HomeMy WebLinkAboutSWG2025-00139 - SWG Application / Design 415 N 6TH STREET,SHELTON,WA 98584
�� MASON COUNTY SHELTON:380�27-9670,EXT400
BELFAIR:360-275-4487,EXT 400
Public Health & Human Services ELMA:360-482-5269,EXT400
FAX:360-427-7787
On-Site Sewage System Tank Only Permit: SWG2025-00139
APPLICANT WILRUSS LLC Phone:
Address: 16725 GIBSON RD SW TENINO, WA 98589
OWNER WILRUSS LLC Phone:
Address: 16725 GIBSON RD SW TENINO, WA 98589
SEPTIC INSTALLER TESSA HOLT* Phone: 360-349-5333
Address: 4225 BLACK LAKE BLVD SW OLYMPIA,WA 98512
Site Address: 420 E DARTMOOR DR
Primary Parcel Number: 321275300104
Permit Description: Replace septic tank only
Permit Submitted Date: 04/16/2025
Permit Issued Date: 04/22/2025
Issued By: Rhonda Thompson
Current Permit Fees Paid: $270.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 04/18/2026 (based on date of Inspection)
Type of Work OSS Repair
Components being Replaced: Septic Tank Only
Surfacing Sewage? No Existing Failure? Yes
Shoreline? No Horizontal Setbacks Met? Yes
Number of Bedrooms: 2 Drinking Water Source: Public Water System
Additional Details: IM-1250 gallon
Permit Conditions:
2 Permit must be installed by a Mason County Certified Installer unless prior written
authorization from Mason County Is obtained.
1 Horizontal setbacks per WAC246-272A-0210 must be maintained, unless prior approval is
obtained
3 Mason County Asbullt Form, Record Drawing,and Installation fee must be submitted for
final installation approval.
4 Proposed development subject to zoning requirements and approval by the planning
department staff per Mason County Title 17.
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: masoncountywa.govlhealth/environmental/onsiteloss-Inspection-request.php or call:
360-427-9670,extension 400. 1
J
i
• OFFICIAL USE ONLY -
DATE ftEC ENEP. i — ' , n 02
MASON COUNTYC L
OMMUNIT'Y SERVICES AMOUNT'�`�"�', RECENTD91cgirt, o m
Public Health(Community Heafth/Env ronmental Health)Gill
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415 N.6th Sis o'I-400 or Whorl.417f4467,en 400 SWG 025 _ 31 O
411 N.em St.eN-Whorl.WA ee5e4 SWG\Yf u !/+
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ON-SITE SEWAGE TANK ONLY APPLICATION 3
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APPLICANT PHONE
DODGE EXCAVATION LLC 360-349-5333 (`i f1 DD. 3
MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE t II �r f I mco
4225 BLACK LAKE BLVD SW OLYMPIA, WA 9851211 UUU / r m
SITE ADDRESS-STREET,CITY,ZIP CODE lit APR 1 6 2025 .1.) K I W
`
420 E DARTMOOR DR SHELTON,WA 98584 PHONE — I N
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NAME OF DESIGNER By l l
N/A 1 � ..,.
