HomeMy WebLinkAboutSWG2024-00126 - SWG Application / Design - 4/1/2024i
MASON COUNTY 415NB SHELTON: ,6HELTO70,EXT 400
SHELTON:36042749670,EXT 400
4 BELFAIR:360.2754467,EXT/00
Public Health & Human Services ELMA:360482-5269,EXT 400
FAX:360427-7787
On-Site Sewage System Permit: SWG2024-00126
APPLICANT FULTON LAVONNE M Phone:
Address: 330 E QUEENS WAY SHELTON,WA 98584
OWNER FULTON LAVONNE M Phone:
Address: 330 E QUEENS WAY SHELTON,WA 98584
SEPTIC DESIGNER CINDY WAITE* Phone: 360-701-0205
Address: 80 E Pickering Lane SHELTON,WA 98584
Site Address: 330 E Queens Way
Primary Parcel Number: 221295200009
Permit Description: Repair-2BR Pressure (oversized)
Permit Submitted Date: 04/01/2024
Permit Issued Date: 04/04/2024
Issued By: Jeff Wilmoth
Current Permit Fees Paid: $805.00 (addldm al fees may ee required anon nuallar n of srsmm).
Permit Expiration Date: 04/0 312 0 2 5 (ba8edaadaaonaauaelon)
Permit Conditions:
1 Proposed development subject to zoning requirements and approval by the planning
department staBper 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/envimnmental/onsite/oss-inspection-mquest.php or call:
360-427-9670,extension 400.
_ OFFICIALUSEONLY
MASON COUNTY DATE MaNEm L' ` -2 4
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ON-SITE SEWAGE SYSTEM APPLICATION 3 A
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APPLICANT PHONE m
MILLISSA FULTON 360-721-7238 z
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MAILINGADDRESS-STREET,CITY STATE.ZIP CODE 3
330 E QUEENS WAY SHELTON WA 98584 m
SITE ADDRESS STREET COY ZIP CODE .'U.
SAME IN
N EOF DESIGNER PHONE I N
CINDY WAITE 360-701-0205
RAME OF INSTALLER PHONE °
TBD
PERMRTYPE(aeb .l DRINXMGMTER SOURCE y N
9RESIDENTALOSS EECOMMUNTTYOSS 15COMMERCIALOSS flPRNATEINDNIDUALWELL 6PRIVATETWO-PARTYWELL =
TYPE OF WORK(aaa U IF PUBLIC WATER SYSTEM WONDERLAND WS
ffiNEWCONSTRUCTIONIUPGRADES ®REPAIRIREPLACEMENT OTHER DETAILS(rrrea aVmMapryYl IS TABLE X REPAIR IQ1
SUBMITTALS 0 SURFACING SEWAGE 0 EXISTING FAILURE ❑SHORELINE
[FDESIGN FORM(REQUIRED) ®SEPTIC DESIGN(REQUIRED) BEDROOMS mTSRE P IN
ff4WIVER(S)(IFAPPUCASLE) 2 1 ACRE 0 I ,O
DINECTIONS TO SITEAND SITE CONDMONS:(u.bMelptle)
GO NORTH ON HIGHWAY 3, TURN RIGHT ONTO PICKERING ROAD, TURN LEFT
ONTO QUEENS WAY, FOLLOW TO END OF CUL D SAC. SOIL LOGSS ARE BEHIND 7
THE RESIDENCE. o 1 0
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SIZE TMFLABBFAFROYMAWRDADANDTESTXOLESMUSTBEFLAOGFOX1THTEBTROLENUMBERS.
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE I FAILURE SOURCE(W gUiM PuR—Q
❑VOLUNTARY O RIAINTENANCEIPUMPING O BUILDING PERMIT DHOMESALE (]COMPLAINT (]OTHER: /VR
INSPECTOR SOIL LOGS COMLENTSICONDMONS mmy
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SOILCOOFH: RECORD DRAWINGAND INSTALLATION REPORT
V=VERY G=GMVELLY S=SAND L=LOAM SI=SIT C=CLAY E=EXTREMELY R=ROOTS REQUIRED FOR FINALAPPRWA_
P LTORSIGIIANflE SUITE PDPLICATpNE%PIUTWN DARE AP TIONAPPROVEW ISSUED BY DATE� Y-'y2y -3 Z .�)-, Y-z
F Y B LTESCANNEUU AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WESSITE REVISED,POTA15
DESIGN FORM—PAGE ONE Assessor's Parcel Numben.2 2 1 2 9 — 5 2 — 0 0 0 0 9
A design will be reviewed when 3 conies of each of the following are submitted:
•Completed design form that has been signed and dated. °Scaled layout sket h including all applicable items on checklist
Scaled plot plan,including all applicable items on checklist. Cross-section skeb h including all applicable items on checklist.
