HomeMy WebLinkAboutSWG2024-00163 - SWG Application / Design - 4/23/2024 415
WA
® MASON COUNTY N6THLFAIRSTREET, 0-2754N ,EXT 400
SHELTON'.360d27-96T0.EXT 400
BELFAIR'.3fi0-2]5d46],EXT 400
Public Health & Human Services ELMA:36oAa2-szss,EXT 400
FAX 360127-7787
On-Site Sewage System Permit: SWG2024-00163
APPLICANT SHAFFER BAXTER NATHANIEL III& Phone.
MICHELLE SHAWN KOKKELER
Address: 15950 S LORA CT OREGON CITY, OR 97045
OWNER SHAFFER BAXTER NATHANIEL III& Phone:
MICHELLE SHAWN KOKKELER
Address: 15950 S LORA CT OREGON CITY,OR 97045
SEPTIC DESIGNER BOB PAYSSE' Phone. 360-426-1803
Address: 3083 E Mason Benson Road GRAPEVIEW,WA 98546
Site Address: 570 E Saint Andrews Dr
Primary Parcel Number: 321275100272
Permit Description: New SFR -2BR Oscar X02
Permit Submitted Dale: 04/23/2024
Permit Issued Date: 06/2012024
Issued By. Jeff Wilmoth
Current Permit Fees Paid: $540.00 (sectional fees may be required uponmomeaxon or system).
Permit Expiration Date: 04/30/2027 (eased on dais of msP.o.m
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 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 backfill of
system components.
5 Installer is responsible for obtaining Septic Designer/Engineer installation approval prior to
baciffill 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.govlhealth/environmental/onsiteloss-inspection-request.php or call:
360-427-9670, extension 400.
OFFICIAL USE ONLY
DATE arcane -
® MASON COUNTY a,?D ` N
OUNN RECEIVED
COMMUNITY SERVICES ""� m O N
Vubll[Xeal1. l 1P a mSEVOFNEnvbonmenmlHealinl y Q
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ON-SITE SEWAGE SYSTEM APPLICATION
D A
m m
APPLICANT PHONE r
NATHAN SHAFFER c
MARINGAooREss-STREET CITY STATE AIPCOOE 3
15950 S LORA CT OREGON CITY OR 97045 z
TREET CITY ZIP CODE
570RTEANST.SS $ANDREWS DR SHELTON WA 98584
NAME OF DESIGNER PHONE N
ROBERT H. PAYSSE 360-426-1803
NAM E OF INSTAL'_ER PHONE O
TBD R I N
PERMIT TYPE YURI ane) C CING WATER SOURCE 0
RI RESIDENTIAL CBS FICOMMUNITYOSS E-1COMMERDIALOGS ULI PRIVATE INDIVIDUAL WELL PRIVATE TWO-PARTY WELL Z
PUBLIC WATER SYSTEM LAKE LIMERICK
TYPE OF N9RK(selN orm) e
En NEW CONSTRUCTION I UPGRADES I, REPAIR/REPLACEMENT OTHEROElILOIxSVIan I1ZIA1OU ❑ TABLE IS REPAIR V1
SUBMITTAL ❑ SURFACING SEWAGE 19 EXISTING FAILURE ❑SHORELINE
LYGI DESIGN FORM(REQUIRED) 9 SEPTIC DESIGN(REDUIREDI BEDROOMS LOT SIZE r
9WAIVER(S)uE APPLICABLE) 0.25 AC 0
0
DIRECTIONS ro SITE AND SITE CONDITIONS RE+ IwERG gSrel
N HWY 3, LEFT ON MASON LK RD. LEFT ON ST ANDR WS DRIVE BY LAKE LIMERICK
FIRE STATION. FOLLOW AROUND TO SITE ADDRESS 570 ON RIGHT (LAKESIDE). o I N
0
I -4
SREMUSTB FR GGEDFRpWNROI ANDTESTXOl sMUTSEFIAGGEOWITNTESTMOLENYMBERS. I N
OFFICIAL USE ONLY BELOWTHIN LINE
UPGRADE/FAILURE SOURCE(C,Wctrx,MI
[]VOLUNTARY OMAINTENANCEIPUMPING []BUILDINGPERMIT ❑HOMESALE ❑COMPLAINT []OTHER- t
IF
INSPECTOR SOIL LOGS COMMENT5I CONDITIONS i`- 441
4
3L 51 rz
RECORD ORAWINGAFO INSTALLATION REPORT
SOILCODES'.
