HomeMy WebLinkAboutSWG2024-00376 - SWG Application / Design - 9/3/2024 WA
584
MASON COUNTY 415NfiTHELTONSTREET,SH27-96 ,EXT 400
SHELTON:360-427-96]0,EXT 400
BELFAIR:360-2I5-4467, EXT 400
Public Health & Human Services ELMA:361 5269, EXT 400
FAX 36OA27-7787
On-Site Sewage System Permit: SWG2024-00376
APPLICANT ANDERSON SUSAN E Phone:
Address: 411 AVENIDA SALVADOR SAN CLEMENTE, CA 92672
OWNER ANDERSON SUSAN E Phone:
Address: 411 AVENIDA SALVADOR SAN CLEMENTE, CA 92672
SEPTIC DESIGNER BOB PAYSSE` Phone: 360-426-1803
Address: 3083 E Mason Benson Road GRAPEVIEW, WA 98546
Site Address: 6921 NE NORTH SHORE RD
Primary Parcel Number: 222095000017
Permit Description: Replacement 3bd ATU to pressure trench
Permit Submitted Date: 09/03/2024
Permit Issued Date: 09/10/2024
Issued By: Rhonda Thompson
Current Permit Fees Paid: $540.00 (additional fees may be requtred upon installation of soom).
Permit Expiration Date'. 09/05/2027 (based on date or 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 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 backfil/of
system components.
5 Installer is responsible for obtaining Septic Designer/Engineer installation approval prior to
backfil)of system components.
6 Mason County Asbuill 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/onsiteloss-inspection-request.php or call:
360-427-9670, extension 400.
OFFICIAL USEONLYENE FECE --
MASON COUNTY NQ C( 3 ou n D
COMMUNITY SERVICES
2� m N
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Public Health ICommuNryHealrh/Envlronmen Healrp y
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ON-SITE SEWAGE SYSTEM APPLICATION
D A
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APPLCANT PHonE m m
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SUSAN ANDERSON z
MAILNG ADDRESS-STREET,cm.STATE,ZIP mor 3
411AVENIDA SALVADOR SAN CLEMENTE CA 92672 m
SIT'_ADDRESS-STREET urr,ZIP coDE
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6921 NE NORTH SHORE RD BELFAIR INA 98528 SP,
NAME OF CESIGNER PHONE N
ROBERT H. PAYSSE 360-426-1803
NAME OF INSTALLER PHONE N
TBD <
PERM R TYPE paler onel CC owrva NC VNreE SOT FEE
r IFE C IFI SIDENTIALOSS LCOMMUNITYOSS COMMERCIALOSS EI PRNATEMG111DUALWELL E PRIVATE TWO-PARTY WELL Z
TYPE OF NR]RK pelxl onef
Ip PUBLIC WATER SYSTEM PEBBLE BEACH AS
ff NEWCONSTRUCTIONILPGRADES 6REPAIRIREPLACEMENT OTIIERGETAI_E!Seim ell/he,,,,, ❑TgBLEX REPAIR IQl
SUBMITTALS ❑ SURFACING SEWAGE ❑EXISTING FAILURE NJSHORELINF
Ln DESIGN FORM(REQUIRED) �SEPTIC DESIGN(REQUIRED) FOROOMS LOT B2E
6WAIVER(S)(IFAPPUGABLE) 3 0.17 0 '
L FECT,ONS WS TEAND SITE CONon (X IONs ,PRk NE RN
FROM BELFAIR, HEAD OUT NORTH SHORE RD TO SITE ADDRESS 6921 ON LEFT.
PDI SIGN POSTED. o o
ti
SITE MUST BE FLAGS EG FROM MAIN flGAO ANO TESTXUIEE MUST9E FlA6GEU WITN TEST NOLENUM9ERs. J
--- OFFICIAL USE ONLY BEI OW THIS LINE
UPGRADE I FAILURE SOURGF(N.mFomng
❑VOLUNTARY 0MAINTENANCF1PUMPINC ORUIICINGPERMIT ❑HOMEEALE ❑COMPLAINT DOPLER.
INSPEC TOR SOIL LOGS CJM11r I CONDITIONS
T1 r D 33 V� C- wLs oil 0
50".1 Es: 1 , r O ' � I I RESIDE IA�G�STALLATION EFFORT
v-VERY C=CRAVF_Lv E-SAND L-LOAM R-ELT C-CLAY E-EXTREMETY R-ROOTS REQUIRED FOR FINALAPPROVAL.
