HomeMy WebLinkAboutSWG2023-00424 - SWG Application / Design - 10/4/2023 MASON COUNTY 415N6T"STREET,$HE7-967 ,EXT 400
J 1 SHELTON.360-42T-96.Q EXT 400
'1 BELFAIR:360-275-4467,EXT 400
' Public Health & Human Services ELMA:360-482-5269.EXT400
FAX:360-427-7787
On-Site Sewage System Permit: SWG2023-00424
APPLICANT NIGHTINGALE ET UX COREY Phone: 360-999-9276
Address: VERONICA CANTALICE HOODSPORT, WA 98548
OWNER NIGHTINGALE ET UX COREY Phone: 360-999-9276
Address: VERONICA CANTALICE HOODSPORT, WA 98548
SEPTIC DESIGNER Bob Paysse -Pioneer Digging Inc Phone: 360-426-1803
Address: 3083 E Mason Benson Road GRAPEVIEW,WA 98546
Site Address: 5392 N Lake Cushman Rd
Primary Parcel Number: 423335102004
Permit Description: 3-bedroom pressure system
Permit Submitted Date: 10/04/2023
Permit Issued Date: 10/24/2023
Issued By: David Anderson
Current Permit Fees Paid: $525.00 (additional ees may be required upon installation of system)
Permit Expiration Date: 10/12/2026 (based on date or 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/ass-inspection-request.php or call:
360-427.9670, extension 400.
- OFFICIAL USE ONLY
MASON COUNTY I U 4 — �3 c >
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COMMUNITY SERVICESDATE RECEIVED•
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Public Health emmmuniyyHeamn/Environmental Helm; ` G y
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ON-SITE SEWAGE SYSTEM APPLICATION
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APPDCAN' PHONE FD
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COREY NIGHTINGALE 360-999-9276 c
MAILINGADDR CITY STATE ZIP CODE 3
5394 NE LAKE SS TCUSHMAN RD HOODSPORT WA 98548 s
5392 N LAKE CUSHMAN RD HOODSPORT WA 98548 I a
NAME OF DESIGNER PHONE I N
ROBERT H. PAYSSE 360-426-1803
NAME OF INSTALLER PRONE o I °'
TBD
PERMIT TYPE(select one) DRINKING WATER SOURCE — °i
PI-RESIDENTIAL OSSFh COMMUNITY O55 h COMMERCIAL O55 g PRIVATE INDIVIDUAL WELL 6 PRIVATE TWO-PARTY WELL 2 IW
TYPE OF WORK(select one; PUBLIC WATER SYSTEM
ri NEW CONSTRUCTION/UPGRADES F] REPAIR/REPLACEMENT OTHER DETAILS(seta)au ma:epplrl 0 TABLE IX REPAIR ICU
SUBMIttALs I� 0 SURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINE W
FJI DESIGN FORM(REQUIRED) [V SEPTIC DESIGN(REQUIRED) BEDROOMS 0=SIZEo
SWAIVER(S)(IF APPLICABLE) 3 7.84 x '
0
DIRECTIONS TO SITE AND SITE CONDITIONS (ex e eO gate)
CALL HOMEOWNER PRIOR TO VISIT. I Iv
NORTH. LK CUSHMAN RD. TO ADDRESS ON MAILBOX, TURN RIGHT, THEN o I O
IMMEDIATE LEFT. TRAVEL THRU GATE (CALL HOMEOWNER) THEN RIGHT INTO I o
PROPOSED DEVELOPMENT AND BUILDING LOCATION. SEE SITE PLAN.
SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. I a
—.- - OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE/FAILURE SOURCE(for repo1ng purposes)