V—VERY G=GRAVELLY S=6ANO L=LO M SI=SILT C=CLAY E=EXTREMELY R=ROOTS R EOUIRED FOR FINAL APPROVAL
IN TOR$IGNATURj DATE APPLICAT ION EXPIRATION DATE AP ATIOR FPPROVEO(/ISS�EO BY LATE
RN (0 20,,2
T BF YBE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISEL4mam5
DESIGNFORM-PAGEONE Assessor's Parcel Number: 3 2 1 2 7 — 5 1 — 0 0 2 7 2
A design will be reviewed when 3 copies of each of the following are submitted:
•Completed design form that has been signed and dated e Scaled layout sketch, including all applicable items on checklist
•Scaled plot plan,including all applicable items on checklist. v Cross-section sketch, including all applicable items on checklist.
This form may he scanned and available for public view on the Mason County Web Sits.Manimum paper size: I I I 117"
PARCEL IDENTIFICATION
Permit Number: SWG ZOZ - DO(e�, _ Designer's Name: ROBERT H. PAYSSE
NATHAN SHAFFER Designer's Phone N'umbev 360426-1803
Applicant's Name: -
Mailing Address: 15950 S LORA CT _ Designer's Address: 3083 E MASON BENSON RD
OREGONCITY OR 97045 GRAPEMEW WA 98546
CitySlate ZipCity Stale Zip
DESIGN PARAMETERS
Treatment Device
❑Glendon Bio llwr ❑Sand Fllmr ❑ Mound ❑Sand Lund]Drainfield ❑Recirculating Filter-Tcpe:
OSCARX02TANK , X02 OSS
fi�Aembic Unit Make/Modal ❑ Disinfeu�tion Unit Meke:Ylodel Other.
Drainfield Type
❑Gravity ❑ Pressure ❑Trench ❑Bed 19 Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 2 Schedule/Class X02 OSS
Daily Flow.Operating Capacity 180 gpd Length - ft
Daily Flow:Design Flow 240 gpd Diameter .5 in
Septic Tank Capacity(working) X02 TANKS gal Number 4 OS50 COILS
Receiving Soil Type(1-6) 4 Separation - H
Receiving Soil Appl. Rate 0.6 gpd/ft2 Orifices
Required Primary Area 400 Be Total Number of Orifices 200 EMITTERS
Designed Primary Area 400 ft2 Diameter .42 GPH in
Designed Reserve Area 400 ft'- Spacing SEE DESIGN in
Trench/Bed Width 8 f: Manifold
Trench/Bed Length 50 fit Schedule/Class SCH. 40
Elevation Measurements Length 25 ft
Original Drainfield Area Slope 2 % Diameter 1 in
New Slope, If Altered 2 % Preferred manifold configuration used' 2/Yes O No
Depth of Excavation uP-slonc 18 in Transport Pipe
from Original Grade Doxo-slonc 18 in Scmd.IaCInss SCH-40
Designed Vertical Separation 12+ in Length sl 50' +/- ft
Gravelless Chambers Required? ❑Yes 11 No O Optional Diameter 1 in
Pump Required? IP1 Yes ON. Dosing and Pump Chamber
Pump/Siphon Specifications Numberofdoses/day PER MFR
Diff. in Elevation Between Pump& Uppermost Orifice `20 R Dose quantity PER MFR gal
Drainfield Squirt Height!Selected Residual(head) - fit Chamber Capacity(flood) 1500 gal
Uppermost Orifice 19 Higher O Lower than Pump Shutaff Pump controls: Please check those required.
Capacity n Total Pressure Head 7.8 gP.tt gTimer gElapse Meter IX Event Counter
Calculated Total Pressure Head _ 30 ft I na P m , n PER MFR pump off PER MFR
Comments -flf
INSTALL SOLIDS HANDLING PUMP AND BASIN. INCUVES 1/2 HP F �i1t IP AND PANEL.
