HomeMy WebLinkAboutSWG2021-00440 - SWG Application / Design - 7/27/2021 (2) LTON,
WA9
MASON COUNTY 115NBTHELTON:STREET,SHE7-967 ,EXT 404
SHELTON:360-2759 70.EXT 400
BELFAIR:360-275-N6],EM 400
_ ._ Public Health & Human Services ELMA:360482-5269,EXT 400
FAX:36"27-7767
On-Site Sewage System Permit: SWG2021-00440
APPLICANT Sharma Burdick Phone:
Address: 5213 25th Ave SE LACEY,WA 98503
OWNER LOUDON JERRY M &BOBBI L Phone:
Address: 7754 SE MONTE BELLA PL PORT ORCHARD, WA 98366
SEPTIC DESIGNER ROD LEFT-Acme Design Phone: 360-698-8488
Address: PO Box 2954 SILVERDALE,WA 98383
Site Address: 220 E Pickering Dr
Primary Parcel Number: 220185000041
Permit Description: REVISION: New two bdrm-shallow pressure trench
Permit Submitted Date: 07/27/2021
Permit Issued Date: 03/28/2024
Issued By: Luke Cencula
Current Permit Fees Paid: $640.00 (additional teas may ba required eaon mstallaoon or sys am).
Permit Expiration Date: 0810512024 (based on date of nspeetioo)
Permit Conditions:
1 Proposed development subject to zoning requirements and approval by the planning
department sta%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 (9)and downslope (9)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.
7 Horizontal setbacks per WAC246-272A-0210 must be maintained, unless prior approval is
obtained
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/onvironmentaUonsitaloss-inspection-request.php or call:
360-427-9670,extension 400.
-OFFICIAL USE ONLY
MFLL!lMD
MASON COUNTY H
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ON-SITE SEWAGE SYSTEM APP3
FROD
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oxc Y & BOBBI LOUDON
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NSPECIOR E.T. MlE APPILATNIH FJPIMTON MTf AP0.IGSTIDNMI'ROVEG'1881400Y
FORM MAYBESCANNEO AMID AVAILABLE FOR PUBLIC NEW ON TXE MASON COUNTY WEBS E PEVISED ID'iIAI�B
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Printed From Mason County DM
PfIt# from MaB un County OMS
DESIGN FORM—PAGE ONE Assessor's Parcel Number: 2 2 0 1 a — 5 0 — 0 0 0 4 1
A design will he reviewed when 3 co ies of each of the following are submitted:
v Completed design form that has been signed and dated. v Scaled layout sketch,including all applicable items on checklist
v
I Scaled plot plan,lnduding all applicable items on checklist "Croessection skeryh,including all eppli P bye£Eras on ch klist.
This form may be scanned and available for public view on the Mason Coun Web site.Mr arm `u see I!
PARCEL IDENTIF/CATION-:.
��_�-9_0� � Designer's Name: Rod Lett
pernutV mbcr SWG 2 360-698-8488
Appl can's Name: Sharma Burdick Designer's Phone Number.
