HomeMy WebLinkAboutSWG2025-00057- - SWG Application / Design - 3/17/2025 f
MASON COUNTY 476NBTH STREET,SHELTON,WA
SHELTON:
SHEL ON,N, EXT400
BELFAIR:360-276407,EXT 400
Public Health & Human Services ELMA:360482-5269,EXT t(M
FAX:360-427-7787
On-Site Sewage System Permit: SWG2025-00067
APPLICANT BERNARD MICHAEL E Phone:
Address: 940 W BULB FARM ROAD SHELTON,WA 98584
OWNER BERNARD MICHAEL E Phone:
Address: 940 W BULB FARM ROAD SHELTON,WA 98584
SEPTIC DESIGNER BOB PAYSSEe Phone: 360-507-1498
Address: 3083 E Mason Benson Road GRAPEVIEW, WA 98546
Site Address: 940 W Bulb Farm Rd
Primary Parcel Number: 519133100010
Permit Description: New SFR-3EIR Pressure
Permit Submitted Date: 03/0312025
Permit Issued Date: 0311712025
Issued By: Jeff Wilmoth
Current Permit Fees Paid: $565.00 (addldonal fees mays redwred uvon mstanenon or system).
Permit Expiration Date: 03/13/2028 (cased on date of mspeuron)
Permit Conditions:
1 Proposed development subject to zoning requirements and approval by the planning
department staBper 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 Drainfield 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 DesignerlEngineer 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.govlheahhlenvironmentaUonsitaloss4nspeetlon{ questphp or call:
360.427-9670,extension 400.
OFFICIAL USE ONLY
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940 W BULB FARM RD SHELTON WA 98584 a
SITE ADDRESS-STREET.GTY.MP CCGE
940 W BULB FARM RD SHELTON WA 98584 °i
NAME OF DESIGNERWJMED
PRONE
ROBERT H. PAYSS360-426-1803
NAME OF INSTALLERPRONE I �
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PEflMITTYPE(KV melDRIN(INGm ER SWflCERESIDENTIALOSS ECOMMALOSS ®PRIVATE INDNIDUALWELL EEPRIVATETVAGPARTYWELL z Iw�PUBLIC YNTER SYSTEM®NEWCONSTRUCTIONIUPGREMENT OTHER OETNLS(eelek YNut+wlH OTABLE IX REPAR w
SUBMCMITTALSOSURFACINGSEW4GE ISEXISTINGFAILURE OSHORELINE mIy,DESIGN FORM(REQUIRED) ED) BEgtO0M3IDT SIZE-WAIVER(S)(IFAPPLICABLE) 3 4.66 ACRES I o
OIRECTIONS TO SITEAND fill£WNWIONS.(m,kCftdPMI
OUT CLOQUALLUM RD, LEFT ON BULB FARM RD. CONTINUE TO SITE ADDRESS ON I I
RIGHT. o I o
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SITE MDETY!MSSED FROM MAIN RDASA TE97ROEES MUSTM FiA--TfBT AP MMYRA
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADEIFAIWRESOWCE(Nl( 1pvplw)
OVOLUNTARY OMAINTENANCEIPUMPING OBUILDINGPERMIT 13HOMESALE OCOMPIAINT ❑OTHER:
INSPECTOR60LLOGS COMMENTS/OONMONS
REWRD DRAWNGAND INSTALLATION REPORT
SOILCODEE:
V=VERY G=GRAVELLY 6=SAND L=LOAM V=SILT C=CLAY E-EXTREMELY R=ROOTS REWIRED FOR FINALAPPRO`ML.
