submitted Date: 06/12/2023 Permit Issued Date: 08/08/2023 Issued By: David Anderson Current Permit Fees Paid: $780.00 (additional fees may be required upon installation of system). Permit Expiration Date: 06/12/2026 (based on date of inspection) Permit Conditions: 1 Proposed development subject to zoning requirements and approval by the planning department staff per Mason County Title 17. 2 Permit must be installed by a Mason County Certified Installer unless prior written authorization from Mason County is obtained. 3 Drainfield installation not to exceed designed upslope and downslope depth specified on design form. 4 Installer is responsible for obtaining Mason County installation approval prior to backfill of system components. 5 Installer is responsible for obtaining Septic Designer/Engineer installation approval prior to backfill of system components. 6 Mason County Asbuilt Form, Record Drawing, and Installation fee must be submitted for final installation approval. THIS PERMIT MUST BE ONSITE DURING INSTALLATION OF OSS. PROPERTY OWNERS ARE RESPONSIBLE FOR DETERMINING AND MARKING ALL PROPERTY LINE AND EASEMENT LOCATIONS. THIS PERMIT MAY BE REVOKED IF THE SITE CONDITIONS HAVE CHANGED SINCE THE SITE WAS INSPECTED AND DESIGN APPROVED. FINAL INSTALLATION APPROVAL IS REQUIRED PRIOR TO TEMPORARY OR FINAL OCCUPANCY OF ANY RELATED STRUCTURES. For Final Inspection visit: masoncountywa.govlhealth/environmental/onsiteloss-inspection-request.php or call: 360-427-9670, extension 400. .,440... , , 4,.,:la-,1.,�;. ::��,.-, _YH1 SON CO N 1 DATE RECEIVED-. Le r L� . �- u) .7- c i COMMUNITY SERVICES AItOUNTRECEIYED: • r.ECEIVED3'i: �,[(� W (p Public Health(Community Health/Environmental Health) < li) 350-127.9570.ea:.400 or 3N}37S�.W7.en1400in 0 ::S N.dth SHe2!-Sn±i!o36 955 d: SWG &/L'1 0O 9 Q z di -4 ; ON-SITE SEWAGE SYSTEM APPLICATION APPLICANT PHONE t to Ill MAILING ADDRESS-STREET.CITY.STATE.ZIP CODE • C PO, 8 o x 215 5 &e/4;r tido,_- , 9-?5Z$ oo To SITE ADDRESS-STREET.CITY,ZIP CODE •�• y't.r, 1 10 NE Klcihowya RaP �ffoir- 4?f!,-. g958$ . I� NAME OF DESIGNER - v{ PHONE /A, � r/iGrO { fV. 4 � - 36a- 7r-5:-Ii IFS iNAME OF INSTALLER — 1w '1 Ei.I RO'.• '' • PHONE r fi 07. .15 • -' - Z PERMIT TYPE(select one) .•TbefORINKING WATER SOURCE CV _ aRp tU-Q!! RESIDENTIAL OSS n COMMUNITY OSS ❑COMMERCIAL OSS ❑ PRIVATE INDIVIDUAL WELL 0 PRIVATE TWO-PARTY WELL Z ILJ TYPE OF WORK(select cne) I$ PUBLIC WATER SYSTEM i tf NEW CONSTRUCTION/UPGRADES ❑ REPAIR I REPLACEMENT OTHER DETAILS(select al that apply) El TABLE IX REPAIR I.-'} SUBMITTALS 0 SURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINE to {�Jt g DESIGN FORM(REQUIRED) ASEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE r- WAIVER(S)(IF APPLICABLE) 3 n t 1.0 DIRECTIONS TO SITE AND SITE CONDITIONS:(er,locked gste) I Cot,, N,5hor0 Rd, -- rr. Q=. (7:, Cyr,Jpr, Dr-. 'L');D'r): 1-e Rd {.�rrt� i,r fp 4?t1{o ?�c q� -hoPo�t,ii(.Foi(oul # Kh041-04)O' (2d, ciO,n 41tx- LA' )5 1'-I ng,1e , r_)t,1 L.P. A-•. )-C 5� F'r'L S. r ate ' 3 ,(o,_.,l` ��one I .. :r , r Kco,aiacll.-, Aor _Nord pg., 1 O 4 SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. ( v/LI RADE!FAILURE SOURCE(for reperting purposes) Olt`' 0 VOLUNTARY 0 MAINTENANCEIPUMPING 0 BUILDING PERMIT CI HOME SALE 0 COMPLAINT 0 OTHER: trt3k9 TR2,- 0_ L1. v6 0�5 C _-/ /v(� a,/ 2i �, itIt*1I COMMENTS!CONDITIONS fie\ 1 r N,� �6���,� Ccm p a t Sul u l 3'►i V t 1�h �� �17iC ao 0 A At ' 0- Yh rrm a� of z '\/ 11 z �� 3 . Z} C') S C p lul bz c3 fV IV C.J u uU RECORD DRAWING AND INSTALLATION REPORT SOIL CODES: ` 7 J `1=VERY G=GRAVELLY S=SAND L=LOAM Si=SILT C=CLAY E=EXTREMELY R=ROOTS REQUIRED FOR FINAL APPROVAL. INSPECTOR SIGNATURE DATE i APPLICATION EXPIRATION DATE APPLICATION APPROVED!ISSUED BY DATE 7/1")/ 1 6/l /z oz367(Z/?oZ6 •01/ / Ya3 THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 117!201S 32223 7S 900 - . f DESIGN FORM-PAGE ONE Assessor's Parcel Number: -'-- -z"--41—'7i- ---1-• 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 Designer's Name: Pc. , 1D�t-4 i c.t o Applicant's Name: S 4 0.'