HomeMy WebLinkAboutSWG2024-00481 - SWG Application / Design - 12/31/2024 (2) LTON,
584
MASON COUNTY 415 N6THELTON:STREET,SHE7-967 ,EXT 400
SHELTON:3fi0-627-9670,EXT 400
BELFAIR:360-2754467,EXT 400
Public Health & Human Services ELMA:360482-5269,EXT 400
FAX W0427-7787
On-Site Sewage System Permit: SWG2024-00481
APPLICANT Casey Ford Phone:
Address: 150 W Lucas Ln ELMA, WA 98541
OWNER FORD ET AL KENNETH ALVAN & Phone: 360-660-5238
SHERRY LOUISE
Address: JARED A R FORD; CASSONDRA J FORD ELMA, WA 98541
SEPTIC DESIGNER Hunter,Adam Phone: 360 753-1226
Address: 2201 93rd Ave SW Olympia, WA 98512
Site Address: 150 W Lucas Lin
Primary Parcel Number: 620177500092
Permit Description: REPAIR TO FAILING OSS
Permit Submitted Date: 1213112024
Permit Issued Date: 01113/2025
Issued By: Jeff Wilmoth
Current Permit Fees Paid: $805.00 (additional fees may be required upon installation ofsysti
Permit Expiration Date: 01/0912028 (batedondate ofnapacfion)
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 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 DesignernEngineer installation approval prior to
backfill ofsystem 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 via it: masoncountywa.govihealthlenvironmentalionsiteloss-inspection-request.php or call:
360-427-9670, extension 400.
OFFICIAL VSE ONLY
MASON COUNTY PUBLIC HEALTH Esw,
D
ONSITE SEWAGE SYSTEMAPPLICATION tl70Y415N6th5treel,(BIdSS) SheltonWA,%584N CSheItaE360427-%70eB400 Belfalr,36Ui754467e4400 /iJ(/ O 0
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CASSY FORD 3606605238
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ADAM HUNTER 3607531226
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p TABLE a REPAIR ❑ SINGLE FAMILY p COMMUNITYMBLIC WATER SYSTEM 2
p TANK(S)ONLY p COMMERCAL SYSTEMNAME: lads
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JAN 13 2025 V °
MASON COUNTY ENVIRONMENTAL HEALTH
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DESIGN FORM—PAGE ONE Assessor's Parcel Number:___ 6209a-76_09092____
A design will be reviewed when 3 motes of each of the following are submitted:
v 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 q hescnede annd avallable for Public view on the Mown CountyWeb site. kfarietam 'size: 7I"X/7"
.. PARCEL IDENTIPIC *TR)N .
Permit Number: SWG Designer's Name:
ADAM HUNTER
Applicant's Name: CABBY FORD Designer's Phone Number: 360-753-1226
Mailing Address: 160 W LUCAS LN Designer's Address: PO BOX 162
ELMA WA 98541 OLYMPIA WA 98507
LTI Slate Zi city Slate Zip
� - DESIGN PARAMCTERS _
Treatment Device
❑Glendon Stuffier 0 Sand Fi ter 0 Mound ❑Sand Lined DrainfcId ❑Recirculating Filler,Type:
❑Aerobic Unit Make/Model ❑Disinfection Unit Make/Model Other:
Drainfreld Type OSCAR III
❑Gravity ❑Pressure ❑Trench ❑Bed ❑Sub Surface Drip
Septic TanWDralnOeld Specifications Laterals
Number of Bedrooms 4 Schedule/Class OSCAR OS100
Daily Flow:Operating Capacity 360 gpd Length PER OSCAR ft
Daily now.Design Flow 400 gpd Diameter PER 0 SCAR in
Septic Tank Capacity 1500 gal Number zcaw Pea-sureaNs
Receiving Soil Type(1-6) 4 Separation PER OSCAR ft
Receiving Soil Appl.Rate 0.6 gpolW tv_ iQ2es
Required Primary Area NO W Total Number�iQces a PER OSCAR
Designed Primary Area 803 ft' Diameter PER OSCAR in
Designed Reserve Area 803 fts Spacing ,� �g PER OSCAR in
Trench/Bed Width 11 ft Q aT 4Ranifold
Trench/Bed Length 73 R Scheddk.lass' ,`2 I 40
Elevation Measurement; Le ,y> 73 ft
Original Dminfield Aree Slope 0 % Diame c3' 1 in
New Slope,If Altered NIA % Preferred m /m.liiguration used? E(Yes 0 No
Depth ofEacavatim Upalnpe OSCAR in Transport Pipe
from Original Grade Doan,, OSCAR in Schedule/Clms 40
Designed Vertical Separation 16 in Length 160 ft
Gravelless Chambers Required? ❑Yes 1113 Optional Diameter 1 in
Pump Required? If 0 No Dosing and Pump Chamber
Pump/Siphon Specifications Number ofdons/day /90
Difference in Elevation Between Pump Shuloff and Uppermost Dose quantity 2.657 gal
Orifice ft Chamber Capacity 12M gal
Uppermost Orifice Of Higher O Lower than Pump Shutoff Pump controls:Please check those required.
