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Home My WebLink AboutSGW2025-00036 - SWG Application / Design - 2/6/2025 MASON COUNTY 415NBTHELTON: , 0427-97 ,EXT 400 SHELTON:360-27 - 70,EXT 400 4 BELFAIR:360-2]544fi7,EXT 400 Public Health & Human Services ELMA:360482-5269,EXT 400 FAX 360427-7767 On-Site Sewage System Permit: SWG2025-00036 APPLICANT BURNS SANDRA D&ROBERT GENE Phone: Address: 13312 197TH ST E GRAHAM,WA 98338 OWNER BURNS SANDRA D&ROBERT GENE Phone: Address: 13312 197TH ST E GRAHAM,WA 98338 SEPTIC DESIGNER CINDY WAITE' Phone: 360-701-0205 Address: 80 E PICKERING LANE SHELTON,WA 98584 SEPTIC INSTALLER BRAYDEN SCHOENING' Phone: 360-742-2982 Address: 121 W GRIZDALE DRIVE SHELTON,WA 98584 Site Address: 171 N CLALLAM PL Primary Parcel Number: 423185100037 Permit Description: Non-Conforming Repair 2bd pressure bed Permit Submitted Date: 02110/2025 Permit Issued Date: 02119/2025 Issued By: Rhonda Thompson Current Permit Fees Paid: $825.00 Ieddi.• Wfees mey b.re W.d•Po meww0on•r.,Wml. Permit Expiration Date: 02/13/2028 Ibesed«,d•ie a ln•wer^nl 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 Dramffeld 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/onvironmental/onsiteloss-inspection4equest.php or call: 360-4279670,extension 400. OFFICIAL USE ONLY p F E�G 0a7 ozs ® MASON COUNTY - US COMMUNITY SERVICES MIWNTRCDYEO i g2.f o m N PutlkIWM�Cammunlry NNhNEnnronmeMal HeaNEI N O SWG ZdZ5 ac��3l� = y ON-SITE SEWAGE SYSTEM APPLICATION 3 m m m CAN PHONE m ROBERTISANDRA BURNS 253-263-3347(MOSS THE BLDR) z MAILINGPDDRESS-STREET CITY.STATE,LIP CODE a+'f 13312 197TH ST E o GRAHAM WA 98338 m gITEADDREMS-STREETCItt.ZIPCODE L� o 171 N CLALLAM PL HOODSPORT WA 98548NAME OF DESIGNER IA CINDY W PHONE AITE ` 360-701-0205 1 ro NAME OF HSTALLER m PHONE I W rn I PERRMpM11TTYPE(s SwRl DRINNINGWATERSDURLE RIHE SIDENTIALOSS ff COMMUNItt053 BCOMMERCIALOSS EIPRNATEINDIVIDUALWELL 6'PRIVATE TWO-PARTY WELL 2 Ico ttPppE OF worm(awem l �PUBLIC WATER SYSTEM LAKE UNHOCMws L.UNEWLGNSTRDLTIGN(UPGRADES REPAIR(REPLACEMENT OTHERDETNLSpN Wftf ) DTABLE IX REPWR ( CFI SUBppMI��NEW GGII ❑SURFACING SEWAGE m EXISTING FAILURE D SHORELINE lmmA.SGN FORM(REQUIRED) R➢SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIzE !1 FLWAIVER(S)(IF APPLICABLE) 2 92DDSF x lO DIRECTIONS TO SITE AND SITE OCNUTIONS.(s+.bcYetl ON) GO UP LAKE CUSHMAN ROAD, TURN LEFT AT TEE ONTO STAIRCASE, TURN LEFT I ONTO MT TEBO WAY, TURN LEFT ONTO POTLATCH OR, FOLLOW POTLACH AND r TURN LEFT ONTO CLALLAM PL, PARCEL IS ON LEFT SIDE OF ROAD, HOLES ARE TOWARDS THE BACK. I I w MITE MUST M FLAG(£D PIIOM YAM RWGANp--..YU.T BE ELAGGEO WITH CMT HOLE NIMNERS 1 -4 OFFICIAL USE ONLY BELOW THIS LINE UPGRADE I FAILURE SOURCE(M,a gW,WFN) DVOLUNTARY DMAINTENANCEIPUMPING O BUILDING PERMIT DNOMESALE DCOMPIAINT DOTHER: INSPECTOR SOIL LOGS COMMENTSICONDITIONS 9 -ep(v)e. 3 b Z� CZ 4vu 5 , 2, � - V 4- (Ov 1ru,+ � O `� ' \ L-4v,s,30•� o � 'Irk y v T RECa+D pw.wlrvcAnp MSTuunoN REPORT y.VERy G=GRAyELLy g=SANp L=LOMI Si-SILT C=CUY E=EXTREMELY R=ROOTS REQUIRED FOR FINALAPPROVAL INSPECTCRSIGNATURE DPTE APRIGATIONE%PIMTIgiDATE APPLIGTIONAPPROVEDIEO DATE �l Z� 13 THIS FORM MAY BE ANNEDANDAVNLABLE FOR PUBLIC NEW ON THE MASON CWHTY WEBSITE REVISED 1WMI5 DESIGN FORM—PAGE ONE Assessor's Parcel Number: 4 2 3 1 8 — 5 1 — 0 0 0 3 7 A design will be reviewed when 3 copies of each of the following are submitted: "Completed design form that has been signed and dated. v Scaled layout sketch,including all applicable items on checklist