HomeMy WebLinkAboutSWG2023-00390 - SWG Application / Design - 9/18/2023 a: MASON COUNTY 415 N 6TH STREET, SHELTON,WA 98584
SHELTON':360-427-9670,EXT 400
xl 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: SWG2023-00390
APPLICANT REYNOLDS NICHOLAS C Phone: 360-535-0424
Address: PO BOX 8592 NEILTON, WA 98566
OWNER REYNOLDS NICHOLAS C Phone: 360-535-0424
Address: PO BOX 8592 NEILTON, WA 98566
SEPTIC DESIGNER BRAD SMITH-septic designer Phone: 253-851-2178
Address: PO BOX 1444 GIG HARBOR, WA 98335
Site Address: XXX E Wild Grape Way
Primary Parcel Number: 221144190020
Permit Description: 4-bedroom pressure system
Permit Submitted Date: 09/18/2023
Permit Issued Date: 10/09/2023
Issued By: David Anderson
Current Permit Fees Paid: 8525.00 (additional fees may be required upon Installation of system).
Permit Expiration Date: 09/18/2026 (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
::'MASON 'OUNTYPUBLICHEALTH DATE RECEIVED-
n`�' SfrFIlcEWA E SYSTEM APPLICATION AMOUNT RE O.. RECENED, W E'^
S" -
015 N 6th' eet,(Bldg 8) Shelton WA,98584 � 3 m
REC .I• •1' 7-9670 ext4g0 Bel(aiO3fiD1]Si487ext 400 SWG .•iQcD3 - r,(`�2(1,/ \ il 2
ca
APPLICANT /) PR•OOS.V l-\-)U-lv y s
I C.�G / uN ai-CS tC0) `; -'J'3'Z - m m
MAILINGI�REES- :MEET.CITY,STATE,,ZIP C/OODE /,., r
l 'Vl �UY C/5-1Zd�l QTv�VY•Zz
% �>.�F�1 /:�✓��d 3
r.)`\1 SITE AADDDREESSSS-STREET.CITY.ZIP COTE /�� i W
Apt-
NAME OF ES PHONE
a <j L.311 '"�
37 OS 1 Y15 l�
NAME OF INSTALLER PHONE
CHECK AL PLICABLE ITEMS DRINKING WATER SOURCE a F-
NEW CONSTRUCTION 0 RV HOLDING TANK ONLY ❑ PRIVATE INDIVIDUAL WELL h I_
❑ REPLACEMENT SYSTEM 0 INSTALLATION PERMIT ONLY a"-PRIVATE TWO-PARTY WELL a s 1
❑ TABLE B REPAIR ❑ SINGLE FAMILY 0 COMMUNITY/PUBLIC WATER SYSTEM I
[' TANK(S)ONLY 0 COMMERCIAL SYSTEM NAME: I
❑ UPGRADE TO EXISTING ❑ OTHER: BEDROOMS LOT SIZE
❑ EXISTING FAILURE "Re CardD 'Blom" I 42 IA �8 -Li w
DIRECTIONS TO SITE-SE SPECIFIC AND ADVISE OF ANY NEEDED INFORMATION FOR ACCESS(ex.Locked saw) I�
L '
I
Ro � no,Jw� r )°,,- 3
d y1 C i 1Lfr-I 0Ta I IC
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SITE MUST BE FLAGGED FROM MAN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS I
rsj
OFFICIAL USE ONLY BELOW THIS LINE— —
UPGRADE'FAILURE SOURCE(Br repoRnp imposes)
O VOLUNTARY 0 MAINTENANCE/PUMPING 0 BUILDING PERMIT ['HOME SALE ['COMPLAINT 0 OTHER'.
INS RECTOR SOB LOGS COMMENTS I CONDITIONS
Tl4i:0-)?LFS „ �/ MYt St7 '((
at 33
7W2'.O- 3Y4II 5 ,- C?1
pis fOf3r 1ti/m014t+It
'I+3.o-33" h LFS ¢�l l
R�st D,4 13"
C=a
Tµy:o 73I (-fcFS.._ t l G
Qccf a� ?3 I . g
,_
SOIL CODES:
V•VERY G•GRAVELLY S•SAND L•LOAM SI•SILT C•CLAY E•EXTREMELY R•ROOTS
INSPECTOR SIGNATURE ILA/ rDATEli APPLICATIONV/( zoTION A APPLICATI APPROVED BY
DATE
76 I /07/77071
THIS FORM/ MANY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBBRE REVISED+anaOls
' DESIGN FORM-PAGE ONE Assessor's Parcel Number: Z2ILt -- —11 - 900
A design will be reviewed when)copies of each of the following are submitted:
'r Completed design form that has been signed and dated. ie Scaled layout sketch,including all applicable items on checklist
I Scaled plot plan,including all applicable items on checklist. r Cross-section sketch,including all applicable items on checklist.