This Mtrrr am be scanned and available br publk Wew an me Mason Coun ab sRa.Morimum n er size: 11"X IT'
P CATION
Permit Number. SWG Designer's Name: CINDY WAITS
Applicant's Name: MELLISSA FUL70N Designer's Phone Num 360-701-0205
Mailing Address: 330 E QUEENS WAY Designer's Address: 80 E PICKERING LANE
SHELTON WA 98584 SHELTON WA 985M
C State Zi Ci State Zip
Treatment Device
❑Glendon Biofilter ❑Send Filter ❑Mound ❑Sand Lined Grainfield Cl Reirculating Filter,Type:
❑Aerobic Unit Make/Model ❑Disinfection Unit Make/Model Other:
1-3 GravityDrainfreld Type
ty Pressure RrTrench ❑ 3A
❑Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 2 Schedule/Class SCHEDULE40
Daily Flow:Operating Capacity 180 gpd Length 50 ft
Daily Flow:Design Flow 240 gpd Diameter 1.25
n
Septic Tank Capacity(working) 1200 gal Number q
Receiving Soil Type(1-6) 3 Separation 2 ft
Receiving Soil Appl.Rate .8 gpd/ft2 Orifices
Required Primary Area 450 ft2 Total Number of il ices 40
Designed Primary Area 600 ft2 Diameter 3/16
n
Designed Reserve Area 600+ ft2 Spacin 60
in
Trench/Bed Width 3 ft Manifold
Trench/Bed Length 200 ft Sc a/C
SCHEDULE 40
Elevation Measurements {s. 2-3 ft
Original Grainfield Area Slope <1 % } 2 in
New Slope,If Altered % $*A;Mn used? ❑Yes ❑No
Depth of Excavation uo-slope 9-12 uc SIGN ort Pipe
from Original Grade Downylope 9-12 m P
in SCHEDULE 40
Designed Vertical Separation 12 in Length 40-50 ft
Gmvelless Chambers Required? ❑Yes ❑No ❑Optional Diameter 2 in
Pump Required? Ed Yes ❑No D N ing and Pump Chamber
Pump/Siphon Specification Number of doses/da 6
Diff.in Elevation Between Pump&Uppermost Orifice 6 ft Dose quantity 40 gal `\\1
Drainfield Squirt Height/Selected Residual(head) __2 ft Chamber Capacity( ) 1200 gal
Uppermost Orifice Mf Higher ❑Lower than Pump Shutoff Pump controls: Ple a heck those required.
