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HomeMy WebLinkAboutWAT Application - 4/16/2008 � . MASON COUNTY DEPARTMENT OF HEALTH SERVICES Environmental Health Porsonal Health PO BOX 1666 SHELTON, WA 9856 LOCAL(360)427-967 BELFAIR(360)275446 Application for Determination of Adequacy FAX(360)427-779 Instructions 1. Complete Part 1. No determination can be made until Part 1 is fully completed. 2. Complete only the portion of Part 2 applying to the type of water system utilized. 3. Submit completed application, with attachments to the health department for review. PART 1: Applicant/Parcel Identification Name of Applicant: Mark Anderson Date: 4116108 Mailing Address: 13121 44tb Ave. Ct. NW Telephone: 263-225-5911 Gig Harbor, WA 98332 Assessor's Parcel Number: 120186200025 Tvide of Water Slirstem Check One): Reason for Application Check One): X Public/Community Water System (2 or mom X Building permit connections)" ❑ Land use application, if so.. ❑ Individual water source(one connectio4, ❑ Division of land: if so.. I.. Well #of Parcels? SPL Spring/surface water ❑ Boundary line adjustment ❑ Other(explain) ❑ Other(explain) "If you have more than one residence ❑ Replacement(please indicate name of water system connected to this well,check the Public box. below if applicable—no signature required) PART 2: Water System Information Complete the section appropriate for the type of water system being evaluated: Public Water System Name of Water System: Island Shores Water Facility Inventory (WFI) Number:36240R (write "none' for two party) X I am the manager of this water system.The water system has been approved fud2 services. There are presently28 connection(s) in use.This will be the 29th connection. ❑ I am the manager of thissystem.This connection will be to up de or change the use of an existing connection on this system(ie:recreational to full time).Please indicate on the following line the nature of this change: This water system is able and willing to provide water o this(these)connection(s)without exceeding the limits of the water syste y It it et by state and local regulation. Signature of Water System Manager Date IWWWSERVERDOCUMEN7SMANA0ED'JSLAND SH0FE5WAL29.D0CUpd=:Ap612005 Individual Water Well ❑ Water well report(attach to application) Depth ft. ❑ Well capacity test(attach to application) gpm gpd e well driller often pe orms we capaci y es s at the time the well is Constructed. Resu is from these tests are noted on the water well report. Results from these tests will be accepted. If the water well report cannot be located by the applicant or if the water well report does not have a capacity test, a well capacitytesf, which provides stabilization of draw- down and recovery data must be peAorma b a licensed contractor ❑ Satisfactory bacteriological test(anach to application) Individual SibringlSurface Water E WDOE permit (attach to application) ❑ Method of disinfection ❑ 1 have reason to believe that this water source can provide at least 800 gallons per day and/or provides water at a rate of 