HomeMy WebLinkAboutSWG2023-00449 - SWG Application / Design - 10/18/2023 MASON COUNTY 415N fiSH SHELTON:
,EXT 400
SHSTREE SHELTON,
EXT584
4 BELFAIR:360-275-4467,EXT 400
Public Health & Human Services ELMA:360482-5269,EXT 400
FAX:360-427-7787
On-Site Sewage System Permit: SWG2023-00449
APPLICANT ROHR REAL ESTATE LLC Phone: 253-3984579
Address: 2027 WALKER PARK RD SHELTON,WA 98584
OWNER ROHR REAL ESTATE LLC Phone: 253-398-4579
Address: 2027 WALKER PARK RD SHELTON,WA 98584
SEPTIC DESIGNER Adam Hunter-Jim Hunter and Phone: 360-753-1226
Associates
Address: PO Box 162 OLYMPIA,WA 98507
Site Address: UNKNOWN
Primary Parcel Number: 320215009014
Permit Description: New 3bd pressure subsurface drip
Permit Submitted Date: 10/18/2023
Permit Issued Date: 0 411 112 0 2 4
Issued By: Rhonda Thompson
Current Permit Fees Paid: $525.00 (additional ees may In nquir u,xm installa4on d system).
Permit Expiration Dale: 1012612026 Icasadoadatadims, bal
Permit Conditions:
1 Proposed development subject to zoning requirements and approval by the planning
department staflper 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 bacmi of
system components.
5 Installer is responsible for obtaining Septic DesignerlEngineer installation approval prior to
backfill of system components.
6 Mason County Asbuitt 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.govlhealthionvironmental/onsiteloss-inspection-request.php or call:
360-427.9670,extension 400.
as
OCT 1 e202 "USELY
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MASON COUNTY PUBLIC 17IECEIVEa y n
ONSITE SEWAGE SYSTEM APPLICAT AN415N6th5tree4(BIdg8) SheQonWA,YB584Shftn:360i27-%70Bd4W BeHai1:360-275i467e#4W N O
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BRAD ROHR 2533984579 m m
MARINOAOMEss-srREET.CITY STATE.ZIP CODE r
2027 WALKER PARK RD SHELTON WA 98584
SIIEAODRESS-BTREEL CRY 3IP000E m
XX WALKER PARK RD SHELTON WA 98584 m
NAME OF DESIGNER PHONE
ADAM HUNTER 3607531226
NAME�INSTALLER PHONE IN
TBD Ic
CHECK AXAPPLIGBLE ITEMS DRINKING WATERSOVRCE
It NEW CONSTRUCTION 0 RV HOLDING TANK ONEELY E3 PRWATEINDNIDUALWELL (M IN
0 REPIACEMENTSYSTEM [3 INSTALLATION PERMIT ONLY PRIVATE TWO-PARTY WELL = I—
p TABLES REPAIR O SINGLE FAMILY O COMMUNITY/PUBLIC WATER SYSTEM
TANK(S)ONLY 13 COMMERCIAL SYSTEM NAME:
UPGRADETOEXISTING 0 OTHER BEDRCgS LOTSDE lr_I
0 EXISTING FAILURE b� NMm 3 0,6u to
DIRECTIMS TO STE-BE SPECIFIC AND ADVISE OF ANY NEEDED INFORMATION FORACCESS(ft.I SKE) 10
WALKER PARK RD EAST TO BEND TO THE SOUTH TO NEW DRIVE 0 THE RIGHT M1
JUST AFTER THE PARK. I k
ocP
ob
SREMUETBE FLAGGED FROM MANY RMDANO TEST HOLES MUSTBE RAGGED KTFH MST NOLE NOUMEA% FNcO1pIJ �I
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE/FNLURESg ImrrepoHlig Pury )
OVOLUNTARY OMAINTENANCE/PUMPING O BUILDING PERMIT OHOMESALE OCOMPLNNT DOTHER:
n
INSPECTOR SOILLWS COMAENTS/CONDRIONS
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INSPECTORSIGNATURE DATE APPUCATION EXPIRATION DATE APPGLRTpNN'PROVED BY DATE
THIS FORM MAY BE SCANNED ANDAVAIIABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBBETE REVISED 1MM15
DESIGN FORM—PAGE ONE Assessor's Parcel Number: 2 2— O i 1 _ 0 — -0A d I Y
A design will be reviewed when 3 copies of each of the following are submitted: ($b✓ ) — 7
v Completed design form that has been signed and dated. v Scaled layout sketch,including all applicable items on checklist
v 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.Ma.timum paper size: 11"X17"
.._..: PARCEL IDENTIFICATION <"
Permit Number: SWG 'fp 2,3—C'04 f.Ff Designer's Name: ADAM HUNTER
BRAD ROHR 360-753-1228
Applicant's Name: Designer's Phone Number:
8n Mailing Address:
2027 WALKER PARK RD Desi er's Address: PO BOX 162
SHELTON WA 995" OLYMPIA WA 98507
city State zip City state Zt
,DESIGN PARAMET
Treatment Device
