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Home My WebLink AboutSWG94-02077 - SWG Application / Design - 12/16/1994 ON-SITE SWAGE SYSTEM SITE EVALUATION AND DISPOSAL PERMIT . . _ MASON COU,TY DEPARTMENT OF HEALTH SERVICES PERMIT NO. SING _ m 426 W.CEDAR/P.O.BOX IW/SHELTON,WA 98584 Date •�� D I t ti PHONE(206)427-9670 Receipt Amouma CHECK APPLICABLE ITEMS MAILING ES Yrl P NE: NSTAUNG NEW SYSTEM ao, P iDSYSTEM - CITY: z q� TA NDING SINGLE FAMILY M a PROPERTY ADORE 2 Af O y. TIER '12SPECIFY: SPECIFIC DIRECTIONS FOR LOCATING SrtE: T PRIVATE MILL (1iy3'JE3 �,cygATH � ,� riiA.fi / PUBLICSYSICSYGTEM / SYSTEM ID ER SYSTEM gAME NAME / APPLICAN �hv �)T cree k NTEA ME MAI INme o la Qnsmler Namof Davie"e` K SIGM W emoms x NE PLOT PLAN Draw edmens onal InC UtlYIg sh -w 0 O Proof.location m b holes own V measured tlspa �® pmpeNy,bound ❑Entry ra ;olhGloeds, CO d—s NOTE: DON AWIN" \ N SYSIGN T �' 'fW � 3 D#OUB OFFICIAL USE ONLY. DO NOT WRITE BELOW DOUBLE LINE IZW 7L` z SOIL LOGS ,-Z.? Z•t zz S-Apal 1- 3 zll R^54 carve OL 2s -WoFv 1u W. -6- SINI�r_orJM•L-�/T rWrF.,4;.,,_ .. F w"+4.Lrr,cL Depth from Original Grade to ResMoUve qq Layer or Water Table: In. DESIGNER DESIGNATION SCORES MINIMUM SYSTEM REQUIREMENTS FIMin Smre Designer Level: 0One A)wo Soll Type 4 Z Vemcel Separation ? o. /Sr Septic Taws, Daily Capacity: /.RR.0 Bel. Flow: 36 0 GPD Slope n InK Parcel Size y1 11 Ac. -7 Rate G+ GPD/FT' Area L O O FT' Distanceto Shoreline N N. M Inapecror 1 COMMENTSICONDITIONS FOR APPROVAL Any change from Na treated use of me property or any site alteration affecting the system desiggn may invalidate Nis permit. TNa Per Any a. 3 years from dale of she Inspection.Denial of this permit maybe appealed to the Health DllkersdlhN 10 days of denial date. SIIE:QAppmretl Rapved ❑NMATp DESIGN: OAppmnW ❑Nat Approved INSTALLATIONA Approved 0Wl Approved �' BV: y1—'^v-�•/ DATE: BY: DATE: 1,N DATE: JUL 13 M 7' �k 0 Q his R �� -T a-C-5 '< No S� o 8�`t PART 4: HEALTH DEPARTMENT REVIEW (OFFICIAL USE ONLY) SOIL LOGS AND SITE CHARACTERISTICS TEST HOLE #1 TEST HOLE #2 Cl A Depth of root penetrations Depth ss� root penetrations 23 Depth to mottling: Depth to mottling: Depth to restrictive layers Depth to restrictive layer: Soil Types Soil Type: Vertical Separation:- vertical Swra, on t" L— Curtain drainable? (Y/N/NA): —;4�01 Slope (%) . Shoreline? (Y/N) : Minimum lot Bizet' Designer level- A vsst,,st, sep=stl is t]sm d"n of 6 Uisssta6, "Wass, uoSLtw.s *011 of TsP`B 2-6 s"st Mists Mtwe tst,,,B of tla .,Assirt. b luos ]fs � s6 vsst1.1 tsssP�!!!! of d,ssi,,ss, Is,sl s111 W w1cul.tM sy, Us M th dp. t 12-1.b ssB.,tion tBi . trsmsis. . M,z,azz It, Mists ,,,,,j@* w s,s, mgjsuvisims and is defisssi Ms Us auuBsB isiss ss.s Pr �.16.s* `s` tsslastisjt g,silatlass, (450 Is,11.. p.t "I)- T'N ,e -r o -/,? � ,Mk/�� (,Jo L�,AJIV skez'(5L ............................... ........... ......... ....... ...... ........................... .. ...... ......... . ... ......... ................... INSPECTOR