HomeMy WebLinkAboutswg2025-00118 - SWG Application / Design - 4/4/2025 ® MASON COUNTY 415N 6SHELTON: 60H27-ON,WA98600
SHELTON:360A7]-4467:EXT 400
BELFAIR'.360.2]5<46],EXT 400
Public Health & Human Services ELMA 360-082-5269,EXT 400
(� FAX:360427-7787
On-Site Sewage System Permit: SWG2025-00118 (n U NT7
APPLICANT CUCULIS CORY&CALIE Phone:
Address: PO BOX 3261 BELFAIR,WA 98528
OWNER CUCULIS CORY&CALIE Phone:
Address: PO BOX 3261 BELFAIR,WA 98528
SEPTIC DESIGNER CINDY WAITEe Phone: 360-701-0205
Address: 80 E PICKERING LANE SHELTON,WA 98584
SEPTIC INSTALLER TAYLOR TONEYa Phone: 360-426-4221
Address: 2971 E PHILLIPS LAKE RD SHELTON,WA 98584
Site Address: 351 NE SCHOONER LOOP
Primary Parcel Number: 123305200043
Permit Description: Nonconforming Repair 2bd gravity trench
Permit Submitted Date: 04/04/2025
Permit Issued Date: 0411 8/2 0 2 5
Issued By: Rhonda Thompson
Current Permit Fees Paid: $825.00 (additional fees maybe required upon instalWien oisyste,n).
Permit Expiration Date: 04/07/2026 (Weed on date orinspecbon)
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 Dreinfield installation not to exceed designed upslope and downslope depth specified on
design form.
4 Installer is responsible for obtaining Masan County installation approval prior to backfill of
system components.
5 Installer is responsible for obtaining Septic DesignerlEngmeer installation approval prior to
backfill ofsystem 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/onsite/oss-inspection-request.php or call:
360-427-9670,extension 400.
OFFICIAL USE ONLY
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APPLICANTPHOIE RI r
CORY/CALIE CUCULIS C/O B-LINE CONST 2 0-426-4221
MAILINGA➢DRE99-STREET,Clrv.STATE,LP CODE C
PO BOX 3261 BELFAIR WA 98528 m
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351 NE SCHOONER BELFAIR WA 98528
NAW!OFDESKINER r PHONE I N
CINDY WAITE 360-701-0205
NAME OF INSTN1Efl By PHDNE I W
B-LINE CONSTRUCTIO 360.4264221
PERMIT Y E(a dwe) DRINKING WATER SOURCE y I W
9RESIDENTIALOSS ECOMMUNITYOSS EOOMMERCIAL OSS 6 PRIVATE INDIVIDUALWELL ElPRIVAT TWO,PARTYWELL O
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15NEW CONSTRUCTION/UPGRADES REPAIR/REPLACEMENT OTHER DETAILS(.w MY,x V*) DYABLE IX REPAIR I I (T
su"IITTAS 13 SURFACING SEWAGE MEMSTINGFAILURE [3SHORELINE
WDESIGN FORM(REQUIRED) JfSEPTIC DESIGN(REQUIRED) BEDROOMS LOTSRE 0 IN
6'WAVER(S)(IFAPPUCABLE) 2 827CI69lx60lX110l n
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OIRECTIONSTD SITEPND bITE CONWTICN3:(¢c bYetlpexJ x
GO TO BELFAIR TOWARDS BELFAIR STATE PARK, TURN RIGHT ON SAND HILL o
ROAD, TURN LEFT ON TO LARSEN BLVD, TAKE SECOND SCHOONER DRIVE ON r
THE RIGHT, PARCEL IS ON THE RIGHT SIDE OF THE STREET, SOIL LOGS ARE AT
THE BACK OF THE HOUSE 141
snEMusraEAuxGEDrRDMxAwRwDAero resrxous,xusraEAuaGER HTm rEsrxwExureERs. I (A)
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE/FAIWRESOURCE(brmg wry e)
E3VOLUNTARY E]MAINTENANCEIPUMPING EISUILDINGPERMIT OHOMESALE OCOMPIAINT ❑OTHER;
INSPECTOR SUL LOGS COMMENTSICONORIONS
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SOILCODEB. RECORDOUWINGAN TALLATONREPoR
V=VERY G-GRAVELLY S=SAID L•LOANi &-MIT C-CLAY E-EXTREMELY R•RDOT9 REQUIRED FOR APPROVAL
INSPECTORSIGNATME OITE APPLIINFXPIM WTE APFLICATONAPPROVEDIIWLJEDSY' I > DATE
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TNISFORMMAYSE ANNED ANOAVAILABLE FOR PUBLIC WEW ONTHE MASON COUNTY WESSRE REVBEDINMSIS
DESIGN FORM—PACE ONE Assessor's Parcel Number: 1 2 3 3 0 — 5 2 — 0 0 0 4 3
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. I Cross-section sketch,including all applicable items on checklist.