NAME OF INSTALLER PHONE
DODGE EXCAVATION LLC 360-349-5333 R
_ y IN
TYPE OF WORK(soled one) DRIN(ING WATER SOURCE
❑ NEW CONSTRUCTION/UPGRADES ® REPAIR/REPLACEMENT 0 PRIVATE INDIVIDUAL WELL 0 PRIVATE TWO-PARTY WELL Z I .,,,i
Q PUBLIC WATER SYSTEM COMPONENT(S)TO BE REPLACED!INSTALLED CO — I
® SEPTIC TANK 0 PUMP TANK CI RV HOLDING TANK BEDROOMS LOT SIZE I 01❑ OTHER /3"Z 9610 SQ FT
� � 0..)OTHER DETAILS(&elect a9(hal rip(*) TANKS)SETBACK CHECKLIST n
❑SURFACING SEWAGE ®EXISTING FAILURE 0 SHORELINE ❑ 100F T+PUBLIC/COMMUNITY WELLS 7C I O
0 SOFT+PRIVATE WELLS,SURFACE WATERS,STREAMS,RIVERS
SUBMITTALS 0 1OFT+DRINKING WATER SUPPLY LINES P i
❑ PLOT PLAN(REQUIRED) 0 TANK CROSS SECTION(REQUIRED) 0
❑ PUMP DETAILS(IF APPLICABLE) ❑ WAIVER(S)(IF APPLICABLE) ❑ SFT+PROPERTY!EASEMENT LINES,FOUNDATIONS,FOOTINGS
PLOT PLAN CHECKLIST oi -�-�
❑ PROPERTY LINES AND EASEMENTS 0 EXISTING/PROPOSED STRUCTURES 0 EXISTING/PROPOSED OSS COMPONENTS AND LINES O
❑ WELLS WITHIN 100FT ❑WATER SUPPLY LINES 0 DRIVEWAYS/PARKING 0 SURFACE WATERS,STREAMS,RIVERS,ETC... O
❑ DIRECTION OF SLOPE/CONTOURS 0 PERIMETER/CURTAIN DRAINS 0 NORTH ARROW 0 SCALE BAR ,�
DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.locked gale)
HEAD EAST ON w RAILROAD AVE
TURN LEFT ONTO N1ST ST
TURN RIGHT ONTO E PINE ST
KEEP STRAIGHT TO GET ONTO WA-3
TURN LEFT ONTO E MASON LAKE RD
TURN RIGHT ONTO E DARTMOOR DR
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE!FAILURE SOURCE(for reporting purposes)
In VOLUNTARY WAINTENANCEJPUMPING 0 BUILDING PERMIT CI HOME SALE ❑COMPLAINT POTHER.
COMMENTS/CONDITIONS
\Q__eie\a c,eJ Sqrrh c 0nlc—
SEWAGE TANKS MUST BE LISTED UNDER DOH'LIST OF REGISTERED SEWAGE TANKS-. TANKS MUST MEET CURRENT MINIMUM SIZE REQUIREMENTS,EQUIPPED WITH RISERS
AND LIDS TO SURFACE,AND INCLUDE AN EFFLUENT FILTER(IF APPLICABLE). RECORD DRAWING AND INSTALLATION REPORT REQUIRED FOR FINAL APPROVAL.
INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED/ISSUED BY DATE
HbIz
G Lilltire_T-`
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12112015
.
/ 'Decommission existing
_ tank.
Reli1ace with 1,200-
gallon infiltrator tank-
Connect from existing stub out to pump
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APPROVED
APR 2 Z 2025
MASON COUNTY E`tY1ROhMENTAL HEALTH 1
RET
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1
r7FILTRATORa iM-1250
septic tanks
Features&Benefits
• Strong Inleotlon molded polypropylene COn '..
• Lightweight plastic construction and lnboerd.lifting lugs allow
for easy delivery and handling
• Integral heavy-duty green lids that tnterConnect with EZanap
risers,Safety Star secondary safety lid system,and pipe riser
solutions
• Structurally reinforced access ports eliminate distortion during'
Installation and pump-outs
• Reinforced structural ribbing and Ilberglass bulkheadtieife1'
additional strength
• Can be installed with 8"to 48"(162 tot21ptulpi :01.00ver,:.
• Can be pumped dry during pump-outs •
0
\ /E D • Suitable for use as a septic tank,pumpaenlver r&nwater'(na?-
�/ potable)tank
APR 2 2 2025 • No special water filling requirements are necessary '.
� '
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MASON COUNTY ENVIRONMENTAL H •
RET
The Infiltrator 1M-1250 is a lightweight, strong and durable septic tank.
This woratertight
tank
nkdedign nis offered
s provide a
with Infiltrator's line of custom-fit EZsnap risers and heavy-duty ectio th aand watertightness.
revolutionary improvement in plastic tank design, offering exceptional long-term9
TANK CUTAWAY Partition baffle wall
C
HEAVY DUTY LID CUTAWAY
Reinforced 24"structural .
