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HomeMy WebLinkAboutSWG2023-00382 - SWG Application / Design - 9/11/2023 MASON COUNTY 415N6TH STREET,SHELTON,WA98584 041, 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: SWG2023-00382 APPLICANT HOLMES KATHLEEN R Phone: Address: PO BOX 98093 LAKEWOOD, WA 98496 OWNER HOLMES KATHLEEN R Phone: Address: PO BOX 98093 LAKEWOOD, WA 98496 SEPTIC DESIGNER DALE TAHJA-Septic Designer Phone: 360-426-5940 Address: 2450 W DEEGAN ROAD WEST SHELTON,WA 98584 Site Address: XXX N Kokanee Cove Way Primary Parcel Number: 422165000080 Permit Description: New SFR-2BR Sand Lined Pressure Bed Permit Submitted Date: 09/11/2023 Permit Issued Date: 10/04/2023 Issued By: Jeff Wilmoth Current Permit Fees Paid: $780.00 (additional ees may be required upon Installation of system). Permit Expiration Date: 10/04/2026 (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 DATE RECEIVED: Q MASON COUNTY 1 • % I • y COMMUNITY SERVICES Wm RECEIVE CO IInn Publk Healt(Community Health/Environmental Health) �• O (a Lo�,.aC SWG �>>r o03873 zz N ON-SITE SEWAGE SYSTEM APPLICATION D A m APPOCANT PHONE m Kathleen Homes (253) 302-6277 r c MAILING ADDRESS-STREET crn STATE,ZIP CODE co 3. P.O. Box 98093 Lakewood WA 98496 co z • A SITCADDRESS-STREET CITY,ZIP CODE C N. Kokanee Cove Dr. Hoodsport WA 98548 0 I a NAME OF DESIGNER PHONE Dale L. Tahja (360) 426-5940 3 N NAME OF INSTALLER PHONE a I N PERMITTYPE(selector* C DRINKING WATER SOURCE y I ' tiRESIDENTIAL O55 COMMUNITY OSS bCOMMERCIALOSS ff PRIVATE INDIVIDUAL WELL 6 PRIVATE TWO-PARTY WELL a Im TYPE OFV WORK(Sabel cnel G'. Ia2.PUBLIC WATER SYSTEM Lake Guthman Wmm Co. y)'.NEW CONSTRUCTION I UPGRADES ftREPAIR/REPLACEMENT OTHER DETAILS(spied all thatappyl 0 TABLE IX REPAIR (ID IQI SuappMl''...��TTALS ❑ SURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINE m LLp:.:DESIGN FORM(REQUIRED) SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE r IC. L_L'WAIVER(S)(IF APPLICABLE) 2 0.29 acreNorth on Hwy n I I O DIRECTIONS TO SITE AND SITE CONDRIONS.(ex /caked gate) North on Hwy 101 to Hoodsport, left on Hwy 119, left on CushmanrPetlaeh-Rd-.,Fghton--1 I CD Lower Lake Rd., right on Dow Cr. Rd., left on Kokanee Cove Dr., property on the left. r0 I O 11 ICO coSIRE MUST BEFLAGGED FROM MAIN ROAD.5d0TEST HOLES WSf DE FLAGGED WITH TEST HOLE NUMBERS. 0 I 0 OFFICIAL USE ONLY BELOW THIS LINE — UPGRADE/FAILURE SOURCE(artrtepmfing ryryaaes) ❑VOLUNTARY 0 MAINTENANCE/PUMPING C BUILDING PERMIT ❑HOME SALE ❑COMPLAINT 0 OTHER: IP INSPECTOR SOIL LOGS �/p COMMENTS I CONDI-DONS `yam I II 2, tV •eez . e" f I � �Ty �c j Z tb_ TN L' li c-fcjcrAc �I out 1 ,a4"3id b ,ks7 w <3•^: p Tff3: (�1Ar`2- 1x l Z 1 t11%4;dp Zi.° 1,•-rc, 2 SOILCOOES: RECORD ORAWNG AND INSTALLATION REPORT ` V-VERY G=GRAVELLY S=SAND L=LOAM S=SILT C=CLAY E=EXTREMELY R=ROOTS REQUIRED FOR FINAL APPROVAL. INS//JTOp�q�)SIGNATURE DATE APPLICATION EXPIRATION DATE LI ATION APPROVED/ISSUED BY DATE HIS M LAJilAn ( D_'r-z) Gl —[I —z Co e�Cddi l0 - Y- _3 T F RM 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: 4 2 2 1 6 — 5 0 — 0 0 0 8 0 A design will be reviewed when 3 conies of each of the following are submitted: r Completed design form that has been signed and dated. "Scaled layout sketch,including