HomeMy WebLinkAboutSWG2024-00036 - SWG Application / Design - 2/5/2024 MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584
SHELTON:360-427-9670,EXT 400
BELFAIR:360-275-4467,EXT 400
Public Health & Human Services ELMA: 360-482-5269,EXT 400
FAX:360-427-7787
On-Site Sewage System Permit: SWG2024-00036
APPLICANT COONE RONALD A Phone: 360-621-5025
Address: 231 FOREST DR BRINNON, WA 98320
OWNER COONE RONALD A Phone: 360-621-5025
Address: 231 FOREST DR BRINNON, WA 98320
SEPTIC DESIGNER DALE TAHJA- Septic Designer Phone: 360-426-5940
Address: 2450 W DEEGAN ROAD WEST SHELTON, WA 98584
Site Address: XX N Mt Jupiter Ct
Primary Parcel Number: 422045000094
Permit Description: 3-bedroom pressure system
Permit Submitted Date: 02/05/2024
Permit Issued Date: 02/16/2024
Issued By: David Anderson
Current Permit Fees Paid: $540.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 02/09/2027 (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/environmental/onsiteloss-inspection-request.php or call:
360-427-9670, extension 400.
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OFFICIAL USE ONLY
DATE RECEIVED: / .5 / �3
MASON COUNTY u) a
iwifillif' COMMUNITY SERVICES AMOUN>•RECEVEa D RECEIVED BY: v CO
Public (Community Health/Environmental Health) C
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ON-SITE SEWAGE SYSTEM APPLICATION
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APPLICANT PHONE m
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Ron Coone (360) 621-5025 i— c
sn MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE T. E
231 Forest Dr. Brinnon WA 98320 n 03
SITE ADDRESS-STREET,CITY,ZIP CODE P
Mt. Jupiter Crt. Hoodsport WA 98548 - I
NAME OF DESIGNER PHONE a) I N
Dale L. Tahja (360) 426-5940
NAME OF INSTALLER PHONE 0 I N
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PERMIT TYPE(select one) DRINKING WATER SOURCE O
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RESIDENTIAL OSS COMMUNITY OSS ECOMMERCIAL OSS E1 PRIVATE INDIVIDUAL WELL --PRIVATE TWO-PARTY WELL Z
TYPE OF WC)RK(select one) i PUBLIC WATER SYSTEM Lake Cushman Water System
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girl NEW CONSTRUCTION/UPGRADES EREPAIR/REPLACEMENT OTHER DETAILS(select all that apply) ❑ TABLE IX REPAIR I (.J1
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SUBMITTALS CC CISURFACING SEWAGE ElEXISTING FAILURE 0 SHORELINE
I.rsI�DESIGN FORM(REQUIRED) IiI:SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE r0 I O
ff WAIVER(S)(IF APPLICABLE) 3 0.24 acre o I O
DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.locked gate)
North on Hwy 101 to Hoodsport, left on Lake Cushman Rd., right on Dow Mt. Rd., right on
Mt. Jupiter Rd., right on Mt. Jupiter Crt., first lot on the left r I C
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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
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UPGRADE/FAILURE SOURCE(for reporting purposes)
❑VOLUNTARY 0 MAINTENANCE/PUMPING ❑BUILDING PERMIT ❑HOME SALE ❑COMPLAINT ❑OTHER:
INSPECTOR SOIL LOPS COMMENTS/CONDITIONS
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RECORD DRAWING AND INSTALLATION REPORT
SOIL CODES:
V=VERY G=GRAVELLY S=SAND L=LOAM Si=SILT C=CLAY E=EXTREMELY R=ROOTS REQUIRED FOR FINAL APPROVAL.
INSPECT SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATIO PPROVED/ISSUED BY DATE
71q/ 01 . 2( 11 /(67z .
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12/7/2015
DESIGN FORM—PAGE ONE Assessor's Parcel Number: 4 2 2 0 4 — 5 0 — 0 0 0 9 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. v 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.Maximum taper size: 11"X 17"
PARCEL IDENTIFICATION .
