HomeMy WebLinkAboutSWG2023-00359 - SWG Application / Design - 8/28/2023 MASON COUNTY 415 N 6TH STREET,SHELTON,
967 .E 98584
SHELTON:360-427-9670,EXT 400
BELFAIR:360-275-4467,EXT 400.' ki` g ` ELMA:360-482-5269,EXT 400
Public Health & Human Services
> FAX:360-427-7787
On-Site Sewage System Permit: SWG2023-00359
APPLICANT Garcia Evergreens Phone:
Address: 83 E Wilburs Way SHELTON, WA 98584
OWNER SPARKMAN KENNETH W Phone:
Address: PO BOX 1112 MORTON, WA 98356
SEPTIC DESIGNER DALE TAHJA- Septic Designer Phone: 360-426-5940
Address: 2450 W DEEGAN ROAD WEST SHELTON, WA 98584
Site Address: 161 W WESTFIELD CT
Primary Parcel Number: 420022490040
Permit Description: New commercial 360GPD pressure sandlined bed
Permit Submitted Date: 08/28/2023
Permit Issued Date: 10/03/2023
Issued By: Rhonda Thompson
Current Permit Fees Paid: $1,215.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 10/03/2026 (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.
OFFICIAL USE ONLY
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415 N.6th Steel-Shelton,WA 99586 DATE RECEIVED:
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ON-SITE SEWAGE SYSTEM APPLICATION 3
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APPLICANT PHONE m
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Garcia Evergreens (360) 481-2774 z
MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE 3
83 E. Wilburs Way Shelton WA 98584 al
SITE ADDRESS-STREET,CITY,ZIP CODE
161 W. Westfield Ct. Shelton WA 98584 I
NAME OF DESIGNER PHONE I ivDale L. Tahja (360) 426-5940
NAME OF INSTALLER PHONE I:, I 0
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PERMIT TYPE(serer!one)
DRINKING WATER SOURCE C I O
ERESIDENTIAL OSS 5ICOMMUNITY OSS g COMMERCIAL OSS E!PRIVATE INDIVIDUAL WELL E PRIVATE TWO-PARTY WELL Z I N
TYPE OF WORK(select one) 7 PUBLIC WATER SYSTEM
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I NEW CONSTRUCTION/UPGRADES E REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) 0 TABLE IX REPAIR I IV
SUBMITTALS ll 0 SURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINE CO 1
OESIGN FORM(REQUIRED) glC1:SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE r- I
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3 5.3 acres
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WAIVERS)(IF APPLICABLE) ///``` I 00
DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.locked gate) /� I /)I'�Iw.1.irl/II .tl f�II D
North on Hwy 101, left onto Dayton/Airport Rd., right onto Westfiel t., propertyla / -4 I o
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road to the left. r I o
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SITE MUST BEOaED FROM A(A1N FK7AD Atvo TEST MUST BE F�OGE
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE/FAILURE SOURCE(for reporting purposes)
❑VOLUNTARY 0 MAINTENANCE/PUMPING ❑BUILDING PERMIT ❑HOME SALE ['COMPLAINT ❑OTHER: �44
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INSPECTOR SOIL LOGS COMMENTS/CCNOITIONS 411 / -
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SOIL CODES: ■
' RECORD DRAWING AND INSTALLATION RE'•:1l! 1/V=VERY G=GRAVELLY S=SAND L=LOAM SI=SILT C=CLAY E=E TREMELY R■ROOTS REQUIRED FOR FINAL APPROVAL,
INSPECTOR SIGNATURE DATE APPLICATION EXPIC3Vrtgrr-��� —
RAT APPLICATION APPROVED/ISSUED BY DA
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THIS FORM MAY Bk SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12/72015
4
DESIGN FORM—PAGE ONE Assessor's Parcel Number: 4 2 0 0 2 — 2 4 — 9 0 0 4 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. '1 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 public view on the Mason County Web site.Maximum paper size: 11"X 17"
PARCEL IDENTIFICATION ,
Permit Number: SWG '2,023 — 0a 3S'1 Designer's Name: Dale Tahja
Applicant's Name: Garcia Evergreens Designer's Phone Number: (360)426-5940
Mailing Address: 83 E.Wilburs Way Designer's Address: 2450 W Deegan Rd W
Shelton WA 98584 Shelton WA 98584
City State Zip City State Zip
DESIG`)`1 PATE: .. .