0 VOLUNTARY 0MAINTENANCE/PUMPING 0 BUILDING PERMIT ❑HOME SALE ❑COMPLAINT 0OTHER.
INSPECTOR SOIL LOGS COMMEN IS/GONDI➢DNS
TItl : 0 - ko` (6L44(015
L1B -L1 r, 65
TRT. d -- 36 )t 6 L ) ee(S
�e �fiw u� 3G �/ ltie4V9 (& pa moh 4
PofSio 36` •
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IN-3: o- if ` (it vwd5 - -
RECORD DRAW NG AND INSTAI LAT on REPOR-
SOIL CODES:
V=VERY G=GRAVELLY S=SAND L=LOAM Si=ELT C=CLAY E=-xREMu" R=ROOTS REQUIRED FOR FINAL APPROVAL
NSPECTOR SIGNATURE DATE APP.(CATION EXPIRADON DATE APPLICATION APPROVED/ISSUED BY DATE
f" I0 //2l2073 Nil/"lig 0. (o/P(M23
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REV'SED IIOrzD1`
DESIGN FORM—PACE ONE Assessor's Parcel Number: 4 2 3 3 3 — 5 1 — 0 2 0 0 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 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. Llaximum puper sice 11".V 1
PARCEL IDENTIFICATION
Permit Number: SWG 'c'O If Zit Designer's Name: ROBERT H. PAYSSE
COREY NIGHTINGALE 360-426-1803
Applicant's Name: _ Designer's Phone Number:
5394 N LAKE CUSHMAN RD 3083E MASON BENSON RD
Mailing Address: _ Designers Address: _
HOODSPORT WA 98548 GRAPEVIEW WA 98546
City State Zip City State Zip
DESIGN PARAMETERS
Treatment Device
❑Glendon Riolilter 0 Sand Filter 0 Mound 0 Sand Lined Drain add 0 Recirculating Bitten l ype:
0 Aerobic Unit Make/Model 0 Disinfection Unit Make/Model Other: _
Drainfield Type
❑Gravity RS 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 30 ft —
Daily Flow: Design Flow 360 gpd / Diameter 1.25 in
Septic rank Capacity(working) 1500 gal - Number 5 '
Receiving Soil Type(I-6) 3 • — Separation 9 ft
Receiving Soil Appl.Rate 0.8 gpd/ft' Orifices
Required Primary Area 450 ft2 / Total Number of Orifices 40 ,
Designed Primary Area 450 (12 Diameter 3/16 in
Designed Reserve Area 450 ft' Spacing 48 in
Trench/Bed Width 3 fl'/ Manifold
i
Trench/Bed Length 150 ft ScheduleClass SCH.40
Elevation Measurements Length 36 ft
Original Drainfield Area Slope 15 n/o Diameter 1.25 in
New Slope,If Altered 15 % Preferred manifold configuration used? 2'Yes 0 No
Depth of Excavation up-slope 19 in Transport Pipe
from Original Grade Dorrn-sIrpe 14 in Schedule/Class SCH. 40
Designed Vertical Separation 24+ in Length 175 It
Gravelless Chambers Required? 0 Yes It No 0 Optional Diameter 2 in
Pump Required? Rf Yes 0 No Dosing and Pump Chamber
Pump/Siphon Specifications Number ofdoscs/day 6
Diff. in Elevation Between Pump&Uppermost Orifice 18 ft Dose quantity 60 gal
Drainfield Squirt Height/Selected Residual(head) 2 ft Chamber Capacity (flood) 1500 gal C
Uppermost Orifice RI Higher 0 Lower than Pump Shutoff Pump controls: Please check those required-
CapacitymTotalPressureHead 24 gpm IfSTimer Rklapse Meter 1e Event Counter
Calculated Total Pressure Head 28 ft If Timer: Pum on 15 MI Pump off 4 HRS
Comments AP P
OCT 2 4 2023
MASON COUNTY ENDVIBANMEN,AL u.EAI-Tu
DESIGN FORM—PACE TWO Assessor's Parcel Number: 4 2 3 3 3 -- 5 1_ -- 0 2 0 0 4
Permit Number: SWC
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
g Test hole locations 171 Drainfield orientation and layout Reference depth from original grade:
g Soil logs g Trench/bed dimensions and lg Septic tank
g Property lines critical distances within layout 1 Drainfield cover
10 Existing and proposed wells m D-Box/Valve box locations Reference depth from original grade
within 100 ft of property g Septic tank/pump chamber and restrictive strata:
g Measurements to cuts, banks, and locations rrd Laterals,trench/bed,top and
surface water and critical areas g Observation port location bottom
g Location and orientation of fi4 Clean-out location ❑ Curtain drain collector
curtain drain and all absorption g Manifold placement 0 Sand augmentation
components
fd Orifice placement Other cross-section detail:
ig Location and dimension of g Lateral placement with distance Er Observation ports/clean-outs
primary system and reserve area to edge of bed
6 Other Information
1 Buildings gt ,
Audible/visual alarm referenced Yes No
lb Direction of slope indicator Lf Scale of drawing shown on scale g 0 Design staked out
g Waterlines bar 0 g Recorded Notices attached
g Roads, easements, driveways, 0 g Waiver(s)attached
parking fib 0 Pump curve attached
g North arrow and scale drawing 0 g Evaluation of failure
shown on scale bar Non-residential justification
❑ lif Waste strength
❑ g Flow
DESIGN APPROVAL
The undersigned designer must be notifie by installer at time of installation g Yes 0 No
Lof iet2 Hz.
4P. ignature of Designer Date /�
The undersigned has reviewed this design on behalf of Mason County Public Health and determined it Vi ED
compliance with state and local on-site regulai ons: OCT 2 c 21723
707 It/7a71
MAs„5 ',,r, -
Environmental Health Specialist Date n/ - .'9'TAL HEALTH
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
/ The design is stamped"Approved" by Mason County Public Health. / 7/Z!/
✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: (G! Z8g
✓ 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: 12/72015
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PIONEER DIGGING, INC.
CU''7-""K COREY NIGHIIVGALE I L 1 1 F c 1 F51 n:I r 2
P1RC II .42333-5E02004 °,I-';1LV;12 Imo"
SEPTIC DESIGNS ADDRISv. 5392 N.LK CUSHMAN RD KOv6'II 13 RJ.b ta 13
3083 F.Savh V BF]SJN RR CR 41}L‘IF\A V:A 985If 12I_I NIB. ROBERT H PAYSSE
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11 FILTER
'.ANKS MUST RE .
