HomeMy WebLinkAboutSWG2023-00462 - SWG Application / Design - 10/27/2023 MASON COUNTY 415 N 6TH STREET,SHELTON, , E 98584
:,: SHELTON: 360-427-9670, EXT 400�} BELFAIR: 360-275-4467, EXT 400
Public Health & Human Services ELMA: 360-482-5269, EXT400
FAX:360-427-7787
On-Site Sewage System Permit: SWG2023-00462
APPLICANT PINKERTON JOHN RANDALL & LORI Phone:
Address: 5679 GAZANIA CT ORCUTT, CA 93455
OWNER PINKERTON JOHN RANDALL & LORI Phone:
Address: 5679 GAZANIA CT ORCUTT, CA 93455
SEPTIC DESIGNER Bob Paysse - Pioneer Digging Inc Phone: 360-426-1803
Address: 3083 E Mason Benson Road GRAPEVIEW, WA 98546
Site Address: 341 E Fox Ln
Primary Parcel Number: 220035000024
Permit Description: 3-bedroom pressure system
Permit Submitted Date: 10/27/2023
Permit Issued Date: 11/15/2023
Issued By: David Anderson
Current Permit Fees Paid: $525.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 11/09/2026 (based 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/onsiteloss-inspection-request.php or call:
360-427-9670, extension 400.
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OFFICIAL USE ONLY
MASON COUNTY ` .13
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COMMUNITY SERVICES AMOUN]�[E �
Public Health(Community Health/Environmental Health)
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<IS N.6th StStreetSt�elton,WA 98584 DATE RECEIVED5 libT
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ON-SITE SEWAGE SYSTEM APPLICATION D
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m APPLICANT F10^:L m
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RANDY PINKERTON z
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MAILING ADDRESS-STREET.CITY STATE,ZIP CODE g
5679 GAZANIA CT ORCUTT CA 93455 m
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SITE ADDRESS-STREET..CITY.ZIP CODE
341 E FOX LANE SHELTON WA 98584 '"
NAME OF DESIGNER PHONE N
ROBERT H. PAYSSE 360-426-1803
NAME OF INSTALLER PHONE 0 I CD
TBD
PERMIT TYPE(select one) DRINKING WATER SOURCE - o
In RESIDENTIAL OSS COMMUNITY OSS III COMMERCIAL OSS b PRIVATE INDIVIDUAL WELL n PRIVATE TWO-PARTY WELL Z
RM' I CO
EOF IAORK(select one) pp PUBLIC WATER SYSTEM 1
WT NEW CONSTRUCTION/UPGRADES b REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) 0 TABLE IX REPAIR I (31
SUBMITTALS ❑ SURFACING SEWAGE 0 EXISTING FAILURE ❑SHORELINE
co DESIGN FORM(REQUIRED) h1 SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE I- I CI
5 WAIVER(S)(IFAPPLICABLE) THREE 0 '
DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.locked gate) I o
NORTH HWY 3. RIGHT ON PICKERING RD. TRAVEL TO HARSTINE IS. ACROSS I o
BRIDGE AND TURN LEFT AT INTERSECTION. CONTINUE NORTH ON ISLAND TO LEFT r
ON FOX LANE. CONTINUE TO SITE ADDRESS ON LEFT. o 0
IN
SEE ALSO PREVIOUS DESIGN UNDER SWG2007-00783
SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. I '' '
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE/FAILURE SOURCE(for reporting purposes)
0 VOLUNTARY 0 MAINTENANCE/PUMPING 0 BUILDING PERMIT ['HOME SALE ['COMPLAINT ❑OTHER-
INSPECTOR SOIL LOG It 0 COMMENTS/CONDITIONS
rµs, U-� C Ling S
a�st a 36'. wi o f (1 f
IflV. U- 6 6Inwit5 �0 ,41 '8)23
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SOIL CODES: RECORD DRAWING AND INSTALLATION REPORT
V=VERY G=GRAVELLY S=SAND L=LOAM Si=SILT C=CLAY E=EXTREMELY R=ROOTS REQUIRED FOR FINAL APPROVAL.
INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED/ISSUED BY ATE
/1/9/ 2073 I I / T(7OZ6 l! ('f/4z;
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12/7/2015
4
i
DESIGN FORM—PAGE ONE Assessor's Parcel Number: 2 2 0 0 3 — 5 0 — 0 0 0 2 4
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 checkli>t. 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: 11"X 17"
PIIIIIIIIIIIIIIIIK PARCEL IDENTIFICATION
Permit Number: SWG 2013 `00 I"(6Z Designer's Name: ROBERT H.PAYSSE
Applicant's Name: RANDY PINKERTON Designer's Phone Number: 360-426-1803
Mailing Address: 5679 GAZANIA CT Designer's Address: 3083 E MASON BENSON RD
ORCUTT CA 93455 GRAPEVIEW WA 98546
City State Zip City State Zip
.r.F .'::"" a a 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:
Drainfield Type
❑Gravity i1 Pressure It 'Trench 0 Bed 0 Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 3 Schedule/Class SCH.40
Daily Flow:Operating Capacity 270 gpd Length 50 ft
Daily Flow:Design Flow 360 gpd Diameter 1.25 in
Septic Tank Capacity(working) 1200 gal Number 3
Receiving Soil Type(1-6) 3 Separation 10 ft
Receiving Soil Appl.Rate 0.8 gpd/ft2 Orifices
Required Primary Area 450 ft2 Total Number of Orifices 39
Designed Primary Area 450 ft2 Diameter 3/16 in
Designed Reserve Area 450 ft2 Spacing 48 in
Trench/Bed Width 3 ft Manifold
Trench/Bed Length 150 ft Schedule/Class SCH.40
Elevation Measurements Length 24 ft
Original Drainfield Area Slope 10 % Diameter 1.25 in
New Slope,If Altered 10 % Preferred manifold configuration used? I 'Yes 0 No
Depth of Excavation up-slope 10 in Transport Pipe
from Original Grade Down-slope 7 in Schedule/Class SCH.40
Designed Vertical Separation 24+ in Length <75 ft
Gravelless Chambers Required? 0 Yes f No 0 Optional Diameter 2 in
Pump Required? liff Yes 0 No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day 6
Diff.in Elevation Between Pump&Uppermost Orifice 15 ft Dose quantity 60 gal
Drainfield Squirt Height/Selected Residual(head) 2 ft Chamber Capacity(flood) 1200 gal
Uppermost Orifice Higher 0 Lower than Pump Shutoff Pump controls:Please check those required.
Capacity @ Total Pressure Head 23 gpm 12rTimer I 'Elapse Meter I 'Event Counter
Calculated Total Pressure Head 25 ft If Timer: Pump on 1 MIN ,Pump off 4 HRS
Comments
SEE NOTE ON SITE PLAN RE. EXISTING TANKS INSTALLED UNDER PREVIOUS 2007 PERMIT
ii
DESIGN FORM—PAGE TWO Assessor's Parcel Number:2 2 0 0 3 — 5 0 -- 0 0 0 2 4
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
g Test hole locations 0 Drainfield orientation and layout Reference depth from original grade:
O Soil logs Lid Trench/bed dimensions and 10 Septic tank
0 Property lines critical distances within layout Drainfield cover
F0 Existingand proposed wells 0 D-Box/Valve box locations
P P Reference depth from original grade
within 100 ft of property 0 Septic tank/pump chamber and restrictive strata:
WI Measurements to cuts, banks,and locations C>2( Laterals,trench bed,top and
surface water and critical areas 1 Observation port location bottom
1 Location and orientation of 0 Clean-out location 0 Curtain drain collector
curtain drain and all absorption 1 Manifold placement 0 Sand augmentation
components 1 Orifice placement Other cross-section detail:
Location and dimension of El Lateral placement with distance 10 Observation ports/clean-outs
primary system and reserve area to edge of bed
Buildings Other Information
10 Audible/visual alarm referenced Yes No
id Direction of slope indicator 0 Scale of drawing shown on scale d 0 Design staked out
0 Waterlines bar 0 0 Recorded Notices attached
O Roads,easements,driveways, 0 1 Waiver(s)attached
parking 0 0 Pump curve attached
1 North arrow and scale drawing 0 0 Evaluation of failure
shown on scale bar Non-residential justification
❑ Er Waste strength
❑ O Flow
DESIGN APPROVAL
The undersigned designer must be notified by installer at time of installation 0 Yes 0 No
caltl'at ‘4- 14'94%4& ) n(27I ZJ
Signature of Designer Date 4 Pp R
The undersigned has reviewed this design on behalf of Mason County Public Health and determined it to be in �®
compliance with state and local on-site r ulations: NOV 1 5 2023
//% .57o2' 3 MASON COUNTY ENVfRO
Envi o mental Health Specialist Date �Jq hh1ENTAL HEA1 TH
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
✓ The design is stamped"Approved" by Mason County Public Health.✓ I /?"2c7' '
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
FOX LANE
7p
FUTURE WATERLINE __
MAINTAIN 10FT SETBACK `
TO OSS COMPONENTS / �'
�, EXISTING TANKS
I INSTALLED UNDER
EXISTING SEPTIC & I PREVIOUS PERMIT,
PUMP TANKS / INSTALLER
i(
/ UNKNOWN. TANKS
ARE 3FT FROM
I PROPERTY LINE.
