HomeMy WebLinkAboutSWG2023-00524 - SWG Application / Design - 12/14/2023 A MASON COUNTY 415 N 6TH STREET, SHELTON,WA 98584
SHELTON:360-427-9670,EXT 400
BELFAIR:360-275-4467,EXT 400
3,yy�+ Public Health & Human Services ELMA.360-482-5269,EXT 400
e „t FAX:360-427-7787
On-Site Sewage System Permit: SWG2023-00524
APPLICANT BADDELEY EDWARD E&RACHAEL M Phone:
Address: 58 W FROSTY LN S SHELTON, WA 98584
OWNER BADDELEY EDWARD E & RACHAEL M Phone:
Address: 58 W FROSTY LN S 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: 443 W Lost Lake Rd
Primary Parcel Number: 419063300210
Permit Description: 2-bedroom pressure system w/sand lined bed
Permit Submitted Date: 12/14/2023
Permit Issued Date: 12/29/2023
Issued By: David Anderson
Current Permit Fees Paid: $525.00 ,additional fees may be required upon installation of system).
Permit Expiration Date: 12/22/2026 (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/environmentallonsite/oss-inspection-request.php or call:
360-427-9670, extension 400.
OFFICIAL USE ONLY
DATEkecBveD•
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MASON COUNTY R RECLIY.D m y
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ON-SITE SEWAGE SYSTEM APPLICATION 3 73
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APPLICANT ONE m
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EDWARD BADDELEY 3
MAILING ADDRESS-STREET CITY.STATE,ZIP CODE SHELTON WA 98584 p
58 W FROSTY LN S
S1TE ADDRESS-STREET CITY.ZIP CCOE SHELTON WA 98584 IA
443 W LOST LAKE ROAD
ONE
ROBERTNAME OF DE 360-426-1803
RORLE H. PAYSSE a I CC)
OF INSTALLER PHONE Q
TBD o
PERMIT TYPE(select one) p DRINKING WATER SOURCE G
p c fl COMMERCIAL OSS �I PRIVATE INDIVIDUAL WELL 5 PRIVATE TWO.PARTYWELL 2 Ia)
IR OFSIDRNTIAL055 LS.COMMUNITY OSS
�.PUBLIC WATER SYSTEM I
rvPgE'!NEW C OF (NSTRUC CW
pMNEWCONSTRUCTIONIU°GRADES LJ REPAIft/REPLACEMENT OTHER0SURFACING SEll NatePPlY) ❑ ING TABLEUREAIR
❑ SURFACING SEWAGE ❑EXISTING FAILURE ❑SHORELINE O IW
SUBMITTALS LOT SIZE
p VSEPTIC DESIGNREQUIRED) BEDROOMS 0.58 AC r L
ICL DEBIGN FORM(REQUIRED) ( A I O
µ WAIVER(s)(IF APPLICABLE) 2
DIRECTIONS TO SITE AND SITE CONDITIONS.Lea locked gale) CD
WEST OUT CLOSQUALLUM TOWARDS ELMNSATSOP. TURN RIGHT ON LOST
LAKE AND THEENDSITE ONILEEFT. ACCESSD THE 400 DRESS BOCK TURN LEFT ONTO ACCES ROAD SLJJUST BEFORE FROSTY LANES SEEOAD a I N.)
SITE PLAN. I
0
SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS.
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE t FAILURE SOURCE)for reporvne purposes)
❑VOLUNTARY ❑MAINTENANCE/PUMPING 0 BUILDING PERMIT ❑HOME SALE ❑COMPLAINT BOTHER:
COMMENTS I CONDITIONS
INSPECTOR SOIL LOSS
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1t1.:0 -11‘ 6f1, R9
24-SS" EGGS
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RECORD DRAWING AND INSTALLATION REPORT
SOIL CODES;v=VERY G=GRAVELLY S=SAND rLOAM Si=SILT C=CLAY E=EXTREMELY R=ROos REQUIRED FOR=1NALAPPROVAL.