❑Glendon Bimilter ❑Sand Filter ❑ Mound ❑Sand Lined Drainfield 0 Recirculating Filter,Type:
❑Aerobic Unit Make/Model ❑Disinfection Unit Make/Model Other:
Drainfleld Type ../
❑Gravity ❑Pressure ❑Trench ❑Bed 0a Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 3 Schedule/Class DRIPTUBE
Daily Flow:Operating Capacity 270 glad Length
450 ft
Daily Flow:Design Flow 360 gpd Diameter 0.5 in
Septic Tank Capacity 1200 gal Number Z
Receiving Soil Type(1-6) 4 Separation 2 ft
Receiving Soil Appl.Rate 0.6 gpd/ft Orifices
Required Primary Area 900 ft2 ✓ Total Number of Orifices 450
Designed Primary Area 900 Diameter DRIP EMITTERS in
Designed Reserve Area 900 ft2 ✓ Spacing 12 in ✓
Trench/Bed Width DRIP ft Manifold
Trench/Bed Length DRIP ft Schedule/Class 40
Elevation Measurements Length VARIES ft
Original Drainfield Area Slope 15 / Diameter i in
New Slope,if Altered 15 % Preferred manifold configuration used? E(Yes ❑No
Depth of Excavation UP-steps 12 in Transport Pipe
from Original Grade Dewy-dam 12 in Schedule/Class 40
Designed Vertical Separation 24 in Length
Gravelless Chambers Required? ❑Yes 1fNo ❑Optional Diameter 1 in
Pump Required? !(Yes O No Dosing and Pump Chamber
Pump/Siphon Specifications Number ofdoses/day 12
Difference in Elevation Between Pump Shljoff and Uppermost Dose quantity 30 gal
_
Orifice 1163 R Chamber Capacity 1200 gal q�
Uppermost Orifice ItHigher ❑Lower than Pump Shutoff Pump controls:Please check those required.
Capacity @ Total Pressure Head (O,4 gpm Minter ErElapse Meter El Event Counter
Calculated Total Pressure Head 12 4•r it If Timer: Pump on 300AL ,Pump off 2HRS
Comments
DESIGN FORM—PAGE TWO Assessor's Parcel Number:32= o y! jo - -03111U
Permit Number: SWG (So�rf��N1
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
1f Test hole locations V Drain6eld orientation and layout Reference depth from original grade:
19 Soil logs EZf Trench/bed dimensions and Ed Septic tank
19 Property lines critical distances within layout U Dminfield cover
E9 Existing and proposed wells E9 D-Box/Valve box locations Reference depth from original grade
within 100 ft of property a Septic tank/pump chamber and restrictive strata:
E9 Measurements to cuts,banks,and locations ❑ Laterals,trench/bed,top and
surface water and critical areas E9 Observation port location bottom
Gd Location and orientation of E9 Cleanou[location ❑ Curtain drain collector
curtain drain and all absorption 9 Manifold placement ❑ Sand augmentation
components F1 Orifice placement Other cross-section detail:
E9 Location and dimension of 9 Lateral placement with distance E9 Observation ports/clean-outs
primary system and reserve area to edge of bed Other Information
19 Buildings if Audible/visual alarm referenced Yes No
19 Direction of slope indicator E9 Scale of drawing shown on scale Rf ❑ Design staked out
9f Waterlines bar ❑ ❑ Recorded Notices attached
19 Roads,easements,driveways, ❑ ❑ Waiver(s)attached
parking ❑ ❑ Pump curve attached
19 North arrow and scale drawing ❑ ❑Evaluation of failure
shown on scale bar Non-residential justification
❑ ❑ Waste strength
❑ ❑ Flow
DESIGN APPROVAL
The undersigned designer must fesigmn
installer at time of installation ItYes ❑ No
10/17/23
Designer Date
The undersigned has reviewed tbehalf of Mason County Public Health and determined it to be in
compliance with state and local on-site rehgulation n
1 "VKr� t
Environmental Health Speclatist Date
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
✓ The design is stamped"Approved"by Mason County Public Health. 1 O
✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is:
✓ Dminfield 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: 12/72015
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MASON CGUN'ENVIRONMENTAL HEALTH
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