Loading...
HomeMy WebLinkAboutSWG2023-00380 - SWG Application / Design - 9/7/2023 MASON COUNTY 415 N 6TH STREET, SHELTON, , E, E 400 98 61": 584 SHELTON: 42 T 967XT 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: SWG2023-00380 APPLICANT BO RUSSELL-septic installer Phone: 360.589.7957 Address: PO Box 336 MONTESANO, WA 98563 OWNER GLICK RHONDA JEAN Phone: Address: 29914 52ND AVE E GRAHAM, WA 98338 SEPTIC DESIGNER CHRIS ELSTROTT-Advanced Phone: 360-561-5000 Engineering Address: 128 NORTH RIVER STREET MONTESANO, WA 98563 SEPTIC INSTALLER BO RUSSELL-septic installer Phone: 360.589.7957 Address: PO Box 336 MONTESANO, WA 98563 Site Address: 744 E Thornton Rd Primary Parcel Number: 221357590143 Permit Description: 3-bedroom pressure system Permit Submitted Date: 09/07/2023 Permit Issued Date: 09/25/2023 Issued By: David Anderson Current Permit Fees Paid: $780.00 (additional fees may be requ red upon installation of system). Permit Expiration Date: 09/22/2026 (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 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.gov/health/environmental/onsiteloss-inspection-request.php or call: 360-427-9670, extension 400. OATF RfCtlYt D: ( / / MASON COUNTY v' ` (/� AMOUNI�l RECEIVE Y Q 1Ti . co. : ___ COM ___ ___MUNITY SERVICES T` ) ' Public Health(Community HeafthhrmronmentalHealth) /� //� /�� fp � • 36e427-9670.ext 400 or 360-27S„67.ext.400 5 W G p� r — v 3 CO _ 415 N.6th Sheet Slreitm,WA 995&3 Z Cl) TEM APPLICATION 3 ON-SITE SEWAGE SYS rn RIPHONE r MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE Ai O A • s Sff E ADDRESS-STREET,CITY,ZIP CODE J-4, IN NAME OF DESIGNER C B Is �l fis l i�r-��, 6D _ �C>// — �(,� � PHONE � I NAME OF INSTALLER ,3 Co S'e 9 — 7 s i > I w SSA'GL DRINKING WATER SOURCE O PERMIT TYPE(select one) n PRIVATE INDIVIDUAL WELL AATE TWO-PARTY WELL Z I`� SIDENTIAL OSS !1 COMMUNITY OSS fl COMMERCIAL OSS 0 PUBLIC WATER SYSTEM r TYPE OF WORK(select one) 1 rudeW ONSTRUCTION)UPGRADES rl REPAIR I REPLACEMENT OTHER SURFACING(sated SEWAGE EXISTING FAILUREAI 0 SHORELINE U3 I� 0 r SUBMITTALS BEDROOMS LOT SIZE O 1 ESIGN FORM(REQUIRED) EPTIC DESIGN(REQUIRED) e/� �L I rl WAIVER(S)(IF APPLICABLE) -3 DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.fodcedgate) /C/N/ xp ,,,N ai�s/6N I•;;, o G 441 7-- L o T pi✓ RIG Tyr /9T TL iv,o -I ('oar` Saari/ L/-7Nlz W �• i SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. ��(( U� SPP U 7 2fl23 ill UPGRADE I FAILURE SOURCE(for reporting purposes) c�fa,_ �► 0 VOLUNTARY 0 MAINTENANCE/PUMPING 0 BUILDING PERMIT ['HOME SALE ()COMPLAINT C13OTHERENTS i'CONDITIONS INSPECTOR SOIL LOGS TH.1- I (JCS f .fo V6frc t O'(� to e4ue, Tiff: o-61 v6 i co / ;ANC %r 60 to Sioc t Tit 0- 68'‘VCi0S Ylvr 5 cic() 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 APPLICATION OR FINAL A!ISSUED 8Y OATF INSPECT S ATURE DATE APPLICATION EXPIRATION DATE g/75/ 0 — 7 ..z7 0 77z7(74 '6. 