HomeMy WebLinkAboutSWG2022-00489 - SWG Application / Design - 9/9/2022 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: SWG2022-00489
APPLICANT BLY FAMILY TRUST ROGER & Phone:
JENNIFER
Address: 150 N DISCOVERY DR HOODSPORT, WA 98548
OWNER BLY FAMILY TRUST ROGER & Phone:
JENNIFER
Address: 150 N DISCOVERY DR HOODSPORT, WA 98548
SEPTIC DESIGNER ADAM HUNTER* Phone: 360-753-1226
Address: PO Box 162 OLYMPIA, WA 98507
Site Address: 150 N DISCOVERY DR
Primary Parcel Number: 423185000040
Permit Description: New 3bd ATU to pressure bed
Permit Submitted Date: 09/09/2022
Permit Issued Date: 02/16/2024
Issued By: Rhonda Thompson
Current Permit Fees Paid: $500.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 11/15/2025 (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 Drainfield 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.
C 4, t L -0G-5LL, Ks (s2
�L�f-r i�LTS
��� (�J �� OFFICIAL USE ONLY
r ,7 •+: I N Cto NTY PUBLIC HEALTH DATE RECEIVED:
<- OS SEV 'GE SYSTEM APPLICATION AMOUNT RECEIVED: RECEIVED BY: C
\i\ GJ ��"415 N 6th Street,(Bldg 8) Shelton WA,98584 �-- C cCn
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�J jlf�Iton:360 427 9670 ext 400 Belfair:360 275 4467 ext 400 C`^IG Q 00 LI 5 m
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APPLICANT PHONE > D
ROGER BLY - 503-319-2880 m m
MAILING ADDRESS-STREET.CITY.STATE.ZIP CODE r
150 N. DISCOVERY DR HOODSPORT WA 98548 z
SITE ADDRESS-STREET,CITY,ZIP CODE CO
SAME AS MAILING m
NAME OF DESIGNER PHONE I_-
JIM HUNTER 360-753-1226
NAME OF INSTALLER PHONE
CHECK ALL APPLICABLE ITEMS DRINKING WATER SOURCE D I
` --
it NEW CONSTRUCTION 0 RV HOLDING TANK ONLY 0 PRIVATE INDIVIDUAL WELL (p I
❑ REPLACEMENT SYSTEM 0 INSTALLATION PERMIT ONLY 0 PRIVATE TWO-PARTY WELL Z
C7:1
❑ TABLE 9 REPAIR le SINGLE FAMILY 0 COMMUNITY/PUBLIC WATER SYSTEM
❑ TANK(S)ONLY 0 COMMERCIAL SYSTEM NAME: I
❑ UPGRADE TO EXISTING 0 OTHER: BED MS LOT SIZE I CPI
❑ EXISTING FAILURE 'Record Drawing required Z 0.6 ACRES co
for all Installations" r icy
DIRECTIONS TO SITE-BE SPECIFIC AND ADVISE OF ANY NEEDED INFORMATION FOR S(ex.locked gate) Q I
X I(J
I
, O I ILJ rC7
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II SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS 10
OFFICIAL USE ONLY BELOW THIS LINE
I UPGRADE/FAILURE SOURCE(for reporting purposes)
❑VOLUNTARY ❑MAINTENANCE/PUMPING ❑BUILDING PERMIT ['HOME SALE ['COMPLAINT ❑OTHER: ,'_
c
INSPECTOR SOIL LOGS COMMENTS/CONDITIONS L-- . ��
Or) -
44
1 1 (1
1 - 2ci D� I :c-,.., 1
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N V
p, 0120 vr5 ._r7
.,\1 - 1c.-ram 64 he,
SOIL CODES:
V=VERY G=GRAVELLY S=SAND L=LOAM Si=SILT C=CLAY E=EXTREMELY R=ROOTS
INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED BY DATE
lcZ) NI\ L6)41 t\ )I rliZ "/ 15 H- C fb-) il
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITl REVISED 12/7/2015
DFAIGN FORM—PAGE ONE Assessor's Parcel Number: 3.,_3 L$ -- S o -- SOS) 4 0
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
'' Scaled plot plan, including all applicable items on checklist. '1 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 I"X 17"
PARCEL IDENTIFICATION
Permit Number: SWG 2 0 22. - 0 o4e-s Designer's Name: t..t,► a��--r
�0(, lL. RL,.`( Designer's Phone Number: 360- 53-1226
Applicant's Name: b
Mailing Address: I S'0 kL lb. 1S cotm.-( UDesigner's Address:
PO BOX 162
t ODSP wA 4$S.,te OLYMPIA WA 98507
City State .4) �V City State Zip
DESIGN PARAMETERS
Treatment Device
❑ Glendon Biofilter 0 Sand Filter 0 Mound 0 Sand Lined Drainfield 0 Recirculating Filter,Type:
a.
