HomeMy WebLinkAboutSWG2024-00453 - SWG Application / Design - 11/26/2024 HELTON,WA
MASON COUNTY 415NBSHELTON: , 0427-97 ,EXT 400
SHELTON:360-2754457,EXT 400
BELFAIR:360-2]5-048],EXT 400
Public Health & Human Services ELMA:360482-5269,EXT400
FAX:360-427-7787
On-Site Sewage System Permit: SWG2024-00453
APPLICANT WEBBER ET AL JASON H Phone: 253439-8360
Address: 42 E HEMLOCK CT SHELTON,WA 98584
OWNER WEBBER ET AL JASON H - Phone: 253-439-8360
Address: 42 E HEMLOCK CT SHELTON,WA 98584
SEPTIC DESIGNER DALE TAHJA-Septic Designer Phone: 360-463-8023
Address: 2450 W DEEGAN ROAD WEST SHELTON,WA 98584
SEPTIC INSTALLER SCOTTJOHNSON' Phone: 360490-5408
Address: 8639 Salty DR NW OLYMPIA, WA 98502
Site Address: 40 &42 E Hemlock Ct
Primary Parcel Number: 320055000005
Permit Description: Repair:4-bedroom gravity system
Permit Submitted Date: 11/26/2024
Permit Issued Date: 12/02/2024
Issued By: David Anderson
Current Permit Fees Paid: $805.00 (addloanai leas may ea raamanes.lnsfaiiawn ofsysfem).
Permit Expiration Dale: 1112612025 (based on date of 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 Drainffeld 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 back ill of
system components.
5 Installer is responsible for obtaining Septic Designer/Engineer installation approval prior to
backffil of system components.
6 Mason County Asbuilt 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-request.php or call:
360.427-9670,extension 400.
OFFICIAL USE ONLY
4 e MASON COUNTY lI- 2(e - Z� w a
COMMUNITY SERVICES NYG^' !J 0°p .m
PUYI.N.tltl.N�umiu�Xo�M�Mdmn,W Mwx.l 3 �
. SWG 2DZ4 — 00g53 a
Z
ON-SITE SE APPLICATION
a �
m m
t.i
n Webber (253)439-8360 z
/iOgi69H=811tEET,CM,SI-LP CWE
.Hemlatk o Shelton WA 98584 m p
IPF56.6fliEET.
42 E. Hemlock Ct. o Shelton WA 986M �^'
e L. Tahja c (360)463-8023 N
to
1 ECF x6T. ER p
Weather Tight (Scott Johnson) (360)763-6577
PERONRTVPE r+ �, CHPMWG W^TFIt BONNE I O
("•, flES6ENFIK06G FcanMlx+rry oss �CDMNERCYLOSS I] PRIVATE EIIXVWALWal EPPoVATETWOPARfYWELL z I kll
- TYPEDFwaixr.Ne>.1 6Tvt�.xwATerssrsrvao...^x..a...
[7 NEW GONSTRUCl10N lUPGRADE6 EY REPAIR/flEPIACEYEM ORIEII DETA^S(YLYMYe¢p)) OTAELE IXREPAEI N I kT
eUeNm,ALS �SUflFACNX3 SEWAGE BEwSTxA FAEURE OEMORELME m
Et DESIGN FDRY(REDUIREO) 55EPTIC DESIGN IpEWYtEU) 6Fu/Ga,Y �a,soE r
17 wArvEws)oFAFrLICASLE) 4 0.26 acre x I O
OINELNCNSTO S?EIH09f1EGOM1110N£(er.trJetlW)
Go out Brockdale Rd., right onto Oak Park Way, right onto Hemlock CL, property first lot on o
the right.
o � o
I � 10
mEnrre6u�aaEomorwxRmw.womrrw+®wsreEwAeemrm,srxYerr®v. rn
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE/FI.N.URE 901RCENrc iapuGy Wpasel
DV NTM Dx NTENPNCF/P .NG E3BUBI,MGPERYR r]NGEIE E r�GOAe+AEN (]OTHER:
MSPELTOR 906 LCG6 OCRIaTB ICONORGNS
TNT' �1111�yP��i
ads r� sl
IS- 3z" Gm¢o(5 R.j
� stom+
3 DYE L.
LICENSED DESIGN
RRtlID IX4WRl6NlD NefN1A1Kx
eaaw V•VEM G•GW�Y 6-SNM l•LM,I 81.9iT C•CIAY E•E%IREIELY R=0.N18 REDNFED FOR FN4^PPPOVAL.