Thistles. maybe scanned and available for public view on the Mason County Web into.Maximum paper size: //"X/7"
PARCEL IDENTIFICATION
Permit Number: SWG 2,2-2 r— O/h ffr Designer's Name: CINDYWAITE
Applicant's Name: CORYICALIE CUCULIS CO B LIN Designer's Phone Number: 360-701-0205
Mailing Address: PO BOX 3261 Designer's Address: 80 E PICKERINTG LANE
BELFAIR WA 98528 SHELTON WA 985M
City State Zip City State Zip
DESIGN PARAMETERS
Treatment Device
❑Glendon Biofilwr ❑Sand Filter 0 Mound ❑Sand Lined Drainfield ❑Recirculating Filter,Type:
❑Aerobic Unit MaketModel ❑Disinfection Unit MaketMadel Other:
Drainfield Type
Itl(Gmvity ❑ Pressure 6)(Trench 0 Bed O Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 2 Schedule/Class ASTM 2729
Daily Flow:Operating Capacity 180 gpd Length 50 ft
Daily Flow: Design Flow 240 glad Diameter 4 in
Septic Tank Capacity(working) ISTIEX NG 1000 gal Number 2
Receiving Soil Type(I-b) 3 Separation 9-12 it
Receiving Soil Appl.Rate .8 gpd/ftr Orifices
Required Primary Area 300 ftr Total Number of Orifices ASTM 2729 PERF
Designed Primary Area 300 ft" Diameter in
Designed Reserve Area 300 ft, Spacing in
Trench/Bed Width 3 ft Manifold
Trench/Bed Length 100 ft Schedul' lass
Elevation Measurements Lengt sad '1/-� it
Original Dreinfield Area Slope <1 % Di _ `k in
New Slope, If Altered % P p �tion used? O Yes lif No
y `
Depth of Excavation Up slope 35 in CA YB 4ta
WAT +� ansporl Pipe
from Original Grade Oowroslope 35 in L CErvs ITS1nNER 3034
Designed Vertical Separation 24 in Leng`tfi"Rss av,o� Y5 it
Gmvelless Chambers Required? Cl Yes O No Cl Optional Diameter 4 in
Pump Required? ❑ Yes Id No Dosing and Pump Chamber
Pump/Siphon Specifications Number ofdosestday
Diff.in Elevation Between Pump&Uppermost Orifice ft Dose quantity gal
Drainfield Squirt Height/Selected Residual(head) ft Chamber Capacity(Flood) � gal
Uppermost Orifice O Higher D Lower than Pump Shutoff Pump controls:Please check those required.
Capacity Q Total Pressure Head glint OTimer DElapse Meter 0 Event Counter
Calculated Total Pressure Read it if Timer: Pump on Pump off
Comments
NON CONFORMING REPAIR GRAVEL BASE DRAINFIELD, RETRO FIT SEPTIC TANK WITH RISERS
A EFFLUE ER-,M ALL CLEAN OUT BETWEEN RESIDENCE AND SEPTIC TANK.
