HomeMy WebLinkAboutSWG2024-00442 - SWG Application / Design - 11/12/2024 MASON COUNTY 415 N BTH STREET, 0427-9 7 ,E 98594
SHELAIR 360-2M4467,EXT 400
BELFAIR:360-275-046),E%T 400
Public Health & Human Services ELMA:360.482-5269,EXT 400
/ /FAX:360427-7787
On-Site Sewage System Permit: SWG2024-00442
APPLICANT ANDERSON BRADLEY T&HILLARY A Phone: f
Address: 2420 NE BOULDERSTONE CT POULSBO, WA 98370
OWNER ANDERSON BRADLEY T&HILLARY A Phone:
Address: 2420 NE BOULDERSTONE CT POULSBO, WA 98370
SEPTIC DESIGNER BOB PAYSSE' Phone: 360-426-1803
Address: 3083 E Mason Benson Road GRAPEVIEW, WA 98546
Site Address: UNKNOWN
Primary Parcel Number: 221055100057
Permit Description: New 3bd Biobarrler to pressure trench with local waiver
Permit Submitted Date: 11/12/2024
Permit Issued Date: 12/09/2024
Issued By: Rhonda Thompson
Current Permit Fees Paid: $540.00 (oddiuorol tees nuu,W matured upon Installation or rysle,n).
Permit Expiration Date: 11126/2027 (eases on dale 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 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 Designer/Engineer installation approval pnor to
backfill 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.
OFFICIALUSEONLY
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ON-SITE SEWAGE SYSTEM APPLICATION
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APPLICANT PHCNE m
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BRAD ANDERSON c
MAILING ADDRESS-STREET OTY.2420 N STATE,E BOULDERSTONE CT POULSBO WA 98370 m
SITE ADDRESS
MASON TREET.CITY.zIP CODE p?
LAKE DRIVE WEST GRAPEVIEW WA 98546 ^�
NAME OF DESIGNER PHONE I N
ROBERT H. PAYSSE 360-426-1803
NAME OF INSTALLER PMg1E S2
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PERMIT TYPE( —T CHINNING W\TER SOURCE y
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Ji RESIDENTIALOSS EDCOMMUNITYOSB 15COMMERCIALOSS JI PRIVATE INDNIDUALWELL 51PRNATETVW�PART WELL 2
TYPE OF MORN(AS.a N ®PUBLIC MMTER SYSTEM
®NEW OONSTRUCTION I UPGRADES REPAIR/REPLACEMENT OTHER DETAILS(WM M(PIT A'P'yl OTABLE IX REPAIR IU1
SURMmus [3SURFACING SEWAGE [3EXISTING FAILU RE OSHOREUNE m
pp11
DESIGN FORM(REQUIRED) MYSEPTIC DESIGN(REQUIRED) BEDROOMS LOTSME l�rlR I �
§rWAIVER(S)(IFAPPUCABLE) 3 0.5
DIRECTIONS TO SITEAND SITE CONDITIONS(M,bdMpMl
N HWY 3, LEFT ON MASON LK RD. CONTINUE TO MASON LAKE. LEFT ON MASON 10
LAKE DRIVE WEST (BACK SIDE OF LAKE). FOLLOW AROUND TO SITE ADDRESS r
3350 AND TURN LEFT UP HILL (NON WATER SIDE) ON ACCESS ROAD TO BACK o 0
SIDE OF APPLICANTS LOT. SEE SITE PLAN. I (n
glEYU9TBEMGG[D IHJMY.VNROADAND IFSTMDIE9YV9i BFF4DGED HTM iE9TNOL[NWBEMS. I V
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE/FAAURE SOURCE impolM9 WIWH'N
OVOLUNTARY OMAINTENANCEIPUMPING O BUILDING PERMIT OHOME9ALE ❑COMPIAINT OOTHER:
RHPECTORSOILLOG9 ...NTE/CONDITIONS
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flECORD DRAMANG AND INSTALLATION REPORT
$OILOODES:
V-VERY G=GRAVELLY S=SAND L-LOAM SI=SILT C=CIAY E=IATREMELY R=ROOTS REQUIRED FOR FINAL APPROVAL
INSPECTOR SIGNATURE DATE APPLICATION WIRATON DATE APPLICATION APPROVED ISSUED BY DATE
I 'I k I z(, 2-7 Yo Iz(R Fz
THIS FORM MY BE CANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSRE REASED1WO015
DESIGN FORM—PAGE ONE Assessor's Parcel Number: 2 2 1 0 5 — 5 1 — 0 0 0 5 7
A design will be reviewed when 3 copies of each of the following are submitted:
v Completed design form that has been signed and dated. 0 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 may be scanned and available for public view on the Mason County Web site. Slaximum paper s'iee: I/',Y 17
PARCEL IDENTIFICATION
Permit Number: SWG ZDcsigner's Name: ROBERT H.PAYSSE
Applicant's Name: BRADLEY ANDERSON Designer's Phone Number: 360-426-1803
