HomeMy WebLinkAboutSWG2023-00375 - SWG Application / Design - 9/6/2023 MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584
SHELTON:360-427-9670,EXT 400
J 4 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: SWG2023-00375
APPLICANT FALK JUDITH L Phone:
Address: 13314 NW 1ST CT VANCOUVER, WA 98685
OWNER FALK JUDITH L Phone:
Address: 13314 NW 1ST CT VANCOUVER, WA 98685
SEPTIC DESIGNER Adam Hunter-Jim Hunter and Phone: 360-753-1226
Associates
Address: PO Box 162 OLYMPIA, WA 98507
Site Address: 5273 E Pickering Rd
Primary Parcel Number: 220095000031
Permit Description: 2-bedroom OSCAR X02 system repair w/OS-50 coils
Permit Submitted Date: 09/06/2023
Permit Issued Date: 09/25/2023
Issued By: David Anderson
Current Permit Fees Paid: $780.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 09/25/2024 (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/healthlenvironmental/onsiteloss-inspection-request.php or call:
360-427-9670, extension 400.
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OFFICIAL USE ONLY
MASON COUNTY PUBLIC HEALTH DATE RECEIVED: lik
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ONSITE SEWAGE SYSTEM APPLICATION AM RECEIVED: �_��e v rn
415 N 6th Street,(Bldg 8) Shelton WA,98584 N
Shelton:360-427-9670 ext 400 Belfair:360-275-4467 ext 400 SW GACID) - lb 0. 1- "' bC :_, (CS'
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APPLICANT PHONE >
J U DY FALK 3607729071 m m
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4;9 MAILING ADDRESS-STREET.CITY,STATE,ZIP CODE
13314 NW 1ST CT VANCOUVER WA 98685
SITE ADDRESS-STREET,CITY.ZIP CODE Co
5273 E PICKERING RD SHELTON WA 98584
NAME OF DESIGNER PHONE J
ADAM HUNTER 3607531226 13�
NAME OF INSTALLER PHONE 153
TBD TBD
CHECK ALL APPLICABLE ITEMS DRINKING WATER SOURCE
❑ NEW CONSTRUCTION ❑ RV HOLDING TANK ONLY EitPRIVATE INDIVIDUAL WELL (n IC
li REPLACEMENT SYSTEM ❑ INSTALLATION PERMIT ONLY 0 PRIVATE TWO-PARTY WELL Z
❑ TABLE 9 REPAIR -_ 0 SINGLE FAMILY ElCOMMUNITY/PUBLIC WATER SYSTEM
❑ TANK(S)ONLY '�' ❑ COMMERCIAL SYSTEM NAME: I
I�(
El UPGRADE TCV6XISTING.9 0 OTHER: BEDROOMS LOT SIZE 'v 1
"Record Drawing required co
El EXISTING FAILURE for all Installations" 2 1.27 O
DIRECTIONS TO SITE-BE'SPECIFIC AND ADVISE OF ANY NEEDED INFORMATION FOR ACCESS(ex.locked gate) C) I
PICKERING RD TO DRIVE ON EAST SIDE (SOUTH OF THE BRIDGE) AT SIGN FOR x lc
5273 la
IV`i
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)
❑VOLUNTARY 0 MAINTENANCE/PUMPING 0 BUILDING PERMIT 0 HOME SALE ❑COMPLAINT 0 OTHER:
INSPECTOR SOIL LOGS COMMENTS/CONDITIONS
i/ 0-1 y\ 'src I✓ rqa
sivosy S7YU "` SEP 0 8 2023
• III '3/f1'160r, + RECEIEVD
SOIL CODES:
V=VERY G=GRAVELLY S=SAND L=LOAM Si=SILT C=CLAY E=EXTREMELY R=ROOTS
INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLI ON APPROVED BY DATE