DESIGN FORM—PAGE TWO Assessor's Parcel Number: l 2 3 3 0 — 5 2 — 0 0 0 4 3
----- -- -----
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
ld Test hole locations m Drainfield orientation and layout Reference depth from original grade:
m Soil logs 21 Trench/bed dimensions and ld Septic tank
Id Property lines critical distances within layout G1 Drainfield cover
❑ Existing and proposed wells 69 D-Box/Valve box locations Reference depth from original grade
within 100 tt of property Rf Septic tank/pump chamber and restrictive strata:
❑ Measurements to cuts,banks,and locations 19 Laterals,trenchlbed,top and
surface water and critical areas 91 Observation port location bottom
❑ Location and orientation of 69 Clean-out location ❑ Curtain drain collector
curtain drain and all absorption ❑ Manifold placement ❑ Sand augmentation
components ❑ Orifice placement Other cross-section detail:
m Location and dimension of RI Lateral placement with distance 61 Observation ports/clean-outs
primary system and reserve area to edge of bed
m Buildings Other Information
❑ Audible/visual alarm referenced Yes No
m Direction of slope indicator 56 Scale of drawing shown on scale ❑ ❑ Design staked out
Id Waterlines bar 61 ❑ Recorded Notices attached
❑ Roads,easements,driveways, ❑ ❑ Waiver(s)attached
parking ❑ ❑ Pump curve attached
m 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 nr by in at at time of installation Ef Yes ❑ No
4 X* of 1 -I1 -2-�
Signature peDesigner Dat
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:
Environmental Health Date
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWDV CONDMON:
✓ The design is stamped"Approved"by Mason County Public Health. f ��-�^
✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: U
✓ 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,L
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.
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APPROVED I o LICENSEOE
APR 18 2025
MASON COUNTY ENVIRONYENTAL HEALTH
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APR 18 2025MASON COUNTY ENVIRTONMENTAL HEALTHREI
FAPMES OSIW
Installation Notes
Gravity Distribution System:
351 N E Schooner 12330-52-00043
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. Retro fit septic tank with risers and effluent filter
3. Install cleanout between residence and septic tank
4. Gravel based drainfield required
S. Keep system as shallow as possible
6. Install system during dry weather with acceptable soil conditions
7. Keep wheeled vehicles off the drainfield area before, during and after installation.
Tracked equipment only
8. 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.
9. Curtain drains can be no closer than 10' upgradient and 30' down gradient of the
drainfield
10. Exposed restrictive layers, cuts, banks, etc. can be no closer than 50' downhill from the
drainfield.
11. Install access risers on the septic tank, D-box and observation ports.
12. Make sure septic tank risers are epoxied or caulked to cast in riser rings on tank.
13. Lids must form a water and gas tight seal with the access risers
14. Install effluent filter at the septic tank outlet.
15. This system must be installed by a Mason County Certified Installer.
16. Deviation from this design without prior approval from the designer and Mason County
Health Department will make this design null and void.
17. 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.
18. Install laterals or bed with contour of the ground
19. Install trench bottoms level and always maintain a minimum of six inche to native soil
20. Filter fabric required over drain rock prior to backfilling. If the dra' -r k extends
above the original grade, run the filter fabric at least 2 inches do th ench wall
APPROVED 3��e ' Sn
APR 18 2025 ! ! 7l
MASON COUNTY ENVIRONMENTAL HEALTHyucEes`sno sac ER -
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System Owner Responsibilities:
1. Operation and Maintenance is required by Washington State Department of Health and
Mason County Health Department.
2. The septic tank should be pumped every three to five years or as needed.
3. System owners are responsible for having maintenance performed every three years as
per WAC246-272A.
4. System owners are responsible for responding to septic issues in a timely manner.
5. System owner agrees to read and abide by information regarding their system in the
User Manual provided by Mason County Public Health.
6. Keep the flow of sewage at or below the approved design operating capacity.
7. Keep waste strength at residential waste strength parameters.
8. Spread loads of laundry through the week.
9. Do not use excessive bleach or detergents with added whiteners.
10. Do not shower, do laundry and dishwasher at the same time
11. Antibiotics can kill or impair the biological process in the septic tank.
12. Leaky plumbing can hydraulic overload your on-site septic system.
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APPROVED -711
APR 18 2025
MASON COUNTY ENVIRONMENTAL HEALTH
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