JU 9 1) Ill/a
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DESIGN FORM-PAGE TWO Assessor's Parcel Number:3 2 1 2 7 - 5 1 -- 0 0 2 7 2
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
R1 Test hole locations [Z Drainfield orientation and layout Reference depth from original grade:
61 Soil logs ld Trench/bed dimensions and Rf Septictank
6b Property lines critical distances within layout EX Drainfield cover
Existing and proposed wells [9 D-Box/Valve box locations Reference depth from original grade
within 100 ft of property l9 Septic lank/pump chamber and restrictive strata:
19 Measurements to cuts, banks.and locations 9 Laterals,trench bed,top and
surface water and critical areas [9 Observation port location bottom
6a Location and orientation of E9 Clean-out location ❑ Curtain drain collector
curtain drain and all absorption Ed Manifold placement ❑ Sand augmentation
components 66 Orifice placement Other cross-section detail:
Location and dimension of 56 Lateral placement with distance l9 Observation ports/cleamouts
primary system and reserve area to edge of bed Other Information
61 Buildings E6 Audible/visual alarm referenced Yes No
6n Direction of slope indicator 56 Scale of drawing shown on scale d ❑ Design staked out
6� Waterlines bar ❑ 1d Recorded Notices attached
66 Roads, easements,driveways, if ❑ Waiver(s)attached
parking 19 ❑ Pump curve attached
19 North arrow and scale drawing ❑ 1f Evaluation of failure
shown on scale bar Non-residential justification
❑ 36 Waste strength
❑ Rf Flow
DESIGN APPROVAL
The undersigned designer must be notified 1b'y installer at time of installation fid Yes ❑ No
�IC�1PA7� H- KLt.1iW�C O 2-
Signature ofDesi er Da[e
'I he undersigned has reviewed this do on behalf of Mason County Public Heal h and determined it to be in
compliance with state and local on ne r gulations:
EnJon etal Health Specialist Date
CAUTION: DESIGN APPR VAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
✓ The design is stamped"Approved- by Mason County Public Health. J
✓ The Onsite Sewage Permit has not expired.the Permit Expiration Date is: Z"2
✓ Drainfield site conditions have not been altered to adversely affect conditions ofdesign approval.
Please Note: The system must be installed by a certified installer,
unless prior authorization is obtained from Mang 0,"6 1t alth.
An installation Fee is required. JUN 2 0 2024
This form may be scanned and available for public view on the Mas "fJ'DGbIFANFlbr57Fei'.I='d w -r:: -.
J F31twdated Date: 12/7,2015
ST
PRIMARYAREA: r,� 3 ,S
400 SOFT - OSCAR XO, �/ D
RESERVE AREA: O `�•.�` REVISED
400 SQFT- OSCAR X0, O O `� DRIVEWAY
•� / & PARKING
XO, TANKS 11
10'
2"SCH. 40
SOLIDS PUMP OUT
HANDLING f, & ABANDON
PUMP BA51N F EXISTING EXIST. TANK & DF
11 fJ, HOME /
PROPOSED
ADDITION
�' LO
APPROXIMATE
`•\ EDGE OF LAKE
\ `\ A
ROV LAKE LIMERICK JUN 2�2a
i Ise v ��,u it c
� H
\ J3VY x
`•\ AN ASSUILTI INSTALL SIGNOFF FEE WILL
BE CHARGED AT TIME OF INSTALLATION
C UPI OMEK: NATHAN SHAFFER rrs HCl n TEII IIL`LE L fEI I LE 3
PIONEER. DIGGING, ING ejK u- 32Z -e1oozn „" ,"
SLPI IC DESIGNS 5706 ANDRENSDR ROOI,I. ,, R"'ll,-36
3083L w�>oN Eerv,lNao. rnnrLelLw;3�<a oxs+a DING;�EIi: ROBERi H.PATSSE
CmLx Soo-¢o-lda; Fat 36U Iz9 L353 HEET: SfrE PLAN
SCALE. 1'=26 °"
3' W/ WAIVER
X02 - OS50 COILS ST
INSTALL PER MFR.
