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HomeMy WebLinkAboutSWG2025-00150 - SWG Application / Design - 4/27/2025 ® MASON COUNTY 415Nfi SHELTON: 6042O70,EXT 864 H STREET, , 7-SHEL-ON,W EXT 400 BELFAIR:360-275-4467,EXT 400 Public Health & Human Services ELM:3604825269,EXT 400 FAX:360427-7787 On-Site Sewage System Tank Only Permit: SWG2025-00150 APPLICANT COX ALVIN Phone: Address: 360 EAST 1ST STREET#768 TUSTIN, CA 92780 OWNER COX ALVIN Phone: Address: 360 EAST 1ST STREET#768 TUSTIN,CA 92780 SEPTIC INSTALLER ANDREW LEHMAN' Phone: 360470-4914 Address: 282 FULLER RD SALKUM,WA 98582 Site Address: 230 E STAVIS RD Primary Parcel Number: 220185300121 Permit Description: Tank repair, patched floor and walls in septic tank.Water held at outlet baffle level for 7 days in unoccupied home.Jetted drainfleld Permit Submitted Date: 0412412025 Permit Issued Date: 04/24/2025 Issued By: Rhonda Thompson Current Permit Fees Paid: $270.00 (additional fine,may be ro4amd upon mamneuon orsymem). Permit Expiration Date: 04/2412026 (based on dale alnfpearon) Type of Work OSS Repair Components being Replaced: Other Surfacing Sewage? No Existing Failure? Yes Shoreline? No Horizontal Setbacks Met? Yes Number of Bedrooms: 2 Drinking Water Source: Public Water System Additional Details: Septic tank Permit Conditions: 4 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 Masan County Asbuitt Form, Record Drawing, and Installation fee must be submitted for final installation approval. 1 Horizontal setbacks per WAC246-2724-0210 must be maintained, unless prior approval is obtained 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/OR DESIGN APPROVED. FINAL INSTALLATION APPROVAL IS REQUIRED PRIOR TO TEMPORARY OR FINAL OCCUPANCY OF ANY RELATED STRUCTURES. For Final Inspection visit: masonmuntywa.govlhealthlenvironmenta6onsitelossanspection-request.php or call: 360-427-9670,extension 400. �C�(�C�M All 111125 OFFICIAL USE ONLY MASON C NTY D,RMCEh IZK Iz� D n COMMUN AMOBHTM N D F j� m w MIN Hmft FC mmun SN HeaIIIVE--Lnni NealtnI t� L/ (m/1 . ..�,,, SWG - OOISO o 0 Z ON-SITE SEWAGE TANK ONLY APPLICATION a A APPl1CANr PHONE m n m _ MAILINGAD 1-STREEECRY,STATE➢P COCE C a�a �4 o- WPT ( dS�01 Emjl SITE ADDRESS-STREET CITY,DP CODE a s© NAME OF DESIGNER PHONE ^\ 1 v N4M Ci IN6TAllER PHONE lO 6o v>B •vg �y z �! ttPF CF YgRK(setrtwgl IXtINpN3 NNTER SOURCE � E3 NEWCONSTRUCTION I UPGRADES REPAIR/REPLACEMENT 13 PRIVATEINDNIOUALWELL L] PRIVATETNCHPARTYWELL = I�r1 DOMPCHENIISI TORE ^' -- q < UBLIC VATER SYSTEM I \NN 4SEPTICTANK ❑PUMPTMK E3WHOWINGTANK BEbROOM5 LOT SIDE ❑ OTHER IOU OTHER DETAL$(aaMYpgMp�yy/ TAHI(IS)SETHACK ST 13 SURFACING SEWAGE EI EXISTNG FAILURE SHORELINE �IOOFT+PUBLICICOMMUNITYNELLS o (� SUBMITTALS � OFT+PRNATEWELLS.SURFACEHATERS.STREAMS.RATERS O PLOT PLAIN(REQUIRED) O TANK CROSS SECTION(REOUIREO) OFT+DRINKING WATER SUPPLY ONES ((�� ❑ PUMP DETAILS OF APPLICABLE) O MIVER(S)(IF APPLICABLE) 'FT+PROPERTY/EASEMENT LINES,FOUNDATIONS,FOOTINGS ILl PLOT PIANCHEc.w O I- 0 PROPERTY LINES ANOEASEMENTS O EXETING PROPOSED STRUCTURES L]EMSTINGY PROPOSED OSS COMPONENTS AND LINES O WELLS WITHIN IDGFT Q WATER SUPPLY LINES O DRIVNYS)PARKING 0SURFACE HATERS,STREAMS,RIVERS,ETC,. I IN Q DIRECTION OF SLOPE,CONTOURS O PERIMETER)CURTAIN DRAINS 13 MORTR ARROW OSCALE BAR 1V DIRECTIONS TO SITE AND SITE CpIMTIONE(u.IMW�F) ,a k4ea� �fea� --J waffs 1) 5e7+f.c h..6- / }'+..k A-0uq{v-4'o,^'t l wceE t.Y9wf� �cs{- 7c-f�aP Oro�1LF.`c/q�. OFFICIAL USE ONLY BELOW THIS LINE IUPGRADE)FAILURE SOURCE W R %P &) ❑VOLUNTARY MAMTENANCEIPUMPING O BUILDING PERMIT EHOMESALE DCOMPLANT D.ER: COMMENTS/ODNOTIONS SEN4C£TANKSMASTMUSTEDUNCERW -LWOFREGISTEREDSENf4GETANKS'.TANKS MU.T.EET CURRENT MINIMUM SME REOUIREMENFS,EQUIPPEDWITHRIBERS ANDUCBTOWRFACEANDINCLWEANEWLUEW ALTERBFAPPLICABLE). RECORD DRNMNGAND INSTALUTIW REPORT REWIRED FOR FIWLAPPROVAL. INSPECTORSM TURE DATE APPLICEXPIRATIONION EXPIRATION MTE AFPJGTKINAFFROVEOIISSUFOBY DATE s `4 �2k�zs �rV, 412v1 THIS FORMMAYBE SCANMEDANDAVAILABLEFOR PUBLK:NEW ON TIE MASp1 COUNTY WEBSITE REVISED IW=16 Mason County OSS Installation Report pg, 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SW G Z� Applicant Name o , e-4, ' Subdivision (Name/Div/Block/Lot) Applicant Address ;11SS.i Fc..ftas- &1 _ der rues cl).L_ 5 Lo City, State, Zip Safkt. ar�l4 qTS-T>- Installer Name Site Address a ?D FCS'r 5A>.3 RJ Designer Name INSTALLATION CHECKLIST ❑ Full System Installation T nk(s)Only ❑ Drainfield Only ❑Repair ❑Other System Type Pretreatment Type >5 ft.from foundation? -------------- ---- --------- ❑WA r21 Yes ❑ NO >50ft.from wells? -- --- --- - -- --- --- ------------ ElCJ ❑ Z >50 ft.from surface water? - - -- - ------- ------------ ❑ ❑ ❑ FCleanout between building and tank? ------------------- ❑ ❑ U Tank baffles present? -- - - -- - --- - --- ---------- - -- ❑ ❑ ❑ a 24"access risers over each compartment?---------- ------ ❑ ❑ ❑ HEffluent filter installed?---- - - - - - - - - - - - - ------- -- - - ❑ ❑ ❑ Septic tank capacity(working) Oep al Manufacturer �O D-box water level and speed levelers used? --------------- NIA ❑YES ❑ NO OLL Manifold/D-box accessible from surface?---- ------------- ❑ ❑ °PZ Check valves installed? - - ---- - ----- ------ -- --- -- - ❑ ❑ O Transport Line Size Schedule/Class Bedrooms installed(check one) K2 ❑3 ❑4 ❑5 ❑6 ❑Commercial/Other >10ft.from foundation?----- ----- - - -------------. WA ❑ YES El 0 >100 ft.from wells?----- - ---------------------_. ❑ ❑ W >100 ft.from surface water?------------------------ ❑ ❑ LL >10ft.from potable water lines?------------ -------- -- ❑ ❑ _ >5ft.from ro p party lines and easements?- ----- - ---- ---- - ❑ ❑ > 30ft.from downgradient curtain/foundation drains?