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HomeMy WebLinkAboutSWG2024-00407 - SWG Application / Design - 10/3/2024 ON, MASON COUNTY 415N6SHELTON:STREET,SHELT967 ,EXT 404 SHELTON:360d2]-98]0,EXT 400 Public Health & Human Services BELFAIR:360-2754467,EXT 400ELMA:360482S269,EXT 400 FAX:360427-7787 On-Site Sewage System Permit: SWG2024-00407 coo APPLICANT CRUZ VARGAS ET UX PABLO DE LA Phone: Address: PO BOX 1108 VAUGHN,WA 98394 OWNER CRUZ VARGAS ET UX PABLO DE LA Phone: Address: PO BOX 1108 VAUGHN, WA 98394 SEPTIC DESIGNER Dave Ghylin-Dave's Septic Service Inc. Phone: 360-710-2449 Address: PO BOX 301 SEABECK,WA 98380 Site Address: 201 E BRAZIER LN Primary Parcel Number: 122057890063 Permit Description: New 3bd gravity trench with Class B waiver Permit Submitted Date: 10/03/2024 Permit Issued Date: 10/29/2024 Issued By: Rhonda Thompson Current Permit Fees Paid: $805.00 (additional raes may ee ra9mied upon insullanon d syslam). Permit Expiration Date: 09/20/2027 leased on dale or mspedmnl Permit Conditions- 1 Proposed development subject to zoning requirements and approval by the planning department stagper Mason County Title 17. 2 Permit must be installed by a Mason County Certified Installer unless prior written authorization tram 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 DesignerlEngmeer installation approval prior to backfill ofsystem components. 6 Mason County Asbultt 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/onsite/oss-inspection-requestphp or call: 360.427-9670, extension 400. OFFICIAL USE ONLY MASON COUNTY �"EEUNEO 10 . 3 -Z� W n COMMUNITY SERVICES µaMa Mm W y PublleNulM(UmmunlpHnIUVO�HmnmentalHnhN O (G (Joyny o z w ON-SITE SEWAGE SYSTEM APPLICATION a a 3 n APPUCN!! PHONE m m Cathy Delacruz Z M4LINGAODRE88-STREET,CRY.STATE,2IPCOOE C a� PO Box 1108 - Vaughn WA 1108 m SREADDREBs-911iEETcm,ZIPcoGE .�. 201 E Brazier LN, Belfair WA 98528 NAME OF DESIGNER PHONE Dave Ghylin 360-710-2449 N)WE OF INBLILLER PHONE I IV C PERMRTYPE(m —) DRINMNGWATENBWRCE N IC) ®RESIDENTIALOSS EICOMMUNTTYOSS hCOMMERCIALOSS EPRNATEINDMDUALWELL ERPRNATETWO-PARTYWELL Z IN TYPPEqE'O� FWGRK(as .) �1 IYJ PUBLIC WATER SYSTEM 1KNEWCONSTRUCTION/UPGRADES ,.yREPAIR/REPIACEIAENT OTHER DETAILS(sele,teptneteyylh QTABLE D(REPAIR I IV suBMDWLB ❑SURFACING SEWAGE ❑EXISTING FAILURE ❑SHORELINE c®TDESIGN FORM(REQUIRED) 9ISEPTICDESIGN(REOUIRED) BEDROOMS LOTSNE 1 IOD MMVER(S)(IFAPPLICABLE) 3 2.5 Acres 0 I 1 DIRECGONS TO BREAD SITE CONDRIONS(u..bWtlSeb) Gc Follow E Brazier LN to the end of the road and follow pink ribbons on si �� i driving down the easement area that doesn't have gravel. I o OCi 0 2 1024 rn SREMUSTaEAAGGED FAOMNNNNGApgNO 1E51H0(ES MUSTBEFLAOOFOWTN,TESTNOIEMI!®ERS By I W OFFICIAL USE ONLY BELOW THIS LINE UPGPADE/FAILURE BG,IRCEI,a,epaNy pepaeee) ❑VOLUNTARY QMAINTENANCE/PUMPING OBUILDINGPERMIT QHOMESALE QCOMPWNT ❑OTHER: �I,N�PIE1CIOR801LLOG8 COMMENTS/COHMDONB 1 � V(,uM-S D_Z--7 RKORO DRAWINGADINsrALLATwN REPORT aaLcaOEs: �� - V=VERY GeGM NN VELLY S-S L=LOAM 81=SILT C-CWY E•E%TREMELY R=ROOTS RED.,.FORFMALMPgOVAL INSPECTOR SIGNATURE OATS APPUC: 011 FXPIRAHONDATE APPUGWRONAPPROVEO18SUEDBY DATE THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTYWEBSITE REVISED=MIS DESIGN FORM—PAGE ONE Assessor's Parcel Number: 1 2 2 0 5 — 7 8 — 9 0 0 6 3 A design will be reviewed when 3 cooles of each of the following are submitted: Completed design form that has been signed and dated. V 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 maybe scanned and available for public view an the Mason County Web site.Marimum paper size: 11"X 17" PARCELIDENMCATION Permit Number: SWGZOti�\' OQmO Designer's Name: Dave Ghylin Applicant's Name: Cathy De La Cruz Designer's Phone Number: 380.710.2449 Mailing Address: PO Box 