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Home My WebLink AboutSWG2025-00031 - SWG Application / Design - 2/5/2025 ® MASON COUNTY 415NB SHSTREET SHELTO70.EXT 400 $H STREET, ,SHEL ON, A9 400 BELFAIR:360-275.4467,EXT 400 Public Health & Human Services ELM:380<825269,EXT 400 FAX 386427-7787 On-Site Sewage System Permit: SWG2025-00031 APPLICANT DISIMONE CORI Phone: ��+ ---- Address: 1339 E MOUNTAIN PL TUCSON,AZ 85719 OWNER DISIMONE CORI Phone: Address: 1339 E MOUNTAIN PL TUCSON,AZ 85719 SEPTIC DESIGNER DALE TAHJA- Phone: 360-463-8023 Address: 2450 W DEEGAN ROAD WEST SHELTON,WA 98584 Site Address: 1050 E DANIELS RD Primary Parcel Number: 320105103002 Permit Description: New 4bd Oscar X02 Permit Submitted Date: 0 2/0 512 0 2 5 Permit Issued Date: 03/07/2025 Issued By: Rhonda Thompson Current Permit Fees Paid: $825.00 (addllbn.Ir ,i n.y bo rx0I upon meulbwn&.1WMl. Permit Expiration Date: 02111/2028 (b...on dab MlmI.,) 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 Drainfreld installation not to exceed designed upslope and downslope depth specified on design to=. 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/envimnmental/onstte/oss4nspection4aquest.php or call: 360-427.9670,extension 400. OFFICIAL USE ONLY MASON COUNTY OZ • 65-20Z5 y COMMUNITY SERVICES Iw[N�M,(EommuMty XyM2mvw,nlmMl He.M,1 � C•F`� LA G M „"A•� � �� SWG 2U25 — LL�31 Seo O A z 0 ON-SITE SEWAGE SYSTEM APPLICATION a a APPL A I M? P WE m m Cori Disimone (520)548-6771 r z AWLIWADORE53-STPFET,CT:SMTE,EV COPE 0 C 1339 E. Mountain PI. M, Tuson AZ 85719 g m N SITE ADME33-STREET CIW,,ZIP CCOE 1050 E. Daniels Rd. o Shelton WA 98584 I w NAME OF DESIGNER PNWE O Dale L. Tahja `�' LL (360)463-8023 m I N u EOF INSTALLER PNME I p m PEIiIl.1RTYFE(wb�fpyf CC GG�� ORCPIKING WATERS ROE L� W KRESIDENTIAI- S LNCOMMUNRYOSS F1 MERCML 0.5E 11PRWATEINDIVIDUALWELL Ly!PRWA7TWO- wWELL, 55 TYPEOF WORK I+AMems1 cc 2PUSLICWATEREYBTEMMII,Q eWm,pym�� I O FMNEWCONBTRUCTION/UPGRADES LyREPAIR/REPLACEMENT OIHEROETNLSPw dM51a,ft OTAIkE I� REPOR N SUSMI &s ❑SURFACINGSEWAGE QE%ISTINGFAILURE t]SHORELINE RVESIGNFORM(REOUIPED) OMMICDESIGN(REWIRED)i� BEDROOAI6 LOT 6GE O I � WAIVER(3)(IFAPPLICABLEI 4 1 acre In TO SITEnMD SITE Cp�g1IDN3'(u.bcbCLw1) x I p Go north on Hwy 3, right on Agate Rd., right on Agate Loop Rd., right on Da iels Rd., I w I to property on the southeast comer of Daniels Rd. and Wilderness Way. o Ip INIQ 6IIEYlIir Bp RgaOEOFROY MAMR AW TEST/ =MYir BEMAIXiFp Niryl r£xr/p1E/R/YBEtx I N OFFICIAL USE ONLY BELOW THIS LINE UPGRADE/FAAURE 8011NCE(b,mplbM WM1�o) O VOLUNTARY �MAINTENANGENIIMPING OBURDWGPERMM OHOI.£SALE QCOMPLAINT ❑OTHER: INSPECTORSWLIWS -TWAT O Z Z/� � � CGWFMBl COr1OITpN6 Z ce ZZ/ 2U+- n &tr _ � I V"EW L= 1 ' RECORE.FMF AND MS,,&, REPORT V+VERY O=ryUVELLV 3•e.WO L•LOAM M=SILT C•LIAY E=F%IREMELY R•ROOTS REWIRED FOR FMALIAppgWk. ECTORHWµNRE PATE APRICATKMIEKPIRATMLMTE A�PLIGTON APPROWOI I58UED BY N� Z�IIIZ� ZIII /G$ 2i��/N TMIB FORM WYBE EDANDAVM LEFORPUBLICVIEWONTNEW CWIT'LVEpBRE REVISED1W=15 DESIGN FORM—PAGE ONE Assessor's Parcel Number: 3 2 0 1 0 — 5 1 — 0 3 0 0 2 A design will be reviewed when 3 