HomeMy WebLinkAboutSWG2023-00484 - SWG Application / Design - 11/14/2023 MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584
SHELTON:360-427-9670,EXT 400
BELFAIR:360-275-4467,EXT 400
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Public Health & Human Services ELMA:360-482-5269,EXT 400
FAX:360-427-7787
On-Site Sewage System Permit: SWG2023-00484
APPLICANT BECHLER GAIL B Phone: 206-678-3817
Address: 2560 NE 98TH ST SEATTLE, WA 98115
OWNER BECHLER GAIL B Phone: 206-678-3817
Address: 2560 NE 98TH ST SEATTLE, WA 98115
SEPTIC DESIGNER Brad Smith Phone: 253-851-2178
Address: PO Box 1444 GIG HARBOR, WA 98335
Site Address: 16571 E State Route 106
Primary Parcel Number: 222145000005
Permit Description: 3-bedroom OSCAR X02 system w/ OS-100 coils: Replacement
Permit Submitted Date: 11/14/2023
Permit Issued Date: 02/16/2024
Issued By: David Anderson
Current Permit Fees Paid: $525.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 11/28/2026 (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 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.
OFFICIAL USE ONLY .
MASON COUNTY PUBLIC HEALTH DATE RECEIVED:
« l 1 Li l 1 U)
ONSITE SEWAGE SYSTEM APPLICATION AMOUN RECE RECEIVED BY C N
415 N 6th Street(Bldg 8) Shelton WA,98584 <J - CA
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Shelton:360-427-9670 ext 400 Belfair:360-275-4467ext400 SWG
APPLICANT PH9AIE Z D
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MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE I-
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'�S 600 'j r,✓ /6 ..5r r0 ` -ritz_I /V A <..�,-�0 c
SITE ADDRESS-STREET,CITY,ZIP CODEco
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4 -7 I S✓t!-- IC)49 6 tL'�T Ie-1 74
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NAME OF DESIGNER
,._J Z`n� WI -E iI PHONE t .'
NAME OF INSTALLER n N O V 1 4 2023 j l PHONE
CHECK ALL APPLICABLE ITEMS .� DRINKING WATER SOURCE 0
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❑ N_E.p CONSTRUCTION ❑ RV HOLDING TANK ONLY 0 PRIVATE INDIVIDUAL WELL N ✓
EPLACEMENT SYSTEM ❑ INSTALLATION PERMIT ONLY 0 PRIVATE TWO-PARTY WELL 0
❑ TABLE 9 REPAIR 0 SINGLE FAMILY ❑ COMMUNITY/PUBLIC WATER SYSTEM
❑ TANK(S)ONLY ❑ COMMERCIAL SYSTEM NAME: (�
❑ UPGRADE TO EXISTING ❑ OTHER: BEDROOMS LOT SIZE `I J
❑ EXISTING FAILURE "Record Drawing required —.
for all Installations" ,�,, �i 7 (.P. :.� 07 L
DIRECTIONS TO SITE-BE SPECIFIC AND AD ISE OF ANY NEEDED INFORMATION FOR ACCESS(ex.locked gate) 00 I
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I 6 S7 1 4
0
OID
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SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS IV 1
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE I FAILURE SOURCE(for reporting purposes)
❑VOLUNTARY ❑MAINTENANCE/PUMPING 0 BUILDING PERMIT OHOME SALE ❑COMPLAINT 0 OTHER:
INSPECTOR SOIL LOGS COMMENTS!CONDITIONS
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SOIL CODES:
V=VERY G=GRAVELLY S=SAND L=LOAM SI=SILT C=CLAY E=EXTREMELY R=ROOTS
INSPECT SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED BY DATE
17/7 emu _ I I I zsi2G Z 6 27/6/zGzy
THI 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: Z2-2-2)" -- SO — O0Qc 'J
A design will be reviewed when 3 conies of each of the following are submitted:
" Completed design form that has been signed and dated. 0 Scaled layout sketch,including all applicable items on checklist
0 Scaled plot plan,including all applicable items on checklist Cross-section sketch,including all applicable items on checklist.