I INSTALLER IS TO
/1'vo1 MOVE EXISTING
TANKSTO5FT
/ SETBACK AND
PROPOSED I CERTIFY or REPLACE
/ 3 BEDROOM I ENTIRELY.
/ HOME
( I
INSTALL
TRANSPORT
I LINE
1
\ 1
1 .
NOV 15 2023
1 MASON COUNTY ENVIRONMENTAL HEALTH
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\\_ PROPOSED
DRAIN FIELE) Y 6:i RceEM31,7.isse 'Zi
EXPIRES
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NAN ASBUILTI INSTALL SIGNOFF FEE WILL
BE CHARGED AT TIME OF INSTALLATION
PIONEER DIGGING, INC. CUSTOMER: RANDY PINKERTON TEST HOLE I: TEST HOLE 2:
PARCEL#:22003 50-00024 -34 0-34 CIS
34+GI
34+CT
SEPTIC DESIGNS \DDRESS: 341E FOX LANE ROOTS 34 ROOTS 34
3083 E MASJN BENSJN RD. GRAPEVIEW,WA 98546 DESIGNER: ROBERT H.PAYSSE DacwMER THIS IS NOT A SURVEY.REFERENCES INCLUOE APPLICANTICOVNTY PROVIDED
PUTS OR SURVEYS.FIELD MEASUREMENTS AND COUNTY GIS.DESIGN INTENDED FOR SEPTIC
OFFICE 36(}4261803 FAX 360-427 2353DEPARTMENT AGENCY REVIEW PURPOSES ONLY �DESIG DSED ESIGNER NOT RESPONSIBLE FOR SETVELOP%ENT SLAY BE B
ACKS STUNRELATOED TO
SHEET: SITE PLAN SCALE 1R=30'
SEPTIC COMPONENTS
AN ASBUILTI INSTALL SIGNOFF FEE WILL 1
BE CHARGED AT TIME OF INSTALLATION f`$ �� THREADED CAP
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CUSTOMER: RANDY PINKERTON TEST HOLE I: TEST HOLE 2:
PIONEER DICCING, INC. PARCEL.#:22003 50 00024 4 4 cT 0-34 GLS
3++CT34+GT
SEPTIC DESIGNS ADDRFSS: 341 E FOX LANE ROOTS 34 ROOTS 34
3083 E MASON BEN,ON RD. GRAPEVIEW,WA 98546 DESIGNER: ROBERT H.PAYSSE ED
PLATSPR SURVEY FiHIS 18�DMEASUREMENTSANDCOUNTY T A SURVEY.REFERENCES INCLUDE APPLICANT/COUNTYTFOR SEPTIC
OFFICE-36(1-426-1803 FAX-360-427-2353 /y PURPOSES OSEY PROPOSED DEVELOPMENT MAY BE SUBJECT TO OTHER
�IIFF.T: DF DETAI SCALE P=1V DEPARTMENT/AGENCY RENEW DESIGNER NOT RESPONSIBLE FOR SETBACKS UNRELATED TO
SEPTIC COMPONENTS.
— 24"RIBBED RISERS W/BOLT ON WATER-TIGHT LIDS APPROVED CLEANOUT USE RISER LID ADAPTERS WITH NO GASKET LIDS
FINISHED GRADE 4 a NOV 1 5 �023
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WATER-TIGHT - EFFLUENT
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TANKS MUST BE
ON STATE DOH 1200 GALLON WATERTIGHT : ::
APPROVED LIST `. CONCRL/tSEP77CTANK ''
OF SEWAGE '
TANKS 1:-. `4� i
PUMP TANKS �',�'' ,... ' .
