HomeMy WebLinkAboutSWG2024-00230 - SWG Application / Design - 5/22/2024 MASON COUNTY 415N6SHELTON: , 0427-97 ,EXT 400
BHELFAR:360-2754470,EXT 400
BELFAIR:360.275448],EXT 400
Public Health & Human Services ELMA:3604825209,EXT 400
FAX:360-427-7787
On-Site Sewage System Permit: SWG2024-00230
APPLICANT AMERICAN MICRO HOMES LLC Phone:
Address: 2103 HARRISON AVE NE 2753 OLYMPIA, WA 98502
OWNER AMERICAN MICRO HOMES LLC Phone:
Address: 2103 HARRISON AVE NE 2753 OLYMPIA, WA 98502
SEPTIC DESIGNER I ADAM HUNTER* Phone: 360-753-1226
Address: PO Box 162 OLYMPIA,WA 98507
Site Address: UNKNOWN
Primary Parcel Number: 321275300149
Permit Description: New 3bd ATU to subsurface drip
Permit Submitted Date: 05/2212024
Permit Issued Date: 0812312024
Issued By: Rhonda Thompson
Current Permit Fees Paid: $540.00 (edddlonel roas,n,ba ragOred aaon,nelarebon ad.wnd.
Permit Expiration Date: 0611712027 (based on dale ornsamron)
Permit Conditions:
1 Proposed development subject to zoning requirements and approval by the planning
department staN 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
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: masonwunlywa.gov/health/environmentaUonsite/oss4nspoction-request.php or call:
360-427.9670,extension 400.
OFFICIAL USE ONLY
MASON COUNTY PUBLIC HEALTH Z`EUBW l
ONSITE SEWAGE SYSTEM APPLICATION MW M F ml-B` W y
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APPDCANT PHONE D
AMERICAN MICRO HOMES LLC 3605562585 IT
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MUNGFDDRE55-STREET.CRY STATE.LP CODE r
2103 HARRISON AVE NE 2753 OLYMPIA WA 98502 3
STTEADDRE99-sTItMT.Cm.DP CODE m
101 E ERRIGAL PL SHELTON WA 985U a
NAME OF DESIGNER PHONE I�
ADAM HUNTER 3607531226
WALE OF INSTKIER PHONE W
TBD
CHECKALLAPRICA&E REMS DRINKING WATER SOURCE
a NEW CONSTRUCTION M RVHOLDINGTANKONLY M PRNATEINDIVIDUALWEU. 3iB �J
M REPLACEMENT SYSTEM M INSTAUATIONPERMITONLY M PRNATETW ARTYWELL 2
M TABLE 9 REPAIR M SINGLE FAMILY I5f COMMUNITYRUSUC WATER SYSTEM
M TANKS)ONLY M COMMERGAL SYSTEM NAME: IAxeuxlnlw nnpI
M UPGRADETOMSTING M OTHER: BEDROOMS
ElLOT 9UE - IV,
EXISTING FAILURE "R,w/MGi+RI^PnwlrW
N..B,rNWMIIPm' 3 0.69
NRECTIONS TO SITE-BE SPECIFIC ANDADVME OF ANY NEEDED INFORMATION FOR ACCESS(¢MMpa4) I
MASON LAKE RD TO A RIGHT ON DARTMOOR, FOLLOW TO CORNER OF ERRIGAL �G
AND DARTMOOR ON THE RIGHT. D �p M D I p
MAY 22 2024 D ° �
9RFYUST BEMGCED FROM MAINRDADAND lE9TNOLE8YU3TBEF ey
OFFICIAL USE ONLY BELOW THIS LINE
UFGRADE I PALURE SOURCE IAA�9Plmo )
MVd.UNTARY MMAINTENANMPUMPING MBUILDINGPERMIT MNOMESALE MCOMPLAINT MOTHER:
INSFDCTORSOLLOGs COMMENTSICONomonS
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INSPECTCNSg TURE TE AP%1GTON E%RRATION DATE APPUCAT APPROVEDSY WTE
THIS FORM MAY BES ANNED AND AVAUABLE FOR PUBLIC VFW ON THE MASON COUNTY WESSITE PEVNSFDINrz015
DESIGN FORM—PAGE ONE Assessor's Parcel Number: 3-aL a��7 -- '� 3-- Q V L S�
A design will be reviewed when 3 cooler 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 a Cross-section sketch,including all applicable items on checklist.
