HomeMy WebLinkAboutSWG2023-00351 - SWG Application / Design - 8/21/2023 MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584
SHELTON:360-427-9670,EXT 400
J I. BELFAIR:360-275-4467,EXT 400
Public Health & Human Services ELMA:360-482-5269,EXT400
FAX:360-427-7787
On-Site Sewage System Permit: SWG2023-00351
APPLICANT Rick Manning Phone:
Address: PO Box 67 SHELTON, WA 98584
OWNER MINEGISHI LLC Phone:
Address: C/O FRED KIKUCHI OR SUE KIKUCHI REDMOND, WA 98052
SEPTIC DESIGNER Bob Paysse -Pioneer Digging Inc Phone: 360-426-1803
Address: 3083 E Mason Benson Road GRAPEVIEW, WA 98546
Site Address: 440 SE Bloomfield Rd
Primary Parcel Number: 319214390030
Permit Description: New SFR -2BR Gravity
Permit Submitted Date: 08/21/2023
Permit Issued Date: 09/21/2023
Issued By: Jeff Wilmoth
Current Permit Fees Paid: $525.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 08/21/2026 (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.
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OFFICIAL USE ONLY
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ON-SITE SEWAGE SYSTEM APPLICATION
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APPLICANT PHO1 L m
RICK MANNING z
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PO BOX 67 SHELTON WA 98584m
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SITE ADDRESS-4 STREET 40 SE BLOOMFIELD ROAD SHELTON WA 98584 I ()`'
NAME OF DESIGNER PHONE
ROBERT H. PAYSSE 360-426-1803
NAME OF INSTALLER PHONE v I
TBD Z I N
PERMIT TYPE(select one) DRINKING WATER SOURCE
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W-RESIDENTIAL OSS COMMUNITY OSS fir COMMERCIAL OSS If PRIVATE INDIVIDUAL WELL 6 PRIVATE TWO-PARTY WELL Z I
TYPE OF WORK(select one)
R PUBLIC WATER SYSTEM r
WI-NEW CONSTRUCTION/UPGRADES la REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) 0 TABLE IX REPAIR 14'
SUBMITTALS ElSURFACING SEWAGE CIEXISTING FAILURE ElSHORELINE
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In DESIGN FORM(REQUIRED) SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE r I co
6WAIVER(S)(IF APPLICABLE) 2 4.9 o I
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DIRECTIONS TO SITE AND SITE CONDITIONS.(ex locked gate)
SOUTH ON OLD OLYMPIC HWY TO LEFT ON BLOOMFIELD ROAD. FOLLOW TO SITE I
ADDRESS AND PDI SIGN ON RIGHT. FOLLOW PINK RIBBONS TO SITE. o I o
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SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. I Q
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE I FAILURE SOURCE(tor reporting purposes)
❑VOLUNTARY ❑MAINTENANCE/PUMPING ❑BUILDING PERMIT ❑HOME SALE OCOMPLAINT ❑OTHER
INSPECTOR SOIL LOGS COMMENTS/CONDITIONS
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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.
INS C OR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED/ISSUED BY DATE
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TH FO Y BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12/7/2015
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DESIGN FORM-PAGE ONE Assessors Parcel Number: 3 1 9 2 1 — 4 3 — 9 0 0 3 0
A design will be reviewed when 3 copies of each of the following are submitted:
o Completed design form that has been signed and dated. 0 Scaled layout sketch,including all applicable items on checklist
0 Scaled plot plan,including all applicable items on checklist. o 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.ILla>rinrunr paper size: 11"X 17"
PARCEL IDENTIFICATION
Permit Number: SWG o)Z3 —("D 35( Designer's Name: ROBERT H.PAYSSE
Applicant's Name: RICK MANNING Designer's Phone Number: 360-426-1803
Mailing Address: PO BOX 67 Designer's Address: 3083 E MASON BENSON RD
SHELTON WA 98584 GRAPEVIEW WA 98546
City State Zip City State Zip
DESIGN PARAMETERS
Treatment Device
❑Glendon Biofilter 0 Sand Filter 0 Mound ❑Sand Lined Drainfield 0 Recirculating Filter,Type:
❑Aerobic Unit Make'Model ❑ Disinfection Unit Make/Model Other:
Drainfield Type
'Gravity 0 Pressure It 'Trench 0 Bed ❑ Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 2 Schedule/Class 2729 PERF
Daily Flow:Operating Capacity 180 gpd Length 50 ft
Daily Flow:Design Flow 240 gpd Diameter 4 in
Septic Tank Capacity(working) 1200 gal Number 2
Receiving Soil Type(1-6) 3 Separation 10 ft
Receiving Soil Appl.Rate 0.8 gpd/ft2 Orifices
Required Primary Area 300 ft2 Total Number of Orifices -
Designed Primary Area 300 ft2 Diameter - in
Designed Reserve Area 300 ft2 Spacing - in
Trench/Bed Width 3 ft Manifold
Trench/Bed Length 100 ft Schedule/Class 3034
Elevation Measurements Length 10 ft
Original Drainfield Area Slope 2 % Diameter 4 in
New Slope,If Altered 2 % Preferred manifold configuration used? Ii1'Yes 0 No
Depth of Excavation Up-slope 12 in Transport Pipe
from Original Grade Dom.slope 11 in Schedule/Class 3034
Designed Vertical Separation 36+ in Length <30 ft
Gravelless Chambers Required? 0 Yes Vi No 0 Optional Diameter 4 in
Pump Required? 0 Yes liti No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day -
Diff.in Elevation Between Pump&Uppermost Orifice - ft Dose quantity - gal
Drainfield Squirt Height/Selected Residual(head) - ft Chamber Capacity(flood) - gal
Uppermost Orifice❑Higher 0 Lower than Pump Shutoff Pump controls:Please check those required.
