HomeMy WebLinkAboutSWG2024-00170 - SWG Application / Design - 4/24/2024 SHELTON,WA
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MASON COUNTY 415N6 SHELTON: , 0427-97 ,EXT 400
SHELTON:360-027-4467,EXT 400
BELFAIR:380-275-4487,FJ(T 400
Public Health & Human Services ELMA:360482-5269,ENT 400
FAX:360427-T787
On-Site Sewage System Permit: SWG2024-00170
APPLICANT LUKKASSON RICKY D &ELLEN M Phone: 360-821-4257
Address: PO BOX 2166 BELFAIR,WA 98528
OWNER LUKKASSON RICKY D&ELLEN M Phone: 360-821-4257
Address: PO BOX 2166 BELFAIR,WA 98528
SEPTIC DESIGNER Jim Zlmny Phone: 360-516-7287
Address: 7178 WINDFLOWER PL NW SEABECK, WA 98380
Site Address: UNKNOWN
Primary Parcel Number: 123212490082
Permit Description: New 4bd gravity bed in Beltair UGA
Permit Submitted Date: 04/24/2024
Permit Issued Date: 05/14/2024
Issued By: Rhonda Thompson
Current Permit Fees Paid: $540.00 (additional fees may be required upon Installatlon of system).
Permit Expiration Date: 05106/2027 (oared on date a 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 Draintteld installation not to exceed designed upslope and downs/ope depth specified on
design form.
4 Installer is responsible far obtaining Mason County installation approval prior to backfill of
system components.
5 Installer is responsible for obtaining Septic Designer/Engineer installation approval prior to
backflll of system components.
6 Mason County Asbuilf Form, Record Drawing, and Installation fee must be submitted for
final installation approval.
7 Applicant needs to provide proof that Capital Facilities Charges have been paid to Public
Works prior to SWG permit final or BLD permit issuance, whichever comes first.
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.
OFFICIAL USE ONLY
MASON COUNTY
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From Belfair head east on Hwy 3. At the first roundabout take the third rt turn( a log Yard I a
Rd) follow .2 miles. At stop sign take left on NE Katchemak Ln. follow across trAintracks
and take rt. Fallow 900 ft to Garrick Ln. Access to lot is at 21 Garrick Ln. follow ribbons to o p
the Test Holes.
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DESIGN FORM—PAGE ONE Assessor s Parcel Number. 123_212490082- —
A design will be reviewed when 3 copies of each of the following are submitted:
•Completed design form that has been signed and dated. "Scaled layout sketch including all applicable item on checklist
•Scaled plot plan,including all applicable items on checklist "Cross-section sketch including all applicable item on checklist.
This form maybe waned and avasable for publicnew on the Masco county Web site.Ato orrum paper size: II"X IT'
PARCEL IDENTIFICATION
Permit Number. SWG Designer's Name: '��m
RICK LU� 3603167287
Applicant's Nacre: Designer's Phone Number.
Mailing Address: PO BOX 2166 Designer's Address: 7178 WINDFLOWER PL NW
s 01Assssor SEABECK WA 98380
® city State zip city State zip
DESIGN PARAMETERS
Treatment Device
❑Glendon Biofilter ❑Sand Filte ❑Mound ❑Sand Lined Drainfield ❑Recirculating Filter,Type:
❑Aembk Uvit MakcfModel ❑Disnifivt on Unit Make/Model Other
Drainfield Type
IrGmwty O Pressure ❑Trench IfBed ❑Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 4 Schedule/Class 3034
Daily Flow:Operating Capacity 360 Slid Length 60 ft
Daily Flow:Design Flow 480 gpd Diameter 4 in
Septic Tank Capacity (working) 1200 gal Number 3
Receiving Sol Type(1-6) 3 Separation 36" ft
Receiving Sol AppL Rate 0.8 gpL/@r orifices
Required Primary Area 600 ftr Total N ces NA
Deargood Primary Area 600 (� ih ' •> ` ;.;� NA in
Designed Reserve Area 600 ftr S NA in
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Trench/Bed Width 10 ft - Manifold
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TrencWBed Length 60 R Schedule/Class NA
Elevation Measurements Length NA ft
Original Drainfield Area Slope 2 % Diameter NA in
New Slope,If Altered 2 % Prefened mantfokl configuration used? O Yea O No
Depth of Excavation Undone 24 in Transport Pipe
from Original Gmde 24 in Schedule/Class 3034
Designed vertical Separation 36 in Length 20 ft
Gravelless Chambers Required? ❑Yes Iff No O optional Diameter 4 in
Pump Required? ❑Yes ifNo Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day NA
Dill.in Elevation Between Pump&Uppermost Orifice NA ft Dose quantity NA gal
Dminfield Squirt Height/Selected Residual(lead) NA ft Chamber Capacity(flood) NA gal
Uppermost Orifice O Higher 0 Lower than Punm Shutoff Pomp controls:Please check these required.
