HomeMy WebLinkAboutSWG2025-00197 - SWG Application / Design - 5/27/2025 MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584
SHELTON:360-427-9670,EXT 400
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BELFAIR:360-275-4467,EXT 400
Public Health & Human Services ELMA:360-482-5269,EXT 400
FAX:360-427-7787
On-Site Sewage System Permit: SWG2025-00197 cod W-r(
APPLICANT BRANDT JOHN L & CATHY P Phone:
Address: PO BOX 749 SILVERDALE, WA 98383
OWNER BRANDT JOHN L&CATHY P Phone:
Address: PO BOX 749 SILVERDALE, WA 98383
SEPTIC DESIGNER DALE TAHJA* Phone: 360-463-8023
Address: 2450 W DEEGAN ROAD WEST SHELTON, WA 98584
Site Address: UNKNOWN
Primary Parcel Number: 321275100039
Permit Description: New 2bd ATU to pressure trench
Permit Submitted Date: 05/27/2025
Permit Issued Date: 06/02/2025
Issued By: Rhonda Thompson
Current Permit Fees Paid: $825.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 05/30/2028 (based on date of inspection)
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 Drain field 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 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/environmental/onsite/oss-inspection-request.php or call:
360-427-9670, extension 400.
OFFICIAL USE ONLY
ea MASON COUNTY DATE RECEIVED: p6 Z 7 _ Z oZS
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' AMOUNT RECEIVE ��� RECEIVED BY:
� Public Health lit Human Services o mm
_
Environmental Health 360-427-9670,ext.400 or 360-275-4467,ext.400 a
415 N.6th Street- Shelton,WA 98584 S WG 2025' - 0«l�`? cn Q
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ON-SITE SEWAGE SYSTEM APPLICATION 3
APPLICANT PHONE m m
Daniel L. Brandt (206) 409-2222 I—
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MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE r C
P.O. Box 749 �, Silverdale WA 98383 m ry
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SITE ADDRESS-STREET,CITY,ZIP CODE Q� — I—
E. Dunoon Place / Shelton WA 98584 m I w
NAME OF DESIGNER N PHONE �'
Dale L. Tahja (360) 463-8023 9- I ^'
NAME OF INSTALLER PHONE
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PERRMCMIT TYPE(select one) DRINKING WATER SOURCE I N
!!7tRESIDENTIAL OSS COMMUNITY OSS ff COMMERCIAL OSS b7 PRIVATE INDIVIDUAL WELL 5 PRIVATE TWO-PARTY WELL Z
TYPE OF WORK(select one) Wa PUBLIC WATER SYSTEM Lake Limerick ter Co.
I
NEW CONSTRUCTION I UPGRADES 6REPAIR I REPLACEMENT OTHER DETAILS(select all that apply) 0 TABLE X REPAIR N I C)1
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SUBMITTALS 0 SURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINE DESIGN FORM(REQUIRED) eSEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE WAS LOT CREATED AFTER4/1/2025? r0W I
b WAIVER(S)(IF APPLICABLE) 2 0.26acre 0 YES 0 NO Z I
DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.locked gate) IC)
Turn left into Lake Limerick on Andrews Dr., right on Tralee Dr., left on Dunoon Place, I o
property on the left.
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colSITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. CD
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE I FAILURE SOURCE(tar reporting purposes)
0 VOLUNTARY 0 MAINTENANCE/PUMPING 0 BUILDING PERMIT ['HOME SALE ['COMPLAINT 0 OTHER:
INSPECTOR SOIL LOGS COMMENTS/CONDITIONS a Ir,
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SOIL CODES: RECORD DRAWING AND INSTALLATION REPORT
V=VERY G=GRAVELLY S=SAND L=LOAM SI=SILT C=CLAY E=EXTREMELY R=ROOTS REQUIRED FOR FINAL APPROVAL.
INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE J
APPLICATION APPROVED/ISSUED BY DATE
( 1-/Wili WI �(- IK V'Sb 10V,11•0())46YY1 (Z�'z'THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE Revised:4/14/2025
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DESIGN FORM—PAGE ONE Assessor's Parcel Number: , �( -EL - o Q 039
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. '1 Cross-section sketch,including all applicable items on checklist.
