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HomeMy WebLinkAboutSWG2025-00209 - SWG Application / Design - 6/2/2025 MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584 SHELTON:360-427-9670,EXT 400 elM.1 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: SWG2025-00209 APPLICANT Zimny, Jim Phone: 360-516-7287 Address: 7178 windflower pl nw Seabeck, WA 98380 OWNER JOLLIFFE ELIZABETH & DARELD Phone: WAYNE JR Address: 7354 BETHEL BURLEY RD SE PORT ORCHARD, WA 98367 SEPTIC DESIGNER Jim Zimny Phone: 360-516-7287 Address: 7178 WINDFLOWER PL NW SEABECK, WA 98380 Site Address: 8621 NE North Shore Rd Primary Parcel Number: 222181400100 Permit Description: Table 10 repair 1bd ATU to pressure bed Permit Submitted Date: 06/02/2025 Permit Issued Date: 06/24/2025 Issued By: Rhonda Thompson Current Permit Fees Paid: $825.00 (additional fees may be required upon installation of system). Permit Expiration Date: 06/03/2026 (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/onsiteloss-inspection-request.php or call: 360-427-9670, extension 400. -OFFICIAL USE ONLY MASON COUNTYDATE REOEIVED: 6(7/ �s— u) aa : AMOUNT IECEVED.S���! RL�NFD�: oo rn f=- Public Health & Human Services J ��! o Environmental Health 360-427-9670,ext.400 or 360-275-4467,ext.400 /]�� /� �f co C 415 N.6th Street-Shelton,WA 98584 S W V �/ 4/}� — / )®/��� Z Cl) CLEAR FORM ON-SITE SEWAGE SYSTEM APPLICATION D n g m n APPLICANT PHONE m Darneld & Betsy Jolliffe 360-265-8696 z MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE K 7354 BETHEL BURLEY RD SE PORT ORCHARD WA 98367 m X SITE ADDRESS-STREET,CITY.ZIP CODE 8621 Northshore RD,BELFAIR WA 98528 r'i NAME OF DESIGNER PHONE ` Jim Zimny 360-516-72872 I( NAME OF INSTALLER PHONE 0 1_1 C N __ PERMIT TYPE(seeecf one) DRINKING WATER SOURCE o RESIDENTIAL OSS fl COMMUNITY OSS rl COMMERCIAL OSS 17t-PRIVATE INDIVIDUAL WELL El PRIVATE TWO-PARTY WELL Z (� TYPE OF WORK(sel cf one) : PUBLIC WATER SYSTEM CC r In NEW CONSTRUCTION/UPGRADES EPAIR/REPLACEMENT OTHER DETAILS(select all that apply) 0 TABLE X REPAIR SUBMITTALS 0 SURFACING SEWAGE ® EXISTING FAILURE 0 SHORELINE CO 71 DESIGN FORM(REQUIRED) f 1 SEPTIC DESIGN(REQUIRED) OpM LOT SIZE WAS LOT CREATED AFTER 4/1/2025? O r S // Ti WAIVER(S)(IF APPLICABLE) \ (Ai-6 0 YES ❑✓ NO r G DIRECTIONS TO SITE AND SITE CONDITIONS.(ex lacked gate) From Bellfair travel 8.5 miles west on Northshore rd. Property is on the left marked with G Pink Ribbons. 1- 0 0 0 SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED W17H TEST HOLE NUMBERS OFFICIAL USE ONLY BELOW THIS LINE UPGRADE I FAILURE SOURCE(tor reporting purposes) 0 VOLUNTARY ❑MAINTENANCE/PUMPING ❑BUILDING PERMIT PHONE SALE ['COMPLAINT ❑OTHER: INSPECTOR SOIL LOGS COMMENTS/CONDITIONS ...