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Home My WebLink AboutSWG2025-00233 TANK ONLY - SWG Application / Design - 6/20/2025 415 N 6TH STREET,SHELTON,WA 98584 J L MASON COUNTY 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 Tank Only Permit: SWG2025-00233 OWNER HARRELL JOHN F&PAMELA A Phone: Address: 2903 E PICKERING RD SHELTON,WA 98584 APPLICANT HARRELL JOHN F & PAMELA A Phone: Address: 2903 E PICKERING RD SHELTON, WA 98584 SEPTIC INSTALLER Royal Flush Phone: 3607903021 Address: P.o.box 1336 Hoodsport,WA 98548 Site Address: 2901 E PICKERING RD Primary Parcel Number: 220041190031 Permit Description: Septic tank replacement Permit Submitted Date: 06/20/2025 Permit Issued Date: 06/2512025 Issued By: Rhonda Thompson Current Permit Fees Paid: $270.00 (additional fees may be required upon Installation of system). Permit Expiration Date: 06/25/2026 (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: 0 Drinking Water Source: Private Well/Spring Additional Details: IM-1250 Permit Conditions: 2 Permit must be installed by a Mason County Certified Installer unless prior written authorization from Mason County is obtained. 4 Proposed development subject to zoning requirements and approval by the planning department staff per Mason County Title 17. 3 Mason County Asbuilt Form, Record Drawing, and Installation fee must be submitted for final installation approval. 1 Horizontal setbacks per WAC246-272A-0210 must be maintained, unless prior approval is obtained 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.gov/health/environmentailonsIteloss-inspection-request.php or call: 360-427-9670, extension 400. • • — --- -- - OFFICIAL USE ONLY- } WET) MASON COUNTY DATE EECD(0 - 2v " zUZ.5 II COMMUNITY SERVICES AMOUNT REC 27p RECEIVED BY 00 m Publlc/oalth(Community Health/Environmental Health) 0 N ,,,427..... . ...., �.,�T..�.� SWG 20 2 ' — 0023.3 Z 115 Ra0�5�eet-SreAa�WAMfIa / D ON-SITE SEWAGE TANK ONLY APPLICATION m n APPLICANT PHONE I— MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE U l C E li L' 9,q C E P,c_1<_e\r',v� AA S Ae,\ VV J 3 ' En SITE AWRESS-STREET,CITY,ZIP CODE JUN 2 0 Z0Z5 P. 01 E P \c__ke_ir\v\o) By NAME OF DESIGNER PHONE I{" • __ I NAME OF INSTALLER PHONE 0 to o',Ack\ P\v� VA p 3 LQ 0 �ici ID .36 D-) `G TYPE OF WORK aafect one) DRINKING WATER SOURCE O 0 NEW CONSTRUCTION!UPGRADES kREPA1R/REPLACEMENT PRIVATE INDNIDUAL WELL Q PRIVATE TWO-PARTY WELL Z COMPONENT(S)TO BE REPLACED/INSTALLED ❑ PUBLIC WATER SYSTEM I I SEPTIC TANK 0 PUMP TANK 0 RV HOLDING TANK BEDROOMS 41,,opitxpin LOT SIZE -zC. A c . ❑OTHER W I— OTHER DETAILS( d of butePPIY) TANK(S)SETBACK CHECKLIST g 1 0 SURFACING SEWAGE ❑EXISTING FAILURE ❑SHORELINE1OOFT+PUBLIC/COMMUNITY WELLS g (� SUBMITTALSSOFT+PRIVATE WELLS,SURFACE WATERS,STREAMS,RIVERS *PLOT PLAN(REQUIRED) ❑TANK CROSS SECTION(REQUIRED) 4 1OFT+DRINKING WATER SUPPLY LINES + (^ ❑PUMP DETAILS(IFAPPLICABLE) ❑ WAIVER(S)(IF APPLICABLE) 41 6FT+PROPERTY!EASEMENT LINES,FOUNDATIONS,FOOTINGS 11 �l PLOT PLAN CHECKLIST Q p ❑ PROPERTY LINES AND