HomeMy WebLinkAboutSWG2024-00428 - SWG Application / Design - 10/31/2024 MASON COUNTY 415NBTHELTON. , 0427-97 ,EXT 404
SHELTON:360<2]-4467,EXT 400
BELFAIR:360-275d46],EXT 400
Public Health & Human Services ELMA:3604825269,EXT 400
FAX:360-427-7787
On-Site Sewage System Permit: SWG2024-00428
APPLICANT BRIAN WILLIAMS Phone: 360-275-8063
Address: PO Box 741 BELFAIR, WA 98528
OWNER HUTSELL PHOEBE G Phone:
Address: PO BOX 741 BELFAIR,WA 98528
SEPTIC DESIGNER ROD LEFT' Phone: 360-698-8488
Address: PO BOX 2954 SILVERDALE,WA 98383
Site Address: 261 E Forest Dr
Primary Parcel Number: 222215300107
Permit Description: Table IX Repair: 2-Bedroom Whitewater ATU w/Glendon Biofilter
Permit Submitted Date: 10/31/2024
Permit Issued Date: 12/11/2024
' Issued By: David Anderson
Current Permit Fees Paid: $805.00 (additional fees may be reauirtd ucon installation of aystem).
Permit Expiration Date: 11/01/2025 (based on dale of i Pfxttmn)
Permit Conditions:
1 Proposed development subject to zoning requirements and approval by the planning
department staNper Mason County Title 17.
2 Permit must be installed by a Mason County Cefbfred 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 prior to
backfill ofsystem components.
6 Mason County Asbui/t 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.govlhealthienvironmentaVonsiteloss-inspection-request.php or call:
360.427-9670,extension 400.
OFFICIAL USE ONLY
MTFRf6fYFD.
MASON COUNTY �Q` 3�"2DO
COMMUNITY SERVICES M° " ° 0 n" o y
Y Publk Hea"(UmmunRy HeskhXnAmnm lalHeakh) < y
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ON-SITE SEWAGE SYSTEM APPLICATION 3 X
ITTIT!APPLICANT PHONE r
Brian Williams 360 275 8063 3
MAILINGAC°RESS-STREEIIV..C ,STATE,ZIP CODE
PO Box 741 Belfair WA 98528 p
SITE ES STREET,CItt.LP CODE Belfair WA 98528 I N
261 61 E.. Forest Dr
Rod
PHONE360-698-8488 I N
Rod Left PHONE o ^'
NAME CF INSTALLER
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see map
1
OCT 31 2024
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NTEMUST BE FLAGGED FROM MAM ROADAND lFSTIM)LES MUSTBEFLAGGEO IMRa TEST MOLENUMBER4 By I I O
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE IMWRE SOURCE Bm mP^R w pugw®I
❑VOLUNTARY ❑MAINTENANCEIPUMPING ❑BUILOINGPERMIT ❑HDMESALE [3COMPLAINT CTOTHER:
INSPECTp1501`LOGS COMMENTS/CONDITIONS
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PATE AFPLI TICN EXPIRATION Can MPLI MtOVM IAUEG BY DATE
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THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBUCVIEW ON THE MASON COUNTYWEBSITE REVlsm lNOptf,
DESIGN FORM—PAGE ONE Assessor's Parcel Number. 2 2 2 2 1 — 5 3 — 0 0 1 0 7
A design will be reviewed when 3 copies 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
v Scaled plot plan,including all applicable items on checklist. v Cross-section sketch,including all applicable items on checklist.