gAerobic Unit Make/Model Sao fr(,V—W4 ❑ Disinfection Unit Make/Model Other:
grainfield Type
❑ Gravity pressure Mrench 0 Bed 0 Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 'L. Schedule/Class 40
Daily Flow:Operating Capacity 1$0 gpd Length VAgrt.Lr-S ft
Daily Flow: Design Flow -2,-4v gpd ✓ Diameter t,-L S in
1 .
Septic Tank Capacity OA 0 gal Number 4
Receiving Soil Type(1-6) 4 Separation 4.S— c9 ft
Receiving Soil Appl.Rate 0. (o gpd/ft2 Orifices
Required Primary Area /0 ft2 ✓ Total Number of Orifices eAC,
Designed Primary Area 4 0 Z ft2 Diameter 3(6(, in
1v
Designed Reserve Area (a 450 ft2 ✓ Spacing 'L 4 in
Trench/Bed Width 3 ft ✓ Manifold
Trench/Bed Length 13 4 ft Schedule/Class 4 0
Elevation Measurements Length i 5 ft
Original Drainfield Area Slope 2 % Diameter l ,5 in
New Slope,If Altered _ % Preferred manifold configuration used? l Yes 0 No
Depth of Excavation Up-slope -� `' in Transport Pipe
from Original Grade Down-slope CO' " in 1 Schedule/Class 4 o
Designed Vertical Separation ? l2-' in Length I.so ft
Gravelless Chambers Required? Yes 0 No 0 Optional Diameter - . in V
Pump Required? liYes 0 No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day (o
Difference in Elevation Between Pump Shutoff and Uppermost Dose quantity �t0 gal
i.
Orifice IQ,,3 ft Chamber Capacity i tiv° gal
Uppermost Orifice 0 Higher 0 Lower than Pump Shutoff Pump controls: Please check those required.
Capacity @ Total Pressure Head 4 I,`0 gprm Ot imer *apse Meter ( vent Counter
: Total
Pressure Head Z • ft /AP i fFt() j � �� 0 ,Pump off mments !`"� �( `/
FEB 16 2024
MASON COUNTY ENVIRONMENTAL HEALTH
RET
DESIGN FORM—PAGE TWO
Assessor's Parcel Number: `t `-- 3 k e, -- 30 -- U U U "t-t)
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan
Scaled Layout Sketch Cross-Section Sketch
Fif Test hole locations Sd Drainfield orientation and layout Reference depth from original grade:
E2i Soil logs ES Trench/bed dimensions and E ' Septic tank
critical distances within layout 12 Drainfield cover
gi Property lines
E7 D-Box/Valve box locations Reference depth from original grade
g Existing and proposed wells within 100 ft of property g Septic tank/pump chamber and restrictive strata:
12 Measurements to cuts,banks,and
locations 0 Laterals,trench/bed,top and
surface water and critical areas E1' Observation port location 0bottom
drain collector
lI Location and orientation of E� Clean-out location 0 CurtainSand drain collector
curtain drain and all absorption ' Manifold placement
on
components 631 Orifice placement Other cross-section detail:
E21 Location and dimension of El' Observation ports/clean-outs
g Lateral placement with distance
primary system and reserve area to edge of bed Other Information
Eg Buildings E2f Audible/visual alarm referenced Yes No
g Direction of slope indicator g Scale of drawing shown on scale t( ❑ Design staked out
g Waterlines bar 0 0 Recorded Notices attached
0 0 Waiver(s)attached
Roads, easements,driveways, 0 0 Pump curve attached
parking 0 0 Evaluation of failure
E2f North arrow and scale drawing Non-residential justification
shown on scale bar
❑ 0 Waste strength
❑ ❑ Flow
DESIGN APPROVAL
The undersigned designer must be notified i r ii °e of installation l 'es 0 No
c_2i-z3
Signatur Designer 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-site regulations: 4 b t
Environmental Health Speci ist Date
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
✓ The design is stamped"Approved" by Mason County Public Health. 1 II/ I ����
✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is:
✓ 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
•
kh _ PAGE
• JAN u 3 2024
MASON COUNTY HEALTH DEPARTMENT RFCVED
ON-SITE SEWAGE DISPOSAL SYSTEM DESIGN
SITE it: PARCEL#: 42318-50-J0040
DATE SUBMITTED: 12/18/23 LEGAL/LOT#: LAKE CUSHMAN
LOT 40
SUBMITTED BY: JIM HUNTER BLA 980379TC
APPLICANT: ROGER BLY
4
ADDRESS: 150 N DISCOVERY DR P p
HOODSPORT,WA 98548 li)O
I.CALCULATIONS
FEB VFD
�lgz°N�0UN�Eh„ 6 20Zy
NUMBER OF BEDROOMS= ✓IRON�ENr / r.