DATE PART 3. HEALTH. DEPARTMENT REVIEW (OFFICIAL USE ONLY) .................... SOIL LOGS AND SITE CBARACTERISTICS Teat Pit A Teez-jz� D'i9 4SMoa LeM c>- 2�`S v Cerfi, Q D 914y tAt^ ID V S {JY Let', IaA if-," n �i�r sa '�o' CEws�r/� Z3-2�' *oe iic Depth of of pen.: L 1 Oepth of twt (on.! _�V Depth of toot pen.: � Depth of that pan.: (� Depth of nottling: Depth of mottling[ rie Depth of mottling: (4 �- Depth of mettllvg: e Depth to at. lent: 4 A Depth N tut. layet: DryN u to tt. layer: Depth tofeet. layer: Soil type (USDA): Soil type (USDA)[ Soil type (mu): Soil two (U®A): Teef..YLCi �� Tee!TSL�H '� /tP....... ?bet Yit HDepth eft t pen.: Depth o[ t pen.: Dap Oeptp that pen.:Dept oL tt1Lp: Depth oL Cling: Dp OepN oL ro[tling:.:p. t teat. lyef: Depth N test. layer: Dep Depth N met. layet: _ foil (USDA): shil type (USDA): Soil-typ (USDA): y I Sal type (USDA): Curtly drain nmdedt&(&_ Cettain stale waded? Cefteln drain neaded] 'Y'I -Cut-tale drain needed? w_ 1^ D � Slope (\): to Slop p(\): '� 1& slope (\)z 5� Slope M, •Y ."tell..? (Y/M): shorslihs? (Y/e)t rf slnnlins? (YIN): ) ^ Shoreline? (Y/s): Mlnimm let size[, HSnSmum lot hiss[' ` MNiaw lot else:, Mtn,— lot elzsi 1 Mlkw lot site applies N nea subdivisions and Is defined as the minlmum allowable land area per f.eldenne at malden- tial equivalent (e50 gallons p¢ day). k !n [r7/� earl fir n IF� � , Revised 09/01/9'. PART 3: HEALTH DEPARTN[INT REVIEW (OFFICIAL USE ONLY) ....................................... .............::- -::............ .......... .......................... ................... ................................................................................................ SOIL LOGS AND SITH CNARACTHICISTICS • ant TwNryff-K— � Dept: of pen.; . ,Depth of . t pan Depth of root pen.: Depth of root en.: — Depth of nottliml Depth of mottling: ::Pth of nothling: Depth of mottling: — Depth to ...t. la,%�: Depth DO rest. imar: Depth to ... IsPars 4) , Depth to rest. la,at: — .oil type (usm), Soil type (usia): sodi type (usmh)c —V-- Sail type come): Test Pit N Toot Pit a Tang Pit B ft.t Pit B Pit B at t Depth of not P..: Depth a/�rmt �n.! Depth .1 root P...33 h/.f root pan. tile D:P�. : mottling: Depth f mottling: De, Of ®tiling: pt1S of mottling: — —ttling n. i Depth t rest./1.�; Dept to, teen. 1.,.: Do, to at. 1.�r pth w rest. Infer% — Sail t� (USDA): Soil ,a (USDA): Sot -type (usm): Soil type cusma)z cOrtain ordim neaded2 Cortnin Orel. =T cartels, Sris .—saa? �aia assosi? Nsfaln Slope % 'I" slope (1): Slope (t): Shoreline? (Y/Y): N shoreline! (Y/N): f4 .1hosellos? MR): ahslin.? (Y/N): hi.1sem lot air.:- 1 minions, lot ira:^ Mininw lot i..:- • MIDI— lot alaa,;a Nsi. lot air. applies to and is defined ae the siolesse -11—bl- load use Per reeident- on --id-- tial ahivalaht (150 gallons par day). comms :94U I tAIK TL dy z1om Revised 09/01/92