4-) --. THIS FORM MAY BE SCANNED AN AVAI LE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12l1/2015 . DESIGN FORM-PAGE ONE Assessor's Parcel Number: 2 2 /3 -- 7 s'"_ 2 a ( 3 - A design will be reviewed when 3 co ies of each of the following are ale s la out sketch,including all applicable items on checklist ubmitted:°Completed design form that has been signed and dated. y applicable items on checklist. Scaled i plan,includingab all applicable available for public view on the Mason Countyh,including all Web site.Maximum i a•er size: 11 X 17 This form may be scanned and ,, _..�„ _ _., A = A11cELIDEN I LC�ATiOSN.. r v> _;i �•'r � c "S.= h�r•� �jl y. Designer's Name: Permit Number: SWG J2 �--5 64 -��� CZ" ! S�GL Designer's Phone Number: Applicant's Name: l3o,P /may N /Pip�l ST Designer's Address: �4 f� 3 Mailing Address: piyS � �aj9�it�iy w/9 9�S6 3 Ci State Zi' Ct Sate ZI 1 x;3 a } Y �J y�T Y iw ., :F.. - .' sir .``Y� y-ate yzS°.'Y'=iu�a� , ..,-rJ":.i>. Treatment Device ❑Glendon Biofilter 0 Sand Filter 0 Mound 0 Sand Lined Drainfield 0 Recirculating Filter,Type: O Aerobic Unit Make/Model 0 Disinfection Unit Make/Model Other: /�i�is• Tns/.4 D ainfield Type Bed 0 Sub Surface Drip ressure rench ❑ Gravity Laterals Septic Tank/Drainfield Specifications -- ' 9 Schedule/Class / Number of Bedrooms Length f sr' Go Daily Flow:Operating Capacity ^ gpd /�y in 36 o gpd Diameter Daily Flow:Design Flow Number 3 Septic Tank Capacity(working) /�e7 gal /d ft� Receiving Soil Type(1-6) ,I,- gp�f)K Orifices Separation Receiving Soil Appl.Rate ft2 i Total Number of Orifices 3� Required Primary Area - z Diameter 3l/b in c ft Designed Primary Area �� in C ft2 f Spacing 60 Designed Reserve Area i� Manifold Try ed Width 3 y0 Sv ft / Schedule/ClassTrh/Bed Length Length 2-0 ft Elevation Measurements 2 in Original Drainfield Area Slope y % Diameter% Preferred manifold configuration used? es O No New Slope,If Altered Transport Pipe Depth of Excavation Up-slope z_/ in ✓ �� from Original Grade Down-slope 2 v in j Schedule/Class / ft in / Length Designed Vertical Separation 2`� 2 in Required? es 0 No 0 Optional Diameter Graveness Chambers Requ Pump Required? Ilkes 0No Dosing and Pump Chamber Pump/Siphon Specifications3 Number of doses/day ._---- 7 � ft Dosequantity /zo gal Diff.in Elevation Between Pump&Uppermost Orifice l— 2d g / Drainfield Squirt Height/ elected Residual(head) 3"g ft Chamber Capacity(flood)Pump controls ease check tho equired. er 0 Lower than Pump Shutoff Miner lapse Meter Event Counter Uppermost Orifice tghm Capacity @ Total Head 2`� ft If Timer: Pump on g = k'1" ,Pump off t l CSs�1� _ ft Calculate;"" //7�� <<'�""v Comments SEP 2 5 2023 MA •► • ► 1 RONMENTAL HEAL Tt' DJA -Assessor's Parcel Number: 2-4 / ) -- .Z -- -L z L-t DESIGN FORM—PAGE TWO ——— Permit Number: SWG DESIGN CHECKLISTS Scaled Plot Plan Scale ayout Sketch Cross-Section Sketch 12--1 est hole locations D ainfield orientation and layout Reference depth from original grade: oil logs lUVTisualibed dimensions and l tic tank c 'tical distances within layout DDrainfield