HomeMy WebLinkAboutSWG2021-00603 REVISION TO OSCAR X02 - SWG Application / Design - 5/28/2024 ------------
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OFFICIALUSEONLY
MASON COUNTY PUBLIC AEALTH
ONSITE SEWAGE SYSTEM APPLICATION a1SN6th5bL 1BM98) Sh WWA98S840
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DESIGN FORM-PAGE ONE Assessors Parcel Number:521 -z-2 -- -,�> - sGQ S
A design wN be reviewed when 3 coi of each of the following me subs tred: � hnble hems on cbecldiM
•Completed design form that has M ate
en signed and dd. Scaled le ut sketch,secluding app
v Scaled plot plan,including all applicable items on checklist Crossaection sketch,including all applicable itehe 1 ehX 17"t.
This form may be scanrnd and wnnabla for bi Mew m this Mason tau Wab ahw Masiinws alu' ll X 17
_ Designer's Name. s
Penru Number: SWG �51.'LYtS;
Applicant's Name: All AA Designer's Phone Number:
,S DesigoePe Address:
Ni �` /�✓
M Address: rl !al L `l.♦• '`V'3'.�
/Hd114 IlA
C State 7m Ci Stan Zi
Treatment Device
Glendon Biofiller nseral"lrcc OMosnd U5zrA road DraiMeld ❑nermulMrog Fills.Type'. Jn
❑A.tn,Unit Makmidel ❑Disunion-Unit MakelMcdel Other:
Drainfield Type ❑Sub Surface Drip
❑Gravity ❑Pressure ❑Trench ❑Bed
Septic Tank/DnlaDdd SPecifiatlom Laterals
J
Numbs of Bedrooms 2 Schedule/Class ft
Daily Flow:Operating Capacity 2(oU gpd Length
Daily Flow:Dealgn Flow BPd
Diameter in
Septic Tank Cap gal galNumber
Separation ft
Receiving Soil Type(1-6) OAfiees
Receiving Soil Appl.Rase
Required Primary Ares 0 gs Total Number of Orifices y
U U Rt Diameter in
ary
Designed Prim Area / � in
DesignedResuve Area (O�V ftr Spacing
ft M ' old S Trench/Bed Width � ft Schedule/Cless
Trwch/Bed Ixngm
Len
gth W AJ ft
Elevation Measurements in
OriP°el Dannfield Area Slaps 1 % Diameter
_�_ Prefmad manifold configuration used? ❑Yes 17 No
New Slope,if Altered Tnnsport P1pe
Depthof Excavation U"Wp° N A in M
fiam Original Grade mxu�jp in Schedule/Class
in Length 8
Designed Vertical Separation 1 in
Gnvellese Chambers Required? Yea o []Optional Diameter �---
as ❑No Doi mid Pump Chilli n�
pump Required? Number ofdo-eijj� iL lii
Pumplstphon Specnlcadona bl galDiffareace in Elevation Between Pump Shutoff end UPPo^^^Oet Dose quantity
O fin .S
/ _ ft Chamber Capacity 1 (J.�b--�— gal/ ❑Lower then Pump Shutoff Pump coanols:Please check those tequirzd. //''
uppermost Orifice,CS Wgha � � 01ffe!>ee Meer !?Event Couma
Capanry8Total Press'me Head La 05a �ft H Timer: Pump on � V� PAP off�,f.
Calculated Total preMma Head ��. ..__
Comments
DESIGN FORM—PAGE TWO Assessor's Parcel Number: Z1Z�1 - 1 — U01'15
Permit Number: SWG
DESIGN CHECTia M
rPlotPlant Plan Seal ayout Sketch Cross-Section Sketch
le locations nfield orientation and layout Referent th from original grade:
s Tenhibed dimensions and Seytic tacky lines �/ca�cal distances within layout ()/6rv�eld cover
g and proposed wellsofD oxNalve box locations Reface depth from original grade
100 ft of property C? Septic tank/pump chamber and reestrictive strata:
ements m rots,banks,and locations p�I-atemis.7mchhed,nap end
surface water and critical areas �lbservation port location bottom
d p Curtain drain collector
❑ Location and and all abs of Cleaz'old locatim ❑ Sand augmentation
curtain drain and all absorption �vlanifold placement
mpments ryOrifice placement Othff;' saction l)orts
Location and dimension of :/ [YObservation portslclemouta
Lateral placement with distance
many system and reserve area to edge of bed Other Information
�mldings ��diblelvisual alarm referenced Yes No �
i 'on of slope in Q'Scale of drawing shown m scale ❑ ecord staked out
Waterlines bar ❑ ❑Recorded Notices attached
❑ p Waiver(s)attached
Roads,easements,driveways, ❑pump curve attached
g [I ❑Evaluation of failure
parking
arrow and scale drawing
shown on scale bar Non-residential justification
❑ ❑Waste strength
❑ ❑Flow
DESIGN APPROVAL
The undersigned designer must be ooti,,.H*msisher at tune of installation es ❑ No
Y yi '
Signadue of Desi. Deh
The undersigned bas r s design m behelf of Mason County Public Health and determined it m be in
compliance with state and local on-site regul :
QNnl�lwdi
Envo mental Heattif Specialist DMe
CAUTION: DESIGN APPROVAL IS�County Public
aDND Health'ER FOLLOWING O DM N:
✓ The design is stamped"Approved"by
✓ The Onsite Sewage Permit has not expired,the Permit Expnstim Dare is:
I Dounfreld site conditions have not been altered to adversely affect condltions 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 re uired.
This form may be scanned and available fw public view on the Mason County Web site.pdared Dare: 12n12015
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Peninsula Septic Designs
P.O.Box 1444
Gig Rotor,Wa"gbu 98335
(253)951-2178
FAX(253)83J-2778
SITE ADDRESS:
A) SYSTEM FLOW REGUEE :
(see Table XY.Oscar LGWeFWW Design Manuel PgA)
a.) System Design Flows- ""fi(p avd
b.) Total Number Coils— -
a) Total Number L turals-
d.) Dow GPM
e.) Flush GPM-------. 6� 9
£) Excess TDH / � �O
g.) Elevation Loss/GPM— l 5
h.) Length of Supply Line- - D — 2.D F-L(Q/K)I"
i.) Total Excess TDH
(Frictioo Loss 2.0 +Elevation GshvLos16LI5 =85 )
B) SYg M BASAL AREA REQUIREMENT;
a.) _ 3(<!J GPD/ C�J GPD/Ff2 � �
b.) Coil Length= X7= Z I witit 6"spacing+ M '� i + ZA — 2Z
c.) Minimum Shoulder Width Q 6"(2X6"51'=
d.) minimum Basal Area- L�
e.) CXJ SQ.FT.
£) 1 A s•,� 4zgm
h.) ReWd
i.) Coil Length+ + +Side Slopes
j.) Minimum BaW Area �•
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