2 gallons per minute based on the following observations. AUTHOR OF STATEMENT DATE RELATIONSHIP TO APPLOANT _ IN ADDITION TO PROVIONG THE ABOVE STATEM=W,THE APPLICANT WILLNEED TO ARRANGE AN OµSITE INSPECTION BY THE HU LTH DEPARTMENT PRIOR TO DETERMINATION OF ADEQUACY. Departmental use only. Do not write below this line. PART 3: Health Department Evaluation (Staff Use Only) I'. SATISFACTORY DETERMINATION: Applicant's water supply appears adequate to meet the needs of its intended use. This determination does not address adequacy of the distribution system, guarantee an adequate supply of water indefinitely into the future, or guarantee compliance with all applicable WDOE water resource regulations. ❑ UNSATISFACTORY DETERMINATION: Applicant's water supply does not appear adequate to meet the needs of its intended use for the following reason (a): REVIEWER'S SIGNATURE DATE IWWWSERVERDOCUMENMWNAGEDJSLAND SHORESIWAL29.DOCUpdW:April 20M MASON COUNTY DEPARTMENT OF HEALTH SERVICES May 01, 2008 PO BOX 1666 Shelton WA 99584 Shelton (360)427-9670 Fax (360)427-8442 MARKANDERSON Erma (360)4825269 13121 44TH AVE T NW GIG HARBOR WA 98332 Belfair (360)2754467 Case No.: BLD2008-00469 Parcel No.: 120185200025 Dear Applicant: Your building permit cannot be approved by Mason County Environmental Health until the following are completed and turned in: aPlease see comments at the end of this letter. Please call me at(360)427-9670, ext. 554 if you have any questions. Sincerely, Trish Woolett tw@co.mason.wa.us Environmental Health Mason County Health Services Comments: Connecting to community drainfield located at 12018-21-00000. Need current Operation and Maintence Report septic system. tw 5/112008 1 of 1 BLD2008-00469 It 3 EDK yG LTYPlcA GKH LOr) SrAU LL VALVE 60K 1Z. DO IUDIYIDIIAL LOTS. I SEE SHEET Z of 3 tmR 8RES 1 =L=158.5 Sj •t �G' REs DWAf o•o \ ml WMT -W lus Db \ I x \. h fps "Wc SCH 40 aI Ir la'; Sr AT ALL aw L� zq RTT sa' I • i s SGH 40 FOPZE MI}IIJ. la MIN•(``k(•yTE MI DEPTH 56- (n+IN 1$" I ) JNDEe-DITCH LINE)) I9STALL ±Z' DUTSIDEOF p POAMURY NVrffla /r INSTALL lg"'WDE2 /+ND Z + I DDVELE SlF-EvE /0(EAa4 SEPTIC TRtJKAnt? SIDE OF ANV V1IpfE9 GINR CHRn1EER.4 I" PIc eFC65-NG+s. '1� �� i CL:cD FoecE.m"MW Tc ANY SEWER; LINE WITHIIJ � ! zRLV eO)c"5EE SHEsr p' OF h W ttTE>Z LIIJE $VMI-L- -TO BE cic alr RM r0 5rA'f£ DF IKSTALLED AS 'ER,CH W"RINC-.rt'D0 DEPT, Cr ECClacy LOT I5 DEQELOPED. C21TF_RIA F�- SEWACi woRY1 , CTYDIGAL EACH QVILDINo A (REV ISGD OCT� 11HS SITE,) w. a«. «...Iv xW ux. ...0 f. Im•ax Z© 1�1a«. \calm a! In[lnlf w Yt•1/. a }i i.fif xl NMlax. IM1.pM u) nu[ ll.e. Na aN14 1[« pN a mWN n..ln. Associates '' A-FEE I RUE OHAR ED FOR TH iNAL 4EOT NAND Y-6UI T ORAWINS A 13 ORrNC.o FLOW CONTROL_ ASSGM9L`(- 5EE TA?Jk-DETAIL-SHt6T- of , TYP. EACH T4KVI '- 1200 6P, 11 ppELZATO"TVPE D05E CHAMBER 14)ITFh OkFNCD mt 2.1* `I 1u 51T'HON-TYP, ewK BED- SEE TANIK'D&-TML-SHEET OF 1 � C. SCH 40 FORCE MP 111 "WCCLZCD MANIFOLD-TyP.EPCH BED a MONITOQ FORT-F.ACN END OF EACH R_EC l o I o I fN If �u Le.