HomeMy WebLinkAboutSWG2023-00363 - SWG Application / Design - 9/30/2023 MASON COUNTY 015 N 6TH STREET,SHELTON,WA 98584
HelSHELTON:360-427-9670,EXT 400
le BELFAIR:360-275-4467,EXT 400
r Public Health & Human Services ELMA:360-482-5269,EXT 400
FAX:360-427-7787
On-Site Sewage System Permit: SWG2023-00363
APPLICANT STEPHENS CYNTHIA P&JEFFREY K Phone: 253-377-1207
Address: 3911 N 25TH ST, APT 204 TACOMA, WA 98406
OWNER STEPHENS CYNTHIA P &JEFFREY K Phone: 253-377-1207
Address: 3911 N 25TH ST, APT 204 TACOMA, WA 98406
SEPTIC DESIGNER Bob Paysse -Pioneer Digging Inc Phone: 360-426-1803
Address: 3083 E Mason Benson Road GRAPEVIEW, WA 98546
Site Address: 17681 E State Route 106
Primary Parcel Number: 222125800034
Permit Description: New SFR-3BR OSCAR X02
Permit Submitted Date: 08/30/2023
Permit Issued Date: 10/04/2023
Issued By: Jeff Wilmoth
Current Permit Fees Paid: $525.00 (additional fees may be required upon mstallalion of system.
Permit Expiration Date: 08/30/2026 (based on date of inspection)
Permit Conditions:
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/environmentallonsite/oss-inspection-request.php or call:
360-427-9670,extension 400.
OFFICIAL USE ONLY
MASON COUNTY RECEIVED 3V , >
COMMUNITY SERVICES at
AM BNI �� RETH m y
0
G N
PubB[INtlih(Community Health/Environmental Health) G (A
cr n GE rune mama(vagary: DATE SWG10L3 -CMGS ° y
ON-SITE SEWAGE SYSTEM APPLICATION n 'n
3 n A
APPLICANT PHONE m m
JEFF STEPHENS z
c
MAILING ADDRESS-STREET CITY,STATE.ZIP CODE 3
3911 N 25TH ST, APT 204 TACOMA WA 98406 m
A
SITEADDRESS r STREET.CITY ZIP CODE
17681 STATE ROUTE 106 BELFAIR WA 98528 I ^'
NAME OF DESIGNER PHONE I N
ROBERT H. PAYSSE 360-426-1803
NAME OF INSTALLER PHONE I N
TBD
PERMIT TYPE(tel%I eFM DRINKING WATER SOURCE -
p
PI RESIDENTIALOSS FCOMMUNITY OSS hI COMMERCIAL O55 .ft PRIVATE INDIVIDUAL WELL 6 PRIVATE TWO-PARTY WELL $ IN
TYPE OF%NOR(paled one) 2. PUBLIC WATER SYSTEM BELFAIR WATER
ff NEWCONSTRUCTION/UPGRADES FI REPAIR I REPLACEMENT OTHER DETAILS Iseled all that appry) 0 TABLE IX REPAIR I SJI
SUBMITTALS 0 SURFACING SEWAGE 0 EXISTING FAILURE iii SHORELINE
W DESIGN FORM(REQUIRED) jI SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE •
m I co p
IYI WAIVER(S)(IF APPLICABLE) 3 0.35
DIRECTIONS TO SITE AND SITE CONDITIONS Ie.bead gale(
FROM BELFAIR, HEAD SOUTH ON STATE ROUTE 106. SITE ADDRESS 17681 ON 10
RIGHT. o I o
ti
ATTN: JEFF WILMOTH I w
SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST MOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS- I A
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE I FAILURE SOURCE Eor reporting purposes(
❑VOLUNTARY 0 MAINTENANCE/PUMPING O BUILDING PERMIT 0HOME SALE ❑COMPLAINT (OTHER.
