HomeMy WebLinkAboutSWG2023-00348 - SWG Application / Design - 8/21/2023 MASON COUNTY 415 N 6TH STREET, 0427-9 7 ,E 98400
0017- 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: SWG2023-00348
APPLICANT DRYER CHRISTOPHER A Phone: 715-661-1628
Address: 961 NE Tahuya River Rd TAHUYA, WA 98588
OWNER DRYER CHRISTOPHER A Phone: 715-661-1628
Address: 961 NE Tahuya River Rd TAHUYA, WA 98588
SEPTIC DESIGNER Jim Zimny -Advantage Perc & Design Phone: 360-516-7287
Address: 7178 WINDFLOWER PL NW SEABECK, WA 98380
Site Address: 961 NE Tahuya River Rd
Primary Parcel Number: 322127500100
Permit Description: 3-bedroom gravity system
Permit Submitted Date: 08/21/2023
Permit Issued Date: 09/12/2023
Issued By: David Anderson
Current Permit Fees Paid: $525.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 08/23/2026 (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
MASON COUNTY DATEg 1 --\ 1 209 3 0 N
COMMUNITY SERVICES RECEIVED BY:
I COm
Public Health(Community Health/Environmental Health) ANN RF W 'Uw)
360-427-9670,ext.400 Or 360-275-4467,ext.400 y/
415 N.6th Street-SAerton,WA 98584 SWG - o0 3 Lt z
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CLEAR FORM ON-SITE SEWAGE SYSTEM APPLICATION z
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APPLICANT PHONE m
Chris Dryer 715-661-1628
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MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE
961 NE Tahuya River RD , Tahuya WA 98588
SITE ADDRESS-STREET,CITY.ZIP CODE
961 NE Tahuya River RD , Tahuya WA 98588
NAME OF DESIGNER PHONE
Jim Zimny 360-516-7287
NAME OF INSTALLER PHONE i
PERMIT TYPE(select one) DRINKING WATER SOURCE -
RESIDENTIAL OSS h COMMUNITY OSS 11 COMMERCIAL OSS PRIVATE INDIVIDUAL WELL ❑ PRIVATE TWO-PARTY WELL Z
TYPE OF WORK(select one) Q PUBLIC WATER SYSTEM
(A NEW CONSTRUCTION/UPGRADES ii REPAIR/REPLACEMENT OTHER DETAILS(select all hal apply) 0 TABLE IX REPAIR
SUBMITTALS 0 SURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINE
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DESIGN FORM(REQUIRED) FI SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE r
WAIVER(S)(IF APPLICABLE) 3 5 Acres C)
DIRECTIONS TO SITE AND SITE CONDITIONS(ex tacked gate) ` N\
From Belfair take Northshore rd for 3.2 mi go rt on NE Belfair Tahuya rd.
Travel 8.1 Mi to NE Tahuya River rd and take left r
site o.9 miles on left marked w pink ribbons. o
Test holes are marked between the burn piles. r1
SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS �\
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE/FAILURE SOURCE(for reporting purposes)
0 VOLUNTARY 0 MAINTENANCE/PUMPING 0 BUILDING PERMIT ['HOME SALE ['COMPLAINT 0 OTHER:
INSPECTOR SOIL LOGS COMMENTS I CONDITIONS
TI1 : d-50 (i •'\
►H3: 0- 3 hS7-- , )
wa 38
TH1:0-3S -Et f$L
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.
INSPEC R IGNATURE DATE APPLICATION EXPIRATION DATE APPLICATI APPROVED/ISSUED BY DATE
, DESIGN FORM—PAGE ONE Assessor's Parcel Number. 32212750010G- —
A design will be reviewed when 3 conies 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. 4'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"Y 17"
t� PARCEL IDENTIFICATION
Permit Number: SWG t 2r�J9-'— l C - Designer's Name: Jim Zimny
Chris Dryer 360-516-7287
Applicant's Name: Designer's Phone Number:
Mailing Address: 961 NE Tahuya River RD Designer's Address: 7178 Windlft)wer PI NW
Tahuya WA 98588 Seabed(Wa 98380
CLEAR FORM
City State Zip City State Zip
DESIGN PARAMETERS
Treatment Device
❑Glendon Biofilter 0 Sand Filter 0 Mound 0 Sand Lined Drainfield 0 Recirculating Filter,Type:
❑Aerobic Unit Make/Model 0 Disinfection Unit Make/Model Other:
Drainfield Type
'Gravity 0 Pressure i 'Trench 0 Bed 0 Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 3 `` -� Schedule/Class 3034 ,J_
Daily Flow:Operating Capacity '3e20Q Z70 gpd ,—
Length +► 50 ft
Daily Flow:Design Flow 36O 'gpd Diameter , 4 tftt 4 in .
