HomeMy WebLinkAboutSWG2023-00260 - SWG Application / Design - 6/22/2023 ii\Tjr MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584
SHELTON:360-427-9670,EXT 400
Public Health & Human Services BELFAIR:E ELMA:360-482 5269,EXT 400
FAX:360-427-7787
On-Site Sewage System Permit: SWG2023-00260
APPLICANT SEGREST ET UX ROBERT Phone:
Address: PATRICIA COSTELLO ALLYN, WA 98524
OWNER SEGREST ET UX ROBERT Phone:
Address: PATRICIA COSTELLO ALLYN, WA 98524
SEPTIC DESIGNER CINDY WAITE-Septic Designer Phone: 3607010205
Address: 80 E PICKERING LANE SHELTON, WA 98584
Site Address: E Johnson Ridge Dr
Primary Parcel Number: 222137700060
Permit Description: New SFR-3BR Pressure
Permit Submitted Date: 06/22/2023
Permit Issued Date: 08/28/2023
Issued By: Jeff Wilmoth
Current Permit Fees Paid: $780.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 06/22/2026 (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/onsite/oss-inspection-request.php or call:
360-427-9670, extension 400.
OFFICIAL USE ONLY
DArE RECEIVED
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ON-SITE SEWAGE SYSTEM APPLICATION D
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APPLICANT
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ROBERT SEGREST z
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MAILING ADDRESS-STREET.CITY.STATE,ZIP CODE g
PO BOX 1949 ALLYN WA 98524 co
SITE ADDRESS-STREET.CITY ZIP CODE
XXX E JOHNSON RIDGE SHELTON WA I N
NAME OF DESIGNER PHOVI- I N
CINDY WAITE 360-701-0205
NAME OF INSTALLER PHONE ❑ I N)
TBD .,
PERMIT TYPE(select one) DRINKING WATER SOURCE —
W.RESIDENTIAL OSS Fi COMMUNITY OSS R I COMMERCIAL OSS E PRIVATE INDIVIDUAL WELL 6 PRIVATE TWO-PARTY WELL Z I W
TYPE OF'WORK(selec:one) g PUBLIC WATER SYSTEM
OT NEW CONSTRUCTION/UPGRADES ft REPAIR/REPLACEMENT OTHER DETAILS(select all mat apply) 0 TABLE IX REPAIR I I
SUBMITTALS 0 SURFACING SEWAGE 0 EXISTING FAILURE ❑SHORELINE
03
DESIGN FORM(REQUIRED) SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE o
V WAIVER(S)(IF APPLICABLE) 3 125'X756'X499'X93'X906' n I I
O
L.mccTIONS TO SITE AND SITE CONDITIONS (ex locked gate)
GO NORTH ON HIGHWAY 3, TURN LEFT ONTO MASON BENSON RD, TURN RIGHT 1 c)
ONTO TRAILS RD , TURN RIGHT ONTO TRAILS END ROAD, TURN LEFT ONTO r-
RASOR ROAD, TURN LEFT ONTO MORRIS CREEK ROAD, TURN RIGHT ONTO -4 0
JOHNSON RIDGE ROAD, GO THROUGH GATE, MARKED LOT #6 I rn
SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. I O
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE/FAILURE SOURCE(for reporting purposes)
0 VOLUNTARY 0 MAINTENANCE/PUMPING ❑BUILDING PERMIT CI HOME SALE ['COMPLAINT ❑OTHER:
INSPECTOR SOIL LOGS / COMMENTS I CONDITIONS
fr\0 5t, rt5
7-- L{
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J U 2 2023
By
RECORD DRAWING AND INSTALLATION REPORT
SOIL CODES:
V=VERY G=GRAVELLY S=SAND L=LOAM Si=SILT C=CLAY E=EXTREMELY R=ROOTS REQUIRED FOR FINAL APPROVAL.