REQUIREMENTS
X02
RESERVE �-
AREA SO,�
X02 CC
O TANKS
� O W
O
O EXIST,
TANK
2" SC O EXIST.
FROM BAA SIN1N � D/F
i
EXISTING HOME ;
TO BE
REMODELED
P DIE
II
� :;J�EVTaLrr<5 :..
y„a�N coulT I =wpp'•1 L -
Jp•. AN ASBUILTI INSTALL SIGNOFF FEE WILL
BE CHARGED AT TIME OF INSTALLATION
�UNO%1111' NATHANSHAFFER TLTIIOLLI T611101F2 TET Hit F3_
PIONEER DIGGING, INC PARC LL v32@73100272 i-11;'I ,�
SLI'TIC DESIGNS vUDRc„ 59oS(ANDRERSDR R.101,C3, Icvl.rasa
3063 F M 10N RFNs0�RD. c R VT\iDA 9Ms l DI AG\TR: ROBERT FL PAYSSE
c+HCI:-30[Ft2n-mo3 Lnr 100427]353 5HEL1: DFDUAIL SCALE P=10' ...n—"°'° —a'E�=".
INSPECTION PORTS W/ CAPS
ORIGINAL & FINISHED GRADES
ASTM C-33 SAND
601,
1
OS 50 COI US (X4)
i�
RESTRICTIVE LAYER
'INSTALL PER MANUFACTURER REQUIREMENTS
AT 18" DEPTH FROM ORIGINAL GRADE
A5TM C-33 SAND OS 50 COILS (X4)
50'
0 FQD O C
1 PORTS
1" SUPPLY o4 t V E
1" RETURN
,IUN 7 U 2024
of �l
AN ASBUILTI INSTALL SIGNOFF FEE WILL
BE CHARGED AT TIME OF INSTALLATION J EW
CUy OMER: NA7HAN SHAFFEK IEI nO1FI TFSl I OtF1 TF_.T HOLL S:
PIONEER DIGGING, WG "I Ill v °'-"1
r vu u_�.s2��-sloo2�z e,. I IF 36- uI I.
SEPT IC- DISIGNS vDORFllBOSTA KEWSOR la.,oc(mls- Rool> e,3o
soxs FSIFoN BFrv,,�s EIGSFA: ROBFRT H.PAYgE -
e MOmerIxa3 FdA Sao+2723,1 uv0-1I"'Illb—SuE
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ALL ELECTRICAL 15 TO
BE DONE BY A
LICENSED ELECTRICIAN
HIGH WATERALARM
BOLT ON, GASKET LID
FLOAT TREE
L I F UN ION/CH ECK/BALL VALVE
RUBBER
GROMMET
RUBBER
GROMMET
INSTALL PER
MANUFACTURERS
INSTRUCTIONS 7
SOLIDS HANDLING 250 GALLON
PUMP, SEE TYPE ORENCO 30"
PUMP BA51N 7FT
IN HEIGHT
PPRQVE
JUN 7 0 2024
000 E , F r' I
t 4t2'>IrY1.
JBW
\ 11�lU,MER. NATHAN SHAFFER
PIONEER. DIGGING, NC- P\RCEL a:32127-5100272 U E K LI ON I In W Ill C 'M I
SEPTIC DESIGNS ADDREF: 570STANDREWSDR- 1]3T\LLI5NKONOR[UN SI0.in_
IliEGOIDo'VD)BTCkFIII �VAI LKIAI.
30831 '1t ,,ABF>ANRD. 6R91'BIM,wT98316 DEIG,NI R: ROBER-T FL PAYSSE -USII RUBBER RIKR FORA
JFFICF 360+201803 FAV-3001D,2353 DEIGN CSGE SOLIDS TANK W{TFR-IICHT3Fll.
