HomeMy WebLinkAboutSWG2024-00404 - SWG Application / Design - 10/1/2024 415 N 6TH STREET,SHELTON,WA 98584
leruP : MASON COUNTY SHEL AIR:360-275-4467,EXT 400
BELFAIR:360-275-4467,EXT 400
f� Public Health & Human Services ELMA:360-482-5269,EXT 400
�! FAX:360-427-7787
On-Site Sewage System Permit: SWG2024-00404
APPLICANT Hunter, Adam Phone: 360 753-1226
Address: 2201 93rd Ave SW Olympia, WA 98512
CONTRACTOR CEZARY NOWOWIEJSKI Phone: 509-868-5691
Address: 2746 NW RUDE ROAD POULSBO, WA 98370
OWNER HEIKES ET AL HEIDI M Phone:
Address: 17627 DENMARK STREET ROCHESTER, WA 98579
SEPTIC DESIGNER ADAM HUNTER* Phone: 360-753-1226
Address: PO Box 162 OLYMPIA, WA 98507
Site Address: 1151 E LAKESHORE DR WEST
Primary Parcel Number: 220175100034
Permit Description: New 3bd pressure subsurface drip
Permit Submitted Date: 10/01/2024
Permit Issued Date: 10/11/2024
Issued By: Rhonda Thompson
Current Permit Fees Paid: $805.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 10/09/2027 (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 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/onsiteloss-inspection-request.php or call:
360-427-9670, extension 400.
OFFICIAL USE ONLY
MASON COUNTY PUBLIC HEALTH DATE RECEIVED: 1 0/2/2024
ONSITE SEWAGE SYSTEM APPLICATION L C D
AMOUNT RECEIVED: 805 RECEIVED BY: C Cn
onlineo m 415 N 6th Street,(Bldg 8) Shelton WA,98584 _ Cl)
Shelton:360-427-9670 ext 400 Belfair:360-275-4467 ext 400
SWG 2024-00404 0 o
Z 6
APPLICANT PHONE Z
CEZAR NOWOWIEJSKI 5098685691 m n
MAILING ADDRESS-STREET.CITY.STATE,ZIP CODE rT1
2746 NW RUDE RD r
POULSBO WA 98370 c
SITE ADDRESS-STREET,CITY ZIP CODE W
1151 E LAKESHORE DR W SHELTON WA 98584 m
NAME OF DESIGNER
PHONE
ADAM HUNTER 3607531226
NAME OF INSTALLER PHONE
TBD
CHECK ALL APPLICABLE ITEMS DRINKING WATER SOURCE ('
IS NEW CONSTRUCTION 0 RV HOLDING TANK ONLY 0 PRIVATE INDIVIDUAL WELL
rn
❑ REPLACEMENT SYSTEM 0 INSTALLATION PERMIT ONLY 0 PRIVATE TWO-PARTY WELL 0
❑ TABLE 9 REPAIR 0 SINGLE FAMILY IS COMMUNITY/PUBLIC WATER SYSTEM Z
❑ TANK(S)ONLY ❑ COMMERCIAL SYSTEM NAME: TIMBERLAI<ES I
❑ UPGRADE TO EXISTING 0 OTHER: BEDROOMS
LOT SIZE
❑ EXISTING FAILURE "Record Drawing required 3
for all Installations" 0.42 W
n
DIRECTIONS TO SITE-BE SPECIFIC AND ADVISE OF ANY NEEDED INFORMATION FOR ACCESS(ex locked gate)
AGATE RD TO A LEFT ON TIMBERLAKE TO A RIGHT ON E LAKESHORE TO SITE ON
THE RIGHT
r-
0
SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE/FAILURE SOURCE(for reporting purposes)
1 0 VOLUNTARY 0 MAINTENANCE/PUMPING 0 BUILDING PERMIT ['HOME SALE OCOMPLAINT ['OTHER
INSPECTOR SOIL LOGS
COMMENTS/CONDITIONS
TH1: 0-46 LFS, 46+ bottom
TH2: 0-34 LFS, 34+ mott
TH3: 0-30 SL, 30+ mott (reserve)
TH4: 0-26 SL, 26+ mott (reserve)
TH5: 0-34 GSL, 34+ till (reserve)
SOIL CODES:
V=VERY G=GRAVELLY S=SAND L=LOAM Si=SILT C=CLAY E=EXTREMELY R=ROOTS
INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED BY
DATE
R Thompson 10/9/2027 R Thompson 2024.10.11
P 15:11:09-07'00'
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE
REVISED 12T72015
DESIGN FORM—PAGE ONE Assessor's Parcel Number: 2201 Z-51-00034
A design will be reviewed when 3 copies of each of the following are submitted:
''Completed design form that has been signed and dated. 'd Scaled layout sketch,including all applicable items on checklist
'' Scaled plot plan,including all applicable items on checklist. ''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: /I"X I 7"
PARCEL IDENTIFICATION
's Name: ADAM HUNTERner
Permit Number: SWG 2024-00404 Designer's 360-753-1226
Applicant's Name: CFZAR NOWOWIEJSKI Designer's Phone Number:
2746 NW RUDE RD PO BOX 162
Mailing Address: Designer's Address:
POULSBO WA 98370 OLYMPIA WA 98507
City State Zip City State Zip
DESIGN PARAMETERS
Treatment Device
❑Glendon Biofilter 0 Sand Filter 0 Mound 0 Sand Lined Drainfield 0 Recirculating Filter,Type:
❑Aerobic Unit Make/Model
0 Disinfection Unit Make/Model Other:
Drainfield Type
❑Gravity 0 Pressure 0 Trench 0 Bed Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms
3 Schedule/Class DRIP
Daily Flow:Operating Capacity
270 gpd Length 150 ft
Daily Flow: Design Flow 360 gpd Diameter 0.5 in
Septic Tank Capacity
1200 gal Number 3
Receiving Soil Type(1-6)
4 Separation 2.12 ft
Receiving Soil Appl.Rate 0.6 gpd/ft
2 Orifices
Required Primary Area
900 ft2 Total Number of Orifices DRIP
Designed Primary Area
900 ft2 Diameter DRIP in
Designed Reserve Area
600 ft2 Spacing 12 in
Trench/Bed Width 25 ft Manifold
Trench/Bed Length
36 ft Schedule/Class 40
Elevation Measurements
Length 34 ft
Original Drainfield Area Slope
3 a/o Diameter 1 in
New Slope,If Altered 3 % Preferred manifold configuration used? EiYes I 'No
Depth of Excavation Up-slope 10 in Transport Pipe
from Original Grade Down-slope 10 in Schedule/Class 40
Designed Vertical Separation
24 in Length 34 ft
Gravelless Chambers Required? 0 Yes 'No 0 Optional Diameter
1 in
Pump Required? uf Yes 0 No Dosing and Pump Chamber
Pump/Siphon Specifications
Number of doses/day 12
Difference in Elevation Between Pump Shutoff and Uppermost Dose quantity
30 gal
Orifice 5.6 ft Chamber Capacity 1200 gal
Uppermost Orifice I 'Higher 0 Lower than Pump Shutoff Pump controls:Please check those required.