------- - -- ❑ ❑ 0 Dreinfeld level and observation ports present --- -- ❑ ❑ ❑ Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?- --- --------------- 0 ❑ ❑ Pump tank setbacks consistent with septic tank?------------- ZfWA ❑ YES NO hePump tank capacity(flood) gal Manufacturer Q 24'access riser(s)and accessible from surface?------------- ❑ ❑ iLAla"or Control Panel Installed? - - - - - --------- y`I ❑ ❑ Control Panel equipped with Timer/ETM/Counter---- -- -- - -- LZJ ❑ ❑ a` Pump installed in ❑ Bucket or ❑ On Block or ❑ Other Pump Make/Model ❑ Floats or ❑Transducer a Tank draw down in/min Pump capacity gpm Squirt Heigh ft Pump on time Pump off time Daily flow set at gpd Mason County OSS Installation Report pg. 2 Parcel a ABANDONMENTRECORD Were existing septic components abandoned as part of this project? -- -- - ❑ YES NO If yes, please describe: Were all components pumped out and properly abandoned per WAC246-272A-0300? - - -- - -- - ❑ YES NO RECORD DRAWING This is a pemunentrecord and must he aca2re and deactivated enough to reAaub In Me need or mnnananw amvle.e and ruWre development Twlwi RttON Dmsdnae bonds, Dramnem a memrad orepamn a Iayoa,sanducamp bans mramn.Notib now mom painful eapmg and formed buildings,wraion of avers..petinea weB,observation sued.usua .and paper malnlemence abuse points. nmmplae Roxed Draxines may made,spatia el dpel in lrml inelaualiun approval and raaN dl. ❑ Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ENGINEER I certify that I installed the system in accordance with I certify that the system has been installed in accor- the septic design stamped°APPROVED"by Mason dance with the septic design stamped"APPROVED"by County Public Health and that any deviations shown Mason County Public Healh and that any deviations here have been clearedlapproved by both the designer shown here have been clearedrapproved by both and Mason County Public Health and meet all State myself and Mason County Public Health and meet all and Mason County Codes. State and Mason County Codes I further certify that all information contained on this I further certify that all information contained on this form and attached Record Drawing is accurate. form and attached Record Drawing is accurate. Signature oflnstaller Dat // Printed Name of Signee MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and Record Drawing on behalf of Mason County Public Health. Signature of Environmental Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE upamdb drzsrzdse 1 MASON COUNTY .HEALTH DEPARTMENT " ' ° s Leal LTO WEST BIRCH STREET M ON G IJNTY - SHELTON, WASHINGTON 9BSB4 -HEAL H MP4RTMENT PHONE J 42A-5561 RECORD OF FINAL INSPECTION OF YOUR SEWAGE DISPOSAL SYSTEM OWNER ADDRESS nL55r4 _ THIS RECORD IS NOT A GUARANTEE OF PiRFORMANCE. LEGAL ASEPTIC SYSTEM IS NOT A MUNICIPAL SEWER. HOWEVER DESCRIPTION WITH PROPER MAINTENANCE AND CAREFUL USE OF WATER 1T CAN GIVE MANY YEARS OF