HomeMy WebLinkAboutSWG2024-00067 - SWG As-Built - 2/23/2024 OW:, 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: SWG2024-00067
APPLICANT MOSBY BOBBY R & CATHERINE J Phone: 253-380-6223
Address: 163 E GRAY AVE SHELTON, WA 98584
OWNER MOSBY BOBBY R & CATHERINE J Phone: 253-380-6223
Address: 163 E GRAY AVE SHELTON, WA 98584
SEPTIC DESIGNER Jim Zimny Phone: 360-516-7287
Address: 7178 WINDFLOWER PL NW SEABECK, WA 98380
Site Address: 41 NE Daybreak Dr
Primary Parcel Number: 123325200001
Permit Description: New SFR -3BR Pressure
Permit Submitted Date: 02/23/2024
Permit Issued Date: 03/14/2024
Issued By: Jeff Wilmoth
Current Permit Fees Paid: $540.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 03/06/2027 (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.
i
OFFICIAL USE ONLY
DATE RECEIVED:
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COMMUNITY SERVICES A � � � CO M
publicHlealth(Community Health/Environmental Health) --��PP Z �
360427-9670,ext 400 a 360-275.4467,ext.400 A /'' I /� /� /�
415 N 61h Street-Shelton,WA 98584 S W G a.!\" 1 t 3 O{ ) -i- Z N
CLEAR FORM ON—SITE SEWAGE SYSTEM APPLICATION v 13
APPLICANT PHONE m
Bob Mosby 253-380-6223 Z
MAILING ADDRESS-STREET,CITY,STATE.ZIP CODE `� g
163 E Gray Ave, Shelton 98584 (� m
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c�l SIT ADDRESS
NE Daybreak DrDBelfair Wa 98524 7° I-----
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NAME OF DESIGNER 1 PHONE
Jm Zlmny 360-516-7287 . . IN
NAME OF INSTALLER PHONE I
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PERMIT TYPE(select one) DRINKING WATER SOURCE (7 I 1.
w RESIDENTIAL OSS h COMMUNITY OSS rI COMMERCIAL OSS n PRIVATE INDIVIDUAL WELL 0 PRIVATE TWO-PARTY WELL Z
TYPE OF W)RK(select one) 2 PUBLIC WATER SYSTEM I 1 v
I W NEW CONSTRUCTION/UPGRADES rl REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) ElTABLE IX REPAIR I
SUBMITTALS 0 SURFACING SEWAGE El EXISTING FAILURE 0 SHORELINE co
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*DESIGN FORM(REQUIRED) WI SEPTIC DESIGN(REQUIRED) BEDROOMS I )
3 LOT SIZE 69 Acres O s
6 WAIVERS)(IF APPLICABLE) n
DIRECTIONS TO SITE AND SITE CONDITIONS(ex ticked gate) �J
From Shelton travel 22.7 Miles north on Hwy 3 to Romance HILL Rd. Take rt up hill .5 miles I e-
to Daybreak Dr. Take rt. Lot is first lot on Left.
