HomeMy WebLinkAboutSWG2021-00146 - SWG Application / Design - 3/23/2021 584
MASON COUNTY 416N6THELTONSTREET, 0H27-970,EXT 400
SHELTON:360427-9670,E%T 400
BELFAIR:3601 EXT 400
Public Health & Human Services ELMA 360482-5269,EXT400
FAX:360-427-7787
On-Site Sewage System Permit: SWG2021-00146
APPLICANT FRANK CLARK Phone:
Address: PO BOX 1954 SILVERDALE,WA 98383
OWNER FRANK CLARK Phone:
Address: PO BOX 1954 SILVERDALE, WA 98383
SEWAGE DESIGNER FRANKLIN CLARK* Phone: 360-830-4765
Address: PO BOX 1954 SILVERDALE, WA 98383
Site Address: UNKNOWN
Primary Parcel Number: 222235105020
Permit Description: New 2bd Oscar X02 with Class C waiver
Permit Submitted Date: 03/23/2021
Permit Issued Date: 09/04/2024
Issued By: Rhonda Thompson
Current Permit Fees Paid: $1,235.00 (additional fees may be required upon Installation of system).
Permit Expiration Date: 04/05/2026 (based on date of Inspection)
Permit Conditions:
i 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 upsiope and downslope depth specified on
design form.
4 Installer is responsible for obtaining Mason County installation approval prior to baciffill 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.
7 Comply with all Shoreline Variance and Ecology requirements.
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.govlhealthlenvironmental/onsiteloss-inspection-request.php or call:
360427-9670,extension 400.
OFFICIAL USE ONLY
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*RESIDENTIALOSS ICOMMUNITYOSS FICOMMERCIALOSS V PRIVATE INDIVIDUAL WELL ff PRIVATE TW6PARTY WELL z �I (.J
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ANEW CONSTRUCTION I UPGRADES FT REPAIR REPLACEMENT D"S.DETAILS/se¢v3 ellmst epPlyl [I TABLE IX REPAIR
SJqSMTTAIS ,[� El SURFACING SEWAGE ❑EXISTING FAILURE ❑SHORELINE
JY ESIGN FORM(RECK IRED) 9SEPTIC DESIGN(REQUIRED) EEIX UCI,A Z LOT SIZE Q
6WAIVER(S)(IFAPPLICABLE)
DIRECTIONS TO S TP ANT SITE CONCRIONS.rAT Ib,AJAA)
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SITE MUST BE NAGGER TRW MAIN ROAD AHO TEST HOLES MUST BE FLAGGED N4H TEST HOLE NUMBERS.
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE/FALJRE COUPLE(kn.1RUTR6LNDeee)
❑VOLUNTARY []MAINTENANCE/PUMPING ❑BUILDING PERMIT OTIOMESALE ❑COMPLAINT OUTLIER.
L`J NSPECTORSOLLOGS COMMENTS/CONDITIONS
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V-VERY GRAVELY E=BANJ L=LOAM Ei=ST C=C Y E=EXTREMELY R=BOOTR REOJ I RED FOR FINALAPPROVA-
INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED/ISSUED BY DATTI
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THIS FORM MAY UP dCANNEDAND AVAILABLE FOR PUBLIC VIEWON THE MASON COUNTYWEBSITE REAISED IIOrz015
DEiIGN FORM —PAGE ONE Assessor's Parcel Number: 2222 0 3 — 51 — 5020
A design will be reviewed when 3 copies of each of the following are submitted:
■ Completed design form that has been signed and dated. I Scaled layout sketch,including all applicable items on checklist
Ill Scaled plot plan,including all applicable items on checklist. N Cross-section sketch,including all applicable items on checklist
This form may be scanned and available for public view on the Mason Countv Web site. Maximum paper size: ll"X 17"
^ PARCEL IDENTIFICATION
Permit Number: SWG d� 10014b Designer's Name: Franklin I Clark
Applicant's Name: Andre Rowe Designer's Phone Number: 360.830.4765
Mailing Address: 7002- 149TH STREET E Designer's Address: PO Box 19S4
PUYALLUP WA 98375
City: State: zip-, Ci :Silverdale State:WA Zi :98383
DE SIGN PARAMETERS
Treatment Device
N Glendon eiofilter N Sand Filter N Mound N Sand Lined Drainfield N Recirculating Filter,Type:
■ Aerobic Unit Make/Model OSCAR-XO2 N Disinfection Unit Make/Model 111 Other:
Drainfield Type
N Gravity N Pressure N Trench N Bed l0 Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 2 Sc s F� Cubnlleh ioWne
