HomeMy WebLinkAboutSWG2023-00508 - SWG Application / Design - 12/4/2023 A , MASON COUNTY 415N 6TH STREET. SHELTON.WA 98584
••••!!!! SHELTON:360-427-9670,EXT 400
BELFAIR:360-275-4967.EXT 400
Public Health & Human Services ELMA:360-482-5269.EXT 400
FAX:360-427-7787
On-Site Sewage System Permit: SWG2023-00508
APPLICANT KILLMAN JACKIE LOUIS &ALISHA Phone:
ANN
Address: 16506 N WYLIE DR NINE MILE FALLS, WA 99026
OWNER KILLMAN JACKIE LOUIS &ALISHA Phone:
ANN
Address: 16506 N WYLIE DR NINE MILE FALLS,WA 99026
SEPTIC DESIGNER Bob Paysse • Pioneer Digging Inc Phone: 360-426-1803
Address: 3083 E Mason Benson Road GRAPEVIEW, WA 98546
Site Address: XXX W Clear Lake Dr
Primary Parcel Number: 421355000047
Permit Description: 5-bedroom pressure system w/sand lined drainfield
Permit Submitted Date: 12/04/2023
Permit Issued Date: 12/15/2023
Issued By: David Anderson
Current Permit Fees Paid: $525.00 (additional tees may be required upon installation of system).
Permit Expiration Date: 12/05/2026 (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 055.
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
MASON COUNTY DATERE<NpID �_ 4c
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APPLICANT PHONE r
JACK & ALISHA KILLMAN c
MAILING ADEREBs-STREE!CITY.STATE ZIP CODE
16506 N WYLIE DRIVE NINE MILE FALLS WA 99026 03
SITE ADDRESS-STREET CrY ZIP
XXX W CLEAR LAKE DR SHELTON WA 98584 la
NAME OF DESIGNER PHONE I N
ROBERT H. PAYSSE 360-426-1803
NAME OF INSTALLER PHONE a
TBD (7) I4,
PERMIT TYPE(selM one) DRINKING
K C RINNG WATER SOURCE 5
V RESIDENTIAL OSS II COMMUNITYO55 FI COMMERCIAL OSS Vd PRIVATE INDIVIDUAL WELL 5 PRIVATE TWO-PARTY WELL $ I01
TYPE OF WORK(selec one) Q PUBLIC WATER SYSTEM
NEW CONSTRUCTION I UPGRADES FI REPAIR/REPLACEMENT OTHER DETAILS IseIeman that applW, 0 TABLE IX REPAIR IV1
SUBMITTALS
SURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINECO
V DESIGN FORM(REQUIRED) W SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE r IC)
9 WAIVER(S)(IF APPLICABLE) 5 2.11 n
•
DIRECTIONS TO SITE AND SITE CONDITIONS (ex locked gale)
N. HWY 101 TOWARDS HOODSPORT. JUST AFTER COUNTY PUBLIC WORKS TURN 10
LEFT INTO GATED COMMUNITY ON CLEAR LAKE DRIVE. CONTACT DESIGNER FOR r
GATE CODE. CONTINUE ON ROAD INTO COMMUNITY AND AROUND LAKE TO 800 0 0
BLOCK. SITE ON RIGHT (WATERFRONT) WITH PDI SIGN POSTED. I a
Cgct Co At
SrTE MUST BE FLAGGED FROM MAW ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS I J
OFFICIAL USE ONLY BELOW THIS LINE -
UPGRADE)FAILURE SOURCE(for reoonmg purpose()
0 VOLUNTARY 0 MAINTENANCE/PUMPING 0 BUILDING PERMIT OHOME SALE ❑COMPLAINT (OTHER.
INSPECTOR SOIL LOGS ' TN I:0_25" 6 4.Avis
COMMENTS/CONDITIONS
�U1112$-65,; E Gis 40 tookin
nil' 0 if 6 L rv{5
27.-60 gi mi4S * brHm',
NO P1S1-
RECORD DRAWN NG AND INSTALLATION REPORT
SOIL CODES:
=VE-VERY G=GRAVELLY S-SAND _LOAM S-SILT C=CLAY E=EXTREMELY R=ROOTS REOL RED FOR FINAL A=RROVAx
INSPEG R SIGNATURE -ATE APPLICATION EXPIRATION DATE APPLICATION APPROVED( S CEO BY DAIS
s/w2 12425(Z�iz6 lz/ M67973
THIS FORM MAY B SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTYWEBSITE REVISED 12/Irz015
FORM-PAGE ONE Assessor's Parcel Number: 4 2 1 3 5 — 5 0 — 0 0 0 4 7
An will be reviewed when 3 conies of each of the following are submitted:
.npleted design form that has been signed and dated. v Scaled layout sketch,including all applicable items on checklist
Scaled plot plan,including all applicable items on checklist. 0 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. /I"X IT'
) PARCEL IDENTIFICATION
Permit Number: SWG 212ZJ -'OOfcQ Designer's Name: ROBERT H. PAYSSE
Applicant's Name: JACK&ALISHA KILLMAN Designer's Phone Number: 360A26-1803
Mailing Address: 16506 N WYLIE DR _ Designer's Address: 3083 E MASON BENSON RD
NINE MILE FALL' WA 99026 GRAPEVIEW WA 98546
City State Zip City State Zip
DESIGN PARAMETERS
Treatment Device
❑Glendon Bit-Filter 0 Sand Filter 0 Mound fiiSand Lined Drainfield 0 Recirculating Filler,Type:
❑Aerobic Unit Make/Modet 0 Disinfection Unit Make/Model Other:
Drainfield Type
❑Gravity II Pressure (Trench 0 Bed 0 Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of edrooms 5 7 Schedule/Class SCH.40
Daily Flow: Operating Capacity 450 - gpd Length 50 ft
Daily Flow:Design Flow 600 ' gpd Diameter 1.25 - in
Septic Tank Capacity(working) 1200+1500 gal Number 4
Receiving Soil Type(1-6) 1 Separation 10 ' ft
Receiving Soil Appl.Rate 1.0 gpd/ft2 Orifices
Required Primary Area 600 11.2 Total Number of Orifices 52
Designed Primary Area 600 " le Diameter 3/16 in
Designed Reserve Area 600 l ft- Spacing 48 in
Trench/Bed Width 3 ft Manifold
Trench/Bed Length 200 . ft Schedule/Class SCH. 40 -
Elevation Measurements Length 33 ft
Original Drainfield Area Slope 2 % , Diameter 1.25 in
New Slope, If Altered 2 % Preferred manifold configuration used'! g Yes 0 No
Depth of Excavation Ilpdope 21+24 SAND in ' Transport Pipe
from Original Grade Dmni-slnpe 20+24 SAND in ' Schedule/Class SCH.40
Designed Vertical Separation 12+ /in Length 300+/- ft
Gravelless Chambers Required? 0 Yes Iii No 0 Optional Diameter 2 in
Pump Required? Ygl Yes 0 No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day 6
•
Dili. in Elevation Between Pump& Uppemost Orifice 28 ft Dose quantity 100 gal
Drainfield Squirt Height/Selected Residual(head) 2 FtChamber Capacity(flood) 1500 gal
Uppermost Orifice g Higher 0 Lower than Pump Shutoff Pump controls: Please check those required.