Capacity @ Total Pressure Head fVA gpm j OTimer DElapse Meter ❑Event Counter
Calculated Total Pressure Head NA fl jq _ . ... _ A .Pump off NA
Comments MAY 14 2024
MASON COUNTY ENVIRONMENTAL HEALTH
DESIGN FORM—PAGE TWO Assmor's Parcel Nnmbc 12R 246H082- __ — _----
PermstNumber. SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
ET Test hole locations B Dmmfield orientation and layout Reference depth from original grade:
ld Soil logs 19 Tamch/bed dimensions and If Septic tank
ld Property lines critical distances within layout B Druinfield cover
Iff Existing and proposed wells 19 D-Box/Valve box locations Reference depth from original grade
within 100 ft of property H Septic tank/pump chamber and restrictive strata:
13 Measurements to cuts,banks,and locations B Laterals,trench bed,top and
surface water and critical was FI Observation port location bottam
H Location and orientation of Iff Clean-out location ❑ Curtain drain collector
curtain drain and all absorption ❑ Manifold placement ❑ Sand augmentation
components ❑ Orifice placement Other cross-section detail:
19 Location and dimension of 16 Lateral placement with distance Iff Observation ports/clean-outs
primary system and reserve area to edge of bed
g Other Information
E5 Buildings
❑ Audible/visual alarm referenced Yes No
iS Direction of slope indicator 16 Scale of drawing shown on scale ❑ ❑Design staked out
16 Waterlines bar ❑ ❑ Recorded Notices attached
16 Roads,easements,driveways, ❑ ❑Waivers)attached
paddng ❑ ❑Pump curve attached
0 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 notified a tthne of installation IYYes ❑ No
y- , z y
SigiLvIoViisigner Date
The undersigned has reviewed this design on behalf of Mason County Public Health and determined it to be in
compliance with slate and local on-site regulations:
Environmental Health Specialist I Date
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
✓ The design a stamped"Approved"by Mason County Public Health.
✓ The Oruate Sewage Penmit bas not expired,the Permit Expiration Date is:_
✓ 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 nay be scanned and available for public view on the Mason County Web site.
Updated Date. 12/7/2015
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MAY 14 2024
MASCI COUNTY ENVIRONMENT H 10'
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Advant ge Perc & Design
Timely•Reaso able•30 Years of Local Experience
Construction Notes for,Be Gravity System
Gravity w/graveless chambers(Rock end pipe maybe substituted)
Install a 30 x 60' Bed w/3160'atera Is
Use a 4 hole d-box and speed level
Install 24"trench depth on High side 6ftrench and maintain 36"of vertical separation
Install level and along contours.
Install in dry weather only.
Use 1200Gallon septic and add rise for pumping and maintenance
System designed for typical resident"A waste strength sewage only.
System designed for366Gallons Per Day
Yes
APPROVED
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MAY 14 2024
MASON COUNTY ENVIRONMENTAL HEALTH
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Advantage Perc&design APDdesi¢nsl9icloud.com 9 (360)516.7297
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