P.O.Box 2954
MailingAddress: 5213 25th Ave SE Designer's Address:
SiNeNab WA met
Lacey WA 9a593
ff Ci State Zi
Ci State
Li Treatment Device
❑GI ndon [3 S. Filter ❑Mound ❑Send Lived Dradifield ❑Renrculating Filter,Type:
Ae ny ❑Disinfection Unit Make/Model Other
Drainfield Type ❑Sub Surface Drip
❑Gravity Pressure SiTrench ❑Bed
Septic Tank/Dminfield Specifications Laterals
2 Schedule/Class 40
Number of Bedrooms 45 ft
Daily Flow:Operating Capacity 180 gpd Length
d Diameter 1 'n
Deily Flow:Design Flow 240 gp 3
Septic Tank Capacity 1250 gal Number
Receiving Soil Type(1fi)
q Separation 5 it
Receiving Soil Appt.Rate 0.6 gpd/fta Orifices
Required primary Area 400 fc Total Numberof Orifices 35
405 ft' Diameter 1B m
Designed Primary Area 118 in
Designed Reserve Area 400 fN' Spacing
TrencNBed Width 3 ft Manifold
135 ft Schedule/Class 40
TmvchBed Length 43 ft
Elevation Measurements Length
Original D if Alld Area Slope
0-1 % Diameter 1 inNew Slope,➢Atered 0-1 % Preferred Manifold cov5gumtiov used? 0 Yes O No
Depth of Excavation lft-u e 9 in Transport Pipe
from Original Grade pp_-sbpe 9 in Scbedule/Clwa 40
24 ,in Length 21 ft
Designed Vertical Separation 2 in
Gravrllcm Chambers Required? es ❑No tt Optional Diameter
Pump D Required? Yes ❑No Dosing and Pump Chamber
f doses/day 8 o
Pump/Siphon Specifications Number30 gal
Difference in Elevation Between Pump Shutoff and Uppermost Dose quantity
OriBre no ft Chamber Capacity 1250 gal
Uppemost Orifice Rf Higher ❑Lower than Pump,Shutoff Pump controls:Please check those required
-
Capacity Total Pressure Head 15.7 gpm Timer G(Blapse Meter Gf Fveat Counter
Capacity(o} 3hrs
Calculated Total Pressure Head 1].4 ft If Timer: PwvP on 1 min ,pump off
Covenants APPROVED
MAR 28 2024
MASON COUNTY ENVIRONMENTAL HEALTH
DdA
DESIGN FORM—PAGE TWO Assessor's Parcel Nomier:2 20 1 8 — 5 0
Permit Number: SWG
r
IGN.CHECKLISTS:
rPlaut Plan ayout Sketch CrossSection Sketchle locations field orientation and layout Reference depth from original grade:s hlbed dimensions and Ed Septic tanky lines l distances within layout 10 Drainfield coverg and proposed wellsx/Valve box locations Reference depth from original grade tanWpump chamber and restrictive strata:100 ft of propertyrements to cuts,banksons Laterals,trench/bed,top andsur water and critical arervation port location bottom
i ❑ Curtain drain collector
El Location and orientation of Clean-out location El Sand augmentation
curtain drain and all absorption Ed Manifold placement
jcomponents 19 Orifice placement Other cross-section detail:
m Location and dimension of 19 Observation portsicleanbuts
56 Lateral Placement with distance
primary system and reserve area to edge of bed Other Information
Buildings Eg Audible/visual alarm referenced Yes No
m Direction of slope indicator 54 Scale of drawing shown on scale ❑ Ed Desiga staked out
56 Waterlines bar ❑ ld Recorded Notices attached
❑ 61 Waiver(s)attached
l� Roads,easements,driveways, gf ❑pump curve attached
parking ❑ 66 Evaluation of failure
Gd North arrow and scale drawing
shown on scale bar Non-residential justification
❑ Rf Waste strength
❑ E6 Flow
DESIGN APPROVAL
The undersigned designer most be notified by install a ms on es ❑ No
3•z�-Zr'alf
Sigoa of Designer Date
The undersig in
ned has reviewed this design on behalf of Mason County Public Health and de
compliance with state and local on-Jt `''aa
Environmental Health specialist Dam-CpU,gIyE B�74
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDTE
stamped" ved"b Mason County Public Health. A NTq(NFgt
✓ The On it,is wageAppm Y
✓ The Onsim Sewage Permit has not expired,the Permit Expiration Dam is: V
✓ Drsmfield 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 re uired.
This form may 6e scanned and available for public view on the Mason County Web sitepdated Date. 12n72015
Pump Se)eCbOn fb a Pressurized System -Single Family Residence Pmject
B U R D I c K/2201&50-00041
Parameters 160
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D'eSigE/3.4.1vy Noe 140
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ICFNSE F916YER
MAR 2 R 2024
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