HomeMy WebLinkAboutSWG2023-00316 - SWG Application / Design - 7/28/2023 MASON COUNTY 416NfiTHSTREET,SHELTO70.EXT 400
584
SBELFAIIR:360-275-4467,EXT 400
f Public Health & Human Services ELMA:360-482-5269,EXT 400
- -- FAX:360-427-7787
On-Site Sewage System Permit: SWG2023-00316
APPLICANT WARNKE JOHN T& REBECCA R Phone:
Address: 8182 NW LAWSTAD PL SILVERDALE, WA 98383
OWNER WARNKE JOHN T & REBECCA R Phone:
Address: 8182 NW LAWSTAD PL SILVERDALE, WA 98383
SEPTIC DESIGNER ROD LEFT-Acme Design Phone: 360-698-8488
Address: PO Box 2954 SILVERDALE, WA 98383
Site Address: XXX E Island Shores Rd
Primary Parcel Number: 120184290011
Permit Description: 3-bedroom OSCAR X02 system w/OS-50 coils
Permit Submitted Date: 07/28/2023
Permit Issued Date: 10/24/2023
Issued By: David Anderson
Current Permit Fees Paid: $685.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 08/22/2026 Masud 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.
TReu % I3'
. OFFIGAL USL ON.Y --
MASON COUNTY 1O//El 1,0273 w
11 = COMMUNITY SERVICES RECEIVER- Cn
o m
--� Public :Community HealiclEnvconmenta HeaVhI — - — — m
m.A9,W SWG 202-3 - 006- N o
O
Z -I;
ON-SITE SEWAGE SYSTEM APPLICATION 3 >
XI
m O
ARROGANT I:PHONE 1
JOHN WARNKE I
MAILING ADDRESS.STREET.CITY.STATE.ZIP CODE 3
8182 NW LAWSTAD PL SILVERDALE WA 98383 co
SITE ADDRESS-STREET Olt ZIP CODE
E. ISLAND SHORE RD SHELTON WA 98584 I
NAME OF DESIGNER PHONE I N
ROD LEFT 360-698-8488
- -
NAME o:INSTALLER PHONE O o
PERMIT rvrE!selnv one, DRINKING WATER SOURCE po
PI p RESIDENTIAL OSS 11 COMMUNIP"OSS (COMMERCIAL O55 IX PRIVATE INDIVIDUAL WELL LL PRIVATE TO-PARTY WELL Z IIDEI
T"r tl m c O
E OF WORK(sekeJ 7 PUBLIC WATER SYSTEM
g NEW CONSTRUCTION!UPGRADES IJ REPAIR I REPLACEMENT EIAIS(Heen aII matavµJ ❑TABLE IXREPAIR I -
SUBMITTALS0 SURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINE
pp p
B]�CESIGN FORM(REQUIRED) KLSEPTIC DESIGN(REQUIRED: BEDROOMS LOT SIZE
CIWAIVERISI(IF APPLICABLE) 3 1 89,298 F
DIRECTIONS TO SIZE AND SCE CONDI IUMS.(e+.ccxe.d pore)
REDESIGN% Moue_ ®P Fda Ioc—,IDw and Sys1e,- fy,x. I o
O
IO
ti
1 —
SITE MuS r eE FLAGGED FROM YAW ROAD AND TEST HOLES MUST SE FLAGGED WITH TEST HOE NuMsERS. I
_ . - -- - OFFICIAL USE ONLY BEI OW THIS LINE- — --
UPGRADE I FNmRE SOURCE NA RWb9 puotses)
Q VOLUNTARY D MAJNTENANCEPUMPING 0 BUILDING PERMIT ❑HOME SALE ❑COMPLAINT ❑OTHER:
IN ROIL I-OR LOG COMMEMSI DOWN HONS
7k1U—IT fS,
&JY u1 (9 I1,-/FY94 S `,t1 (-oar
T#L:O- 254[ fit
t N LIT (IAJ+ 4+ 78' of km}
dt 4310- Irtr5i-
' (le5f cl{ /9'1 V/'tot if 9ne4iii ix*.