- W �✓ Io. `3"PVC CL ZOO FCRLEK,RIN- T',—r EOCH_aEL I / D 1�07-E Mk2k.. LL eaWFELAED B C' DTI} P>=e.1N ANC1.%T 120N GOC'r5. CNECK VM.V GLUED ENDCAP UNTIL HOOKU7 PALL VaIVE(ovv t,UhL }1OOk,�P� VALE 95OX D6 f$I L "ItAinium Ig^ `11M HUNTER 4 Associate F w, DE(:HAR4=0 FCR THE FINAL NSPEGTION . I ' PVC LASS 7,00 71PIPE 6 OLES END GAP `wIEEP TY O. �45 I �EAA1P1r4 ¢EC.u,Rc9 cfJ ALL- LRTE2hl GNG. e 6 6 O PVC PERF PPE PV 51,4EEP CLEANOVT DETAIL NO 5CALE GENER.� L CONSTRUCTION NOTE 6EL7 LD I"FN510N5 - /0 FF x 7S FT EACH BED BED DEPTH - /'-O' BELOW 0.6. GRAVEL - 63 YD5 OF I/2" - O Vim"WASHED ROCK TOTAL BAGKFILL. - AFFROVEDEXCAVATEDMATEFiIAL 5EFTIC TANK - NEW I,L5 6AL., WATER TISHT TANK 7D5° CHAMBER - Iaco 6AL.. INATER T 6MT PUMP MODEL - OSI 214 DoSINc. SIPeoN SET TO FUMP AT=C—AL. INTERVALS. CHECK VALVE AND HIGH LEVEIA . A-f2�M REQUIRED. NOTE: PL-.AGE ORIFICE .AT 12 O'G LOCK, U5E "T" TO "T" TYPE CON5TRUCTION. min r—iir=l ' Q 3^ FALL �� P1TCR PA2¢IC YE / 'O J2 c.i V C C 1-/ I, 1W NEC LRPfO CCK Iy + 2-6 Q KESTi,CT,VF ` T✓PICAL NO SCALE ALE 10 L"I NO P1 DESIGNER - DICK YUNKER SHEET 2 OF 4 P.O. 80X 1(52 OLY, WA g8501 --- I,7 Y11 =�G13-2484 �C ,ALE — 1 " = 30' r) Ij� SEFTIG SYSTEM DESIGN LOT 21, 24, 25, 2 f 30 FOR MARK ANDER�ON I_LAND SHORES 3 >s-� TDR WMb TF# 12002100000 SITE# Oranco Systams Inc. JPon'*Eo r L•�f(f 2626 Colonial Road, Roseburg, Oregon 97470 z/Q� 503/673.0165 (Dos]APR p ps]Sl William Russell HIGHLAND EXCAVATION E. 200 Arellem Road Union, WA 98592, PH. (206)898-3773 IN �� 36•• en EfifKKFl 46" � '. f3QDUI�JD I •oil ;ti —` Tf4H1V— i� E :. C?IJTROL , __ ' :. ''2/1,p. "SEME.LV (EA(,M TAmt) �� °w F1Ce F `�2r\ —� SET Tk1.1K cN AT LEA-.e1 CHPrM5r=P_ DV_L1*IL_ iI,o gao ' . . .-'PrATNFICLD OSI'200 SERIES DOSING SIPHON >'IaE eilEva IN TYPICAL IZOD GAL. OXE COMPARTMENT DoSF— TANK THE 200SERIES DOSING SO'FK)NS WERE DEVELOPED • IF THE TANK SHOWN ABOVE WAS 6i0'97_AND AMODEL PRIMARILY FOR USE WHERE STATES OR DISTRICTS OSI2I�.SIPHON WAS USED,THE VOLUME OR EFFLUENT OR A SEPARATE DOSING TANK STILL REQUIRE TWO COMPARTMENTSEPTIC TANKS " DISCF CHARGED PER DOSE WOULD BE " 6 3 X 47- X 14 X T.{S ,3&,GALLONS IlzB MODELNUMBER 200 210 -212 214 •_ OPAWDaYN B 6" 101. 12•' Id•' OFFLEVELTO BOTTOM OF E I9" . 20.. ASSEMBLY DISCHARGE RATE (GPM) 37- 3¢ 3q- 40 fit� iC ft.yPt=�-Sc'/1( tzo 182t q co oo. PFTtgU. OF L 1/v. FoR � OT5 2y -25- 17 Sc n yo I DR/11NFIE�p 3" 5iEE1- CAS/NG 15 LINOFR S�Hy� � E5 vRENG g' I w� v E R- N`{AE �NODuT6fT. HFRF '2 I�/47R a N"WATER MAIN /5 A8o4T 3FT FROM VI-AcK Tva ,o-va3ri. pp-AP ,4„SE ^DJA7tRf� -��Is�ti� QE' v>ATERH y� — — —s� 13' �_ _ I.- __y7� SE n/E2 CoNNEGTIaKS /20 /8Z/ UDU o0 Z)r=rA /L OF I /AIE AT- FAID O F -Roq D J V j 1 I AL SEWkR �R-v — 3 CH AM iN SAME fREN I - — - - T S', Pvsr i R{is A TO c4SiNC7 j is I gsiyy C� stews 2 CONNECT/o, v vi h_ ;p � h is"da�Nt '�pOba MBE 7�rd,�.Pe��� v t1l�:yr tea,-��9,[S�.�l Yil "A�IE a agqt 'j �' ✓:p,.',,,, •.,+�wro: . . n+, Fri , .. -W na"M43, Rk� V:V k "'i ;tgAm MIR, I J.-l",Ll lly�f / Slti k .� �i� �£C7 rho*� i� a�M1fi.