r CTOR SIGNATURE DATE APPLICATION EXPIRATION DATE r _ AP• I APPROVED/ISSUED BY -
•
Li , - � l /vv�
T IS MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12/7/2015
Amok
DESIGN FORM-PAGE ONE Assessor's Parcel Number: 2 2 2 1 3 - 7 7 - 0 0 0 6 0
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 laa'out 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. .tlaximum paper size: I 1-X I—
rr�� � �-O Designer's Name:PARCEL IDENTIFICATION
Permit Number: SWG . \02- - WAITE
CINDY _
Applicant's Name: ROBERT SEGREST _ Designer's Phone Number: 360 701-0205
Mailing Address: PO BOX 1949 _ Designer's Address: 80 E PICKERING LANE
ALLYN WA 98524 SHELTON WA V 98584
City State Zip City State Zip
DESIGN PARAMETERS
Treatment Device
❑Glendon Biolitter 0 Sand Filter 0 Mound 0 Sand Lined Drainfield 0 Recirculating Filter.Type:
O Aerobic Unit Make/Model 0 Disinfection Unit Make/Model Other:
Drainfield Type
❑Gravity 6 'Pressure [Trench 0 Bed 0 Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 3 Schedule/Class SCHEDULE 40
Daily Flow:Operating Capacity 270 gpd Length 51 ft
Daily Flow: Design Flow 360 an ter 1.25 in
Septic Tank Capacity(working) 1200 gar P tin I•VE I 4
Receiving Soil Type(1-6) 4 A1'c S p�1� 8'13 •
5-10 It
Receiving Soil Appl. Rate .6 AU6 it ,
d/tt ;• Orifices
Required Primary Area 600 �IAS� t a�NTYE , � bAb�il�liGldes 44
Designed Primary Area 612 ft2 i 'y r 3/16 in
Designed Reserve Area 600+ 112 ��paci ,i 60 in
french Bed Width 3 ft ,iv�o'.i/As ��/1 I Manifold
'french/Bed Length 204 ft-�`�' �t�: .. ?t,",, 10 SCHEDULE 40
Elevation Measurementsy�' SLes I Nam/ 2-2.5 ft
Original Drainfield Area Slope 3 �, et LICE ' E 'w t�\ in
C�S NEI31i'� 2
New Slope, If Altered A. ��wusaz a: i; i�� nfiguration used? 0 Yes 0 No
EXPIR.s 05,1o, �+v+rr •�, >;
Depth of Excavation tip-slope 9 in Transport Pipe
from Original Grade no n-slope 8
in Schedule/('lass SCHEDULE 40
Designed Vertical Separation 12 in Length 30 _ ft
Gravelless Chambers Required? 0 Yes 0 No 0 Optional Diameter 52 in
Pump Required? Eff Yes 0 No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day. 6 \�Dill. in Elevation Between Pump& Uppermost Orifice 10 ft pose quantity 45
=al N
Drainfield Squirt Height/Selected Residual(head) 2 ft Chamber Capacity(flood) 1200 gal
Uppermost Orifice Higher 0 Lower than Pump Shutoff Pump controls: Please check those required.
Capacity a,Total Pressure Head 25.96 In
Sp CifTimer gElapse Meter lig Event Counter
Calculated Total Pressure I-lead _ 12.35_ ft If Timer: Pump on ,Pump off
Comments -
. WILL RESTAKE DRAINFIELD AFTER CLEARING, CONCRETE TANKS REQUIRED, GRAVEL BASED
DRAINFIELD REQUIRED, CONTROLS TO BE SET AT TIME OF INSTALLATION
DESIGN FORM—PAGE TWO Assessor's Parcel Number: 2 2 2 1 3 -- 7 7 -- 0 0 0 6 0
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
VI Test hole locations 6/1 Draintield orientation and layout Reference depth from original grade:
FA Soil logs EZ1 Trench/bed dimensions and lilSeptic tank
VI Property lines critical distances within layout QJ Draintield cover
Ng Existing and proposed wells Lii D-Box/Valve box locations
within 100 ft of property [ii Septic tank/pump chamber Reference depth from original grade
and restrictive strata:
I-2i Measurements to cuts, banks,and locations
surface water and critical areas Q( Observation port location Laterals, trench/bed,top and
bottom
6Z1 Location and orientation of fiZ( Clean-out location 0 Curtain drain collector
curtain drain and all absorption [i1 Manifold placement 0 Sand augmentation
components
lid Orifice placement Other cross-section detail:
EZ1 Location and dimension of
primary system and reserve area II Lateral placement with distance 61 Observation ports/clean-outs
to edge of bed
Buildings Other Information
lig Audible/visual alarm referenced Yes No
0 Direction of slope indicator
lit Scale of drawing shown on scale It 0 Design staked out
Q1 Waterlines bar 0 0 Recorded Notices attached
fii Roads.easements,driveways, p p R 0 V E [if 0 Waiver(s)attached
parking 0 0 Pump curve attached
fiii North arrow and scale drawing 0 0 Evaluation of failure
shown on scale bar. AUG 2 8 2023
;LTH
Non-residential justification
iM/SON COUNTY ENVIRONMENTAL 0 ❑ Waste strength
JBW 0 ❑ Flow
DESIGN APPROVAL
The undersigned designer must he noti y installer t time of installation It Yes 0 No
LI il /202,7
Signature vo• esigner Date
The undersigned has reviewed this • ••ign on behalf of Mason County Public Health and determined it to be in
compliance with state and local o� regulati jn :
/
C�
�. S-25z5
E it tal Health S ialist 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: 7---Q"---2 97
/ Drainfield site conditions have not been altered to adversely affect conditions of design approval.