cover rty lines /Valve box locations Reference depth from original grade within101X i 100 ft of property and proposed wells Septic tank/pump chamber and restrict' a strata: At Measurements to cuts,banks, and 1 tions aterals,trench bed,top and surface water and critical areas 0b8ervation port location bottom n-out location Curtain drain collectoration and orientation of I' Sand augmentation c 1ai1-and all absorption ifold placement o co onents Ori a placement Other cross-s coon detail: Location and dimension of ateral placement with distance servatian ports/clean-outs Ogiary system and reserve area to edge of bed Other Information B 'ldings ❑r/kudible/visual alarm referenced Yes No riD/birection of slope indicator ❑/ net ign staked out Scale of drawing shown on scale El [9' corded Notices attached �a rlines bar 0 Waiver(s)attached OL4Oads,easements,driveways, ❑P p curve attached par ' g ❑ valuation of failure ❑ orth arrow and scale drawing Non-residential justification shown on scale bar x r Waste strength a VI Flow DESIGN APPROVAL The undersigned designer must be notified by installer at time of installation : Yes 0 No g-.f-2-3 Signature of Designer Date i on behalf of Mason County Public Health and de a nePi RO The undersigned has reviewed this design E compliance with state and local on-sit e ations: fi SEP 2 5 2023 r +'EN N CO ' En ironmental Health Specialist Date UNTY ENVIRONMENT'„E I+%I CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITI /j� 7 ✓ The design is stamped"Approved"by Mason County Public Health. (/ (/ ✓ The Onsite Sewage Permit has not expired,been alteredPo adversely ermit affection Date condrtions of design approval. ✓ Drainfield site conditions have not Pleas e Note: The system must be installed by a certified installer, unless prior authorization is obtained from Mason County Public Health. An Installation Fee is re uired. This form may be scanned and available for public view on the Mason County Web site.Updated Date: 12/7/2015 i f �" s r'w ,S cn s j \ / V ff L4,\J '-k.-4' I> . .413--:$ / / . 0 ec,#) STAT4 96 • f N •+ Z 9 Z 'f• tO 91% 17 iiAy ' D 3 7 5 �1 � , �, O O � ►.� 9f Co• c • n •Z / /4r oq lrn w' --.1 .00 " rri o tin D O \`�� , ,0 4., ''' N' CD fl a N• ,cit, 4, 00 .. z ` 0 FAR 1 w z , m c � , : ,‘ 4 ,,,,„ . 0 s i % . . , , ,, A. m. , \., ,,, __ --- _ \ , cA N ),,,t w Q \ , kl bIN N w n t\ w 3 3 Ill 11 w c 0 oo\ O a' Co rn • rli NP • t o < ). • 1 I r T1 F b' r) ti r 30 > r. � \ ' r e it m oz IV 'v � ap Z �o \. 0 ‘ . !, : . oh � � is\1^ 1 �w ..:.' k''' 1) W /' 'c . S .e l�TiG/r'� • �`a /s7 z& ' m o, N ..i . . co V Q. U P W N .+ h ( Ss ap O• �V Iw Na 0Q' n l' x N b1 o m. .0 a/Q c 9 c 40 t'M ° ° HnQ ° ® • QI '�s • G' o V a H� Ts ..n od 3 r P •Covi r c r - h M qL. k m •• rnrnx u ' v ?' U F. 64i r- - r; 0 "74-'..":".....'SA,4;1 '-^ kli v9 (4 ts'''''-' 1' . 1 1''si:1 MPI el c.,,, ...) kl 1... ••C 'I. s 1, liv co ..rLn x N .+ z 0 m R, � � � � ti ® hti ell .1 a ' u r.• o 4 f w m 4 ry H ,, ... .r...i,,,.!