yr Z 7/Z /Zez ` 705/
zcz3 Z/ZGZ� t
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12/7/2015
DESIGN FORM—PAGE ONE Assessor's Parcel Number: d_ O ) -- 67 S.) -- U 5111 _1_
A design will be reviewed when 3 copies of each of the following are submitted:
'1 Completed design form that has been signed and dated. '1 Scaled layout sketch,including all applicable items on checklist
'1 Scaled plot plan,including all applicable items on checklist. '1 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"X 17"
^�)> PARCEL IDENTIFICATION AI
Permit Number: SWG a/G '90 75 Designer's Name: ADAM HUNTER
JUDY FALK Desi er's Phone Number: 360-753-1226
Applicant's Name: Designer's
13314 NW 1ST CT Designer's Address: PO BOX 162
Mailing Address: g
-1 VANCOUVER WA 98685 OLYMPIA WA 98507
. City State Zip City State Zip
: M ,e ': :. ,'; a. _ .,. ..f4 . .. l!'.: . DESIGNPA.RAIYIETERS.. . 4: _- ' ; Yz� Y. `1', :x '.x:.:
V
Treatment Device
1
❑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: X02
Drainfield Type OSCAR X02(0S-50 COILS)
❑Gravity 0 Pressure 0 Trench 0 Bed 0 Sub Surface Drip
' Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 2 Schedule/Class PER OSCAR
0 Daily Flow:Operating Capacity 180 gpd / Length PER OSCAR ft
Daily Flow: Design Flow 240 gpd , Diameter PER OSCAR in
Septic Tank Capacity 1000 gal % Number 4
Receiving Soil Type(1-6) 5 Separation PER OSCAR ft
Receiving Soil Appl.Rate 0.4 gpd/ft2 Orifices
Required Primary Area 600 ft2 Total Number of Orifices PER OSCAR
Designed Primary Area 600 ft2 Diameter PER OSCAR in
Designed Reserve Area N/A ft2 Spacing PER OSCAR in
Trench/Bed Width 23 ft Manifold
Trench/Bed Length 26.1 ft Schedule/Class 40
Elevation Measurements Length 26 ft
Original Drainfield Area Slope <5 % Diameter 1 in
New Slope,If Altered N/A % Preferred manifold configuration used? ErYes 0 No
Depth of Excavation Up-slope N/A in Transport Pipe
from Original Grade Down-slope N/A in Schedule/Class 40
Designed Vertical Separation 18 in Length 110 SUPPLY+110 RETURN ft
Gravelless Chambers Required? 0 Yes VNo 0 Optional Diameter 1 in
Pump Required? It Yes 0 No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day 411
Difference in Elevation Between Pump Shutoff and Uppermost Dose quantity 0.584 gal
Orifice 38 ft Chamber Capacity 1000 gal
Uppermost Orifice It Higher 0 Lower than PumwEap Shutoff Pump controls: Please check those required.
Capacity @ is - ` : gpm Timer elapse Meter 1�'Event Counter
Calculated'I'otaI ressure' a'a ft If Timer: Pump on 30SEC ,pump off 3MIN
Comments 11 SEP 2 5 2023
•
MASON COUNTY ENVIRONMENTAL HEALTH
Din
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DESIGN FORM—PAGE TWO Assessor's Parcel Number:a D O a -- .5.-- -- Q.S2 Q�1_.