INSPEC-OR SOIL LOGS 1 COMMENTS I CONDITIONS
� N� rli1N ,5Icre
506 /144 rot l -2 y -t 27 (- )
RECORD DRAWING AND INSTALLATION REPORT
SOIL CODES:
V VERY G=GRAVELLY S=SAND L=LOAM Si=SILT C-CLAY E-EXTREME_ R-ROOTS REQUIRED FOR FINAL APPROVAL
`CT OR SIGNATURE DATE APPLICATION EXPIRATION DATE APP CA ONAPPROVED/15SUEDE DATEOR SIGNATURE DATE APPLICATION CATION EXPIRATION DATE APP CA ONISSUEDF
T 5 AY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED'.2O2015 — l3
•
DESIGN FORM—PACE ONE Assessor's Parcel Number: 2 2 2 1 2 — 5 8 — 0 0 0 3 4
A design will be reviewed when 3 copies of each of the following are submitted:
Completed design form that has been signed and dated. " Scaled layout sketch,including all applicable items on checklist
v 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: II"X /7"
PARCEL IDENTIFICATION
Permit Number: SWG ,7 oz w
3— l tic 3 Designer's Name: ROBERT H.PAYSSE
Applicant's Name: JEFF STEPHENS Designer's Phone Number: 360-426-1803
Mailing Address: 3911 N 25TH ST.APT 204. --_ Designer's Address: 3083 E MASON BENSON RD
TACOMA WA 98406 GRAPEVIEW WA 98546
City State Zip City Slate Zip
DESIGN PARAMETERS
Treatment Device
❑Glendon thornier 0 Sand Filter ❑ Mound 0 Sand Lined Orainticld 0 Recirculating Filler.Type:
fidAerobic Unit Make/Model OSCAR X02 ❑ Disinfection Unit Make/Model Other:
Drainfield Type
❑Gravity 0 Pressure 0 Trench 0 Bed g Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 3 Schedule/Class NETAFIM
Daily Flow: Operating Capacity 270 gpd Length 6 COILS ft
Daily Flow: Design Flow 360 gpd Diameter 0.5 in
Septic Tank Capacity(working) 1200 gal Number 3 LATERALS
Receiving Soil Type(I-6) 3 Separation 0.5 ft
Receiving Soil Appl. Rate 0.8 gpd/ft2 Orifices
Required Primary Area 450 ft2 'Iota]Number of Orifices 300 EMITTERS
Designed Primary Arca 455 ft2 Diameter 0.42 GPH in
Designed Reserve Area 455 IN Spacing 12 in
Trench/Red Width 13 ft Manifold
1 rench/Bed length 35 ft Schedule/Class SCH. 40
Elevation Measurements Length 30 ft
Original Drainfield Area Slope 0 /o n i,,Diameter 1 in
e
New Slope. If Altered 0 +' / y t et��l tpppppppni�ldrr,`prffigura[ion used? ( Yes 0 No
Depth of Excavation Up-slope & PER MFR n 8f t Transport Pipe
from Original Grade oo'„i slu e // )��
a PER MF n "SCTet1u lass W SCH. 40
Designed Vertical Separation 24+ - In Length <50 ft
Graveness Chambers Required? 0 Yes 0 No 0 Optional .iB4*r 1 in
Pump Required? g Yes 0 No Dosing and Pump Chamber
Pump/Siphon Specifications Number ofdosesday PER MFR
Diff.in Elevation Between Pump& Uppermost Orifice 20 R Dose quantity PER MFR gal
Drainfield Squirt Height/Selected Residual(head) - ft Chamber Capacity(Flood) 1200 gal
Uppermost Orifice g Higher 0 Lower than Pump Shutoff Pump controls: Please check those required.
Capacity @ Total Pressure Head 6.9 gpm Timer gElapse Meter M Event Counter
Calculated Total Pressure Head - _ ft If Timer Pump on PER MFR .pump off PER MFR
Comments
THE DISCHARGE PUMP IS AN LOWRIDGE ONSITE TECH., 1/2 HP, 30 GPM, MODEL LOT-30
DOUBLE-COAT CONCRETE TANKS AND TEST FOR LEAKS PER WAIVER REQUIREMENTS.
DESIGN FORM—PAGE TWO Assessor's Parcel Number:2 2 2 1 2 -- 5 8 -- 0 0 0 3 4
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
g lest hole locations fid Draintield orientation and layout Reference depth from original grade:
g Soil logs g Trench/bed dimensions and g Septic tank
g Property lines critical distances within layout g Drainfield cover
g Existing and proposed wells g D-Box/Valve box locations Reference depth from original grade
within 100 ft of property 65 Septic tank/pump chamber and restrictive strata:
g Measurements to cuts,banks,and locations 12 Laterals, trench/bed,top and
surface water and critical areas fd Observation port location bottom
g Location and orientation of g Clean-out location 0 Curtain drain collector
curtain drain and all absorption fs?1 Manifold placement D Sand augmentation
components
Orifice placement Other cross-section detail:
g Location and dimension of Lateral placement with distance g Observation ports/clean-outs
primary system and reserve area toed edge of bed
6 Other Information
EZI Buildings m Audible/visual alarm referenced Yes No
g Direction of slope indicator
g Scale of drawing shown on scale d 0 Design staked out
WI Waterlines bar ❑ g Recorded Notices attached
g Roads,easements,driveways, g 0 Waiver(s)attached
parking 0 g Pump curve attached
• North arrow and scale drawing �r ,- 1 e! :��
E ❑ lif Evaluation of failure
shown on scale bar I Lr Non-residential justification
dgW ❑ It Waste strength
0 g Flow
DESIGN APPROVAL
The undersigned designer must be notified by installer at time of installation Ili Yes 0 No
Signature of Designer G 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 'ite regulations:
E vir m ntal Health Specialist Date
CAUTION: DESIGN APP OVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
/ The design is stamped "Approved-by Mason County Public Health.