•r:•to,.. •rg0*I1,41411.; „«.{r1:1:••.40,,10:pyru ,[dt'Mr,4ati.:ft{'r"Mot (7. . IA ,b.,l.F.n.zr•,11,g%As.,.i ra.r,:r. ,t.,.... : ,.u.rV i..!tn•Pollq. ar•un:isrr<xr.r:4.e1:r.•ia.v:n:,;.rr..,,...OD:.. ..1..,,.4s.'::a;i u t: o. N. r Y 9. [[,•0: N N rr rr rr A ai Y.-. � N r J01,nA r0 VI W N ` r. V11 *• 0000000000. Ro ❑ °a OON0 b .0 C+ Y, A 0000000000. -x `"yruz� :• y HEAD-FE . ".1 i .-3 n mai m i'2 ttlgn o•0en crow- o,H�t • • • nm o „ r m P�y� mo zmq 1./ o la }., a0 �• rr,,rr WY 'ci 3 lm-•�vDJ opab H p o(T�� a T o ' rM 30 wN r r owm Jins r .d r+ O ���C+ A3❑W.00, u , m N 7 N r UI m O N w w N w r \F�0 A t S W z.o f W o p L• p�] ,��77 Or"n x 4 .___/ `y- • m 3re0 ......... -•q ' N<N DJ 5 fix "-�(ZM O 410111111111111111111 CS{ ■ ilir s (s m r r M r[Ct"`'" ❑ r] G] (rye \I� ` ��//yy O<O<O<fRD ^^Y'[ro[++C Cn z 7.mm DJ in ; in ; in 1 r v rj.- r-' M�W • CCCm NNNNNNNN NN �H£Or0 O yyy xOH 1 I _7. ^ ,�� �, 11��11 N ri g g r 0 Or rYrNNN W P tI+s77 H '1 mHw IA AUf'�' in. ArUI Y ~ ktV Cam.5. w_,, v O C' ;. x•7 xY NI A N000 00 W 000 C" L Cr t� AMIMMOMM°° <� y oytncn o o z a o q ' "_s�w�w �s' __ � c Imo' Y PN r r MjrOyW(p"" x RC1 rp.yt�n+x n H,yy� .1 t O , l `Y' O .0,,...," O,om JmcnN W Nr M Hm7 ,YH0X1 a1 y N b] ry r ,p r•.. ■._`•_ (� y W r N J O.N UI A A I. N N r O rt{Nq H OOD S, •O DJ H b1� n ma' ID'd r•r t�R, �1 .:S ■I `/• UI iDW JOdmr dm ... a o .d ••�' iT 3 R R rt g 1 v IT n �y ° co a r b��rr+ -{� MMOMMON,.,K m ' N,0•+r N o • . •O N 11'r w� =�o O 5.• O , r rMC O O 0r •Q O,Om 7, W N IomJ 0, y C. m 01,10NN IPWNr m a0 'I Xt. O LSI o,IJINA A W NNr 0 -7•W Y m�NyO , p OOOHb ;,4, .On O , ■_= �I) .Oi•,ca r Y Chi •xr N�C � yO C1ED p r\n,7mlyu o� T , �_ VAl "", �•' o000000000ii 08.V M r.3a MIR: Hdu r• ';- 1::: ��/�•n OroH N < -fit }yYYJp-2 `�� >1DDI( 1\ O. E �, H C'5 5 —_1`. t'! • r+ yppy N CC G' N^ (-'r(�1• �ONHy U • G00• H N A •�•P M WWWWww NNrr ...--tSr"' b r \iitt.i. ,OJ VIWOm Nr JN I^,I /MI ••,,i mo Ar JOOJ Jtn y H 0 „' yy1 S W Z "1 O r N ., 0 W N r : ill • rQ] 8 r O N I N N N N N r r r r H rt N H ,j m u $ 4, 3 r, m m w I+]CT •e ,rennlfV•: ,:,ed::..;, .,••s...0M3rryr]rrt I:I t ids'-U+Y„YR.,r•:FIr,C•.,,✓.lIH ,.l:j._•:[.,0,,,•.,`4,.•,,•tr..c..,;,1r'rti,H>n' •w'Ckhi7N#'h•Y, 43 N01,p NO\i0 N.nm -� 3 `J M 0 i i n m m n 4 ....3„_a4,0. ",:t:,. r,. ...,.: ,.it..Sry/ .:...,4:;,.rt,:.4.•....•,ii,..!•:.0.4 04.+!W,••XV4.'4:14.:J';..»?N,.rvr mC716 h,.{XI•'•ei i A k/ • 't Z---------- ----Th-* Z r, m u, a w N , 4, Q\ x e • L rr on cCr'z GI c� ' ' i .. ,-, C x •-ion C1 •a a L__.=t �?i . z V • •I re 0 a r r O Q -.."--• PI V xrV:i } r �` ,f 0 n z w -at a a I Ii t. rn • • r icl z • r \ III �, • _ri (\ • S ` r Z •C O-CxaxA �,�', \(npjI k -_ 1- No Vrrazoar ;• ` . - 1 zm0a >Ar 0. r G :,'e o Cn-I \ iI -1 ,-. ^"1 • j" ria _'4 'I• 'Y2 'Awe t.`r!8k•':iica.• •t1t id{9?.iiO ^.atL1. o._.,..r:,.i......i u'•.,►.... ., .+• ' I -gqI �� Orin n cl - — -..A :.. . vnrn \\ax t , © rJ 7 \. •. m ra -t1mn • rnz-i ,o IIT { �T1 ,1 J/ t+rnram�� I • i 111 . t. 0 ,‘'.. —. r— •-173rn —� III /� V 7 l 11 N i z ox d rn*1 !II!