Scaled plot plan, including all applicable items on checklist. v Cross-section sketch,including all applicable items on checklist. This form maybe scanned and m allable for public view,on the Mason County Web aite.Maximum ersize: 11"X 17" PARCEL IDENTIPICATION Permit Number: SWO ZoZS-CJC7O 3(( Designer's Name: CINDY WAITE Applicant's Name: ROBERTISANDRA BURNS Designer's Phone Number: 380-701-0205 Mailing Address: 13312197TH ST E Designer's Address: 80 E PICKERING LANE GRAHAM WA 913338 SHELTON WA 98584 Ci State Zip city State Zip DESIGN PARAMETERS Treatment Device ❑Glendon Biofdwr ❑Sand Filter ❑ Mound ❑Sand Lined Drainfield ❑Recirculating Filter,Type: ❑Aerobic Unit Make/Model ❑ Disinfection Unit Make/Model Other. Drainfield Type ❑Gravity Rf Pressure ❑Trench 5i(Bed ❑Sub Surface Drip Septic Tank/Drainfield Specifications Laterals Number of Bedrooms 2 Schedule/Class SCHEDULE40 Daily Flow:Operating Capacity 180 gpd Length 30 It Daily Flow: Design Flow 240 gpd Diameter 1.25 in Septic Tank Capacity(working) 1200 gal Number 4 Receiving Soil Type(1-b) 3 Seperatio - 2 ft Receiving Soil Appl.Rate .8 gP d/ft e } Orifices Required Primary Area 300 ft' Total p, 24 Designed Primary Area 300 8' Di 3I18 m , i in Designed Reserve Area 300 ftr ng 51 41 a IND WAi 11 D in TrenchBed Width 10 ft U k nifald Trench/Bed Length 30 ft Schedu%/Cg69P'w SCHEDULE 40 Elevation Ment rements Length 6 It Original Drainfield Area Slope 1 % Diameter 2 in New Slope,If Altered o/ Preferred manifold configuration used? O Yes lifNo Depth of Excavation Up-slope 9 in Transport Pipe from Original Grade Down-slope 7 in Schedule/Class SCHEDULE 40 Designed Vertical Separation 14-19 in Length 20 ft Gmyelless eliambers ReclKired? es o Diameter 2 in Pump Required? If Yes ❑No Dosing and Pump Chamber Pump/Siphon Specifications Number ofdoses/day 4 i\/d Diff.in Elevation Between Pump&Uppermost Orifice 10 ft Dose quantity 45 gal `r-1 Drainfield Squirt Height/Selected Residual(head) 2 fl Chamber Capacity(flood) 1200 gal Uppermost Orifice If Higher O Lower than Pump Shutoff Pump controls:Please check those required. Capacity @ Total Pressure Head 14.16 gpm IfTimer G(Elapse Meter lif Event Counter Calculated Total Pressure Head 12.07 ft If Timer: Pump on ,Pump off Comments CONCRETE TANK REQUIRED, GRAVEL BASED DRAINFIELD REQUIRED, PUMP CONTROLS TO BE SET AT TIME OF INSTALLATION AT 180GPD DESIGN FORM-PAGE TWO Assessor's Parcel Number:4 2 3 1 8 — 5 1 — 0 0 0 3 7 Permit Number: SWG DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch Ed Test hole locations 1Z Drainfield orientation and layout Reference depth from original grade: 21 Soil logs Rf Trench/bed dimensions and Ed Septic tank hJ Property lines II ,c,�ritical distances within layout EX Dminfield cover &Existing and proposed wells 19 AWeox/Valve box locations Reference depth from original grade within 100 ft of property R1 Septic tank/pump chamber and restrictive strata: 91044easurements to cuts, banks,and locations p 10{ M .r 9 Laterals,trench/bed,top and surface water and critical areas S6 Observation port location bottom Pllloocation and orientation of 69 Clean-out location ❑ Curtain drain collector curtain drain and all absorption I)( Manifold placement ❑ Sand augmentation components 19 Orifice placement Other cross-section detail: m Location and dimension of Rf Lateral placement with distance ❑ Observation ports/clean-outs primary system and reserve area to edge of bed m Buildings Other Information E9 Audible/visual alarm referenced