--.W \ aP 0._-‘1 ko \I VP\„.,) (16,\—Col\---(011/t c'N T6:\-- k00-kt/n --\-6t1/ -e' 1 0 \Wl 4C43,. . C) \ °J''' 'TA-7 -, c Ar)\--L- RECORD DRAWING AND INSTALLATION REPORT SOIL'CODES: V=VERY G=GRAVELLY S=SAND L=LOAM S,=SILT C=CLAY E=EXTREMELY R=ROOTS REQUIRED FOR FINAL APPROVAL. INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED/ISSUED BY DATE (6\7/1491/1 6/3/7r 6�r6/ m c� /macr�rTHIS FORM ME SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE Revised:4/14/2025 DESIGN FORM-PAGE ONE Assessor's Parcel Number: 222181400100- -- A design will be reviewed when 3 copies of each of the following are submitted: 0 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. °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"A"1 7" PARCEL IDENTIFICATION Permit Number: SWG 2025-00209 Designer's Name: Jim Zimny Applicant's Name: DARELD&ELIZABETH JOLLIFFE Designer's Phone Number: 360-5616-7287 Mailing Address: 7354 BETHEL BURLEY RD SE Designer's Address: 7178 Windflower pl NW PORT ORCHARD WA 98367 City State Zip Seaebeck WA 98380 CLEAR FORM apddesi ns@icloud.COm City State Zip Designer's Email 9 DESIGN PARAMETERS Treatment Device ❑Glendon 0 Sand Filter 0 Mound ❑ Sand Lined Drainfield 0 Recirculating Filter 0 ATU bnr-500 u other Treatment Level (check all that apply): p A 0 B 0 C 0 BL 1 0 BL2 0 BL3 ❑ E ❑N Drainfield Type ❑ Gravity Ifr Pressure 0 Trench i'Bed 0 Sub Surface Drip Septic Tank/Drainfield Specifications Laterals -# Number of Bedrooms 1 Schedule/Class; .. sch 40 Daily Flow:Operating Capacity 180 gpd Length � • �h 24' ft Daily Flow: Design Flow 240 gpd Diameter q° . 0, 1" in Septic Tank Capacity(working) 1000 gal Numbe,� . ��,j ri y ICEN- . rii"SIGNER �\ 0' Receiving Soil Type(1-6) Z► Se.. ,...:_.....� .t, �a C ft Receiving Soil Appl.Rate 1.0 gpd/ft2 CI '1''Z Orifices Required Primary Area 240 ft2 Total Number of Orifices SZ-- ? Designed Primary Area 240 ft2 Diameter 1/8" in Designed Reserve Area 240 ft2 Spacingq`� 2 in Trench/Bed Width 10 ft Manifold Trench/Bed Length 24 ft Schedule/Class sch 40 Elevation Measurements Length 6' ft Original Drainfield Area Slope 1 % Diameter 1.5" in New Slope.If Altered 1 % Preferred manifold configuration used? 0 Yes 0 No Depth of Excavation Up-slope 18 in Transport Pipe from Original Grade Down-slope 18 in Schedule/Class sch 40 Designed Vertical Separation 24+ in Length 20' ft Gravel-based Drainfield Required? i 'Yes 0 No Diameter 2" in Pump Required? E'Yes 0 No Dosing and Pump Chamber Pump/Siphon Specifications Number of doses/day 6 Diff. in Elevation Between Pump&Uppermost Orifice 5 ft Dose quantity 30 gal Drainfield Squirt Height/Selected Residual(head) 5 ft Chamber Capacity(flood) 1000 gal Uppermost Orifice erHigher 0 Lower thatt Pump Shutoff Pump controls: Please check those required. Capacity Via?Total Pressure Head 111 7 gpm e( Timer 0' Elapse Meter V Event Counter Calculated Total Pressure Head 15.5 ft If Timer: Pump on S L Al ,Pump off 4 hrs Comments A P P R O JUN 2 LJ 2025 woi c;64rf Blain VP MI-I -ALTH RET Revised:4/14/2025 •DESIGN FORM—PAGE TWO Assessor's Parcel Number. 222181400100.