EASEMENTS 0 EXISTING/PROPOSED STRUCTURES ❑EXISTING/PROPOSED OSS COMPONENTS AND LINES ❑ WELLS WITHIN 100F7 0 WATER SUPPLY LINES ❑DRIVEWAYS/PARKING 0 SURFACE WATERS,STREAMS,RIVERS,ETC... CI DIRECTION OF SLOPE/CONTOURS ❑PERIMETER/CURTAIN DRAINS ❑NORTH ARROW 0 SCALE BAR I�� DIRECTIONS TO SITE AND SITE COMMONS:fax locked gate) — - - -- OFFICIAL USE ONLY BELOWTHIS LINE UPGRADE!FAILURE SOURCE(for rooming purpoaea) ❑VOLUNTARY ❑MAINTENANCE/PUMPING ❑BUILDING PERMIT ❑HOME SALE ❑COMPLAINT ❑OTHER: COMMENTS/CONDmONS le—kiaa,CIL St,PVTC- +e/W \o(----. SEWAGE TANKS MUST BE USTED UNDER DOH'LIST OF REGISTERED SEWAGE TANKS-.TANKS MUST MEET CURRENT IW MMUM SIZE REQUIREMENTS,EQUIPPED WITH RISERS AND 1I0S TO SURFACE.AND INCLUDE AN EFFLUENT FILTER(IF APPUCABLE).RECORD DRAWING AND INSTAL ATTON REPORT REQUIRED FOR IINALAPPROVAL INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED!ISSUED BY DATE r-----------' C) iev iu ‹osi osizc-- THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSTTE REVISED 12aGoIs Thurston County Environmental Health Division APPROVED Public Health& Social Services Department 1��; � ,{'Is 3000 Pacific Avenue SE,Olympia,WA 98501 4 ' . t J U N 2 5 2025 (360)867-2673/(360)867-2660(Fax) 1 i_ _ TTY/TDD 711 or 1-800-833-6388 :T! MASON COUNTY ENVIRONMENTAL HEALTH vw.thurstoncountywa.gov/phss z .s a7a1.. 1.4 RET SEPTIC SYSTEM SKETCH The Septic System Professional must use this form to draw a sketch of the septic system components based on their inspection.This information is necessary for system maintenance. Information on this form is to be used for general reference and not for legal or official use.Property Address: i.---q 0 ( e P I c K�,2 L N G R j , 3 W L ro 1,1 w K} . 96 S" '4 Tax Parcel#: 2.2-00 L{ ( ( q OO 3 k *Measurements on the drawing must be from fixed points,such as a building foundation.The sketch must include all existing site features, including all septic system components(tanks,transport lines,drainfield area),wells,waterlines, structures,and surface water. Any encroachments(i.e.structures,driveways,etc.)onto the septic system components must be identified on the sketch. (North '1'� ( N i 33' Rf(61k --- P , I.(' } 4( I 0 � _J Signature of Industry Professional: ii)/ - Date: nb- ` fr 2.o Z5 i Company Name: —fey 4J (1/trs2 -s e I/c APpRO1✓ D MIM --TanissjUN UN IY E;;yJRONMEN TAt HEA IM-1250 ET The Infiltrator IM-1250 Is a lightweight, strong and durable septic tank. This watertight tank design is offered with Infiltrator's line of custom-fit EZsnap • risers and heavy-duty lids. Infiltrator injection IM 1250 molded tanks provide a revolutionary improvement in plastic tank design, offering exceptional long-term strength and watertightness. Benefits OS lilt 1110 Ilia Strong Injection molded Lightweight plastic con- Integral heavy-duty green Structurally reinforced rconnect polypropylene construe suctlift i t ing on and lugs allow forrd lids easy EZsnaptriiseers, Safety Stath access ports r tortion during iiminate dis- installation delivery g deliviv ery and handling