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SWG2023-00312 - SWG Application / Design - 7/26/2023
MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584 ak: 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: SWG2023-00312 APPLICANT Thelma Mendenhall Phone: Address: 12222 4th EVERETT, WA 98204 OWNER MARTINEZ ALFRED &YASUKO Phone: Address: 21290 E STATE ROUTE 3 BELFAIR, WA 98528 SEPTIC DESIGNER ACME SEPTIC DESIGN & Phone: 360-698-8488 MAINTENANCE Address: PO BOX 2954 SILVERDALE, WA 98383 Site Address: 21290 E State Route 3 Primary Parcel Number: 122064400090 Permit Description: New SFR-2BR Nuwater Permit Submitted Date: 07/26/2023 Permit Issued Date: 08/28/2023 Issued By: Jeff Wilmoth Current Permit Fees Paid: $525.00 (additional fees may be required upon installation of system). Permit Expiration Date: 08/02/2026 (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/onsiteloss-inspection-request.php or call: 360-427-9670, extension 400. , • OFFICIAL USE ONLY CO' D MASON COUNTY DATE RECEIVED, ji — / 4. )- u) C (n,� COMMUNITY SERVICESAUNT RECENED �RECENED BCO M:41,I6 •�L;.J,. Public Health(Community Heal pJl�H 1(� ,6'I 1 1 �` ^/ �'1 T 0 'a„ 3so-a)-%]e.:,a+ooa3sWa9esls). 11�" 14J1 Lam. SWG �u �� f '�`� 1 f)/./"� O Wit"--,-~ 415 N.6M Street-Shelton WA sesM 27 v J ) ` o 0 2 z CJl ON-SITE IF APPLICATION z 73 rn n ���//� ''jq m APPLICANT ` '� +ENE r THELMA MENDENHAL By-- Z c MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE co12222 4TH PL W EVERETT, WA 98204 70 SITE ADDRESS-STREET.CITY.ZIP CODE ,,2 t29ai E STATE ROUTE 3, BELFAIR WA 98528 1--- NAME OF DESIGNER PHONE I` v ACME SEPTIC DESIGN 360-698-8488 NAME OF INSTALLER PHONE 0 IN c IC] PERMIT TYPE(salad one) 11 DRINKING. WATER SOURCE � 0 tiI,IRESIDENTIAL OSS 5 COMMUNITY OSS ECOMMERCIAL OSS LKU PRIVATE INDIVIDUAL WELL IJ!PRIVATE TWO-PARTY WELL Z I c, Di PUBLIC WATER SYSTEM TYPE OF WORK(soled one) I-, ENEW CONSTRUCTION/UPGRADES REPAIR/REPLACEMENT OTHER DETAILS(select th all at apply) 0 TABLE IX REPAIR �� 0 SURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINE CO SUBMITTALS II r DESIGN FORM(REQUIRED) IYJlSEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE IX 0 EVJAIVER(S)(IF APPLICABLE) I 2 0 . b DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.locked gate) �1 SEE MAP G O r 10 H "l.7 SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. I 0 OFFICIAL USE ONLY BELOW THIS LINE UPGRADE/FAILURE SOURCE Or reporting purposes) ❑VOLUNTARY 0 MAINTENANCE/PUMPING ❑BUILDING PERMIT 0 HOME SALE ❑COMPLAINT 0 OTHER: COMMENTS/CONDITIONS INSPECTOR 12- ),..,lt r• 2_1-5- ,j5 V..1"?..... zy t3 RECORD DRAWING AND INSTALLATION REPORT SOIL CODES: REQUIRED FOR FINAL APPROVAL. V=VERY G=GRAVELLY S=SAND L=LOAM Si=SILT C=CLAY E=EXTREMELY R=ROOTS • TION APPROVED/ISSUED BY DATE INS ECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE � J it1114/a �_2 ' " i.