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HomeMy WebLinkAboutSWG2023-00432 - SWG Application / Design - 10/10/2023 MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584 �P SHELTON:360-427-9670. 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: SWG2023-00432 APPLICANT RANDALL ET AL KAREN G Phone: 360-426-4221 Address: 60 SE Mt Ellinore Ct SHELTON, WA 98584 OWNER RANDALL ET AL KAREN G Phone: 360-426-4221 Address: 60 SE Mt Ellinore Ct SHELTON, WA 98584 SEPTIC DESIGNER TOBY SYRETT-septic designer for B• Phone: 360-426-4221 line Address: 2971 E Philips Lake Rd SHELTON, WA 98584 SEPTIC INSTALLER DON WOOLLISCROFT B-Line Phone: 360-426-4221 construction Address: 2971 E PHILLIPS LAKE LOOP ROAD SHELTON, WA 98584 Site Address: 60 SE Mount Ellinore Ct Primary Parcel Number: 319045700025 Permit Description: 3-bedroom gravity system: Repair Permit Submitted Date: 10/10/2023 Permit Issued Date: 10/18/2023 Issued By: David Anderson Current Permit Fees Paid: $780.00 (additional fees may be required upon installation of system). Permit Expiration Date: 10/17/2024 (based on date of 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—-- OCf .4%99 MASON COUNTY ""RITLNLD 1 0 - 1 0 - ) 3 `f. ✓ 1p`j „ COMMUNITY SERVICES AM°RNiEw RECEIVED C 3. Pub( Health(C ( n E nnenal Healthl ' ` y 46 c sr WC SS e,Aessar SWG .013 - 60432. o o 6 Z N ON-SITE SEWAGE SYSTEM APPLICATION 3 A m m FPWLSANT PHONE m r GAGE C/O B-LINE CONST. INC. 360-426-4221 w E .MAT:RC ADDR SS EwEE-.cur sunea CODE I 3 2971 E PHILLIPS LAKE RD. SHELTON WA 98584 Dp m SITE ADDRESS-S I REE-.CITY ZIP CONE 0 60 SE MT. ELLINOR CT. SHELTON WA 98584 *O I `'' NAME OF DESIGNER PHONE O TOBY SYRETT @ B-LINE CONST. INC. 360-426-4221 O NAME OF INSTALLER PHONE - O I CD DON WOOLLISCROFT @ B-LINE CONST. INC. 360-426-4221 < PE RMR TYPE isele^I one) DRINKING AVER SOURCE - � � Tif RESIDFNBAL OSS h I COMMUNITY 055 it COMMERCIALOSS El PRIVATE INDIVIDUAL WELL b PRIVATE TWO-PARTY WELL Z IA T PE Dh•'OAk lserea ones 2 PUBLIC WATER SYSTEM Fl NEW CONSTRUCTION I UPGRADES AI REPAIR/REPLACEMENT OTHERDETAILS IaeleG all that apply) m TABLE IX REPAIR CM v TTa3 m SURFACING SEWAGE m EXISTING FAILURE 0 SHORE..,INESI,E CO N DESIGN FORM(REQUIRED) WWII SEPTIC DESIGN(REQUIRED) BEDROOMS I LOT SIZE I-J IJ yI WALVER(S)(IF APPLICABLE) 3 L 0.37 ACRES c ' Uif RECT ONS TO SITE AND SOE CCNR Iz RGOSS /ea eeo gore) _ x I o TAKE COLE RD. TO SHADOWOOD DEVELOPMENT. TAKE LEFT ON SE SHADOWOOD I 0 DR. FOLLOW TO END AND VEER LEFT ON MT. ELLINOR CT. SITE IS #60 AT END ON o I o RIGHT. -I NISI 01 SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED MTH TEST HOLE NUMBERS. I EP OFFICIAL USE ONLY BELOWTHIS LINE ---- — --- UPGRADE/FAN RRE SOURCE Trot reeving purposes) ❑VOLUNTARY []MAINTENANCE/PUMPING U BUILDING PERMIT ❑HOME SALE ❑COMPLAINT 0OTHER. !TSPHC I CR SOIL LOGS COMMENTS/CONOII IONS Th7 0-23L 6IS 23- LI2 •cprPfciad C? Z S neffat4tit of tit `/ 4.'11 - 42: 0-3a'' City 3©-36" ccn, A4 r, t u �nz_ti RECORD GRASSING AND INSTALLATION REPORT SOIL LODES'. .=ARV G=GRAVELY S=SAND L=LOAM Si=SILT 0=CLAY E=EX'REMELV R=ROOTS REQUIRED FOR FINAL APPROVAL INSPECT DR S NAT DATE APPLICATION EXPIRATION DATE APPLICAT N APPROVED/ISSUED BY DATE ( L- 10/I7/76 0 7. Al lc 'f lD ( ' '0 THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REUSED 12/7201E pp , � PAGE ( OF /� Fc.(9» b ' SEPTIC SYSTEM DESIGN ? _. , . 3 F h I. ` * 4+ ` \l • P 1, f a: SITE ADDRESS: 60 SE Mt Ellinore Ct. SITE CITY STBTLZIP: Shelton, WA PARCEL NUMBER: 31904-57-00025 q P p n LEGAL DESCRIPTION: Shadow ood Lot 25 OVFo OWNER: Gage DATE: 29 September 2023 OCT j 8 701� o`N _ DJA ATAL HFAgH B-LINE CONSTRUCTION, INC. Milli 8MUNE 2971 E PHILLIPS LAKE SHELTON, WA 98584I 360 426 4221 office 360.426.0509 fax b-lineeonst4ii.msn.com PAGE /.. OF Jm OWNERSHIP AND USE OF DESIGN DOCUMENTS: 1. This Design Document has been prepared by B-Line Construction, Inc. via its employees, subsidiaries and sub-contractors. 2. This Design Document has been produced in order to attain an on-site septic system installation by B-Line Construction, Inc. for the property indicated herein. 3. This Design Document represents decades of combined experience of B-Line Construction, Inc. its employees, sub-contractors, etc. in construction processes, technical applications and developments as well as interpersonal understandings and relationships with other professionals, manufacturers, suppliers, regulators, and private parties. 