This form may be sunned and available for public vlw on tha Mason County We late.Maximum paper size: 11"X 17"
PARCEL mEN'FgRCATlOF' . .
Permit Number: SWG� { ele)2% ' FLU Designer's Name: 1irA (i �JIT1T
N
Applicant's Name: r �Q I.
k21ttwUh Designer's Phone Number: Cam. OS I - Z. Y7 3
F
Mailing Address: .?L. "r?C 1Z--- Designer's Address: j7 < OC 14 'I
)orrorc srd fvf C79.,7_4-1., 6,lro Herbaria G0 L:
City Stale Zip City State Zip
Treatment Device
❑(tendon Biofdter ❑Sand Filter D Momd ❑Send Lined ihainficld ❑Recirculating Filter.Type.
0 Aerobic Unit Make/Model ❑Disinfection Unit Make/Model Other:
Drainfield Type
❑Gravity 0 Pressure ❑Trench ❑Bed 0 Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms Schedule/Class I/Q
Daily Flow:Operating Capacity ..) gpd Length gr ft -'
‘-jrDaily Flow:Design Flow — S 6/ gpd ' Diameter 14. in
I Septic Tank Capacity ; i✓.-r gal- Number '
Receiving Soil Type(1-6) d ' Separation _r ft --
Receiving Soil Appl.Rate r gpd/ft Orifices
Required Primary Area ()0 ftr , Total Number of Orifices is
Designed Primary Area OC2 f - Diameter a 11 tj in
Designed Reserve Area JJ Or.' ftt • Spacing _ in
Trench/Bed Width ,-
-fi ft / Manifold
Trench/Bed Length v7O ft Schedule/Class GU.")
I ft
Elevation Measurements Length I
Original Drainfield Area Slope i % - Diameter .�-1 in
New Slope,If Altered % - Preferred manifold configuration d7 i Yj_o No
Depth of Excavation UPslere /0 in Transport Pipe
from Original Grade Dnwa,ilm+r el in Schedule/Class --I''
Designed Vertical Separation 2 ip Length ft
Gravelless Chambers Required? ❑Y 0 No ptional. Diameter .% in
Pump Required? taxes 0 No Dosing and Pump Cbamber
Pump/Siphon Specifications Number of doses/day 0
Difference in Elevation Between Pump Shutoff and Uppermost Dose quantity &d gal
Orifice -j ft Chamber Capacity (2-SC gal
Uppermost Orifice I:fi{tgher 0 Lower than Pump Shutoff Pump controls:Please check those required.