Permit Number: SWG Z0Z4 0 as;G Designer's Name: Dale Tahja
Ron Coone Desi ner's Phone Number: 3604265940
Applicant's Name: g
Mailing Address: 231 Forest Dr. Designer's Address: 2450 W Deegan Rd W
Brinnon WA 98320 Shelton WA 98584
City State Zip City State Zip
DESIGN PARAMETERS
Treatment Device
❑ Glendon Biofilter 0 Sand Filter 0 Mound lily Sand Lined Drainfield 0 Recirculating Filter,Type:
❑Aerobic Unit Make/Model 0 Disinfection Unit Make/Model Other:
Drainfield Type
❑ Gravity li6 Pressure 0 Trench l '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 39 ft
Daily Flow: Design Flow 360 ' gpd Diameter 1.25 in
Septic Tank Capacity(working) 1,250 - gal Number 3
Receiving Soil Type(1-6) 1 — Separation 3 ft
Receiving Soil Appl. Rate 1.0 ,- gpd/ft2 Orifices
Required Primary Area 360 ft2 Total Number of Orifices 60
Designed Primary Area 360 ft2 Diameter 1/8 in
Designed Reserve Area 360 4 ft2 Spacing 24 in
Trench/Bed Width 9 - ft Manifold
Trench/Bed Length 40 v ft Schedule/Class Sch. 40
Elevation Measurements Length 6 ft
Original Drainfield Area Slope 0 % Diameter 1.5 in
New Slope,If Altered 0 , % Preferred manifold configuration used? 0 Yes Iii'No
Depth of Excavation up-slope 46 - in Transport Pipe
from Original Grade Down-slope 46 in Schedule/Class Sch. 40
Designed Vertical Separation 24 in Length 7 ft
Gravelless Chambers Required? 0 Yes lid No 0 Optional Diameter 1.5 in
Pump Required? g Yes 0 No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day 4
Duff.in Elevation Between Pump& Uppermost Orifice 5 ft Dose quantity 67.5 / gal
Drainfield Squirt Height/Selected Residual(head) 6 ft Chamber Capacity(flood) 1,000 gal
Uppermost Orifice 'Higher 0 Lower than Pump Shutoff Pump controls:Please check those required.
Capacity @ Total Pressure Head 30 gpm lifTimer ficElapse Meter D'Event Counter
Calculated Total Pressure Head 15 ft If Timer: Pump on 2.5 min ,pomp off 5 hrs 57.5 min -
Comments
DESIGN FORM—PAGE TWO Assessor's Parcel Number:4 2 2 0 4 — 5 0 -- 0 0 0 9 4
Permit Number: SWG
DESIGN;.CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
g Test hole locations g Drainfield orientation and layout Reference depth from original grade:
fii3 Soil logs g Trench/bed dimensions and g Septic tank
g Property lines critical distances within layout Q! Drainfield cover
g Existing and proposed wells g D-Box/Valve box locations Reference depth from original grade
within 100 ft of property fizI Septic tank/pump chamber and restrictive strata:
g Measurements to cuts, banks, and locations
Q( Laterals,trench bed,top and
surface water and critical areas g Observation port location bottom
g Location and orientation of RI Clean-out location ❑ Curtain drain collector
curtain drain and all absorption g Manifold placement Gif Sand augmentation
components Ei Orifice placement Other cross-section detail:
Iii Location and dimension of g Lateral placement with distance g Observation ports/clean-outs
primary system and reserve area to edge of bed
g Other Information
g Buildings Ed Audible/visual alarm referenced Yes No
66 Direction of slope indicator fii Scale of drawing shown on scale [� ❑ Designstaked out
fii Waterlines bar 0 0 Recorded Notices attached
fid Roads,easements,driveways, 0 0 Waiver(s) attached
parking Eif 0 Pump curve attached
g North arrow and scale drawing 0 0 Evaluation of failure
shown on scale bar Non-residential justification
❑ 0 Waste strength
❑ ❑ Flow
DESIGN APPROVAL
The undersigned designer n:7 ,:s
be notified • at time of installation g Yes 0 No r
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Signature of Designer Date 50NC0
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The undersigned has reviewed this design on behalf of Mason County Public Health and dete -.,.`-• `in '2 $FAC rN
compliance with state and local on-site lations: �'/ y _'�.cik .c'It':••ram,. . ,o
Environmental Health Specialist . Date '� %b 3 '"' "'8 W P
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDI 1 ' = 0
✓ The design is stamped`"Approved"by Mason County Public Health...4The Onsite Sewage Permit has not expired,the Permit Expiration Date is: 2( f/70' 2 7 I \%'
✓ 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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Installation/Maintenance
Pressure Distribution/Bed Systems
1. Install bed bottom level and in contour with the ground.
2. Install drainfield during dry weather and soil conditions.Any soil smearing must be
eliminated by hand raking any areas that get smeared.
3. Install audio/visual high-water alarm.
4. Install effluent filter in septic tank outlet or pump vault with 1/16-inch maximum
filtration mesh size.
5. Install check valve in pump outlet line to prevent back-flow into the pump chamber.
6. Install 1/8-inch orifices on 24 inch centers. Install the orifices pointing straight down
(6:00 o' clock).
7. Divert all storm water run-off away from septic system components.
8. No curtain (french) drains allowed within l Oft. of the up-slope edge of the drainfield and
reserve area.
9. No curtain(french) drains allowed within 30ft. of the down-slope edge of the drainfield
and reserve area.
10.Have the septic tank and pump chamber pumped or inspected every 3 to 5 years.
11.Inspect and clean pump screen as needed.
12.Inspect floats and test high water alarm every 6 to 12 months or as needed.
13.All material and workmanship must meet County and State requirements.
14.Install risers on septic tank and pump chamber.
15.Deviation from this approved design without prior approval from the Designer and
Mason County Health Department will make this design null and void.
16.The prepared Site Plan is not a survey, it is the owner's responsibility to verify property
line locations prior to installation. Any discrepancies must be reported to the Designer
immediately.
17. Locate all utilities prior to starting installation.
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