HomeMy WebLinkAboutSWG2024-00025 - SWG Application / Design - 1/22/2024 A , 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,EXT400
FAX:360-427-7787
On-Site Sewage System Permit: SWG2024-00025
APPLICANT FREEMAN REVOCABLE TRUST Phone:
FREDERICK W
Address: FREDERICK W FREEMAN TRUSTEE EVERETT, WA 98208
OWNER FREEMAN REVOCABLE TRUST Phone:
FREDERICK W
Address: FREDERICK W FREEMAN TRUSTEE EVERETT, WA 98208
SEWAGE DESIGNER CINDY WAITE-Septic Designer Phone: 360-701-0205
Address: 80 E PICKERING LANE SHELTON, WA 98584
Site Address: 4090 E Mason Lake Dr W
Primary Parcel Number: 221055100002
Permit Description: New SFR-2BR sand lined bed
Permit Submitted Date: 01/22/2024
Permit Issued Date: 02/29/2024
Issued By: Jeff Wilmoth
Current Permit Fees Paid: $805.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 02/15/2027 (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/onsite/oss-inspection-request.php or call:
360-427-9670, extension 400.
OFFICIAL USE ONLY
DATE RECEIVED:
MASON COUNTY i —�►a,
COMMUNITYSERVICES AMOU RECEIVED: RECEIVED BY
Public Health(Community Health/Environmental Health)0
C cn
360-427-9670,eet.400 or 360-275.4467,ext.400 S G / � � (n Q
415 N.6th Street-Shelton WA 90584 W 303 O�JI_X2d Z 6
ON-SITE SEWAGE SYSTEM APPLICATION Dxl
3 n
APPLICANT
PHONE m m
r
FREEMAN REVOCABLE TRUST 503-318-9506
MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE E
10925 51ST AVE SE EVERETT WA 98208 03
4090SITE EE MASON SS-STREET.CITY. PLAKE DR W GRAPEVIEW WA 98546 I i"
NAME OF DESIGNER PHONE I N
CINDY WAITE 360-701-0205
NAME OF INSTALLER PHONE v I —
_
TBD <
PERMIT TYPE(select one) DRINKING WATER SOURCE y O
M-RESIDENTIAL OSS II I INq
COMMUNITY OSS COMMERCIAL OSS pfls PRIVATE INDIVIDUAL WELL ff PRIVATE TWO-PARTY WELL Z I
TYPE OF WORK(select one) 12 PUBLIC WATER SYSTEM t
b-NEW CONSTRUCTION/UPGRADES REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) ❑ TABLE IX REPAIR I (31
SUBMITTALS 0 SURFACING SEWAGE RI EXISTING FAILURE 0 SHORELINE CO
DESIGN FORM(REQUIRED) VSEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE I— I —1
5-WAIVER(S)(IF APPLICABLE) 2 80'X281' 0 I CD
DIRECTIONS TO SITE AND SITE CONDITIONS(ex locked gate)
GO OUT NORTH ON HIGHWAY 3, TURN LEFT ONTO MASON BENSON ROAD, TURN RIGHT ONTO I O
TRAILS RD, TURN LEFT ONTO MASON LAKE DR W. GO TO ADDRESS. LOT IS ON THE LEFT WITH A
GATE, GATE CODE IS 5846. SOIL LOGS ARE HALF WAY DOWN THE HILL ON TYHE RIGHT SIDE. THE p I O
FIRST SOIL LOG WAS TOO CLOSE TO THE WELL, THE OTHER IS IN THE DRAINFIELD AREA. DID NOT
WANT TO DIG ANOTHER BECAUSE I FELT IT WOULD BE TOO MUCH DISTURBANCE IN THE BED AREA. I O
SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. I IV
OFFICIAL USE ONLY BELOWTHIS LINE
UPGRADE/FAILURE SOURCE(for reporting purposes)
❑VOLUNTARY 0 MAINTENANCE/PUMPING ❑BUILDING PERMIT ['HOME SALE ['COMPLAINT 0 OTHER.
INSPECTOR SOIL LOGS COMMENTS I CONDITIONS
0 .......... .0 64
, ,„,, ,
e
i 0, („, 1, „._,
RECORD DRAWING ANC INSTALLATION REPORT
SOIL CODES:
V= •Y G=GRAVELLY S=SAND L=LOAM Si=SILT C=CLAY E=EXTREMELY R=ROOTS REQUIRED FOR FINAL APPROVAL.
SP TO'SIG ATURE DATE APPLICATION EXPIRATION DATE AP CATION APPROVED/ISSUED BY DATE
I �/d �/ 'I ,I4.---2, .04% ?-�27 e ti A ?-2�'��.