Capacity(§Total Pressure Head w.6 gpm der t MEJ f,. , vent Counter
tam
{t. iiIII o.tl,e")-A j i
Calculated Total Pressure Head 'L'Z ft If Timer:r� Pump on ,Pump o
Comments C '.'e, a'i f;: $ u
opt 0 q 7023
DESIGN FORM—PAGE TWO Assessor's Parcel Number: Z1 j_4 --4 I_ -- O O-Z ,Z
Permit Number: SWG
DESIGN CHECKLISTS -'
Scale_d Plot Plan Sc d Layout Sketch Cross-Section Sketch
O l t hole locations grainfield orientation and layout Reference depth from original grade:
Cli,m1 logs Trench/bed dimensions and ®' ,Septic tank
property lines far ticai distances within layout 0. Drainfreld cover
D Existing and proposed wells f Box/Valve box locations Reference depth from original grade
}Within l00 ft of property aff Septic tank/pump chamber and restrictive� strata:
J� Measurements to cuts,banks,and ations Laterals,trench/bed,top and
;efface water and critical areas � aservation port location bottom
Q Location and orientation of CYC -out location 0 Curtain drain collector
curtain drain and all absorption � Manifold placement 0 Sand augmentation
yomponents k7/ ifice placement Other cross-section detail:
B Location and dimension of
Br teral placement with distance ❑'Observation ports/clean-outs
primary system and reserve area to-edge of bed
Er Buildings Other Information
p Audible/visual alarm referenced Yes No
C rection of slope indicator ❑` Scale of drawing shown on scale ❑ Cr sign staked out
d Waterlines bar ❑ l% orded Notices attached
0 Roads,easements,driveways, ❑ Waiver(s)attached
,parking _❑limy curve attached
North arrow and scale drawing ❑ td w'aluation of failure
shown on scale bar Non-residential justification
❑ ❑ Waste strength
❑ ❑Flow
DESIGN APPROVAL //
The undersigned designer must be noiifiedby instaileraltime of installatioh,t3'S' ❑ No
)Sign Designer Date
The undersigned has reviewed this design on behalf of Mason County Public Health and deteri�»iie_it t ( "w E t b
compliance with state and local on-sit gulations:
/0 ( / 107) OCT 09 2023
Environmental Health Specialist Date
CAUTION; DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
I The design is stamped "Approved"by Mason County Public Health. 7 fc 7/ 76
I The Onsite Sewage Permit has not expired,the Permit Expiration Date is: (/ C,
✓ 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
CIOHARBOR,WA 98335
(253)B51 2178
DATE: 9 ' 4 ' 2�/= q JOB# �.t_t �
RE SITE: 'Z-�ItA ' 4(7a 1�-�J /�`(„ �....,'1
PRESSURE DISTRIBU7IONDESIGN.Worksheet for sites where laterals will be at Efferent
elevations.
L DESIGN DISTRIBUTION NETWORK
A DAILY DESIGN FLOW= � .
B.APPLICATION RATE,based on soil type=
C.REQLIIBFD ABSORPTION AREA-= Er0ft
a.._ya CIL.0 TRENCH OR BED WIDTH 3g
•
1TAL BID OR TRENCH LENGTH® _ `2-76 f3.
`` •' I' ON OF PROPOSED DRAINFIELD CONFIGURATION:
(5) 05' L k /-r EA:
0744414FOLD ASSY
A LATERAL LENtx1H= .E ft.
B.LATERAL SPACING= "Jr ft.
C.TRANSPORT PIPE LENGTH= E
AND DIAMETER- 2"
D.MANIFOLD LENGTH= 2ft.
LATERAL RESIDUAL ORIFICE LATERAL #O CES ORIFICE
NUMBERS PRESSURE DIS. DIS. :$PACING
�) (GPM) (GPM) LA (FT-)
J 7,Zt ( I a
OCT y %1?
Page 1
L SELCECT 13E MANIFOLD DIAMETER,USE APPENDIX 4: 2"
I. WITH INFILTRATOR TRENCHS,ORIFICES TO EtE FACING UP: ,,
1. RECOMMENDED DOSING FREQUENCY/DAY= Y/ DOSES/DAY.
2. RECOMMENDED DOSE VOLUE= (3O GAT.
-3. REQUIRED PUMP CAPACITY= 3, - TOTAL GAL.
(sum of all discharge rates from all laterals)
3.TOTAL FRICTION LOSSES N ME NETWORK:
A. TRANSPORT PIPE LOSS- \ 17 FT.
PIPE PIPE FLOW FRiCITON LOSS PER PIPE FRICTION LOSS
MATERIAL DIAMETER (GPM) 103 FT.OF PIPE LENGTH IN PIPE
J,
B.CALCULATEITE TOTAL ELEVATION LIFT= J 0lJ FT-
4.OEIERMDE THE TOTAL DYNAMIC HEAD:
• SELECTED RESIDUAL PRESSURE + 2.5 FT.
• TRANSPORT PIPE FRICTION LOSSES 1 FT.
• MANIFOLD ASSY.LOSSES + ( 2- ? FT.
• MANIFOLD AND LATERAL.FRICTION LOSSES + 1.0 if.
• TOTAL FT FVATION LIFT + 5, Dfj FT.
TOTAL-DYNAMICSEAA-= 7-Z .A ET.
5.SEI.ECTA PIMP:
REQUIRED CAPACITY 314, GYM TOTAL DYNAMIC BEAD
USE PUMP OR EQUIVALENT 't lD( j_ D
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