HomeMy WebLinkAboutSWG2024-00238 - SWG Application / Design - 5/30/2024 MASON COUNTY 415NBSHELTON: ,SHELT967 ,EXr 400
SH STREET,
,SHEL-ON,W Xr 400
BELFAIR:360.275-4167,EXT 400
Public Health & Human Services ELMA:360d62-5269,EXr 400
FAX 360-427-7767
On-Site Sewage System Permit: SWG2024-00238
APPLICANT SECURED HOLDINGS LLC Phone:
Address: PO BOX 64041 TACOMA, WA 99464
OWNER SECURED HOLDINGS LLC Phone:
Address: PO BOX 64041 TACOMA, WA 9B464
` SEPTIC DESIGNER JON KNODEL' Phone: 360.589.7425
Address: PO BOX 2753 WESTPORT,WA 98595
SEPTIC INSTALLER JACOB PETTIT* Phone: 253-268-0322
Address: PO BOX 1460 SHELTON, WA 98584
Site Address: 131 E AN NAS WAY
Primary Parcel Number: 220175000096
Permit Description: Table 9 Repair 2bd Glendon M32
Permit Submitted Date: 05/30/2024
Permit Issued Date: 06/11/2024
Issued By: Rhonda Thompson
Current Permit Fees Paid: $805.00 (add,wnai tees may dd mquhed upon Instelletlon ot.,t.m).
Permit Expiration Date: 06/10/2025 (leased on date m loseecnon)
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 Dminfield 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 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.gov/health/environmental/onsite/oss-inspection-request.php or call:
360-427-9670,extension 400.
OFFICIAL USE ONLY
DAY NE—D
MASON COUNTY O 1 aLO;LLA
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ON-SITE SEWAGE SYSTEM APPLICATION v
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Holdings, LLC 253-565-3683 _� 17
ADDREBS-STREET CRY.STALE,VI CODE Box 64041 Tacoma WA 98464 0,CD a
SIIEADONE88-STREET CRY 21P LOGE 1
131 East Annas Way Shelton WA 98584 m I N
NAME OF DESIGNER PHONE I N
Olympic Northwest Design & Drafting PLLC 360-589-7425 CD
NAME OF INSTALLER PHONE O
CD
AAA Septic 253-268-0322 w
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EPNEWCONSTRUCTN)N/UPGRADES WIREPAIRIREPIACEMENT OTHER DETAILS Iwtmmw eppry) STABLE IX REPNR NI0
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SUBMITTALS O SURFACING SEWAGE H EXISTING FAILURE ❑SHORELINE W
9OESIGN FORM(REQUIRED) FSEPTIC DESIGN(REQUIRED) BEDROOMS LOTSM 6 I O
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From Shelton, northeast on WA-3, right on East Agate Road, left on East Timberlake Drive, I o
right on East Lakeshore Drive West, right on East Timber Parkway, right on East Lakeshore r o
Drive East, left on East Annas Way, site located on left just past East Annas Place. 4
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OFFICIAL USE ONLY BELOW THIS LINE
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tI VOLUNTARY EIMAINTENANCEIPUMPING EIBUILDINGPERMIT EIHONESALE EICOMPIAINT EIOTHER:
INSPECttW8pLLOGS COMMENTS/CONDITIONS
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BDM1COOES RECORD DRAWING AND INSTALLATION REPORT
V-WW G=GRAVELLY S=&WD L-LOAM &=SILT C=CLAY E=EXTNEMELY R.ROOTS REOUIREO FOR FINLLPPPROWLL.
INSPECTOR SIGNATURE DICE I APPLICATION EIPIRATXDN DATE APPLICATION APPROVEOI ISSUED BY DATE
9 THIS FORM MY BESCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISEDiWMIS
i
DESIGN FORM—PAGE ONE Assessor's Parcel Number: 2 2 0 1 7 — 5 0 — 0 0 0 9 6
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 items on checklist
Scaled plot plan,including all applicable items on checklist. I Cross-section sketch,including all applicable items on checklist.
