HomeMy WebLinkAboutSWG2023-00361 - SWG Application / Design - 8/28/2023 MASON COUNTY 415 N 6THELTON:SHELTON,WA EXT 98584
SHELTON: SHEL- EXT 400
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: SWG2023-00361
APPLICANT ARNOLD JESSICCA &TYLER Phone:
Address: 800 W WYNWOOD DR SHELTON, WA 98584
OWNER ARNOLD JESSICCA&TYLER Phone:
Address: 800 W WYNWOOD DR SHELTON, WA 98584
SEPTIC DESIGNER Bob Paysse -Pioneer Digging Inc Phone: 360-426-1803
Address: 3083 E Mason Benson Road GRAPEVIEW, WA 98546
Site Address: 800 W Wynwood Dr
Primary Parcel Number: 420257500260
Permit Description: 4-bedroom gravity system
Permit Submitted Date: 08/28/2023
Permit Issued Date: 10/13/2023
Issued By: David Anderson
Current Permit Fees Paid: $525.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 09/13/2026 (based on date at 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/environmental/onsiteloss-inspection-request.php or call:
360-427-9670, extension 400.
OFFICIAL USE ONLY
DATE Rfc[rvEDZa ••• \ p
L • MASON COUNTY LtM y >
� , ' COMMUNITY SERVICES CD CD
AMOUNT a L Y m CD
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Public Noah(Community ealtNEnNmnmental Health) 5 < N
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ON-SITE SEWAGE SYSTEM APPLICATION > A
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APPLICANT PHONE m
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TYLER & JESSICCA ARNOLD c
MAILING ADDRESS-STREET.CITY STATE ZIP CODE 3
800 W WYNWOOD DRIVE SHELTON WA 98584 z
SITE ADDRESS•STREET CITY ZIP CODE ••
SAME AS MAILING I a
NAME OF DESIGNER PHONE I N
ROBERT H. PAYSSE 360-426-1803
NAMECF INSTALLER PHONE a I 0
TBD
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En N
PERMIT TYPE(Select One) DRINKING WATER SOURCEUPI
ff RESIDENTIALOSS F COMMUNITY O55 F COMMERCIAL OSS PT PRIVATE INDIVIDUAL WELL 6 PRIVATE TWO-PARTY WELL Z I al
TYPE OF WORK(select one) Q PUBLIC WATER SYSTEM
W NEW CONSTRUCTION/UPGRADES F REPAIR(REPLACEMENT O'HER DETALLS'select an that apply)_ 0 TABLE IX REPAIR I V
SUBMITTALS G 0 SURFACING SEWAGE ❑EXISTING FAILURE ❑SHORELINE
Pi DESIGN FORM(REQUIRED) w1 SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SZE r IE.II
giWAIVER(S)OF APPLICABLE) 4 6.40 x
0
DIRECTIONS TO SITE AND SITE CONDITIONS (ee?ocher,vier
HEAD OUT ON CLOQUALUM ROAD. AFTER HWY 101 OVERPASS, TURN RIGHT I 0
ONTO WYNWOOD DRIVE. FOLLOW TO INTERSECTION W/ SADLER HILL RD AND r
LOOK FOR PDI SIGN. FOLLOW PINK ROBBONS STRAIGHT DOWN CLEARED AREA o N
TO DRAINFIELD. I I rn
SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE WADERS I I 0
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE I FAILURE SOJRCE oaf reporting punoseSI
❑VOLUNTARY [MAINTENANCE/PUMPING 0 BUILDING PERMIT ❑HOME SALE ❑COMPLAINT [OTHER.