Follow pink Ribbons to Test Holes. o I C
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SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. I
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE/FAILURE SOURCE(for reportng purposes)
0 VOLUNTARY 0 MAINTENANCE/PUMPING ❑BUILDING PERMIT ['HOME SALE ❑COMPLAINT 0 OTHER:
INSPECTOR SOIL LOGS COMMENTS/CONDITIONS
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RECORD DRAWING AND INSTALLATION REPORT
SOIL CODES:
V=VERY G=GRAVELLY Sr SAND L=LOAM Sr=SILT C=CLAY E=EXTREMELY R=ROOTS REQUIRED FOR FINAL APPROVAL
IN OR SIGNATUR DATE APPLICATION IXPIRATION DATE A T APPROVED)ISSUED BY DATE
�-�-27 Ilivkaik3/y:2
T S FOR 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. ( 2 7 ? Z— S" G.__C) 0 C) 0 t
A design will be reviewed when 3 copies of each of the following are submitted:
'1 Completed design form that has been signed and dated. '1 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: 11"X 17"
PARCEL IDENTIFICATION
Permit Number: SWG,A024-- ()DO b-"A Designer's Name: Jim Zimny
Bob Mosby , 360-516-7287
Applicant's Name: Designers Phone Number:
Mailing Address: 163 E Gray Ave Designer's Address: 7178 Windfbwer pL NW
Shelton WA 98584 Seabed( WA 98380
CLEAR FORM
City State Zip City State Zip
DESIGN PARAMETERS
Treatment Device
❑Glendon Biofilter 0 Sand Filter 0 Mound 0 Sand Lined Drainfield ❑Recirculating Filter,Type:
❑Aerobic Unit Make/Model 0 Disinfection Unit Make/Model Other:
Drainfield Type
❑Gravity Er Pressure L'Trench 0 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 70',70', 60' ft
Daily Flow: Design Flow 360 gpd Diameter 1 1/4' in
Septic Tank Capacity(working) 1200 gal Number 3
Receiving Soil Type(1-6) 4 Separation 5' ft
Receiving Soil Appl.Rate 0.6 gpd/ft2 Orifices
Required Primary Area 600 ft2 Total Number of Orifices 43
Designed Primary Area 600 ft2 Diameter 1/8 in
Designed Reserve Area 600 ft2 Spacing 60 in
Trench/Bed Width 3 ft ••o# Ma i ifold
Trench/Bed Length 200 ft Scheduleqi'I•. •rt SCh 40
Elevation Measurements Length/$ '1'
2' ft
Original Drainfield Area Slope 5 % Dia '3ri.,, <�►e 2" in
New Slope,If Altered 5 % Pr uz t:144,1404. _•?,,.tion used? ®'Yes 0 No
Depth of Excavation up-slope 7.5 in L'ley Transport Pipe
from Original Grade Down_stope 6 in Schedule/Class sch 40
Designed Vertical Separation 24 in Length 140 ft
Gravelless Chambers Required? 0 Yes 0 No 'Optional Diameter 2�� in
Pump Required? P'Yes 0 No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day 6
Diff. in Elevation Between Pump&Uppermost Orifice 10 ft Dose quantity 45 gal
Drainfield Squirt Height/Selected Residual(head) 5 ft Chamber Capacity(flood) 1200 gal
Uppermost Orifice 0 Higher 0 Lower than mp Shutoff Pump controls:Please check those required.
Capacity @ Total Pressure Head IR n elapse Meter ®'Event Counter
pCalculated Total Pressure Head 12 ■ I�I'i -r. . 'A i 1 min 15 Secs pump off 4 hrs
Comm tt FOUNDATION DPIAIN i:
30' DOWN GRADIENT OF MAR 14 1014 lk
PRIMARY/RESERVE DRAINFIELD MASON COUNTY ENVIRONMENTAL HEALTH
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DESIGN FORM—PAGE TWO Assessor's Parcel Number: ( 2 3 3 L— SZ--- 0 c--) 6 0
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
Er Test hole locations 0 Drainfield orientation and layout Reference depth from original grade:
O Soil logs V Trench/bed dimensions and Loj Septic tank
O Property lines critical distances within layout B Drainfield cover
0 Existing and proposed wells 0 D-BoxNalve box locations Reference depth from original grade
within 100 ft of property 0 Septic tank/pump chamber and restrictive strata:
O Measurements to cuts,banks,and locations 0 Laterals,trench/bed,top and
surface water and critical areas 1 Observation port location bottom
O Location and orientation of 0 Clean-out location 0 Curtain drain collector
curtain drain and all absorption V Manifold placement 0 Sand augmentation
components 0 Orifice placement Other cross-section detail:
O Location and dimension of 0 Lateral placement with distance V Observation ports/clean-outs
primary system and reserve area to edge of bed
0 Buildings g Other Information
g Audible/visual alarm referenced Yes No
0 Direction of slope indicator 0 Scale of drawing shown on scale 0 0 Design staked out
O Waterlines bar 0 0 Recorded Notices attached
O Roads,easements,driveways, 0 Waiver(s)attached
parking le 0 Pump curve attached
O North arrow and scale drawing a'„ ^
0 0 Evaluation of failure
shown on scale bar '" + s',, Non-residential justification
L. •.,..�- ' ❑ 0 Waste strength
EIS '` r_,TR
•='Sr. 0 0 Flow
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0 1 E ''! ' 9SIGN APPROVAL
PerPnLigner mu-; ,otified by . er at time of installation 1'�Yes 0 No
MAR 1 4 2024 2 - !t-t-Zy
,,'ASON COUNTY ENVIRO "EN-TM-hE Signature f e 'gner Date
The undersigned has BIN
reviewed this design on behalf of Mason County Public Health and determined it to be in
compliance with state and local - ite regulations:
C..) t\A4AS 3 -/y-,2 `%
ental 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: 3 - 2
✓ 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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Construction Notes for Pressure Distribution 3 Bedroom System:
Pressure Distribution w/graveless chambers(Rock and pipe may be substituted)
Install 2—70' and 1-60' Laterals of 1 1/4"sch 40 PVC pipe .