ON STATE DOH 1 1500 CALLONWAIER77cHT
APPROVED EST t CONCRETESEGDC TANK
OF SEWAGE ' ''i f4t
TANKS A
PUMP TANKS
OVER GAL 't • J ' .bS+`
ACCESS RISWO ,y.- ., r..lt . 4� .�d�_• ...( 1” V .,Si,
ACCESS RISERS <^ - 4%. •
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PUMP TANKS �r'; crrvY'az-`,
LO AI EP ATHICHER AWAVORE6
EL Fl ATIOA'THANDRAI CONTROL PANED
n i. LEN i� er. • 24 RIBBED RISERS
HAAVEVE A ANTI MUST � �� t�'- a � / NATER TIGHT LIDS
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DEVICE INSTAL LED- .----, t I FINISHED GRADE
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INLET i a UNION G BALL VALVE
1500 CALLONWA7ER77cHT \ .
CONCRt/t PUMP TANK
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JOINTS V
PRFSSVRC TRF I O CHECK VALVE
(GR FI OATS)
I.'SE TANKS FITTED
A/CAST IN WATER
TICIII FITTINGS FOR USE RU F.R
I N LET/OUTLESAND PUMP BUCKET: _ GrOMFTSFOR
C 1L RISER RACKET 4 IGHT MUST BE � TPAR.SPORT LINE
ADAPTERS TO AT LEAST HEIGHT OF PUMP I C AND ELECTRICAL
ENSURE WATER I ON RISERS MAKE
TIC TIGHTNESS 'r „ . SURE ALLHOLES
ARE WATER-TIGHT
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PIONEER DIGGING, INCCUH `IE R: COREYMGENGALE
ERl I 42333-51-02004 INSTALL TANKS ON ORIGINAL OR
S[PIlc DCSIGNS ADDRESS.5392N LK CUSHMAN COMPACTED LEVEL SOILS RUN CROSS
DFNG\LIL ROBERT ELPAYSSE CONNECTIONS IN TO ORIGINAL SOILS TO
4UN3 I.[1AIJH RFN"aN RD. GR 410i4N.N T 9tlSIP A .
Jmu iCnHx 1803 FEC 300 427 2153 ,I II:I I. TANKS A?vI I: NA VOI2 SETTLE NC
Flow/Capacity in Liters Per Minute =MEW uetleGlAflT
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Flow/Capacity in US Gallons Per Minute
LATERAL LATERAL FEEDER TOTAL ORIFICE ORIFICE ORIFICE DIST.TO TOTAL TOTAL
LATERALft LENGTH PIPE SIZE LENGTH LENGTH DISCHARGE SPACING 1ST ORIFICE HEAD
SIZE(inch) ORIFICES
(feet) (inches) (feet) (feet) RATE(gpm) (feet) (inches) (feet)
1 30 1.25 3 33 3/16" 0.59 4 12 8 0.12
2 30 1.25 9 39 3/16" 0.59 4 12 8 0.14
3 30 1.25 18 48 3/16" 0.59 4 12 8 0.17
4 30 1.25 27 57 3/16" 0.59 4 12 8 0.21
5 30 1.25 36 66 3/16' 0.59 4 12 8 0.24
DRAINFIELD HEAD(feet) 0.88
TRANSPORT LINE HEAD(feet) 175
ELEVATION CHANGE(feet) 18
RESIDUAL/SQUIRT(feet) 2
EXTRA LOSS/FITTINGS(feet) 5
TOTAL DYNAMIC HEAD(feet) 27.63
0 TOTAL GALLONS PER MINUTE 23.6
OCT 2 4 2023
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3083E \Nv\'hE\¢ON RD. CRAPI HF\\L\YA 98510 DEIG\IR. ROBERT FL PAYSSE o-hS
OFFICE-3n6A2(11803 IAC '3004252353 5111IT'. 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.
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 may or
may not meet other requirements.
13.All onsite septic systems require regular maintenance to verify satisfactory operation. The systeJ� er/operator is
responsible for the continuous operation and maintenance of the system per WAC 246-272A. For 6ppd cci �}pe'Qter�
information, refer to Mason County Public Health Homeowner's Manual,which should be received after insta^a p D
14. System owner should be cautious of landscaping around septic components. Root intrusion Ocl
can cause premature failure of the drainfield area. In addition, bushes and trees should be keWASEN CC 4 2�23
away from lids and other septic maintenance points. yy'YED 49 Aigr .. L HE
q(7H
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 ,[S-''
proposed variations from design. Changes may result in additional fees and permitting. n�',�,s,„Y .
77,
PIONEER. DIGGING, NC ` us I R\R R 33 GALE
SLIPIIC. DI-NIGNS \DDRH 5392N.LKCUSHMANRD 1 , s.z-t ucr
308 3 r-st,t,ON BENO,N RD. (KAPPA IFw. VA 9a51t, DF>IG\FR_ ROBERT FL PAYSSE
011ILL 3001201803 FP-3W-I27-2353 ' SI III I: NOTES SCALE NA