This form may be scanned and available for public view on the Mason County Web site.Maximum paper size: 11"X 17"
PARCEL IDENTIFICATION
Permit Number: SWG o�1.DaM O2-6n Designer's Name: ADAM HUNTER
Applicant's Name: AMERICAN MICRO HOMES LLC Designer's Phone Number: 360-753-1226
Mailing Address: 2103 HARRISON AVE NE 2753 Designer's Address: PO BOX 162
OLYMPIA WA 98502 OLYMPIA WA 98507
city State Zip City State Zip
DESIGN PARAMETERS:
Treatment Device
❑Glendon Biofilter ❑ Sand Filrcr ❑Mouod ❑Sand Lined Drainfield ❑Recirculating Filter,Type:
❑Actable Unit Make/Model ❑Disinfection Unit Make/Model Other:
Drainfield Type .�/
❑Gravity ❑Pressure ❑Trench 13 Bed as Sub Surface Drip
Septic Tank (Drainfield Specifications Laterals
Number of Bedrooms 3 Schedule/Class DRIP
Daily Flow:Operating Capacity 270 gpd Length 90 ft
Daily Flow:Design Flow 360 gpd Diameter 112 in
Septic Tank Capacity 1200 gal V1 Number 5
Receiving Soil Type(1-6) 4 Separation 3 It
Receiving Soil Appl.Rate 0.6 gpd/ft' Orifices ✓
Required Primary Area Soo ft ✓ Total Number of Orifices 450
Designed Primary Area 900 to Diameter DRIP in
Designed Reserve Area 900 ft2 Spacing 12 in
TrenchBed Width 27 ft Manifold
Trench/Bed Length 45 R Schedule/Class 40
Elevation Measurements Length 27 tt
Original Drainfield Area Slope 25 % Diameter 1 in
New Slope,If Altered 25 % Preferred manifold configuration used? 6i'Yes O No
Depth of Excavation UP-lope 12 in V Transport Pipe
from Original Grade Dowo-elope 12 in Schedule/Class 40
Designed Vertical Separation 24 in Length 53 It
Gmvelless Chambers Required? ❑Yes RfNo ❑Optional Diameter 1 in
Pump Required? 17(Ycs ❑No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day 12
Difference in Elevation Between Pump Shutoff and Uppermost Dose quantity 30 gal V
Orifice 10 It Chamber Capacity 1200 gal
Uppermost Orifice SdHigher ❑Lower than Pump Shutoff Pump controls:Please check those required.
Capacity Q Total Pressure Head 13.2 gpm d7rimer 5Elapse Meter 9(Event Counter
Calculated Total Pressure Head 124.1 AP *GV`E-Dn
9.5MIN ,Pump off 2HRS
Comments
AUG 2 3 2024
MASON COUNTY ENVIRONMENTAL HEALTH
DESIGN FORM—PAGE TWO Assessor's Parcel Number.3aL':7
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
F9 Test hole locations EX Drainfield orientation and layout Reference depth from original grade:
19 Soil logs 12( Trench/bed dimensions and a Septic tank
69 Property lines critical distances within layout I,Z Dminfield cover
E9 Existing and proposed wells 9 D-Box/Valve box locations Reference depth from original grade
within 100 ft of property Ed Septic tank/pump chamber and restrictive strata:
la Measurements to cuts,banks,and locations ❑ Laterals,trench/bed,top and
surface water and critical areas 1Z Observation port location bottom
♦9 Location and orientation of 6X Clean-out location ❑ Curtain drain collector
curtain drain and all absorption E� Manifold placement ❑ Sand augmentation
components 9 Orifice placement Other cross-section detail:
19 Location and dimension ofRr 1f Observation ports/clean-outs
primary system and reserve area Lateral placement with distance
to edge of bed Other Information
V Buildings It Audible/visual alarm referenced Yes No
fa Direction of slope indicator i( Scale of drawing shown on scale Ef ❑ Design staked out
9 Waterlines bar ❑ ❑ Recorded Notices attached
19 Roads,easements,driveways, ❑ ❑Waiver(s)attached
parking ❑ ❑Pump curve attached
19 North arrow and scale drawing ❑ ❑ Evaluation of failure
shown on scale bra Non-residential justification
❑ ❑Waste strength
❑ ❑ Flow
DESIGN APPROVAL
The undersigned designer m otifie nstaller at time of installation na Yes ❑ No
5/20/24
gtta of Designer Date
The undersigned has reviewed thi design on behalf of Mason County Public Health and determined it to be in
compliance with state and local on-site regulations:
kjmg)vcN" % IZ `-J
Environmental Health S iafist 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: 12/72015
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APPROVED
AUG 2 3 2024
MASON COUNTY ENVIRONMENTAL HEALTH cn
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