HomeMy WebLinkAboutSWG2025-00198 - SWG Application / Design - 5/28/2025 MASON COUNTY 415 N 6TH STREET,SHELTON, ,E 98584
ea: SHELTON:360 427-9679670 EXT 400
BELFAIR:360-275-4467,EXT 400
Public Health & Human Services ELMA:360-482-5269,EXT 400
FAX:360-427-7787 imm
On-Site Sewage System Permit: SWG2025-00198 C,0 0 I\
APPLICANT SCOVILL DAVID E &JODY JUNE Phone:
Address: 51 E ELM PL SHELTON, WA 98584
OWNER SCOVILL DAVID E &JODY JUNE Phone:
Address: 51 E ELM PL SHELTON, WA 98584
SEPTIC DESIGNER Jim Zimny Phone: 360-516-7287
Address: 7178 WINDFLOWER PL NW SEABECK, WA 98380
Site Address: UNKNOWN
Primary Parcel Number: 320215601013
Permit Description: New 3bd ATU to gravity trench
Permit Submitted Date: 05/28/2025
Permit Issued Date: 06/27/2025
Issued By: Rhonda Thompson
Current Permit Fees Paid: $555.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 06/26/2028 (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 Drainfield 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 COUNTY : 05 - 2- ,2°Z
46
AMOUNT RECEIVED: RECEIVED BY:
, fP Public Health & Human Services It5'56 CO N
Environmental Health 360-427-9670,ext.400 or 360-275-4467,ext.400 C N
415 N.6th Street- Shelton,WA 98584 SWG Z02S DO I 1U]� N ❑
xi
Z 6
CLEAR FORM ON-SITE SEWAGE SYSTEM APPLICATION
D D
I g x
n
APPLICANT PHONE m m
David Scovill 360-480-5052 I U\ z
MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE I< ' w g
51 E ELM SHELTPN WA 98584 (LM n m
SITE ADDRESS-STREET,CITY,ZIP CODE I•V
lot 13 PANORAMA DR, SHELTPN WA 98584 0 cci t T
NAME OF DESIGNER PHONE rui N
JIM ZIMNY 360-516-7287 2US Q
NAME OF INSTALLER PHONE PIAF I C
PERMIT TYPE(select one) DRINKING WATER SOURCE O
iNi
of RESIDENTIAL OSS F1 COMMUNITY OSS Ir1 COMMERCIAL OSS h PRIVATE INDIVIDUAL WELL ❑ PRIVATE TWO-PARTY WELL Z
I TYPE OF WORK(select one) a PUBLIC WATER SYSTEM w I r
M.NEW CONSTRUCTION/UPGRADES REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) 0 TABLE X REPAIR 1k I(f
SUBMITTALS ❑ SURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINE w
DESIGN FORM(REQUIRED) SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE WAS LOT CREATED AFTER 4/1/2025o rO 1I 6—
5-WAIVER(S)(IF APPLICABLE) 3 8400 sq ft ❑ YES Q NO I
0 I
DIRECTIONS TO SITE AND SITE CONDITIONS.(ex locked gate)
from Hwy 3 take E Agate Rd south for 3.8 miles and turn rt ob Crestview Dr. Follow for 2.5 I
miles then take left on E Panorama Dr. follow for 800 feet and lot is on the Rt.
Marked with Pink Ribbons. Test holes are marked with pink ribbons. ° I 0
SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST MOLE NUMBERS I " "
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE I FAILURE SOURCE(for reporting purposes)
❑VOLUNTARY ❑MAINTENANCE/PUMPING ❑BUILDING PERMIT ❑HOME SALE OCOMPLAINT ❑OTHER:
INSPECTOR SOIL LOGS COMMENTS/CONDITIONS
ek f 1 I k
, -Tirk--9
- .\\--2- 0, 3`t (S L- i so T- -t \
(t‘Qv2A,Q)
t
c.
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 APPLICATION APPROVED/ISSUED Y DATE
uvh LI2U1. I 1/7
THIS FORM MAY B SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE Revised:4/14/2025
DESIGN FORM—PAGE ONE Assessor's Parcel Number. 320215601013- --
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. ''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
Permit Number: SWG 2oZ5 ^ 0019y Designer's Name: JIM ZIMNY I
Applicant's Name: David Scovill Designer's Phone Number: 360-516-7287
Mailing Address: 51 E ELM PL Designer's Address: 7178 WINDFLOWER PL NW
SHELTON WA 98584 City State Zip SEABECK WA9B370
CLEAR FORM
City State Zip Designer's Email APDDESIGNS@ICLOUD.COM
DESIGN PARAMETERS
Treatment Device
0 Glendon ❑Sand Filter 0 Mound 0 Sand Lined Drainfield 0 Recirculating Filter p A u BN R 500 IJ Other
Treatment Level(check all that apply): ❑A ❑B ❑C ❑BLI ❑BL2 ❑BL3 O E El N
Drainfield Type
'Gravity 0 Pressure 0 Trench 0 Bed 0 Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 3 Schedule/Class 3034
Daily Flow:Operating Capacity 270 gpd Length 50 ft
Daily Flow:Design Flow 360 gpd Diameter 4 in .
