HomeMy WebLinkAboutSWG2023-00376 - SWG Application / Design - 9/6/2023 MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584
A SHELTON:360-427-9670, EXT 400
1+� 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: SWG2023-00376
APPLICANT ROCK HOLDINGS LLC Phone: 253-228-7462
Address: P 0 BOX 66110 SEATTLE, WA 98166
OWNER ROCK HOLDINGS LLC Phone: 253-228-7462
Address: P 0 BOX 66110 SEATTLE, WA 98166
SEPTIC DESIGNER Adam Hunter-Jim Hunter and Phone: 360-753-1226
Associates
Address: PO Box 162 OLYMPIA, WA 98507
Site Address: 491 E OLDE LYME RD
Primary Parcel Number: 321275300213
Permit Description: Table 9 Repair 2bd Oscar X02
Permit Submitted Date: 09/06/2023
Permit Issued Date: 10/20/2023
Issued By: Rhonda Thompson
Current Permit Fees Paid: $780.00 (additional lees may be required upon installation of system).
Permit Expiration Date: 10/03/2024 (based on dale 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.
7 Solid waste enforcement case (EHC2020-00031) must be in Status
ABATED/CORRECTED prior to Closing septic permit.
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.
tii OFFICIAL USE ONLY
// MASON COUNTY PUBLIC HEALTH DATE RECEIVED
tRE1
ND
ONSITE SEWAGE SYSTEM APPLICATION M ay/:, � `m W
: m
415 N 6th Street,{Bldg 8) Shelton WA,98584 < 0
Shelton:360-4279670 RI 400 Belfair:360-275-4467 ext 400 SWG 73.� 0
Z 'D
APPLICANT PHONE D
CRYSTAL MATTSON 2532287462 m 73
m
MAILING ADDRESS-STREET CITY STATE ZIP CODE
r
PO BOX 867 MCKENNA WA 98558 3
SITE
ESS-STREET CITY ZIP CODE 1.0
491 RE OLDE LYME RD SHELTON WA 98584 z
NAME OF DESIGNER PHONE IV
ADAM HUNTER 3607531226 1
NAME OF INSTALLER PHONE /"
CHECK ALL APPLICABLE ITEMS DRINKING WATER SOURCE • Fx�� �
O NEW CONSTRUCTION 0 RV HOLDING TANK ONLY 0 PRIVATE INDIVIDUAL WELL M 1'
REPLACEMENT SYSTEM 0 INSTALLATION PERMIT ONLY 0 PRIVATE TWO-PARTY WELL Z
TABLE 9 REPAIR 0 SINGLE FAMILY COMMUNITYIPUBLIC WATER SYSTEM
O TANK(S)ONLY 0 COMMERCIAL SYSTEM NAME'. LAKE LInEeI<K
O UPGRADE TO EXISTING 0 OTHER'. BEDROOMS LOT SIZE IC/t
O EXISTING FAILURE "Record Or-awing required 2 0.23 m ` ll
for sl/Installations" O IV-
DIRECTIONS TO SITE-SE SPECIFIC AND ADVISE OF ANY NEEDED INFORMATION FOR ACCESS(ex looked gale) O I
OLDE LYME RD TO SITE ON THE LEFT AT 491 x Ic
b
o 9i
—1
1---
A
SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS 1 "
-_ - OFFICIAL USE ONLY BELOW THIS LINE -
UPGRADE/FAILURE SOURCE(for rep: ding purposes)
❑VOLUNTARY 0 MAINTENANCE/PUMPING O BUILDING PERMIT OHOME SALE 0C,2allF�VM- -_
INSPECTOR SOIL LOGS COMMENTS
S I •NDITIONS
SEP 0 8 2023 Co 7
T I "" o Z`1 �lS fa RE e
CI'��-t"'e'i) Myvl1� Tv d
VVVv,\' kt 5ov-hl`
SOIL CODES:
V=VERY G=GRAVELLY S=SAND L=LOAM Si=SILT C-CLAY E=EXTREMELY R=ROOTS
INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED BY l�1 DATE
THIS FORMS FORM MAT AND 10(31.7
AVAILABLEFOR PUBLIC THE MASON COUNTY WEBSITE � 'OII ohs0
DESIGN FORM-PAGE ONE Assessor's Parcel Number: IS t ZZ- S 3 -- C)C1- s-43
.A design will he reviewed when 3 copies of each of the following are submitted:
" Completed design form bat has been signed and dated. " 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: /I"X/7"
q q PARCEL IDENTIFICATION
Permit Number: SWG ZO7 J� °° Jik Designer's Name: ADAM HUNTER
Applicant's Name: CRYSTAL MATTSON 360-753-1226
Designer's Phone Number:
Mailing Address: PO BOX 867 PO BOX 162
Designer's Address:
MCKENNA WA 98558 OLYMPIA WA 98507
City State Zip City State Zip
DESIGN PARAMETERS
Treatment Device
❑ 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: esearwr....�neixeA�mexT
kv.=
Drainfield Type OSCAR II NB-PRETREATMENT
❑ Gravity ❑ Pressure ❑Trench 0 Bed k67.-0 Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 2 Schedule/Class PER OSCAR
Daily Flow: Operating Capacity 180 gpd Length PER OSCAR ft
Daily Flow: Design Flow 240 gpd Diameter PER OSCAR in
Septic Tank Capacity 1500 gal Number 3
Receiving Soil Type(1-6) 4 Separation PER OSCAR ft
Receiving Soil Appi. Rate 0.6 gpd/ft2 Orifices
Required Primary Area 400 ft2 Total Number of Orifices PER OSCAR
Designed Primary Area 400 ft2 Diameter PER OSCAR in
Designed Reserve Area 400 ft'- Spacing PER OSCAR in
Trench/Bed Width - -j G ft Manifold
Trench/Bed Length 26 ft Schedule/Class 40
Elevation Measurements Length 20 ft
Onginal Drainfield Area Slope 0 / Diameter 1 in
New Slope, If Altered 0 °% Preferred manifold configuration used? 6 'Yes 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 24 in Length 90 ft
Gravelless Chambers Required? 0 Yes 1eNo 0 Optional Diameter 1 in
�J
Pump Required? m Yes 0 No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day _ 360
Difference in Elevation Between Pump Shutoff and Uppermost Dose quantity 0.67 gal
Orifice "° ft Chamber Capacity 1000 gal
Uppermost Orifice lit Higher 0 Lower than Pump Shutoff Pump controls: Please check those required.