• �� f • • • 4 \-\-1, iilli - -C-.. •t, le' l :, t: n O r. a n ro o n'I 11 A� II v v rn d ,.itr r' ' • D • A m L. a c� 7J W li 7 _ (— b Z \ r ' r� z n • • • \ 0 - 4;4 { • OF f : . g x `A ���" I. m ...30. (T A W IN • 1' 9 Homo -too Yaa a..a ...im. na. ona oo. HH rt. xl�l�0aan-i ,fit = l,!l_�Ij __ c m r x x a z m•a z n Z O r z x m H o H m O r A o x s x Z m x in m n o x \\\�-`."��'�//////( / 1l "� also•-, rna." >v•e nv, r mv+ n vzr acro rn rn cvminvn<z�-• 4. �r •i. 4- - ;o.".-r rl rx� myv 'V NON >•+I .-.d s�voov. y 1 an-1-'1 (nz:v We, v,m 71 m O(n ••I ox AOn n nn zrmOX7 •. z• J o z Z m z .-i 1 _<< o n n m n n z x ,v K a -i.v o "n o 0 o m m�l z-I O n-i >': p 1 -•� Hmoz H H m s H sA HO,na r T< mV,O•n am-••-, tr 1 . ali I�- $ rlv ci RI cyox r..rC .,CC. r f5 r f v rlo=r i z �..hrizoo,n * ZT f ./ �; •m• 'n ro m rr .-,Orr. ozwr HO HH rom HW H mWzn z !F�' F' '1 0 :+,CC Coff v s oX.�••,W zH.+ "nm •io o-i •<a zH Hm • il ' r .H yy O•-1 'L a ,aWH w 2rl y•i O m n rn nOZr mV'a f IC Till�U`�U t '.0_. car ,„K,•. n o m z H A , a H H-1 • c,•.. z• ^ I' =o f NE r rHoa +m HmaHa� 00ozf c� L�1a Ym X a x-C rx Ar.-. mm v a Hrl•i H-.no i 00 "s nr~H. r• -tow yaam oa nro .rz ,onto z moomxmomeN Cmmrr*1v+ H< r �rH-! > <,n NVfoDamccn I �r A N x >-I mr<H HOx oz m'v ba2 Hx HVCra;[r- PoA ^ a am a Xo rl aN HxLm 0-I 'O aHa •aa .n0 rroa (� Horn ar n Z O M i4 VS r Hr.. to ,-.A Z xr <i •iv,z mr m annul > m ::: rr v, -Imnc�a 9t • C.") 1 0 cN ti o �' HO o-I n0 mx mO0 cir -1n I) H ,nCH `�+ ,x-. ni Oa arIHO zr Ina,". ,rlm m•-. mOvi s� nyr. <O m� r nv••,x m Wa tom zz0Z ZZrl Ao_ =e \�\� .0 o OM a- z`n Hz r mav,irzl Oa • mtt- H Am,nzw ufI OO a nmom rH A ,Li,,n n a-+ H Hn• io /\�\�\/\/\\\ o �, L Om rt7 mxZm r7�> nm Hz0• aZ v0 .7v� m-' zrl rHn rto oIn •-1>7 VIZ -t .n t7m x ��f Cln 9 (0 rl V. m,n H N z< m rn -1 z N o ,n H > >m r 0 72, �i OH-1 H< m,•. - ZC z-la o ao H < K-. Zo_r -V,m t7 C \ ,+yL m o x om ac m m(1 n z v H v m v, n 0.o a H /I[r��� Odom v z o ton n> ao m rF, A -1- r.mn m C. [--� , r% Z a.•,am •nmz H I -!.. tom L Glv z> �J § // ��i� m VI> n z-.o O o o o a z -•1.'n 2 0 n>m >m z m sI. m<r°- o- x zrr-zo-n--'i arn0 ra-m o-i oz-` In> om,<. zoo. e� �. a. zaa r as HOC CC Za r-. a zn z •N-I H Ho M• •� - y/�6• m,".Z z r V t1 f .6 r n r • xa o aKanxa • O y Ir ., In r V, n H o r m-• r x.-, .. Or r r-• V,o.-. att I z /i In> 00 nz'n-c mz,. H a r a Hr v, H-IC -I L. a. > . • m rev H Mc10 mxKH o v o o< .r -� rx x� Aa mV. -I rnn 'o z-1�SHN tm t ` > �a ama o m oa cx, apH ti Ko vo a amxFlK-cRx at I `) .Q] 5, XI v. F :L r m-,a H z H z o .0m. ,n ,n 1 mHm a o no • r Az r Oo x xH < <m SHAM p 1 Z t. '//' 1 I I O m•, OH HIV CGIr m V. NO m >In0 mmZ t .� • C 'r 4 ^'-im or H.-.a m x ax o z,n�• a v,n l� �� \ as oxrn m- ,W zio m�a z< rIa m mxmz•ri•+.0 1 'in // /// ^r H m Z a X K m r.r a O O N n m x r C O tT7 t y\ Ca -c�Oxz• r '� %' v',;:•,•T;Iw::,11.Vwi::4{l•:10.11,+Y.is I,/4rd,01.,IL.Mr. ,_ __ . ..,w'4,. •• ,.{ t• . ' a��J• ,r. ...,y '.Yad•Her,,•:Po:.i'A.itCwYl'Yh•7-rK:+s4'+N:ntS"u'4"\-