HomeMy WebLinkAboutSWG2024-00463 - SWG Application / Design - 12/12/2024 MASON COUNTY 615NBSHELTON: 60427-O70,EXT 584
SHELTON:360-275-4467,EXT 400
BELFAIR:380-275-4487,EXi 400
Public Health & Human Services ELMA:360482-5269,EXT 400
FAX 360-427-T 87
On-Site Sewage System Permit: SWG2024-00463
APPLICANT FROST THOMAS J Phone:
Address: 14937 JOY LN SW PORT ORCHARD,WA 98367
OWNER FROST THOMASJ Phone:
Address: 14937 JOY LN SW PORT ORCHARD, WA 98367
SEPTIC INSTALLER JIM HUNTER` Phone: 360-753-1226
Address: PO BOX 162 OLYMPIA,WA 98507
Site Address: 375 W Dry Bed Creek Rd
Primary Paroel Number: 620152490150
Permit Description: New 3-bedroom Gravity System wl Bed Drainfeld
Permit Submitted Date: 12/12/2024
Permit Issued Date: 12/26/2024
Issued By: David Anderson
Current Permit Fees Paid: $540.00 (additional fees msy be requned upon Installation of system).
Permit Expiration Date: 12/20/2027 (based on data mlnapaoJon)
Permit Conditions:
1 Proposed development subject to zoning requirements and approval by the planning
department staffper 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 backfill of
system components.
5 Installer is responsible for obtaining Septic Designer/Engineer installation approval prior to
backffll ofsystem components.
6 Mason County Asbuht 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/envimnmental/onsiteloss-inspection-raquest.php or call:
360.427-9670,extension 400.
If OFFICIAL USE ONLY
MASON COUNTY PUBLIC HEALTH D EM`EN °' 12_ /Z- 102 N a
ONSITE SEWAGE SYSTEM APPLICATION MWMR NID. REOBWDBE
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MAIIINGM°RESS.STREET CITY STATE,ZIP CODE r
14937 JOY LN SW PORT ORCHARD WA 98367 3
SITE ADDRESS-STREET.CRY ZIP CODE w
375 W DRY BED CREEK RD MATLOCK WA 98560 z
NAME OF
DESIGNER PHONE JIMHUNTER 360 753-1226
NAME OE INSTALLER PRONE
CHECKALLMPUCABLE ITEMS DRINKING NN RSOURCE R I�
5f NEW ❑ J
CONSTRUCTION RV HOLDING TANK ONLY Y PRIVATE INDIVIDUALWELL y I--
❑ REPIACEMENTSYSTEM ❑ INSTALLATION PERMIT ONLY E3 PRNATETWOPAR VWLL Z
❑ TABLE 9 REPAIR ❑ SINGLE FAMILY ❑ COMMUNRYIPUBLIC WATER SYSTEM I IV 1
❑ TANKS)ONLY ❑ COMMERCIAL SYSTEM NAME:
❑ UPGRADE TO EXISTING ❑ OTHER: BEDROOMS LOTS-
0 EXISTING FAILURE 3 1.25ACRES
aN Ad m.Mmxw,..^ � r
DI%CTNINSTOSIIE-BESPECIFCMDADVISEOFPNYNEEDEOINFORMATIONFORACCESS(u.b 09) T
WEST ON SHELTON MATLOCK RD TO MATLOCK. DECKER RD 1 MILE LEFT ON DRY f�
BED CREEK RD, TO LEFT ON PRIMITIVE DRIVE JUST BEFORE 371 ADDRESS. r
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sREMIgreEFuOO®/FOMMNH RDAD ANO rEsrxDLesxusree FuaDED MOTHTEsrrxolENweus I"
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE1 FAILURE SOURCE(Iw,y wPu UPPIRD
[]VOLUNTARY OMAINTENANCEIPUMPING O BUILDING PERMIT OHOMESALE ❑COMPLANT OOTHER:
INSPECTOR SOIL LOGS COMMENTSICONDRNINS
TNI1. 1 ' ( LC#45 trwfl
to- 70" Vh ► 03 (I)XI ) 17 ho"
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17^70" V47 /Nds hT bV*M
SCILCOOES:
V-VERY G=GRAVELLY S=SAND L=LOAN SI-SILT C=CLAY E=EXTREMELY R=ROOTS
INSP LTOR SIGNATURE DATE APPLICKDON EXPIRATION DATE AP PROVED BY DATE
121,02014 ►Z z 12s7 r
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 1WhOL5
DESIGN FORM—PAGE ONE Assessor's Parcel Number: 62GI 52496150____
A design will be reviewed when 3 copies of each of the following are submitted:
Completed design form that bas been signed and dated. 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 maybe scanned and available for public view on the Mason County Web site.Maximum paper size: 11"X 17"
PARCEL IDENTIFICATION
I�
Permit Number: SWG ° 7 Designer's Name: JIM HUNTER
Applicant's Name: TOM FROST Designer's Phone Number: 360-753-1226
Mailing Address: 14937 JOY UN SW Designer's Address: PO BOX 162
PORT ORCHARr WA 99367 OLYMPIA WA 9a507
City State zip city State zip
DESIGN PARAMETERS
Treatment Device
❑ Glendon Biofilter ❑ Send Filter ❑Mound ❑ Sand Lined Drainfield ❑Recirculating Filter,Type:
❑Aerobic Unit Meke/Model ❑Disinfection Unit Make/Model Other:
Drainfield Type
h(Gmvity ❑Pressure ❑Trench ❑Bed ❑Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 3 Schedule/Class put, T-t-O'j
Daily Flow:Operating Capacity gpd Length 45 ft
Daily Flow:Design Flow '3 LpV gpd Diameter 4 in
Septic Tank Capacity 1200 gal Number 4
Receiving Soil Type(1-6) .3 Separation Z,5 ft
Receiving Soil Appl.Rate 0.8 gpd/ft Orifices
Required Primary Area 490 Rr Total Number of Orifices N/A
Designed Primary Area disc, fe Diameter N/A in
Designed Reserve Area 4 S t) ftr Spacing N/A in
Trench/Bed Width 10 ft Manifold
Trench/Bed Length 45 ft Schedule/Class arc_
Elevation Measurements Length �(.S ft
Original Drainfield Area Slope % Diameter 4 in
New Slope,If Altered ; R % Preferred manifold configuration used? 0 Yes 0 No
Depth of Excavation UP lc 14 ", in Transport Pipe
from Original Grade Dow -I. 2,4 in Schedule/Class puc, `2."1-r.9
Designed Vertical Separation 36 in Length 30 R
Gmvelless Chambers Required? ❑Yes IN. []Optional Diameter 4 in
Pump Required? ❑ Yes Ed No Dosing and Pump Chamber
Pump/Siphon Specifications Number ofdoses/day N/A
Difference in Elevation Between Pump Shutoff and Uppermost Dose quantity NIA gal
Orifice WA ft Chamber Capacity N/A gal
Uppermost Orifice[]Higher []Lower than Pump Shutoff Pump controls:Please check those required.
