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HomeMy WebLinkAboutSWG2025-00033 - SWG Application / Design - 2/6/2025 584 MASON COUNTY 415 N6 SHELTON: ,SHELTO70,EXT 400 $HELTOR:360-42]-96]0,EXT 400 40 BELFAIR:360-275-4467,EXT 400 Public Health & Human Services ELMA:360482-5269,EXT 400 FAX M0427-7787 On-Site Sewage System Permit: SWG2025-00033 APPLICANT DELANY KIM ANN Phone: Address: 2629 SCHIRM LP RD NW OLYMPIA,WA 98502 OWNER DELANY KIM ANN Phone: Address: 2629 SCHIRM LP RD NW OLYMPIA,WA 98502 SEPTIC DESIGNER JIM HUNTER* Phone: 360-753-1226 Address: PO BOX 162 OLYMPIA, WA 98507 Site Address: UNKNOWN Primary Parcel Number: 320221190100 Permit Description: New 4bd gravity trench Permit Submitted Date: 02106/2025 Permit Issued Date: 02/12/2025 Issued By: Rhonda Thompson Current Permit Fees Paid: $825.00 (additional fees may be museas broad installation OHystem). Permit Expiration Date: 02111/2028 (based on data or inspection) Permit Conditions: 1 Proposed development subject to zoning requirements and approval by the planning department staHper 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 backfill of system 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 visit: masoncountywa.gov/health/environmental/onsiteloss-Inspection-request.php or ca[I: 360427-9670,extension 400. OFFICIAL USE ONLY MASON COUNTY PUBLIC HEALTH OAIFBLCDYFD: D Z p(( z OZS m a ONSTfE SEWAGE SYSTEM APPLICATION MWM9EQMD E N DBY: 415 N 6th StimI(Bldg 8) Shelton WA98594 V z N Shel[on:360427-9610a2488 Bel(aIr:360.275446]eat4B0 SWG 00z5 - 600 33 A 2 N 9 APPLICANT PHONE D KIM DELANY o 360 280-2660 m m MAI CODE P­ 2LDRESS-STREET CITY,SCHIRM LOOP P OP 629 NW m DLYMPIA WA 98502 S1E35955 RESTVIEW DCITY ZIP CODE R o SHELTON WA 98584 z NAME OF DESIGNER ^ 'J ' PHONE L \� JIM HUNTER 360 753-1226 DO a INSTALLER PHONE W CHECK ALLAPPLICABLE ITEMS DRINKING WATER SOURCE Bf C NEW CONSTRUCTION [3 RV HOLDING TANK ONLY tl J PRNATE INDMDUAL WELL Lp O REPIACEMENTSYSTEM ❑ INSTALLAPMNEWITONLY ❑ PRIVATETAO-PARTYWELL Z O TABLE 9 REPAIR of SINGLE FAMILY O COMMUNITYIPUBLIC M TER SYSTEM ❑ TANK(S)ONLY O COATIERCIAL SYSTEM NAME: O UPGRADE TO METING O OTHER: BEDROOMS LOTSf7F 1 O EXISTING FAILURE 4 ror xllnawrouw' V O DIRECTONSTO SITE-BE SPECIFICANDADVISE OFANY NEEDED INFORMATION FORACCESSPnM plel (� uWV S 0" "467.' �z WcST CN /ac.A-EIS 1-41311' " --ro LILVLlk-j or.L L_L9F--r r}r cr.4A.0 3�aJLs Ail,1t,j, 'S AAA-'14-01- L_4atfl-W o 1354' ICJ JW loll`�'Ls o I IQ� �(py() A,,L� �Jl.-l-ow l=L_.l}LG .aS I. -YL2Aa` 'fa rrtrlT I�LTf r y r�1 SITE MUSTBE FIAGGFD FROYYNNRMDANOTF51NOlE5YU5TBE ilAGGFD NITNTESTHOIENIMBFRS I Iv OFFICIAL USE ONLY BELOW THIS LINE UPGR/rDEIFNLURESOURCE(Mrg Wpup K) OVOLUNTARY E]MAINTENANCEJ UMPING OBUILDINGPERMIT OHOMESALE OCOMPLAINT OOTHER: EM�p.�QJr� INSPECTOR SOIL LOGS OOMMENIS/OONDRIONS ( m 74 SCHLCODa: V=VERY G-GRAVELLY S=SAND L=LOM1 S-911 C=CLAY E=EXTREMELY R=ROOTS INSPECTOR SIGNATURE WTE I-K:AXIONEXPIRATIONDATE APPLIGATIONAPPROVEDBY MTE vl1( 2 ILL W THIS FORM MAY BE SCIANNED AND AVAILABLE FOR PUBLIC WEW ON THE MASON COUNTY WEBSITE REVISED1Yl/At5 DESIGN FORM—PAGE ONE Assessor's Parcel Number:____32022_11_9©100---- A design will be reviewed when 3 copies of each of the following are submitted: •Completed design form that has been signed and dated. I Scaled layout sketch,including all applicable items on checklist v Scaled plot plan,including all applicable items on checklist. I 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: //"X/7" PARCEL EDENTIFICATION Pe rmit Number: SWG q n)S-- OD0�J-�> Designer's Name: JIM HUNTER Applicant's Name: KIM DELANY Designer's Phone Number: 360-753-1226 Mailing Address: 2629 SCHIRM LOOP NW Designer's Address: PO BOX 162 OLYMPIA WA 98502 OLYMPIA WA 98607 City Slate DEZi city State SIGN PARAIYIETE zip Treatment Device ❑Glendon Biofilter ❑Sand Filter ❑Mound ❑Sand Lined Dndnfield ❑ Recirculating Filter,Type: ❑Aerobic Unit Make/Model ❑ Disinfection Unit Make/Model Other: Drainfield Type 0 Gravity ❑Pressure ❑Trench ❑Bed ❑ Sub Surface Drip Septic Tank/Drainfreld Specifications Laterals Number of Bedrooms 4 Schedule/Class /k$11CAn 2.rT t 1 Daily Flow:Operating Capacity 300 gpd Length 35 ft Daily Flow:Design