-?gyp �rW,("�$�REVISED 72Rf207� �3 ` ilS AY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE / / I DESIGN FORM—PAGE ONE Assessor's Parcel Number: 1 2 2 0 6 — 4 4 — 0 0 0 8 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 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 publicybl view on nn{the Mason County Web site.Maximumg�� paper size 11 X 17 .,K E�' �� :.,p !a..S?_, `; .5. y,C`*.Ya w© -tWttid Ztb }..x:AeT 1'w,..11*?,�K]t:'0"'�"�L t...010.§n+F�.:�.t i`'A Permit Number: SWG 20 2-3 --'m0:9 3t,Z Designer's Name: ACME SEPTIC DESIGN THELMA MENDENHALL Designer's Phone Number: 360-698-8488 Applicant's Name: PO BOX 2954 Mailing Address: 12222 4TH PL W Designer's Address: EVERETT WA 98204 SILVERDALE WA 98383 City State ZipState�� �; Zip r T ti= FeS' 1• 1 E3 S"3_ City__ _ .-.. r_, , ;, w;. Treatment Device ❑Glendon Biofilter 0 Sand Filter 0 Mound 0 Sand Lined Drainfield 0 Recirculating Filter,Type: Ci(Aerobic Unit Make/Model BNR 500 0 Disinfection Unit Make/Model Other: Drainfield Type 0 Gravity lid Pressure 0 Trench 0 Bed 0 Sub Surface Drip Septic Tank/Drainfield Specifications Laterals Number of Bedrooms 2 Schedule/Class 40 Daily Flow:Operating Capacity ►% gpd Length 35 ft Daily Flow:Design Flow 240 gpd Diameter 1 in Septic Tank Capacity 1000 gal Number 4 Receiving Soil Type(1-6) 4 Separation 5 ft Receiving Soil Appl.Rate 0.6 gpd/ft2 Orifices Required Primary Area 400 ft2 Total Number of Orifices 35 Designed Primary Area 400 ft2 Diameter 1/8 in Designed Reserve Area 400 ft2 Spacing 48 in Trench/Bed Width 3 ft Manifold Trench/Bed Length 135 ft Schedule/Class 40 Elevation Measurements Length 315 ft Original Drainfield Area Slope 3-5 % Diameter 1 in New Slope,If Altered 3-5 % Preferred manifold configuration used? gir Yes 0 No Depth of Excavation up-Slope 12 in Transport Pipe from Original Grade Down-slope g in Schedule/Class 40 Designed Vertical Separation 12 in Length 64 ft Gravelless Chambers Required? 0 Yes 0 No lid Optional Diameter 2 in Pump Required? lif Yes 0 No Dosing and Pump Chamber Pump/Siphon Specifications Number of doses/day 8 Difference in Elevation Between Pump Shutoff and Uppermost Dose quantity 30 gal Orifice 4 ft Chamber Capacity I Z SO gal Uppermost Orifice lif Higher 0 Lower than Pump Shutoff Pump controls:Please check those required. QlTimer I�Elapse Meter 0 Event Counter Capacity @ Total Pressure Head 30 gpm 1 MIN 3 HR 5 ft If Tinier: Pump on ,Pump off Calculated Total Pressure Head _ Comments PPROVE . .' 2 8 2023 AUG .F: MASONCOtJNTY ENVIRONMENTAL HEALTH Jaw idiommooioorigwmr DESIGN FORM—PAGE TWO Assessor's Parcel Number: 1 2 2 0 6 -- 4 4 -- 0 0 0 8 0 Permit Number: SWG . DESIGN CRECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch fil Test hole locations 12i Drainfield orientation and layout Reference depth from original grade: O Soil logs 0 Trench/bed dimensions and 0 Septic tank O Property lines critical distances within layout 0 Drainfield cover D-Box/Valve box locations Reference depth from original grade 6d Existing and proposed wells P within 100 ft of property 0 Septic tank/pump chamber and restrictive strata: 0 Measurements to cuts,banks,and locations 0 Laterals,trench/bed,top and surface water and critical areas 0 Observation port