Septic Tank Capacity(working) 500 gal Number 3
Receiving Soil Type(1-6) 4 Separation 5' CtC ft
Receiving Soil Appl.Rate 0.8 gpd/ft2 Orifices
Required Primary Area 450 ft2 Total Number of Orifices NA
Designed Primary Area 450 ft2 Diameter ti in
Designed Reserve Area 450 ft2 Spacing �t in
Trench/Bed Width 3 t°_ �#i
ft . Manifold
Trench/Bed Length 150 ft Schedule/. s ;;t+ NA
uCE i 81G�F
Elevation Measurements Length''' n„ �� ft
Original Drainfield Area Slope 13 % Diameter S L'LI- in
New Slope, If Altered 13 % Preferred manifold configuration used? 0 Yes 0 No
Depth of Excavation up-slope 19 in Transport Pipe
from Original Grade Down_sIope 15 _ in Schedule/Class 3034
Designed Vertical Separation 3'C in Length 5' ft
Gravel-based Drainfield Required? 0 Yes e No Diameter 4 in
Pump Required? 0 Yes Iv1No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day na
Diff. in Elevation Between Pump&Uppermost Orifice ft Dose quantity gal
Drainfield Squirt Height/Selected Residual(head) ft Chamber Capacity(flood) gal
Uppermost Orifice 0 Higher 0 Lower than Pump Shutoff Pump controls:Please check those required.
Capacity @ Total Pressure Head gpm 0 Timer 0 Elapse Meter 0 Event Counter
Calculated Total Pressure Head ft If Timer:Pump on ,Pump off
Comments APPROVED
JOIN 27 2025
koerstftlto:, ,�,,trtrAt.11tAtI i
Revised:4/14/2025
i .
DESIGN FORM—PAGE TWO Assessor's Parcel Numbers 320215601013- --
Permit Number. SWG
DESIGN CHECKLISTS
'Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
Ei Test hole locations V Drainfield orientation and layout Reference depth from original grade:
d Soil logs 0 Trench/bed dimensions and E1 Septic tank
Er Property lines critical distances within layout V Drainfield cover
V Existing and proposed wells Pr D-Box/Valve box locations Reference depth from original grade
within 100 ft of property 0 Septic tank/pump chamber and restrictive strata:
H Measurements to cuts,banks,and locations V Laterals,trench/bed,top and
surface water and critical areas Fr Observation port location bottom
B Location and orientation of V Clean-out location 0 Curtain drain collector
curtain drain and all absorption 0 Manifold placement 0 Sand augmentation
components 0 Orifice placement Other cross-section detail:
lil Location and dimension of 0 Lateral placement with dis • 0 ce VI Observation ports/clean-outs
primary system and reserve area to edge of bed
Buildings g Other Information
El 0 Audible/visual alarm referen ed Yes No
O Direction of slope indicator Ili Scale of drawing shown on s ale 0 Er Design staked out
El Waterlines bar Cl ❑ Recorded Notices attached
O Roads,easements,driveways, El Elevation benchmar .and rel. .ve Cl 0 Waiver(s) attached
parking elevations of systei:?•'; pon-nts ❑ 0 Pump curve attached
ii
V North arrow and scale drawing °,t'. ❑ ❑ Evaluation of failure
shown on scale bar 1. ? ri _ �'et Non-residential justification
'411e, 0 0 Waste strength
r a t.� 0 0 Flow
:.o to t
st
The undersigned designer must be notified by: jrer at t e of i.. , lation Er Yes Cl No
Signature of) e r 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:
C6uivv\e(A/ri cofv7/7vs--"
Environmental Health Specialist Date
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THIS FOLLOWING CONDITION:
✓ The design is stamped "Approved"by Mason County Public Health. 0
(
✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: `0 J'? fly 0
/ 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
..„4-1. , \..,
. L,i
__
..--.„--- ic6-9 Y''' '.-)
E e E E ~ �;
N ry 3 r
Pi 0
c TO
r
8 3
II II - II II
g� ® N
G 0
0
3 �.Jco
�, J 0) E r J • E 3 J
S r V rt+ r cttb RS l20 ►�i
N N N — t? N �P
t� CO _ X a
OCr) CV cn
c O __ C 0 F" 1 1 ' !�
C C • lo O C of W in w
C • C L O z 11 cy N r
CI) G. as
w
E J ri. E J H
m H a. 1
CY
Z r O z Om �- Q 8- d c O n O T
CD �L.� Li. Z
o R o at tc al 0 3 o Q 4
'Q - m O J J
ro
c as O E W 'W
E 2 E r0-. _• (71 C 3 -0 'C
O a 2 TI3 J > -E E Z Z
Q F- i-
4.4
co
co 2
441 a)
E a) a:
o c iC >., ^ ^
e
0 a) E 0 EEE
T
§ 8
C\.I CO
CO ; 0CDcC v CD
N fl
V Cn .>
O Z Z
CA -� t� F- F- v)
crs co
0C J O Cl) fl •v "CD I A ,.... N 0
J CC J = E E cc
O 'an)
d.CD c7:1
Q 0- a
cn
-0 E C
1 CZ
E E
a X o
Q
�02 co
0 CC TO g
E Alk•• eci ,_, ,...) .....