This form maybe scanned and available for public view an the Mason County Web sips.Maximum Paper size: 11"X 17"
Permit Number: SWG 20Z4 -QQg96 Designees Neme: Rod Left
Applicant's Name: Brian Williams _ _ Designer's Phone Number: 380-fi98-8488
�'Mailing Address:
PO Box 741 Dcsi s Address: PO Box 2954
Beffair WA slim Silverdale WA 98383
Ci State zipCi State Zip
GN PARAMETERS _
Treatment Device
S(Glendon Biofilter ❑Sand Filter 0 Mound 0 Sand Lived Drainfield ❑Recirculating Filter,Type:
91 Aerobic Unit Make/Model tNHi' WTL[i O Disinfection Unit Make/Model Outer
Drainfield Type
❑Gravity ❑Pressure ❑Trench ❑Bed ❑Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 2 Schedule/Class NA
Daily Flow:Operating Capacity 110 gpd Length NA 11
Daily Flow:Design Flow 240 gpd Diameter NA in
Septic Tank Capacity NA gal Number NA
Receiving Soil Type(1-6) 4 Separation NA ft
Receiving Soil Appl.Rate X 0- �gpd/ft Orifices
Required Primary Area L4013 ft Total Number of Orifices NA
Designed Primary Area ftr Diameter NA in
Designed Reserve Area � _ 82 Spacing NA in
Trcnch/Bed Width 7. ft Manifold
Trench/Bed Length 97- ft Schedule/Class 40
Elevation Measurements Length 10 ft
Original Drainfield Area Slope 3 % Diameter 1 in
New Slope,If Altered 3 % Preferred manifold configuration used? 0 Yes 0 No
Depth of Excavation ui,stpc NA in Transport Pipe
from Original Grade Bownslape NA in Schedule/Class 40
Designed Vertical Separation 12 in Length 15 ft
Gravelless Chambers Required? ❑Yes 0 No 0 Optional Diameter 1 in
Pump Required? Ill Yes 0 No Dosing and Pump Chamber
Pump/Siphon Specifications Number ofdosea/day 144
Difference in Elevation Between Parole Shutoff and Uppermost Dose quantity 1.6 gal
Orifice s' it Chamber Capacity 1000 gal
Uppermost Orifice If Higher 0 Lower than Pump Shutoff Pump controls:Please check those required.
Capacity(a)Total Pressure Head gpm RfTimer lifElapse Meter &(Event Counter
Calculated Total Pressure Head NA ft If Timer: Pump on 14Sec ,Pump off 10min
Comments
DESIGN FORM —PAGE TWO Assessor's Parcel Number:2 2 2 21 -- 5 3 -- 0 0 1 0 7
PermitNumbcr: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
d Test hole locations 6f Drainfield orientation and layout Reference depth from original grade:
Lrlr Soil logs N(Trench/bed dimensions and Itd Septic tank
Pf Property lines critical distances within layout d Drainfield cover
d
❑ Existing and proposed wells /D-Box/Valve box locations Reference depth from original grade
within 100 It of property E Septic tank/pump chamber and re�ltrictive strata:
❑ Measurements to cuts,banks,and /locations �J Laterals,trench/bed,top and
surface water and critical areas 0 Observation port location bottom
❑ Location and orientation of d Clean-out location ❑ Curtain drain collector
curtain drain and all absorption I( Manifold placement ❑ Sand augmentation
components ❑ Orifice placement Other cross-section detail:
Location and dimension of ❑ Lateral placement with distance Or Observation ports/clean-outs
primary system and reserve area to edge of bed Other Information
5( &"ldings E(/Audible/visual alarm referenced Yes No
d Direction of slope indicator p Scale of drawing shown on scale ❑ C 3esign staked out
d Waterlines bar ❑ 0 Recorded Notices attached
d Roads,easements,driveways, ❑ P curve r}�arver(s)attached
parking ❑/ cYpump attached
R/North arrow and scale drawing H ❑Evaluation of failure
shown on scale bar Non-,r�/Qgidential justification
❑ rr Waste strength
❑ Now
DESIGN .APPROVAL.
The undersigned designer must be notified by rust r time of instal u M Yes ❑ No
/? V-400V
Sign3pA of Designer Date
The undersigned has reviewed this design on behalf of Mason County Public Health and de AAM
be in
compliance with state and local on-site regulations: %
I Z/lI /Z li- �t 0410 VF
Environmental Health r Date CO f
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CON]F a
✓ 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 may be scanned and available for public view on the Mason County Web site.laced Date: 12n/101;
Washington Glendon,BioFilter Design Manual .
November 29,2010
Page 17 of 23
Glendon®BioFilter Model M31 Worksheet
Slopes 0 -< 5 %
Basin Capacity, GPD �D
Basin Dimensions L__k; W_S_D
Soil Absorption Rate,Gal/Ft`/Day _f)b
9°+a.m.R amnroro-sx smw 5ecffaitF'iailyTYBig"
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_ A'OR
GPD X 1"/4 GPD =30
Rim available= d/gSONCO4N���
0
Basin volume required= l2o GPD X 2.2ft.3/GPD 40�q N*FNI4Z11
Basin volume available—
Absorption area required= lao GPD/(_Gal/Ft2/Day = °--Ft.
2
Primary area calculations
K-L' A'14- Sw FT
a rs - 9X6 = a2) , 5%
Reserve area calculations
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fiMP1R69 it199124
r lncludmg the annular spsce. 1
0 Gledon,BicFiftu Technologies,Ina 2olo All rights reserved.
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