IN EE-GR EIGNATDRE � IATF APPLICATI�EIPI���� APPLICATICN APPRDVEG,..ESUE� o/'
THIS FORM MAY BE SCA NEOANO AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE 1 REVISEO12PG015 Z
DESIGN FORM—PAGE ONE Assessor's Parcel Number: 2 2 2 0 9 — 5 0 — 0 0 0 1 7
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. e 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.M1friximum so ei sire II I V I-"
'I PARCEL IDENTIFICATION
Perm it Num ber Designer's Name: ROBERT H. PAYSSE
Applicant's Name: SUS NANDERSON _ _. Designer's Phone Number 360426-1803
411 AVENIDA SALVADOR 3083 E MASON BENSON RD
Mailing Address: Designer s Address:
SAN CLEMENTE CA 92672 GRAPEVIEW WA 98546
City Stale Zip City State Zip
DESIGN PARAMETERS
Treatment Device
❑ Glendon Riorlter ❑ Sand Filler ❑ Mound ❑Sand Lined Drainfield ❑Reclrauladng Hite, Ijpt,
5 kcrubic Unit MA'At. d NUWATER BNR500 O Dur,aucction Unit NIA, odd Other:
Drainfield Type
❑Gravity, lRf Pressure [if Trench ❑Bed ❑ Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms THREE Scludule<lass SCH. 40
Daily Flow Operating Capacity 270 gpd Length 25 ft
Daily Flow: Design Flow 360 gpd Diameter 1,25 in
Septic Tank Capacity(working) BNR500 gal Number 6
Receiving Soil Type(Ifi) 3 Separation 9+ ft
Receiving Soil Appl. Rate 0.8 gpd/ft2 Orifices
Required Priniap' Area 450 W "1 otal Number of Orifices 42
Designed Primary Area 450 11' Diameter 3/16 in
Designed Reserve Area 450 ft, Spacing 48 in
Trenclr'Bed Width 3 ft Manifold
French Bed Length 150 ft Schedule Class SCH.40
Elevation Measurements Length 45 it
Original Drainfield Area Slope 2 % Diameter 1.25 in
New Slope-If Altered 2 % Preferred manifold configuration used'" 2(Yes 0 No
Depth of Lecavatiou UA., 19 in Transport Pipe
from Original Grade Ix.wn..1., 18 in Schedule/Class SCH. 40
Designed Vertical Separation 21 in Length <50 IT
Gravcllcs Chambers Required? ❑ Yes lid No 0 Optional Diameter 2 in
Pump Required? RfYcs 0 No Dosing and Pump Chamber
Pump/Siphon Specifications Numberofd....day 6
Diff, in Elevation Between Pump& Uppermost Orifice 12 ft Dose quantity 60 aal
Drainfield Squirt Height, Selected Residual(head) _ 2 fi Chamber Capacity(Flood) 1500 gal
Uppemtost Orifice 1f l ligher 0 Lower than Pump Shutoff Pump commis: Please check those required.
Capacity 0 Total Pressure Head 24.8 epm RfI and, IIBlepse Merer Cvent Counter
Calculated Total Pressure Head 204 fl If Timer_ Pump on 1.5 MIN ,Pump off 4 HRS
DESIGN FORM—PAGE TWO Assessor's Parcel Number: 2 2 2 0 9 -- 5 0 -- 0 0 0 1 7
Permit Number: SW6
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
6 '1 esl hole locations 19 Drainfield orientation and layout Reference depth from original grade:
96 Soil logs Ed l7ench/bed dimensions and 1f Septic tank
Sd Property lines critical distances within layout 19 Drain0eld cover
lig Existing and proposed wells [9 D-Box/Valve box locations Reference depth from original grade
within 100 ft of property 19 Septic tank/pump chamber and restrictive strata:
19 Measurements to cuts, banks,and locations IZ Laterals,trench/bed,top and
surface water and critical areas 19 Observation port location bottom
61 Location and orientation of fd Clean-out location ❑ Curtain drain collector
curtain drain and all absorption E6 Manifold placement ❑ Sand augmentation
components
m Orifice placement Other cross-section detail:
0 Location and dimension of Ed 1f Observation orts/clean-outs
primary system and reserve area Lateral placement with distance p
to edge of bed Other Information
m Buildings
E6 Audible/visual alarm referenced Yes No
Z Direction of slope indicator Ed Scale of drawing shown on scale
d ❑ Design staked out
9 Waterlines bar ❑ 2f Recorded Notices attached
A Roads, easements,driveways, ❑ if Waiver(s)attached
parking 19 ❑ Pump curve attached
9 North arrow and scale drawing ❑ 19 Evaluation of failure
shown on scale bar Non-residential justification
❑ 1d Waste strength
❑ Ed Flo"
DESIGN APPROVAL
The undersigned designer must be notified by installer at time of installation E6 Yes ❑ No
1A'(0e `� --Q.,
ignature of Designer Data
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:
'I�Iow"
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.