location bottom 0 Location and orientation of 0 Clean-out location 0 Curtain drain collector curtain drain and all absorption 0 Manifold placement 0 Sand augmentation components Ii Orifice placement Other cross-section detail: 0 Location and dimension of 0 Lateral placement with distance 0 Observation ports/clean-outs primary system and reserve area to edge of bed Other Information PI Buildings 0 Audible/visual alarm referenced Yes No Direction of slope indicator lid Scale of drawing shown on scale 0 d Design staked out 0 Waterlines bar 0 0 Recorded Notices attached 0 Roads,easements,driveways, 0 0 Waiver(s)attached parkingg ❑Pump curve attached 0 0 Evaluation of failure 0 North arrow and scale drawing shown on scale bar Non-residential justification ❑ 16 Waste strength ❑ It Flow - DESIGN AITR0' AL .... - The undersigned designer must be notified by ins er at time o ' lation 0 Yes 0 No 16 3—kly3 Sign a of Designer Date The undersigned has reviewed .. - 'pi on behalf of Mason County Public Health and determined it to be in compliance with state and loc. on-sit, regulations: Ul//- 1--, 2S--23 .viro p ,tal Health Specialist Date CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER'1'13E FOLLOWING CONDITION: ✓ The design is stamped"Approved"by Mason County Public Health. —2 r� / The Onsite Sewage Permit has not expired,the Permit Expiration Date is: SN✓ 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 Coun of i r..: r• , Oeinr AUG 2 8 2023 MAC COUNTY ENVIRONMENTAL HEALTH Jaw Pump Selection fora Pressurized System -single Family Residence Project M EN D EN HALL 112206-44-00090 Parameters 160 DiscrargeAsserrbySize 200 icit, Ti d sp<a tlerg6r 64 Sad Ti a oNu tPipeC`ass 40 TraspertCreSrze 200 tcit5 DstbirgVatveMcdd Ncre 140 Ma<IDerd m Lit 5 bet MaifidLen* 35 feet Meri zidPipeClass 40 Maribd Pipe sue 1.00 ides Write dlatralsperCen 4 120 Ladd Le 35 bet Lafaral Pipe C lass 40 lidPipas¢e 1.03 iciis Orii sSize 16 kits y °niceSpxiy 4 bet IL 100 ResCLEI Heed 5 feet I 0 FbwMda Ncre id I- 'Ad-cn Friciml mrs., 0 co cu = 80 Calculations u NirinFbNRatperOritz 0.43 gm ea m Nu,Ln d Dribs per Zcre 35 c 156 gm 0 PF500.51 Tod FbvRabpaZme I 70 60 NurberdLa�als per Zone 4 %FbmDi(aaial 1s01astOri ce 1D % H I - rAli Tracizat\Eic 15 e111! 1ii111!s2311111III11I1111111I Frictional Head Losses 40 pu' : . III Loss tramDiisdacc 0.5 bet I LcssinTransport 03 Irss burgh Vde 0D bet LcssinMarii-id 12 feet • IresinLaidds 0.1 bet 20 umstrcup Hp...crater 0.0 fzet 111111 ',ad}m'FricbnLrsses 0D bet Pipe Volumes 112 gat 0 0 10 20 30 40 50 60 70 80 VdcfWieritid Lie rg (gpm) vddMaifyd 16 �s Net Discharge Vddl disperZcre 63 s Taa Vdu e 190 gds Minimum Pump Requirements PumpData Legend Des ae 1E6 gm PF5005H ill He edEketPurp SsbnCuve — Tdal DyraTIc,Heaf 121 bet 50 GRA 1/2r1P 11523N 106CHz173YZj?✓30(CH z PurpCwe PurpOpirrelRac — Ark O•4'ding Part 0 A, lik lia _ Desi3,Pdrt Q 0. L "7---,—/ / !1 i r= PPROVE . lig ar LICEN a DESrDNER . i'. / /ZZfl?