1108 Designer's Address: PO Box 301 Vaughn WA 03M Seebeck WA 98380 city State Zip city State Zip DESIGN PARAMETERS Treatment Device ❑Glendon Biofilter ❑Sand Filter ❑Mound ❑Sand Lined Drainfidd ❑Recirculating Filter,Type: ❑Aerobic Unit Make/Model ❑Disinfection Unit Mak./Model Other: Drainfield Type faf Gravity ❑Pressure Trench ❑Bed ❑ Sub Surface Drip Septic Tank/Drainfield Specifications Laterals Number of Bedrooms 3 Schedule/Class 3034 Daily Flow:Operating Capacity 360 gpd Length 40' ft Daily Flow:Design Flow 360 glad Diameter 4" in Septic Tank Capacity(working) 1200 gal Number 4 Receiving Soil Type(1-6) 3 Separation 6 It Receiving Soil ryAppl. Area Rate .8 gpd/ft' GrlDceP Required Primary Area 450 fir Total Number of Orifices A P P Designed Primary Area 450 g9i()ft2 Diameter OCT � n nnnt in Designed Reserve Area 1,320 ftr Spacing ��282T in NASON }giq ,L HEALTH Trench/Bed Width 3 ft Manifold Trench/Bed3034 Length fel'0 ft Schedule/Class fd Elevation Measurements Length 20' ft Original Drainfield Area Slope 0-5% % Diameter 4" in New Slope,If Altered N/A % Preferred manifold configuration tsed? O Yes RfNo Depth of Excavation Ui snipe 14" in Transport Pipe from Original Grade M sa l� 12" in Schedule/Cluss 3034 Designed vertical Separation 18" in Length 70' R Gravelless Chambers Required? ❑Yes O No RfOptional Diameter 4" in Pump Required? ❑Yes RfNo Dosing and Pump Chamber Pump/Siphon Specifications Number ofdoses/day N/A Diff.in Elevation Between Pump&Uppermost Orifice ft Dose quantity gal Drainfield Squirt Height/Selected Residual(head) ft Chamber Capacity(flood) gal Uppermost Orifice O Higher O Lower than Pump Shutoff Pump controls:Please check those required. Capacity Qa Total Pressure Head gpm OTimer OElapse Meter ❑Event Counter Calculated Total Pressure Head ft If Timer: Pump on .Pump off Comments Met with Rhonda Thompson ( Mason County Public Health)on site 9/20/2024 at 10 am. DESIGN FORM—PAGE TWO Assessor's Parcel Number: 1 2 2 0 5 — 7 8 -- 9 0 0 6 3 Permit Number. SWG DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch R1 Test hole locations IZ Drainfield orientation and layout Reference depth from original grade: 56 Soil logs 66 Trench/bed dimensions and 16 Septic tank Ib Property lines critical distances within layout IZ Drainfield cover Ed Existing and proposed wells E6 D-Box/Valve box locations Reference depth from original grade within 100 ft of property Rf Septic tank/pump chamber and restrictive strata: ❑ Measurements to cuts,banks, and locations 6f Laterals,trench/bed,top and surface water and critical areas E6 Observation port location bottom ❑ Location and orientation of Qf Clean-out location ❑ Curtain drain collector curtain drain and all absorption ❑ Manifold placement ❑ Sand augmentation components ❑ Orifice placement Other cross-section detail: 16 Location and dimension of ❑ Lateral placement with distance 66 Observation ports/cleanouts primary system and reserve area to edge of bed 19 Buildings Other Information ❑ Audible/visual alarm referenced Yes No R1 Direction of slope indicator 66 Scale of drawing shown on scale ❑ 9 Design staked out Ed Waterlines bar 9 ❑ Recorded Notices attached A Roads,easements,driveways, Rf ❑ Waiver(s)attached parking ❑ fd Pump curve attached RI North arrow and scale drawing ❑ Rf Evaluation of failure shown on scale bar Non-residential justification ❑ if Waste strength ❑ Rf Flow DESIGN APPROVAL The undersigned designer must be no ' ed by installer at time of installation 16 Yes ❑ No Signature of Designer '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 on-site regulations: (b12gIZ� Environmental Health Specialist I Date CAUTION: DESIGN APPROVAL IS VALID ONLY TINDER THE FOLLOWING CONDITION: ✓ The design is stamped"Approved"by Mason County Public Health. IZ ✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: ✓ Drainfield she 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 Masan County Web site. Updated Date: 12/72015 Mason County WA GIS Web Map � OT APPROVED OCT 29 2024 MASON COUNiYENVIRONMENTAL HEAL H REi 9A. 24,e:57:02 AM 1:3,060 0 003 nos ol0: E3 County Boundary I--------l--- ---.