HomeMy WebLinkAboutSWG2025-00041 - SWG Application / Design - 2/12/2025 84
MASON COUNTY 415NBTHELTON: , 0427-970,EXT 400
SHELTON:360-2754467,EXT 400
BELFAIR:360-275-1467,EM 400
Public Health & Human Services ELMA:3604825289,EXT 400
FAX:360427-7787
On-Site Sewage System Permit: SWG2025-00041
APPLICANT Ochnik,Janusz& Krysyna Phone:
Address: 4805 Delridge Way SW Unit D SEATTLE,WA 98106
SEPTIC DESIGNER DALE TAHJA' Phone: 360-463-8023
Address: 2450 W DEEGAN ROAD WEST SHELTON,WA 98584
SEPTIC INSTALLER TJ GODS* Phone: 360.490-0217
Address: 150 E MARISA PL SHELTON,WA 98584
Site Address: E Adonai Way
Primary Parcel Number: 221232250040
Permit Description: New SFR-3BR Pressure
Permit Submitted Date: 02/12/2025
Permit Issued Date: 02/19/2025
Issued By: Jeff Wilmoth
Current Permit Fees Paid: $825.00 (adcnionat fees may be required aooe matansuon of system).
Permit Expiration Date: 02/19/2028 (based on dale of inspection)
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 Dminfield 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/environmentagonsiteloss-inspection-requesLphp or call:
= 360-427-9670,extension 400.
OFFICIAL USE ONLY
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ON-SITE SEWAGE SYSTEM APPLICATION
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Adonai Way,thru gate, first lot on the right.
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DESIGN FORM—PAGE ONE Assessor's Parcel Number: 2 2 1 2 3 — 2 2 — 5 0 0 4 0
A design will he reviewed when 3 conies of each of the following are submitted:
•Completed design form that has been signed and dated. 0 Scaled layout sketch,including all applicable items on checklist
•Scaled plot plan,including all applicable items on checklist. I Cross-section sketch,including all applicable items on checklist.
Thle farm may be scanned and available M Public view an the Manat C webslte.Mazinrurn rsize: 11"XIT'
Permit Number: 4� SWG 2OZ5- 000"11 Designer's Name: Dale Tahja
Applicant's Name: Janusz&Krystyna Ochnik Designer's Phone Number: 3604265W
Mailing Address: 4805 D Delndge Way
(�S�W' Designer's Address: 2450 W Deegan Rd W
ISQC& WA \C)�O� Shelton WA am
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Treatmeut Device
❑Glendon Biofiher ❑Sand Filter ❑Mound ❑Sand LmodDramileld ❑Recirmdatmg Filter,Type:
❑Aerobic Unit Meke/Model ❑Disinfection Unit Make/Model Other: N/A
Drainfield Type
•Gravity Pressure h(Trench ❑Bed ❑Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 3 - Schedule/Class Sch.40
Daily Flow:Operating Capacity 270 gpd Length 67 ft
Deily Flow:Design Flow 360 gpd Diameter 1.25 in
Septic Tank Capacity(working) 1,260 gal Number 3-
Receiving Soil Type(1-6) 4 Separation 10 ft
Receiving Soil Appl.Rate 0.6 - gpd/fe Orifices
Required Primary Area 600 ft' Total Number of Orifices 51
Designed Primary Area 600 ft Diameter 1/8 in
Designed Reserve Area 600 ftt Spacing 48 in
Trench/Bed Width 3 - it Manifold
Trench/Bed Length 200 It Schedule/Class Sch.40
Elevation Measurements Length 35 ft
Original Drainfield Area Slope 10 % Diameter 1.25 in
New Slope,If Altered 8 % Preferred manifold configuration used? O Yes IigNo
DepthofExcavation up-wi 27 in Transport Pipe
from Original Grade noxn�stopa 24 in Schedule/Class Sch.40
Designed Vertical Separation 24+ in Length 110 ft
Omvelless Chambers Required? 1f3 Yes O No lif Optional Diameter 2 in
Pump Required? ILYes ONo Dosing and Pump Chamber
Pump/Siphon Specifications Number ofdoses/day 4
Diff,in Elevation Between Pump&Uppermost Orifice 5 ft Dose quantity 67.5 gal
Drainfield Squirt Height/Selected Residual(head) 6 ft Chamber Capacity(flood) 1,000 gal
Uppermost Orifice Of Higher O Lower than Pump Shutoff Pump controls:Please check those required
Capacity Q Total Pressure Head 24 gpm lilTimcr h(Elapse Meter Event Counter
Calculated Total Pressure Head 15 ft T' 0 3 'n pip off 5 hm 57 min
Comments v r n v v +'
FEB 19 2029
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DESIGN FORM-PAGE TWO Assessor's Parcel Number:2 2 1 2 3 - 2 2 - 5 0 0 4 0
Permit Number: SWG
DESIGN CKNICKLISTS -