RECORD DRAWING AND INSTALLATION REPORT
SOIL CDOES
=VERT G=GRAV_LL S-SAND LOAM Si=SILT C=CLAY F-EXTREMELY R-ROOTS REQUIRED FOR FINAL APPROVAL
INSPECTOR SIGNATURE - DATE APPLICATION EXECRATION DATE i APPuunONAPPROVED/ISSUED re DATE '
417— /o/lo%a 9I7Z/Zoz6 I tiV /0/7'//loz3
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSFTE R�mS=D vC.T[iP
r -
DESIGN FORM -PAGE ONE Assessor's Parcel Number: 1 2 0 I 8 — 4 2 — 9 0 0_ 1 1
A design will be reviewed when 3 copies of each of the following are submitted:
e Completed design form that has been signed and dated. 'Scaled layout sketch,including all applicable hams on checklist
• Scaled plot plan,including all applicable items on checklist ° Cross-section sketch,including all applicable items on checklist-
This forth may be scanned and available for public view on the Mason County Web site.Maximum paper size. 11"X 17
r1 PARCEL IDENTIFICATION
Permit Number SWG ?d?3-00JI6 - Designer's Name: Rod Lett
John Warnke Desi rer's Phone Number 360-698-8488
Applicant's Name: gn Mailing Address. 8182 NW Lawstad PI Designer's Address: PO Box 2954
Silverdale WA 98383 Silverdale WA 98383
City State Zip City State lip
_' —
DESIGN PARAMETERS
Treatment Device
❑Glendon Blot ❑Saud Filter IRC Mound ❑Send Lined Drainfield ❑ Recirculating Filter,Type -
liffAerobicCnit Make:model Oscar X02 ❑Disinfection Unit Make/Model _ Other-
Drainficld Type
❑Gravity ❑ Pressure 0 Trench ❑Bed ❑Sub Surface Dnp
Septic Tank/Drainfield Specifications Lat qal/s� (�([--/' per`
Number of Bedrooms 3 Schedule/Class �N ✓Jl,iilk
Daily Flow.Operating Capacity 270 gpd Length ft
Daily Flow:Design Flow 360 gpd Diameter m
Septic Tank Capacity 1500 gal' Number
Receiving Soil Type(I-6) 4 - Separation ft
Receiving Soil Appl. Rate 0.6 gpd/ft" Orifices ( AA
Required Primary Area 600 ft: Total Number f Orifices Os
Designed Primary Area 600 ft2 Diameter O
Designed Reserve Area 600+ ft' Spacing In
Trench/Bed Width 18 ft ' Maoli''l�t))ooplld (7�p�/��
Trench/Bed Length 33.5 f Schedule/Class I'pr 1/51 wt.
Elevation Measurements Length ft
Original Drainfield Area Slope 3-4 % Diameter in
New Slope,If Altered N/A °°a Preferred manifold configuration used' ❑Yes O No
Depth of Excavation Up slops7 in Transport Pipe
from Original Grade on,,,,else 3 in Schedule/Class 40
Designed Vertical Separation 12+ m Length 312 ft
Graselless Chambers Required'? 0 Yes 66No ❑ Optional Diameter 1 In
Pump Required? 66 Yes O No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day Pre-set
Difference in Elevation Between Pump Shutoff and Uppermost Dose quantity gal
Onficc ft Chamber Capacity 1000
Uppermost Orifice 0 Higher 0 Lower than Pump Shutoff Pump controls.Please check those required.
Capacity @ l otal Pressure I lead gpm OTimer OElapse Meter ❑ Event Counter
Calculated Total Pressure Head _ 2209 ft If Timer. Pump on 30 sec ,Pump off 3 min
Cortnnents
Redesign to change OSS location and type APPROVED
OCT 2 4 2023
MASON COUNTY PAIRCiiMENTAI-FSAI'r
Lal. .