/7/f/t/ LILLI AUGy `r .., Orenco Systems• EXPIRES 121151t� AUG 2 8 202? MASBN} J `=." c OOiJNTY ENVIR i %midDn.W. ,K OArti1ENTAL hEl i Tr, �,� �� JBW .. ooto9r 111111%‘ liiiiiiii r óVYl9r lr+to pill, ��� N. P 4111/ hr _...... ........ ,..... . 1 ........, _.... ._ . � Ili v .� �� " _.„.. 11 ..,i up ID t do .1111‘wr i 4, ) , , %., CPI 1114)1°6 0 Will t#13. 0 IYi 4114-‘1116"., 1C)1 I I'• l l.�\ � Iy I �l Ia Pt ,.. 1 CI et iii 1/1111 illi, ,7-tED [11 .. PARTS LIST NuWater NR Assembly Diagram V I 1 A DUAL PORT AERATOR AC POLY DIFFUSER BAR(2) B.3/fi"RUBBER 90'V�H CLP APS(2) N.1'PVC.(3 1/2'SECTION) C.3/B"BARBED ADAPTOR X 1/2"NPT(2) O.1.SUP CAP ® Cl.1/2"SUP X 1/2"NPT ADAPTOR P.1/8"CLEAR PVC HOSE(OPTIONAL V) A E.1"STREET X-1/2"NPT BUSHING(3) Q.1/2"PVC PIPE(BY INSTAI I ER) tJ F.1/2"90'ELBOW(3) R.1"PVC.PIPE(BY INSTALLER) G.r".X'1"X 1/2'TEE S.7 PVC PIPE.(BY INSTALLER) it �" IT H.1"90•ELBOW(3) T.118'BARBED ADAPTOR TO 1/4"NPT(2) c I.7 X 1"BUSHING U.112"STR TX 1/4"NPT BUSHING(2) ppR o IiI J.2"SANLTARYTEE V.1/2"PVC COUPLER(2) 4, IC 1"PVC CROSS W.2"COUPLER(BY INSTALLER) 3 AUG 2 8 21 ;b. L 1"COUPLER(BY INSTALLER) MASON COUNTY ENVIRON TAL HEALTH J B WRevised 2/25/12 • _ s-r DUAL PORT AERATOR" vo TERTIGHT - UP vENT Gyp) -\ ,ems m•P, N - - 11 yyam' -...�� t „MAX r PcrG(Tri') ; t-7 RLNE V— MASTIC 1.1 S -I i RBV — -_ - L. 2 TE ,� SZLlDGE . 12` RETURN UPfE i 2'PVC �— t 1 . , \—J WASH GRAMBER DIGESTER ER 131 GIARWJEfi oPERAnno G TY:4 7 GALLONS OPERATING CAPAC;IfY:421 GALLONS ( f fMBM ROOD c AJ'ALTTY:490 GA4LOWS FLOOD CAPACITY:494 GALLQNS 350 C,AU oNs PLOW:131 GAL lsr Sr a 0 0 1'XtL" 36 c o o a Ems/ Tg 0 1 ..V--. OAZ L T ATTVRU rof4. 12 I yI SLUDGE R7/1/7 t ' 1.5 TAMA .1 SIDE vrtri �_ -t,t i T PROVE OR Auir�SAND °` �°"' S°° AUG 2 8 2023 ; i tsTAL LATICR4�rSTRUc tows ( �,' 1)Excavate tank hole with vertical wails to 1 foot larger than MASON COt1NTY EN�/IRONMENTAL-�E-T�+ 2 If on a is sty,ire 3"at compact sand&level s'-2" a out with screed. 1 void space on n——————7 f- 3)Inset task tom,keeping 24"BLOWER I all Bides or SINE 4)As tank Is Mktg wti t wafer. l in void space with= act { roP of g ( so@ tree of large dumps of caq. I I I5) n i-ii at system,&affix risers 10 adapters vAth Ii 3 <'8' oaf achesive CI 1 6)Performtest in field as required by focal �,R15 I 1 I 7)Upon over tap a l to r > iiattve TRASH CNAMBE t I • I I ggammal sobs ofgrade p of tank _ ——J 8)Ftrral grade the surface to avoid chartering s L J water turd tank TOPS r=LBt . .... - ,_ AEROBIC TREATMENT TANK DETAIL FOR �i' t :: NuWATER BNR-5OO TREATMENT UNIT - {� ..... ENVIRO-FLO, INC. r ED: 3/ 1112 ws Or Treafinert Te rnologies �� BOX 321161, Rowaod,MS 33s232 SCALE* - " P.o 83s-8476 (60f)843-4716€ax 1" — 1.4 ff. _ '' l www.erndro-flo.net • Mason County WA GIS Web Map r } „,---71 / / // ../--/ 1 ) f .______ Z.V aif mow, ,�' W t 3t>c Ln WOO it LSI it I' ea t / / 'V ----- V 7 / i 1-1/1// I / — \ \ — „ lip gr. I.` RA r^�.� \ I f LI p oaten,:i �t,Rd. D T E North Ate. bf J i �\ ' r I r/ 1\k / \ lik."/ . 1.IIIIIIIIIIIXI P i 7 N 9/20/2022, 10:06:18 AM 1:6,120 0 0.05 0.1 0.2 ml 0 County Boundary i ,' l 1 , ' , . 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