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
56 Test hole locations 9 Drainfield orientation and layout Reference depth from original grade:
fa Soil logs lid Trench/bed dimensions and Rf Septic tank
iL Property lines critical distances within layout 61 Drainfield cover
® Existing and proposed wells Rf D-BoxfValve box locations Reference depth from original grade
within 100 ft of property 21 Septic tank/pump chamber and restrictive strata:
0 Measurements to cuts,banks,and locations &T Laterals,trench/bed,top and
surface water and critical areas 19 Observation port location bottom
m Location and orientation of 69 Clean-out location ❑ Curtain drain collector
curtain drain and all absorption it Manifold placement ❑ Sand augmentation
components 66 Orifice placement Other cross-section detail:
id Location and dimension of Ed Lateral placement with distance ❑ Observation ports/clean-outs
primary system and reserve arcs to edge of bed
m Buildings Other Information
Rl Audible/visual alarm referenced Yes No
56 Direction of slope indicator Rf Scale of drawing shown on scale Rf ❑Design staked out
m Waterlines ❑ ❑Recorded Notices attached
fa Roads,easements,driveways, P P R 0 V E ❑ ❑ Waiver(s)attached
parking R1 ❑Pump curve attached
56 North arrow and scale drawing M FEB 19 2021 ❑ ❑Evaluation of failure
shown on scale bar MASON COUNTY ENVIRONMENTAL HEALTH Non-residential justification
JBW ❑ ❑Waste strength
❑ ❑Flow
DESIGN APPROVAL:
The undersigned designer t be inst ai time of installation 86 Yes ❑ No
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Signature of Designer \ Date
The undersigned has reviewed this design on behalf of Mason County Public Health and date
compliance with state and to �i regulations: ,
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nvironmental Health Specialist Date
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDI
✓ The design is stamped"Approved"by Mason County Public Health.
✓ The Desire Sewage Permit has not expired,the Permit Expiration Date is: �2-_)�)-
✓ 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 maybe scanned and available for public view on the Mason County Web site.
Updated Date: 12/7/2015
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Liberty Pumps 280 - 1/2 HP Cast Iron Submersible Sump/Effluent Pump (Non-
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Installation/Maintenance
Pressure Distribution/Trench Systems
1. Install trench bottom level and in contour with the ground.
2. Install drainfield during dry weather and soil conditions.Any soil smearing must be
eliminated by hand raking any areas that get smeared.
3. Install audio/visual high water alarm.
4. Install effluent filter in septic tank outlet or pump vault with 1/16 inch maximum
filtration mesh size.
5. Install check valve in pump outlet line to prevent back-flow into the pump chamber.
6. Install 1/8 inch orifices on 4ft. Centers. Install the orifices pointing straight down (6:00
o' clock).
7. Divert all storm water run-off away from septic system components.
8. No curtain (french) drains allowed within I Oft. of the up-slope edge of the drainfield and
reserve area.
9. No curtain (french) drains allowed within 30ft. of the down-slope edge of the drainfield
and reserve area.
10.Have the septic tank and pump chamber pumped or inspected every 3 to 5 years.
11.Inspect and clean pump screen as needed.
12.Inspect floats and test high water alarm every 6 to 12 months or as needed.
13.All material and workmanship must meet County and State requirements.
14.Install risers on septic tank and pump chamber.
15.Deviation from this approved design without prior approval from the Designer and
Mason County Health Department will make this design null and void.
16.The prepared Site Plan is not a survey, it is the owner's responsibility to verify property
line locations prior to installation. Any discrepancies must be reported to the Designer
immediately.
17. Locate all utilities prior to starting installation.
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