RESIDENTIAL GPD FLOW= 240 RFr '4`He
IF NON-RESIDENTIAL-GPD FLOW
WILL BE AS FOLLOWS:
GPD=
APPLICATION RATE= 0.6 GPD/FT2
REDUCTION=LL°A'E BLANK IF NO REDUCTION TAKEN
DRAINFIELD SIZING
ABSORPTION AREA= 402 FT2
TRENCH LENGTH OR BED CONFIG.= 134 FT
II.WATERPROOF SEPTIC TANK
COMPOSITION AND SIZE= BNR 500 TANK
NEW OR EXISTING= NEW
III.DRAINFIELD CROSS SECTION
DEPTH TO DRAINROCK BOTTOM= GRAVELLESS CHAMBERS
ROCK DEPTH BELOW PIPE= GRAVELLESS CHAMBERS
SEPARATION FROM TRCNCH BOTTOM TO IMPERMEABLE
MATERIAUSEASONAL SATURATION= >1'-0"
FILL DEPTH= 1 -0
TRENCH WIDTH= 3'-0"
IV,PUMP REQUIREMENTS
DOSING VOLUME IN GALLONS= 40
NUMBER OF DOSES PER DAY= 6Ar
3
RED►
Q 1k},iF,S A F9 ' 0
EXP 'f-S: 03/22/2
PAGE 2
V.PRESSURE CALCULATIONS
USING PIPE CLASS= 40
ORIFICE DIAMETER= 3/16
LATERAL#1 =
SQUIRT HEIGHT(FT)= 2.00
(NOTE(2).ORIFICE DISCHARGE RATE=(11.79)X(ORIFICE DIAMETER)S02 X
SQ ROOT OF(TOTAL PRESSURE HEAD)
ORIFICE DISCHARGE RATE= 0.58618
LATERAL LENGTH IN FEET= 24.00
ORIFICE SPACING= 2 0"
DISTANCE FROM END CAP= 1'0"
NUMBER OF HOLES= 12
LATERAL DISCHARGE RATE= 7.034
LATERAL#2= A�
SQUIRT HEIGHT(FT)= 2.00
ORIFICE DISCHARGE RATE= 0.58618
LATERAL LENGTH IN FEET= 14.00ORIFICE SPACING= '0 4�s0A, FFB �6'
DISTANCE FROM ND CAP= 1'0" N�Fy`j <Q?4
�p/y/
NUMBER OF HOLES= 7 /c'e7 44;i,79 H
LATERAL DISCHARGE RATE= 4.103
��rH
LATERAL#3=
SQUIRT HEIGHT(FT)= 2.00
ORIFICE DISCHARGE RATE= 0.58618
LATERAL LENGTH IN FEET= 0 C`
ORIFICE SPACING= 2'0"
DISTANCE FROM END CAP= 0'6"
NUMBER OF HOLES= (`r
LATERAL DISCHARGE RATE= 4•
LATERAL#4=
SQUIRT HEIGHT(FT)= 2.00
ORIFICE DISCHARGE RATE= 0.58618
LATERAL LENGTH IN FEET= 22.00
ORIFICE SPACING= 2'0"
DISTANCE FROM END CAP= 1'0"
NUMBER OF HOLES= 11
LATERAL DISCHARGE RATE= 6.448
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PAGE 3
LATERAL#5=
SQUIRT HEIGHT(FT)= 2.00
ORIFICE DISCHARGE RATE= 0.58618
LATERAL LENGTH IN FEET= 22.00
ORIFICE SPACING= 2'0"
DISTANCE FROM END CAP= 1'0"
NUMBER OF HOLES= 11
APPROVED
LATERAL DISCHARGE RATE= 6.448
LATERAL#6=
SQUIRT HEIGHT(FT)= 2.00 FEB 16 2024
