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HomeMy WebLinkAboutSWG2020-00489 - SWG Application / Design - 9/23/2020 415 N 6TH STREET,SHELTON,WA 98584 MASON COUNTY SHELTON:360427-9670,EXT 400 COMMUNITY SERVICES BELF :360482- 6 ,EXT 400 ELMAMA:360-082-525269,EXT 400 .m n�m.c—0'1n m FAX 360427-7787 ENVIRONMENTAL HEALTH REVIEW OF OSS APPLICATION ROD LEFT-Acme Design PO Box 2954 SILVERDALE, WA 98383 Applicant: HANNEM KIRT E &JILL K Parcel Owner: Site Address: E Duck Cove Rd Primary Parcel Number: 221332390133 OSS Permit Number: SWG2020-00489 Permit Description: 3BR Pressure wl class B waiver Permit Submitted Date: 09/23/2020 Permit Review Date: 10/29/2020 The above mentioned Onsite Sewage System Application was reviewed by Environmental Health and found more information is required. Design approval given pending filing of attenuation zone records at the auditors office. Please contact me with the Auditors fling number to obtain permit approval.jwilmoth@co.mason.wa.us or 3604279670 ex 543 If you have questions or concerns let us know. Sincerely, Jeff Wilmoth 3 ilmoth@co. Ext.543 jwilmoth@co.mason.wa.us OFFICIAL USE ONLY M1E"fCFNEk ® MASON COUNTY rn COMMUNITY SERVICES m E"° " "R ° N helm N.+lu I�Gommunv�HmNVENLaNNntN neaMl y SWG _- CS�`k 5 N ON-SITE SEWAGE SYSTEM APPLICATION 3 m m pP0.1LPHT FMINE KIRT E HANNEM 360-620-6643 z c MAl1Np yEyG-9}pEET LT',STATE.LP CCDE 3 5936 AppSE LAKE VALLEY RD PORT ORCHARD WA 98367 = m WEAu M-mREETcm.vpWDE D N E DUCK COVE RD SHELTON WA 98584 z .E CF OE9l1E0. PHONE IT! I N ROD LEFT 360-698-8488 3 NME OF INSTll N P1KKIE Q 11 < I W w PEF1.11TiYPE(a'w't ov) �I DRIW(IN(1 WATERSWRLE Q JORESIDEN71ALM EDCOMMUNMOSS BCOMMERCIAL WS 61PRIVATEINDIVIWALWELL EPRIVATETWb WELL Z I W VPEOFWON (ryw ) �T PUBLIC WATER SYSTEM 1 ENEW CON6TRlILTIONl11PGPADE6 IyREPAIRI REPLACEMEM OTHERDETAILSMWCF"N ) 13TABLE NR R IN suSMm.LL9 O SUPFAGNG SEWAGE 0 EXISTING FAILURE ❑SHOHEUNE OTBDF W I w p®LD"ESIGN FORM piEplIREO) ®SEPTIC DESIGN(REWIRED) BEDROgYR O 1 Ip1WANER(S)OFAWUCABLE) 3 62E726.4 X I� NRECIp1L4TO SREAND SRECONUT z(n.W.+tWFI NORTH ON HWY 3. EAST ON PICKERING. SOUTH ON PHILLIPS. WEST ON DUCK TO PROPERTY ON THE RIGHT. o w 5/IC YUSTBEMGGED FNOYNAMROAOANOTESTMOILSYWiBERAOD®N9MT®TMDLENW6FA5' I ca OFFICIAL USE ONLY BELOW THI5 LINE UMWEIFAIWRESWRLEIMNF WTo+r) OVOLUNTARY OMMMENANCEPUMPING [313IIILDINGPERMIT OHGMEEALE OLOMPLNNT OOTHER: IHSPECTURSOILLWS �� L ENBIL ONS { -.2 ♦m� SL -3-ry c p.�p�, 4 .44 R NEGDNDDRAWINGANDIH TIONREFORT 801E ODE> V-VERY G-GRAVELLY S.. L+LO V,T L+CIAY E.EXI0.OMLY R+RO0I9 RE ,ATMpMWLL DPiE a ¢In�� Mn AEPLIGTNNIEWSMTpN WTE MRICATxMIMRiovEwlssuEO BY REVISED 1XII3015 IB MAY BE SCANNED AND AVAILABLE FOR PUBLICNEW ON THE MASON COUNTY W6M8 OFFICIAL USE ONLY MTEMCENELE ® MASON COUNTY - c It.