copies of each of the following are submitted: •Completed design form 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 fermi be scanned and wallable for Mae view an the Mawr Wwebsft.Maximum r size. 11"X 17" 2025-00031 Designer's Name: Dale Tahja Permit Number: SWG ffit Applicant's Name: Cod Diamone Designer's Phone Number: (360)463-8023 Mailing Address: 1339 E.Mountain PI. Designer's Address: 2450 W Deegan Rd W To. AZ e5r19 Sheacn WA 98584 C Some Zi Ci State Zip Treatment Device ❑Glendon Biufiner ❑Sand Fii4r ❑Mound ❑Sand LinedDminfield ❑Recm aIaang Filter,Typc: ❑Aerobic Unit Make/Model Oscar= ❑Disinfecdon Unit Make/Model Other: Drainfield Type ❑Gravity ❑Pressure ❑Trench (if Dol lif Sub Surface Drip Septic Tank/Drainfield Specifications Laterals Number of Bedrooms 4 Schedulc/Clwi OS-50 coils Daily Flow:Operating Capacity 360 gpd Length 25 ft Daily Flow:Design Flow 480 gpd Diameter Netafim Bioline in Septic Tank Capacity(working) 1,000 gal Number 8 Receiving Soil Type(1-6) 4 Separation 1 ft Receiving Soil Appl.Rate 0.6 gpd/tit Orifices Required Primary Area 800 ft Total Number of Orifices 400 emitters Designed Primary Area 800 fta Diameter Netafim Bioline in Designed Reserve Area 800 ft' Spacing 6 in Trmch/Bed Width 18 ft Manifold TrenchBed Length 45 ft Scbedule/Class Sch.40 Elevation Measurements Length 120 it rOngilsslDraiufveld Area Slope 13 % Diameter 1 in New Slope,If Altered 12 % Preferred manifold configuration used? O Yes IgNo Depth of Excavation Uo-dope 0 in Transport Pipe from Original Grade Dow -A. 0 in Schedule/Class Sch.40 Designed Vertical Separation 17 in Length 5 ft Gravelless Chambers Required? ❑Yes 66No ❑Optional Diameter 1 in Pump Required? Rf Yes ❑No Dealing and Pump Chamber Pump/Siphon Specifications Number of doses/day 360 Diff.in Elevation Between Pump&Uppermost Orifice 8 ft Dose quantity 1.33 gal Drainfield Squirt Height/Selected Residual(head) drip it Chamber Capacity(Rood) 17000 gal Uppermost Orifice if Higher ❑Lower than Pump Shutoff Pump controls:Please check those required. Capacity Q Total Pressure Head 30 Spot NITimer S(Elapse Meter it Event Counter Calculated Total Pressare Head 50 11 If Time: Pump on 0.48 min. Pump off 3.52 min. Commertts Audio/Visual Alarm required. Install within Lowridge Onsite Technology Requirements. Install Jute matting. r � DESIGN FORM—PAGE TWO Assessor's Parcel Number:3 2 0 1 0 — 5 1 -- 0 3 0 0 2 Permit Number. SWG DESIGN CHECMSTS--. Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch 16 Test hole locations 19 Drainfield orientation and layout Reference depth from original grade: it Soil logs 5d Treach/bed dimensions and Rf Septic tank id Property lines critical distances within layout 19 Drainfield cover m Existing and proposed wells id D-Box/Valve box locations Reference depth from original grade within 100 ft of property 19 Septic tank/pump chamber and restrictive strata: 66 Measurements to cuts,banks,and locations 6f Laterals,trench/bed,top and surface water and critical areas 66 Observation port location bottom lit Location and orientation of 19 Clean-out location ❑ Curtain drain collector