TROUBLE FREE SER- TD VICE. MANY PROBLEMS WITH SEPTIC TANKS ARE CAUSED SOIL ` BY FLUSHING EXCESSIVE AMOUNTS OF PAPER, CLOTH COMMENTS AND PLASTIC MATERIALS DOWN THE DRAIN, OR BY SITE A KD X LARGE AMOUNTS OF WATER FROM LEAKY FAUCETS OR NO. SI ZE FAULTY FIXTURES. DEPTH TO MONTH THE SEPTIC TANK ITSELF SHOULD BE CLEANED EVERY WATER TABLE OF YEAR TWO OR THREE YEARS DEPENDING ON THE HABITS OF THE INSTALLER FAMILY, THE NUMBER OF FIXTURES IN THE HOUSE, AND . C aV c N THE AMOUNT THAT A GARBAGE DISPOSAL IS USED.CLEAN- SIZE SEPTIC TANK (5( ING AT THE RIGHT TIME WILL AVOID THE-RISK OF INJUR- - ING OR DESTROYING THE DRAINFIELD DUE TO SOLIDS DRAINFIELD FEET CARRYING OVER INTO THE DRAINFIELD. CALL THE LENGTH MASON COUNTY HEALTH DEPARTMENT FOR A LIST OF TRENCH AREA SQ. FT. LICENSED SEPTIC TANK CLEANERS IN YOUR AREA. THE CLEANER CAN SERVE YOU BEST IF YOU SHOW HIM THIS DEPTH lOQ CORRUGATED 3.RIGID ❑ CEMENT RECORD WHEN HE COMES. DEPTH HEAVY TRUCKS OR EQUIPMENT SHOULD NEVER BE CRUOYDS b ELLS - " TOTAL TOTAL DRIVEN OVER THE TANK OR DRAINFIELD. CONSULT THIS SPACE RESERVED FOR RECORD IN CASE OF ANY BUILDINGS, DRIVEWAYS, REPLACEMENT DISTRIBUTION FIELD: 50. FT. SWIMMING POOLS, OR EXTENSIVE GRADING OR FILLING ARE LATER CONTEMPLATED. }:NORTH SHRUBS OR TREES SHOULD NOT BE PLANTED CLOSE TO THE SEPTIC TANK AS THEY WOULD INTERFERE WITH CLEANING OF THE TANK. THEY CAN BE PLANTED IN THE DRAINFIELD AREA PROVIDING WILLOWS ARE NOT USED. • '' •';- "_�: `':-' - - + - • THE YARD GRADE IN THE DISPOSAL AREA SHOULD BE SUCH THAT SURFACE WATER IS NOT POCKETED ON THE $ . A L .. DRAINFIELD. ANY SETTLING OF THE GROUND OVER THE TRENCHES SHOULD BE FILLED IN WITH SOIL. DO NOT EX- r . TW PPRO E D CESSIVELY WATER THE LAWN IN THE DRAINFIELD AREA. • ••i r ' WATER EVAPORATION FROM THE DRAINFIELD IS ABOUT ,Q EQUAL TO ONE HALF INCH OF RAIN PER DAY. FOOTING DRAINAGE, DOWNSPOUTS AND WATER Y 'r - - MASON yN(TENV�`0j, ENTAL HEALTH •. y SOFTENER RECHARGE to WATER SHOULD NOT BE CON- -�; :, ' ' : I' • ROT . . . N NECTED TO THE SEPTIC SYSTEM OR DISCHARGED INTO THE - y DRAINFIELD AREA. - - .�. I.. _ • " i THE TYPES OF BACTERIA NEEDED IN A SEPTIC TANK ARE ALWAYS FOUND IN SEWAGE. THERE IS NO NEED TO ADD YEAST OR OTHER STARTERS TO A SYSTEM. THE USE OF RE- " JUVENATORS OR CHEMICALS TO CLEAN A SEPTIC TANK �� .• 1 ' .j HAVE NOT BEEN PROVEN TO BE BENEFICIAL AND MAY BE .I- ,•�oT �P• 1 HARMFUL BY FLUSHING SOLIDS OUT OF THE TANK OR BV 'I' • - T ' CHANGING THE CHARACTERISTICS OF THE SOIL. THEA NORMAL USE OF BOWL CLEANERS OR CLEANING COM-POUNDS WILL NOT KILL THE BACTERIAL ACTION OR SLOWDOWN THE OPERATION OF THE SEPTIC TANK.THIS IS AN IMPORTANT DOCUMENT GATED BY KEEP IT WITH DEED ER OTHERESSENTIAL PAPERS. MlE BY � BEFORE APPROVED APR 2 4 2025 MASON COUNTY ENVIRONMENTAL HEALTH REi ✓ .N z AFTER PATCH IN G- Held water for one week at level of outlet baffle (vacant home),Jetted drainfield APPROVED , i