7
6xNM1lURE O^TE APFlFAT4M E%PIMTpN MTE APPNG M^iWEO,'xBUEL BY MlE
►I i k 117z61/Zas P Z /zoz
TMIB FORY YAYBE BCAIYlFDAND/NYIAEIE FGR 01Bl1C WEW ON THE 1rAEGNCWNIYYYE88RE REN6®,Y/ROts
. i
DESIGN FORM—PAGE ONE Assessor's Parcel Number: 3 2 0 0 5 — 5 0 — 0 0 0 0 5
A design wig be reviewed when 3 comee 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. Cross-section sketch,including all applicable items on checklist.
This form reef be scanned and available for btk view on the Mason C Webalee.Man'mvm rsize: JI"X17"
ss
Pemnit Number: SWG b 72 2Y - N53 Designer's Name: Dale Tahja
Applicant's Name: Jason Webber Designer's Phone Number: (360)46"023
Mailing Address: 42 E.Hembck Ct. Designer's Address: 2450 W Deepen Rd W
shelton WA 118584 Stepan WA 98584
city State Zi C' Suite Zi
k •z"a`t., ;y�.�T e:4^re°`.. � n.:.�C.,' v :.>f £ . 2?,.'^. ''.f•„ ='.
Treatment Device
❑Glendoo Biofilter O Sand Filter Cl Mound ❑Sand Lined Dreinfield ❑Ravcubaing Filter,Type:
❑Aerobic Unit Make/Model ❑Disinfection Unit Makc Model Other: WA
Drainfteld Type
6fCnavity ❑Pressure ❑Trench S(Bed ❑Sub Surface Drip
Septic Tank/Drainfeld Specifications Laterals
Number ofEedrooms 4 Schedule/Clam 3034
Daily Flow:Operating Capacity 360 gpd Length 32 ft
Daily Flow:Design Flow 480 grid Diameter 4 in
Septic Tank Capacity(working) 1,500(eAsting) gal Number 6
Receiving Soil Type(1-6) 3 Separation 3 It
Receiving Soil Appl.Rate 0.0 gpd/ftr Orifice's
Required Primary Area 600 fe Total Number of Orifices Perf. Pipe
Designed Primary Area 600 81 Diameter x in
Designed Reserve Am NIA ftr Spacing X in
Trench/M Width 9 ft Manifold
T=ch/Bed Length 68 it Schedule/Class 3034
Elevation Measurements Length 60 ft
Original Dramfield Area Slope 0 % Diameter 4 in
New Slope,If Altered 0 % Preferred manifold configuration used? ❑Yes RfNo
Depth of Excavation UppAw 36 in Transport Pipe
from Original Grade 36 in Schedule/Class 3034
Designed Vertical Separadon 36 in Length 30 ft
Gravelless Chambers Required? Ed Yes ❑No ❑Optional Diameter 4 in
Pump Required? ❑Yes fffNo Dosing and Pump Chamber
Pump/Siphon Specifications Number ofdoses/day Gravity
Diff.in EIvr4on Between Pump&Uppeamoa Orifice X it Dose quantity Gravity gal
Drainfield Squirt Height/Selected Residual(head) X ft Chamber Capacity(flood) Gravity gal
Uppermost Orifice❑Higher O Lower than Pump Shutoff Pump controls:Please check those required.