This form may be scanned and available for public view on the Mason County Web site.Maximum paper size: 11"X 17"
PARCEL IDENTIFICATION j
Permit Number: SWG 2025-00197 Designer's Name: Dale L.Tahja
Applicant's Name: Daniel L. Brandt Designer's Phone Number: (360)463-8023
Mailing Address:
P.O.Box 749 Designer's Address: 2450 W. Deegan Rd.W.
Silverdale WA 98383 City State Zip Shelton WA 98584
City State Zip Designer's Email daletahja@gmail.com
DESIGN PARAMETER` `, .
Treatment Device
0 Glendon 0 Sand Filter 0 Mound 0 Sand Lined Drainfield 0 Recirculating Filter 0 ATU NuWater BNR-500 0 O' er --
Treatment Level(check all that apply): ❑A E B ❑ C 0 BLI E BL2 0 BL3 ❑E ❑N
Drainfield Type �4)- )
lgGravity 0 Pressure l 'Trench 0 Bed 0 b ace jp
Septic Tank/Drainfield Specifications Laterals F/L <
Number of Bedrooms 2 Schedule/Class Sch.40 <;e)
Daily Flow: Operating Capacity 180 gpd Length 62&73 f3
Daily Flow: Design Flow 240 gpd Diameter 1.25 in
Septic Tank Capacity(working) NuWaterBNR500 gal Number 2
Receiving Soil Type(1-6) 4 Separation 10 ft
Receiving Soil Appl.Rate 0.6 gpd/ft2 Orifices
Required Primary Area 400 ft2 Total Number of Orifices 35
Designed Primary Area 400 ft2 Diameter 1/8 in
Designed Reserve Area 400 ft2 Spacing 48 in
Trench/Bed Width 3 ft Manifold
Trench/Bed Length 135 ft Schedule/Class Sch.40
Elevation Measurements Length 20 tt
Original Drainfield Area Slope 20 % Diameter 1.25 in
New Slope,If Altered 18 % Preferred manifold configuration used? ❑Yes 'No
Depth of Excavation Up-slope 16 in Transport Pipe
from Original Grade Down-slope 9 in Schedule/Class Sch. 40
Designed Vertical Separation 12 in Length 30 ft
Gravel-based Drainfield Required? 0 Yes e No Diameter 1.25 in
Pump Required? Er Yes El No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day 4
Diff. in Elevation Between Pump&Uppermost Orifice 1 ft Dose quantity 45 gal
Drainfield Squirt Height/Selected Residual(head) 6 ft Chamber Capacity(flood) 1,000 gal
Uppermost Orifice 0 Higher ❑Lower than Pump Shutoff Pump controls:Please check those required.
Capacity @ Total Pressure Head 18 gpm Lg Timer VI Elapse Meter Event Counter
Calculated Total Pressure Head 15 ft If Timer: Pump on 2.5 min. ,Pump off 5 hrs.57.5 min.
Comments APPRoVEl)
J U N 0 2 2025
obtri CmnitmRbt+ !Ekhht HC4(.TH
p rT Revised:4/14/2025
,- ; .
, . DESIGN FORM—PAGE TWO Assessor's Parcel Number:3�, \ �L -- � -- ()__CI( 2
Permit Number: SWG 2025-00197
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
P1 Test hole locations ref Drainfield orientation and layout Reference depth from original grade:
El Soil logs El Trench/bed dimensions and ig Septic tank
El Property lines critical distances within layout la Drainfield cover
P l Existing and proposed wells g D-Box/Valve box locations Reference depth from original grade
within 100 ft of property L1 Septic tank/pump chamber and restrictive strata:
O Measurements to cuts,banks, and locations ® Laterals,trench bed,top and
surface water and critical areas B Observation port location bottom
Pia Location and orientation of le Clean-out location 0 Curtain drain collector
curtain drain and all absorption g Manifold placement 0 Sand augmentation
components H Orifice placement Other cross-section detail:
0 Location and dimension of L1 Lateral placement with distance 0 Observation ports/clean-outs
primary system and reserve area to edge of bed
Other Information
I L1 BuildingsEl
0 Audible/visual alarm referenced Yes No
Direction of slope indicator ET Scale of drawing shown on scale I 0 Design staked out
Pin Waterlines bar 0 0 Recorded Notices attached
Ei Roads,easements,driveways, El Elevation benchmark and relative 0 0 Waiver(s) attached
1 parking elevations of system components iff 0 Pump curve attached
Lot North arrow and scale drawing 0 0 Evaluation of failure
shown on scale bar Non-residential justification
❑ 0 Waste strength
❑ ❑ Flow
DESIGN APPROVAL
The undersigned designer ust be notified installer at time of installation E 'Yes 0 No
Signature of Designer J • Date i
4.1�k 0
The undersigned has reviewed this design on behalf of Mason County Public Health and determi�.;,�• .:`b�iJ
compliance with state and local on-site regulations: '0,-6
avi Gi-7-frc.f:-----c7-4f:"Akii, i•31 04.