Capacity @ Total Pressure Head N/A gpm []Timer []Elapse Meter 0 Event Counter
Calculated Total Pressure Head NIA ft If Timer: Pump on N/A Pump off WA
Comments
•DESIGN FORM—PAGE TWO Assessor's Parcel Number:___ 620-4 5 24 90-1 50
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
0 Test hole locations EZ Drainfield orientation and layout Reference depth from original grade:
Ef Soil logs E9 Trench/bed dimensions and E2f Septic tank
EZ Property lines critical distances within layout Ed Drainfreld cover
19 Existing and proposed wells of D-BoxNalve box locations Reference depth from original grade
within 100 ft of property 9 Septic tank/pump chamber and restrictive strata:
la Measurements to cuts,banks,and locations ❑ Laterals,trench/bed,top and
surface water and critical areas EZ Observation port location bottom
❑ Location and orientation of EZ Clean-out location ❑ Curtain drain collector
curtain drain and all absorption Rf Manifold placement ❑ Sand augmentation
components V Orifice placement Other cross-section detail:
E9 Location and dimension of 19 Lateral placement with distance d Observation ports/clean-outs
primary system and reserve area to edge of bed
g Other Information
IZ Buildings
Ed Audible/visual alarm referenced Yes No
E9 Direction of slope indicator 9 Scale of drawing shown on scale d ❑Design staked out
E9 Waterlines bar ❑ ❑Recorded Notices attached
19 Roads,easements,driveways, ❑ ❑ Waiver(s)attached
parking ❑ ❑ Pump curve attached
lit North snow and scale drawing ❑ ❑ Evaluation of failure
shown on scale but Non-residential justification
❑ ❑ Waste strength
❑ ❑ Flow
DESIGN APPRON All
The undersigned designer must be notifiednNr
installation ❑Yes Of No
t, -ter'.7_4
Signature o esrgner Date p^R
The undersigned has reviewed this design on behalf of Mason County Public Health and detennin`•ed i to
compliance with state and local on-sit [ions: r7F ��
1 Z�2G�10 Z`( �g�"`��MrF�os
En ental Health Specialist Date O✓A rypfNT
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION: HE4[Ty
✓ The design is stamped"Approved"by Mason County Public Health.
✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: 12 )Z lZ
✓ Dminfield 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: 12/7/2015
PAW
MASON COUNTY HEALTH DEPARTMENT
ON-SITE SEWAGE DISPOSAL SYSTEM DESIGN
SITEM PARCELP.62015-24%150
DATE SUBMITTED: 12J10Y2024 LEGAULOT#: LOT 3 SP 1460
SUBMITTED BY: JIM HUNTER
APPLICANT: TOM FROST
ADDRESS: 14937 JOY UN SW
PORT ORCHARD.WA 93367
I.CALCULATIONS
NUMBER OF BEDROOMS= 3
RESIDENTIAL GPD FLOW= 380
IF NON-RESIDENTIAL-GIRD FLOW
WILL BE AS FOLLOWS:
GPD=
APPLICATION RATE= 0.8 GPDIFT2
REDUCTION=LEAVE& NK IF NO REDUCTION TAKEN
DRANFIELD SIZING
ABSORPTION AREA= 450 FT2
TRENCH LENGTH OR BED CONFIG.= 10 FT X 45 FT
II.WATERPROOF SEPTIC TANK
COMPOSITION AND SIZE= 1200 GAL.CONCRETE
NEW OR EXISTING NEW
III.DRAINFIELD CROSS SECTION
DEPTH TO DRAINROCK BOTTOM= 2'4"
ROCK DEPTH BELOW PIPE= 0'-9"
SEPARATION FROM TRENCH BOTTOM TO IMPERMEABLE
MATERIAUSEASONAL SATURATION= >3'-0"
FILL DEPTH= 1'-0"
TRENCH WIDTH= WA
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