HomeMy WebLinkAboutSWG2023-00388 - SWG Application / Design - 9/14/2023 , MASON COUNTY 4l5N 6TH STREET,SHELTON,WA 98584
SHELTON:360427-9670,EXT 400
BELFAIR:360-275-4467,EXT 400
'11.16 ,40P Public Health & Human Services ELMA:360 FAX: v na
On-Site Sewage System Permit: SWG2023-00388
APPLICANT JESSICA SHUBERT Phone: 425-394-8732
Address: 671 E Island Shores Rd SHELTON, WA 98584
OWNER JESSICA SHUBERT Phone: 425-394-8732
Address: 671 E Island Shores Rd SHELTON, WA 98584
SEPTIC DESIGNER CINDY WAITE-Septic Designer Phone: 3607010205
Address: 80 E PICKERING LANE SHELTON, WA 98584
Site Address: 341 E Island Shores Rd
Primary Parcel Number: 120192190011
Permit Description: 2-bedroom gravity system
Permit Submitted Date: 09/14/2023
Permit Issued Date: 10/24/2023
Issued By: David Anderson
Current Permit Fees Paid: $940.00 faddulooanees may be required upon installation of system).
Permit Expiration Date: 10/06/2026 based on date of nspeauonl
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.govlhealth/environmental/onsiteloss-inspection-request.php or call:
360-427-9670, extension 400.
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ON-SITE SEWAGE SYSTEM APPLICATION 3 A
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APPLICANT FLFNE 1" m
JESSICA SHUBERT 425-394-8732 i
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ESS -.TREE% I ITV'TAM ZEE RODE g
671 ER ISLAND SHORES RD SHELTON WA 98584 m
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SITE ADDRESS STREET CITY ZIP SORE
341 E ISLAND SHORE RD SHELTON WA 98584 I•'•
NAME OF DESIGNER PHONE I'V\
CINDY WAITE 360-701-0205
NAPE OF NISTA LER PHUNE I C
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SE{RESIDEN'1AL 055 TI COMMUNITY OSG {1 COMMERCIAL 055 Pr PRIVATE INDIVIDIAI WFI I CI PRIVATE TWO PARTY WELL $
Tl R „_•, 0 PUBLICVAT ER SYSTEM
p' NEW CONSTRUCTION I UPGRADES 11 REPAIRS REPLACEMENT I OT % -1 4-.)M 0 TABLE IX REPAIR I N
SLEA T A 0 SURFACING SEWAGE 0 EXISTIN" FAILURE 0 S'IORFI INF
Ia DESIGN FORM(REQUIRED} V SEPTIC DESIGN(REQUIRED) PEDROOIM= w, NATE S
❑ WAIVERISI FIE APPLICAB_EI 2 533'X1047X378'X653 0 '
DIRECTIONS TO SIT AND SITE CONDITONS•.R T n oogir
GO ONTO HARSTINE ISLAND, TURN RIGHT AT TEE(SOUTH ISLAND DR), TURN IN
RIGHT AT NEXT TEE(HARSTINE ISLAND RD S), TURN LEFT ONTO v i '• (�
ROAD(ACROSS FROM FIRE STATION), PARCEL IS ON THE L CDE OF ROAD, o I'
GATE ACROSS BUT NOT LOCKED. Petry to/7o/1az3
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SITE MUST SE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBER'. I fZ' 0—FI CI (711-5 11oc l Cl G ^I
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THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE FE LED L. _RI.
DESIGN FORM-PAGE ONE
Assessor's Parcel Number: ; . ' -.
A design will he reviewed when of each of the follows nsubmitted: -- -- - --- y
3 cnies
v Completed design form that hasbeen S
:enedanodhe Sealed layout etch. including all applicable item:o ,checklist
v Scaled plot phi including all applicable item son schecklist. o-
( iosycuectim sketch. including aII:limitable. items on checklist
This form may he scanned and available for public view on the Mason County Web site.Maximum paper size l l 'X 17
PARCEL IDENTIFICATION
Permit Number SWG 202 _00-11',? Domains
JESSICA SHUBERT "N'1°" CINpV WRITE
Applicant's Name:
__-- - - - - - De. cis Plume Number
d60-7o1-02G5
Mailing Address. 671 E ISLAND SHORES RD De [Hier's Address: 80 E PICKERING LANE
SHELTON WA 98584 SHELTON
-------- WA 93584-
City Slam Zip
DESIGN PAR MIA FRS CIS Stale -_-_Zip
lrcalment Device
❑Glendon Bioflier 0 Sand Filler 0 Moon
0 Sand 1"nied Di dintidd G Recncolating Is Irr i
❑Aerobic Unit Make/Modeler"'—
---__ 0Urvulecrion llnn MakmMadd- Glhcr.
