HomeMy WebLinkAboutSWG2024-00494 - SWG Application / Design - 11/24/2024 OFFICIAL USE ONLY
MASON COUNTY PUBLIC HEALTH GATRBOEVGD 11-15-24
ONSITE SEWAGE SYSTEM APPLICATION ANWNTRECENEO RECENEDBY online c
415 N 6M StAIBt(Bldg 8) Shelton WA,98S84 y
Shehan:36P427-967OW400 BeHalr360-275W7ek4W SWG 2024 _ 00494 to
O A
Z N
APPLICANT PHONE
DEAN GOLDY 3605846062 m M
"LING ADDRESS-STREET,CITY,STATE rn,ZIP CODE r
PO BOX 159 MATLOCK WA 98560 c
SITE ADDRESS-STREET,CITY,21P CODE
80 N CARP PL HOODSPORT WA 98548 z
NAME OF DESIGNER
PHONE
ADAM HUNTER 3607531226
NAME OF INSTALLER PHONE
TRAVIS VILLINES
CHECKALL APPLICABLE ITEMS DRINKING NMTER SOURCE G
LSI NEWCONSTRUCTION ❑ RV HOLDING TANK ONLY [I PRIVATE INDMOUALWELL N
❑ REPLACEMENTSYSTEM O INSTALLATION PERMIT ONLY ❑ PRIVATETWO-PARTYWELL
TABLE 9 REPAIR I] SINGLE FAMILY RY COMMUNITYIPUBLIC NITER SYSTEM Z
❑ TANK(S)ONLY ❑ COMMERCIAL SYSMIANAME: LAVEOMDIMW
UPGRADE TO EXISTING OTHER: BEDROOMS LOTSITE
EXISTING FAILURE "A4ucDM./np iwubea .3 Q,17 m b W LybgpfOns• r
DIRECTIONS TO SITE-BE SPECIFICANDADVISE OFANY NEEDED INFORMATION FORACCEW HR.trkAE peM)
CUSHMAN POTLATCH TO A RIGHT AT LOWER LAKE TO A LEFT AT N KOKANEE TO A
LEFT AT OLYMPIC TO A RIGHT ON RAINBOW TO A LEFT ON CARP PL TO SITE AT THE
END ON THE RIGHT.
o
STTEMUST BEFUIGGED HgMYAIN ROAOANO TESYNOIES MUSTSEFIAGGEO NRTN TESTHOIENUMBERS
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE I FAILURE SOURCE In,HNNHiI,TwR )
[3VOLUNTARY OMAINTENANCEIPUMPING ❑BUILDING PERMIT [3HOMESALE ❑COMPLAINT ❑OTHER:
INSPECTOR SOIL LOGS COMMEMSICONDMONS
22-24" sandy loam to hardpan with no GW
all test holes similar
ML mom:
V=VERY G=GRAVELLY S=SAND L=LOAM Si-SILT C=CIAY E=EXTREMELY R-ROOTS
INSPECTORSIGNATUR ATp E DATE APPLICN EXPIRATION DATE APPLICATIONAPPROVEDBY DATc
,,k d "--% 11-24-24 11-24-27 dE`T M, 12/16/2024
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 1WMIS
DESIGN FORM—PAGE ONE Assessor's Parcel Number: 422 116-53-004 1 6
A design will be reviewed when 3 copies of each of the following are submitted:
Completed design force that has 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 pape,size.: 11"X IT
PARCEL IDENTIFICATION
Permit Number: SWG 2024-00494 Designer's Name: ADAM HUNTER
Applicant's Name: DEAN GOLDY Designer's Phone Number: 360-753-1226
Mailing Address: PO BOX 159 Designer's Address: PO BOX 162
MATLOCK WA 98560 OLYMPIA WA 98507
city State Zip city State Zip
DESIGN PARAMETERS
Treatment Device
❑Glendon Biofilter ❑ Sand Filter ❑ Mound ❑Sand Lined Dminfield ❑ Recirculating Filter,Type:
VAerobic Unit MakNModel XO2 ❑Disinfection Unit Make/Model Other:
Drainfield Type OSCAR X02
❑Gravity ❑Pressure ❑Trench ❑Bed ❑ Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 3 Schedule/Class OSCAR
Daily Flow:Operating Capacity 270 gpd Length OSCAR ft
Daily Flow:Design Flow 360 gpd Diameter OSCAR in
Septic Tank Capacity 1200 gal Number 3
Receiving Soil Type(1-6) 4 Separation 0.5 ft
Receiving Soil Appl.Rate 0.6 gpd/ft2 Orifices
Required Primary Area 600 ft2 Total Number of Orifices OSCAR
Designed Primary Area 600 ft Diameter OSCAR in
Designed Reserve Area 600 ftz Spacing OSCAR in
Trench/Bed Width 20 it Manifold
Trench/Bed Length 30 ft Schedule/Class 40
Elevation Measurements Length 30 R
Original Dminfield Area Slope 0 % Diameter 1 in
New Slope,If Altered 0 % Preferred manifold configuration used? EYYes 0 No
Depth of Excavation Up-slope OSCAR in Transport Pipe
from Original Gmde DownsloPe OSCAR in Schedule/Class 40
Designed Vertical Separation 18" in Length 15 1t
Gravelless Chambers Required? ❑Yes dNo 0 Optional Diameter 1 in
Pump Required? dYes 0 No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day 411
Difference in Elevation Between Pump Shutoff and Uppermost Dose quantity 0.876 gal
Orifice ft
Chamber Capacity 1200 gal
Uppermost Orifice dHigher 0 Lower than Pump Shutoff Pump controls:Please check those required.