Gpdated Date: 12,72019
0 APPLICANTS WATERLINE TO BE RE-INSTALLED
E� 10'* FROM 055 (SLEEVE IF W/INTO')
0�
5�
�0 A PROPOSED PRIMARY & RESERVE
3 (3 BEDROOM)
r
EXISTING TANK & DRAINFIELD
ALREADY PUMPED &ABANDONED.
(TANK WAS REMOVED)
0 10' FOUNDATION/
FOOTING SETBACK
0-
i \
i
0U . 30' PERIM ETER/FOOTI NG
� DRAIN SETBACK
NEIGHBORING
WATERLINE TO
BE RE-INSTALLED A
10'+ FROM OSS
NUWATER &
PUMP TANK
TRAFFIC-RATED \ '
5'SETBACK
\ `� t \ APPROXIMATE
\ \,1--' NEW HOME
\ PUMP OUT&
ABANDON
N \� EXISTINGKAIN TANK
A� 1 � & DRAINFIELD
I 1 �
BULKHEAD
f�4 xxh.
HOOD
AN ASSUILTI INSTALL SIGNOFF FEE WILL CANAL
RE CHARGED AT TIME OF INSTALLATION \
PIOI�IEER DIGGING, INC 0%VR: SUSAN ANDER.SON TPST IOI F T HJI F 9:
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i
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NEW WATERLINE,
0�F,�0 / \ SLEEVE IF WITHIN 10'
OB PORT
WATER / C/ OUT
BOXES \
o \
10'
ABANDON \
EXISTING , "' ;-•.
WATERLINES _ \ "
& REINSTALL AV
NEW \ 9 \
WATERLINE
F /
VALVE �
�= \ BOX /
o`:' Foes s_,mw
PARKING
AN ASBUILT1 INSTALL SIGNOFF FEE WILL I `
BE CHARGED AT TIME OF INSTALLATION
PIONEER DIGGING, INC ""`'"' SUSAN AND ON I�I ICLL I I I;I, TF�I L,I F
14RC.CL=:2220450-00017 I al'R cdm nli 101M, I
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SIPII( DISIGNS -vDDRIl, 6921NOPTHSHOREan +.�,vI011 14+�10 II I,,,\10II
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JFFIG[ 3e012o18"1 Fad 3otr12-,23,3 >HFFT: DFDEGQ. SCALE II -s1,1E, =L E—1 ,_ 'TI
LATERA
UATERI FEEDER TOTAL
ICE ORIFICE ORIFICE DIST.TO TOTAL TOTAL
CRITICAL. LENGTHL PIPES SIZE URGTIH LENGTH SIZE IFn[M1l DISCHARGE
SPACING 1STORIFI E ORIICES H el) �
(fe
1 25 1.25 3 28 3/16" 0.59 4 6 ) 0.OR
2 A 125 9 m 3/16" 0.59 4 6 1 CIO
3 25 125 18 43 3/16" 0.59 4 6 7 0.12
9 25 1 11 27 S2 3/16" 0.59 4 6 7 0.15
5 25 l2S 36 11 3/16" 0.59 4 6 7 0.17
6 25 L25 45 70 3/16" 0.59 0 6 7 0.20
gUINFIELDHEAD(feet) 0.82
TRANSPORT ONE HEAD(feet) 055
ELEVATION CHANGE(feet) 12
RESIDUAL/SQUIRT(feet) 2
EXTRA LOSS/FfrtING511eetl S
_ TOTAL DYNAMIC HEAD(feet) 20.36
TOTAL GALLONS PER MINUTE 24.78
OBSERVATION PORT
CLEANOVT �•J► PS ?
. a
ORIG./FINISH GRAPE
FILTER L/Nt(.
FABRIC y� o u
WASHED - -- $
ROCK
N
REST. LAYER
THREADED CAP R*�'
VALVE
ADJVSTTOvnuEeox
# OF LATS
16"ORIFICES Cl)
12.00W/ SHIELDS '_ow
�1.