Capacity(Qa Total Pressure Head 23.6 gpro IfTimer GYElapse Meter GrEvent Counter
Calculated Total Pressure Head 8.39 ft If Timer: Pump on ,Pump off
Comments
CONCRETE TANKS REQUIRED, GRAVEL BASED DRAINFIELD QUIRED, TIMER TO BE SET AT
240 GPD(DRAINFIELD IS OVERSIZED), CONTROLS TO BE SET TIME OF INSTALLATION.
DESIGN FORM—PAGE TWO Assessor's Parcel Number. 2 L 2 9 — 5 2 -- 0 0 0 0 9
Permit Number: SWG
DESIGN CHECKLISTS
SS led Plot Plan Se led Layout Sketch Cross-Section Sketch
L; Test hole locations 67 Drainfield orientation and lay Reference depth from original grade:
fidr Soil logs Trench/bed dimensions and M, Septic tank
Property lines critical distances within layoui Er Dminfield cover
Existing and proposed wells 1d B-BvmWalve box locations Reference depth from original grade
y,�within 100 ft of properly Q'Septic tank/pump chamber and restrictive strata:
pr Measurements to cuts,banks, and locations P l•F m•Y
surface water and critical areas fa' Observation port location W Laterals,trench/bed,top and
bottom
Location and orientation of W Clean-out location ❑ Curtain drain collector
curtain drain and all absorption R Manifold placement ❑ Sand augmentation
componentswe Location and dimension of Gr Orifice placement Other cross-section detail:
primary system and reserve area 9 Lateral placement with distant V Observation ports/clean-outs
to edge of bed Other Information
lJ� Buildings kr Audible/visual alarm reference I Yes No
bA Direction of slope indicator
Gd' Scale of drawing shown on sea 11"' ❑ Design staked out
1Y Waterlines bar ❑ ❑ Recorded Notices attached
Roads,easements,driveways, ❑ ❑ Waiver(s)attached
/ parking ,Z.RR S4+0tW ia+ 1 4 Ty' ❑ Pump curve attached
® North arrow and scale drawing TtN Pao yl t. lydwt tom{ � ❑ Evaluation of failure
shown on scale bar Gte 1 dt"e Non-residential justification
❑ CJ&AeAtrength
DESIGN APPROVAL
The undersigned designer must be n d by 'installer at time of installatiot Yes (NgNr, fT 4 ?4
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Signature of Designer Da a yJ� ycv�i "FH
The undersigned has reviewed this design on behalf of Mason County Publi I 4ealth and determined it to be in
compliance with state and local on ' regulations:
Z
E i muted Health Specia ts[ Date
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE F LOWING CONDITION:
✓ The design is stamped"Approved"by Mason County Public Health.
✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date it 7 —�
✓ Drainfield site conditions have not been altered to adversely affect condi i Ins of design approval.
2
Please Note: The system must be installed by certified installer,
unless prior authorization is obtained from Ma n 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: 12/72015
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Installation Notes
Pressure Distribution Sys
22129-52-00009 330 E Queens Wa
1. The prepared site plan is not a survey. It's the owners rf s Donsibility to verify property
lines, utility lines (water, sewer, power, phone and gas) F ri r to installation.
2. There is no records on this parcel. System is probably 50 plus years old. System has
been driven on and is very close to the till layer.
3. Gravel based drainfield required
4. Concrete tanks required
5. Pump controls to be set at time of installation RFOR I FO GPD.
6. The tanks may be moved as necessary to accommodate building requirements. Septic
tank location must meet all required setbacks.
7. Keep wheeled vehicles off the drainfield area before, durin j and after installation.
Tracked equipment only,
8. All ground, surface water and roof drains must be diverted way from the septic tanks
and drainfeld. Ensure the final grade slopes away from tt is as 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.
9. Curtain drains can be no closer than 10' upgradient and down gradient of the
drainfield
10. Exposed restrictive layers, cuts, banks, etc. can be no clo Bar than 50' downhill from the
drainfield.
11. Install access risers on the septic tanks, valve box and an of lateral
12. Make sure septic tank risers are epoxied or caulked to ca t in riser a ,>DI o w
13. Lids must form a water and gas tight seal with the access r ers.
14. Install effluent filter specified in this design at the septic to outlet. APR
15. This system must be
16. Self-install systems installed
met Mason County proced I stall �C0UN7yENVI R4OAIM' HEA1T
17. Deviation from this design without prior approval from the signer and MasonIAYyty H
Health Department will make this design null and void.
18. This design was sized per Washington Administrative Coc a WAC246-272A-0230. The
operating capacity is based on 45 gallons per day per cap t 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° ut anticipated flow is ninety
gallons per bedroom per day.
19. Install laterals with contour of the ground.
20. Install trench bottoms level and always maintain a In in of six inches into native
soil..
21. Install threaded clean outs at the ends of all later p ust extend to within six
inches of finish grade and be in a valve box as ~� ram. 1`I
�
22. Install audio/visual alarm. °
23. Filter fabric required over drain rock prior to III t' N roc extends above
the original grade, run the filter fabric at Is o E h wall.
LICENSE- ESIIt I
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System Owner Responsibil es:
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 rformed annually.
4. System owners are responsible for responding to septic is ues in a timely manner.
5. System owners shall not at any time change or alter setti i s in the control box.
6. System owner agrees to read and abide by information arding 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 param t 3rs.
9. Spread loads of laundry through the week.
10. Do not use excessive bleach or detergents with added w ir eners.
11. Do not shower, do laundry and dishwasher at the same tir e
12.Antibiotics can kill or impair the biological process in the tic tank.
13. Leaky plumbing can hydraulic overload your on-site septi ystem.
APPROVE
APR 0 4 1014
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