Yes No m Direction of slope indicator vt.g� m..0 56 Scale of drawin shown on scale Ed ❑ Design staked out R1 Waterlines bar ❑ ❑ Recorded Notices attached It Roads,easements,driveways, ❑ ❑ Waiver(s)attached parking 59 ❑ Pump curve attached 19 North arrow and scale drawing ❑ E6 Evaluation of failure shown on scale bar Non-residential justification ❑ ❑ Waste strength ❑ ❑ Flow DESIGN APPROVAL The undersigned designer must be noti by installer at time of installation 4a Yes ❑ No 2 � LeZ.zt Signature' f Designer Da e, The undersigned has reviewed this design on behalf of Mason County Public Health and determined it to be in compliance with state and local on-site regulations: Lq (z Environmental Health Specialist Date CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION: ✓ The design is stamped"Approved'by Mason County Public Health. e2, ' I -�5I 2-0 ✓ 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. 2�a 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 y � { | ■ � � � � �� - - } \ }. \ S17 - � ) -7 ,7 l - raa � : & ate , . Z7S � } a ( ! � b �� . ` ■ � . �� . A . A: PPROy@D \ ' g , g , � ■ - -- - - - m , ■ w / \ ^ � \ \ \ \ N \ / / ` `/, , \ =L o00Ee \ ^ aJ ) 4 = = :30 K � 2 , 3 ; me \ \ a \ 2a < ; ¥ \ w - sCD_ , ff ° \ ) E � •� NJ . E E x 2 � ORIFICE SPACING 5 Lateral# Length Length Orifice # Distance from Distance from end Len In# # (Feet) (Inches) Spacing" Orifices feeder line of end of lateral 1 30 360 60 6 2.5 2.5 30 2 30 360 60 6 2.5 2.5 30 3 30 360 60 6 2.5 2.5 30 4 30 360 60 6 2.5 2.5 30 120 24 115 TRANSLENGTH GPM K (2"SCHEDULEN 40) FRICTION LOSS Squirt 2 Elevation difference 10 TDH 12.077704 I711 6 � M 60" V C �g o ?� ,-- APPROVE LiGE N ED°°°'° 11 GN E WA9A pE51 FEB 19 2025 MASON COUNTY ENVIRONMENTAL HEALTH TRENCH CROSS SECTION RET Fr,,,aP 6" ' p p j ,/ Qt.l�e /Y" Sri pQ 60,E d a1 d�,.�tf � 1� DRAINFIELD LAYOUT 2 9 10 1� 7 „ /Z,/ X7=CLEANOUT/OBS PORTS(Y) A X2=D BOXIVALVE BOX 1�� X3-CheokValvesci) Tlcg sae.)- ��X4=Flow Control Valve .(J gE.".L' L �� ~� / '� Va�I�T EMRIRL511110/ X5=Soil Logs OAf P/of may. APPROVED FEB 19 2025 �1 MASON COUNTY ENVIRONMENTAL HEALTH RET ' 2 00 C��G�r .J�P�IL T4A•� SECURED LID WITH OAS TOW SEAL 1 2P DIAMETER ACCESS RISER FINISH GRADE ZF / TO PUMP CIUNSER FRGMEEWAoe SOURCE FLOAMNOM11T AP D US LT" 8EOIHIENT9 '. APPROVER FEB 19 2025 AEPTHCTAN(ImpiaA I N CE CI D SI Ire LI ODE ONE� MASON COUNTY ENVIRONMENTAL HEALTH RET SM DwITHWSTIGHTSEAL THREADED UNION W DIAMETER ACCESS RISER FINISHORADE SERVICE VALVE. FROM SEPTIC 6 ELT Q TANK TO DRAINFIELD ENEROENMSTORAOE ANTISIPHON HIGH WATERALARM LEVEL -- VALVE• WORKING VOLUNE INDEPENDENT NORMAL TIMER OFF LEVEL FLOAT STEM FOR FLOAT ENCLOSEDPLNIP MOUNTING SEDIMENTSHROUD• CHECKVALVE- Tr BEOIMENTB SUSMERSISIi CENTRIFUGAL PUMP PUMP CHAMM (TWIM i s^ 0'a- I R •AS NEEDED 1z00 ga /loA PR„ p TaA� ;F Pump Specifications �I`rl�l�� lUb�oiPumpw 250-Series Submersible � a1� Sump / Effluent Pump ii� !!!!!!!!!! 20 0 is1, APPROVED T!!!!!!!!►! FP • 1 1 !!!!!!!!!- 1 Installation Notes Pressure Distribution System 171 N Clallam Place 42318-51-00037 1. The prepared site plan is not a survey. It's the owner's responsibility to verify property lines, utility lines (water, sewer, power, phone and gas) prior to installation. 2. Gravel base drainfield required 3. Septic and pump tank must be concrete. 4. The tank may be moved as necessary to accommodate building requirements. Septic tank location must meet all required setbacks. 