HomeMy WebLinkAboutSWG2023-00518 - SWG Application / Design - 12/11/2023 MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584
SHELTON:360-427-9670,EXT 400
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BELFAIR:360-275-4467,EXT 400
Public Health & Human Services ELMA:360-482-5269,EXT 400
FAX:360-427-7787
On-Site Sewage System Tank Only Permit: SWG2023-00518
APPLICANT Derek McMasters Phone:
Address: 130 Hillside Rd UNION, WA 98592
SEPTIC DESIGNER DALE TAHJA- Septic Designer Phone: 360-426-5940
Address: 2450 W DEEGAN ROAD WEST SHELTON, WA 98584
SEPTIC INSTALLER TJ Goos-TJ's Excavating Phone: 360-490-0217
Address: 150 E MARISA PL SHELTON, WA 98584
OWNER Derek McMasters Phone:
Address: 130 Hillside Rd UNION, WA 98592
Site Address: 61 N KINGSWAY SOUTH
Primary Parcel Number: 422165200093
Permit Description: Holding Tank
Permit Submitted Date: 12/11/2023
Permit Issued Date: 12/18/2023
Issued By: Rhonda Thompson
Current Permit Fees Paid: $255.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 12/11/2026 (based on date of inspection)
Type of Work OSS New Construction
Components being Replaced: RV Holding Tank
Surfacing Sewage? Yes Existing Failure? No
Shoreline? No Horizontal Setbacks Met? Yes
Number of Bedrooms: 0 Drinking Water Source: Public Water System
Additional Details: Holding tank
Permit Conditions:
4 Proposed development subject to zoning requirements and approval by the planning
department staff per Mason County Title 17.
3 Mason County Asbuilt Form, Record Drawing, and Installation fee must be submitted for
final installation approval.
1 Horizontal setbacks per WAC246-272A-0210 must be maintained, unless prior approval is
obtained
2 Permit must be installed by a Mason County Certified Installer unless prior written
authorization from Mason County is obtained.
5 This holding tank septic permit is not granting approval to have two RVs on this property at
one time. Contact the Planning Department for questions regarding zoning.
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/OR 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.
OFFICIAL USE ONLY- Q 4-7/F�
MASON COUNTY DATE RECEIVED r_ — L 1,— 1,3 >1,(
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COMMUNITY SERVICES AMOU RE I=ECEIVEDIc au. ` Fo
Public Health(Community Health/Environmental Health) C 0)
415N.6th Street
-Shelton,
ltn,WA9 5114 ere 100 SWG Z 0 )� _6 O c� 0 O O
�t 5 N.6tf+Street-Snehon,WA 98Sa4 (V' 73
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ON—SITE SEWAGE TANK ONLY APPLICATION m
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APPLICANT PHONE m
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Derek McMasters (253) 205-1877 ' z
MAILING ADDRESS-STREET,CRY,STATE,ZIP CODE g
130 E. Hilldale Rd.. Union, WA 98592 02
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SITE ADDRESS-STREET,CITY,ZIP CODE 0
61 N. Kings Way S., Hoodsport, WA 98548 r
NAME OF DESIGNER PHONE {�
Dale L. Tahja (360) 426-5940 V �J+
NAME OF INSTALLER PHONE 0 I,-
T.J. Goos (360) 490-0217 R
TYPE OF WORK(select one) DRINKING WATER SOURCE N op,
• NEW CONSTRUCTION/UPGRADES ❑ REPAIR/REPLACEMENT O PRIVATE INDIVIDUAL WELL 0 PRIVATE TWO-PARTY WELL Z
0 PUBLIC WATER SYSTEM Lake Cushman Ater Co. t
COMPONENT(S)TO BE REPLACED/INSTALLED i../...
