HomeMy WebLinkAboutSWG2023-00531 - SWG Application / Design - 12/22/2023 416 N 6 SHELTTON:360-427--9670,EXT 400
MASON COUNTY Public Health & Human Services BEe.: E MA 3604825269 EXT 400
FAX'.360- XT 0
87
On-Site Sewage System Permit SWG2023-00531 407 71s-oo9z
Phone'.
160 E 3RD ST UNION,WA 98592 407-716-0092
APPLICANT FOLSOM KENNETH M &LINNEA phone:
Address: FOLSOM KENNETH M &LINNEA
160 E 3RD ST360-698-8488
OWNERPhone:
Address: UNION,WA 98592
G ROD LEFT -Acme Design WA 98383
SEWAGE DESIGNER PO Box 2954 SILVERDALE,
Address:
160E 3rd St
Site Address: 160E 3rd St
Primary
Parcel Number: 3 2325009 pressure system: Upgrade gravity to Pressure OSS
006
1212212023
Permit Description: /20112212023
Permit Submitted Date: David Anderson
a6enmaal lees may be required upon installation of system)
Permit Issued Date: t
Currentu Permit: $525.00
(based on date of inspection)
Fees Paid: 1212912026
Permit Expiration Date: tanning
subject to zoning requirements and approval by the p
Permit Conditions'.
1 Proposed t stalfpeoMason County Title 17.
department mustu be installedp a Mason County Certified Installer unless prior written
2 author from Mason
n is obtained.
e depth specified on
sloe and downslop
authorization Mason County approval prior to back fill of
3 Drainfield installation not to exceed designed up pinstallation
design form.
isresponsibleMason County
Septic Designer/Engineer installation approval prior to
4 Installer f for obtaining
system components.
5 Installer is responsible for obtaining
b ckfill system components. and Installation fee must be submitted for
6 Masonason County Asbuilf Form, Record Drawing,
final installation approval.
THIS PERMIT MUST BE ONSITE DURING INSTALLATION OF OSS.
pITE WVS I SPE TED ANDD DESISTRUGN APPROVED.
IF THE SITE CONDITIONS HAVE CHANGED SINCE THE SITE WAS INSPECTED DESIGN APPROVED.
A
Y
PROPERTY OWNERS ARE RESPONSIBLE FOR DETERMINING AND MARKING ALL PROPERTY LINE AND EASEMENT LOCATIONS.
THIS L INSTALLATIONA AY BE REVOKEDgttiED•STRUCSURES or cal
,,,la.govlhealthlenvironm entallo ns iteloss-i nsp
FINAL APPROVAL IS REQUIRED PRIOR TO TEMPORARY OR FINAL O
360-427-9670,extension 400.
For Final Inspection visit: masonseunty
OFFICIAL USE ONLY— — - --
MASON COUNTY DATINEEENrD ,a ' a '� c y
COMMUNITY SERVICEAMOUNT � DE" o m
publk vla IiCom ml Or try emeotel Health` y y0
41,0 360 IM�.a „.�,..a,45M SWG nY'eD., -_653I 6
co
ON-SITE SEWAGE SYSTEM APPLICATION 3
m oil
En
aNE r
APPIMANT Linnea & Ken Folsom 407-716-0092 En
c
C
MAILING ADDRESS.STREET CITY,STATE ZIPGOGE WA 98592 A
160 E. 3rd St Union
SITE ADDRESS STREE,CITY ZIP CODE WA 98592 I ?
160 E. 3rd St Union
NAME of DESIGNER PHONE I N
Rod Left 360-698-8488
-- PHONE. O N
NAME of INSTALLER <
DRINKING WATER SOURCE 5
PERMIT
ARR one)
G rypDENTIAL0 C
WI RESIDENTIAL O55 IU.COMMUNITY O55 FLOMMERCIAL O55 6 PRIVATE INDIVIDUAL WELL U PRIVATE TWO-PARTY WELL Z N
— - PUBLIC WATER SYSTEM Umm�Water i'e20
—
RE GE oCO(NSTdUCl IX I
n�NEW CONSTRUCTIONIUPGRADES []�REPAIR IREPUCEMENT PIKER 0S se URFACING
SEunalaeob) ❑ T FUREAIR
❑ SURFACING SEWAGE 0 EXISTING FAILURE ❑SHORELINE (71
SUBMITTALS LOT SIZE rr I 0
6-WAIVER(S)
-DESIGNFORM(PWCIRED) AL SEPTIC DESIGN(REQUIRED) BEDROOMS 3 16,552sgy- o '
6WAI RISxIF APPLICABLE) T' I
DIRECTIONS'O SITE ANS SITE CONDITIONS;(ar.lxked ENNA
See map r
I CD
o 10
ti
10
SUE MOST RE FOGGED FROM WIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS.