-- -.._-_
LhYGravitDrainfield
Y 0 Pressure 0"french [g13ed
❑ ll'S
Sep[ic'Fank/Drainfield Specifications
Laterals OCI-
Number of Bedrooms 2 / 7
Schedulc'Clura AST427 ? 810
Daily Flow: Operating Capacity 180 �/ 1�
._ Lnavm 30 Daily Plow: Design Flow 240 Q
_ gild Dlansmr 4 Septic Tank Capacity(working) 1200 in
gal Number
Receiving Soil Type(I-6) 3 3
separation 3 Receiving Soil Appl. Rate $ ___ ft
BP�ttr Orifices
Required Primary Arca 300
fte fatal Nmnha of Orifice, AS TM 2729 PERE
Designed Primary Area 300
CIS Diameter
Designed Reserve Area 300 In
F pucmK
TrenehiBed Width 10 - in
It
Trench/Bed Length Manihiki
30 I1 / Sehcdulci Clnxs
Elevation Measurements I cneth �'—
Original Drainfield Area Slope It
New Slope. If Altered
I. in
_ 'Y,, l "(_�d Ili! I' Hp ur aft used'P O Yes O No
Depthof Excavation GI -I pe 24(se,page 4 nnl 1oir
Dot Originalf ) in P
Grade D sinus 12 sea 1mfransport Pipe
( page 4 note l) „r fit It �T� 3034
Designed Vertical Separation i.a sys
36 In �r h s111 1 0 15,Grevelless Chambers Required'? 0 Yes 0 No D Option dr cr — - fl
I /p Dn 11S .4 a V mll 4
" C r e wqn�\ -. __ inireLICENSED DEStrserd 3 OSI t and Pump C
Pump Required? ❑ yeti g No
handier
Pump/Siphon Specifications sync ,e sae min 4
r
Diff. in Elevation Between Pump St Uppermost Orifice — — 0 Dose ose tp us$
yuumity
Drainfield Squirt!leight/Selected Residual (head) II C'lininhar Capacity (Rood I gal
Uppermost Orifice 0 Higher 0 Lower than Pump Shutoff Pump nl scat mis. Please heck rhos Jams rd. -- gal
Capacity(rJ Total Pressure I lead !�
9Por ❑Timm DI lapse p Meter
Calculetcd fowl Pressure(lead 0 Event Counter
ti II limo. Pump ON
,Pomp oil
Comments
-' • 1. CONTRACT DESIGNER PRIOR TO STARTING INSTALLATION. 2. GRAVEL BASED DRAINFIELD
,'. REQUIRED. 3. CONCRETE TANK REQUIRED
DESIGN FORM—PAGE TWO
Assessor's I'erocl Number
Permit Number: S WO _
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch
LY Test hole locations Di Cross-Section SkeSketchmn bmit Lion and layout Reference depth from original grade:
Er Soil logs - - , p' Trench/bed
din imustons and
critical distances within layout
Cr Property linesScpric tank
W Existing and proposed wells ElD-13ox/Valve box locutions ❑ii DramGeld cover
Within I 00 h of property SepticReference depth dam original grade
P P y Er tank/pump chamber
I' leasurements to cuts, banks, and locations r and restrictive strata:
11LI.