/ The Onsite Sewage Permit has not expired.the Permit Expiration Date is:
✓ Drainfield site conditions have not been altered to adversely affect conditions of design approval. �'-' 0
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: 1217/2015
N.
N. BIG CEDAR
, • i /
HOOD CANAL L� 3 BEDROOM OSX-360-5
,'' A:CQ PRIMARY 13X35=455 SOFT
N./ CW/ SETBACK WAIVER)
S0 n2 / RESERVE 100%
,p
; .% N,
CO / �'1 0 0
X02 TANKS / // V„0 _ '12-Sa-N
y00037
(W/ WAIVER) ,/ 0�4 . ?,, /
/ C / \N / CUT AREA
/ (POOR 5011S)
�IL 10' FOUNDATION /
N.
fix/ SETBACK
EXISTING `
DRAINFIELD 2 212- R-00056
/
PER RECORDS N. ` EXISTING HOME /
// N. TO BE REPLACED
/
/ N.
/ N.
% 1l/ N.
(l.!) I 0 PPii40 /r .0
�7 6 EXISTING j V 2 L' I o
I SEPTIC TANK /
// PER RECORDS \ \ 1 �a�Q,003., / R
/ PUMP OVT& ABANDON • / O
/ / ,Lci
/ EXISTING TANK AND DRAINFI ELL)
rliC
,� `AT TIME OF INSTALLATION \ . /
6: cce5,;4 "w
Y ,qc� .,&.-..
�'-_S AN ASBUILTI INSTALL F FEE WILL
OF INSTALLATION
CHARGED AT TIME OF INSTALLATION
PIONEER DIGGING, ING I I ;: 2 ��'3 T E`I HOI I I E H�L E ,.
P 1Rt 11...2991738-00034 A1R(.1n U27tln
5r1w. , Iw.
SEPTIC DESIGNS ADDRESS: l768lSTATEROUIEl06
3083 Fh1S4:]BI>�\S RD. GR API AILN',w\)x510 DF GNER: R.OBERT FL PAYSSE -
.FFI F RFD IA,-Ixul E{\ Soo 427 2sss SI II I.I: SFTE RAN SCALE r=20' - FOR '-^ - m
s
2
a
c
€ °R
nai $
N.
r.
EL
I
in Ef = I—
O 3
sa - a
M
1
ct
V ), m
O !IV*
,
,
w yy
I t to
LL t o. N
11.4
H10IM 1VSV9
1— I
U-
N
0
Nini
N
Nj
N O
H
Z
J WI
Ei N Q
O
1.
a p <
Y
j
al V
a
I
x
'!' . i y.
.
Y
C
N
0X II
:sue+... 0/•,:-.'a'.001.7aet:sw0CraC^us:? c
1 H w
_. Y�J Ir11111YI,Y:1�1 V o0 I�„. o o
J
LL
W I_ • Z_ >
d Z O
3li1 '.w.w.xcc nu:x0 'w.�wr^'!.
A 1 K3 }
U U I �5.' ~
an
6 Y
h �?j� �T� •
c3 'j—�'
O
-
V -16 o
U
w
1-
w e
I—
.
�,, z co
1 w
o m
o z
paQ
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 loft 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 loft 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 mayor
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 246-272Arror ti a rglirden4ncs
i.
information, refer to Mason County Public Health Homeowners Manual,which should be rgtefvetiftet if�9ta idr1 approval.'`.
14.System owner should be cautious of landscaping around septic components. Root intr jlgrd0 •
can cause premature failure of the drainfield area. In addition, bushes and trees should beept
away from lids and other septic maintenance points.
F
15. Changes made at time of installation may impact designer calculations, pump sizing,and ft
compliance w/county and state requirements. Contact designer prior to install w/any .b '
./
proposed variations from design. Changes may result in additional fees and permitting. „„,,,
PIONEER. DIGGING, INC ``I,I°"l a' jiff STEP R �� �?a
\Rl LL z:22217-58-00034 6 ". a b:
SEPTIC DESIGNS vDDft[- I76BISTATEROUTEI06 an.-,,
33333F 1-i83-0V uu>onao. CR IPN IPv,V n 08510 DGICAF82 ROBE�R SCALE
CH.� PAYSSE
J �r.E31 300 12331803 I H.0 300 i27-2353 0111I:I c
`: NOTES W NA