Pumps•
' Pump Specifications
LE50 Series
1/2 HP Submersible • •
LITERS PER MINUTE
0 100 200 300 400 500 600
TFF
I �p 8
25
r T
20 6
5w
w a
15 i
0
� _�� az
I- a
10 I 3
it
f R 0 V E
JUN 2 0 2074
II
0 20 40 60 60 100 120 140 160 J BW
GALLONS PER MINUTE
1151 .....mn,mr ao,knurv,�.�.spKm.mu.,.,,n�<w m=n�, ...:wm.m..� R.•..•E�
Installation & System Notes
1. Installer must contact designer for final inspection of the installation prior to cover. All components, includingtanks, lids,
transport line,drainfield,and water lines must be open for inspection. A$3S0.00 fee will be charged for time involved with the
inspection of the installation and creation of the record drawing. The designer reserves the right to charge additional fees if
multiple visits are needed due to installation errors or inaccessible components.
2.This septic design must be installed by a certified installer with the local health department. All components shall be installed
according to state,county, and manufacturer requirements. For Homeowner Installs,the owner must get approval from the
designer and local health department prior to attempting installation.
3. Designer is not a surveyor. Installer must familiarize themselves with property line locations prior to installation. Any
confusion or conflicts with line locations should be reported to the property owner. A licensed surveyor maybe necessary prior
to installation to confirm all line locations. Any d iscrepancies found must be reported to the designer immediately.
4. Drainfield area may only be cleared by a licensed insta Ile rfamiliar with sensitive drainfield area preservation. The builder, lot
developer,or property owner shaI l not clear the drainfield area. Any clearing required for drainfield installation shall not
remove or disturb any top soil in Primary and Reserve areas. Rem ova l or disturbance to drainfield soils could render design
void.
5.The property owner and installer are responsible for locating all underground utilities(ex.water,gas,electric)prior to
installation. Any utility locations shown within design drawings are likely approximate and may not be exact.
6.All proposed tanks must be installed on original soils or compacted gravels. Extend all tank connection lines out onto original
soil to avoid settling issues. Risers and lids must be brought to finished grade and left accessible for future operations and
maintenance. Component manufacturers(ex. ATLI,Glendons,) may have other requirements not listed within this design.
7.All electrical wiring shall be done by a licensed electrician or homeowner(if allowed)and must be permitted through Labor
and Industries. Designer not responsible for electrical permitting or other electrical specific code requirements.
8.The proposed septic system should be installed in dry weather conditions. Any failed attempts at installation during wet
weather conditions may render this design void.
9. Maintain loft to waterlines with all septic components. If less than loft is required,sleeving in sch. 40 pvc is required. If
sewage transport lines and waterlines must cross,waterline must be 18"above sewage line with one of the lines sleeved in sch.
40 pvc loft in each direction of crossing.
10.This design may include waiver applications with specific mitigation measures pertaining to installation,operation and
maintenance of the proposed components.
11. Stormwater runoff,footing drains, roof drains must be diverted away from any septic system components. No curtain,
foundation, perimeter drains shall be installed 30ft downslope and loft upslope of drainfield areas.
12.This design is site specific and intended to meet state and county requirements that are related to the system components
being proposed. Any placement of proposed buildings,proposed wells or other non-related items on these drawings may or
may not meet other requirements.
13. All onsite septic systems require regular maintenance to verify satisfactory operation. The te�oyli�et[operatori
responsible for the continuous operation and maintenance of the system per WAC 246-272A o n
information, refer to Mason County Public Health Homeowner's Manual,which should be re after insta la Ion t
14.System owner should be cautious of landscaping around septic components. Root intru n 'l IN 2074 t�,.+'
can cause premature failure of the drainfield area. In addition, bushes and trees should be W610"d -away from lids and other septic maintenance points. Jew
15. Changes made at time of installation may impact designer calculations,pump sizing,and
compliance w/county and state requirements. Contact designer prior to install w/any '
proposed variations from design. Changes may result in additional fees and permitting.
PIONEER DIGGIN( , IN mI fiHl 3 NAT10027 t AF ( L/
I'�RCEI.=:32127-s1-00272
SEPTIC DESIGNS M)DRI ?_ 9OSTANDREWSDK
30831 NI\SS\BEN`\RD- (RAP69LW%\'A 98510 I)I bl(.\I.R: 20BER.T H.PAYSSE
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