Mailing Address: 2420 NE BOULDERSTONE CT Designer's Address: 3083 E MASON BENSON RD
POULSBO WA 98370 GRAPEVIEW WA 98548
city State zip City State Zip
Treatment Device
❑Glendon Biofilter ❑Sand Filter O Mound ❑Sand Lined Dreinficld ❑Recirculating Filter,Type:
❑Aerobic Unit Make/Model ❑Disinfection Unit Make/Model Other. BIOBARRIER/MBR 0.5-N
Drainfield Type
❑Gravity GI)Pressure &(Trench ❑Bed ❑Sub Surface Drip
Septic Tank/Drainfteld Specifications feterith
Number of Bedrooms 3 Schedule/Class SCH.40
Daily Flaw:Operating Capacity 270 gpd Length VARIES ft
Daily Flow:Design Flow 360 gad Diameter 1.25 in
Septic Tank Capacity(working) MBR 0.5-N gal Number 4
Receiving Soil Type(1-6) 3 Separation 9+ ft
Receiving Soil Appl.Rate 0.8 gpd/fte Orifices
Required Primary Area 450 ftt Total Number of Orifices 51
Designed Primary Area 450 ft Diameter 3116 in
Designed Reserve Area 450 ft2 Spacing 36 in
Trench/Bed Width 3 ft Manifold
Trench/Bed Length 150 ft Schedule/Class SCH.40
Elevation Measurements Length 48 ft
Original Drainfield Area Slope 12 % Diameter 1.25 in
New Slope,If Altered 12 % Preferred manifold configuration used? Gif Yes 13 No
Depth of Excavation ut-slope 12 in Transport Pipe
from Original Grade Down-slope 8 in Schedule/Class SCH.40
Designed Vertical Separation 12 in Length <20 ft
Gravelless Chambers Required? ❑Yes III No 0Optional Diameter 2 in
Pump Required? III Yes ❑No Dosing and Pump Chamber
Pump/Siphon Specifications Number ofdoses/day 6
Diff.in Elevation Between Pump&Uppermost Orifice <10 ft Dose quantity 60 gal
Dminfield Squirt Height/Selected Residual(head) 2 ft Chamber Capacity(Flood) 1000+ gal
Uppermost Orifice fff Higher O Lower than Pump Shutoff Pump controls:Please check those required.
Capacity Q Total Pressure Head 30 gpm gTimer GfElapse Meter GgEVent Counter
Calculated Total Pressure Head 19 It I If 1 ,Pump off 4 HRS
Comments
DEC 0 9 20A
MASON COUNTY ENVIRONMENTAL HEALTH
RET
DESIGN FORM—PAGE TWO Assessor's Parcel Number.2 2 1 0 5 — 5 1 -- 0 0 0 5 7
Permit Number: SWG
=PJnnSMIed
ESIGN CHECKLISTS
t Plan Scaled Layout Sketch CrossSectian Sketch
le locations 19 Dminfield orientation and layout Reference depth from original goads:
s � Trench/bed dimensions andy lines critical distances within layout 19 Septic tank
6L Dminfieldcover
g and proposed wells � D-Box/Valve box locationsReference de from on net100 ft of property Rf Septic tank/pump chamber gee
and restrictive strata:
ments to cuts,banks,and loc ulons
surface water areas lid Laterals,,hench/bed,top and and critical a Observation port location bottom
lb Location and orientation of E9 Cleanout location ❑ Curtain drain collector
curtain drain and all absorption 121 Manifold placement ❑ Sand augmentation
components
m Location and dimension of Pf Orifice placement Other cross-section detail:
primary system and reserve area Iff Lateral placement with distance ❑ Observation porWeleanouts
ro edge of bed
III Buildings Other Intormafion
10 Direction of slope indicator 19 Audible/visual alarm referenced Yes No
Eb Waterline if of drawing shown on scale @J ❑Design staked out
bar ❑ fit(Recorded Notices attached
m Roads,easements,driveways, Rf ❑Waivers)attached
parking fid ❑Pump curve attached
Ib North arrow and scale dmwing ❑ It Evaluation of failure
shown on scale bar Nonresidential Justification
❑ Of Waste strength
❑ Rf Flow
DESIGN APPROVAL
The undersigned designer most be notified kly installeE at time of installation 21 Yes ❑ No
Signature Date gner� pets
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:
Environmental Hmlth tells! pars
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDMON:
✓ The design is stamped-Approved'by Mason County Public Health.