- -- Permit Number: SWG DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch P.1 Test hole locations ief Drainfield orientation and layout Reference depth from original grade: El Soil logs Ef Trench/bed dimensions and El Septic tank d Property lines critical distances within layout B Drainfield cover 0 Existing and proposed wells V D-Box/Valve box locations Reference depth from original grade within 100 ft of property 112f Septic tank/pump chamber and restrictive strata: h3 Measurements to cuts,banks,and locations Er Laterals,trench bed,top and surface water and critical areas Observation port location bottom El Location and orientation of WI Clean-out location ❑ Curtain drain collector curtain drain and all absorption of Manifold placement 0 Sand augmentation components Orifice placement Other cross-section detail: El Location and dimension of P1 Observation ports/clean-outs system and reserve area Ig Lateral placement with distance p rts/clean-outs to edge of bed Buildings Other Information El Audible/visual alarm referenced Yes No Ef Direction of slope indicator 0 Scale of drawing shown on scale 0 Ei Design staked out El Waterlines bar 0 0 Recorded Notices attached Ef Roads,easements,driveways. 0 Elevation benchmark and relative Lot ❑Waiver(s)attached parking elevations of system components ®' ❑ Pump curve attached El North arrow and scale drawing 0 0 Evaluation of failure shown on scale bar Non-residential justification ❑ ❑Waste strength ❑ ❑ Flow DESIGN APPROVAL The undersigned designer must be notified b n Iler at time of installation VYes 0 No /- 2j� Signature D signer 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: Environmental Health(IMAIY\y751(n ialist Date CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION: ✓ The design is stamped "Approved"by Mason County Public Health.✓ (5 The Onsite Sewage Permit has not expired,the Permit Expiration Date is: p 174 ✓ 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. RVY1Nd, Of/DV F. atEr� z g i rs N EN1nt2 A , CO 0 a 'Ti t to :4M„ (v0 uw o ` ) co o 0 oc aq c or O , G c1-4 00 3r•S y � �.c 3 v CI) Z "_ I I o a, v . a, c a = r `+- p " ¢ � cn ¢ < p m N 0 ate. cn m co 0 Q Z E APPROVED JUN 2 /t 2025 0 v MASON COUNTY ENVIRONMENTAL HEALTH Y a, RET 2 , c•as cu •-- 4. so a � v V ) r-wa >z o ° o < wm 5 I a_ a_ i 46 Z L © I I I I a) a 0 in a) 2 od d 0 °- ss a) a� � �. m 1054' y' 102' v (� C i5 U rd of s o c/ ,� O 0) T Z£IZ I ��7. I ZbZ .•• G y L �\ J ,o,Tti 1-15/ Z ' ' 4- ,1'r 0 3 Q 3CI ft 4.�. GJ 'Ite y L..4.5 C1 I a.' t' MS 1 .1 !� 11 'CZ ''.-.4 Cr)iV 3 v 1.5 o) Z 3 �� i `)' Q Doom r\I al as r co vO APPROVED J.= co 0 s JUN242025s " 03 �Z MASON COUNTY ENVIRONMENT$!.HEALTH ( 0.8 RET ' ' in (15 ioz' I-- fl v vim. a w rna en 4! \FC, 0 / ` 4! 2, / / re i t ., ..:±9.1_,4:1.:1:.:. , ,y)\-0, , . .. • ,_. s ‘p 76 ,,, en k i =i= ii 11 N. •• eZtiZ ,IEIT r\' TO , "a -p C C rS MS tft N 13 13 d v. CO .--1+ * = N pp 'O 00 # le I— O F=-. p od J Advantage Perc & Design T; mely•Reasonable•30 Years of Local Experience Construction Notes for Pressure Distribution bed for)Bedroom System: Pressure Bed Distribution w/Rock and pipe Install 10 x 24' beds. Install 18" deep through and level in trench Install 4- 1 inch sch PVC pipes w/ 1/8" orifices at 12 o'clock w/shields on 24" centers beginning 12" from the beginning of the trench Use 1000 Gallon BNR 500 ATU and 1000 Gallon Pump Tank W/water-tight secured risers to the surface of the ground. See pump Chart for Pump Specs Use Nuwater Control Panel or equivalent w/audible and visual alarms for low and high water. System designed for