OVER 1000 GAL. • - • >: r �F w s '•
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REQUIRES TWO ;... ..4 ,:.. .: ,�z` -.,
ACCESS RISERS :r;; <',..� `; ,a' i sc.•�•, �:a;::..t 1-;,,tea:;.; ;; f., c. •
TO GRADE 4 FCHER'9317 . 5E _�' '
PUMP TANKS ,���•ixiii i� iiii
LOCATED AT HIGHER AQUAWORKS EXPIRES
ELEVATION THAN CONTROL PANEL
DRAIN FIELD MUST WI TIMER,EVENT COUNTER ELECTRICAL WORK DONE 24"RIBBED RISERS
&HOUR METER By LICENSED ELECTRICIAN
HAVE ANTI-SIPHON o WI WATER TIGHT LIDS
DEVICE INSTALLED.
a ,____4-, a FINISHED GRADE
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--- \ -- TRANSPORT LINE
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1200 GALLON WATER7IGHT
• CONCRETEPI/MP TANK
(22.5 GAL./IN.) •
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JOINTS f
•• PRESSURE TRANSDUCER
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• (OR FLOATS) CHECK VALVE
USE TANKS FITTED
W/CAST IN WATER
TIGHT FITTINGS FOR USE RUBBER
INLET/GUTLESS AND • PUMP BUCKET: •
GROMETS FOR
CAST IN RISER BUCKET HEIGHT MUST BE TRANSPORT LINE
ADAPTERS TO AT LEAST HEIGHT OF PUMP AND ELECTRICAL
ENSURE WATER I 1 _ ' ON RISERS. MAKE
TIGHTNESS . .•` • .a • '• . - .4 .4..
.•••••• ' .. . a SURE ALL HOLES
4 ARE WATER-TIGHT
CUSTOMER: RANDY PINKERTON SCALE:NA
PIONEER DIGGING, INC. PARCEL#22003 50-00024 INSTALL TANKS ON ORIGINAL OR
SEPTIC DI:SIGN` ADDRESS:341 E FOX LANE COMPACTED LEVEL SOILS. RUN CROSS
3083 E MASON BENSON RD. GKAPEVIEW,WA 98546 DESIGNER: ROBER.T H.PAYSSE CONNECTIONS INTO ORIGINAL SOILS TO
OFFICE-360.4261803 FAX-360-427-2353 SHEET: TANKS SC'.:\I F: NA AVOID SETTLING.
Iillie jPumps.
Pump Specifications 4- s i
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PumPs
LATERAL LATERAL FEEDER TOTAL ORIFICE ORIFICE DIST.TO TOTAL
ORIFICE TOTAL
LATERAL# LENGTH PIPE SIZE LENGTH LENGTH DISCHARGE SPACING 1ST ORIFICE HEAD
(feet) (inches) (feet) (feet) SIZE(inch) RATE(gpm) (feet) (inches) ORIFICES (feet)
1 50 1.25 3 53 3/16" 0.59 4 12 13 0.47
2 50 1.25 20 70 3/16" 0.59 4 12 13 0.62
3 50 1.25 24 74 3/16" 0.59 4 12 13 0.66
DRAINFIELD HEAD(feet) 1.76
TRANSPORT LINE HEAD(feet) 0.72
ELEVATION CHANGE(feet) 15
RESIDUAL/SQUIRT(feet) 2
EXTRA LOSS/FITTINGS(feet) 5
TOTAL DYNAMIC HEAD(feet) 24.47
TOTAL GALLONS PER MINUTE 23.01
PIONEER DIGGING, INC. PARCEL# 2200 SppY2PIN4
KERTON
SEPTIC DESIGNS ADDRESS: 341 E FOX LANE
3083 E MASON BENSON RD. GRAPEVIEW,WA 98546 DESIGNER: ROBERT EL PAYSSE
OFFICE-360-426-I803 FAX-360-427-2353 SI 111'T: CALCS SCALE NA
•
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. Designer not responsible for electrical permitting or other electrical specific code requirements.
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 10ft 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 10ft 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 may or
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. NOV 1
2413
15. Changes made at time of installation may impact designer calculations, pump sizing,and �4
compliance w/county and state requirements. Contact designer prior to install w/any 'dtA(
proposed variations from design. Changes may result in additional fees and permitting. NEa�if;
CUSTOMER: RANDY P[NKERTON ,11.1•�
PIONEER DIGGING, INC. PARCEL# 22003 50-00024 s r.o3n
r $p`> RQBER,N 9AY55E lr•�
SEPTIC DESIGNS ADDRESS: 341E FOX LANE .��� 'if;
3083 E MASON BENSON RD. GRAPEVIEW,WA 98546 DESIGNER: ROBERT I-L PAYSSE EXPIRES
OFFICE-360-426-1803 FAX-360-427-2353 SI 11.11: NOTES SCALE NA