DATE
INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE
APPd,-
ThISROVED/ISSUED BY
9k-7z /Z/Z2/ZWU1777?/7073
FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE
REVISED 1 27RO.5
, DESIGN FORM—PAGE ONE Assessors Parcel Number: 4 1 9 0 6 — 3 3 — 0 0 2 1 0
A design will be reviewed when 3 conies 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. s(Toss-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: II".Y C"
'�/��+}, x\ PARCEL IDENTIFICATION
Permit Number: SWG per.J-L0 - Designer's Name: ROBERT H. PAYSSE
EDWARD BADDELEY 360-426-1503
Applicants Name: _ Designer's Phone Number:
Mailing Address: 58 W FROSTY LN S _ Designer's Address: 3083 E MASON BENSON RD
SHELTON WA 98584 GRAPEVIEW WA 98546
City State Zip City State Zip
DESIGN PARAMETERS
Treatment Device
❑ Glendon Biofilter 0 Sand Filter 0 Mound l4f Sand I.incd Drainfield 0 Recirculating Filter,Type:
❑Aerobic Unit Make/Model 0 Disinfection Unit Mak✓Model Other: _
Drainfield Type
❑Gravity g Pressure }'Trench 0 Bed 0 Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 2 / Schedule/Class SCH.40--
Daily Flow:Operating Capacity 180 gpd Length 24 ft
Daily Flow: Design Flow 240 / gpd Diameter 1.25 / in
Septic Tank Capacity(working} 1200 — gal Number 4
Receiving Soil Type(1-6) 1 -' Separation 1.5 _ ft
Receiving Soil Appl. Rate 1.0 gpd/ft Orifices
Required Primary Area 240 r re Total Number of Orifices 32
Designed Primary Area 240 ft- Diameter 3/16 in
Designed Reserve Area 240 r ft- Spacing 36 in
Trench,/Bed Width 10 - ft Manifold
Trench,'Bed Length 24 - ft Schedule/Class SCH.40
Elevation Measurements Length 4 ft
Original Drainfield Area Slope 0 % Diameter 1.25 in
New Slope, If Altered 0 % Preferred manifold configuration used? lid Yes 0 No
Depth of Excavation up-store 18+24 SAND in Transport Pipe
from Original Grade Itar,„_Kiefe 18+24 SAND in-• Schedule/Class SCH. 40
Designed Vertical Separation 12+ in ' Length <50 it
Gravel less Chambers Required? 0 Yes 66 No 0 Optional Diameter 2 in
Pump Required? g Yes 0 No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day 4
Diff.in Elevation Between Pump& Uppermost Orifice 6 R Dose quantity 60 gal
Drainfield Squirt Height/Selected Residual(head) 2 ft Chamber Capacity(flood) 1200 r gal
Uppermost Orifice 'Higher 0 Lower than Pump Shutoff Pump controls: Please check those required.
er
Capacity Ek Total Pressure Head 18.9 gpm gTimer gElapse Meter 172f Event Counter
Calculated Total Pressure I lead 13.9_ ft [�.r,�t; IF—.,lgT,'aglfr u®mppon @'�1.2 MIN ,pump off 6 HRS
Comments 1I I I�' 4 Y/ L Q„�Y
DEC 2 9 2023
'c4soV COUNTY ryy'RONMENTAL HEALTH
DJA
DESIGN FORM—PAGE TWO Assessor's Parcel Number: 4 1 9 0 6 -- 3 3 -- 0 0 2 1 0
Permit Number: SWG
DESIGN CHECKLISTS
Sealed Plot Plan Scaled Layout Sketch Cross-Section Sketch
g Test hole locations rd Drainfield orientation and layout Reference depth from original grade:
gl Soil logs g Trench/bed dimensions and g Septic tank
Fli Property lines critical distances within layout IV1 Drainfield cover
• Existing and proposed wells Eil D-Box/Valve box locations Reference depth from original grade
within 100 ft of property lg Septic tank/pump chamber and restrictive strata:
g Measurements to cuts, banks,and locations 0 Laterals,trench/bed,top and
surface water and critical areas I21 Observation port location bottom
121 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:
121 Location and dimension of lg Lateral placement with distance g Observation ports/clean-outs
primary system and reserve area to edge of bed Other Information
g Buildings g Audible/visual alarm referenced Yes No
• Direction of slope indicator Scale of drawing shown on scale ' 0 Design staked out
g Waterlines bar 0 g Recorded Notices attached
to Roads,easements,driveways. 0 g Waiver(s)attached
parking Rj 0 Pump curve attached
g North arrow and scale drawing 0 lr Evaluation of failure
shown on scale bar Non-residential justification
❑ lM Waste strength
❑ g Flow
DESIGN APPROVAL
The undersigned designer must be notified b ' in al at time of installation g Yes 0 No
cap � 1z( J9 z3
Signature of Designer / Date
The undersigned has reviewed this design on behalf of Mason County Public Health and de ' n toobbe in
compliance with state and local on-site ulations: �'
