HomeMy WebLinkAboutSWG2025-00221 - SWG Application / Design - 6/11/2025 MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584
SHELTON:360-427-9670,EXT 400
J L 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: SWG2025-00221
APPLICANT THOMAS WOLTER Phone: 1.206.200.3325
Address: 18329 E STATE ROUTE 3/ PO BOX 76 ALLYN, WA 98524
OWNER EXODUS ACRES LLC Phone:
Address: P 0 BOX 76 ALLYN, WA 98524
SEPTIC DESIGNER Hunter, Adam Phone: 360 753-1226
Address: 2201 93rd Ave SW Olympia, WA 98512
Site Address: 341 W Haven Dr
Primary Parcel Number: 619305100026
Permit Description: septic system for new sfr
Permit Submitted Date: 06/11/2025
Permit Issued Date: 07/02/2025
Issued By: Jeff Wilmoth
Current Permit Fees Paid: $555.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 07/02/2028 (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.
1
OFFICIAL USE ONLY
MASON COUNTY DATE RECENED: / i 1 I I''I C Cn
J L IVP J (� Cn
AMOUNT RECEIVED: RECENEDS
Public Health & Human Services �j� G )t I}"e, CO m
Environmental Health 360-427-9670,ext.400 or 360-275.4467,ext.400 O o
415 N.6th Street-Shelton,WA 98584 SWG D
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CLEAR FORM ON-SITE SEWAGE SYSTEM APPLICATION
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APPLICANT PHONE rn
THOMAS WOLTER 2062003325 z
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MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE E
PO BOX 76 ALLYN WA 98524 03
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SITE ADDRESS-STREET.CITY,ZIP CODE
341 W HAVEN DR ELMA WA 98541 I m
NAME OF DESIGNER PHONE I C9
W
ADAM HUNTER 3607531226 01
NAME OF INSTALLER PHONE
a
TBD <riiIo
PERMIT TYPE(select one) DRINKING WATER SOURCE O IV
RM c IN
Lf RESIDENTIAL OSS 6-COMMUNITY COMMUNITY OSS ILI COMMERCIAL OSS l- PRIVATE INDIVIDUAL WELL 6-" PRIVATE TWO-PAFiTy WELL z I
TYPE OF WORK(select one)
PUBLIC WATER SYSTEM la _4 I? 0(4— H.- I
I
6 NEW CONSTRUCTION I UPGRADES 6 REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) El TABLE X REPAIR I
SUBMITTALS El DESIGN
SEWAGE 0 EXISTING FAILURE El SHORELINE
C W
LN DESIGN FORM(REQUIRED) INJ SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE r
WAS LOT CREATED AFTER 411/2025? 0
ff WAIVER(S)(IF APPLICABLE) 3 0.34 NI YES • NO 0 I
DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.locked gate)
MATLOCK BRADY RD TO A LEFT ON E STATSOP RD TO A LEFT ON HAVEN DR TO SITE I
ON THE LEFT. o
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!FAILURE SOURCE(for reporting purposes)
❑VOLUNTARY ❑MAINTENANCE/PUMPING ❑BUILDING PERMIT ❑HOME SALE ['COMPLAINT ❑OTHER:
INSPECTOR SOIL LOGS COMMENTS!CONDITIONS
5c.