typical residential waste strength sewage only. System designed for 240 Gallons Per Day-operating at 180 Gallons per day APPROVED P� JUN 24 2025 y 3 %. MASON COUNTY ENV1RONM.BTAL HEALTH °""'" LICE DESIGNER - RET Advantage Perc &design APDdesigns@icloud.com (360) 516-7287 • 3 E z 0 a a 00 ° o In E O U ooc U E N F- C o ¢ C ` Z a) aJ [ C C C 7 c di 0-)N 3 Q To v — La a) n 0 N •N pg � p - o v r4 0 2 aJ p •-, ¢ Ncn Q a '' a 0 N a) • 0 1N'NS a � SS//�� a �� a o R5t C yaS , 1 a tw, 1-+ ~ 4. •-•r,,,, 0 DPP o v, RAVED N J N2N242025 b `� MASON COUNnEh'VIROh'4�r, (Ni rts2 RET tiTAL NEQLT,N © N N 0 d N 0 N a) V C al a) L.)a) li I ca O N C> 0 C � O1. d' RS V1 O-cscci . ,yr I 1..:111� N m Li)U as Ni E ,_ aai II 0 v, 'co U IlH • a) boom 4 U Oce0U - Ii: 0 '� 0 E a) 0 > U T..; Z 141.11° Nu �Nat�r ..� Actvonc...f Tn,c,In ,'i,I SY••1,-ms Ov Envlro FI€,.lna, APPROVED �' ��- JUN 24 20 25 .,� i mAz ,uNnENV1ROHMENTA ''''''''N,,,,...... � ET -R HEALTH I.• ....- @>_it I V-© -....., tr. co :I;...."--• 7 o 44#.% , -...... I ! ��.. I kill' v. +` � 0 .. .111114.1..••••"; r 'Y 0\ uill I u IC_ Q 111,11 0 ® a A t '- lb D...... (.* 48,10 i* lira* Ii ea I r. �, �1 i 0§) en.z,„ a [II 11111% if rt 41. e -0 4:1, $1101111/. 11110 PARTS LIST NuWater NR Assembly Diagram U I N 414 A DUAL PORT AERATOR M POLY DIFFUSER BAR(2) B 318"RUBBER 90'W/CLAMPS(2) N 1"PVC(3 1i2"SECTION) el C 3'8"BARBED ADAPTOR X 1/2' NPT(2) O 1"SLIP CAP ��It NPT CO D 1/2"SLIP X 1/2"NPT ADAPTOR P 1/8"CLEAR PVC HOSE(OPTIONAL 5I i� •f, A E 1"STREET X U2"NPT BUSHING(3) Q 1i2"PVC PIPE(BY INSTALLER) y 2�) F 1Q"90 ELBOW(3) R 1"PVC PIPE(BY INSTALLER) -�e C.•'. �i 1, it'd -. G 1"X 1"X 112"TEE S 2'PVC PIPE(BY INSTALLER) j .•3i,,, s i 40 H 1"90 ELBOW(3) T 1/8"BARBED ADAPTOR TO 1'4"NPT(2( LICE. E ESIGNER $ •`' 12"X 1"BUSHING U 1/2'STREET X 1'4'NPT BUSHING(2) J 2"SANITARY TEE V 1i2"PVC COUPLER 12) 6 - /_'2 c K r PVC CROSS W 2'COUPLER(BY INSTALLERI L 1'COUPLER(BY INSTALLER) I Revised 2/25/12 . • -- - - ----- ---------- 9'-2 VENTED LIDS(TYP) DUAL PORT AERATOR- WATERTIGHT RISERS(TYP) \ 1 ' -, 1 COUPLING&PIPE - I 36'MAX. CAST IN LID(TYP) y 1/2"PVC AIRLINE - MASTIC 2 l "COUPLING--. &REDUCER �-•.! L _ 1"PVC(TYP) -,,, —� i 2'TEE 4 1"PVC SLUDGE I 12" RETURN LINE 2"PVC �'_ j TRASH CHAMBER DIGESTER CHAMBER CLARIFIER OPERATING CAPACITY.417 GALLONS OPERATING CAPACITY:421 GALLONS CHAMBER FLOOD CAPACITY:490 GALLONS FLOOD CAPACITY:494 GALLONS 160 GALLONS ��� FLOOD 191 GAL. 65" 58" 54' I) 50" 53" APPROVED 36" . I1TEE .X1/2" JUN 24 2025 `° e MASON COUNTY ENVIRONMENTAL HEALTf�, t2 DIFFUSER BARS(2) I• RET PARALEL TO TANK WALL 1 4., 3" 1 3" SLUDGE RETURN -- i 1.5"TAPER .I SIDE VIEW 7 =7.4 11 STONE-FREE NATIVE SOIL OR COMPACTED SAND INSTALLATION INSTRUCTIONS OVER STONY SOIL !-24'BLOWER 1)Excavate tank hole with vertical walls to 1 foot larger than I HOUSING CAST tank on all sides. / ON TOP OF LID 2)If bottom of hole is stony,install 3"of compact sand&level F • 9`2" J { out with screed. r — — - 3)Install tank in center of hole, keeping 1 ft.void space on I all sides. 