Capacity C Total Pressure Head 12.000 gpm timer EFElapse Meter ErEvent Counter
Calculated Total Pressure Head — 1s 2a ft If Timer: Pump on 225EC ,Pump off 3MIN 395EC
Comments
DESIGN FORM—PAGE TWO Assessor's Parcel Number: 3 t t rt S d6
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
• Test hole locations 12. Drainfield orientation and layout Reference depth from original grade:
Er Soil logs V Trenchibed dimensions and V Septic tank
a Property lines critical distances within layout a Drainfield cover
1r Existing and proposed wells Y D-Box'Valve box locations Reference depth from original grade
within 100 ft of property 121 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
✓ Location and orientation of ES Clean-out location 0 Curtain drain collector
curtain drain and all absorption M Manifold placement 0 Sand augmentation
components a Orifice placement Other cross-section detail:
QS Location and dimension of 12i Lateral placement with distance D Observation ports/clean-outs
primary system and reserve area to edge of bed
Other Information
Buildings Er Audible/visual alarm referenced Yes No
Pi Direction of slope indicator 121 Scale of drawing shown on scale et ❑ Designstaked out
O Waterlines bar 0 D Recorded Notices attached
Roads, easements,driveways, 0 0 Waiver(s) attached
parking 0 0 Pump curve attached
a North arrow and scale drawing ❑ ❑ Evaluation of failure
shown on scale bar Non-residential justification
❑ Cl Waste strength
O ❑ Flow
DESIGN APPROVAL
The undersigned designer m.st b: �d by installer at time of installation Yes ❑ No
6/5/23
Mgr Tire of Designer Date
The undersigned has reviewed this ..sign on behalf of Mason County Public Health and determined it to be in
compliance with state and local on-site regulations:
y
1 � ! \ .IM iGcIS (O(20/t )
Environmental Health Spe ialist Date
CAUTION: DESIGN APPROVAL 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.
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
MASON COUNTY HEALTH DEPARTMENT
ON-SITE SEWAGE DISPOSAL SYSTEM DESIGN
PARCEL N.321275300213
SITE p'
DATE SUBMITTED. 10/1612023 LEGAL/LOT 4:LAKE L MERICK n4
Tr213
SUBMITTED BY. ADAM HUNTER
APPLICANT. CRYSTAL MATTSON
ADDRESS. PO BOX 867
MCKENNA.WA 98558
I.CALCULATIONS
NUMBER OF BEDROOMS= 2
RESIDENTIAL GPD FLOW= 240
IF NON-RESIDENTIAL-GPO FLOW
WILL BE AS FOLLOWS.
GPD=
APPLICATION RATE= 0.6 GPD/FT2
REDUCTION=LEA vC BL/P:%IF'.O vEuc IIONTaca1
DRAINFIELD SIZING
ABSORPTION AREA= 415 FT2
TRENCH LENGTH OR BED CONEIG.= 26'X16
PER OSCAR
II.WATERPROOF SEPTIC TANK
COMPOSITION AND SIZE= I000GAL-X02 TANK
NEW OR EXISTING= NEW
III.DRAINFIELD CROSS SECTION
SAND DEPTH=
IV.PRESSURE CALCULATIONS
USING PIPE CLASS 40
ORIFICE VETAFIM DRIPLINE
LENGTH DIAMETER FLOW FRICTION LOSS
SECTION (FT) (IN) (GPM) (FT)
SUPPLY 90.00 1.00 12.000 6.9789
RETURN 90.00 1.00 12.000 0.9789
TOTAL= 13.9578
"TOTAL HEAD LOSS "
1)FRICTION LOSS THROUGH SYSTEM= 13.958
2)ELEVATION DIFFERENCE = 5.300
TOTAL= 19.258
1 0/1 6/2 3 APPROVED
OCT 20 2023
MASON CCU4i'ENviCMENTALHEALTH
V.CHECK THE PUMP CAPACITY.
PUMP AY-MCDONALD 30GPM-12HP PUMP(MODEL p 22050E2AJ) (PER OSCAR)
EXCESS TON 50.00 (PER OSCAR)
TOTAL HEAD LOSS IN SYSTEM 19 26
STANDARD PUMP CONFIGURATION IS SUFFICIENT, YES
APPROVED
OCT 20 2023
MASON CCUNTvEti11RONYESTALHEALTH
10/16123 RET
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