✓ The Onsite Sewage Permit has nor expired,the Permit Expiration Date is: I
✓ Drinfield 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: 1"12015
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PROPOSED DRAINFIELD
OPQ PRIMARY& RESERVE T
FUTURE 1
PSG DRIVEWAY
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PROPOSED -�\ // �J EXISTING WELL�I
BIO-BARRIER , I > \ 0
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AN ASBUILTI INSTALL SIGNOFF FEE WILL
BE CHARGED AT TIME OF INSTALLATION
CUSTOMER BRADLEY ANDERSON T2 CIS A LE k 1 LE 2.
PIONEER DIGGING, INC PARCEL x22JOS3F00057 0,2 IS O6wC WG
SEPTIC DESIGNS ADDRESS: VIM LK DRW ROOTS 24 ROOTS M
3083E MASON BEN40N RD. GRAPEVIEW,WA 9$546 DESIGNER: ROBERT H.PAYSSE
OFFICE-36042 1803 FAX-3604V-B53 SHEET: SITE PLAN SCALE P=9O
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DEC 09 2024
MASON COUNTY ENVIRONMENTAL HEALTH 1 i
RET 1 7'
VALVE
' BOX
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BIO-BARRIER
MBR 0.5-N 1 y.
AN ASBUILTI INSTALL SIGNOFF FEE WILL
BE CHARGED AT TIME OF INSTALLATION I '
PIONEER DIGGNG, NC- CUSTOMER: BMIX.EY ANDERSgV (p24 US HO Ek TFSTHO&MUS E2
rARCEL x 22105-51m057 2,.co GS 3&COWGS
SEPTIC DESIGNS ADDRESS: )000(MASON IK DR W ROOTS-24 ROOTS %
3083EMASON BENSON RD. GRMEYIEW,WA98546 DESIGNER ROBERTHPAYSSE
�FRCE-3604261803 FAX-36014E2353 SHEET: DFDETAQ. SCALE P=IU o��,w..�.•..,•,•
OBSERVATION PORT
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DEC 09 2024
MASON COUNTY ENVIRONMENTAL HEALTH
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LATERAL LATERAL FEEDER TOTAL ORIFICE ORIFICE ORIFICE DBT.TO TOTAL TOTAL
LATERAL# LENGTH PIPESIZE LENGTH LENGTH DISCHARGE SPACING 1STORIFICE IdLD
(feet) (inches) (feet) (feet) SIZE(Inch) RATE(gPrn) (feet) (Inches) ORIFICES (feet)
1 14 1,25 46 62 3/16' 0.59 3 12 5 0.09
2 40 1.25 32 72 3/16' 0.59 3 6 14 0.74
3 54 1.25 15 59 3/16" 0.59 3 18 18 1.12
4 42 1.25 12 54 3/16. 0.59 3 1e 14 0.55
150 51
DRAINFIELDHEAD(feet) 2.51
TRANSPORT LINE HEAD(feet) 0.39
ELEVATION CHANGE Ifeet) 8
RESIDUAL/SQUIRT(feet) 2
EI(TRALOSS/FRTINGS(feet) 5
TOTAL DYNAMIC HEAD[foot) 17.90
TOTAL GALLONS PER MINUTE 30.09
PIONEER. DIGGING, WG RcEL E 2210
SEPTIC DESIGNS ADDRESS. X7W(MASON L.K DEL
3083EMAS0NBDWNRD. GWEVIEW,WA985* DESIGNER ROBFRT FL PAYSSE
O E 36042(,W3 FAX 3fi0427-2353 SHEET. CALAZS SCALE- NA
InstWlotion&System Notes
1.Installer must contact designer for final inspection of the installation prior to cover. All components,including tanks,lids,
transport line,drainfield,and water lines must be open for inspection. A$350.00 fee will be charged for time involved with the
inspection of the installation and creation of the record drawing. The designer reserves the right to charge additional fees if
multiple visits are needed due to installation errors or inaccessible components.