t
Septic Tank Capacity(working) 1250 gal Number ;? �, ►.t 4
Receiving Soil Type(1-6) 4 -- Separatio' I) Vt 5 ft
Receiving Soil Appl.Rate 0.6 gpd/f 0� t,• . ► Orifices
Required Primary Area 600 ft2 " Total vat. b, ,:: ,t N/A
Designed Primary Area 600 ft2 ` Diameter in
Designed Reserve Area 600 ft2 I Spacing in
Trench/Bed Width 3 ft Manifold
Trench/Bed Length 200 ft--' Schedule/Class N/a
Elevation Measurements Length ft
Original Drainfield Area Slope 10 % Diameter in
New Slope,If Altered 10 % Preferred manifold configuration used? ❑Yes 0 No
Depth of Excavation uP-Slope 13 in" Transport Pipe
from Original Grade Douai-slope 10 in Schedule/Class 3034
Designed Vertical Separation 36 in x Length 20' ft
Gravelless Chambers Required? 0 Yes 0 No 'Optional Diameter 4 in
Pump Required? 0 Yes leNo Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day N/a
Diff. in Elevation Between Pump&Uppermost Orifice ft Dose quantity gal
Drainfield Squirt Height/Selected Residual(head) ft Chamber Capacity(flood) gal
Uppermost Orifice 0 Higher 0 Lower than Pump Shutoff Pump controls:Please check those required.
Capacity @ Total Pressure Head gpm ❑Timer I-IF.lapse Meter ❑Event Counter
Calculated Total Pressure Head ft (- Q ,Pump off
Comments
SEP 1 2 2023
!mount LOUNTY ENVIRONMENTAL HEALTH
DJ
DESIGN FORM—PAGE TWO Assessor's Parcel Number. 322127500100— —
Permit Number. SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
g Test hole locations a Drainfield orientation and layout Reference depth from original grade:
El Soil logs le Trench/bed dimensions and Ig Septic tank
El Property lines critical distances within layout F( Drainfield cover
le Existing and proposed wells Er D-BoxNalve box locations Reference depth from original grade
within 100 ft of property P1 Septic tank/pump chamber and restrictive strata:
B Measurements to cuts, banks, and locations El Laterals,trench/bed,top and
surface water and critical areas El Observation port location bottom
la Location and orientation of id Clean-out location 0 Curtain drain collector
curtain drain and all absorption 0 Manifold placement 0 Sand augmentation
components 0 Orifice placement Other cross-section detail:
P1 Location and dimension of ❑ Lateral placement with distance El Observation ports/clean-outs
primary system and reserve area to edge of bed
PI Buildings g Other Information
0 Audible/visual alarm referenced Yes No
Direction of slope indicator l Scale of drawing shown on scale 0 0 Design staked out
Er Waterlines bar 0 ❑ Recorded Notices attached
El Roads,easements,driveways, 0 0 Waiver(s)attached
parking 0 0 Pump curve attached
El North arrow and scale drawing y� 41.�i,s 0 CI Evaluation of failure
shown on scale bar k ° Non-residential justification
1.0,3,
❑ ❑Waste strength
LICi:. OES.GNER 0 El Flow
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DESIGN APPROVAL
The undersigned designer must be notified by in b ;rat time of installation le Yes 0 No
U- 5 " 2- >
Signature of D:•1 Jr Date
The undersigned has reviewed this design on behalf of Mason County Public Health and deter e t0): i .
;, . .. V
compliance with state and local on-site ulations:
7//Z/Z80 SEP 1 2 2023
Envi onmen Health Specialist Date
p MASON COUNTY ENVIRCNP;IENTAL H 'ACTH
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITIONDJA
✓ The design is stamped "Approved"by Mason County Public Health. 57/
(7�� ��
✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is:
✓ 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
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Advantage Perc & Design
Timely-Reasonable-30 Years of Local Experience
Construction Notes for 3 Bedroom Gravity System A P P I®\
Gravity w/graveless chambers(Rock and pipe may be substituted) SEP 1 2 2023
Install 4-50' Laterals.
Use a 6 hole d-box and speed levelers "ASON COUNTY ENVIRONMct; . .
Install on 5'foot centers. DJA
Install 10"trench depth on low side of trench and maintain 36" of vertical separation
Install level and along contours.
Install in dry weather only.
Use 1200-Gallon septic and add risers for pumping and maintenance
System designed for typical residential waste strength sewage only.
System designed for 360 Gallons Per Day
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