Capacity @ Total Pressure Head - gpm ❑Timer ❑Elapse Meter 0 Event Counter
Calculated Total Pressure Head - ft If Timer: Pump o p p R Pump off -
Comments 0 V E h
SEP 2 12023 rr
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DESIGN FORM—PAGE TWO Assessor's Parcel Number: 3 1 9 2 1 -- 4 3 -- 9 0 0 3 0
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
El Test hole locations it Drainfield orientation and layout Reference depth from original grade:
7 Soil logs 7 Trench/bed dimensions and 7 Septic tank
7 Property lines critical distances within layout 7 Drainfield cover
7 Existingand proposed wells 7 D-Box/Valve box locations
P Po Reference depth from original grade
within 100 ft of property 7 Septic tank/pump chamber and restrictive strata:
7 Measurements to cuts,banks, and locations 7 Laterals,trench/bed,top and
surface water and critical areas 7 Observation port location bottom
7 Location and orientation of 7 Clean-out location 0 Curtain drain collector
curtain drain and all absorption 7 Manifold placement 0 Sand augmentation
components RI Orifice placement Other cross-section detail:
7 Location and dimension of Lateral placement with distance 7 Observation ports/clean-outs
primary system and reserve area to edge of bed
Buildings g Other Information
Fii
7 Audible/visual alarm referenced Yes No
Iii Direction of slope indicator 7 Scale of drawing shown on scale 7 0 Design staked out
7 Waterlines P
P R 0 V E 'u ❑ 7 Recorded Notices attached
7 Roads,easements,driveways, • 0 7 Waiver(s)attached
parking SEP 2 1 2023 •❑ 7 Pump curve attached
7 North arrow and scale drawing c.' o RI Evaluation of failure
shown on scale bar MASON COUNTY ENVIRONMENTAL HEALHNon-residential justification
J BW 0 lid Waste strength
❑ 7 Flow
DESIGN APPROVAL
The undersigned designer must be notified by • to at time of installation 7 Yes 0 No
ti-9i46iX 8 ,2 (2-_3__
ci attire of signer 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- ' regul.tions:
- �A Lj k,K,JJ Gl-2('Z7)
Env. o . Health Specialist Date
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
I The design is stamped"Approved'by Mason County Public Health.
I The Onsite Sewage Permit has not expired,the Permit Expiration Date is: ej—ei —2.CP
✓ 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: 12/712015
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NAN ASBUILT/INSTALL SIGNOFF FEE WILL
BE CHARGED AT TIME OF INSTALLATION
ells I OMLR: RICK MANNING; TEST HOLE I: TEST HOLE 2
PIONEER DIGGING, INC. PARCEL 3192143 90030 0 48 CAS 0 56 GLS
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SEPTIC DESIGNS ADDRESS: 44o BLOOMFIUD RD ROOTS•48 ROOTS-56
3083 E.MASON BENSON R.D. GRAPEV1EW,WA 98546 DESIGNER: ROBERT FL PAYSSE: DIATSOR 71118 IS NOT A SURVEY.REFERENCES INCLUDE APPLICANT/COUNTY PROVOEE
PUTS OR SURVEYS.FELD MEASUREMENTS AND COUNTY GS.DESIGN MENDED FOR SEPTIC
OFFICE-360-426-1803 FAX-360427 2.353 SHEET: SITE PLAN SCALE I'=100' EPARTTAAENTT€ENCY REVIEW EDSK,NER NOT RESPONSIBLE FO DEvELOINAENT MAYORR SETBACKS U RELATEDTC
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AN ASBUILTI INSTALL SIGNOFF FEE WILL AN PORT (X?)