ORIFICE DISCHARGE RATE= 0.58618 MASON COUNTY ENVIRONMENTAL HEALTH
LATERAL LENGTH IN FEET= 22.00 ORIFICE SPACING= 2'0" RET
DISTANCE FROM END CAP= 1'0"
NUMBER OF HOLES= 11
LATERAL DISCHARGE RATE= 6.448
LENGTH DIAMETER FLOW FRICTION LOSS
SECTION (FT) (IN) (GPM) (FT)
AB 130.00 2.00 37.516 3.0632
BC 1.00 1.50 20.516 0.0260
CD 1.00 1.50 14.068 0.0129
DE 15.00 1.50 7.034 0.0538
EF 24.00 1.25 7.034 0.1825
TOTAL= 3.3386
TOTAL HEAD LOSS "
1)FRICTION LOSS THROUGH SYSTEM= 3.3366
2)ELEVATION DIFFERENCE = 19.3000
RESIDUAL = 2.0000
TOTAL= 24.6386
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PAGE 3
LATERAL#5=
SQUIRT HEIGHT(FT)= 2.00
ORIFICE DISCHARGE RATE= 0.58618
LATERAL LENGTH IN FEET= 22.00
ORIFICE SPACING= 2'0"
DISTANCE FROM END CAP= 1'0"
NUMBER OF HOLES= 11
LATERAL DISCHARGE RATE= 6.448
LATERAL#6=
SQUIRT HEIGHT(FT)= 2.00
ORIFICE DISCHARGE RATE= 0.58618
LATERAL LENGTH IN FEET= 22.00
ORIFICE SPACING= 2 0
DISTANCE FROM END CAP= 1'0"
NUMBER OF HOLES= 11
LATERAL DISCHARGE RATE= 6.448
LENGTH DIAMETER FLOW FRICTION LOSS
SECTION (Fr) (IN) (GPM) (FT)
AB 130.00 2.00 'SFS.i:W��� 3:tS3
BC 1.00 1.50 20.516 0.0260
CD 1.00 1.50 14.068 0.0129
DE 15.00 1.50 7.034 0.0538
EF 24.00 1.25 7.034 0.1825,`
TOTAL= 3.4 3i
••TOTAL HEAD LOSS "
1)FRICTION LOSS THROUGH SYSTEM= 3.`-34(
2)ELEVATION DIFFERENCE = 19.3000
3)RESIDUAL = 2.0000
v~ TOTAL= Z-4,13 41
e- 2-3
y - ' •t? ss
• S1a).73 � , APPROVED
!'l,NITER +t FEB 16 2024
«A�����. i1�, NMENTAL HEALTf;
FAMES: 03/22/7,- • MASON COUNTY ENV1RORET
MYERS ME7 SERIES
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J W >0 W W z W J W 0 0 co cc i_ = > O H ILI Q cn D a U -I o Ow
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Z a U 0 Q Z
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0 J W
U w U 0 cc O < w z w w Q Z CO~ oU J o Q w W _o
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O w J 00 ¢ cn ( _ w w 2 O = Z O z W a a_ c o
w = a w CC Z cn p °° F= ~O Q U w cn au ow Z
tw- _ p > > Z Z 0O U w0 < U i w i- U c) w I- O 0O
J
o ~ Z D Z C 2 na- = Q J W O O = Z W = 0
Z a u- < 0 < Ow a s D F- d < ? U Q F- _ = F- z