- S ;- to ssoc-i rdeS Designer's Phone Number: 7."-,')-°?7- 5-4 l 7 Mailing Address: -Pe box ,Z75' Designer's Address: ?0 ton f 1;ii acILiv wactt. 'iff.S2Y // S()r. :,.-ti. 37%;=/� City State Zip City State Zip DESIGN PARAMETERS Treatment Device' ❑ Glendon Biofilter 0 Sand Filter 0 Mound 0 Sand Lined Drai field 0 Recirculating Filter,Type: ❑ Aerobic Unit Make/Model 0 Disinfection Unit Make/Model Other: Drainfield Type ❑Gravity El Pressure 0 Trench 0 Bed 0 Sub Surface Drip Septic Tank/Drainfield Specifications Laterals Number of BedroomsL. Schedule/C .�ti yp Daily Flow: Operating Capacity 3(0 p gpd Length ,- A. , 3 5 ft �, /, 2-S in Daily Flow:Design Flow 3Gb gpd DiametT.:? ...= .'.'i , r•.. Septic Tank Capacity(working) !Zoo gal Num, _ 4. 0 :f�f Receiving Soil Type(1-6) V .032 $eP r „or o•.. i :r:.uez°' '= ft Receiving Soil Appl. Rate -G gpd/ft2 �Uci: l i ,`', Ices t- t�ic•'cS-2C2 Required Primary Area (, 3.b ft2 Total Number of Orifices 72 Designed Primary Area (. 3,0 ft2 Diameter 3//6 in IDesigned Reserve Area ,3 0 •C ft2 Spacing 3.4, in Trench/Bed Width 3 ft Manifold Trench/Bed Length ,?.(O ft Schedule/Class =:1/'j Elevation Measurements Length ( ft Original Drainfield Area Slope % Diameter in New Slope,If Altered 6 % Preferred manifold configuration used? C. Yes 0 No Depth of Excavation Up-slope v I( in Transport Pipe from Original Grade Down-slope in Schedule/Class 7�� Designed Vertical Separation .> 7 1 in Length 86 ft Gravelless Chambers Required? 0 Yes 0 No 0 Optional Diameter A,0 in Pump Required? -0 Yes 0 No Dosing and Pump Chamber Pump/Siphon Specifications Number of doses/day 6 Diff. in Elevation Between Pump&Uppermost Orifice ft Dose quantity 60 gal Drainfield Squirt Height/Selected Residual(head) j ft Chamber Capacity(flood) (ion gal Uppermost Orifice Cl Higher IE Lower than PumAS to • it Q. , s:Please check those required. Capacity @ Total Pressure Head - J 8,h' :-m � i ier ❑Elapse Meter 0 Event Counter Calculated Total Pressure Head 10 ft er: Pump on v, N• ,Pump off `.C----I AUG 0@iii Comments (4 MASON COUNT'r;';.,^^NMENTALHEALTH L. f1 DESIGN FORM-PAGE TWO Assessor's Parcel Number: ?—¢-4 7 g-- Z Permit Number: SWG ZOZ3 - -.., - - DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch Ei Test hole locations l2l Drainfield orientation and layout Reference depth from original grade: l Soil logs 12:1 Trench/bed dimensions and © Septic tank DI Property lines critical distances within layout In Drainfield cover El Existing and proposed wells D ; = Naive box locations Reference depth from original grade within 100 ft of property El Septic tank/pump chamber and restrictive strata: El Measurements to cuts,banks, and locations surface water and critical areas El Observation port location Laterals,trench bed, top and bottom fill Location and orientation of n Clean-out location 0 Curtain drain collector curtain drain and all absorption p- Manifold placement 0 Sand augmentation components 0 Orifice placement Other cross-section detail: it Location and dimension of El Lateral placement with distance ports/clean-outs primary system and reserve area Observation to edge of bell ❑ Buildings .,.h. Other Information El Audible/vis fat•aI' referenced Yes No d Direction of slope indicator - ET Waterlines El Scale of drawing sue`u:n on scale ® 0 Design staked out bar . "J,i;'- 0 E Recorded Notices attached ; �:�� ._l . ® Roads, easements,driveways, ,'.i`i . `T t" : '.