^ COMMUNITY SERVICES M° '""°Ea g"`°" s y FuMk NxNM1 cmmunSyEuNWEnvlmn nw H.M) y O SWG C� )'� _ 0�565 o z 2 N ON-SITE SEWAGE SYSTEM APPLICATION a s z m m APPLICANT PHDNE r KIRT E HANNEM 360-620-6643 c MuuNGAODRES3-4TREEi.CIrv,SGTE.LPCOOE � m 5936 SE LAKE VALLEY RD = SITEACMESS-STREETOWMPCOOE D N E DUCK COVE RD z NAME OF DESIGNER PHONE ' I N ROD LEFT 360-698-8488 NAME OF INV EN RHOME H Iw PERMITTYPEPNM ) DRINKING NATER SOUH:E ®RESIDENTIAL OSS �COMMUNITYOSS LLCOMMERCMLOSS �PRIVATEINDIVIDUALWELL ®PRIVATETWOPARTVWEU_ Z I W TYPE OF MORK PI MU.) PUBLIC WATER SYSTEM I ®NEWCONSTRUCTION/UPGRADES DIREPAIR/REPLACEMENT OTHER DETNLS(w LO MMryP)9 ❑TABLE D REPAIR IN SUBMITTALS p SURFACING SEWAGE ❑EXISTING FAILURE ❑SHORELINE OL 56E m I W /DESIGN FORM(REQUIRED) SEPTIC DESIGN(REQUIRED) BEDROOMS O VER(S)(IF APPLICABLE) 62,726.4 O ®WPN lREV)SIaN 3 x co DRECTNXESTOSITEANDSDECUEMTIONS:IM.b IPOSl NORTH ON HWY 3. EAST ON PICKERING. SOUTH ON PHILLIPS. WEST ON DUCK TO PROPERTY ON THE RIGHT. SRPMMSTBf PEAaaED FI1aMYAM/R°AO ANa TE3TNOEFS MUSIBEFtAOGEa NfINTE3iM°LFNUMBFRb. I0 I W OFFICIAL USE ONLY BELOW THIS UNE IIPGRA°E/FNLURE SOMCEBMI M ❑VOLUNTARY OMAINTENANCNANCEtPUMIPUMPING [3 BUILDING PERMIT PHONE SALE pLOMPGINT POTHER: INSPECTORSOILLOOS CCMMFMS/CCNDTICNS RECORDDVMMNQAMlMRTALUTIONREPORT SOIL WOES: REQUIRED FOR FINALAFPROVAL. V=`VERY G•GMVEUY S•SWO L•LOAM SI•SILT C•CIAY E•E%IREMELY R•ROOTS DARE IXSPECTDR SIGM4TME DATE APPNGTIONEK .DSONGTE APPIJGTICNAPPRWEDISSIIED BY THIS FORM MAYBE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WESSITE REVISED 12ROM5 DESIGN FORM—PAGE ONE Assessors Parcel Number: 2 2 1 3 3 — 2 3 — 9 0 1 3 3 A design will be reviewed when 3 copies of each of the following are submitted: Completed design form that has been signed Rod dated. v Scaled layout sketch,including all applicable items an checklist Scaled plot plan,including all applicable items on checklist. v Cross-section sketch,including all applicable items on checklist. This term mew be seemed and available for ubllc view on the Mason Conn web site.Maximum paper size: ll"X JT' Designer's Name: ROD LEFT Permit Number: SWG gn 380-698-6490 Applicant's Name: KIRT HANNEM Designer's Phone Number: 5938 BE LAKE VALLEY RD Designer's Address: P.O.BOX 2954 Meiling Address: PORT ORCHARC WA 98387 SILVERDALE WA 98383 city state 2i city State 2i Treatment Device ❑Olendon Biofilter ❑Sand Filter ❑Mound ❑Sand Lined Drainfield ❑ReorcuLdng Filter,Type: ❑Aerobic Unit Make/Model ❑Disinfection Unil Make/Model Other: Drainfield Type Gravity b'(Pressure ❑Trench ❑Bed ❑Sub Surface Drip Septic Tank/Drainfield Specifications Laterals Number of Bedrooms 3 Schedule/Class 40 Daily Flow: Operating Capacity 360 gpd Length ft I Daily Flow:Design Flow 360 gpd Diameter in Septic Tank Capacity 1150 gal Number 4 Receiving Soil Type(1-6) 4 Separation 5 ft Receiving Soil Appl.Rate .6 gpd/ft? Orifices Required Primary Aroa 600 fe Total Number of Orifices 50 Designed Primary Area 600 At Diameter 1/6 in Designed Reserve Area 600 fit Spacing 48 in Trench/Bed Width 3 ft Manifold Trench/Bed Length 200 ft Schedule/Class 