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
Er Test hole locations ' Drainfield orientation and layout Reference depth from original grade:
g Soil logs t2f Trench/bed dimensions and 1' Septic tank
Property lines critical distances within layout a Drainfield cover
g Existing and proposed wells II D-Box/Valve box locations Reference depth from original grade
within 100 ft of property ' Septic tank/pump chamber and restrictive strata:
Measurements to cuts,banks, and locations 0 Laterals,trench/bed,top and
surface water and critical areas a Observation port location bottom
a Location and orientation of E' Clean-out location 0 Curtain drain collector
curtain drain and all absorption Ed Manifold placement 0 Sand augmentation
components a Orifice placement Other cross-section detail:
• Location and dimension of RI Lateral placement with distance & Observation ports/clean-outs
primary system and reserve area to edge of bed Other Information
11 Buildings M Audible/visual alarm referenced Yes No
Er Direction of slope indicator ' Scale of drawing shown on scale g 0 Design staked out
g Waterlines bar 0 0 Recorded Notices attached
21 Roads,easements,driveways, 0 0 Waiver(s)attached
parking 0 ❑ Pump curve attached
g North arrow and scale drawing 0 0 Evaluation of failure
shown on scale bar Non-residential justification
❑ 0 Waste strength
❑ ❑ Flow
DESIGN APPROVAL
The undersigned designer must .: •I t. -. 'y installer at time of installation 0 Yes 0 No
ilk
Signature of Designer Date
The undersigned has reviewed this design on behalf of Mason County Public Healt ned it to be in
compliance with state and local on-site r gulations: ~��
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77?V z�Z 3 sco D
Enviro ental Health Specialist MASO Date ?5 e�?3
N COUNTY f
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING th*OktIVN:
✓ The design is stamped"Approved"by Mason County Public Health. Ni4ETy
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✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: r
✓ 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.
r`,- This form may be scanned and available for public view on the Mason County Web site.
• Updated Date: 12/7/2015
PAGE 1
MASON COUNTY HEALTH DEPARTMENT
ON-SITE SEWAGE DISPOSAL SYSTEM DESIGN
SITE#: PARCEL#:220095000031
DATE SUBMITTED:8/25/2023 LEGAL/LOT#:
SUBMITTED BY: ADAM HUNTER
APPLICANT: JUDY FALK
ADDRESS:
I.CALCULATIONS
NUMBER OF BEDROOMS= 2
RESIDENTIAL GPD FLOW= 240
IF NON-RESIDENTIAL-GPD FLOW
WILL BE AS FOLLOWS:
GPD=
APPLICATION RATE= 0.4 GPD/FT2
REDUCTION=LEAVE BLANK IF NO REDUCTION TAKEN
DRAINFIELD SIZING
4
ABSORPTION AREA= 600 FT2
TRENCH LENGTH OR BED CONFIG.= 26.1'X 23'
PER OSCAR
II.WATERPROOF SEPTIC TANK
COMPOSITION AND SIZE= 1000GAL-X02 TANK
NEW OR EXISTING= NEW
III.DRAINFIELD CROSS SECTION
SAND DEPTH= 0'-6"
IV.PRESSURE CALCULATIONS
USING PIPE CLASS 40
ORIFICE VETAFIM DRIPLINE
LENGTH DIAMETER FLOW FRICTION LOSS
SECTION (FT) (IN) (GPM) (FT)
SUPPLY 110.00 1.00 12.000 8.5298
RETURN 110.00 1.00 12.000 8.5298
TOTAL= 17.0595
TOTAL HEAD LOSS "
1)FRICTION LOSS THROUGH SYSTEM= 17.060
2)ELEVATION DIFFERENCE = 3.800
TOTAL= 20.860
ffr•
8/21/23 APPROVED
Na APP
1 ! 5 2023
^. .. ,11 ..} SEP 2
AN' e. ;:'tf MASON COUNTY ENVIRONMENTAL HEALD-'
' !' '•:?'•11 DJA
i`-• ADAM J.HUNTER ' 11
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•
PAGE 2
V.CHECK THE PUMP CAPACITY.
PUMP: A.Y.MCDONALD 30GPM-1/2HP PUMP(MODEL#22050E2AJ) (PER OSCAR)
EXCESS TDH 50.00 (PER OSCAR)
TOTAL HEAD LOSS IN SYSTEM 20.86 I
STANDARD PUMP CONFIGURATION IS SUFFICIENT? YES
APPROVED
SEP 2 5 2023
MASON COUNTY E V J ONMENTAt HEALT)
ifr8/21/23
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