0.
rcS
/1 C aO 0 z .- NI0 O
`���� st/ N —a I— (NIv c
Co0 2
N.
>
N ,OZZ a� ce
13% V)
z
4
Q
z
0
CO
Q z
p W • u p d
,-+ a) 0 2
p N, O o0 IU Q
b ' -
co O Q O
c-+ wo r^ = w N Ni 3-1dVW
n tiin >
' ,8Z 2 y
. \ .-..._ -
-(0O 0. Y
rd
r' 00 • �'�,
a E—
a
cc
1 (..,
O F-
_0 a
I
.a O o
0o
L.) o0
0 Q Q z oo APPROVED aJ
E � J Z
>- J o J 0 _ r �UN272Q25 sotil w p J MASON COUNTY ENVIRONMENTAL HEAL C- 0 b o
z z
< ON_. , ..< ON Q ,„
RETz a) ° '- aQ3
1
.t V) w m�n a
= °u,° a = coa = m - w 6. i i
i
Ho � I— o � � o � iI
•
Advantage Perc & Design
Timely•Reasonable•30 Years of Local Experience
Construction Notes for ATU to GRAVITY 3 Bedroom System:
Gravity w/graveless chambers(Rock and pipe may be substituted)
Install a 4 hole D-box
Install 3 -50' Laterals
Install on 5'foot centers.
Install 15"trench depth on low side of trench and maintain 36" of vertical separation
Install level and along contours.
Only Install in dry weather only.
Use 500-Gallon trash tank, 1000 gallon BNR-500, w/locking lid risers to the surface of the ground
See pump Chart for Pump Specs
Use Nuwater control panel with low air alarm
System designed for typical residential waste strength sewage only.
System designed for 360 Gallons Per Day
_ ill
r11
i
i 4-4._ �1/
JUN
n Q? ir
r:y3 ,112 �1n..5 f LICE DE
MASON CCUNTYENV1RC 4 .1,
RET
Advantage Perc&design • APDdesigns@icloud.com 0 (360) 516-7287
nil
n 7
F '
n 1 '1
3
s
Z a `" r l i___
rt3 I I n @
i n F
m
r I
�� ro� It
o n1 I I A m
A ) O' T• I I IY
tn
N{A // li
< t
n
i R.
w 1'+ycn ... n = 3
w 1
1 S n
r I w
�1 r 9
i
i
A
%.44t
APPROVED
9 W
JUN 2 l 2025
MASON COUNTY ENVIRONMENTAL HEALTH
4011
X
RET =
g Wok =MEC. 1 o.
( 3 ,if'
n.
I
d -
i a N
i 0.
e m o.
I
C
lQ fl N a — Q03(°1 N la'''. =
rD
N — f �co stD
N
1 V_
i
1 1..0 =$\
- ' ; ' N
'1M RA WPM"-, SIN 4M W 0 („
a Twos 699L•L99 W Xtld 999L•L99 OK 3NONd ,lk'40 V% V
p 1 1S�l 009 ABNO 0 e09B6 tlM ONf»02f`J 3111V8 LBO£.XO9 O d \u;`,'�
1 t+ankae/tw:cw+: ,•.s„9 aiva .0NI ONIU 3NION3 >'12
It
s ." 41+ - -
`y;,„ i -
'ist
1 .ia
=Y'_ i _
Tt
--HILT
i
Y a
i
_ 4 ,
t -te '4 R3sr' # `f-- -
a I s ;
1r 9#
APPROVED
JUN 2 7 ,2025
MASON COUNTY ENV RbN' !�ENTAL HEALTH
RE
/ 9._2- _ k
WATERT'GMT LID VENT Rye) DUAL PORT AERATOR
RISERS(TYP) i
38'MAX.1 1'PVC(TYP) 'e
e 1ir PVC MASTIC
�— �7 A1fiLINEf
.1 4'
I l l 2'COUPLING-- , `— —
�( a REDUCER
'\ 6' { f 1 _ 1
Z'TEE i SLUDGE I
12" RETURN LINE
2"PVC
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.