Capacity@ Total Pressure Head 12 Van Wfimer StElatim Meter EYEvent Counter
Calculated Total Pressure Head s7817 it If Timer: Pump on 22 SEC Pump off 7MIN 38SEC
Comments
I )
DESIGN FORM—PAGE TWO Assessor's Parcel Number: 62017-75-00092
Permit Number: SWG
DESIGN CHECKLISTS
Sealed Plot Plan Scaled Layout Sketch Cross-Section Sketch
9 Test hole locations EZ Drainfield orientation and layout Reference depth from original grade:
a Soil logs 1f Trench/bed dimensions and 9 Septictank
19 Property lines critical distances within layout ®' Draitdield cover
Eg Existingandproposed wells E f D-Box/Valve box locations
Reference depth from original grade
within 100 ft of property Ib Septic tank/pump chamber and restrictive strata:
fd Measurements to cuts,banks,and locations ❑ Laterals, trenchlbed,top and
surface water and critical areas 9 Observation port location bottom
❑ Location and orientation of 9 Clean-out location ❑ Curtain drain collector
curtain drain and all absorption Ef Manifold placement ❑ Sand augmentation
components 9 Orifice placement Other cross-section detail:
lit Location and dimension of 9 Lateral placement with distance E f Observation ports/clmn-outs
primary system and reserve area to edge of bed
59 Buildings Other Information
9 Audible/visual alarm referenced vas No
lZ Direction of slope indicator Sd Scale of drawing shown on scale d ❑Design staked out
61 Waterlines A ,Ull
❑ ❑ Recorded Ntices attached
E9 Roads,easements,driveways, P p R0VE ❑ Waiv (,)attached
parking ❑ ❑ Pump curve attached
Eg North arrow and scale drawing J N 13 2025 ❑ ❑Evaluationof failure
shown on scale barMASON C YENVIRONMENTALHEALT Nan-residentialjusfincation
JBW ❑ ❑ Waste strength
❑ ❑Flow
DESIGNAPPROVAL
The undersigned designer must 'fie ler at time of installation Ili<Yes ❑ No
12/31/24
a we of Designer Date
The undersigned has reviewe d s design on behalf of Mason County Public Health and determined it to be in
compliance with state and loco rte regulations: C
E r e tat Health S ialist Date
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
✓ The design is stamped"Approved"by Mason County Public Health.
✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: 1Z--
✓ Drainfleld 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 Dale: 12M2015
MASON COUNTY HEALTH DEPARTMENT
ON-SITE SEWAGE DISPOSAL SYSTEM DESIGN
SITE N: PARCEL N:820177500082
DATE SUBMITTED:IMU 021 LEGALUOT N:W IM LOT
SUBMITTED BY: ADM HUNTER
APPLICANT: CASSY FORD
ADDRESS: I W W LUCAS LN
ELMA,WA 80541
I.CALCULATIONS
NUMBER OF BEDROOMS= 4
RESIDENTIAL GPD FLOW= 490
IF NONRESIDENTIAL-GPO FLOW
WILL BE AS FOLLOWS:
GPO=
APPLICATION RATE= 0.6 GPDFT2
REDUCTION=LEWEB AW IT NOREDUCTIDY TAM
GRAINFIELD SIZING
ABSORPTION AREA 800 FT2
TRENCH LENGTH OR BED CONFIG.= 73'X11'
PEROSCAR
H.WATERPROOF SEPTIC TANK
COMPOSITION AND SIZE- I GAL-CONCRETE
NEW OR EXISTING= NEW
III.ORAINFIELD CROSS SECTION
SAND DEPTH
W.PRESSURE CALCULATIONS
USING PIPE CLASS 40
pTFICE NETAHM DRIKINE
LENGTH DIAMETER FLOW FRICTICHLOSS
SECTION (FT) ON) (GPM) (FT)
SUPPLY 200.00 1.00 12.000 15.50BS
RETURN 200.00 tOO 12.M 15.SOB8
TOTAL= 31.0173
-TOTAL HFAD LOSS " Z
1)FRICTNNJ LOSS THRWOH SYSTEM=
2)ELEVATION DIFFERENCE = N4 6.*00 by
TOTAL=
_ 12131124
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nuklo�m
V.CHECK THE PUMP CAPACRY.
wnla: A.Y.McooNMDaoCEN.V2HP PUMP�EI/apMOEw) (PERC3 )
EXCESS TDH BOAR (PER OSCAR)
TOTAL HEAD LOSS OO SYSTEM37.82
STANDARD PUMP CONFIOURATKN11S SUFFICIENP YES
APPROVE
JAI 13 2025
MASON COUNTYJBW NT�HEALTH
12/31/24
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