HomeMy WebLinkAboutSWG2023-00447 - SWG Application / Design - 10/18/2023 MASON COUNTY 415N6THELTON:STREET,SHELTON,
967 .EXT 400
SHELFAIR 36() 227 670.EXT 400
BELFAIR:360-2]5-04fi],EXT 400
Public Health & Human Services ELMA.36"82-5269,EXT 400
FAX:360427-7787
On-Site Sewage System Permit: SWG2023-00447
APPLICANT ROHR REAL ESTATE LLC Phone: 253-398-4579
Address: 2027 WALKER PARK RD SHELTON,WA 98584
OWNER ROHR REAL ESTATE LLC Phone: 253-3984579
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: 320215009012
Permit Description: New 3bd pressure subsurface drip
Permit Submitted Date: 10/1812023
Permit Issued Date: 04/11/2024
Issued By: Rhonda Thompson
Current Permit Fees Paid: $525.00 laddidonalroes mar 6a mymrsdapon inatalle0en onyslem7.
Permit Expirabon Date: 10/26/2026 (based on data mmepeobon)
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 Drainfreld 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 backhll 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/onvironmental/onsiteloss-inspection-request.php or call:
360427-9670,extension 400.
OCT 1 0 2023 OFFICIAL USE ONLY
MASON COUNTY PUBLI HEAkTHEIVED a .' m a
ONSITE SEWAGE SYSTEM A ; y
415 N 6th Strtet(Bldg 8) Shelton WA 98584 z IT
SheltuR360427-9670eId400 BehiR360-275-4467eA400 �•`^,� Lb
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APPLICANT PRONE a a
BRAD ROHR 2533984579 tail m
MAILING AODRESS-STREET CITY STATE,ZIPCODE r
2027 WALKER PARK RD SHELTON WA 98584 c
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SITE ADDRESS.STREET cm,ZIP CODE m
XX WALKER PARK RD SHELTON WA 98584 a
NAME OF DESIGNER ENGINE IW
ADAM HUNTER 3607531226
NAME OF INSTALLER PHONE II'
TBD 1
CHECKALL MPLMABLE RENTS DRINKING WATER SOURCE 0 D
it
` Ir
NEW CONSTRUCTION D RV HOLDING TANN ONLY 0 PRIVATE INDIVIDUAL WELL y D REPLACEMENT SYSTEM 0 INSTA TIONPERMITONLY Of FRNATETWCPARTYWELL 0
0 TABLE 9REPAIR 0 SINGLE FAMILY D COMMUNITYIPUBLICWATERSYSTEM 1 --
0 TANK(S)ONLY 0 COMMERCWL SYSTEM NAME:
0 UPGRADETOEXISTING 0 OTHER: BEDROOAS LOT SII£
0 EXISTING FAILURE _ � 3 •9,.i-I= O I SD m 10
DIRECTIONS TO SITE-BE SPECIFIC ANDADVISE OF ANY NEEDED INFORMATION FOR ACCESS(ex,M BIN) o I
WALKER PARK RD EAST TO BEND TO THE SOUTH TO NEW DRIVE ON THE RIGHT Ix Ic
JUST AFTER THE PARK. +o
o I�
612E MMSTBE MD FROMW1MRd10ANO TESTMOLES WASTES MGDED N'1I11TESTXOLENDYBE R`C B<� Ir
--- OFFICIAL USE ONLY BELOW THIS LINE
9 UPGWNEI FAILURE 90URCE(MIegHMJ PIRNFeFj
1 OVOLUNTARY OMAINTENANCEIPUMPING DBUILDING PERMIT OHOMESALE OCOMPLAINT DOTHER'.
INSPECTOR SOIL LOGS COMMENTSICONDITIONS
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INSPECTOR SIGNATURE DATE I APPLICATION EXPIMTION DATE APPLICATION APPROVED BY SAID
THIS FORM MAY BE&ANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISEDIWMIS
DESIGN FORM-PAGE ONE Assessor's Parcel Number:-3 z o b t - Q -- O g -L-7.