" '�' ALLVALVES
ANASBUILT/INSTALL SIGNOFF FEE WILL VALVES
CLUED TEE BE CHARGED AT TIME OF INSTALLATION N'FLP1P)
PIONEER DIGGING, WC IONilRSUSANANDER.SON IlJLLI IL,III ILL I ILY, II,.LL3_
P�ARL:[I = 22209-5000017 OI>_OLLJIILI .1 r_amllu. ne:Iniui.
IditlIAb I' 41 1 CW(AA'
SI.PIIL_ UI.SIGNS 1DDRL?. 6921NORTHSHORERD 181M01I I , v1"[1 i,vJO[I
3083 F.Ala c�Rnv��Ro cnaPFCIFAA,Ica�xsx, DEIGSIR. R.OBERT FL PAYRSE -
JnICL 310 ¢N303 I1v dao-127-253 cull 1` OF DETAB.(2) SCALE NA ^"^' LF= °^wL"l
i
TA.AKS,MUST BE
ON STATE DOH
APPIFOVED LIST NUWATER
oY TANKS
BNR500
TA\FS
PUMPTAA'KS
OVER1000 GA:. lSF. SVRBER
REOUI RES T,%O W MF,!S FOR
A� KS RISERS p 2AN5PORT LINE
I GRAVE t - t 4" AAD E.ECTRICAL
` ON RISERS- SAKE
PUMPTA.NQS SURE ALL HOLES
LOCATEP AT HIGHER _. A;E WATER-TICH'I
c
ELE%MT:O\ THAN .
P::AINPIAI.D A1115T
HAbEANII-SIPI IJN' ..
n .nr-R corcrrol 7nNL..
Pee ILE \STALLEP 0 RIBBCV RISERS
wL AAP RTICHT ups
r� FIMSHED GRADE.
I1iANSPJRI'LINE
INLET UNION n BALL VALVE
'rYATEK-TIGHT J f500 GALLON WA TERT7GH7
JOINTS ++ CONCRETEVUMR TANK
CHECKVALVE
HIGH WATER FLOAT
USE TAN KS-171 EP
ON/OFF FLOAT W/cAST IN WAJ=R
y: r TIGHT FITTACS FOR
LA'LET/OUTLESAAP
PUMPBVGKET — CAST INRlser.
ADAPTERS TO
ENSURE V VER
1 .-HT.NESS
PIONEER NC- U1,10M1K: SUSANANDERSDN
IONEER DIG .,
P4RCFI.r2220 9-5 0 0 0 017 INSTALL TANKS ON JRICINALOR
SEPTIC DESIGNS SDDRI- 6921 NORTH SHORE RD COMPACTEPLEVFLscI s- ru.NCR055
SU%31 ebe�.�A BLys`V liu GIL�PFtIN4.SCi)%4m DhIG,NLR. ROBERTH PAYSSE CO.A,NFCTIONS INTO ORIGINAL SOILS TO
JffIkF Sao-Izalasi IN\ Soo J2; 1353 DFIGAPSEL TANKSDEFAL AVOIPSETTLING.
Inst611ation & System Notes
1. Installer must contact designer for final inspection of the installation priorto cover. All components, including tanks, lids,
transport line,drainfield,and water lines must be open for inspection. A$350.00fee will becharged fortime involved withthe
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 discrepancies found must be reported to the designer immediately.
4. Drainfield area may only be cleared by a licensed installer familiar with sensitive drainfield area preservation. The builder, lot
developer, or property owner shall not clear the drainfield area. Any clearing required for drainfield installation shall not
remove or disturb any top soi l in Primary and Reserve areas. Removal 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. ATU, GI end ons,( 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 system owner/operator is
responsible for the continuous operation and maintenance of the system per WAC 246-272A. For operation and maintenance
information, refer to Mason County Public Health Homeowner's Manual,which should beteai*sd 3fterfnbtapadoo approval.
14.System owner should be cautious of landscaping around septic components. Root intrusion
can cause premature failure of the drainfield area. In addition, bushes and trees should be kept
away from lids and other septic maintenance points. - '..
15. Changes made at time of installation may impact designer calculations, pump sizing,and
compliance w/county and state requirements. Contact designer priorto install w/any
proposed variations from design. Changes may result in additional fees and permitting.
c lhl Js117i: 5I15AN ANDERSON
PIONEER DIGGING, INC p\Rl 1' 222ogs0000l7 L
SCPTIC DCtiIGNS \ooRlss e921woRnf seoRBw
soaxr_stsc\ul»oNaD. eaarulLWe. y98sk. DI4GVIK: ROBFRTHIPAYSSE
01JI, 1 16,11211103 Ire 3r1nnzaaa :1 TIF 1. NOTES SCALE NA