Capacity @ Total Pressure Head 12 Spot ®`rimer EIElapse Meter EtEvent Counter
Calculated Total Pressure Head 14.254 ft If Timer: Pump on 30SEC pump off 3MIN
Comments
max install depth 6"
DESIGN FORM—PAGE TWO Assessor's Parcel Number: 42216-53-00116
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
E9 Test hole locations EZ Drainfield orientation and layout Reference depth from original grade:
Ib Soil logs 9 Trench/bed dimensions and 9 Septic tank
19 Property lines critical distances within layout ld Drainfield cover
19 Existing and proposed wells 9 D-Box/Valve box locations Reference depth from original grade
within 100 ft of property 9 Septic tank/pump chamber and restrictive strata:
Ea Measurements to cuts,banks,and locations ❑ Laterals,trench/bed,top and
surface water and critical areas fZ Observation port location bottom
❑ Location and orientation of Ef Clean-out location ❑ Curtain drain collector
curtain drain and all absorption If Manifold placement ❑ Sand augmentation
components 9 Orifice placement Other cross-section detail:
0 Location and dimension of 91' Lateral placement with distance Ef Observation ports/clean-outs
primary system and reserve area to edge of bed
❑ Buildings Other Information
9 Audible/visual alarm referenced Yes No
❑ Direction of slope indicator ®' Scale of drawingshown on scale d ❑ Design staked out
IZ Waterlines bar ❑ ❑ Recorded Notices attached
IZ Roads,easements,driveways, ❑ ❑ Waiver(s)attached
parking ❑ ❑ Pump curve attached
E� North arrow and scale drawing ❑ ❑ Evaluation of failure
shown on scale bar Non-residential justification
❑ ❑ Waste strength
❑ ❑ Flow
DESIGN APPROVAL
The undersigned designer at t [ifie by installer at time of installation Rf Yes ❑ No
) Z--.*/ 10/14/24
S !9 m of Designer Date
The undersigned has reviewed th' e i on behalf of Mason County Public Health and determined it to be in
compliance with state and local on-site regulations:
Q�k W 19/1 Fi=94
E*ir&Wental Health Specialist Date
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
✓ The design is stamped"Approved"by Mason County Public Health. 11 21 27
✓ 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.
Updated Daze: 12/72015
THURSTON COUNTY HEALTH DEPARTMENT
ON-SITE SEWAGE DISPOSAL SYSTEM DESIGN
SITE k: PARCEL#:422165300116
DATE SUBMITTED:1011,=N LEGAIiLOT M:LAKE CUSHMAN
#16 TR 116
SUBMITTED BY: ADAM HUNTER
APPLICANT: DEAN GOLDY
ADDRESS:
I.CALCULATIONS
NUMBER OF BEDROOMS= 3
RESIDENTIAL GPO FLOW= 360
IF NON-RESIDENTIAL-GPD FLOW
WILL BE AS FOLLOWS:
GPD=
APPLICATION RATE= 0.6 GPD/FT2
REDUCTION=LEAVE BLANK IF NO REDUCTION TAKEN
DRAINFIELD SIZING
ABSORPTION AREA= 6W FT2
TRENCH LENGTH OR BED CONFIG.= 30'X20'
PER OSCAR
II.WATERPROOF SEPTIC TANK
COMPOSITION AND SIZE= 1200GAL-X02 TANK
NEW OR EXISTING= NEW
III.GRAINFIELD CROSS SECTION
SAND DEPTH= 0'-V
N.PRESSURE CALCULATIONS
USING PIPE CLASS 40
ORIFICE NETARM DRIPLINE
LENGTH DIAMETER FLOW FRICTION LOSS
SECTION (FT) (IN) (GPM) (FT)
SUPPLY 50.00 1.00 12.OW 3.8712
RETURN 50.00 1.00 12.OW 3.8T12
TOTAL= 7.7543
"TOTAL HEAD LOSS "
1)FRICTION LOSS THROUGH SYSTEM= 7.7511
2)ELEVATION DIFFERENCE = 6.500
TOTAL= 14.251
10/14/24
- � Approved
Mason County Environmental Health
^' Amui:x xTen �"
Jeff Wilmoth 12/16/2024
V.CHECK THE PUMP CAPACITY.
PUMP'. AY.MCDONALD30GPM-1OHP PUMP(MODEL 922050E1 D (PER OSCAR)
EXCESS TDH WOO (PER OSCAR)
TOTAL HEAD LOSS IN SYSTEM 1425
STANDARD PUMP CONFIGURATION IS SUFFICIENT? YES
Approved
Mason County Environmental Health
Jeff Wilmoth 12/16/2024
10/14/24
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