HomeMy WebLinkAboutSWG2023-00322 - SWG Application / Design - 8/4/2023 111��
MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584
SHELTON: ,S 42 TON, ,EXT 400
584
t�l; 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 Permit: SWG2023-00322
APPLICANT SAGE ROYAL E & LINDA Phone:
Address: 1291 E LAKESHORE DR W SHELTON, WA 98584
OWNER SAGE ROYAL E & LINDA Phone:
Address: 1291 E LAKESHORE DR W SHELTON, WA 98584
SEPTIC DESIGNER CINDY WAITE-Septic Designer Phone: 3607010205
Address: 80 E PICKERING LANE SHELTON, WA 98584
Site Address: 1291 E Lakeshore Dr W
Primary Parcel Number: 220175100026
Permit Description: 2-bedroom gravity system repair: Non-conforming
Permit Submitted Date: 08/04/2023
Permit Issued Date: 08/10/2023
Issued By: David Anderson
Current Permit Fees Paid: $780.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 08/10/2026 (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.
7 Non-conforming septic repair. The septic system may need to be brought into full
compliance before future permits can be approved. Detail: The existing gravity system has
less than 36 inches of vertical separation.
•
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
MATE RECEIVED:
MASON COUNTY (3 1 / C CD
7 �� u)
1 ) COMMUNITY SERVICES 11NTRECEIVV RECEIVED BY o
Public Health(Community Health/Environmental Health � C cp
360.427-%70.ext.400or 360-275-4467,ext.400 �^ (n O
G415 N.6th Street•Shelton,WA 98584 g) 11J\ - — �� Z x
ON-SITE SEWAGE SYSTEM APPLICATION Cam( cii
APPLICANT PHONE
m
ROYAL SAGE 360-427-5888 R ' 42w3
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MAILING ADDRESS-STREET.CITY STATE.ZIP CODE EIVED
1291 E LAKESHORE DR W SHELTON WA 9858, co
SITE ADDRESS-STREET.CITY.ZIP CODE
SAME iv
NAME OF DESIGNER PHONE I IV
CINDY WAITE 360-701-0205 0.,,,;
NAME OF INSTALLER PHONE I C]
v_
_ By ` 1
PERMIT TYPE(select one) DRINKING WATER SOURCE —
RESIDENTIAL OSS 5COMMUNITY OSS [l COMMERCIAL OSS 6 PRIVATE INDIVIDUAL WELL 6.PRIVATE TWO-PARTY WELL Z I
7TYPE OF WORK(select one) PUBLIC WATER SYSTEM TIMBERLAKES WS
I
fl NEW CONSTRUCTION I UPGRADES 6TREPAIR I REPLACEMENT OTHER DETAILS(select all that apply) Ej TABLE IX REPAIR I 01
SUBMITTALS 0 SURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINE CO
Fir DESIGN FORM(REQUIRED) WSEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE 0 1
1WAIVER(S)(IF APPLICABLE) — 2 0 I t
O
DIRECTIONS TO SITE AND SITE CONDITIONS(ex locked gate)
GO INTO TIMBERLAKES, STAY ON TIMBERLAKES DR E, GO TO LAKESHORE DRIVE o
W, PARCEL IS ON THE CORNER OF TIMBERLAKES DR E AND LAKESHORE DRIVE. o 0
SOIL LOGS ARE ON THE TIMBERLAKES DR E BEHIND THE HOUSE --I
IN
SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS.
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE I FAILURE SOURCE(for reporting purposes)
❑VOLUNTARY ❑MAINTENANCE/PUMPING ❑BUILDING PERMIT ❑HOME SALE ❑COMPLAINT ❑OTHER:
INSPECTOR SOIL LOGS f COMMENTS!CONDITIONS
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SOIL CODES: RECORD DRAWING AND INSTALLATION REPORT
V=VERY G=GRAVELLY S=SAND L=LOAM Si=SILT C=CLAY E=EXTREMELY R=ROOTS REQUIRED FOR FINAL APPROVAL
INSPEC SI LIRE DATE APPLICATION EXPIRATION DATE APPLICA • !PPROVED'ISSUED BY DATE
ff7/072013 g/M 7 Za Z6 //e,
S47(0/e0 Z
T IS RM MAY BE SCANNED AND AVAILABL FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12/7/2015
1
DESIGN FORM-PAGE ONE Assessor's Parcel Number: 2 2 0 1 7 - 5 1 - 0 0 0 2 6
, A design will be reviewed when 3 copies of each of the following are submitted: I
''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. Maxiin==m paper si:e: I I"X f 7"
PARCEL IDENTIFICATION
Permit Number: SWG_I92 - 'L. Designer's Name: CINDY WAITE I
ROYAL SAGE 360-701-0205 Applicant's Name: _ _ Designer's Phone Number: ....�. _ _