�•t*�Pt T�aY�jd�`Ji���� �=2�d� � �t + v„ Sit ,+ S ° � x�i• z cyA �'�S^,� r, i i �� fik F t v o • 'eu�m® + - -�L NLMA$A b NMDSblGICiCILStA f/+II'�Y}\`M TFYet LN'AYHM'N'Yf C e#S t - x (psx r'�dt 14a�,71. lIrY.. 3.� 3jC' �e 3r `�Ntb ynr+W " M 'F! r1r'�� 1 tl f a^,e¢ mV tt etdw(73e,� 3 ", J, f} sld .6 aec a qi_ �f J I i f , v r� ORENCO SYSTEMSTM (' DOSING SIPHONNAULT ASSEMBLY INSTALLATION INSTRUCTIONS MODELS OSI-208, OSI-210, OSI-212, AND OSI-214 important: 3"diameter pipe should be used from the dosing tank to the drainfeld, mound; sandfilter, etc. and must slope continuously downward to prevent air—entrapment problems that can cause greatly reduced flow and/or pressure. Test and operate siphon before backfilling transport pipe trench to be sure air—entrapment problems have not occurred. STEP 1 In a new tank, install the discharge fitting (provided) in the end or side of the septic tank, 36 inches down from the top of the tank, DETAIL 2, opposite, illustrates installation of the fitting in a concrete septic tank. Cut a 4-inch diameter hole in the tank wall and firmly pack grout ("Waterplug" by Thoro, or equal) around the tank fitting. Note: "Waterplug" sets up in as little as 3 minutes, so you must work swiftly, DETAIL 3, opposite, illustrates installation of the tank fitting in a fiberglass or polyethylene tank. Drill a 2 7/8-inch diameter hole with a hole saw and insert the 2-inch neoprene grommet, which is provided on request. Lubricate 2-inch schedule 80 nipple with gasket lube, silicone or Vaseline ® and insert it through the grommet. StTEP 2 Connect the end of the hose having a PVC female adapter to the 2-inch PVC fitting inside the septic tank wall. Connect the other end of the flex hose which has a pin lug connector to the 2" MIPT X FIPT 900 ell at the bottom of the vault. Tighten firmly by hand. It is essential that these two connections are made carefully. If they leak, the siphon will not work. STEP 3: The OSI Dosing Siphon is to be suspended in the septic tank and supported on top of the tank by the two support pipes provided. Install the support pipes in the slots in the top of the siphon's PVC vault as shown in the photograph accompanying the support pipes. STEP 4 Lower the dosing siphon/vault assembly into the empty septic tank. STEP 5 Pour about 1 gallon of water into each vertical pipe at the top of the dosing siphon assembly. If the traps are not filled at this time, the system will'..not operate. In addition, be sure the flexible discharge hose is completely filled with water. Any air trapped in the discharge hose will cause erratic behavior. Place an 8" concrete block or similarly weighted object on toil of the vault to prevent floating. QSTEP 6 Connect the 2" x 3" x 1" air-relief fitting to the tank fitting protruding from the outside of the dosing tank, then connect Zhe 1" air-relief piping, venting it into the manhole riser Unless it is vented in this manner, the siphon will not work. STEP 7 Run water into the septic tank until the siphon discharges. While the tank is filling, check to be sure that the 2" PVC flex hose is not floating. Air trapped in