2 0 - 13 ° 56-
0 L-Ve-6- 5
v,cci t2,30 4_62
RECORD DRAWING AND INSTALLATION 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 DATE APPLICATION EXPIRATION DATE PLICATION APPROVED'ISSUED BY DATE
THI F AY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE Revised:4/14/2025
DESIGN FORM—PAGE ONE Assessor's Parcel Number: 619305100026 -- --
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/7"
PARCEL IDENTIFICATION
Permit Number: SWG ZO2.c 002A.k Designer's Name: ADAM HUNTER
Applicant's Name: THOMAS WOLTER Designer's Phone Number: 3607531226
PO BOX 76 Designer's Address: PO BOX 162
Mailing Address: g
ALLYN WA 98524 City State Zip OLYMPIA WA 98507
CLEAR FORM HOTMAIL.COM JHANDASSOCIATES
City State Zip Designer's Email @
DESIGN PARAMETERS
Treatment Device
❑Glendon 0 Sand Filter 0 Mound lg Sand Lined Drainfield 0 Recirculating Filter 0 ATU 0 Other
Treatment Level(check all that apply): J A J B I C J BLI J BL2 J BL3 _I E _1 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 40
Daily Flow: Operating Capacity 270 gpd Length 40 ft
Daily Flow: Design Flow 360 gpd Diameter 1.25 in
Septic Tank Capacity(working) 1200 gal Number 3
Receiving Soil Type(1-6) 1 Separation 1.5 ft
Receiving Soil Appl.Rate 1.0 gpd/ft2 Orifices
Required Primary Area 360 ft2 Total Number of Orifices 120
Designed Primary Area 360 ft2 Diameter 3/16 in
Designed Reserve Area 360 ft2 Spacing 24 in
i
Trench/Bed Width 9 ft Manifold
Trench/Bed Length 40 ft Schedule/Class 40
Elevation Measurements Length 6 'ft
Original Drainfield Area Slope 0 % Diameter 2 in
New Slope, If Altered 0 % Preferred manifold configuration used? I'Yes 0 No
Depth of Excavation Up-slope 48 in Transport Pipe
from Original Grade Down-slope 48 in Schedule/Class 40
Designed Vertical Separation 18 in Length 12 ft
Gravel-based Drainfield Required? 0 Yes P'No Diameter 2 in
Pump Required? E2'Yes 0 No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day 6
Diff. in Elevation Between Pump&Uppermost Orifice 4 ft Dose quantity 60 gal
Drainfield Squirt Height/Selected Residual(head) 2 ft Chamber Capacity(flood) 1200 gal
Uppermost Orifice'Higher 0 Lower than Pump Shutoff Pump controls: Please check those required.
Capacity @ Total Pressure Head 35.171 gpm M'Timer I'Elapse Meter 01 Event Counter
Calculated Total Pressure Head 7.057 ft If Timer: Pu n MO,VmEf4 HRS
Comments
JUL 0 2 2025
MASON COUNTY ENVIRONMENTAL HEALS
JBW Revised:4/14/2025
DESIGN FORM—PAGE TWO Assessor's Parcel Number: 619305100026 -- --
Permit Number: SWG LOB S— O O Z2
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
WI Test hole locations ' Drainfield orientation and layout Reference depth from original grade:
g Soil logs ' Trench/bed dimensions and igc Septic tank
g Property lines critical distances within layout la' Drainfield cover
if Existingand proposed wells l� D-Box/Valve box locations
P P Reference depth from original grade
within 100 ft of property & Septic tank/pump chamber and restrictive strata:
11 Measurements to cuts, banks, and locations E% Laterals,trench/bed,top and
surface water and critical areas ' Observation port location bottom
g Location and orientation of Clean-out location EZ Curtain drain collector
curtain drain and all absorption fgf Manifold placement E Sand augmentation
components EZ Orifice placement Other cross-section detail:
g Location and dimension of Observation ports/clean-outs
primary system and reserve area Lateral placement with distance
to edge of bed Other Information
Eif Buildings Fif Audible/visual alarm referenced Yes No
gr Direction of slope indicator g Scale of drawing shown on scale Ef 0 Design staked out
21 Waterlines bar 0 0 Recorded Notices attached
g Roads,easements,driveways, 0 Elevation benchmark and relative ❑ 0 Waiver(s)attached
parking ptel ptplif otif cEtnipts g 0 Pump curve attached
g North arrow and scale drawing 0 0 Evaluation of failure
shown on scale bar JUL 0 2 2025 Non-residential justification
• ❑ ❑Waste strength
A ASON COUNTY ENVIRONMENTAL HEALTH ❑ 0 Flow
DESIBWPROVAL
The undersigned designer mt(st be 'fie by installer at time of installation 12f Yes 0 No
5/30/25
Si ature 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-s' egulations:
Envir m: I'ealth Specialist Date
i (/‘) IL441/1 7 --12-5
,i
CAUTION: DESIGN APPROV L 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: C — I ,p Zg
✓ 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
i
41M11.111..