curtain drain and all absorption 19 Manifold placement 19 Sand augmentation components 69 Orifice placement Other cross-section detail: is Location and dimension of 56 Lateral placement with distance Rf Observation ports/clean-cuts primary system and reserve area to edge of bed Other Information R1 Buildings Rf Audible/visual alarm referenced Yes No it Direction of slope indicator gf Scale of drawing shown on scale Ed ❑Design staked out ftl watefiines bar ❑ ❑Recorded Notices attached Id Roads,easements,driveways, ❑ ❑ Waiver(s)attached pare 66 ❑Pump curve attached Ed North arrow and scale drawing ❑ ❑ Evaluation of failure shown on scale bar Non-residential justification ❑ ❑ Waste strength ❑ ❑Flow DESIGN APPRf1VAi. The undersigned designer st be n�\otifi yin I er at time of installation RfYes ❑ No Signature ofIlesigner -Date The undersigned has caviewed this design on behalf of Mason County Public Health ernd be y� compliance with state and local on-site regulations: ti�it Environmental Health Specialist _ b ^,�. �%+90 v� Sy CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CO ✓ The design is stamped"Approved"by Mason County Public Health. I l i�U ✓ 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 ske. Updated Date: 12/72015 A- 9-1 a 310- l� £ wo i Oho APPROVED MAR 0 7 2025 MASON COUNTY ENVIRONMENTAL H 8 RET o r ry I \ra'�nY JiYA— 3� APPROVED MAR 01 2025 100214 02 Deb L.TahIP6` MASON COUNTY ENVIRO 3 H i LICENSED DESI R RET N T .r e 6„ -\ " q4tro tc\\� cg1 d f �S3rn vV A L.To C� Dale L. LICENSED DESIESt GNER O a- _ N ' � V Y 1 ° APPRO MAR 0 7 2025 MASON COUNTY ENVIRONMENTAL NEALTii RET t I1 1 Thermoplastic 7:: Reinforced Thermoplastic motor bracket and discharge with built-in guide hearing.This 1/2 HP pump has a stainless steel top bearing and motor coupling.These are assembled with our U McDonald stainless steel motors.Two wire single phase models include pump,motor,and 10'lead. This tour inch submersible is supplied with grounded leads meeting the National Electrical Code(N.EC.)specifications. The performance curve below will assist you in choosing the pump that meets your needs. MODELS E-tRWIN 00 E - 30 GPM 2� E I/!NP lair. • fiaPs.L 299 -_ at - - - - IN Fjj- shoplexP 4 STARES - - - 0 B III Is 21 th so ss 41 oepbx a 1a m 30 a so w 70 10 WORK a 26 a 60 a IN in in 1w FLOW spa APPROVED Specification MAR 07 2025 Largo 1A Plastic 115 1 1a94 ass 23 MASON COUNTYENYIRONMENTAtHEALTa,. R URoossRtl SUBMITTAL INFORM ON - Stainless steei pump shell and pump shaft - - Poaemd Try A.Y.McDonald submersible motors 112 HP. - Reinforced Thermoplastcdtflusers and impellers - 11/4"FMPTT Discharge - Thermoplastic Intake screen and cable guard NOUAD:The weighted average of the welted surface of this no-lead product contacted by consumable watercmdains less than we quarter of one percent(025%)lead. 0aste Teehaologies,Inc. Tat fret I-877416-8823 dave@lowridgetech.com P.O.Box 1 00 P.O.Box 179 fax:1-425-335-3622 oscaromRecom Labe Stevens,WA 98258 A y.Naaaald mWdamthe inhrmetbn 0M6 a bNdmmjewma tnpuhashed.am and oft.yawamil incwd'naspafi am amsuai:ttDchoewidum aatim. Submitted by: "�"