surface water and critical areas [Y Obsm'vi Cr Laterals, trench/bed, top and
ahon port Ioc;niull
pi`'Location and orientation of bottom
:o Ivan-out location ❑ Curtain drain collector
curtainain drain and all absorption
components OEdvlplacementSnd fold plac
ement 0 Sand augmentation
cr
Location and dimension of C}!_Orilice placement Other cross-section detail
primary system and reserve area Lateral placement with distance ❑ Observation ports/clean-outs
121' Buildings to edge of bed
Other Information
12( Direction of slope indicator -_A°1lihldrisual alarm references! yes No
{i Waterlines D Scale of drawing shown on scale 0 0 Design staked out
bar
❑ 0 Recorded Notices attached
(,a Roads, easements,driveways,
parking ❑ 0 \Nuivc attached
❑ North arrow and scale drawing 0 ❑ Pumpcurve attached
shown on scale bar El 1lvaluation of failure
Non-residential justification
0 0 Waste strength
❑ ❑ Flow
DESIGN APPROVAL,
The undersigned designer must be notified by installer at time of installation a Yes ❑ No
Signature of Designer IO/ Ji ,r�u23
IatL
The undersigned has reviewed this design on behalf of Mason County Public !Mahn and dedern4{p
compliance with state and local on site r g lauum:� 7 a
Lnviionnlental I lealth Specialist 6
Dote /da en �CT J'y 2023
CAUTION: DESIGN APPROVAL. IS VALID ONLY UNDER 'THE FOLLOWING CONDITIOnby AcATA
V The design is stamped"Approved"by Mason County I ublic Health. q NI
s The Onsitc Sewage Permit has not expired, the Permit Expiration Date Is: - 1Ofi/2-07ra
✓ Drainfteld 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.
Cpdateu Date I 2 7i:.015
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APPROVED 530; , 4
OCT 2 4 2023 1 i 9
MASON COUNTY ENVIRONMENTAL HEALTH
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}—Access R:r_rTa Grade
I -�Ink with 45 a Fedag Down
�J d Speed Levelen(ar eWeq required
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Leveling Pee
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Distribution Box(No Scale)
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OCT 2 4 2023
,T,RONMENTAL HEALTH vn wrrno rook „� / 3.
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APPROX. WEIGHT I 1 ,000 I -S. �
Installation Notes gppR
Gravity Distribution System: %isp O T 7
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41C,
341 E Island Shore Rd 12019-21-90011 eti;go
1. Gravel based drainfield required D'7q NMt'1'
gc4(7 2. Designer and installer to meet on site prior to installation
3. Install system during dry weather with acceptable soil conditions
4. Keep wheeled vehicles off the drainfield area before, during and after installation.
Tracked equipment only.
5 All ground, surface water and roof drains must be diverted away from the septic tanks
and drainfield. Ensure the final grade slopes away from these areas and water doesn't
collect on or around them. Use swales. berms, catch basin and tight lines, curtain drains,
etc. to divert all waters.
6. Curtain drains can be no closer than 10' upgradient and 30' down gradient of the
drainfield
7. Exposed restrictive layers, cuts, banks. etc can be no closer than 50' downhill from the
drainfield.
8. Install access risers on the septic tank. D-box and observation ports.
9. Make sure septic tank risers are epoxied or caulked to astir riser rings on tank.
10. Lids must form a water and gas tight seal with the access risers
11. Install effluent filter at the septic tank outlet.
12. This system must be installed by a Mason County Certified Installer.
13. Deviation from this design without prior approval from the designer and Mason County
Health Department will make this design null and void
14. This design was sized per Washington Administrative CodeWAC246-272A-0230. The
operating capacity is based on 45 gallons per day per capita with two persons per
bedroom. The minimum design flow per bedroom per day is the operating capacity of
ninety gallons multiplied by 1.33. This results in a minimum design flow of one hundred
twenty gallons per day. This creates a surge factor of 32% but anticipated flow is ninety
gallons per bedroom per day.
15. Install laterals or bed with contour of the ground
16. Install trench bottoms level and always maintain a minimum of six inches into native soil
17. Filter fabric required over drain rock prior to backfilling. If the drain rock extends above
the original grade, run the filter fabric at least 2 inches down the trench wall.
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System Owner Responsibilities:
1. Operation and Maintenance is required by Washington State Department of Health and
Mason County Health Department.
2. The septic tank should be pumped every three to five years or as needed.
3. System owners are responsible for having maintenance performed every three years as
per WAC246-272A.
4. System owners are responsible for responding to septic issues in a timely manner.
5. System owner agrees to read and abide by information regarding their system in the
User Manual provided by Mason County Public Health.
6. Keep the flow of sewage at or below the approved design operating capacity.
7. Keep waste strength at residential waste strength parameters.
8. Spread loads of laundry through the week.
9. Do not use excessive bleach or detergents with added whiteners.
10. Do not shower, do laundry and dishwasher at the same time
11. Antibiotics can kill or impair the biological process in the septic tank.
12. Leaky plumbing can hydraulic overload your on-site septic system.
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