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HomeMy WebLinkAboutSWG2024-00299 - SWG Application / Design - 7/12/2024 MASON COUNTY d15N8SHELTON: 0427-97 ,EXT 400584 H STREET, ,SHELON,W 98 BELFAIR:360-2754467,EXT 400 Public Health & Human Services ELMA:360482-5269,FXT400 FAX:360-427-7787 On-Site Sewage System Permit: SWG2024-00299 APPLICANT FRANKLIN CLARK` Phone: 360-830-4765 Address: PO BOX 1954 SILVERDALE, WA 98383 OWNER HUSON JOHN M &DEBORAH J Phone: Address: 120 NE TIMBERLINE DR BELFAIR, WA 98528 SEPTIC DESIGNER FRANKLIN CLARK* Phone: 360-8304765 Address: PO BOX 1954 SILVERDALE,WA 98383 SEPTIC INSTALLER FRANKLIN CLARK• Phone: 360-8304765 Address: PO BOX 1954 SILVERDALE,WA 98383 Site Address: 120 NE Timberline Or Primary Parcel Number: 123204390130 Permit Description: Repair 3bd OscsrXO2 Permit Submitted Date: 07/12/2024 Permit Issued Date: 07/17/2024 Issued By: Rhonda Thompson Current Permit Fees Paid: $805.00 (addldoaal fees may or repulmd upon msbaltebbn or system). Permit Expiration Date: 07/16/2025 (dased oa dabs or msaammn) 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 backfi'll 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: masonmuntywa.gov/healthlenvironmentallonsiteloss-inspection4equest.php or call: 360-427.9670,extension 400. OFFICIAL USE ONLY DATERFCLNEo: ® MASON COUNTY IoZ M N COMMUNITY SERVICES m ^'^°"'^ 5 MCDVFDSY M, p T PBMIMWM1 Icmmmunlry HealtvFmimnmenul Health < N C� N sawn+sw e..wosxons..aT.....w SW( w O N am sm..- .wANSH VV A 2 m ON-SITE SEWAGE SYSTEM APPLICATION 3 z rn cT MPLICNIT - PHONE r J c MNLINGADDREW.STREET,CRY STATE.ZIPCIO,O'EF (�(+{. •l V.Qf `V SRE SB-STREEL CRY IPC E � ' (� 1)3.11'o.q- 5 - r�l_r NAME OF DESIGNER n" NFMEaINSTAl1ER ^ ` � _ga 3 �V LA PEIWIT (.wblme) T VMTER SOURCE ESIOENTWL OSS COMMUNITY OSS ®COMMENATE INDMDUAL WELL PRIVATE TWOPMIY WELL 2TYPEOFNORK(aNeNu.) BGC YWTER SYStEM Efl NEW CONSTRUCTION I UPGRADES REPAIRIREPTAILS pH'MMXNIWWI OTABLE IX REPAIR SueM ��T/� RFACING SENNGE EXISTING FAILURE OSHORELINE DESIGN FORM(REQUIRED) MMSFATIC DESIGN(REQS LA LOTS¢E t �` C fV#UVER(S)(IFAPPUCABLE) (\Y DIRECTION^zbr\REQp SITE ORLON MU�I� S grvi Ce - �5 Gll\ WA T495SR W Al6.ev, �t y E,"a oe S� > WA -8A to WIN •3ooW> P.1E 1in�berLtClQ-' bje Nt Ti(v40'ef_Ul1 e I� l� ,�.Q\�Qckr- I U)A GSj'L8 � N.YUSTBEFIAGMO FfKNK MAIN FOND AND TEST FpL6 MYSTOR FUDGED INN TESTANSUF l81lA OFFICIAL USE ONLY BELOW THIS LINE UPGRADE I FAEURE SOURCE( rN MWN^a^1) OVOLUNTARY [3MAINTENANCEIPUMPING OBUILDINGPERMIT OHOMESALE [3COMPLAINT OOTHER: INSPECTOR SOIL LOGS COMMENTS ICONDRIONS `ai- rvl ati' J r RECORD DRXWNG AND INSTALLATION REPORT BDLCOOEB:V.VERY G=GRAVELLY S=SAND L=LOAN SI=SILT C-CLAY E=E:EMELY R=ROOTS REQUIRED FOR FINALMPRMR. INSPECTOR SIGNATURE DATE APPLICAiN1N E%PIRATON DATE APPLICATION APPROVED ISSUED BY DAl£ 1I � b zs �1i�tz THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTYWEBSITE REVISED lw=15 DESIGN FORM -PAGE ONE Assessor's Parcel Number:_ t Z J !� —Li 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 O Cross-section sketch,including all applicable items on checklist This form may he scanned and available for public view on the MursonCourtylifebsite. Maximum paper size: 11"X 17" PARCEL Permit Number: SWG Designer's Name: Franklin J Clark Applicant's Name: HUSON.JOHNBDEBORAH Designer's Phone Number. 360.830.4765 Mailing Address: 120 NE TIMBERLINE DR Designer's Address: P.O.Box 1954 BELFAIR.WA 985289632 City: State: zip: Cit :Silverdale State:WA Zip:98383 DE SIGN PARAMETERS Treatment Device N Glendon BiofiRer N Sand Filter N Mound N Sand Uned Drainfield N Recirculating Filter,Type: N Aerobic Unit Make/Model N Disinfection Unit Make/Model I Other. OSCAR-X02 Drainfield Type N Gravity N Pressure N Trench N Red ■ Sub Surface Drip Septic Tank/Drainfield Specifications Laterals Number of Bedrooms 3 Schedule/Class 60yaskinNitabnikke Daily Flow:Operating Capacity 360 gpd Length 5 ft Daily Flow: Design Flow 360 gpd Diameter 1/2 ini Septic TankCapacity 1,200 gal Number