5. Keep wheeled vehicles off the drainfield area before, during and after installation. Tracked equipment only, 6. All ground, surface water and roof drains must be diverted away from the septic tanks and drainfield. Ensure the final grade slopes away from these areas and water doesn't collect on or around them. Use swales, berms, catch basin and tight lines, curtain drains, etc. to divert all waters. 7. Curtain drains can be no closer than 10' upgradient and 30' down gradient of the drainfield 8. Exposed restrictive layers, cuts, banks, etc. can be no closer than 50' downhill from the drainfield. 9. Install access risers on the septic tanks, valve box and ends of laterals. 10. Install observation ports at the beginning of each lateral and observation port and clean out at the ends of each lateral. 11. Make sure septic tank risers are epoxied or caulked to cast in riser rings on tank. 12. Lids must form a water and gas tight seal with the access risers 13. Install effluent filter specified in this design at the septic tank outlet. 14.This system must be installed by a Mason County Certified installer. 15. Deviation from this design without prior approval from the designer and Mason County Health Department will make this design null and void. 16. This design was sized per Washington Administrative CodeWAC246-272A-0230. The operating capacity is based on 45 gallons per day per capita with two persons per bedroom. The minimum design flow per bedroom per day is the operating capacity of ninety gallons multiplied by 1.33. This results in a minimum design flow of one hundred twenty gallons per day. This creates a surge factor of 33% but anticipated flow is ninety gallons per bedroom per day. 17. Install laterals with contour of the ground 18. Install trench bottoms level and always maintain a minimum of six inches into native soil 19. Install locator tape on top of all drainfield laterals. 20. Install threaded clean outs at the ends of all laterals (caps must4xtend to.within six inches of finish grade and be in a valve box as shown on diagram. 21. Install audio/visual alarm 22. Filter fabric required over drain rock prior to backfillin th in rock extends above the original grade, run the filter fabric at least the trench wall. APPROVED y JlI FEB 19 2025 DYE WAi uc s e i MASON COUNTY ENVIRONMENTALHEALTh RET System Owner Responsibilities: 1. Operation and Maintenance is required by Washington State Department of Health and Mason County Health Department. 2. The septic tank and pump tank should be pumped every three to five years or as needed. 3. System owners are responsible for having maintenance performed annually. 4. System owners are responsible for responding to septic issues in a timely manner. 5. System owners shall not at any time change or alter settings in the control box. 6. System owner agrees to read and abide by information regarding their system in the User Manual provided by Mason County Public Health. 7. Keep the flow of sewage at or below the approved design operating capacity. 8. Keep waste strength at residential waste strength parameters. 9. Spread loads of laundry through the week. 10. Do not use excessive bleach or detergents with added whiteners. 11. Do not shower, do laundry and dishwasher at the same time 12. Antibiotics can kill or impair the biological process in the septic tank. 13. Leaky plumbing can hydraulic overload your on-site septic system. 4 =J Ml >% 5100418 p INOTE WAIT LICENSED DESIGNER S I .gees osla APPROVED FEB 19 2025 MASON COUNTY ENVIRONMENTAL HEALTH 1 RET