INSPECTOR SOIL L'I 5T. COMMENTS I COND TIONS
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RECORD DRAW WG AND INSTAEATION REPORT
SOIL
VERYV= 0=DRAVEL.Y 5=SAND
})L==LLO)AM Si=SILT C=CLCLAY 1E=EXTREMMEELL�Y' 7R=ROOTS REQUIRED FOR FINAL APPROVAL /�7
INSPEY
SIGNATURE D9/2$/ Ii 1) APPLICATION
�l5/z /� APPLIC O APPROVED 7 ISSUED
23ATE
TAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE /URREVISED 40l291
DESIGN FORM—PAGE ONE Assessor's Parcel Number: 4 2 0 2 5 — 7 5 — 0 0 2 6 0
A design will be reviewed when 3 conies of each of the following are submitted:
v Completed design form that has been signed and dated. v Scaled layout sketch,including all applicable items on checklist
v Scaled plot plan, including all applicable items on checklist. v 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: 1I"X 17"
PARCEL IDENTIFICATION
Permit Number: SWG 70Z3-0036 / _ Designer's Name: ROBERT H.PAYSSE
Applicant's Name: TYLER&JESSICCA ARNOLD Designer's Phone Number: 360-426-1803
Mailing Address: 800 W WYNWOOD DRIVE Designer's Address: 3083 E MASON BENSON ROAD
SHELTON WA 98584 GRAPEVIEW WA 98546
City State Zip City State Zip
DESIGN PARAMETERS
Treatment Device
❑Glendon Bioliilter 0 Sand Filter ❑Mound 0 Sand Lined Drainfield 0 Recirculating biker.Type:
❑Aerobic Unit Make/Model 0 Disinfection Unit Make/Model Other: -
Drainfield Type
Ei Gravity 0 Pressure fi'(Trench 0 Bed 0 Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 4 Schedule/Class 2729 PERF
Daily Flow: Operating Capacity 360 gpd Length 50 ft
Daily Flow: Design Flow 480 gpd ' Diameter 4 in
Septic Tank Capacity(working) 1500 gal Number 4
Receiving Soil Type(I-6) 3 - Separation 10 ft
Receiving Soil Appl. Rate 0.8 gpd/ft- Orifices
Required Primary Area 600 ft' / Total Number of Orifices NA
Designed Primary Area 600 ft2 . ' Diameter - in
Designed Reserve Area 600 ft2 . Spacing - in
Trench/Bed Width 3 ft Manifold
Trench/Bed Length 200 ft - Schedule/Class 3034
Elevation Measurements Length 30 ft
Original Drainfield Area Slope 15 % Diameter 4 in
New Slope, If Altered 15 % Preferred manifold configuration used? 0 Yes 0 No
Depth of Excavation UPxlope 21 in Transport Pipe
from Original Grade gown-sIope 20 in Schedule/Class 3034
Designed Vertical Separation 18+ in Length 75 ft
Gravelless Chambers Required? CI Yes liffNo 0 Optional Diameter 4 in
Pump Required? ❑Yes 1111No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day -
Diff.in Elevation Between Pump&Uppermost Orifice ft Dose quantity - gal
Drainfield Squirt Height/Selected Residual(head) - ft Chamber Capacity(flood) - gal
Uppermost Orifice 0 I ligher 0 Lower than Pump Shutoff Pump controls: Please check those required.
Capacity aA Total Pressure Head - gpm OTimer DElapse Meter 0 Event Counter
Calculated Total Pressure Head ft If Timer: Pump on - ,Pump off -
Comments
DESIGN FORM—PAGE TWO Assessor's Parcel Number:4 2 0 2 5 — 7 5 -- 0 0 2 6 0
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
g Test hole locations Drainfield orientation and layout Reference depth from original grade:
g Soil logs g Trench/bed dimensions and g Septic tank
▪ 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 g Septic tank/pump chamber and restrictive strata:
VI Measurements to cuts,banks,and locations RI Laterals,trench bed,top and
surface water and critical areas 64 Observation port location bottom
m Location and orientation of g Clean-out location 0 Curtain drain collector
curtain drain and all absorption g Manifold placement 0 Sand augmentation
components
g Orifice placement Other cross-section detail:
g Location and dimension of g Observation ports/clean-outs
g Lateral placement with distance
primary system and reserve area to edge of bed
g Other Information
g Buildings g Audible/visual alarm referenced Yes No
g Direction of slope indicator
g Scale of drawing shown on scale It 0 Design staked out
g Waterlines bar g 0 Recorded Notices attached
g Roads,easements,driveways, g 0 Waiver(s)attached
parking 0 g Pump curve attached
m North arrow and scale drawing ❑ g Evaluation of failure
shown on scale bar Non-residential justification
❑ GI Waste strength
❑ g Flow
DESIGN APPROVAL
The undersigned designer must be notified by installer at time of installation 0 Yes 0 No
YeI 4 8(Zal��
Signature of Desigria Date
. i . :�-....
The undersigned has reviewed this design on behalf of Mason County Public Health and detertiin d i tdbein
compliance with state and local on-site regulations:
lal /7o3
Environmental Health Specialist Date ,
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
✓ The design is stamped"Approved"by Mason County Public Health. /�/ �o��
✓ The Onsite Sewage Permit has not expired, the Permit Expiration Date is: 7/[/
✓ 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: 12/720 15
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'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 246-272A. For operation and Maintenance
information, refer to Mason County Public Health Homeowner's Manual,which should be received after installation approval.
14. System owner should be cautious of landscaping around septic components. Root intrusion
can cause premature failure of the drainfield area. In addition, bushes and trees should be kept -
away from lids and other septic maintenance points. - - - -
•
15. Changes made at time of installation may impact designer calculations, pump sizing,and
compliance w/county and state requirements. Contact designer prior to install w/any
proposed variations from design. Changes may result in additional fees and permitting. ,. .
•
PIONEER DIGGING, INC. c 01c.11 n4z uL -00260° Ld
SEPTIC DESIGNS vDDRI_:5: 800 WYNWODD DR _re ,-h.e-th7zrzty
3083 I_sl.uo\BLN'0\ItD. c,RAPF\IF\ v,:j 965,lo DI SIC,\FR: ROBERT EL PAYSSE
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