4. This Design Document constitutes physical and intellectual property © B-Line Construction, Inc. and may not be used by any other individual, company, contractor, etc. to construct an on-site septic system for this or any other property. 5. This Design Document shall not be construed as a product that stands alone from the achievement of an on-septic system on the specified property for the client by B-Line Construction, Inc. 6. This Design Document remains the sole property of B-Line Construction, Inc. whether the project for which it was made is executed or not. 7. The submission or distribution of this Design Document to meet official regulatory requirements, or for other purposes in connection with the project, shall not be construed as publication in derogation of B-Line Construction, Inc.'s rights regarding this document as physical and© intellectual property. 8. In the event that B-Line Construction, Inc. is not retained for the installation of the system, this Design Document shall not be used by subsequent parties/contractors. 9. If B-Line Construction, Inc. is not retained for completion of this septic system installation project, subsequent parties/contractors wishing to install an on-site septic system on this property must produce their own design documents for use in a separate research/development/design/permitting/installation process. 10. If B-Line Construction, Inc. is not retained for completion of this septic system installation project, client shall be liable to subsequent parties/contractors for new design documents and additional permit fees as required in pursuit of re-inspection, re-desidl pltigstallation. O VED OCT 18 2023 8-Line Construction, Inc. MASON COI1NryENVIRONMENT 2971 E Phillips Lake Rd., Shelton, WA 98584 DJq At HEALTH 360.426.4221 (office) 360.426.0509 (fax) b-lineconst(amsn.corn Pher 3v im • DESIGN FORM-PACE ONE Assessor's Parcel Number: 3 1 9 0 4 - 5 7 - 0 0 0 2 5 A design will be reviewed when 3 copies of each of the following are submitted: Completed design form that 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.vice I]"X IT' PARCEL IDENTIFICATION Permit Number SWG Designer's Name: TOBY SYRETT @ B-LINE CONST. GAGE C/O B-LINE CONST. Designer's Phone Number. 360-426-4221 Applicant's Name: _ _ - - RD. - 2971 E PHILLIPS LAKE RD. Designer's ter's Address'. 2971 E PHILLIPS LAKE RD. Mailing Address: _ 6 - -SHELTON WA 95584 SHELTON WA 98584 City State Zip City State Zip DESIGN PARAMETERS Treatment Device ❑Glendon Dial-liter ❑Sand Filter 0 Mound 0 Sand Ifni Draintield 0 Recirculating Filter.Type: ❑Aerobic Unit Make/Model 0 Disinfection Unit Make/Model Other:_ Drainlield Type 1Gravity ❑ Pressure 10Trench 0 Bed 0 Sub Surface Drip Septic Tank/Drainfield Specifications Laterals Number of Bedrooms 3 ScheduleiClass 3034+ DailyFlow: OperatingCapacity 270 AVG gpd/._ Length 50 ft Daily Plow: Design flow 360 MAX gpd Diameter 4 in 7- Septic Tank Capacity(working) 1200 EXISTING gal Number 3 ` Receiving Soil hpe II-6) 3 - Separation 9' ft - P. Receiving Sail Appl, Rate 0.8 gpd/I(/ Orifices Required Primary Area 450 B'- / Total Number of Orifices N/A Designed Primary Area 450 $21 Diameter N/A in Designed Reserve Area 450 ft'- Spacing N/A in Trench/Bed Width 3 ft- Manifold Trench/Bed Length 150 ft - Schedule/Class D-BOX Elevation Measurements Length D-BOX If Original Drainlield Area Slope 8 °/ Diameter D-BOX in New Slope, If Altered SAME % Preferred manifold configuration used? 0 Yes 0 No Depth of Excavation un-slope 10" MAX in - Transport Pipe from Original Grade oorrr-slope 7" in Schedule/Class 3034+ Designed Vertical Separation 24" MIN in Length 50'MAX fl Gravelless Chambers Required? 0 Yes 0 No 0 Optional Diameter 4 in Pump Required? 0 Yes ❑No Dosing and Pump Chamber Pump/Siphon Specifications Number of doses/day N/A Dill, in Elevation Between Pump& Uppermost Orifice N/A ft Dose quantity N/A gal Drainfleld Squirt Height/Selected Residual (head) N/A R Chamber Capacity(flood) N/A gal ^ ..,• controls: Please check those required. Uppermost Orifice 0 I ligher ❑ Lower than Pump Shutoff t Capacity Total Pressure Head N/A gpm tt'Timer ❑Elapse Meter 0 Event Counter Calculated Total4sprie�.