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SEPTIC DESIGNS ADDRESS: 440 BLOOMFIH D RD ROOTS-48 ROOTS-56
3083 E MASON BENSON R.D. (.;RAI'EVIEW,WA985F6 DESIGNER: ROBERT I I.PAYSSG FSATTSOR SIRvEYLAIMER:THISSSF,E DAMEASUREMENTSANDCOUNTYS �DESIGCNINENDEDFORCOUNTY OSEPM
OFFICE-360-426-1803 FAX-360-427-2353 SHEET: DF DETAIL SCALE 1 =10' PURPOSES ONLY PROPOSED DEVEENT MAY BE SRAECT TO OTHER
DEPARTMENT/AGENCY REVIEW DESIGNER NOT OT RESPONSIBLE FOR RETRACES UNRELATED IC
SEPTIC COMPONENTS
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Installation & System Notes
1. Installer must contact designer for final inspection of the installation prior to cover. All components,including tanks,lids,
transport line,drainfield,and water lines must be open for inspection. A$350.00 fee will be charged for time involved with the
inspection of the installation and creation of the record drawing. The designer reserves the right to charge additional fees if
multiple visits are needed due to installation errors or inaccessible components.
2.This septic design must be installed by a certified installer with the local health department. All components shall be installed
according to state,county,and manufacturer requirements. For Homeowner Installs,the owner must get approval from the
designer and local health department prior to attempting installation.
3. Designer is not a surveyor. Installer must familiarize themselves with property line locations prior to installation. Any
confusion or conflicts with line locations should be reported to the property owner. A licensed surveyor may be necessary prior
to installation to confirm all line locations. Any discrepancies found must be reported to the designer immediately.
4. Drainfield area may only be cleared by a licensed installer familiar with sensitive drainfield area preservation. The builder,lot
developer,or property owner shall not clear the drainfield area. Any clearing required for drainfield installation shall not
remove or disturb any top soil in Primary and Reserve areas. Removal or disturbance to drainfield soils could render design
void.
5.The property owner and installer are responsible for locating all underground utilities (ex.water,gas,electric) prior to
installation. Any utility locations shown within design drawings are likely approximate and may not be exact.
6.All proposed tanks must be installed on original soils or compacted gravels. Extend all tank connection lines out onto original
soil to avoid settling issues. Risers and lids must be brought to finished grade and left accessible for future operations and
maintenance. Component manufacturers (ex.ATU,Glendons,) may have other requirements not listed within this design.
7.All electrical wiring shall be done by a licensed electrician or homeowner(if allowed) and must be permitted through Labor
and Industries.
8.The proposed septic system should be installed in dry weather conditions. Any failed attempts at installation during wet
weather conditions may render this design void.
9. Maintain loft to waterlines with all septic components. If less than 10ft is required,sleeving in sch. 40 pvc is required. If
sewage transport lines and waterlines must cross,waterline must be 18" above sewage line with one of the lines sleeved in sch.
40 pvc loft in each direction of crossing.
10.This design may include waiver applications with specific mitigation measures pertaining to installation,operation and
maintenance of the proposed components.
11. Stormwater runoff,footing drains, roof drains must be diverted away from any septic system components. No curtain,
foundation, perimeter drains shall be installed 30ft downslope and 10ft upslope of drainfield areas.
12.This design is site specific and intended to meet state and county requirements that are related to the system components
being proposed. Any placement of proposed buildings, proposed wells or other non-related items on these drawings may or
may not meet other requirements.
13. All onsite septic systems require regular maintenance to verify satisfactory operation. The system owner/operator is
responsible for the continuous operation and maintenance of the system per WAC 246-272A. For operation and maintenance
information, refer to Mason County Public Health Homeowner's Manual,which should be received after installa`tion approval.
14. System owner should be cautious of landscaping around septic components. Roothitrysion`JC(day h
can cause premature failure of the drainfield area. In addition, bushes and trees should sgpt ` 1 2023 he
away from lids and other septic maintenance points. NTY '0RC
15. Changes made at time of installation may impact designer calculations,pump sizing,and `�� '�`vTAC h6q(Th
compliance w/county and state requirements. Contact designer prior to install w/any 4,4`
proposed variations from design. Changes may result in additional fees and permitting. '.` p .Y
LISTOMER: RICK MANNING (.2 �'•�
PIONEER DIGGING INC.
O PARCEL#.31921-43-90030
SEPTIC DESIGNS ADDRESS: 440 BLOOMFlFLD RD ,rr ��• �,=�xtnY
3083 L MASON BENSON RD. GRAPEVIEN,H A'»*1-0 DESIGNER ROBERT 11.PAYSSE E ""
OrrICE-360.426-1803 rAX-360-427-2353 SHEET: NOTES SCALE: NA