all applicable items on checklist te Scaled plot plan,including all applicable items on checklist. v 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" �ry�� PARCEL fORMwlCATI©N Permit Number: SWG 2-02:5 — "l /3 2-- Designer's Name: Dale Tahja Applicant's Name: Kathleen Holmes Designer's Phone Number: (360)426-5940 Mailing Address: P.O.Box 98093 Designer's Address: 2450 W Deegan Rd W Lakewood WA 98496 Shelton WA 98584 City State Zip City State Zip Dlf:$AGNPApAM61E83 Treatment Device ❑Glendon Biofilter ❑Sand Filter 0 Mound It Sand Lined Drainfield ❑Recirculating Filter.Type: ❑Aerobic Unit Make/Model 0 Disinfection Unit Make/Model Other: Drainfield Type ❑Gravity Hi Pressure 0 Trench fib Bed 0 Sub Surface Drip Septic Tank/Drainfield Specifications Laterals Number of Bedrooms 2 Schedule/Class Sch. 40 Daily Flow: Operating Capacity 180 gpd Length 35 ft Daily Flow: Design Flow 240 gpd Diameter 1.25 in Septic Tank Capacity(working) 1,250 gal Number 2 Receiving Soil Type(I-6) 1 Separation 3.5 ft Receiving Soil Appl.Rate 0.1 /ftz Orifices Required Primary Area 240 ft' Total Number of Orifices 42 Designed Primary Area 240 ft' Diameter 1/8 in Designed Reserve Area 240 ft2 Spacing 20 in Trench/Bed Width 7 ft Manifold Trench/Bed Length 35 ft Schedule/Class Sch.40 Elevation Measurements Length 3.5 ft Original Drainfield Area Slope 0 p/ Diameter 2 in New Slope,If Altered 0 % Preferred manifold configuration used? O Yes l7f No Depth of Excavation Up-slops 46 in Transport Pipe from Original Grade oom-smp.. 46 in Schedule/Class Sch. 40 Designed Vertical Separation 24 in Length 10 ft Gravelless Chambers Required? 0 Yes 0 No l7lOptional Diameter 2 in Pump Required? ES Yes 0 No Dosing and Pump Chamber Pump/Siphon Specifications Number of doses/day 4 Diff. in Elevation Between Pump&Uppermost Orifice 5 ft Dose quantity 45 gal Drainfield Squirt Height/Selected Residual(head) 6 ft Chamber Capacity(flood) 1,000 gal PUppermost Orifice Higher ❑Lower than Pump Shutoff P controls:Please check those required. Capacity @ Total Pressure Head 20 gpm HiTimer 2'Elapse Meter Hi Event Counter Calculated Total Pressure Head 15 ft I If Timer. Pump on 2.25 min ,pump off 5 his 57.75 min Comments p Submittal to replace expired septic permit SWG2018-00417. No test holes p pp��d, Se2�R , ,h expired septic application for soil log. OCT 0 4 2023 iv, MASON COUNTY EN\1ECy':'E>!TP_HEALTH JBW DESIGN FORM—PAGE TWO Assessor's Parcel Number:4 2 2 1 6 -- 5 0 -- 0 0 0. 8 0 Permit Number: SWG DESIGN CIIECKLISTSc Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch PH Test hole locations g Drainfield orientation and layout Reference depth from original grade: 1A Soil logs g Trench/bed dimensions and Ig Septic tank g Property lines critical distances within layout 671 Drainfield cover • Existing and proposed wells lif D-Box/Valve box locations Reference depth from original grade within 100 ft of property g Septic tank/pump chamber and restrictive strata: O Measurements to cuts, banks,and locations Laterals,trench/bed,top and surface water and critical areas 6if Observation port location bottom 60 Location and orientation of 6d Clean-out location 0 Curtain drain collector curtain drain and all absorption 121 Manifold placement g Sand