40 Elevation Measurements Length 37 ft Original Grainfield Area Slope 2-3 a/ Diameter 1 in New Slope,If Altered 2-3 % Preferred manifold configuration used? I(Yes ❑No DepthofEzcavation up-slope 11 in Transport Pipe from Original Grade Oo.,,a-swpe 11 in Schedule/Class 40 Designed Vertical Separation 12 in Length 103 It Graveness Chambers Required? O Yes ❑No GdOptionel Diameter 2 in Pump Required? lidyes [3 No Dosing and Pump Chamber Pump/Siphon Specifications Number of doses/day 6 Difference in Elevation Between Pump Shutoff and Uppermost Dose quantity 60 gal Orifice '4 ft Chamber Capacity 1000 gal Uppermost Orifice❑Higher ❑Lower than Pump Shutoff Pump controls:Please check those required.Capacity Q Total Pressure Head 30 gpm Timer litElapse Meter 911vent Counter Calculated Total Pressure Head e it If Timer: Pump on 2 MIN ,Pump off 4 HR Comments DESIGN FORM—PAGE TWO Assessor's Parcel Number:2 2 1 3 3 — 2 3 -- 9 0 1 3 3 Permit Number: SWG DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch Ed Test hole locations 1Z Drainfield orientation and layout Reference depth from original grade: m Soil logs ❑ Trench/bed dimensions and fib Septic tank 0 Property lines critical distances within layout [9 Drainfield cover 1A D-Box/Valve box locations Existing and proposed wells Reference depth from original Bade within 100 ft of property Rf Septic tank/pump chamber and restrictive strata: ❑ Measurements to cuts,banks, and locations 9f Laterals,trench/bed,top and surface water and critical areas [9 Observation port location bottom ❑ Location and orientation of 19 Clem-out location ❑ Curtain drain collector curtain drain and all absorption Ed Manifold placement ❑ Sand augmentation components R1 Orifice placement Other cross-section detail: 0 Location and dimension of Ed Lateral placement with distance 9 Observation ports/clean-outs primary system and reserve area to edge of bed Other Information Ib Buildings 69 Audibletvisual alarm referenced Yes No la Direction of slope indicator 16 Scale of drawing shown on scale ❑ Rf Design staked out 0 Waterlines bar ❑ 9 Recorded Notices attached 6d Roads,easements,driveways, 6K ❑Waiver(s)attached parking [9 ❑ Pump curve attached ❑ 19 Evaluation of failure Ed North arrow and scale drawing shown on scale bar Non-residential justification ❑ ❑Waste strength ❑ ❑ Flow xk;' [ DESIG PPROVAL _. The undersigned designer must be n d l t him on Rf Yes ❑ No I(ea � t atu o De ' ter Dam The undersigned has reviewed this d ign on behalf of Mason County Public Health and determined it in be in compliance with state and local on-si regulations: 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 maybe scanned and available for public view 011 the Mason County Web site.Updated Date: 12Y7C2015 Pump $eleacm fbr a Pressurized System -Single Family Residence Project HAN N EM 122133-23-90133 Parameters DW. 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