�O N/A ft :/ -lr�ump on N/A ,Pump off N/A K rH-LED v'w . • rt_v-, -23 Comments ''�A _ t1 OCT 18 2023 a II' ' •a aN COUNTY ENVIRONMENTAL HEALTH ' 17:117:-' `',f2A` 1 DJA "I PASC Lf OF ids DESIGN FORM—PAGE TWO Assessor's Parcel Number: 3 1 9 0 4 -- 57 -- 0 0 0 2 5 Permit Number: SWG DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch E Test hole locations g Drainfield orientation and layout Reference depth from original grade: g Soil logs lid Trench/bed dimensions and g Septic tank 6d Property lines critical distances within layout g Drainfield cover ❑ Existing and proposed wells lid D-Box/Valve box locations Reference depth from original grade Within 100 ft of property g Septic tank/pump chamber and restrictive strata: ❑ Measurements to cuts, banks,and locations GL Laterals, trench/bed,top and surface water and critical areas m Observation port location bottom ❑ Location and orientation of g Clean-out location 0 Curtain drain collector curtain drain and all absorption lid Manifold placement 0 Sand augmentation components G Orifice placement Other cross-section detail: 6/1 Location and dimension of LidLateral placement with distance g Observation ports/clean-outs primary system and reserve area to edge of bed Other Information iiii Buildings 0 Audible/visual alarm referenced Yes No • Direction of slope indicator m Scale of drawing shown on scale g 0 Design staked out g Waterlines bar ❑ RI Recorded Notices attached g Roads,easements, driveways, ExistingInfiltrator system ❑ g Waiver(s)attached parking ❑ Rl Pump curve attached filled with roots and soil, g 0 Evaluation of failure • North arrow and scale drawing ponded into d-box and shomr Oil scale bar surfacing Non-residential justification "1 0 0 Waste strength - Si. ❑ 0 Flow DESIGN ' ? SL,Ir i—i t1 t. The undersigned designer must be notified by installer ji.::4,:, r:- ' • •Yes ■ • : - I `•�i , •, � :,� 2°j5-Ce Z 3 1, +_ -S ' signature of Desi� ,�'�,��t�_c:!'i ,i(!" g g.ia'''`t 1. • The undersigned has reviewed this design on behal' •f Ma t o-•y i uredgeal h and determined 4Pp� compliance with state and local on-si regulations'. OVE l0/7YIZd23 ooT Environmental Health Specialist Date 'HASO 1 610' h 0O0ryryt- tj CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION: b/RONIgc, ifThe design is stamped "Approved"by Mason County Public Health. �����/���� 0OA 4(H=4(iR ✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: / Drainfeld 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. 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It is the owner's responsibility to verify property line locations prior to installation. Any discrepancies must be reported to the contractor immediately. 2. Keep wheeled vehicles off the drainfield area before, during and after installation — tracked vehicles only. 3. All ground and surface water (including roof drains) must be diverted away from the drainfield and tank areas. Ensure that final grade slopes away from these areas and that water does not pool around/behind them. Use swales, berms, along with catch-basins and tight-lines, curtain drains, etc. to divert ground and surface water. 4. Curtain drains can be no closer than 10' uphill or 30' downhill from the drainfield. 5. Exposed restrictive layers, cuts, banks, etc. can be no closer than 50' downhill from the drainfield. 6. Operation & Maintenance is required by the state of Washington and the county for all septic systems. 7. Please contact B-Line Construction for periodic Operation & Maintenance service of your system. 8. System Owner is responsible for having maintenance performed according to the schedule set forth by Mason County. 9. System owner/operator is responsible for responding to malfunctions/backups in a timely manner and alerting maintenance personnel as needed. 10.System owner/operator MUST NOT make changes on settings to the system. Only authorized maintenance personnel may alter/adjust system. 11. System owner/operator agrees to read and abide by information regarding their system in USER MANUAL provided by Mason County. B-Line Construction, Inc. PRove� 2971 E Phillips Lake Rd., Shelton,WA 98584 A 360.426.4221 (office) 360.426.0509 (fax) a 2�13 b-lincconstiumsn.com QQ� MEN kHEP1SN MASON COUNSV ENpJP