ICD
OFFICIAL USE ONLY BELOW THIS LINE - — ----"
G - uRE souRCE O a m pwung p.rwl4'S)
UPGRADE,
VOLUNTARY O MAIN TENANCEPUMPING 0 BUILDING PERMIT °HOME SALE ❑COMPLAINT COMMENTS CONOCONDITIONST1:0 TOIL 4„
INNTET-o
H FAL
Re l- at qro r.rrmok
TNt=0-22.4L FS&
22-40' FS
nos at vo" Limit
TH):0-2g " rs� rover *+ zt
!1Tcd le " -or '
RECORD DRAWING AND INSTALLATION REPORT
sou.CODE'. - nEOUIRED FOR FINAL APPROVAL
-VERY G=GRAVELLY S=SAND L=LOAM Si=SILT C-CLAY E-EXTREMELY RROOTSC FIALPROVAL. DATE
s SIGNATURE DATE APPLICATION EXPIRATION DATE IC APPROVED/# nl2/Z9�2i 17 (7ilza7C I�.0 - l/Y/ToVi
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE
REVISED I2u20l5
DESIGN FORM-PAGE ONE Assessor's Parcel Number: 3 2 2 3 2 — 5 0 — 0 9 0 0 6
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
v Scaled plot plan,including all applicable items on checklist 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 //"X 17"
2 ry^�r�PARCEL IDENTIFICATION
Permit Number SWG wwl _0 •�y7�(_ Designer's Name: Rod Lek
Linnea 8 Ken Folsom Designer'sPhone Number: 360-698-8488
Applicant's Name: _
Mailing Address. 160 E 3rd St _ Designer's Address. PO Box 2954 Priori WA WA 98592 Silverdale WA OW 9JrCn
- ip
City State Zip City State Zip
DESIGN PARAMETERS
Treatment Device
❑ Glendon Riohiter 0 Sand Filter ❑Mound ❑Sand Lined Draiafeld ❑ Recirculating Filter,Type:
❑Aerobic Unit Make/Model 0 Disinfection Unit Make/Model Other _
Drainfield Type
❑Gravity Pressure EtTrench 0 Bed 0 Sub Surface Drip
Septic Tank/Drainfteld Specifications Laterals
Number of Bedrooms 3 Schedule/Class 40
Daily Flow.Operating Capacity Q`/O f gpd Length L10 iift
Daily Flow'. Design Flow gpd Diameter 1 - in
Septic Tank Capacity M 1200 T1y2>, gal Number 5
Receiving Soil Type(1-6) 4 Separation 5 ft
Receiving Soil Appi.Rate 0.6 tv`Pdiffa Orifices
Required Primary Area 600 - ft2 Total Number of Orifices 50
Designed Primary Area 600 92 Diameter 1/8 in
Designed Reserve Area 900 ft2 Spacing 48 in
IrenchBed Width 3 . ft Manifold
TrenchiBed Length 200 . ft Schedule/Class 40
Elevation Measurements Length 65 ft
Original Drainfield Area Slope 6-10 % Diameter 1 in
New Slope, If Altered 6-10 % Preferred manifold configuration used? g Yes 0 No
Depth of Fxcavmlon tip-slope 15 - in Transport Pipe
from Original Grade Down-slope 12 - in Schedule/Class 40
Designed vertical Separation 24 - in Length 5 ft
Gravelless Chambers Required? ❑ Yes 0 No g Optional Diameter 2 in
Pump Required? g Yes ❑No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day I�.
Difference in Elevation Between Pump Shutoff and Uppermost Dose quantity to gal
Orifice a' — fi Chamber Capacity 1000 gal
llppennost Orifice g Higher th Lower than Pump Shutoff Pump controls: Please check those required.