DESIGN FORM—PAGE TWO Assessor's Parcel Number: 1 2 0_ 1 8 — 4 2 -- 9 0 0 1 1
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
63 Test hole locations 1 Drainheld 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 0 Drainfield cover
• Existing and proposed wells g D-Box/Valve box locations Reference depth from original grade
within 100 ft of property A Septic tank/pump chamber and restrictive strata:
❑ Measurements to cuts,banks, and locations g Laterals, trench/bed,top and
surface water and critical areas g Observation port location bottom
❑ Location and orientation of 12I Clean-out location 0 Curtain drain collector
curtain drain and all absorption Liff Manifold placement 0 Sand augmentation
components g Orifice placement Other cross-section detail
• Location and dimension of g Lateral placement with distance 0 Observation ports/clean-outs
primary system and reserve area to edge of bed Other Information
Buildings g Audible/visual alarm referenced Yes No
• Direction of slope indicator g Scale of drawing shown on scale ❑ d Design staked out
g Waterlines bar ❑ lg Recorded Notices attached
g Roads, easements, driveways, 0 g Waiver(s)attached
parking 0 Ii4 Pump curve attached
WI North arrow and scale drawing ❑ liti Evaluation of failure
shown on scale bar Non-residential justification
❑ PI Waste strength
O g Flow
DESIGN APPROVAL
The undersigned designer must be notified by insta r at time of- s la- g Yes 0 No
iI Dc-Fobzr zoz-3
Si re esigner Date
The undersigned has reviewed this design on behalf of Mason County Public Health and da4i rPA y
compliance with state and local on-sit regulations: /c(/z / ED
r if/ ?czy _— OCT 2 4
Env r nmental Health Specialist Dagj 2�23
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDIT VMSNTAL HEAL h
✓ The design is stamped"Approved"by Mason County Public Health. 7/'�P
/ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: g,727/ZDZb
✓ 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 WA GIS Web Map
% ,- \
E__— f i
in_ c.,
r ',_
v :e.
ce. l
1 �I
111
V
1 — l —) ' 1 t `,
J �—�ll I v < V �I �\
1 I
1
��� ,
1 �\
x ,
�� ,
�,/
I__.
z
N k
_re .
I
1- 7 , am
Imo` � .�
10/11/2023, 9:15.31 AM 1.6,143
APPROVED 0 0.05 0 1 02m1
3 County Boundary 0 0 07 0.15 0.3 km
❑ No Filled OCT 2 4 2023
E Tax Parcels (Zoom in to 11 Q,00) Sources Esn.HERE Gaimn merman.increment Carp GEBCO USCG,
FAO, NPS, NRCAN GeoBase IGN KMae:e Na Ordnance Survey Esn
Japan MET. Esn china IHona Kong).(a,OpenS'eetMao contnDtms,and
the GIS Use Commvary
oc Gunry WA G s Web map App canna
Bweee at Lana Manaaemeri Fs-Cenaca Es ni I.HERE Gann.INCREMENT Prnteman.CSGS METITNASA.EPA USDA I
o
o
\ -31'1 II -\
9ti
N
.,
�
o \ a�� A
��1 �j 1 � \ \
I
\ , 7 V v ,,
� �\ kt/i
rrio
o `' / , z �,/ o
a \ \
- ram,
Ili 1
0I
co 5
m u 1
� '
— f - -
33;
_- — -- �ES Oil;
, -
_ cn ; mDve _ � 000D =
- D m m y y H r A Ti p m C A m A Z
I 1 15 1 A T O C C m v m r 0 < 3 N { V 1
cnI
/ '/ . r ?c, oA zc � " Z
mrr z - 1mm Doza > - a
r
Mo
mi za Trosrz o Dz m(� O O N y CN mrNrDA ZCAA:I) 3 r vo SZAroa �II / / � ii O 03zmoz co o ° ?FfI Ia� mm r / a �Zmzz . Hm0n z , zC 20m5C Q rcm { o < 2
/050c
jP
2o n : s n D ° jojziD m 0 p 00Ac n 0 m ToC �n o smF f ro > S i Fmoa � r 2z < A27o Z n � m N ° � {yN am AiymZ � mpm _ z�nnor q iONOD R m Nam 0 2lz ^'�73 y IO I+ sr7 zr 1pmmDre - oy CI) oo o ! UUU
D '^ 0zm � 'AH onNm _ 1IzxIi !