Capacity(a}Total Pressure Head x cum OTimer DElapse Meter ❑Event Counter
Calculated Total Pressure Head x ft If Timmer: Pump on NIA ,Pump off NIA
Comments
Use existing septic tanks. Using easement on tax parcel 32005-50-00043, granted by Oak Park
Homeowners Association 4 FIV: zi t g y
DESIGN FORM—PAGE Two Assessor's Parcel Number:3 2 0 0 5 — 5 0 — 0 0 0 0 5
Permit Number: SWO
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:
A soil logs fid Trench/bed dimensions and Rf Septic tank
9 Property lines critical distances within layout lif Drainfield cover
19 Existing and proposed wells R1 D-Box/Valve box locations Reference depth from original grade
within 100 ft of property R1 Septic tank/pump chamber and restrictive strata:
m Measurements to cuts,banks,and locations GN Laterals,trench/bed,top and
surface water and critical areas 9 Observation port location bottom
19 Location and orientation of 19 Cleanom location ❑ Curtain drain collector
curtain drain and all absorption Ed Manifold placement ❑ Sand augmentation
components ❑ Orifice placement Other cross-section detail:
0 Location and dimension of Lateral placement with distance Rf Observation ports/clear outs
primary system and reserve area to edge of bed Other Information
lri Buildings ❑ Audiblelvisual alarm referenced Yes No
la Direction of slope indicator fid Scale of drawing shown on scale Ed ❑Design staked out
id Watedlines bar Ed ❑Recorded Notices attached
Roads,easements,driveways, ❑ ❑Waiver(s)attached
parking ❑ ❑Pump curve attached
21 North arrow and scale drawing 56 ❑Evaluation of failure
shown on scale bar Non-resideatial justification
❑ ❑ Waste strength
❑ ❑Flow
DESIGN APPROVAL
The undersigned designer t be notifie igt le at time of installation
�lid Yes
�q❑ No
t
Signature of Designer Date
The undersigned has reviewed this design on behalf of Mason County Public Health and l 'i
compliance with state and local on-site regulations:
I� Z Z6 Z- b�
Environmental Health Specialist Date
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDM Hc�
✓ The design is stamped"Approved"by Mason County Public Health.
✓ The Onsite Sewage Permit bas not expired,the Permit Expiration Date is: - Z IAA
✓ Drainfield site conditions have not been altered to adversely affect conditions of design approval. /4
Soy
Please Note: The system must be installed by a certified inst ??o
unless prior authorization is obtained from Mason County Public 44*17
4
An Installation Fee is required. r'
This form may be scanned and available for public view on the Mason County Web site.
Updated Date: 12/7/2015
o
�Q
s ,
R w
oyryFN`co1�14 �� o \ /
oy1 U
FgIT \
SeQ'�� ark Se#
APPROV
MASONCOUNDEC
? POpy 3 "J7 �Nr
��R ONMEN7AG HF ` 5100214
q qG Dale L.Tattle
G LICENSED DESIGNER
CO3
G
tt
3b' 61
)--4
X
llk
Installation/Maintenance 9ON'04 41F00?,?o zb
F zy
Gravity Distribution/Bed Systems oq�a�FNrq`HFA`
1. Install bed bottom level and in contour with the ground.
2. Install drainfield during dry weather and soil conditions.Any soil smearing must be
eliminated by hand raking any areas that get smeared.
3. Divert all storm water run-off away from septic system components.
4. No curtain(french) drains allowed within 1 Oft. of the up-slope edge of the drainfield and
reserve area.
5. No curtain(french) drains allowed within 3011. of the down-slope edge of the drainfield
and reserve area.
6. Have the septic tank pumped or inspected every 3 to 5 years.
9. All material and workmanship must meet County and State requirements.
8. Install risers on D-Box.
9. Deviation from this approved design without prior approval from the Designer and
Mason County Health Department will make this design null and void.
10.The prepared Site Plan is not a survey, it is the owner's responsibility to verify property
line locations prior to installation. Any discrepancies must be reported to the Designer
immediately.
11. Locate all utilities prior to starting installation.
x� 510Dg1! F.{
o Dale L.lyhp
LICENSED DESIGNER
�1