�•`r 0 ❑ Waiver(s)attached parking . „� :�r�. ry; s;:c:2, %I l 0 Pump curve attached )51 North arrow and scale drawing . );:l:WHOHYo::EN_@:.1tt_Ro•. �t 0 13 Evaluation of failure shown on scale bar `` Non-residential justification ❑ 0 Waste strength 0 0 Flow DESIGN APPROVAL The undersigned designer must be notifiedby installer at time of installation IT Yes 0 No / --,,� f\4--, Signattre 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-site lations: Environmental Health Specialist Date R® tfreitj CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THEA FOLLOWIN%•� CDIT][t 8 2023 ✓ The design is stamped"Approved"by Mason County Public Health. ,y ✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: 6 /z/Zoz�'� TY D`41V I I 4"V V � JA TqC y Drainfield site conditions have not been altered to adversely affect conditions of design approval. F,4O`,,i 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 • c�cJyy / C7- 1.4-1A PRESSURE DISTRIBU IO.` Y - REQU.IRE24.E iTS .dais`6a?o ? is z%IC,�1 bottoms e DF ran trenches are be level without any slope check valves are to being used on elf:eb es-it Qleva ti.����.-r �nc ate keepbe used between laterals 'jit'I,. ._ ~: manifold Prime aasnstall trenches withd at all tames, - • _ the Cont.OLL of the ground . •4 o Install .?orator. tape to surface to locate laterals if ever needed ` `5asnstala obsertration'tor-cs within 24'1 of ends of all trenches. 6 .Install trenches during dry conditions. if smearing occurs,. contact designer or the health debt, official- who signed _ the design. Thy s.-is a must or designer is not responsible for failure caused-'by smearing of the trench walls.7=Ineta .l a check valve in the transport line within the pump chamber. . Install either a pump chamber screen or an effluent filter -to---protect-the Pip and the ci=min f f old ram:cantamizating • solid matter. �asnsc2?1 hi - high level water-alarm system to warn owners of pump failure, - 1 O Install lateral cleanouts, screw fittings forty five up to • finish-grade. 5 1 o Risers are to be -i nstali ed at the pump tank to the grade level for,tease in pumpremoval. if baffle type - is boa c- filter - ii used risers .must also be brought to the surface.. b?. iaistall filter-- fabric' over trenches completely over trenches. r' - - • 13 0 Di vert all home and storm drains away from the drainfield a Septic• system is to be inspected, o tJ e_ to and or far�ic8d every • o years. tank should be pumped at a minimum of every ,i:,4Oyears o v_ation from-this design without prior approval with • Designer br Health Dept. official will- make this design, voids as well as the- responsI y. i*.•the .Designer. - 1 -- Install audio and visual alarm inDu p cha 7mber. - -•- . - - - • • ,;.; LA . - . . _ , .6-.,,z,„ „cc. ,-7.1r,. - ,.. { ' •-2�44• PROVE® soo,z5 ---,* AUG 82013 n:ANSTIONI CY BEN DELUERO•: A: MASON COUN .,a�n,;.-r. :•:� `,}l Ep�ON�dENTAL HEAItN p io oB 2e Z Y A - d ir d 1c(41-DUYF), Kd• . 7%,E ►"=4or 0o �c �` r APPROV D _ .. .._. �..--- AUG 082023 I • MASON COUNTY ENVIRONMENTAL.HEALTH aka /l a4. 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Esri Tax Parcels (Zoom in to 1:30,000) Japan,METE Esri China(Hong Kong),(c)OpenStreetMap contributors,and the GIS User Community — Contours 5 ft Mason County WA GIS Web Map Application Bureau of Lard Management.Esri Canada,Esri,HERE,Gamin.INCREMENT P,USGS,EPA,USDA i J