❑ SEPTIC TANK 0 PUMP TANK •RV HOLDING T K BEDROOMS LOT SIZE 1(71
❑ OTHER \. N/A CO
SETBACK CHECKLIST r
TANK(S)SE
OTHER DETAILS(select all that apply) 0
❑ SURFACING SEWAGE ❑EXISTING FAILURE 0 SHORELINE ® 100FT+PUBLIC!COMMUNITY WELLS n
0 50FT+PRIVATE WELLS,SURFACE WATERS,STREAMS,RIVERS
SUBMITTALS
® PLOT PLAN(REQUIRED) 8 TANK CROSS SECTION(REQUIRED) ® 10FT+DRINKING WATER SUPPLY LINES
❑ PUMP DETAILS(IF APPLICABLE) 0 WAIVER(S)(IF APPLICABLE) 0 SFT+PROPERTY!EASEMENT LINES,FOUNDATIONS,FOOTINGS
r
PLOT PLAN CHECKLIST 6 I
® PROPERTY LINES AND EASEMENTS ® EXISTING/PROPOSED STRUCTURES ■EXISTING/PROPOSED OSS COMPONENTS AND LINES
• WELLS WITHIN 100FT ■WATER SUPPLY LINES ® DRIVEWAYS/PARKING ❑SURFACE WATERS,STREAMS,RIVERS,ETC...
® DIRECTION OF SLOPE/CONTOURS 0 PERIMETER/CURTAIN DRAINS • NORTH ARROW •SCALE BAR V..°
DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.locked gate) f
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Go to Hoodsport, left on Lake Cushman Rd., left on Potlach-Hoodsport Rd., left on „~ v1
Rainbow Way, right on Chinook Dr., left on Kings Way S., property at end of cul-d-sack` ei
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the left.
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OFFICIAL USE ONLY BELOW THIS LINE I �- ,
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UPGRADE/FAILURE SOURCE(for reporting purposes) 1; a '..- '
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❑VOLUNTARY 0 MAINTENANCE/PUMPING 0 BUILDING PERMIT ❑HOMES ��• .; ` A
COMMENTS I CONDITIONS fl DEC 11 iI Z3 '"a�.�,'-
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SEWAGE TANKS MUST BE LISTED UNDER DOH`LIST OF REGISTERED SEWAGE TANKS'. TANKS MUST MEET CURRENT MINIMUM SIZE REQUIREMENTS,EQUIPPED WITH RISERS
AND LIDS TO SURFACE,AND INCLUDE AN EFFLUENT FILTER(1F APPLICABLE). RECORD DRAWING AND INSTALLATION REPORT REQUIRED FOR FINALAPPROVAL.
INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED/ISSUED BY DATE
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THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 07109/2019
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DEC 18 2023
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MASON COUNTY ENVIRONMENTAL HEALTf
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Holding Tank Sewage Systems-Recommended Standards and Guidance
Effective Date:July 1,2021
Introduction
A Holding Tank Sewage System (HTSS) is an alternative to a conventional on-site sewage
system with very special and limited applications. Simply, the HTSS provides a means to collect
and temporarily store sewage from a facility or dwelling, for subsequent removal and transport to
an approved treatment and disposal site. Depending upon the facility served or the particular set
of circumstances surrounding the use of a HTSS, the expense of sewage pumping, hauling, and
disposal at an approved facility can be very costly, especially on a long-term basis. In addition,
the potential for operational/management problems with resulting public exposure to raw sewage
is significant. For this reason, use of a HTSS must be closely regulated by the local health
agency.
A HTSS is an on-site sewage system that incorporates a holding tank, the services of a sewage
pumper/hauler, and the off-site treatment and disposal of the sewage generated at the site served
by the HISS.
Figure 1. Longitudinal-Section of Typical Holding Tank Sewage System.
�IWarning Light and
Audible Alarm
Access Riser with secured Pumping Access Port with
gas tight lid t, sloped concrete pad
V
1 }
Inlet
from'->d A �
structure P ROVED
kInlet
pipe Reserve Storage Volume DEC 1 $
MASON COUNTY ENi1RONME2023'iTAL HEALTh
1111— RET
Normal Operating Volume
\a00 T \c\Th
*Septic tanks with plugged outlets are not allowed.Tank must not have an outlet.
DOH 337-006 Page 6 of 17