1 ;- 24"RISERS P) 4)As tank is filling with water,fill in void space with compact I 1 granular(sandy)soil free of large clumps of clay. I I 5)Install rest of system, &affix risers to adapters with waterproof adhesive. I i I 4'8" 6)Perform watertightness test in field as required by to�'r►� jurisdiction. - 11 12"RISER 7)Upon approval to backfill,carefully backfill with n- , �11 I I soils over top of tank. l o « 11 TRASH CHAMBER DIGESTER (CLARIFIER. 8)Final grade the surface to avoid chanelling su„ `'1•..?. "I�,Ij L .L L water toward tank. ti� • '.,III - !o` , ��• �Ifj TOP VIEW J' LI y 7'=2.8,ft WI% 'V.�.% `ES%%%%%%%%% • 43 > ::::•. AEROBIC TREATMENT TANK DETAIL FOR NuWA TER BNR-500 TREATMENT UNIT ikli• �I,�� .. '� ENVIRO-FLO, INC. REVISED : :: •� M^ Waste E;,�_::.. TT r„ water T�aafinenl Techno%gees '/�(� -a fP D. BOX 321161, Flowood, MS 39232 "/� (877)836-8476 MI)845,05 f c fo nel ... . S f r? • r 1 1 • f ii L `. •vc ; . .. .. i Or < Y . • 4. a y * APPROVED i .4 - JUN 2 4 2025 .- MASON COUNTY ENVIRONMENTAL HEALTH RET. +,k't . i SEDUISFE1LEIINlMMST>NRSEAL • DREADED VIEW ' aroma AGMS111Ne SUMACS 19NEM GRADE _..1 I I./ '1111.1111111 ,1,4IT I I /I -> . >w,rla ] - -TANK ( Tom ■ c__A — BIERGENOY STORAGE I ANTI NPHON VALVE* HIGH MATER ALARM LEVEL • i INDEPENDENT %roa Ns VOl11ME I FLa4T SEEM u new41111 TUMID AFC tea. —i FOR FLOAT v tiouti 11TG ENOLSIIMEOPUIV • SIITS LADED• OHECIC VALVE* ®N 1M ill 1 i >DLE A PL18P 1 0CJU EUMe-QHfillagg 5R« ,....,_ A.NEEDED FIGURE 2 - PV' i l .:.-' A l 1 Lij . 2,� ;, 3o, 4l o?' J„ ,,wen L CEN • i����l���%ED �r%%%� 11, 1.:*.' CQ - 1 ^2 Y• . , Pump Selection for a Pressurized System-single Family Residence Project Parameters Discharge Assembly Size 2.00 inches 100 Transport Length 295 feet .. Transport Pipe Class 40 Transport Line Size 2.00 inches 90 , Distributing Valve Model None Max Elevation Lift 5 feet -+ Manifold Length 8 feet Manifold Pipe Class 40 80 Manifold Pipe Size 1.50 inches 1 Number of Laterals per Cell 4 Lateral Length 24 feet / Lateral Pipe Class 40 70 Lateral Pipe Size 1.00 inches Orifice Size 1/8 inches d 1 Orifice Spacing 2 feet LL_ Residual Head 5 feet I 60 0 PFFF50 e Flow Meter None inches F- 'Add-on'Friction Losses 0 feet Co Calculations u m 50 0 E i Minimum Flow Rate per Orifice 0.43 gp re Number of Orifices per Zone 52 >, i Total Flow Rate per Zone 22.6 gpm f 40 Number of Laterals per Zone 4 :o %Flow Differential 1st/Last Orifice 1.5 % to- Transport Velocity 2.2 fps 30 I \ Frictional Head Losses Loss through Discharge 1.0 feet Loss in Transport 2.7 feet 20 Loss through Valve 0.0 feet Loss in Manifold 0.1 feel - Loss in Laterals 0.2 feet Loss through Flowmeter 0 0 feel 10 t 'Add-on'Friction Losses 0.0 feet Pipe Volumes 0 Vol of Transport Line 51.4 gals 0 20 40 60 80 100 120 140 160 Vol of Manifold 0.8 gals Net Discharge(gpm) Vol of Laterals per Zone 4.3 gals Total Volume 56.6 gals Minimum Pump Requirements PumpData Legend Design Flow Rate 22.6 gpm PFEF50 Effluent Pump System Curve: Total Dynamic Head 13.9 feet 1/2HP,115/230V 10 Pump Curve: D ( lt,cr.J, Pump Optimal Range: art 1 " , Operating Point:0 :itt "4-'4' Fri�.,, Design Point:0 APPROVED e• f rep;,, JUN 2 4 2025 " � � 3 �i "? I. SLICE�•-'�DESIGNER MASON COUNTY ENVIRONMENTAL NEALT c �_/�, L