Capacity he Total Pressure Head 23.9 gpm gTimer fdElaose Meter Pi Event Counter
Calculated Total Pressure Head _ 19 a , ft If Timer. Pump on I Mi n IS$2 ,Pump off a t.ti
Comments
Retrofit existing gravity trenches to pressure. Add 80' of new trench to equal 200' total. ii
1 , 'DESIGN FORM—PAGE TWO Assessor's Parcel Number 3 2 2 3 2 -- 5 0 -- 0 9 0 0 6
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
54 Test hole locations 121Drainfield orientation and layout Reference depth from original grade:
Pi Soil logs lig Trench/bed dimensions and 54 Septic tank
tb Property lines critical distances within layout Pif Drainfield cover
❑ Existing and proposed wells Eil D-Box/Valve box locations Reference depth from original grade
within 100 ft of property lig Septic tank/pump chamber and restrictive strata:
❑ Measurements to cuts, banks, and locations g Laterals, trench/bed,top and
surface water and critical areas g Observation port location bottom
O Location and orientation of g Clean-out location ❑ Curtain drain collector
curtain drain and all absorption g Manifold placement 0 Sand augmentation
components g Orifice placement Other cross-section detail:
(b Location and dimension of s4 Lateral placement with distance 64 Observation ports/clean-outs
primary system and reserve area to edge of bed Other Information
Ed Buildings (a Audible/visual alarm referenced Yes No
® Direction of slope indicator lig Scale of drawing shown on scale ❑ d Design staked out
Fil Waterlines bar 0 rd Recorded Notices attached
fig Roads,easements,driveways, 0 g Waiver(s)attached
parking firl ❑ Pump curve attached
O North arrow and scale drawing 0 PS Evaluation of failure
shown on scale bar Non-residential justification
❑ fi'(Waste strength
❑ g Flow
DESIGN APPROVAL
The undersigned designer must be notified by installer at ' f installation EI Yes ❑ No
5 nature of Designer Date tra sq,
The undersigned has reviewed this design on behalf of Mason County Public Health and determined it to n
compliance with state and local on-si • egulations: ";/� /44/ W..
E or ental Health Specialist Date
7udJ
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING COM)ITiON
/ The design is stamped"Approved"by Mason County Public Health. �,� ,�����
/ The Onsitc Sewage Permit has not expired,the Permit Expiration Date is: 1
✓ 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
Pump Selection fora Pressurized System -Single Family Residence Project
FOLSOM/160 E.3RD ST
Parameters
DreoTAswrWsae 2m mho 160 HI ( IIiI I
Tra..znui 2 u'
I on tnneCr s m II
I
r amre� 2m I1
Dw,uayvaau� n� 140 1
Mac FBe�nt� 5 �_ Li ,
Mallidlagr 101 i 7
Ng61PB52e 'D0 sties I I I I t I
Nub alae'ds serail 5 120 1
Llmgh 40�d lot I 1 1
IPttC�s 90 1 '-
u,aReca- 1m tvvrs I i 1 I _
Once 2,7- 16 mho m I III I
°nice Sprig 4 bet o 100 II I
,
Fh a
sMels ve do 1-
'Nllo1Fn.Silrases 9 feet 9 _ 1 - —
x 80 I
Calculations u ��
NinuiFtvFSR/Cike 343 4n E I I
nuror 1Onke5 rzae w ` 4
0
rfce
r 1tadL zoe 'd9 �n 1
m m '
rvvrce mzae 5 0 60 _ ..._
TaopuMa* 23 Os 1 I'l-
Factional Head Losses 40
�stmq•Dsm�e 11 be! _
Imsio4ra4vl 01 bet _ }+
I,8tmg1Vd2 09 � I I �It.
l6smNkllio re m I
lassnLsod+ c2 20 L �_ _,_. _ .._
m n 99 1g
I I I
rtmatTzmlv�s 00 to --�_._ 4I 1 1. I I I.
Pipe Volumes 0—LL �� I III ( ' :
dTrasfnt{e 12 Os 0 10
W 20 30 40 50 60 70 80
Vaarvtrtm 45 scis Net Discharge(gpm)
VtldlffiazseZae 09 gis
T61\Mvre 147 gcls
Minimum Pump Requirements PumpData Legend
DacJincnIRPI09. con PF9}5HpMe1[aSIPnp SyS9nCLn€ —
Till DytalcHeal 192 leet 96Pv11@IP
15233/100Hz23YII0✓ Ui1c PurpCuve
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