lZ� ®V ®
uzz
Envi nmental Health Specialist ate , DEC 29 1923
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONIi#1t4ON:,,_h_
✓ The design is stamped "Approved"by Mason County Public Health. / `;✓A 1 'c'1'fggh
✓ The Onsite Sewage Permit has not expired.the Permit Expiration Date is: I Z Z.hp[b
✓ 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: 12/772015
1
ACCESS'EMENT
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DEC 2 9 2023
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AN ASBUILT/INSTALL SIGNOFF FEE WILL OB PORT TO
BE CHARGED AT TIME OF INSTALLATION
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SEPIICDESIGNS vDDRI, 443W LOST LKED
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Submersible Effluent Pump
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MASON COUNTY EN., HEALTH
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1111 1 DJA
:�2:1 'F 5"3
LATERAL LATERAL FEEDER TOTAL ORIFICE ORIFICE DIST.TO TOTAL
LATERAL8 LENGTH PIPE SIZE LENGTH LENGTH ORIFICE DISCHARGE SPACING 1ST ORIFICE TOTAL HEAD
SIZE(inch) ORIFICES
(feet) (Inches) (feet) (feet) RATE(gpm) (feet) (inches) (feet)
1 24 1.25 4 28 3/16' 0.59 3 18 8 0.10
2 24 1.25 2 26 3/16' 0.59 3 18 8 0.09
3 24 1.25 4 28 3/16' 0.59 3 18 8 0.10
4 24 1.25 2 26 3/16' 0.59 3 18 8 0.09
DRAINFIELD HEAD(feet) 0.39
TRANSPORT LINE HEAD(feet) 0.50
ELEVATION CHANGE(feet) 6
RESIDUAL/SQUIRT(feet) 2
EXTRA LOSS/FITTINGS(feet) 5
TOTAL DYNAMIC HEAD(feet) 13,89
TOTAL GALLONS PER MINUTE 18.88
PIONEER DIGGING, LNG EY
PjfCI I- :ow 4190�3m B"°°°
SEPTIC DESIGNS AI)DRI>s. 443 W LOST I.eFD
3083 L'0A;:N HI>f.`N RD. CR APL3 ILIA.LS A 08518 DI.sic,AI K. ROBERT H.PAYSSE
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•
24"P I RRE15 RISERS IN/ ROI T )A l4'ATER-TIGHT LIDS
CLEANOHT USE RISER LIP4AP'f ERS WITH NC)GASKET LIPS
DEC 2 9 2023
. . FIN'ISHFP GRAPE �—..—I
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TANKS MUST RE •
ON STATE PUP A 7200 CALLONWATER77GHT )
APPROVE])LIST °. CONCRE7ESEV77C TANK
OF SEi'JAGE �: .t' 11 P‘`
VN1P IANKs e 1
TANKS 1
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k CI RISERS
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TO CRAPE E i,
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LCCATEPATFIIQHER AQHAVOPKS
ELEV\TIC N F:AN CONTROL PANEL Z
t r.evrvT vTEK RREP RISERS
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11
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I JJ _ TRANSPORT LINE
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1200 GALLON WAlER77GHT \
CONCRETE PUMP TANK
c (215 GAT../IN )
WATER=FIGHT
•
JOINTS I
PRESS. RE TRAINSPI/CER
(OP FLOATS) " CHECK VALVE
ILSE TANKS FITTED
W/CAST IN WATER
TIGHT FITTINGS FOR SEI RRER
INLET/CUTLES AND PUMP RHCKEI G GMEIS FOR
CAST RISER LEAST F PUMP � LINE
ANrTRA ELECT IOAL
APAPTERS TO AT LEASTHEIGHT OF PVMP AAD LECFMAKE
ENSURE WAIEK _ ON RISERS. MAKE
TIGHTNESS - n SURE ALL HOLES
ARE WATER-TIGHT
CLI31 G1N1FR; EDWARD BADDELEY SGSLt.V s
PIONEER DIGGING, NC.
AR( 41 4190633-007JO INSTALL TANKS ON ORIGINAL OR
SIT I IC. DI SIGNS ADDRI* 443 W LOST LAKE RD COMPA.EP LEVEISCII, RI IN CROSS
3083 F 33,33030 BE\RCN RD. 4R Mil II3A mA 9315R I)1>I(0\I:R: ROBERT H.PAYSSE CONNECTIONS I.A'TC ORIGINAL SOILS TO
CI F is_I. so) iscis 3 IiV 9a}1J¢l53 3311FE I: TANKS >GV I: NA AVOIDSEIILING
-
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 he 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 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 opesti d'+maaintenance
information, refer to Mason County Public Health Homeowner's Manual,which should be received afOli1{ Ra��r v p .
14.System owner should be cautious of landscaping around septic components. Root intrusion b.4
can cause premature failure of the drainfield area. In addition, bushes and trees should be kept DEC 2 9 2023
away from lids and other septic maintenance points.
15. Changes made at time of installation may impact designer calculations, pump sizing,and 0JA " ^ 4l nAi H
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. rk74 MA/
PIONEER DIGGING, INC ;R t "4;90°.;moo DD°
SI.P IIC DESIGNS ADDIucs. 4f3 WLOST'LICE RD �
9na3 F A 6FAC'ARo. CR-wraps,ss\98540 DEN( NI R. ROBERT H.PAYSSE
OFF ICI Son.F2'1803 rt\ 3ao 427 2353 SHEEP. NOTES SCALE NA