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HomeMy WebLinkAboutSWG2024-00365 - SWG Application / Design - 8/27/2024 MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584 SHELTON:360-427-9670,EXT 400 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: SWG2024-00365 APPLICANT Russell, Justin Phone: 3609701233 Address: po box 14531 TUMWATER. WA 98511 CONTRACTOR TRAVIS ROWLAND Phone: 360-870-1287 Address: 1091 SE Craig Rd SHELTON, WA 98584 OWNER FIELD ET UX PETER Phone: Address: 4702 LUHR RD NE OLYMPIA, WA 98516 SEPTIC DESIGNER JUSTIN RUSSELL* Phone: 360.956.7242 Address: PO BOX 14531 TUMWATER, WA 98511 Site Address: 101 E COMMUNITY CLUB RD Primary Parcel Number: 221345000019 Permit Description: New 2bd Glendon M32 Permit Submitted Date: 08/27/2024 Permit Issued Date: 09/18/2024 Issued By: Rhonda Thompson Current Permit Fees Paid: $805.00 (additional fees may be required upon installation of system). Permit Expiration Date: 09/16/2027 (based on date of inspections 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 DATE RECEIVED: 9/3/2024 MASON COUNTY cn D COMMUNITY SERVICES AMOUNT RECEIVED: RECEIVED BY:online COcn m 805 — cn Public Health(Community Health/Environmental Health) C (n 360 N.6th 70,tret-400 or elton. A 985847,ext.400 SWG 2024-00365 0 0 615 N.6th Street-Shelton WA 9858a Z cn ON-SITE SEWAGE SYSTEM APPLICATION m n APPLICANT PHONF m 1— PETER FIELD 360-359-5017 z MAILING ADDRESS-STREET.CITY.STATE,ZIP CODE g 4702 LUHR RD NE OLYMPIA WA 98516 co SITE ADDRESS-STREET.CITY,ZIP CODE 101 E COMMUNITY CLUB RD I NAME OF DESIGNER PHONE ALPHA SEPTIC SOLUTION, LLC. 360-970-1233 NAME OF INSTALLER PHONE a TBD I PERMIT TYPE(select one) r DRINKING WATER SOURCE IC RESIDENTIAL OSS COMMUNITY OSS I' I COMMERCIAL OSS g PRIVATE INDIVIDUAL WELL PRIVATE TWO-PARTY WELL Z TYPE OF WORK(select one) PUBLIC WATER SYSTEM , lid NEW CONSTRUCTION/UPGRADES REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) ❑ TABLE IX REPAIR SUBMITTALS 0 SURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINE co ffiDESIGN FORM(REQUIRED) VI SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE b I 17 WAIVER(S)(IFAPPLICABLE) 2 .58 0 I t DIRECTIONS TO SITE AND SITE CONDITIONS:(ex locked gate) FROM HWY 3 AND PICKERING RD, EAST ON PICKERING RD, LEFT ONTO I COMMUNITY CLUB RD, TO SITE ADDRESS ON LEFT. 5 0 -4 SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. I OFFICIAL USE ONLY BELOW THIS LINE UPGRADE I FAILURE SOURCE(for reporting purposes) 0 VOLUNTARY 0 MAINTENANCE/PUMPING 0 BUILDING PERMIT 0 HOME SALE ❑COMPLAINT 0 OTHER: INSPECTOR SOIL LOGS COMMENTS/CONDITIONS TH1: 0-16 CL with moderate structure, 16+ mott TH2: 0-20 CL with moderate structure, 20+ mott RECORD DRAWING AND INSTALLAT-:ON REPORT SOIL CODES: V=VERY G=GRAVELLY S=SAND L=LOAM Si=SILT C=CLAY E=EXTREMELY R=ROOTS REQUIRED FOR FINAL APPROVAL. INSPECTOR SIGNATURE 9/16/24 DATE APPLICATION EXPIRATION DATE APPLICATION APPROVF2 4 ISSUED BY DATE 9/16/2027 R Thompson 13:2:1a-:roc• R Thompson THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12/7/2015 DESIGN FORM—PAGE ONE 22134-50-©0019 Assessor's Parcel Number: A design will be reviewed when 3 co ies of each of the following are submitted: ''Completed design form that has been signed and dated. � �Scaled plot plan,including all applicable items on checklist. � Scaled layout sketch,including all applicable items on checklist This form may be scanned and available for public view on the Mason County Web site.s-section sketch, n44ccrimug all m applicable er size:on 11"checklist. I7" PARCEL IDENTIFICATION Permit Number: SWG 2024-00365 Designer's Name: ALPHA SEPTIC SOLUTION,LLC. PETER FIELD Applicant's Name: Designer's Phone Number: 360-956-7242 Mailing Address: 4702 LUHR RD NE Designer's Address: 4931 68TH AVE NE OLYMPIA WA 98516 Ci State OLYMPIA WA 98516 Zip DESIGN PARAMETERS City State Zip Treatment Device CifGlendon