xtir r ' 1i ' lyl �4m 0 < a / 444 > Fm -I CD 0OC-p p � � Z n � (: I p 1 m D y D MI x v M tt7 ' _o HA / iop i p � nmA ac1myD C m�n ff � '' RA { Z mmD3camApAmOI m0 LO TQ o 9 _ 3O > i 7
•23
23
rn D rnz m � m * na)m imD3A37 > o1D3 Dz0AA -Imo, O mu
c 0 cn
O — m Iv it 0 0 { m a D m T { Z G p D N m Z D [0~
III -I yy n-(n_, oo 5T H 'N Amn !ri
pm Gr � - Nc < z _ [�
Cn _ - om mAT0Ox: D � NAp im00Z11
of (n NJ
� ! 0 I JD ` Z ➢ ➢ No Z Aim - < 0 fl z mp JDy, A Ci > m�
'o o ors u y ` o � Z G y ccYm 1A;-Ino
I' o FQ om ' D < < < cm
-' •T F { r3nR - < N3ArdZ � i16'CJ N N Z W �.�.1 OO O �_' �V1 ���ocr, mZ ? 3 � Z rn m j C � CO m `r
CD m I I ' 2 Z O K V m Q 3 C 0 i I D 0 o 0 n { 0 N 0 o Z Rl
c z1
U) ' o x _ .0 c3 mm0 a O x OOmO z O(0
m 73 w �" `a. Do N ® pmO � � Z DA x m � = 0 N 0@
o E —� m o q N z � r m poom D � 0
7 n 1 '+ o o . 0 1 zz " 1 F C
v D 7 o = ' A ,Z
ZI a o m { 0zm � m m�
Cal) _ s. oR �Zi e 9 z . 0 z p n� zi Dahl
Om .°3 a g `Iv 3 s o Z r 1 N -< c 1 D < r 'nLc
r o U , , a 4 i� N . 0 coop o 2C
� w m co , f 0,09 o . 1 . . a30 z. a
o �. � E < >� < r JZ o on zzp ' N �<
�m
m � � pO a n _ m 55 E1N N �
_r �in ivz' " � �" 5 A - A r _ 0 p
c5 <n d R 3 fvax 1 D r
o � ap' m ; iT f, m m m
0
ii
D T ¶ I 3Tr CyZ ZZZ 330
Ocrm krp0CICDZyA m
pc c > Za c0 _1 0 Kw' - k cD 0
0Aa' 0 3mmm > m ¢ m031 Z
I ImI r D = C { T -
ZOmO � m 2mTTz7 A 0
3
Dom0 music( 300r3ncpm r221 A
nz . . m02Km65 bocn2 j (3 o la il
�I n. �i �I�
i � om = rUn aZmmA I r m n \ "I 1
DDZ 5 P. ^ lDx mo
omz > � � mr � N 1 _ � o II
or oC 0 DH . ram �, 11 -o
�� 11 0l
PT 1L 1
A126 i 7 mw 1 e 1� 1' III 1 Spy._ I 4
0 m m Fr. 1 /// I' �� 1
n AAZ cc (�` — — 4I c.d`e '� 1 W
D 0 `- - II 1
l Il ��Sa i�
m D m 1 _ csx
o
0 A
D
:d
r
ri
gi
lA —_
-0 i1uonP A�
x klil 1
1i
o 0
0
., _
- 1
ri q �.
m ,
CC mz
000.
��� — n1�����;11�1p
WII
co
N ml
o
= p
a -U73
i=;�� . 1 o
vs 173
iicm — 0i
is P. tZla As to 092 -Ass S ] 5P5 .5 ' z 1 5) //j//�� o N.2,2
O 1
beam F t j 792 8 y921 1 c_ � 3 n ��C\ / .°g d" b 3 $� £m r 7 �a�l rill
E V J
rut r , .� € s s ; f $ 1.f �,p
Sa.z c a �F s < � � c �s .� 2 -1 no � '.
,=5�m ; y rs €4 T O
r a^ C�
~arm. € r
n£$` —
a'od m 2s 0_ F i2 .— - ( ie' �— r
as"8 _ >s 0
m4. , 8E - - - "2 - n25
51 --
1 �sts€ 8o s - 1- ;8 2 n 0 (Pc
§APE o
5 1 - 8 n 0 { 6 , �� �� -D
e�� 1 s trAtA
s�.e O ` 111 0 0 o
n4 \
D Iog
s76
�olg - _ •� c� C7
_ _ C O
C7
z c I
0
T
o 's
5
7 _ AU
_i�
mo9 .21z4 _ x Z ro m
' o 1 F . 6 gas �; Z� l � , !)�� z
ms
D 5 1 3 3- �' z o_ i-1 t o l7
rn � ' f A w m 1 < �� ' ➢ 71
to o R s - y e 4 z C r- Iy ll(� J�
A p
o w r u Y 6 5 2 2 c } `. 3 ' `� o �1{"j I� I.
3 Y 4 �
mI 8 -
1cm c
± t/���1 s g 3 u
0 c0 I II
m
m A m
o Sao Z = �
�, N co k oF `
m� r'- e
w
Oim
0