Treatment Device
❑Glendon Biofilter 0 Sand Filter 0 Mound iif Sand Lined Drainfield 0 Recirculating Filter,Type:
❑Aerobic Unit Make/Model 0 Disinfection Unit Make/Model Other:
Drainfield Type
❑Gravity rif Pressure 0 Trench l 'Bed 0 Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
i Number of Bedrooms 360 9r 4 Schedule/Class Sch. 40
Daily Flow: Operating Capacity 270 gpd Length 36 ft
Daily Flow:Design Flow 360 gpd Diameter 1.25 in
Septic Tank Capacity(working) 1,200 gal Number 3
Receiving Soil Type(1-6) 1 Separation 3.33 ft
Receiving Soil Appl.Rate 1.0 gpd/ft2 Orifices
Required Primary Area 360 ft2 Total Number of Orifices 60
Designed Primary Area 360 ft2 Diameter 1/8 in
Designed Reserve Area 360 ft2 Spacing 21 in
Trench/Bed Width 10 ft Manifold
Trench/Bed Length 36 ft Schedule/Class Sch.40
Elevation Measurements Length 6.66 ft
Original Drainfield Area Slope 0 % Diameter 2 in
New Slope,If Altered 0 % Preferred manifold configuration used? 0 Yes Fif No
Depth of Excavation Up-slope 46 in Transport Pipe
from Original Grade Down-slope 46 in Schedule/Class Sch.40
Designed Vertical Separation 24 in Length 120 ft
Gravelless Chambers Required? 0 Yes 0 No 0 Optional Diameter 2 in
Pump Required? SI Yes 0 No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day 4
Duff in Elevation Between Pump&Uppermost Orifice 5 ft Dose quantity 67.5 gal
Drainfield Squirt Height/Selected Residual(head) 6 ft Chamber Capacity(flood) 1,000 gal
Uppermost Orifice G'Higher 0 Lower than Pump Shutoff Pump controls:Please check those required.
Capacity @ Total Pressure Head 30 gpm filTimer l 'Elapse Meter Gil Event Counter
Calculated Total Pressure Head 18 ft If Timer: Pump on 2.25 min. ,pump off5 hrs. 57.75 min
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DESIGN FORM—PAGE TWO Assessor's Parcel Number:4 2 0 0 2 — 2 4 -- 9 0 0 4 0
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
66 Test hole locations 97 Drainfield orientation and layout Reference depth from original grade:
El Soil logs El Trench/bed dimensions and El Septic tank
66 Property lines critical distances within layout 621' Drainfield cover
El Existing and proposed wells El D-Box/Valve box locations Reference depth from original grade
within 100 ft of property It Septic tank/pump chamber and restrictive strata:
VI Measurements to cuts, banks, and locations g1 Laterals,trench/bed,top and
surface water and critical areas g Observation port location bottom
Fii Location and orientation of g Clean-out location ❑ Curtain drain collector
curtain drain and all absorption Ft Manifold placement I Sand augmentation
components 6t Orifice placement Other cross-section detail:
• Location and dimension of El Lateral placement with distance El Observation ports/clean-outs
primary system and reserve area to edge of bed
g Other Information
w Buildings El Audible/visual alarm referenced Yes No
Ft Direction of slope indicator Eli Scale of drawing shown on scale Lz 0 Design staked out
ft Waterlines bar 0 0 Recorded Notices attached
ft Roads,easements,driveways, 0 0 Waiver(s)attached
parking ll 0 Pump curve attached
El North arrow and scale drawing 0 0 Evaluation of failure
shown on scale bar Non-residential justification
O 0 Waste strength
O ❑ Flow
DESVIN APPROVAL
The undersigned designer m be notified install t time of installation El Yes 0 No
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Signature of Designer 'J Date .E Est` • ii 1
The undersigned has reviewed this design on behalf of Mason County Public Health and dete ' ` sein ,I t
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compliance with state and local on-site regulations: 41. +' c,.., . _.N
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Environmental Health Specialist Date "' L"
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CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CON is%tie'
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✓ The design is stamped"Approved"by Mason County Public Health. O ` S 4 4
✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: l (3/2�
✓ 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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APPROVED \
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MASON COUNTY ENVIRONMENTAL HEALTH
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APPROVED
OCT 0 3 2023
MASON COUN i Y ENVIRONMENTAL HEALTh
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Installation/Maintenance
Pressure Distribution/Bed Systems
1. Install bed bottom level and in contour with the ground.
2. Install drainfield during dry weather and soil conditions.Any soil smearing must be
eliminated by hand raking any areas that get smeared.
3. Install audio/visual high-water alarm.
4. Install effluent filter in septic tank outlet or pump vault with 1/16-inch maximum
filtration mesh size.
5. Install check valve in pump outlet line to prevent back-flow into the pump chamber.
6. Install 1/8-inch orifices on 21 inch centers. Install the orifices pointing straight down
(6:00 o' clock).
7. Divert all storm water run-off away from septic system components.
8. No curtain (french) drains allowed within l Oft. of the up-slope edge of the drainfield and
reserve area.
9. No curtain(french) drains allowed within 30ft. of the down-slope edge of the drainfield
and reserve area.
10.Have the septic tank and pump chamber pumped or inspected every 3 to 5 years.
11.Inspect and clean pump screen as needed.
12.Inspect floats and test high water alarm every 6 to 12 months or as needed.
13.All material and workmanship must meet County and State requirements.
14.Install risers on septic tank and pump chamber.
15.Deviation from this approved design without prior approval from the Designer and
Mason County Health Department will make this design null and void.
16.The prepared Site Plan is not a survey, it is the owner's responsibility to verify property
line locations prior to installation. Any discrepancies must be reported to the Designer
immediately.
17. Locate all utilities prior to starting installation.
APPROVED
do fIe OCT 03 2023
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