Mailing Address: 1291 E LAKESHORE DR W - Designer's Address: 80 E PICKERING LANE
SHELTON WA 98584 SHELTON WA 9584
City State Zip City , State • Zip
DESIGN PARAMETERS
Treatment Device
0 Glendon 13ioliltcr 0 Sand Filter 0 Mound 0 Sand Lined I)r111111 ld 0 Recirculating Filter. f\pe: I
i
0 Aerobic Unit Make/Model 0 f)isinlection unit make/model Other: _ __._....._ . . __1 _.
Drainticld "Type i
cif Gravity 0 Pressure 0 'Trench g Bed 0 Sub Surface'Drip
Septic Tank/Drainfield Specifications Laterals •
Number of Bedrooms 2 v Schedule/Class ASTM 2729
Daily Flow: Operating Capacity 180 gp _ Length 43 rat�_..--
Daily Flow: Design Flow 240 gpd / Diameter 4 i'11
Septic Tank Capacity(working) EXISTING 1000 Dual Number - 3 f
Receiving Soil Type(1-6) 3 � Separatic • 2 ft
Receiving Soil Appl. Rate .8 gp4 Orifices
Required Primary Area 300 ti' Iota `inber�p 'if c., / ASTM 2729 PERF
Designed Primary Area 300 112 Di. Oaf* ': 4 v in
Designed Reserve Area 300 ft'/ Stu inLg c ck
t, Jo
Trench/Bed Width 7 ft / 'CINDY E WAITE �1' Manifol(I
it ENS DESIGNER
french/Bed Length 43
ft y Sche NA
Elevation Measurements l.enh�'i ti
Original Drainh eld Area Slope <1 °/n Diameter in
New Slope, If Altered `%, Preferred manifold configuration used? 0 Yes 0 No
Depth of Excavation Up-slink 36 in ' Transport Pipe
from Original Grade Due,i-stoke 35 in - Schedule/Class 3034
Designed Vertical Separation 24 in Length 10-15 Ii
Gravelless Chambers Required? 0 Yes 0 No 0 Optional Diameter 4 iri
Pump Required? 0 Yes lifNo Dosing and Pump Chamber i
Pump/Siphon Specifications Number of doses/day
•
Diff. in Elevation Between Pump& Uppermost Orifice______It Dose quantity gill
Drat f [' " i °sidual (head) _--ft Chamber Capacity(flood) g l °
b A
<, Pump controls: Please check those required. `�Uppermost Orifice 0 Higher . ver than Pump Shutoff
Capacity @ilt ttl rtps tre Head gpm ❑-Timer ❑T:lapse Meter 0 Event Vounter
�Ailculated Total Pressutl' ead --- _-- tt II Timer: Pump on _ . Pump off
C'onun ITtNf YENVIRONMENTAL HEAT
RETRO FIT g#'TIC TANK WITH RISERS AND EFFLUENT FILTER, GRAVEL BASE DRAINFIELD
REQUIRED. DESIGNER AND INSTALLER TO MEET ON SITE PRIOR TO STARTING INSTALL
DESIGN FORM—PAGE TWO Assessor's Parcel Number: 2 2 0 1 7 -- 5 1 -- 0 0 I 2 6
Permit Number: SWG
DESIGN CHECKLISTS
I
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
56 Test hole locations El Draintield orientation and layout Reference depth from original grade:
iid Soil logs IT Trench/bed dimensions and 0 Septic tank
el Property lines critical distances within layout t21 Drainfield cover
r`'1!�❑ Existing and proposed wells fg D-Box/Valve box locations
Reference depth from original grade
within 100 ft of property ftil Septic tank/pump chamber and restrictive strata:
t-11-E1 Measurements to cuts, banks, and locations -P 1•P "r
121 Laterals, trench/bed, top and
surface water and critical areas Er Observation port location bottom
11.401.0 Location and orientation of f7' Clean-out location 0 Curtain drain collectoj
curtain drain and all absorption ait-Manifold placement 0 Sand augmentation i
components
MP—Orifice placement Other cross-section detail:
IZ1 Location and dimension of 0 Observation
primary system and reserve area Lateral placement with distanceports/clen-outs
to edge of bed Other Information FA Buildings
411 Audible/visual alarm referenced Yes No j
fti Direction of slope indicator
PJ(Scale of drawing shown on scale RI 0 Design staked out
Gii Waterlines bar 0 0 Recorded Notices attached
fi Roads, easements,driveways. ❑ 0 Waiver(s)attached
parking 0 0 Pump curve attached
10 North arrow and scale drawing _parr 4 I f - tif 0 Evaluation of failure
shown on scale bar
Non-residential justification
❑ 0 Waste strength
❑ 0 Flow
DESIGN APPROVAL
The undersigned designer must be notifi by inst ler at time of installation lid Yes 0 No
etAii 8f 3( 262 ,
Signatur j
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 r Illations: Ap p ROV D
7.5 y q
Environmental Health Specia ist Date AUG 1 0 2023
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOW VONN' QaMENT L HEALTF
✓ The design is stamped "Approved" by Mason Counts' Public Health. DJA