IN TORS NiTU GATE APPLIGTION EXMmnoNN mm A IWAPPR TE
I6SUED BY 3-I W
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1H FDRY YW9CANNEDANDAVMLAEIE FORPUSUDVIEWON THE MABONCWNTY WEBYIE RWSED1Z 15
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DESIGN FORM—PAGE ONE Assessor's Parcel Number: 5 1 9 1 3 — 3 1 — 0 0 0 1 0
A design will be reviewed when 3 copies of each of the following are submitted:
Completed design form that has been signed and dated. O 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 BM Mesas County Web alb.Mzrimum papersize: ff"XIT'
PARCEL[D
Permit Number: SWG Designer's Name: ROBERT H.PAYSSE
Applicant's Name: MIKE BERNARD Designer's Phone Number: 360-426-1803
Mailing Address: 940 W BULB FARM RD Designer's Address: 3083 E MASON BENSON RD
SHELTON WA 98564 GRAPEVIEW WA 98546
city State zip city State Zip
Treatment Device
❑Glendon Biofilter ❑Send Filter ❑Mound ❑Send Lined Drainfield ❑Recirculating Filter,Type:
❑Aerobic Unit Make/Model ❑Disinfection Unit Make/Model Other:
f Drainfield Type
❑Gravity IO Pressure G(Trench ❑Bed ❑Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms THREE Schedule/Class SCH.40
Daily Flow:Operating Capacity 270 gpd Length 60 ft
Daily Flow:Design Flow 360 gpd Diameter 1.25 in
Septic Tank Capacity(working) 1500 gal Number 5
Receiving Soil Type(1-6) 5 Separation 10 ft
Receiving Soil Appl.Rate 04 gpd/ftt Orifices
Required Primary Area 900 112 Total Number of Orifices 75
Designed Primary Area 900 1112 Diameter 3/16 in
Designed Reserve Area 900 ft2 Spacing 48 in
Trench/Bed Width 3 ft Manifold
Trench/Bed Length 300 ft Schedule/Class SCH.40
Elevation Measurements Length 40 It
Original Drainfield Area Slope 5 % Diameter y1.25 in
New Slope,If Altered 5 % Preferred manifold configuration used? R Yes 13 No
Depth of Excavation Uislope 14 in Transport Pipe
from Original Grade wwo-slupe 12 in Schedule/Class SCH.40
Designed Vertical Separation 24+ in Length <100 ft
Gmvelless Chambers Required? ❑Yes Id No 0 Optional Diameter 2 in
Pump Required? Id Yes 0 No Dosing and Pump Chamber
Pump/Siphon Specifications Number ofdoses/day 6
Diff.in Elevation Between Pump&Uppermost Orifice 5 ft Dose quantity 60 gal
Drainfield Squirt Height/Selected Residual(head) 2 ft Chamber Capacity(flood) 1500 gal
Uppermost Orifice Of Higher 0 Lower than Pump Shutoff Pump.Icontrols:Please check those required.
Capacity @ Total Pressure Head 26 yy Spur mTlmel e(a[p Counter
Calculated Total Pressure Head , C ft If Timer: Pump o I tJ1/1
Comments
MAR 17 2025
MASON COUNTY ENVIRONMENTAL HEALTH
bESIGN FORM—PAGE TWO Assessor's Parcel Number:5 1 9 1 3 — 3 1 — 0 0 0 1 0
Permit Number. SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
Id Test hole locations 66 Drainfield orientation and layout Reference depth from original grade:
Ed Soil logs R1 Trench/bed dimensions and 1f Septic tank
E6 Property lines critical distances within layout 2 Drainfield cover
19 Existing and proposed wells If D-BoxNalve box locations Reference depth from original grade
within 100 ft of property Ed Septic tank/pump chamber and restrictive strata:
66 Measurements to cuts,banks,and locations 69 Laterals,trench/bed,top and
surface water and critical areas 19 Observation port location bottom
19 Location and orientation of Ed Clean-out location ❑ Curtain drain collector
curtain drain and all absorption Eff Manifold placement ❑ Send augmentation
components 19 Orifice placement Other cross-section detail
Ed Location and dimension of A Lateral placement with distance If Observation ports/clean-outs
primary system and reserve area to edge of bed Other Information
m Buildings 9 Audible/visual alarm referenced Yes No
61 Direction of slope indicator If Scale of drawing shown on scale R1 ❑Design staked out
ba Waterlines bar ❑ Rf Recorded Notices attached
® pukingeazemen[s,driveways, p p R O V E �Wai P(s)attached
❑ Pum curve attached
Ib North arrow and scale drawing E6 Evaluation of failure
shown on scale bar AMAR 17 2025 on-residential justification
MASON COUNTY ENVIRONMENTAL HEA to Rf Waste strength
❑ h'j Flow
DESIGN APPROVAL
The undersigned designer must be notified by installer at time of installation 21 Yes ❑ No
aG✓�-fnbL, AyAyogk z 1
Si oure[ foure[ f Designer 17 Date
The undersigned has reviewed this design on behalf of Mason County Public Health and determined it to be in
compliance with state and local
/onn--�t/I/�regulations:
E e Health Specialist Date
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
✓ The design is stamped"Approved"by Mason County Public Health. 2 _l
✓ 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.