Biofilter 0 Sand Filter 0 Mound 0 Sand Lined Drainfield 0 Recirculating Filter,Type:❑Aerobic Unit Make/fvlodel 0 Disinfection Unit Make/Model Other: Drainfield Type O Gravity fiiPressure 0 Trench 0 Bed Septic Tank/Drainfield Specifications Sub Surface Drip Number of Bedrooms Laterals 2 Schedule/Class Daily Flow:Operating Capacity 240 Daily Flow: Design Flow gpd Length g PER GLENDON gpd Diameter ft Septic Tank Capacity(working) 1000 in gal Number Receiving Soil Type(1-6) Receiving Soil Appl.Rate 5 Separation .4 gpd/ft2 ft Required Primary Area 600 2 Orifices ft Total Number of Orifices Designed Primary Area 600.56 Designed Reserve Area ft2 Diameter 600 ft2 Spacing in Trench/Bed Width NA in Trench/Bed Length ft Manifold NA ft Schedule/Class Elevation Measurements Length Original Drainfield Area Slope 4 ft New Slope,If Altered % Diameter NA % Preferred manifold configuration used? 0 Yes 0 No in Depth of Excavation Up-slope NA from Original Grade in Transport Pipe Down-slope NA Designed Vertical Separation in Schedule/Class 21 in Length Gravelless Chambers Required? ❑Yes ft lii No 0 Optional Diameter Pump Required? l�Yes 0 No in Pump/Siphon Specifications Dosing and Pump Chamber in Elevation Between Pump UppermostNumber of doses/day & Orifice 10 ft Dose quantity Drainfield Squirt Height/Selected Residual(head) ft Chamber Capacity(flood) gal Uppermost Orifice Q'Higher ❑Lower than Pump Shutoff Pump controls:Please check those required. gal Capacity @ Total Pressure Head gpm ❑Timer ❑Elapse Meter 0Event Counter Calculated Total Pressure Head ft If Timer: Pump Comments - on ,Pump off EH APPROVED Rhonda Thompson 09/18/2024 f Assessor's Parcel Number: �z 3 ! ' D -- D I DESIGN FORM—PAGE TWO `� p� S Permit Number: SWG ���� �O 6 DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch 21 Test hole locations 0 Drainfield orientation and layout Reference depth from original grade: 0 Soil logs 91 Trench/bed dimensions and El Septic tank critical distances within layout RI Drainfield cover Iii Property lines D-Box/Valve box locations Reference depth from original grade withinIA ii 100 ft of property 0 Septic tank/pump 0xing and proposedwells chamber and restrictive strata: Q Laterals,trench/bed,top and 0Measurements to cuts,banks,and locations surface water and critical areas 0 Observation port location bottom ❑ drain collector O Location and orientation of 0 Clean-out location 0 CurtainSand augmentation curtain drain and all absorption 0 Manifold placement components ❑ OrificeOther cross-section detail: placement O Location and dimension of 0 Lateral placement with distance 0 Observation ports/clean-outs primary system and reserve area to edge of bed Other Information 21 Buildings 21 Audible/visual alarm referenced Yes No Q1 Direction of slope indicator 0 Scale of drawing shown on scale d 0 Design staked out bar ❑ 0 Recorded Notices attached 0 Waterlines ❑ �Waivers)attached 0Roads,easements,driveways, ❑ 0 Pump curve attached parking on ❑ 0 Evaluation of failure !� North arrow and scale drawing Non-residential justification shown scale bar ❑ 0 Waste strength ❑ ❑ Flow DESIGN APPROVAL The undersigned designer must be notifi d by inst r t time of installation 0 Yes 0 No Silmatur of Designer 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 on-site regulations: 2024.09.18 • R Thompson 13:20:41-07'00' Environmental Health Specialist Date CAUTION: DESIGN APPROVAL IS VALID ONLYuUNDER THE FOLLOWING CONDITION: ✓ The design is stamped"Approved"by Mason County 9/16/2027 V The Onsite Sewage Permit has not expired,the Permit Expiration Date is: royal. ✓ Drainfield site conditions have not been altered to adversely affect conditions of design ape Please Note: The system must be installed by a certified installerH unless prior authorization is obtained from Mason County Public Health. 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