Environmental Heal Specialist • Date ‘;, '41 ;.d,s ro u, 1 !
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING COND "t3 i
✓ The design is stamped"Approved"by Mason County Public Health. "(/1� ��``� "/
✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: -> J✓o in ---kk
✓ 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. Revised:4/14/2025
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INSTUA1ON INSIRJCi1QIS C1v615FGYY9�L
1)Eccavate tack hie watt vetial walls to 1 foot lager thst
tack on all sides.
2)If b cf It cttam de is stay,irst 3'd ocirpec t sad&level 9-2
a t Lrittl screed \.
3)Install taik in cats cf Irde;keeping 1 ft.vdd space on I I ——— —
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7)L xn addrvd to ba ill,ca�afd tidalithrtativve •0 II
sills o✓er top d fork A;«19L1CHMER t1 1BR I 1 CLARIFIER
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AEROBIC MEM-TANK DETAIL FOR
NuWATER 13NR-500 TREATMENT'UNIT
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Liberty Pumps 280 - 1/2 HP Cast Iron Submersible Sump/Effluent Pump (Non-
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APPROVED
JUN 0 2 2025
MASON COUNTY ENVIRONMENTAL HEALTH
RET
•
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Installation/Maintenance
Pressure Distribution/Trench Systems
1. Install trench bottom level and in contour with the ground.
2. Install drainfield during dry weather and soil conditions.Any soil smearing must be
eliminated by hand raking any areas that get smeared.
3. Install audio/visual high water alarm.
4. Install effluent filter in septic tank outlet or pump vault with 1/16 inch maximum
filtration mesh size.
5. Install check valve in pump outlet line to prevent back-flow into the pump chamber.
6. Install 1/8 inch orifices on 4ft. Centers. Install the orifices, with orfice schields, pointing
straight up ( 12:00 o' clock).
7. Divert all storm water run-off away from septic system components.
8. No curtain (french) drains allowed within 10ft. of the up-slope edge of the drainfield and
reserve area.
9. No curtain (french) drains allowed within 30ft. of the down-slope edge of the drainfield
and reserve area.
10.Have the septic tank and pump chamber pumped or inspected every 3 to 5 years.
11.Inspect and clean pump screen as needed.
12.Inspect floats and test high water alarm every 6 to 12 months or as needed.
13.All material and workmanship must meet County and State requirements.
14.Install risers on septic tank and pump chamber.
15.Deviation from this approved design without prior approval from the Designer and
Mason County Health Department will make this design null and void.
16.The prepared Site Plan is not a survey, it is the owner's responsibility to verify property
line locations prior to installation. Any discrepancies must be reported to the Designer
immediately.
17. Locate all utilities prior to starting installation.
18. A Final Inspection and Record Drawing fee will be charged upon completion of the
installation.
19. The installer will notfy the designer, Dale Tahja(360)463-8023, 48 hours prior to the
start of the installation.
20. An additional re-design fee may be charged if c. , ges are requested from the applicant
after the original design is approved. 0.,
APPROVED �,�� ►,
UN 02 2025 �� 'F 1 gat
MASON COUNTY ENVIRONMENTAL HEALTH ' 1 t
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Daissi.Tails ,LICENSED DESIGNER •