Install on 5'foot centers.
1/8" Orifices on 60" centers beginnint 30"from the beginning of the lateral and oriented at 12 O'clock.
Install 6"trench depth on low side of trench and maintain 24" of vertical separation
Install level and along contours.
Install in dry weather only.
Use 1200-Gallon septic and 1000-gallon pump tank.
See pump Chart for Pump Specs
Use Rhombus SJE Control Panel or equivalent w/audible and visual alarms for low and high water.
System designed for typical residential waste strength sewage only.
System designed for 270 Gallons Per Pay
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MAR 14 2024 r r
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MASON COUNTY ENVIRONMENTAL H 1IL
Jody EALTH
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Pump Selection for a Pressurized System-Single Family Residence Project
Parameters
Discharge Assembly Size 2.00 inches 70 '
Transport Length 70 feet
Transport Pipe Class 40 I '
Transport Line Size 2.00 inches
Distributing Valve Model None f r- -j•---
Max Elevation Lift 5 feet e° ; I i ' 1{ —
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Manifold Length 2 feet !i } -
Manifold Pipe Class 40 --_r t
Manifold Pipe Size 1.25 inches _ t• s -,
Number of Laterals per Cell 3 ___________;______ r ;
Lateral Length 70 feet 5 i- . 4 I t i !
Lateral Pipe Class 40 t
Lateral Pipe Size 125 inches t } k.1 r j
Orifice Size 1/8 inches / "
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Orifice Spacing 5 feel Ia. - , 1 1
Residual Head 5 feet Z i f
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Flow Meter None inches F 40 ( i a
'Add-on'Friction Losses 0 feet p --I ± i 4 , ---
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Calculations i o ( — ': 1 i
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Minimum Flow Rate per Orifice 0.43 gpm : 30 `• 1 1 ' 1 t -
Number of Orifices per Zone 45 t
Total Flow Rate per Zone 19.6 gpm tt ' ` {r, I
Number of Laterals per Zone 3 3 --'----4 i. f
%Flow Differential 1st/Last Orifice 1.6 % F� - ---.-- I -4'- 1 t
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Transport Velocity 1.9 fps ♦ i I I
20 , �
Frictional Head Losses ___.__.__ ; . . ' ,
Loss through Discharge 0.8 feet - i 1 i `—
Loss in Transport 0.5 feet f
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Loss through Valve 0.0 feet - :-- It. i I
Loss in Manifold 0.0 feet 10
Loss in Laterals 0.2 feet 1 I
Loss through Flownreter 0.0 feet '_ ..7_ • -
'Add-on'Friction Losses 0.0 feet ; - '
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Pipe Volumes I r ,
Vol of Transport Line 12.2 gals 0O 40 80 120 160
Vol of Manifold 02 gals Net Discharge(gpm)
Vol of Laterals per Zone 163 gals
Total Volume 28.7 gals
Minimum Pump Requirements PumpData Legend
Design Flow Rate 19.6 gpm PFSW50 Sewage Pump System Curve:._:
Total Dynamic Head 11.5 feet 1/2HP.115/230V 10
�v�✓ Pump Curve:6r E
Pump Optimal Range:
i�fttf Operating Point:
ti �1,,. Design Point:
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Z- \�-2-� MAR 14 2024 '
Orenco MASON COUNTY ENVIRONMENTAL ,.
HEALTH
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