2.This septic design must be installed by a certified installer with the local health department. All components shall be installed
according to state,county,and manufacturer requirements. For Homeowner Installs,the owner must get approval from the
designer and local health department prior to attempting installation.
3.Designer is not a surveyor. Installer must familiarize themselves with property line locations priorto installation. Any
confusion or conflicts with line locations should be reported to the property owner. A licensed surveyor may be necessary prior
to installation to confirm all line locations. Any discrepancies found must be reported to the designer immediately.
4.Dreinfield area may only be cleared by a licensed installer familiar with sensitive drainfield area preservation. The builder,lot
developer,or property owner shall not clear the drainfield area. Any clearing required for drainfield installation shall not
remove or disturb any top soil in Primary and Reserve areas. Removal or disturbance to drainfield soils could render design
void.
5.The property owner and installer are responsible for locating all underground utilities(ex.water,gas,electric)prior to
installation. Any utility locations shown within design drawings are likely approximate and may not be exact.
6.All proposed tanks must be installed on original soils or compacted gravels. Extend all tank connection lines out onto original
soil to avoid settling issues. Risers and lids must be brought to finished grade and left accessible for future operations and
maintenance. Component manufacturers(ex.ATLI,Glendons,)may have other requirements not listed within this design.
7.All electrical wiring shall be done by a licensed electrician or homeowner(if allowed)and must be permitted through Labor
and Industries. Designer not responsible for electrical permitting or other electrical specific code requirements.
8.The proposed septic system should be installed in dry weather conditions. Any failed attempts at Installation during wet
weather conditions may render this design void.
9. Maintain 10ft to waterlines with all septic components. If less than 10ft is required,sleeving in sch.40 pvc is required. If
sewage transport lines and waterlines must cross,waterline must be 18"above sewage line with one of the lines sleeved in sch.
40 pvc 3011 in each direction of crossing.
10.This design may include waiver applications with specific mitigation measures pertaining to installation,operation and
maintenance of the proposed components.
11.Stormwater runoff,footing drains,roof drains must be diverted away from any septic system components. Nocurtain,
foundation,perimeter drains shall be Installed 30ft downslope and loft upslope of drainfield areas.
12.This design is site specific and intended to meet state and county requirements that are related to the system components
being proposed. Any placement of proposed buildings,proposed wells or other non-related items on these drawings may or
may not meet other requirements.
13.All onste septic systems require regular maintenance to verify satisfactory operation. The system owner/operator is
responsible for the continuous operation and maintenance of the system per WAC 246-272AFrtat{otgd fnain®ance
Information,refer to Mason County Public Health Homeowner's Manual,which should be r c ed r I oval.
14.System owner should be cautious of landscaping around septic components. Root intrusion DEC 0 9 1014
can cause premature failure of the drainfield area. In addition,bushes and trees should 1pRgp) MNTYENVIRONMENTALHEA!-
away from lids and other septic maintenance points. T
15. Changes made at time of installation may impact designer calculations,pump sizing,and
compliance w/county and state requirements. Contact designer prior to install w/any x '
proposed variations from design. Changes may result in additional fees and permitting.
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PIONEER DIGGING, INC CS TM ,AD°tSON we s.,w
SEPTIC DESIGNS ADDRESS: E)=MASON LKDRW
308311 A9 NBRWNRD. CRAI'MM WA99546 DESIGNER: ROBERT H.PAYSSE EXPIRES
0MCE 36042GW3 FAX-3 6 0 427 235 3 SHEET: NOM SCALE NA