t:pdated Dace: 12/72015
--------------------
BULB FARM RD
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DRIVEWAY � I
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PROPOSED SEPTIC TANKS I I
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POSSIBLE WELL51TE
50'+ FROM TANKS
100'+ FROM DRAINFIELD I PROPOSED 3 BEDROOM DRAINFIELD
PROPOSED BUILDING AREA
APPROX. BASE OF HILL
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PPROVEMAR1
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^,1NSON COUNTY ENVIRONMENMENTALHEALTN
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AN ASBUILTI INSTALL SIGNOFF FEE WILL
BE CNARGEO AT TIME OF INSTALLATION
PIONEER DIGGWG, INC `USTOMER: ABC1iAFL BERNARD TEST HO EL T38 NOW
PARCEL 7519133H10010 0 * LOAM 03851 LOAM
1l?NrGNLOAM 3858G9LO4\1
SEPTIC DESIGNS ADDRESS 9Q W BULB FARM RD R0.TS @ 48 R4 TS @ 55
3083E MASON BENSON M. GRMFWEW,WA 985/6 DESIGNER: ROBEECT R PAYSSE
OFFI E 3 26I803 FAX-36 V-2353 SHEE: SUE PLAN SCALE P=200 =,. °"^—'°°°^_' ° 101"°"
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DRIVEWAY
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PROPOSED 3 BEDROOM
DRAINFIELD AREA
PROPOSED SEPTIC TANKS -
POSSIBLE WELL SITE \
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50'+ FROM TANKS �� \
100'+ FROM DRAINFIELD PROPOSED
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I 1 I \I BUILDING
I I I I AREA
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APPROX. BASE OF HILL.
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PPROVE ®
�MAR 17 2025
MASON COUNTY ENVIRONMENTAL HEALTHA\T
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JBW EnwF
AN ASBOILEIINSTALL S FFEEWILL
BE CHARGED AT TIME OF INS INSTALLATION
PIONEER DIGGING, INC CUSTOMER: MICFUEL BFItNARD TAT HOLE TEST HOLE 2
PARCEL P.51913-31-ODOIO oao a wnM 3&58 9 L
a0-16 C 9IDMt 3&58 6 N LOAM
SEPTIC DESIGNS ADDRESS: 940 W BULB FARM RD ROOTS @ 48 KOOTS @ 55
3083EMASON eFrsoN aD. cnnrEVlEw,wn swab DESIGNER: ROBERT HE PAYSSE
OFFICE-36042&WM FAX-36U427-2353 SHEET: SIZE PLAN(2) SCALE P .a.= _..ate=.ww.a.mow°. ene�cxsuxx[urt
AT OB PORT&
CLEANOIIf
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APPROVE
MAsoNcooMARNV oV5 9,
JBw MENTAL HEAL-
VALVE
BOX
2"5CH. 40A
TRANSPORT LINE
EXPF
AN"WILT/INSTALL SIGNOFF FEE WILL
BE CMRGEO AT TIME OF INSTALLATION
CLLSFOMER MICHAFI.BERN TEST HOLEL TEST HOLE2
PIONEER DIGGING, ING PARCELk519L3-3HMIO *�Ciq 3&�9LOW
SEPTIC DESIGNS ADDRESS 940 W 8L9.B FARM RD li\ITS @ 8 p�is C+55
3033 E MASIXJ I E ON RD. CaAPEVIEW,WA 9&W DESIGNER: ROBERT R PAYSSE
OFFICE-3W42 W3 FAX-3604 2353 SHEET: DF DETAIL SCALE. r=10' r�.o,E.b.^ %'•••�•• ^°••"•
OBSERVATION PORT
CLEANOUT
ORIGINALGKAPE
FAIRIC
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WASH EP
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MASON COUNTY ENVIRONMENTAL HEALTH
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RISER
OR
THREADED CAP :•
ORIFICE5 m ••
W/ SHIELDS BALL
VALVES
90 SWEEP
;� yi 1 1 1 1 1� ■ ■ ■
ECK
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GLUED TEE • "
OF
BE CHARGED AT TIME OF NSTAL.t.ATION
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PARCEL t. 100 1
DD.