augmentation components 0 Orifice placement Other cross-section detail: 6rJ Location and dimension of lii Lateral placement with distance g Observation ports/clean-outs primary system and reserve area to edge of bed Other Information 6r] Buildings &1 Audible/visual alarm referenced Yes No g Direction of slope indicator g Scale of drawing shown on scale C+1 ❑ Design staked out wl Waterlines bar 0 ❑ Recorded Notices attached 69 Roads,easements,driveways, 0 0 Waiver(s)attached parking g 0 Pump curve attached wl North arrow and scale drawing 0 ❑Evaluation of failure shown on scale bar Non-residential justification O 0 Waste strength O ❑ Flow DESIGN APPROVAL The undersigned designer t be notifi 7 at time of installation 51 Yes 0 No • �i • Signature of Designer Date •"•SJ " ',F6 r,4 The undersigned has reviewed " design on behalf of Mason County Public Health and de ,.,.'t.:..; - in i" t compliance with state and to•sit; regulations: v *F, ta.pf; it Leen 'nvi r 'mental Health Specialist Date �I1`y� fa .` CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDIT�'Itly`,f j ✓ The design is stamped"Approved" by Mason County Public Health. J h I The Onsite Sewage Permit has not expired,the Permit Expiration Date is: CAI-i(-7.-49 ,, ) ✓ 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 ?bJjct IAn Installation Fee is required. k. OCT 0 4 zu'ts This form may be scanned and available for public view on the Mason Co 'W�1 E VIRCNLIENTAL HEALTH M' O�u�s tjp tiWate: 12/7i2015 for 1 ivak\c\\P-QS\ \Ac\hws •3,rca\t ` ` \ t O(0-50;O irji� \sa�e.Cnh-sporN `\ \.-- :: dip/ 1by ., Oat\e `L-�a� o, gs, -,- K, \• If (.- y p� C Vic ,, o' Jr inCa- - . . • <..._ , - y ,. "PROVE \ ► r o 4 2023 -fie l�\QPI pg \ , vASONCCUNc EN:.;r..= , r ;\ ,%' BW N,/ \\ c OA 12 O O (: .3 z-_ram'' 'feeP, i ph- <o t.•: 'ii � .r .,A ' \tv II .4",'�.. s 00214 v'. VI v NJ (h v� ��. DALE T A ♦ jr)n V ea V - i 7 ‘ ; r .• r N. ve__ �� ..may ` . . . I wit 1411111IL4fr: ant1I V k 'Ato -1 1 t. , w .UO tr t Ro\A Clf'-nn G..k \\ .i . - -4� � a� A-,) l- ; `' �,l Sr1m,ti10 ''ve - ,ll ,1,..... rierS"t ,et, _ -`�— ' — tt (t\cScc -� tea-,`neAe o P P R O VE der x /-1`. .r .1" C-4 A OCT 0 4 2023 ( r satr �,._ rp 1 .. ' 1, JBW �,1;Writ \�N s 1 It sr II w}h S1�G714 ,, c It iS DALE L TA"JA '''! . , ` 1!-f NEED ug51 NER i A C "'Sky4 1•5, 4�:+", �wn�ws".v1. 1lO CT F Media Gallery X Liberty Pumps 280- 1/2 HP Cast Iron Submersible Sump/Effluent Pump (Non- Automatic) Performance Curve: 280-Series 1 40 i 7- -- I - 351 t '- - • - i- - • ? - , 1 - - - - = 1--- --- - - - • r -4- -* * 30 i • • • I • ' . ` ' • • rd. “--‘-r-."‘ - r-.- 1-.- 4 1--• 7 • - - - - 1 - - .1 - • • 1 = dn. ea Lt. ----- 20 -..-1------- -- . - i - ,--- = I .4..4 . '0 1 al1 5 ; - • = -10-= - - - - - - -- = - - -- - W 4 , • I- --• 4 1 1 ' 1 10 I -'----5- .. r 4---#---.-- 1 4- 4 1-- 5 4 = -r • • • , 0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 U.S. Gallons Per Minute 4 Pftp , . t, liefs ,vmscjA 06,10 jvCouk 4 elkh / et u Jaw 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 I/8-inch orifices on 20 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 1 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. i i+A . i PPPOu � ,s. �a t%$dr t. "O- •ALE L. IA $ \1 L10ENS D D S1 NER ' 11 S. LS; - •