secondary saf prise lid sys- and pump-outs tem and pipe • Suitable for use as a septic No special water filling elk Silk fill Silk Reinforced structural Can be installed with 6"to uiremeal are necessary re- ribbing and fiberglass 48"(152 to 1,219 mm)of tank, pump npotable}tank The tank may be backfilled bulkheads offer additional cover with suitable native soil. strength TANK CUTAWAY partition baffle wall , I Infiltrator t EZsnap Riser System , • i HEAVY DUTY LID CUTAWAY Reinforced 24"structural access port I, . \ .� i �t i .1 0.44 Structural bulkheads I MID-SEAM Infiltrator . CUTAWAY Water Technologies Reinforced water Part of SAD6 tight Infiltratorwater.com•(800)221-4436 owilak I IM-1250 General Specifications and Illustrations LIFTIN STRAP(1YP.) LIFTING LUG(TYP.) RISER CONNECTION(TYP.) The IM-1250 is an injection molded two-piece mid- seam polypropylene tank.The injection molded J 1711111111111i111�111illlil0111 �•�'i; design of theIM 1250 allows for a mid seam joint that ;•' � I I�UI�)Ral�lllllllll IIIIIh •�! 61.7 has precise dimensions for accepting an engineered lam III RI ,II„tc hs6�l ►.!1 III ill,ll! in l ti EXTERIOR EPDM gasket.The engineered mid-seam joint accepts [Illll�timdllll IIlI IIIILI I `C• WIDTH a continuous loop EPDM gasket. Infiltrator's EPDM "-"��I�IIIIIlI ill 1.i1 lit 111111 1� 111 �\� gasket design utilizes technology and materials from -I I I 1 ' l the sanitary sewer pipe Industry to deliver a reliable 162.3[3,666) watertight seal.The two-piece design is permanently EXTERIOR LENGTH fastened using a system of molded-in alignment dowels and locking OUTLET PIPE Must be backfilied and f� � (The)installed In accordance /'r 0a �PIei�.�Q with the Infiltrator IM- v>� 41:1111: sd.s Ail • y° and CM-Series Septic Ta k ,l(JN [l,3a71 ` • p�, S 2EXTERIOR .:071.11" .'�� .1;L General ON CO yr 2025S CLIP ,��►' H IGH7 • i nu.�rue•d r t 1 •h'. .0 . • '�t Installation Instructions. UI Ehr"UN�AE�� •• 1 •i�• '' For shallow ground water RET LIFTING S7•• a�\, ,.I,) 1 CI Ij.��'11.• +"• conditions reference the (T''P•) Infiltrator IM-and CM-Series SCAN ME Tank Buoyancy Control • Guidance. 4 10 l es p 24 0 61 ACCESS PORT Please visit vyww.inflltratorwater.com or scan QR �E wrTHLtoc°I�NOLIo(z) pvc ) 10.0 t254)FREEBOARD PVC OR ABS code for the latest Information. OUTLET TEE 0.2(51 WALL IM-12S0 V - TrI�cKNEss 1,278 GAL(4,839 L) J PER copE �i 'fie PER CODE Working Capacity F�E xz s� 1,480 GAL(5,602 L) SUPPORT LDem Total Capacity ) Airspace 16.30% Length 154" (3,911 mm) • Width 61.7" (1,567 mm) Length-to-Width Ratio 2.8:1 CONTINUOUS TANK TOP ELASTOMERIC Height 54.6' (1,387 mm) NA`F GASKET Liquid Level 44"(1,118mm) ff � 1 —SEAM CUP Invert Drop 3"(76 mm) 1P ' Fiberglass Supports 4 -Compartments 1 or2 TANK RorroM HALF Maximum Burial Depth 48"(1,219 mm) • Minimum Burial Depth 6"(152 mm) . Maximum Pipe Diameter 4"(102 mm) Weight 405 lbs(184 kg) Contact Infiltrator's Technical Services Department for assistance at Infiltrator 1-800-221-4436 or Info@infiltratorwater.com Part ofsms 1M25 0675