e0r 58"
I (� 50"
5r 53'
1 i 1
36' oe co a 1•X1/2'
4TEE
APPROVED • ` e
I JUN272025 12"
DIFFUSER BARS(2) I
! MASON COUNTY ENVIRONMENTAL HE4LTh PARALELTOTANXWAll 4•
- ;
ti
\ • R F T ' SLUDGE RETURN
:/ 1.5"TAPER /4
■1. !
STONE-FREE NATIVE SOIL
OR COMPACTED SAND
INSTALLATION INSTRUCTIONS OVER STONY SOIL
1)Excavate tank hole with vertical walls to 1 foot larger than i
tank on all sides.
2)If bottom of hole is stony,Install 3"of compact sand&level 4 8x At
out with screed. .. —— — \
3)Install tank in center of hole,keeping 1 ft.void space on 1 r
all sides. I Zr ) 24"BLOWER
,HOUSING CAS
4)As tank is filling with water,fill In void space with compact � N roa OF Lr
granular(sandy)soil free of large clumps of clay. I I I
5)Install rest of system,&affix risers to adapters with C I I I '
waterproof adhesive. I I I I I 4'-8"
6)Perform watertightness test In field as required by local
1:1;)
Jurisdiction. 12•RISER I I
7)Upon approval to backfill,carefully backfill with native
soils over top of tank. i•f1I I TRASH CHAMBER I DIGESTER I I20=81
8)Final grade the surface to avoid chaneiling surface ; to ___ _ __ _J? _ _ _ __ _ ___i L __J
water toward tank. ,,1?...
III \
T + t
TOP VIEW
=" G.A = =� ATMENT TANK DETAIL FOR
� `&. Nu ATER BNR-500 TREATMENT UNIT
1gij ENVIRO—FLO, INC. REVISED: 3/01/12
4. is " Wastewater Treatment Technologies
,...."�,,,,,.sr';: P.O.BOX 321161, Flowood,MS 39232 SCALE:
(877)836-8476 (601)845-4716 fax 1" = 1.4 ft.
www.enviro-Bonet
i' lfsiluNAfaltr
a Aa31+or'cod Trrrrstt'inr+t SYa1e,rr.I •y Erivrro-rto,inc
9 '-41•10),0 0 e...,a of-i•_,___i-iii
.... 1
��• .. .\
O
I
�`\ ''' J J ! \' ---
/ 4 b.....tee fiNts ,
4,4 ..
1! "
e ,/ D
U �•
lil
174 twv. t.
` ' u ♦.
I;1 C
i ,...14(0,)
ailIS
*.W' ti 1 t',1
�� :'' ei
�,�1 4, ppR®v . . 1f %
co �• �� JUN 2 7 202' �y ;
I [I
1110/1111111 e,-41)I" ASONCOUNTYENV7RONYE
RET EALTH +,.% 1:0
1110 J ,
PARTS LIST NuWater NR Assembly Diagram j
A DUAL PORT AERATOR M POLY DIFFUSER BAR(2)
I
H 40
B 3/8"RUBBER 90`W/CLAMPS(2) N 1"PVC(3 112`SECTION)
C 3i8"BARBED ADAPTOR X 112'NPT(2) O 1"SLIP CAP (F0
D 112"SLIP X 1/2"NPT ADAPTOR P 1/8"CLEAR PVC HOSE(OPTIONAL 5') A
q E 1"STREET X 1/2"NPT BUSHING(3) Q 1/2"PVC PIPE(BY INSTALLER)
F 1/2"90'ELBOW(3) R 1"PVC PIPE(BY INSTALLER) I�i(►
i
G 1"X 1"X 1/2"TEE 4' �,i t S 2"PVC PIPE(BY INSTALLER) 4P .
H 1"90"ELBOW(3) i,'1 Alt T 118"BARBED ADAPTOR TO 1/4"NPT(2)
r
12"X 1"BUSHING 3 •,.�' it 1/2"44 STREET X 114"NPT BUSHING(2) l-
J 2"SANITARY TEE " /A? 29 � fib 112"PVC COUPLER(2) 17
K 1"PVC CROSS 0 +
., MEN" Dlt tit T COUPLER
L 1' COUPLER(BY INSTALLER/ .., r'
(—2. C
Revised 2/25/12
5