This form may be scanted and available for blic view an the Mason County Web site.Maximum paper sire: 11"X IT'
Permit Number: SWG (/" —O�Z.�U Designer's Name: Olympic Northwest Design B Drafting
Applicant's Name: Secured Holdings LLC Designer's Phone Number: 360-569-7425
Mailing Address: PO Box 64041 Designer's Address: PO Box 2753
Tacoma WA 98464 Westport WA 98595
City State Zip Oil State Zip
Treatment Device
L9rGlendon Biofilter ❑ Sand Filter ❑Mound O Sand Lined Drainfield ❑ Recirculating Filter,Type:
❑Aerobic Unit Make/Model ❑Disinfection Unit Make/Model Other:
Dr tinfteld Type
❑Gravity E(Pressure ❑ Trench ❑Bed ❑Sub Surface Drip
Septic Tank/Drainfield Specifications I.aterals
Number of Bedrooms 2 Schedule/Class N/A
Daily Flow:Operating Capacity 240(ISs) gpd Length N/A ft
Daily Flow: Design Flow 240 gad Diameter N/A in
Septic Tank Capacity(working) 1000 gal Number N/A
Receiving Soil Type(1-6) 4 Separation N/A it
Receiving Soil Appl.Rate 0.6 gpd/ft' Orifices
Required Primary Area 400 ft Total Number of Orifices N/A
Designed Primary Area 401 ft' Diameter N/A in
Designed Reserve Area 0 (REPAIR) ft2 Spacing N/A in
Trench/Bed Width 28.50 ft Manifold
Trench/Bed Length 14.08 ft Schedule/Class N/A
Elevation Measurements Length N/A ft
Original Drainfield Area Slope 7 % Diameter N/A in
New Slope,If Altered 7 % Preferred manifold configuration used? O Yes ❑No
Depth of Excavation Dp-slopce 6 in Transport Pipe
from Original Grade Downslope 0 in Schedule/Class Per Glendon
Designed Vertical Separation 31 in Length 22 it
Gravelless Chambers Required? ❑Yes If No O Optional Diameter Per Glendon in
Pump Required? Ef Yes O No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day Per Glendon
Diff. in Elevation Between Pump&Uppermost Orifice 10 it Dose quantity Per Glendon gal
Drainfield Squirt Height/Selected Residual(head) N/A ft Chamber Capacity(Flood) 1000 gal
Uppermost Orifice Cf Higher ❑Lower than Pump Shutoff Pump controls:Please check those required.
Capacity @ Total Pressure Head Per Glendon gpm EfFimer Etlapse Meter 9Event Counter
Calculated Total Pressure Head Per Glendon ft If Timer: Pump on Per Glendon,pump off Per Glendon
Comments
Table IX repair due to approximately 62 feet separation to surface water(westerly unnamed creek). Glendon M32
biofiher designed due to limited space because of multiple large trees. Glendon unit meets TLA, exceeding required
treatment level of Table IX.
DESIGN FORM—PAGE TWO Assessor's Parcel Number:2 2 0 1 7 -- 5 0 -- 0 0 0 9 6
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
P1 Test hole locations B Drainfield orientation and layout Reference depth from original grade:
16 Soil logs N( Trench/bed dimensions and H Septic tank
P1 Property lines critical distances within layout B Drainfield cover
iff Existing and proposed wells 09 D-BoxNalve box locations Reference depth from original grade
within 100 ft of property 6 Septic tank/pump chamber and restrictive strata:
to Measurements to cuts,banks,and locations Q Laterals,trench/bed,top and
surface water and critical areas 9 Observation port location bottom
® Location and orientation of H Clean-out location B Curtain drain collector
curtain drain and all absorption 9 Manifold placement B Sand augmentation
components p Orifice placement Other cross-section detail:
H Location and dimension of 9 Lateral placement with distance If Observation ports/clean-outs
primary system and reserve area to edge of bed Other Information
® Buildings pf Audible/visual alarm referenced Yes No
H Direction of slope indicator pf Scale of drawing shown on scale ❑ Iff Design staked out
9 Waterlines her ❑ Nf Recorded Notices attached
El Roads,easements,driveways, ❑ Nf Waiver(s)attached
parking ❑ Iff Pump curve attached
9 North arrow and scale drawing ❑ Iff Evaluation of failure
shown on scale bar Non-residential justification
❑ ❑ Waste strength
❑ ❑ Flow
DESIGN APPROVAL
The undersigned designer must be notified by installer at time of installation Nf Yes ❑ No
?/,.L,^ S IZo 1 Za v4
Signatuto of Designer Date r-
The undersigned has reviewed this design on behalf of Mason County Public Health and determined it to be in
compliance with state and local on-site regulations:
Environmental Health Specialist Date
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
✓ The design is stamped"Approved"by Mason County Public Health.
✓ The Onsite Sewage Permit has 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 may be scanned and available for public view on the Mason County Web site.
Updated Date: 12/7/2015
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