1: :�SONRD GRAPEVIEWWA98546 DESIGNER- ROBERT H.PAYSSE _
24'RIBBED RISERS W1 BOLT ON WATER-TIGHT LIDS
CLEANOUT VSE RISER LIP ADAPTERS WITH NO CASKET LIDS
FINISHED GRADE
WATER-TIGHT
JOINTS
INLET
OUTLET
TWO WAY TEE
4"051
EFFLUENT
WATER-TIGHT FILTER
JOINTS
TAN K5 MU5 r BE
ON STATE DOH f"CALLOW WA 7FA 77471lr
APPROVED LIST COA(CRE7ESEP77C TANK
OF SEWAGE X.
TANKS
PVMPTANKS 9
OVER 1000 CAL.
REOUIRESTWO ............ ..........
ACCESS RISERS
TO GRADE
PUMP TANKS AQUAWORKS
LOCATED AT HIGHER CONTROL PANEL
Exclea
ELEVATION THAN W/�MEK�TCk 2,4�RIBBED RISERS
PRAINFIELD MUST H�R MMR BY UCEMEP ELEMCM W/WATER TIGHT LIDS
HAVE ANTI-SIPHON 11,1
DEVICE INSTALLED.
------- xf=� FINISHED GRADE
TRANSPORT LINE
INLET NION&BALL VALVE
f"GALWNWA7FR77GHr ROVE
CO3VCPX7EAl11YP TANK
WATER-TIGHT (28 CAL,/IN.) MAR 111025
D
)OINT5 MASO UNTY ENVIRONMENTAL HEALTH
PRESSURE TRANSDUCER
(OR FLOATS) COWALVE
USE TANKS FITTED
W1 CAST IN WATER USE RUBBER
TIGHT FrMNG5FOR
INLET/OUTLESANP PUMP BUCKET: GROMETS FOR
CAST IN RISER BUCKET HEIGHT MUST BE TRANSPORTLINE
ADAPTERS TO AT LEAST HEIGHT OF PUMP AND ELECTRICAL
ENSURE WATER ON RISERS MAKE
TlGHTNE55 a SURE ALL HOLES
ARE WATER-TIGHT
PIONEER DIGGING,
NC- CUSTOMER- MIKE BERNARD
PARClL I 51913-3H=10 INSTALL jTA:NKS ON ORIGINAL OR.
SEPTIC DESIGNS ADDRESS:140 W BM FARM KID COMPACTED LEVEL SOILS, RUN CROSS
CONNECTIONS PAYSSE LAVOID SETTLING.
"3EMASONBEN�NR.O c"DvjEwwA� DESIGNER: FLOBEXT H. CONNECTIONS INTO ORIGINAL SOILS TO
OFFICE 36042618M F� 3�Z72353 SHEET TANG SCALE NA
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1Yr••we EXPIRES LATERAL LATERAL FEEDER TOTAL ORIFICE ORIFICE ORIFICE D6T.TO TOTAL TOTAL
NTERAIe LENGTH PIPE SIZE LENGTH LENGTH SIZE(inch) DISCHARGE SPACING 1STORIFICE OENf1:5 NFAD
(feet) (Inches) (feet) (feet) RATE(9pm) (feet) (inches) Ifeet)
1 60 1.25 3 63 3/16' 0.59 4 24 IS 0.73
2 60 1.25 10 70 3/16" 0.59 4 24 15 0.81
3 EO 1.25 20 80 3/16" 0.59 4 24 15 0.93
4 60 L25 30 90 3/16' 1.59 4 24 15 6.55
5 60 1.25 40 100 3/16' 0.59 4 24 15 L16
GRAINFIELD HEAD(feet) 10.19
TRANSPORT LINE HEAD(feet) 3.20
ELEVATION CHANG E(feet) 5
RESIDUAL/SQUINT(feet) 2
EXTRA LOSS/FRTINGS(feet) 5
TOTAL DYNAMIC HEAD(feet) 25.39
T G P M U
PIONEER. DIGGING, INC ac°L MI�o B "'•
SEPTIC DESIGNS ADDRESS 940 W BULB FARM RD
MAR 17 2025
9
3033EMASONBETJONRO. cRAPEVIEWWA985* DESIGNER: ROBERTHPAYSSE MASON COUNTY ENVIRONMENTAL HEALTH
OFFICE-360426003 FAX-360417-2M3 SHEET: CAL.CS SCALE NA JBW
Installation & System Notes
1.Installer must contact designer for final inspection of the installation prior to cover. All components,including tanks,lids,
transport line,drainfield,and water lines must be open for inspection. A$350.00 fee will be charged for time involved with the
inspection of the installation and creation of the record drawing. The designer reserves the right to charge additional fees if
multiple visits are needed due to installation errors or inaccessible components.