all access port
• I
:1` •r l
. .1;s, . , Structural bulkheads
J w'jr r
'`-.1
' MID-SEAM CUTAWAY
,, Reinforced water tight INFILTRATOR
mid-seam gasketed water technologies
connection
IM-1250 General Specifications and Illustrations APPROVED
The IM-1250 Is an Injection molded two-piece mid-seam APR 22 2025
polypropylene tank.The injection molded design of MkSgoragV1RnflMT�hTii
�,�,p�
thelM'1250 allows for a mid-seam joint that has precise Lint STRAP(TYP.) ET
dimensions for accepting an engineered EPDM gasket. „ri t •� ,T p;Y; „_
The engineered mid-seam joint accepts a continuous 'l'it 11� 51111I�I�I1I111I1II1-1I(jillt�Ir i t.ff,
loopEPDM Infiltrator's EPDM• sket design ' �itull ins'li1iiiiiii iU iII• �-. 81.7
gasket. liii.iw\itiiiiii IN 1y � (1,5871
ttt�t� C ,�I�_ .utilizes technology and materlsle from the sanitary III c nin in t ;`r EXTERIOR
sewer pipe lndj,atry,to.deliver a reliable watertight seal.' 'ad.in iii n�'iiinnin in Ill IeI"�!. WIDTH
The two-pl 'deeigti'�g perinaner tlytestetled using 7+ I_li�'�I I��li.�'lL'1I��'i���I���I�'I�. +A i
`: a system<ef lrtolded-irl.allgnme1 t doweis and:lOoking _ 152.3 P,88131 -
seam clips.The IM-1250 la assembled and•sold through • EXTERIOR LENGTH
a network of certifled.Iniiltrator distributors.
TOP VIEW
Must be backfiiled and installed in
❑ -
L , ''� accordance with the Infiltrator IM-and
I iPea � CM-Series Septic Tank General OUTP;IPE
Installation Instructions.For shallow
S• '''r -1!L.A ground water conditions reference vv
• the Infiltrator IM-and CM-Series Tank lititg__, • a
•••°e' G , Buoyancy Control Guidance. lit
u• - '4� .�,_: SEAM cLrP
Please visit www,infiltratorwater.com PP)LIFTING STRAP ��
1 f
SCAN M E or scan CM code for the latest (TYP)
Information.
END
ND VIEW
Working Capacity 1,278 GAL(4,839 L) o ( )
/��.�.�.�f�, i r �s ,wm.0 6101 ACCESS PORT p 4(1tnJ
Total Capacity 1,480 GAL(5,602 L) -._ IN0 2) 10.0 t21i4)FREEBOARD OUTLET
A8S
Airspace - 16.-- Gu. -Ail r �!.' -', ■ -
�::ua r
Length 154" (3,911 mm) A' III ^o2fs l
Width 61.7" (1,567 mm) J cPEecoDE in�� ,
Length-to-Width Ratio 2.8:1 '51 x Jim__ C lw
F suPPORT
Height 54.6" (1,387 mm) (^'PJ_ _ ,_4—
Liquid Level 44"(1,118 mm)
3"(76 mm) SIDE VIEW
Invert Drop __-
Fiberglass Supports 4 '
k CONTr4000S
Compartments 1 or 2 TANK TOP EWTOMERIC
HALF GASKET
all • Maximum Burial Depth 48"(1,219 min) 4�
Minimum Burial Depth 6"(152 min) •
` ra SEAM— .4 Cm CUP
/Maximum Pipe Diameter 4"(102 mm)
Weight 405 lbs(184 kg) rfTEGRALALK)NMENT
-- —-- Dower A wet BOTTOM
ME4 Business Psi(Rood
P.o.Box 76e MID-HEIiiHTSEAM$ C ...., •.
ad CT o64 s
(160.577-777-7000•tax%0 57 7 70171
1.800-721-4436
INFILTRATOR www.MObabrwater.com
water technologies woetnldtratorrreter.cem
For V.S.Patents information visit eww.lnlWralorwater.00nlpatents.OOxr patents pending.Ina ante,.Ouick4 and Utlow ere registered trademarks el IniWalor Water Tectndogies.Inillrator Wala Tech'obgieo Is a
whoily-owned subsidiary of Advanced Drainage Systems,Inc.IADS).
m 2024 Infiltrator Water rechnobgles.t 1 C.Not responsi5lo for any lypogaprrt errors.Printed in U.S.A. ed 125 0124
Contact Infiltrator Water Technologies' Technical Services Department for assistance at 1-800-221-4436