Capacity @ Total Pressure Head 30.7 gpm EiTimer gElapse Meter g Event Counter
Calculated Total Pressure Head 42,3 ft If Timer: Pump on 1.5 MIN ,Pump off 4 FIRS
Comments Ai—) 6- L,bw , ... __.
DEC 28 2023
. . .. . !L ...T .JL HEALTH
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DESIGN FORM PAGE"RLYO%2023 ssessor's Parcel Number:4 2 1 3 5 — 5 0 — 0 0 0 4 7
RECE/V D Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
O Test hole locations Q1 Drainfield orientation and layout Reference depth from original grade:
g Soil logs 121 Trench/bed dimensions and lig Septic tank
1 0 Property lines critical distances within layout fg Drainfield cover
• Existing and proposed wells 64 D-Box/Valve box locations Reference depth from original grade
within 100 ft of property M Septic tank/pump chamber and restrictive strata:
m Measurements to cuts,banks,and locations fig Laterals,trench/bed,top and
surface water and critical areas 64 Observation port location bottom
g Location and orientation of It Clean-out location 0 Curtain drain collector
curtain drain and all absorption Rf Manifold placement 0 Sand augmentation
components fig Orifice placement Other cross-section detail:
Cb Location and dimension of Rd Lateral placement with distance fig Observation ports/clean-outs
primary system and reserve area to edge of bed
g Other Information
Buildings Ed Audible/visual alarm referenced Yes No
61 Direction of slope indicator Scale of drawing shown on scale g d 0 Design staked out
EZI Waterlines bar 0 lig Recorded Notices attached
It Roads,easements,driveways, 0 g Waiver(s)attached
parking Gg 0 Pump curve attached
tii North arrow and scale drawing 0 fig Evaluation of failure
shown on scale bar Non-residential justification
❑ 0 Waste strength
❑ It Flow
DESIGN APPROVAL
The undersigned designer must be notified by install ant time of installation g Yes 0 No
tz�ZZ1Z
Signature Date
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-si ulations:
IZ/ Zggzoz?
Environmental Health Specialist Date Ott c (uLj
CAUTION: DESIGN APPROVAL iS VALID ONLY UNDER THE FOLLOWING CONDITION: S'�IJ-cOr.M_A,Al HEALTH✓ The design is stamped"Approved"by Mason County Public Health. �t A
/ The Onsite Sewage Permit has not expired.the Permit Expiration Date is: 17(o(` 0Z
✓ 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
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LATERAL LATERAL FEEDER TOTAL ORIFICE ORIFICE DIST.TO TOTAL
ORIFICE TOTAL
LATERAL 4 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 13 63 3/15 0.59 4 12 13 0.56
3 50 1.25 23 73 3/16 0.59 4 12 13 0.65
4 50 1.25 33 83 3/16' 0.59 4 12 13 074
DRAINFIELD HEAD(feet) 2.43
TRANSPORT UNE HEAD(feet) 4.87
ELEVATION CHANGE(feet) 28
RESIDUAL/SQUIRT(feet) 2
EXTRA LOSS/FITTINGS(feet) 5
TOTAL DYNAMIC HEAD(feet) 42.30
TOTAL GALLONS PER MINUTE 30.68
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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. 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 10ft 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' t nmapproval.
14. System owner should be cautious of landscaping around septic components. Root intrusion
1 l.••b \ �.'n�av
can cause premature failure of the drainfield area. In addition, bushes and trees should be kept K'"
away from lids and other septic maintenance points. DEC 2 8 2023
mAs^
15. Changes made at time of installation may impact designer calculations,pump sizing,and JNry rw,,,�,,,,,,_
compliance w/county and state requirements. Contact designer prior to install w/any ,87' DJA' "�f' ALM
proposed variations from design. Changes may result in additional fees and permitting. " ,.
PS,
PIONEER DIGGING, INC CUSIO\fIR. JACK ICWMAN
V7C I I.a 49353000047
SEI'[IC DI:SI(1NS \l)DRI'>: xxxw CLEAR LKDR. r c 7 iczr_
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:mil. 3n0.4201803 FAN-3b(l 27-2153 >IILI.I'. NOTES SCALE NA