the hose will cause it to float. This air must be removed from the hose or the siphon will not operate. The siphon will discharge when the water reaches the level appropriate for the model you're installing: OSI 208 3 inches over the top of the bell OSI 210 6 3/4 inches over the top of the bell OS1212 6 3/4 inches over the top of the bell OSI 214 10 1/2 inches over the top of the bell Observe the siphon through several cycles. Erratic behavior usually indicates trapped air, either in the flex hose or in the transport pipe. THE SIPHON IS NOW OPERATIONAL&WILL FUNCTION AUTOMATICALLY. INSTALLATION IN ALREADY OPERATIONAL SEPTIC TANK CAUTION: The atmosphere in an operational septic tank may be poisonous! It is not necessary nor is it recommended that a person enter the tank. Only licensed septic tank installers should be employed to perform the roork. Installation is the same as for a new tank with these exceptions: A. The tank must be uncovered to provide working room to install the vault and to cut the discharge hole. B. The tank's contents must be pumped to bring the liquid level below the discharge hole. C. After the hole is cut into the septic tank,securely fasten one end of the tank fitting(connected 2- inch male adapters) to the female adapter on one end of the 2-inch flex hose. The hose is stiff enough that the end with the discharge fitting can be lowered through the vault hole and pushed out through the discharge hole in the end or side of the septic tank."Waterplug"by Thorn or a similar compound can then be used to grout the discharge fitting in place. Seal off any other discharge pipe in the tank with an expandable dollar plug or cap. MAINTENANCE We recommend that a visual inspection be made periodically (perhaps twice annually) to ensure the system is operating. Care should be taken when remgving the manhole lid so that leaves or other debris do not fall into the vault thus by- passing the screen and creating a potential for blockage. If the siphon is not dosing, but merely trickling, it can be restarted by lifting the siphon/vault assembly about 12 inches to recharge the bell with air then setting it back in place. Whenever the dosing tank is pumped, the vault and screen should be removed and both should be flushed with a hose. To remove the screen and siphon from the vault, remote the ® support pipes and unscrew the 3/4" plug. The siphon and screen will now lift out. NO7I= : LOTS ZT i 2G APE TD erE comeINED La TS Z9 It 30 APE. TO RE Co P-JPEZ, RIGFFTOF Why Nore I' R101W of WAY E-7-ILRDA,:MM lr PERMIT REG1u12ED MOM MA-ZD 3 CtwNTy, IJOTE'• APPRoxIrAPfTF. I_oCA-Tlcu 54ownl Fop MM ukITEp fV LIU�. INNVipuqL Lcr STUB LOC"ous NOT 5RowN)i MVSt M W0T614ED Fog, O tp LO u A SEc GIJLARGEME+1T 8 a M � s.reer x. oc 38° '4o3 '�Fco E CArCo SEWER L/NE TV h`eRr: A+UhL yJ INSTI4U FORCC EE I TP (ZOIg-ZI-000OD i 1'A ]53 27-6 —fI% Os- / 6C DESIGNER — DIGK YUNKER SHEET 1 OF 4 P.O. BOX 162 OLY, NA 98507 SEPTIC SYSTEM DE516N LOT 2I, 24, 25, 2-7 a 50 FOR MARK ANDERSON ISLAND SHORES #3 TP# 120182100000 SITE# JIM HUNTE