Daily Flow: Operating Capacity 240 gpd Lei LSD PIwa13'GId(wtam Nelani&dneft
Daily Flow: Design Flow 240 gpd Di ter 112 in
Septic Tank Capacity 1,200 gal N MAY $ 2 2024 r 4
Receiving Soil Typ e(1-6) 4 Separation 16 ft
y
Receiving Soil Appl.Rate Prl: .6/Res:.6 gpd/ft: ifices
Total Number of Orifices OS-50 c.il,h.v,50cm,t tars
Required Primary Area 400 ft' narh)no emirrcr�mral
Designed Primary Area 400 ft2 Diameter 8.42gphemii in
Designed Rcscrvc Area N/A ft2 Spacing 6"O.C. in
Trench/Bed Width 28'0" ft Manifold
Trench/Bed Length 15'0" ft Schedule/Class SyIMMaSisetialiud RaadWodeAssµ
Elevation Measurements Length Con5edngolll)314irosAdddiAfgle,„and ft
Original Drainfield Area Slope 5-10 % Diameter IIIdownAT,,,131Rmuref EandlS)Sekmdsin
New Slope,If Altered N/A o/ Preferred manifold configuration used7l Yes N No
Depth of Excavation UP-sloae 0 in Transport Pipe
from Original Grade Down-slope 0 in Schedule/Class 40
Designed Vertical Separation 24 in Length 50 IT
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 of doses/day 240
Difference in Elevation Between Pump Shutoff and Uppermost Dose quantity 240 gal
Orifice S ft Chamber Capacity 1DCE, gal
Uppermost Orifice! Higher Lower than Pump Shutoff Pump controls:Please check those required.
Capacity@ Total Pressure Head 2.1 gpm ■ Timer ( Elapse Meter I Event Counter
Calculated Total Pressure Head 50' ft If Timer: Pump on 22 Seconds Pump off 3 minutes38 Seconds
Comments This is a Low Ridge Technology Treatment Lvl A Wastewater Treatment system which meets the waiver requirement for a 50'Setback from
surface water's edge.The OSCAR-X02 wastewater treatment system consists of a Septic Tank with an Aerobic Treatment Unit in the second compartment
and a 2-Corot Pump Tank and all required system components,see"Manufactures System Specification',which Includes a unique control panel which Is
factory set,but can be adjusted if needed.
DESIGN FORM -PAGE TWO Assessor's Parcel Number: 22223_ 51 __05020
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 ■ Septic tank
■ Property lines critical distances within layout ■ Drainfield cover
■ Existing and proposed wells ■ D-BoxNalve box locations Reference depth from original grade
within 100 ft of property ■ Septic tank/pump chamber and restrictive strata:
■ Measurements to cuts,banks,anc locations
■ Laterals,trench/bed,top and
surface water and critical areas ■ Observation port location bottom
■ Clean-out location ® Curtain drain collector-N/A
® Location and orientation of ■ Manifold placement ■ Sand augmentation
curtain drain and all absorption S Orifice placement -N/A Other cross-section detail:
components ports/clean-outs
■ Lateral placement with distance ■ Observation P
■ Location and dimension of to edge of bed
primary system and reserve area Other Information
■ Audible/visual alarm referenced Yes No
Buildings
■ Scale of drawing shown on scale ® ■ Design staked out
■ Direction of slope indicator bar ■ R Recorded Notices attached
■ Waterlines ® ■ Waiver(s)attached
■ Roads,easements,driveways, 0 ■ 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 0 No
05/21/2024
Signatureof esigner Date
The undersigned has reviewed this design on behalf of Mason County Public Health and determined it to be in
compliance with state and local onsite regulations: 14� IIIA'L�
Environmental Health Specalist _1 Date
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
® The design is stamped"Approved"by Mason County Public Health. 1 A I �I,�C
® The Onsite Sewage Permit has not expired,the Permit Expiration Date Ls- l _
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 may be scanned and available for public view on the Mason County Web site.
Updated Date: 12/7/2015
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