This form msa be scanned and available for publc view on the Mason County Web site.Maximum paper size: 11"X 17"
a... I'T CAT.1Qg
Permit Number: SWG 7,023" 004 R9 Designer's Name: ( 1.. )
Applicant's Name: GA-1L Designer's Phone Number: 0 SI,.L 4-7'C'
Mailing Address: 2 W N 1?4 `P Designer's Address: 1 1.4`k-i)1'
(764 to- 9 J) ()M c,z, , , 1\M
City State Z ip City State Zip
.. ,. _ ,rx �. : ,.7....... DESIGN PARAMETERS , , ,, .` `
Treatment Device
Cl Glendon BiAlter ❑Sand Filter ❑Mound 0 Sane Lined Drainfield ❑Recirculating Filter,Type: n,�7
❑Aerobic Unit Make/Model 0 Disinfection Unit Make/Model Other: t-{/CI.""X-07...--
Drainfield Type
❑Gravity 0 Pressure 0 Trench ❑Bed ❑ Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms f Schedule/Class !V �lia
/
Daily Flow: Operating Capacity 0 2 O gpd Length ft
Daily Flow:Design Flow -36e, gpd Diameter , _ . in
Septic Tank Capacity !tot() ! ry gal Number _
Receiving Soil Type(1-6) e S Separation ft
Receiving Soil Appl.Rate e ali 0 gpd/ft2 Orifices
Required Primary Area (jd ft2 Total Number of Orifices _
q Designed Primary Area el 0ft2 Diameter s C L in
Designed Reserve Area 9 U 0 ft2 Spacing ) in
Trench/Bed Width- ft Manifold
Trench/Bed Length ft Schedule/Class N
Elevation Measurements Length iv ., ft
Original Drainfield Area Slope I. % Diameter ,- _ .._ in
New Slope,If Altered % Preferred manifold configuration used? QYes C7 No
Depth of Excavation Up-slope in Transport Pipe
from Original Grade Down-slope in Schedule/Class 40
Designed Vertical Separation 2-2 in Length i 0 ft
Gravelless Chambers Required? 0 YesOptional Diameter 11,4` in
Pump Required? es 0 No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day 5k:C,
Difference in Elevation Between Pump Shutoff and Uppermost Dose quantity `CW1-- gal
Orifice 'MT ft Chamber Capacity \4000 gal
Uppermost Orifice 014/�er 0 Lower than Pump Shutoff Pump control •Please check thosgrequired.
Capacity @ Total Pressure Head gpm EICT6er i lB lap�Meter Dent Counter
Calculated Total Pressure Head ft If Timer: Pump on t�- -- '-' ,Pump off -- -
Comments
r DESIGN FORM—PAGE TWO Assessor's Parcel Number:ZZl---\ 6_ -- So -- o U OOL
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled� Layout Sketch Cross-Section Sketch
KE T t hole locations Q" D 'nfield orientation and layout Referen�c!e depth from original grade:
DSo1 logs Trench/bed dimensions and 0'Septic tank
perty lines c . 'cal distances within layout [YDrainfield cover
D' Existin andproposed wells ox/Valve box locations
g Reference depth from original grade
mthin 100 ft of property Septic tank/pump chamber and restrictive strata:
easurements to cuts,banks, and arions Cd Laterals,trench/bed, top and
su ace water and critical areas El �servation port location
Location and orientation of Mean-out location bottom
❑ Curtain drain collector
curtain drain and all absorption 141cManifold placement 0 Sand augmentation
ze6mponents ifice placement Other crss-section detail:
Location and dimension of Cr-Lateral placement witht" Observation ports/clean-outsary system and reserve area P e distance
to edge of bed Other Information
iipriv
moldings p..Audible/visual alarm referenced Yes No J,.
irection of slope indicator ❑'Scale of drawingshown on scale 0 0 Designstaked out
DV/Waterlines bar 0 0 Recorded Notices attached
R ds, easements,driveways, 0 0 Waiver(s)attached
asking 0 0 Pump curve attached
North arrow and scale drawing 0 0 Evaluation of failure
shown on scale bar Non-residential justification
❑ ❑ Waste strength
i ❑ ❑Flow
DESIGN APPROVAL
The undersigned designer must b nvtified-by ihstaller at time of installati•`• [3'Yes • No
<777
Signature ofT¢es r 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 lations: FEE J
a716( oz (-/ 6 ��24
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Environmental Health Specialist DateON OONNryENVIRONMENTAL
dJA HEALTH
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
✓ The design is stamped"Approved"by Mason County Public Health. f/ r��J 7 /
✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: I l Z t7:GO Z6
✓ 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
Peninsula Septic Designs
• P.O.Box 1444
Gig Harbor,Washington 98335
(253)851-2178
FAX(253)851-2178
SITE ADDRESS: I(oS( )0
A) SYSTEM FLOW REQU�.
(see Table XY-Oscar LOWeFLOW Design Manual Pg.4)
/4111.'"6
a.) System Design Flows- 3(�
b.) Total Number Coils—
c.) Tout Number Laterals
d.) Dose GPM 2., I
e.) Flush GPM----------... 6 ci M4SONc Ee 6�G?4
f.) Excess TDH— c<°�? r��N✓r
g.) Elevation Loss/GPM 3� b�A NM�`�TA(HFgCTH
h.) Length of Supply Line- \1 0 'j F=L(Q/K)
i.) Total Excess TDH e
(Friction Loss ft.r1 +Elevation Gain/Loss 7,7 +4,7
B) SYSTEMBAS F AREA 1~Q rrR Fga
GPD/ GPD/FT2 7 1 '
b.) Coil Length= - 21_with 6"spacing+_�I
c.) Minimum Shoulder Width @ 6"(2X6"=1'= 2-2 4- j Z-Z
d.) Minimum Basal Area=
e.) " O 0 SQ.FT./ -
f.) j.(�-e ,,_ fi r, �
g.) Sloping Site=60"coil X 1 $ %slopem r
Additional Sand Req'd
1.) ?s \ Coil Length+ (o +Shoulder 4 8 y
j.) Minimum Basal Area= 2 ;� +Side Slopes
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