Flow JC80 glad Diameter 4 in Septic Tank Capacity 1250 gal Number 6 Receiving Soil Type(1-6) 3 Separation 6 ft Receiving Soil Appl.Rate 0.8 gpd/ft' Orifices Required Primary Area woo ft, Total Number of Orifices N/A Designed Primary Area , aj0_ J flz Diameter N/A in Designed Reserve Area (o o o ft' Spacing N/A in Trench/Bed Width 3 ft Manifold Trench/Bed Length 210 ft Schedule/Class A S`rAA Z O 3I- Elevation Measurements Length h Original Drainfield Area Slope I % Diameter 4 in New Slope,If Altered % Preferred manifold configuration used? 0 Yes 0 No Depth of Excavation UPSIope q " in Transport Pipe from Original Grade DownuW (a in Schedule/Clan /.rS<AA '3c34 Designed Vertical Separation 36 in Length ft Gravelless Chambers Required? Ili(Yes 0 No 17 Optional Diameter 4 in Pump Required? ❑Yes ifNo Dosing and Pump Chamber Pump/Siphon Specifications Number ofdows/day N/A Difference in Elevation Between Pump Shutoff and Uppermost Done quantity N/A gal Orifice WA ft Chamber Capacity N/A gal Uppermost Orifice 0 Higher 0 Lower than Pump Shutoff Pump controls:Please check those required. Capacity @ Total Pressure Head N/A gpm OTimer DElapse Meter ❑Event Counter Calculated Total Pressure Head WA ft If Timer. on N/A Pump off N/A Comments FEB 12 2025 L HEALTH RET DESIGN FORM—PAGE TWO Assessor's Parcel Number: 32022_11-90-100____ Permit Number: SWG DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch Rf Test hole locations 1J Drainfield orientation and layout Reference depth from original grade: 19 Soil logs If Trench bed dimensions and d Septic tank 53 Property lines critical distances within layout 1Z Drainfield cover 19 Existing and proposed wells E9 D-Box/Valve box locations Reference depth from original grade within 100 R of property E9 Septic tank/punrp chamber and restrictive strata: Fa Measurements to cuts,banks,and locations ❑ Laterals trench/bed,top and surface water and critical areas 9 Observation port location bottom 13 Location and orientation of 9 Clean-out location ❑ Curtain drain collector curtain drain and all absorption 9 Manifold placement ❑ Sand augmentation components V Orifice placement Other cross-section detail: F9 Location and dimension of E� Lateral placement with distance E9 Observation ports/clean-outs primary system and reserve area to edge of bed ❑ Buildings g Other Information E9 Audible/visual alarm referenced Yes No 9 Direction of slope indicator E9 Scale of drawing shown on scale Design Ej ❑ slaked out 9 Waterlines bar ❑ ❑ Recorded Notices attached E� Roads,easements,driveways, ❑ ❑ Waiver(s)attached parking ❑ ❑ Pump curve attached E9 North arrow and scale drawing ❑ ❑ Evaluation of failure shown on scale bar Non-residential justification ❑ ❑ Waste strength ❑ ❑ Flow DESIGN APPROVAL The undersigned designer must be nod w;: nstallation ❑ Yes I t No z -4--Ly Signa of Designer Date The undersigned has reviewed[his design on behalf of Mason County Public Health and determined it to be in compliance with state and local on-site regulations: o� ►2�z s Environments Health ecialist 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: ( I r/� ✓ 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 Date: 12/7/2015 • FncEL MASON COUNTY HEALTH DEPARTMENT ON-SITE SEWAGE DISPOSAL SYSTEM DESIGN SITE# PARCEL#: 32 02 2-11-%IW DATE SUBMITTED 02I03I25 LEGAIAOT N. SUBMITTED BY: JIM HUNTER APPLICANT: KIM DELANY ADDRESS: 2629 SCHIRM LP RD NW OLYMPK WA 915502 I.CALCULATIONS NUMBER OF BEDROOMS= 4 RESIDENTIAL GPD FLOW= 480 IF NON-RESIDENTIAL-GPD FLOW WILL BE AS FOLLOWS: GPD= APPLICATION RATE= 0.6 GM 2 REDUCTION=LF.I VE BLANK F NO REDUCTION TAKEN DRAINFELD SIZING ABSORPTIONAREA= 630 FT2 TRENCH LENGTH OR BED CONFIG.= 210 FT II.WATERPROOF SEPTIC TANK COMPOSITIONANDSIZE= 1,M CAL.WNCRETE NEW OR EXISTING NEW III.ORAINFIELO CROSS SECTION DEPTH TO DRAINROCK BOTTOM= O-9' ROCK DEPTH BELOW PIPE= 0'-6' SEPARATION FROM TRENCH BOTTOM TO IMPERMEABLE MATERV EASONAL SATURATION= >T v FILL DEPTH= 1-0' TRENCH WIDTH= 3'-0' APPROVED MASON FEB 111015 N COUNTY °^ Ni?"ENVIROHMENiAIHEALTH REi `�• slwzn �? LAMES A MUNIER _• LIC@13EO UESIsw-R Exp"S: 03/22/-ZG I I � m Zp i v1 TT< w ! 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