- 4 0 0na 00e Ole" No Filled El Tax Parcels(Zoom in to 1:30,000) �,� Ewa ran rem.an x.eab ram.on.s anti.un .'b"ce�c"m.°ie 0bq bM ro oo.a..ws maaem... u�a.mraaevrryokW�* IYxiCV W JVYmwvy.iiaaµ vMie✓�t4Y6.NbYb WsamibemtiM'Il�any�_Mi General Designer Notes APPROVED Owner Name: Cathy De La Cruz OCT 2 9 2024 Reference: 12205-78-90063 MASON COUNTY ENVIRONMENTAL HEALTH RET #1 —Soil logs have been dug on this site and are the responsibility of the property owner or owner's agent to have these soil logs buried after the inspection process has been completed #2—If during the construction process, soil conditions are found that may lead to premature failure of the system,construction shall stop immediately and the designer shall be notified. Such soil conditions may include but not limited to ground water,surface water,fill material,clay soil,bedrock,or excessively permeable gravels. #3—Any substitutions or deviations from these plans shall be approved by the Health Department or the designer prior to construction. All changes of the system components shall be documented by the designer on the final As-built drawing. #4—Peak design flow is 360__g.p.d.,Recommended daily flow should not exceed 288_g.p.d. or premature failure may occur. #5—Backfill sewage disposal system immediately after final inspection process,cover soils should be loamy sand or better. Seed final cover with grass or shallow rooting ground cover. #6—Keep all maintenance access lids and ports accessible to ground surface. #7—Installer should rake the finished grade smooth and slope it to divert all surface water runoff away from tank and drainfield areas. #8—Setbacks from house foundation to drainfields and reserve areas are 10',septic tanks 5' and transport lines 2'unless otherwise stated within the design. #9—Driveways and parking areas must stay 5' from dram7erd areas. Tanks—maybe located within parking area and driveways if approved for this application. #10—Sewage waste strength should meet the following criteria or be lower Bod-5 = 130-174 mg4,TSS= 47-71 mg/i,FOG= 10-20 mg/l,PH=6.5-7.2 with microscopic life forms present. #11 —Installer must adhere to all manufacturer installation requirements for all products used. #12—The attached septic design does not represent a survey nor does it purport to show all easements or encroachments,if any. Designer recommends property lines be located prior to any final installation occurs. Surveys may be required to accomplish this. #13—Property lines and comers have been represented by owner or owner's agent,the designer is not responsible for errors due to inaccurate measurements from property lines or comers that are inaccurate. #14—If a curtain drain is required with this design it must meet all Health Department installation requirements. #15—Developers,homeowners and installers,installations of on-site sewage disposal system should always be installed in dry weather conditions. Irreparable soil damage may occur if systems are installed in wet conditions. Planning the installation of system is very important and should be done as early in the building development stage as possible. Wet weather conditions have caused delays in final approval dates. #16—Maintenance is required will all sewage disposal systems. Owners will receive details of this in the designer manual with the final approval of the application. #17—Adhere to all designer notes