O-•: AY BE SCAN ED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12/7/2015
DESIGN FORM—PAGE ONE Assessor's Parcel Number: 2 2 1 0 5 — 5 t1 — 0. 0 _0 0 2
A design will be reviewed when 3 copies of each of the following are submitted:
`'Completed design form that has been signed and dated. 'd 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 paper size: 11"X 17"
PARCEL IDENTIFICATION
Permit Number: SW(Uc - s Designer's Name: CINDY WAITE
Applicant's Name: FREEMAN REVOCABLE TRUST Designer's Phone Number: 360-701-0205
_ _ _ , _ ____ _ , ___ __ ____
MailingAddress: 10925 51ST AVE SE 80 E PICKERING LANE
_ _____ _ __ _ ______= Designer's Address:
EVERETT WA 98208 SHELTON WA 98584
City
_ ' State lip City State Zip
DESIGN PARAMETERS
Treatment Device
❑Glendon Biofilter 0 Sand Filter 0 Mound at Sand Lined Drainfield 0 Recirculating Filter,Type:
❑Aerobic Unit Make/Model 0 Disinfection Unit Make/Model Other:
Drainfield Type
❑ Gravity S 'Pressure 0 'trench I 'Bed ❑ Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 52 Schedule/Class SCHEDULE 40
Daily Flow: Operating Capacity 180 gpd Length 24 ft
Daily Flow: Design Flow 240 gpd Diameter 1.25 in
Septic Tank Capacity(working) 1200 gal Number 4
Receiving Soil Type(1-6) 3 Separation 2 ft
Receiving Soil Appl. Rate .8 gpd/ft2 Orifices
Required Primary Area 240 ft2 Total Number of Orifices 40
Designed Primary Area 240 ft2 Diameter 3/16 in
Designed Reserve Area LIMITED ft2 Spacing 30
in
Trench/Bed Width 10 ft �� Manifold
Trench/Bed Length 24 ft Sch //C �`-9� SCHEDULE 40
�• �
Elevation Measurements L 4cl'� ' °2 �2 1-3 ft
1
Original Drainfield Area Slope 3 % y Teter ib VII 2 in
51 [[
New Slope, If Altered % d+�re 'Said dckn ation used? 0 Yes 0 No
Depth of Excavation lip-slope SEE PAGE#4 in LI NSED DESIGNER
Z nsport Pipe
from Original Grade Down-slope SEE PAGE#4 in EXPIRES 05,10,
Schedule/Class SCHEDULE 40
Designed Vertical Separation SAND AUG 36+ in Length 80-100 ft
Gravelless Chambers Required? 0 Yes 0 No 0 Optional Diameter 2 in
4 Pump Required? Eli Yes 0 No Dosing and Pump Chamber `
Pump/Siphon Specifications Number of doses/day 4 \ 1� .
Diff. in Elevation Between Pump& Uppermost Orifice 25 ft Dose quantity 45 gal `
Drainfield Squirt Height/Selected Residual(head) 2 ft Chamber Capacity(flood) 1200 gal
Uppermost Orifice 0 Higher 0 1,ower than Pump Shutoff Pump controls: Please check those required.
Capacity @ Total Pressure Head 23.6 gpm lifrimer giElapse Meter fib Event Counter
Calculated Total Pressure Head __27.184 ft If Timer: Pump on ,Pump off
Comments
CONCRETE TANKS REQUIRED, GRAVEL BASED DRAINFIELD REQUIRED, CONTROLS TO BE
SET AT TIME OF INSTALLATION.
1JLait,iv r UKM-PAGE TWO Assessor's Parcel Number: 2 2 1 0 5 -- 5 1 -- 0 0 0 0
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
66 Test hole locations 6r Drainfield orientation and layout Reference depth from original grade:
0 Soil logs It Trench/bed dimensions and
0 Septic tank
0 Property lines critical distances within layout Q( Drainfield cover
0 Existing and proposed wells se D-Box/Valve box locations
,within 100 ft of property Q! Septic tank/pump chamber Reference depth from original grade
lii Measurements to cuts, banks, and locations i'(q/ pbri
and restrictive strata:
GA
surface water and critical areas l Observation port location Laterals,trench/bed, top and
bottom
ii\'ocation and orientation of Q( Clean-out location 0 Curtain drain collector
curtain drain and all absorption Fti Manifold placement 0 Sand augmentation
components Orifice placement
0 Location and dimension of p Other cross-section detail:
primary system and reserve area 0 Lateral placement with distance Cif Observation ports/clean-outs
to edge of bed
10 Buildings Other Information
liZ( Audible/visual alarm referenced Yes No
El Direction of slope indicator I
0 Scale of drawing shown onl'sea ',,a NI 0 Design staked out
Waterlines bar ❑ ❑ Recorded Notices attached
10 Roads, easements,driveways, ❑ 0 Waiver(s)attached
parking PPROVE ❑ ❑ Pump curve attached
0 North arrow and scale drawing A FEB 2 9 2024 D- EI 0 Evaluation of failure
shown on scale bar Non-residential justification
MASON COUNTY ENVIRONMENTAL HEALTH ❑ 0 Waste strength
JBW ❑ 0 Flow
DESIGN APPROVAL
The undersigned designer must be notif d by ins ller at time of installation 0 Yes 0 No
f2.470,_#;,'
Signatur of Designer ``
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- •' regulations:
[A b7R1--
m--'-') 0-- • _ k-('
Envi on tal Health Specialist Date
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
/ The design is stamped"Approved"by Mason County Public Health.