Please Note: The system must be installed bycertified
a 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: 12/7/20 15
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EXPIRES 05'H)r
Lateral# Length Length Orifice # Distance from Distance from end Length #
# (Feet) (Inches) Spacing " Orifices feeder line of end of lateral 1 51
612 60
11 0.5 0.5 51
2 51 612 60 11
3 51 612 60 0.5 0.5 51
11 0.5 0.5 51
4 S1 612 60
Total 204 44 0'S 0.5 51
204
TRANS LENGTH 30
GPM 25.96
K (2" SCHEDULEN 40) 284.5
FRICTION LOSS 0.3577114
Squirt 2
Elevation difference 10
TDH 12.357711
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RISER WITH LOCKING LID
TO DRAINFIELD
PRESSURE LATERALS
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PUMP CHAMBER
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SECURED LID WITH GAS TIGHT SEAL
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FLOATING MAT
APPROVED
EFFLUENT
FILTER
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SEPTIC TANK
(TYPICAL)
SECUREQ),ID WITH GAS TIGHT SEAL
THREADED UNION
24"DIAMETER
ACCESS RISER
FINISH GRADE
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EMERGENCY STORAGE
HIGH WATER ALARM LEVEL ANTI SIPHON
isVALVE*
WORKING VOLUME
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NORMAL TIMER OFF LEVEL I INDEPENDENT
AT STEM
1 131 I FLOUNTING
ENCLOSED PUMP 41 FOR FLOAT
SEDIMENT SHROUD' -
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CHECK VALVE'
SE MENTS 18"
IIIMI SUBMERSIBLE
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Pump Specifications
250-Series Submersible ,; _,,L '�,
Sump / Effluent Pump
LITERS PER MINUTE
0 20 40 60 80 100 120 140 160 180
25 - 1 1
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EXPIRES 05i10
Pumps
Installation Notes
Pressure Distribution System:
22213-77-00060 XXX Johnson Ridge
1. The prepared site plan is not a survey. It's the owner's responsibility to verify property
lines, utility lines (water, sewer, power, phone and gas) prior to installation.
2. Extreme care to be taken when clearing, remove no top soil
- 3. Installer and designer to meet on site after clearing to layout drainfield laterals.
4. Concrete tanks required
- 5. Pump controls to be set at time of installation .
Install system during dry weather with acceptable soil conditions
7. The tanks may be moved as necessary to accommodate building requirements. Septic
tank location must meet all required setbacks.
8. Keep wheeled vehicles off the drainfield area before, during and after installation.
Tracked equipment only,
9. 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.
10. Curtain drains can be no closer than 10' upgradient and 30' down gradient of the
drainfield
11. Exposed restrictive layers, cuts, banks, etc. can be no closer than 50' downhill from the
drainfield.
12. Install access risers on the septic tanks, valve box and ends of laterals.
13. Make sure septic tank risers are epoxied or caulked to cast in riser rings on tank.
14. Lids must form a water and gas tight seal with the access risers
15. Install effluent filter specified in this design at the septic tank outlet.
16. This system must be installed by a Mason County Certified installer.
j' 17. Self-install systems must meet Mason County procedures.
18. Deviation from this design without prior approval from the designer and Mason Count
Health Department will make this design null and void. y
19. 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.
20. Install laterals with contour of the ground
21. Install trench bottoms I I and always maintain a minimum of six inches into native soil
22. Install locator tape o p all drainfield laterals.
23. Install threaded cle ��uts�, the ends of all laterals (caps must extend to within six
inches of finish gr sand a valve box as shown on diagram. �,��
24. Install audio/vis "�S"�
25. Filter fabric re gd oy k°airr k prior to backfilling. If th aiPrcL°ic the original fie. ru•,;, it er ` Rt€Oi4Ev
t least 2 inches do ^F- trewalll.
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System Owner Responsibilities:
1. Operation and Maintenance is required by Washington State Department of Health and
Mason County Health Department.
2. The septic tank and pump tank should be pumped every three to five years or as
needed.
3. System owners are responsible for having maintenance performed annually.
4. System owners are responsible for responding to septic issues in a timely manner.
5. System owners shall not at any time change or alter settings in the control box.
6. System owner agrees to read and abide by information regarding their system in the
User Manual provided by Mason County Public Health.
7. Keep the flow of sewage at or below the approved design operating capacity.
8. Keep waste strength at residential waste strength parameters.
9. Spread loads of laundry through the week.
10. Do not use excessive bleach or detergents with added whiteners.
11. Do not shower, do laundry and dishwasher at the same time
12. Antibiotics can kill or impair the biological process in the septic tank.
13. Leaky plumbing can hydraulic overload your on-site septic system.
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