Receiving Soil Typ e(1-6) 4 Separation .5 Receiving Soil Appl.Rate Pri:.6/Res:.6 gpd/ftr Orifices Required Area 600 h' Total Number of Orifices each coils have sotal tern eq 3'mnary, a-5 annns have 0a DesigneclPrini Area, 600 ft' Diameter 0.4gphemor; in Designed Reserve Area 600 ft2 Spacing 40 in Trench/Bed Width 35'-0" h Manifold Trench/Bed Length 18'-0" h Schedule/Class Elevation Measurements Length ft Original Drainfield Area Slope 0-5 % Diameter in New Slope,dAltered N/A % Preferred manifold configuration used?l Yes N No Depth of Excavation up-sloaa 0 in Transport Pipe from Original Grade Downsrope 0 in Schedule/Class 40 Designed Vertical Separation 13 in Length 100 ft Gravelless Chambers Required? N Yes ■ No N Optional Diameter 1.0 in Pump Required? ■ Yes N No Dosing and Pu mp Chamber Pump/Siphon Specifications Number ofdows/day 360 Difference in Elevation Between Pump Shutoff and Uppermost Dose quantity 360 gal Orifice S ft Chamber Capacity 1,200 gal Uppermost Orifice I Higher Lower than Pump Shutoff Pump controls:Please check those required. Capacity@ Total Pressure Head 2.1 gpm 8 Timer ■ Elapse Meter I Event Counter Calculated Total Pressure Head SO' ft If Timer: Pump on 22SK" . Pump off 3mi ates3l6nnds Comments Treatment System comes with all required system components,see"System Spectification".The system comes with the Control Panel preset at the factory,uses one Effluent Pump and OSCAR 05100 coils. DESIGN FORM-PAGE TWO Assessor's Parcel Number. Permit Number: SWG DESIGN CHECK LISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch ■ Test hole locations ■ Drainfield orientation and layout Reference depth from original grade: ■ Soil logs ■ Trench/bed dimensions and ■ Septictank ■ Property lines critical distances within layout ■ Drainfield cover ■ Existing and proposed wells ■ D-Box/Valve box locations Reference depth from original grade within 100 ft of property ■ Septic tank/pump chamber and restrictive strata: ■ Measurements to cuts,banks,and locations ■ Laterals,trench/bed,top and surface water and critical areas ■ Observation port location bottom ■ Clean-out location 0 Curtain drain collector-N/A ® Location and orientation of ■ Manifold placement ■ Sand augmentation curtain drain and all absorption 0 Orifice -placement components P N/A Other cross-section detail: ■ Location and dimension of ■ Lateral placement with distance ■ Observation ports/clean-outs to edge of bed Other Information primary system and reserve area ■ Audible/visual alarm referenced Yes No Buildings ■ Scale of drawing shown on scale ® ■ Design staked out ■ Direction of slope indicator bar ■ 0 Recorded Notices attached ■ Waterlines 0 ■ Waiver(s)attached ■ Roads,easements,driveways, N ■ Pump curve attached parking 0 ■ Evaluation of failure ■ North arrow and scale drawing Non-residential justification shown on scale bar 0 ■ Waste strength 0 ■ Flow DESIGN APPROVAL The undersigned designer must be notified by installer at time of installation■ Yes ®No 07/11/2024 Signatureof esigner Date The undersigned has reviewed this design on benau County Public Health and determined it to be in compliance with state and local onsite re ulations: Environmental Health SpliKalist Date CAUTION:CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION: ® The design is stamped`Approved"by Mason County Public Health. i 0 The Onsite Sewage Permit has not expired,the Permit Expiration Date: 0 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 maybe scanned and available for public view on the Mason County Web site. Updated Date:12/7/2015 >s M MIS SYMBOLS LEGEND qp 1111 Y� ~ 1 €I ®• CLEANONt �g� ���> g '� � �ggs� yn.. ranovxavExrccoW�w �p ROM �•lF i� ,REE E\ERG:EFH 5 J9 W. w Sa'LiF4lMLCGilg1 S © WxIFASLWiYWF11 0'� q 2y�y ��'y^¢rR^�y(' © WAi AE1EA 'C P 9 C,RX:LL y a£ ELE10.4�CHlEN S5 Y P O �1 4n O ELFLIMVIJIWCIxN B1C rM„ X/ Ufl„YPoLE WxaEaRrLaanaN OExIR11Nc mEE1��Leac1 WPME . $_ piMpNG WRiERSL0.RYLRE _. 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