located on design layout page. #18—If development exceeds 10,000 square feet of impervious surface an engineered drainage plan may need to be submitted. Options are available to reduce square footage requirements, such as wagon wheel driveways,contact DCD for further details. Owners are responsible for any fee for redesigns or revisions that may be needed after BSA submittal not due to designer error. #19—Low flow water fixtures are recommended within the home to help lower the hydraulic load to the system. #20—Watertight components are a must for all onsite sewage systems. Installers are required to ensure all components are watertight,extreme care should be used during backfilling of these components to prevent settling and or water intrusion issues. If leaking components are not fixed in a timely manner,the designers warranty may be void. #21 —Installation of this design most meet all Health Department regulations and all adopted policies by the Health Department that may apply. Installer is required to be versed in these regulations,if any questions contact designer. #22—All components used must be on State Department of Health approved products list for use with residential waste. #23 —Installer must inspect all tanks used at time of delivery and any tanks with defects must be rejected and not used. When using any existing tank,the installer must due a 24 hour leak test to ensure all tanks used are watertight. #24—All plumbing must be muted into the new sewage system that has been designed. It is the property owners responsibility to show the designer all plumbing stub outs and all gray and black water discharge points. A plumber may be needed on old homes to ensure that all stub out locations are connected to the new proposed sewage disposal system. An inside pump basin may be needed in some cases where plumbing is located in basements and elevations for a gravity discharge cannot be maintained. #25—Do not use low profile chambers or the system will be red tagged. All lateral lines must be a minimum of 6"off the infiltrative surface. Lateral ends most be secured at the cleanout and must be in the center of the port. #26—Gravel trenches are recommended,but Arc 36"chambers are allowed. Specific Designer Notes: #1-This application is for a new 3-bedroom home. 92-A new gravity system is proposed with 160' of drainfield. #3-A maximum I T'trench depth is proposed with a additional 12"of cover material for the drainfield. #4-Any large stumps holes to be filled with sand filter sand. #5-Extreme caution most be taken on clearing drainfield area.Native soils can't be damaged Recommended to be done by septic installer. APPROVED OCT 29 1024 MASON COUNTY ENVIRONMENTAL HEALTH RET 9F�a` FYilgEitGTJ' Dave's Septic Services, Inc. P.O. Box 301 Seebeck, WA 98380 (360) 710-2449 Customer Information: Date: 9/23124 Applicants Name: Cathy 0e La Cruz Site Address: 201 E Brazier LN Belfair WA 98528 Tax ID#: 12205-78-90063 APPROVED OCT 29 2024 MASON COUNTY ENVIRONMENTAL HEALTH RET z IL O J O Q O co = co r W W vp-1 r H 2 K d p = z- W W 3 LL U O r Z p O w pv1 rw0 N U W QQ pLu 0 — W KZ OQ� O L Z = W U U` N (Yj W = W Z Z W O 0Z W N � o N � � N Wz K w w w Z h > i Z p ¢ -� O _Qw W UZa w c� Q 7p wa r a W O 0 N —Z m U N C9 O m Q Q W 0 � N V N c� of v ui .6 m X U o O w n r w m m W IL F- o a Lu W O O ci w O W m W a a = � w ° NOw Ul N J Y 0VQ :4z w a/ Z APPROVED a N OCT 29 2024 Q " r O— MASON COUNTY ENVIRONMENTAL I RET i 00 \ \ / _ \ EL } - 0 k f% )/ s / \ } \ \ Q ( } § coA \ k 4 , � , ¥ CO ® 0 [ af k § )/ 2 { k � ^ ! _ \ \ beHel / . � ® 2 ( § \ _ � ` E 2 ° \ o E ] ) / ) , II 2If u \ S $ k 5 \ O ) ) \ k ) \ k i a © C3 4 _\ § Le LU iOD ! ) \ k � § Ir co k \ S � > ` w » O R - 0 ? 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