PAC"-: •
MASON COUNTY HEALTH DEPARTMENT
ON-SITE SEWAGE DISPOSAL SYSTEM DESIGN
SITE#: PARCEL#: 619305100026
DATE SUBMITTED:05/30/25 LEGAL/LOT#: RIVER HAVEN
TR 26
SUBMITTED BY: ADAM HUNTER
APPLICANT: THOMAS WOLTER
ADDRESS: PO BOX 76
ALLYN,WA 98524
I.CALCULATIONS
NUMBER OF BEDROOMS= 3
RESIDENTIAL GPD FLOW= 360
IF NON-RESIDENTIAL-GPD FLOW
WILL BE AS FOLLOWS:
GPD=
APPLICATION RATE= 1.0 GPD/FT2
REDUCTION=LEAVE BLANK IF NO REDUCTION TAKEN
DRAINFIELD SIZING
ABSORPTION AREA= 360 FT2
TRENCH LENGTH OR BED CONFIG. = 9FTX4OFT SAND LINED BED
II.WATERPROOF SEPTIC TANK
COMPOSITION AND SIZE= 2633 GAL.CONCRETE
NEW OR EXISTING= NEW
III. DRAINFIELD CROSS SECTION
DEPTH TO DRAINROCK BOTTOM= N/A-GRAVELLESS CHAMBERS
ROCK DEPTH BELOW PIPE= N/A-GRAVELLESS CHAMBERS
SEPARATION FROM TRENCH BOTTOM TO IMPERMEABLE
MATERIAL/SEASONAL SATURATION = >1'-6"
FILL DEPTH = 1'-3"
TRENCH WIDTH = 9'-0^
IV. PUMP REQUIREMENT
DOSING VOLUME IN GALLONS= 60
NUMBER OF DOSES PER DAY= 6
V. PRESSURE CALCULATIONS
USING PIPE CLASS 40
ORIFICE 3/16
5/30/25
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LATERAL#1 =
SQUIRT HEIGHT(FT) 2.00
(NOTE(2):ORIFICE DISCHARGE RATE=(11.79)X(ORIFICE DIAMETER)SQ2 X
SO ROOT OF(TOTAL PRESSURE HEAD)
ORIFICE DISCHARGE RATE= 0.58618
LATERAL LENGTH IN FEET= 40.00
ORIFICE SPACING= 2'0"
DISTANCE FROM END CAP= 1'0"
NUMBER OF HOLES= 20
LATERAL DISCHARGE RATE= 11.724
LATERAL#2=
SQUIRT HEIGHT(FT) 2.00
ORIFICE DISCHARGE RATE= 0.58618
LATERAL LENGTH IN FEET= 40.00
ORIFICE SPACING= 2'0"
DISTANCE FROM END CAP= 1'0"
NUMBER OF HOLES= 20 p p pa
LATERAL DISCHARGE RATE= 11.72 n 0 V E
LATERAL#3= U
SQUIRT HEIGHT(FT) 2 L O 2 202.1[
ORIFICE DISCHARGE RATE= 0.5 "COUNTYLATERAENV�R
ORIFICEL LENGTH SPACING IN FEET= 42;000" JB,`O'NMENTAL HEALTH
DISTANCE FROM END CAP= 1'0" •e
NUMBER OF HOLES= 20
LATERAL DISCHARGE RATE= 11.724
LENGTH DIAMETER FLOW FRICTION LOSS
SECTION (FT) (IN) (GPM) (FT)
AB 12.00 2.00 35.171 0.251
BC 1.50 2.00 23.447 0.015
CD 3.00 2.00 11.724 0.008
DE 40.00 1.25 11.724 0.783
TOTAL= 1.057
**TOTAL HEAD LOSS **
1)FRICTION LOSS THROUGH SYSTEM= 1.057
2)ELEVATION DIFFERENCE = 4.000
3)RESIDUAL = 2.000
TOTAL= 7.057
5/30/25
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