A design will be reviewed when 3 conies of each of the following are submitted:
v Completed design form that has been signed and dated. 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 he scanned and available for public view on the Mason County Web site.M=imtaa ersize: ll"X 17"
..- —1-,:1...- _ . VARM IDENT ATION�
Permit Number: SWG !2AZ3—R'Jc-I L1, Designer's Name: ADAM HUNTER
Applicant's Name: BRAD ROHR Designer's Phone Number: 360-753.1226
Mailing Address: 2027 WALKER PARK RD Designer's Address: PO BOX 162
SHELTON WA 98584 OLYMPIA WA 98607
city State Zip city State zip
Treatment Device
❑Glendon Bicfilter 0 Sand Filter ❑Mound ❑Send Lined Drainfield ❑Recimulating Filter,Type:
❑Aerobic Unit Make/Model ❑Disinfection Unit Make/Model Other:
Drainfield Type
❑Gravity 0 Pressure ❑Trench ❑Bed 9Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 3 Schedule/Class DRIPTUBE
Daily Flow:Operating Capacity 270 gpd Length 450 R
Daily Flow:Design Flow 360 gpd Diameter 0.5 in
Septic Tank Capacity 1200 gal Number 3
Receiving Soil Type(1-6) 4 Separation 2 ft
Receiving Soil Appl.Rate 0.6 gpd/ft' Orifices
Required Primary Area 900 ftt Total Number of Orifices 450
Designed Primary Area 900 111 Diameter DRIP EMITTERS in
Designed Reserve Area 900 ftt 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 1 in
New Slope,If Altered 15 % Preferred manifold configuration used? W.y Yes 0 No
Depth of Excavation Up-slope 12 in Transport Pipe
from Original Grade odope 12 in Schedule/Class 40
Designed Vertical Separation 24 in Length /SJ ft
Gravelless Chambers Required? ❑Yes If No 0 Optional Diameter in
Pump Required? IfYcs 0 No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day 12
Difference in Elevation Between Pump Shutoff and Uppermost lose quantity 30 gal
Orifice 12 .9 ft Chamber Capacity 1200 gal
Uppermost Orifice Higher 0 Lower than Pump Shutoff Pump controls:Please check those required.
Capacity Q Total Pressure Head 10,6 Spit f7 (1'1r�° n UElapse Meter i7Event Counter
Calculated Total Pressure Head t2d 1 e it r'i r If'Tfile!! MudptA✓ 3 ,Pump off 2HRS
Comments APK I I 2024
MASON COUNTY ENVIRONMENTAL HEALTH
RET
DESIGN FORM-PAGE TWO Assessor's Parcel Number:3 7-
Permit Number: SWO
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
Rf Test hole locations V Drainfield orientation and layout Reference depth from original grade:
E� Soil logs 12f Trench/bed dimensions and if Septic tank
EZ Property lines critical distances within layout V Drain6eld cover
Ib Existing and proposed wells 19 D-Box/Valve box locations Reference depth from original grade
within 100 ft of property 9 Septic tank/pump chamber and restrictive strata:
U Measurements to cuts,banks,and locations ❑ Laterals,trenchlbed,top and
surface water and critical areas 19 Observation port location bottom
19 Location and orientation of 19 Clean-out location ❑ Curtain drain collector
curtain drain and all absorption d Manifold placement ❑ Sand augmentation
components 1Z Orifice placement Other cross-section detail:
19 Location and dimension of Rf Lateral placement with distance Ef Observation ports/clean-outs
primary system and reserve area to edge of bed
19 Buildings Other Information
E9 Audible/visual alarm referenced Yes No
19 Direction of slope indicator 69 Scale of drawing shown on scale Design
� ❑ staked out
IY Waterlines bar ❑ ❑ Recorded Notices attached
Rf 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 be nriqW b installer at time of installation lid Yes ❑ No
10/17/23
Si a Ire of Designer Date
The undersigned has reviewed this esign on behalf of Mason County Public Health and determined it to be in
compliance with state and local onsite regulations:
Environmental Health Speciali Date
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
✓ The design is stamped"Approved"by Mason County Public Health. CID
(�(,_Zlo
!
✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: 1.
✓ 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: 12n12015
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APPROVED
APR 11 2024
10/12/23
MASON COUNTY ENVIRONMENTAL HEALTH
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