2.This septic design must be installed by a certified installer with the local health department. All components shall be installed
according to state,county,and manufacturer requirements. For Homeowner Installs,the owner must get approval from the
designer and local health department Er Eto attempting installation.
3.Designer is not a surveyor. Installer must familiarize themselves with property line locations prior to installation. Any
confusion or conflicts with line locations should be reported to the property owner. A licensed surveyor maybe necessary prior
to installation to confirm all line locations. Any discrepancies found must be reported to the designer immediately.
4.Dainfield area may only be cleared by a licensed installer familiar with sensitive drainfield area preservation. The builder,lot
developer,or property owner shall not clear the drainfield area. Any clearing required for drainfield installation shall not
remove or disturb any top soil in Primary and Reserve areas. Removal or disturbance to drainfield soils could render design
void.
S.The property owner and installer are responsible for locating all underground utilities(ex.water,gas,electric)prior to
installation. Any utility locations shown within design drawings are likely approximate and may not be exact.
6.All proposed tanks must be installed on original soils or compacted gravels. Extend all tank connection lines out onto original
soil to avoid settling issues. Risers and lids must be brought to finished grade and left accessible for future operations and
maintenance. Component manufacturers(ex.ATLI,Glendons,) may have other requirements not listed within this design.
7.All electrical wiring shall be done by a licensed electrician or homeowner(it allowed)and must be permitted through Labor
and Industries. Designer not responsible for electrical permitting or other electrical specific code requirements.
8.The proposed septic system should be installed in dry weather conditions. Any failed attempts at installation during wet
weather conditions may render this design void.
9.Maintain 1011 to waterlines with all septic components. If less than 10ft is required,sleeving in sch.40 pvc is required. If
sewage transport lines and waterlines must cross,waterline must be 18"above sewage line with one of the lines sleeved in sch.
40 pvc 10N In each direction of crossing.
10.This design may include waiver applications with specific mitigation measures pertaining to installation,operation and
maintenance of the proposed components.
11.Stormwater runoff,footing drains, roof drains must be diverted away from any septic system components. No curtain,
foundation,perimeter drains shall be installed 30ft downslope and loft upslope of drainfield areas.
12.This design is site specific and intended to meet state and county requirements that are related to the system components
being proposed. Any placement of proposed buildings,proposed wells or other non-related items on these drawings may or
may not meet other requirements.
13.All onsite septic systems require regular maintenance to verify satisfactory operation. The system owner/operator is
responsible for the continuous operation and maintenance of the system per WAC 246-272A. For operation and maintenance
information,refer to Mason County Public Health Homeowner's Manual,which should be receia aarP[ t0' t�Va
14.System owner should be cautious of landscaping around septic components. Root intrusio v VIE
can cause premature failure of the drainfield area. In addition, bushes and trees should be MAR 17 M5
away from lids and other septic maintenance points. MASON COU Y ENVIRONMENTAL HEALT
15. Changes made at time of installation may impact designer calculations,pump sizing,and BW
compliance w/county and state requirements. Contact designer prior to install w/any '
proposed variations from design. Changes may result in additional fees and permitting. , .•r
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PIONEER DIGGING, INC CUSTOMER: 3-3H 1 BI7tNARD
PAR -3HX1010 '•'01^
q•....ve"e"*" rareae
SEPTIC DESIGNS ADDRESS:- 940 W BILB FARM RD K '
3083 E.MASON BDd9JN RD. GR IEW,WA 98546 DESIGNER, RCIBERT H.PAYSSE EXPIRES
OFFICE 36n426003 FAX-360417-2753 SHEET. NOTES SCALE NA