✓ The Onsite Sewage Permit has not expired, the Permit Expiration Date is:_ 570/10Z 1
✓ Draintield site conditions have not been altered to adversely affect conditions of design approval. 'IV
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: 147/2015
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01 APPROVED
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A UG 10 2023
MASON COUNTY ENVIRONMENTAL H
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LICENSE. DESIGNER • ,44
EXPIRES USnQI
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Installation Notes
Gravity Distribution System:
1291 E Lakeshore Dr W 22017-51-00026 4��
1. Original system was installed in 1981. Laterals are full of roots. . 'O
2. Gravel based drainfield required. QU
ng
ic tank with
4. Designer and3. Retro fit installer t to meet on site rpd effluent to installation
filter MgS0NCOU G �ZOZ3
priorIlation NTy
5. Install system during dry weather with acceptable soil conditions l4 N`,Ie4I Z H
6. Keep wheeled vehicles off the drainfield area before, during and after installation. EgCrp
Tracked equipment only,
7. All ground, surface water and roof drains must be diverted away from the septic tanks
and drainfield. Ensure the final grade slopes away from these areas and water doesn't
collect on or around them. Use swales, berms, catch basin and tight lines, curtain drains,
etc. to divert all waters.
8. Curtain drains can be no closer than 10' upgradient and 30' down gradient of the
drainfield
9. Exposed restrictive layers, cuts, banks, etc. can be no closer than 50' downhill from the
drainfield.
10. Install access risers on the septic tank, D-box and observation ports.
11. Make sure septic tank risers are epoxied or caulked to cast in riser rings on tank.
12. Lids must form a water and gas tight seal with the access risers
13. Install effluent filter at the septic tank outlet.
14. This system must be installed by a Mason County Certified Installer.
15. Deviation from this design without prior approval from the designer and Mason County
Health Department will make this design null and void.
16. This design was sized per Washington Administrative CodeWAC246-272A-0230. The
operating capacity is based on 45 gallons per day per capita with two persons per
bedroom. The minimum design flow per bedroom per day is the operating capacity of
ninety gallons multiplied by 1.33. This results in a minimum design flow of one hundred
twenty gallons per day. This creates a surge factor of 33% but anticipated flow is ninety
gallons per bedroom per day.
17. Install laterals or bed with contour of the ground
18. Install trench bottoms level and always maintain a minimum of six inches into native soil
19. Filter fabric required over drain rock prior to backfilling. If the drain rock extends above
the original grade, run the filter fabric at least 2 inches down the trench wall.
44, �F _
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508
O`er WAITE
LICENSED DESIGNER
EXPIRLS 05/10.
System Owner Responsibilities:
1. Operation and Maintenance is required by Washington State Department of Health and
Mason County Health Department.
2. The septic tank should be pumped every three to five years or as needed.
3. System owners are responsible for having maintenance performed every three years as
per WAC246-272A.
4. System owners are responsible for responding to septic issues in a timely manner.
5. System owner agrees to read and abide by information regarding their system in the •
User Manual provided by Mason County Public Health.
6. Keep the flow of sewage at or below the approved design operating capacity.
7. Keep waste strength at residential waste strength parameters.
8. Spread loads of laundry through the week.
9. Do not use excessive bleach or detergents with added whiteners.
10. Do not shower. do laundry and dishwasher at the same time
11. Antibiotics can kill or impair the biological process in the septic tank.
12. Leaky plumbing can hydraulic overload your on-site septic system.
APPROVED
AUG 1 0 2023
MASON COUNTY-. -. •...
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EXPIRLS U5'10,