Ca aci Total Pressure Head 11.2 gpm Timer l�lapse Meter 'Event Counter
p �'@ 52MIN
Calculated Total Pressure Head 95.9 ft If Timer: Pump on 9. ,Pump off 2HRS
Comments
EH APPROVED
Rhonda Thompson 10/11/2024
DESIGN FORM—PAGE TWO Assessor's Parcel Number: 2201 7-510D034
Permit Number: SWG 2024-00404
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
E' Test hole locations ®' Drainfield orientation and layout y Reference depth from original grade:
9' Soil logs 61 Trench/bed dimensions and
0' Er Property lines critical distances within layout Septic tank
❑' Drainfield cover
121 Existing and proposed wells 6 ' D-Box/Valve box locations
Reference depth from original grade
within 100 ft of
property 6' Septic tank/pump chamber and restrictive strata:
0' Measurements to cuts, banks,and locations
surface water and critical areas 6' Observation port location 0 Laterals,trench bed,top and
0' Location and orientation of '' Clean-out location bottom
curtain drain and all absorption ❑ Curtain drain collector
components
67 Manifold placement 0 Sand augmentation
E2' Orifice placement Other cross-section detail:
6� Location and dimension of
primary system and reserve area Lateral placement with distance 6' Observation ports/clean-outs
Cr Buildings to edge of bed Other Information
6'
Direction of slope indicator Audible/visual alarm referenced Yes No
6' Scale of drawing shown on scale Er 0 Design staked out
g Waterlines bar
0 0 Recorded Notices attached
0' Roads,easements,driveways, 0 0 Waiver(s)attached
parking 0 0 Pump curve attached
0 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 mus .e no ified o installer at time of installation 6'Yes 0 No
9/30/24
Si: 4esiner
Date
The undersigned has reviewed this de- gn .n behalf of Mason County Public Health and determined it to be in
compliance with state and local on-site regulations:
R Thomps4 2-07'00'
Environmental Health Specialist Date
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
✓ The design is stamped"Approved"by Mason County Public Health.
✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: 10/9/2027
/ 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.
Updated Date: 12/7/2015
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Orenco Technical Data Sheet
SYSTEMS
Using a Pump Curve
A pump curve helps you determine the best pump for your system.Pump curves show the relationship between flow and pressure(total dynamic
head or"TDH"),providing a graphical representation of a pump's optimal performance range.Pumps perform best at their nominal flow rate.These
graphs show optimal pump operation ranges with a solid line and flow rates outside of these ranges with a dashed line.For the most accurate pump
specification,use Orenco's PumpSelect`"software.
Pump Curves
500 ■■W 400
E0ries60HzO '!1Ohp - IPF20Series,60Hz,0.5-1.5hpl
400 . �®��im
m ............ 350 1PF20151 1
`�' 350 PF1010 ............i 41 i
•. MI ............ 300
300IME.RI............ I......
UtN_.......... 250 PF2010 ........
f 250 11S411...�O......... 2 1
........E.'........ .e 00
200......,'A,....... CI
PF2(105 ' \\\\\
co150.......1►..�...... 150 .............
-e'` ...1.....N.. .....
•
-- -- ORN.= o -- •-
50 �.......•:�..R.. ~ 50 _
Mal • —
0 2 4 6 8 10 12 14 16 18 0 0 5 10 15 20 25 30 35 40
Flow in gallons per minute(gpm) Flow in gallons per minute(gpm)
900
IPF30501 ! 1
I PF30 Series,60 Hz,0.5-5.0 hp I
800 EH APPROVED
700 _ Rhonda Thompson 10/11/2024
CI
600 _
IPF3o301-
500 "" 9/30/24
v 400 {PF302UJ ... c....
-.
.rpFanc
z 300 I-
a PF3010 7.. -..•-'
7:4 200 . -A. ,1--""-- -...... ' ' \
IPF3OO., •••••••• _ '' AA HUNTER ,s'i
100 PF3005 .max'.'''
26
0 5 10 15 20 25 30 35 40 45
Flow in gallons per minute(gpm)
NTD-PU-PF-5
Rev.3®01/27 Orenco Systems •800-348-9843•+1 541-459-4449•www.orenco.com
Page 4 of 5
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