�/ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: 2._ & "f--
V Drainfield site conditions have not been altered to adversely affect conditions of design approval.
--2/`\,
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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1 24 288 30 10 1 0.5 24
2 24 288 30 10 0.5 1 24
3 24 288 ..:70.. 10 1 0.5 24
4 24 288 10 0.5 1 24
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TRANS LENGTH 20
GPM 23.6
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LITERS PER MINUTE
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Installation Notes
Sand Augmented Pressure Distribution System:
22105-51-00002 4090 E MASON LAKE DR W
1. The prepared site plan is not a survey. It's the owner's responsibility to verify property
lines, utility lines (water, sewer, power, phone and gas) prior to installation.
2. No records of existing system, system is close to 60 years old.
3. Pump controls to be set at time of installation .
4. Install system during dry weather with acceptable soil conditions
5. The tanks may be moved as necessary to accommodate building requirements. Septic
tank location must meet all required setbacks.
6. Keep wheeled vehicles off the drainfield area before, during and after installation.
Tracked equipment only,
7. All ground, surface water and roof drains must be diverted away from the septic tanks
and drainfield. Ensure the final grade slopes away from these areas and water doesn't
collect on or around them. Use swales, berms, catch basin and tight lines, curtain drains,
etc. to divert all waters.
8. Curtain drains can be no closer than 10' upgradient and 30' down gradient of the
drainfield
9. Exposed restrictive layers, cuts, banks, etc. can be no closer than 50' downhill from the
drainfield.
10. Install access risers on the septic tanks, valve box and ends of laterals.
11. Make sure septic tank risers are epoxied or caulked to cast in riser rings on tank.
12. Lids must form a water and gas tight seal with the access risers
13. Install effluent filter specified in this design at the septic tank outlet.
14. This system must be installed by a Mason County Certified installer.
15. Deviation from this design without prior approval from the designer and Mason County
Health Department will make this design null and void.
16. This design was sized per Washington Administrative CodeWAC246-272A-0230. The
operating capacity is based on 45 gallons per day per capita with two persons per
bedroom. The minimum design flow per bedroom per day is the operating capacity of
ninety gallons multiplied by 1.33. This results in a minimum design flow of one hundred
twenty gallons per day. This creates a surge factor of 33% but anticipated flow is ninety
gallons per bedroom per day.
17. Install laterals with contour of the ground
18. Install trench bottoms level and always maintain a minimum of six inches into native soil
19. Install locator tape on top of all drainfield laterals.
20. Install threaded clean outs at the ends all laterals (caps must extend to within six
inches of finish grade and be in a valv as shown on diagram.
21. Install audio/visual alarm
22. Filter fabric required over drain roc for Mb, ckfilling. If the drain rock extends above
the original grade, run the filter f co ,,,g- cs � 'nches down the trench wall.
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System Owner Responsibilities:
1. Operation and Maintenance is required by Washington State Department of Health and
Mason County Health Department.
2. The septic tank and pump tank should be pumped every three to five years or as
needed.
3. System owners are responsible for having maintenance performed annually.
4. System owners are responsible for responding to septic issues in a timely manner.
5. System owners shall not at any time change or alter settings in the control box.
6. System owner agrees to read and abide by information regarding their system in the
User Manual provided by Mason County Public Health.
7. Keep the flow of sewage at or below the approved design operating capacity.
8. Keep waste strength at residential waste strength parameters.
9. Spread loads of laundry through the week.
10. Do not use excessive bleach or detergents with added whiteners.
11. Do not shower, do laundry and dishwasher at the same time
12. Antibiotics can kill or impair the biological process in the septic tank.
13. Leaky plumbing can hydraulic overload your on-site septic system.
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