HomeMy WebLinkAboutSWG2025-00256 - SWG Application / Design - 6/30/2025 0 .: 415 N 6TH STREET,SHELTON,WA 98584
MASON COUNTY SHELTON:360-427- ,EXT 400
BELFAIR:360-275-44674467, EXT 400
ELMA:360-482-5269,EXT 400
f Public Health & Human Services FAX:360-427-7787
On-Site Sewage System Permit: SWG2025-00256
APPLICANT
Hunter, Adam Phone: 360 753-1226
Address: 2201 93rd Ave SW Olympia, WA 98512
OWNER
CUTLER BERT A Phone:
Address: 5334 N 78TH WAY SCOTTSDALE, AZ 85250
SEPTIC DESIGNER
ADAM HUNTER* Phone: 360-753-1226
Address: PO Box 162 OLYMPIA, WA 98507
Site Address: 2120 E SPENCER LAKE RD
Primary Parcel Number:
221325000045
Permit Description: Conforming repair 3bd Oscar II
Permit Submitted Date: 06/30120250710312025
Permit Issued Date:
Issued By: Rhonda Thompson
Current Permit Fees Paid:
$825.00 (additional fees may be required upon installation of system).
Permit Expiration Date:
07/02/2026 (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 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/670environmental/oextension on 400 nsiteloss-inspection-request.php or call:
360-42
OFFICIAL USE ONLY
eleD s
MASON COUNTY DATE RECEIVED: 6/30/25 (/)
AMOUNT RECEIVED: 825 RECEIVED BY: Online CO Cn
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� Public Health & Human Services �,
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Environmental Health 360-427-9670,ext.400 or 360-275-4467,ext.400 �, `vv' 2 0 2 5-0 0 2 5 6 O
415 N.6th Street -Shelton,WA 98584 ;U
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CLEAR FORM ON-SITE SEWAGE SYSTEM APPLICATION D >
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APPLICANT PHONE r
ADAM HUNTER 3607531226 z
MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE g
PO BOX 162 OLYMPIA WA 98507 03
SITE ADDRESS-STREET.CITY ZIP CODE
2120 E SPENCER LAKE RD SHELTON WA 98584 N
NAME OF DESIGNER PHONE W
ADAM HUNTER 3607531226 N.'
CTI
NAME OF INSTALLER PHONE 00 O
C O
C)
PERMIT TYPE(select one) I� DRINKING WATER SOURCE O
6 RESIDENTIAL OSS �COMMUNITY OSS III COMMERCIAL OSS i�PRIVATE INDIVIDUAL WELL 6 PRIVATE TWO-PARTY WELL Z CP
TYPE OF WORK(select one) a. PUBLIC WATER SYSTEM
h NEW CONSTRUCTION/UPGRADES ft REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) 0 TABLE X REPAIR
SUBMITTALS 0 SURFACING SEWAGE Er EXISTING FAILURE ❑SHORELINE CO
r
c
Lam] DESIGN FORM(REQUIRED) INJ SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE WAS LOT CREATED AFTER 4/1/2025? 0
6-WAIVER(S)(IF APPLICABLE) 3 1.77 0 YES Q✓ NO n I
7
DIRECTIONS TO SITE AND SITE CONDITIONS (ex.locked gate)
PICKERING RD TO A RIGHT ON SPENCER LAKE RD TO SITE ON THE LEFT.
I-
O
-I
SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS.
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE I FAILURE SOURCE(for reporIng purposes)
0 VOLUNTARY 0 MAINTENANCE/PUMPING 0 BUILDING PERMIT ❑HOME SALE OCOMPLAINT 0 OTHER:
INSPECTOR SOIL LOGS COMMENTS/CONDITIONS
TH1: 0-24 VGLMS (50% gravel), 24-36 VGMS
TH2: 0-24 VGMSLM, 24-44 EGCS
TH3: 0-36 VGLMS, 36+ compact
RECORD DRAWING AND''NSTALLATION REPORT
SOIL CODES:
V=VERY G=GRAVELLY S=SAND L=LOAM Si=SILT C=CLAY E=EXTREMELY R=ROOTS REQUIRED FOR FINAL APPROVAL
11 INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED/ISSUED BY DATE
EH APPROVED
.4\t gym? (WI. 7/2/25 7/2/26 EH
T^PPRPPR 074)3MI5
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE Revised:4/14/2025
Assessor's Parcel Number: 221325000045 -- —— -- —————
DESIGN FORM—PAGE ONE applicable items on checklist.
been signed and dated. ',I Scaled layout sketch,including all items on checklist.
A design will be reviewed when 3 co iegs of each of the following are submitted:
Completed deign form that hasapplicable items on checklist. '' Cross-section sketch,including all applicable
Scaled plot plan,o including all
and available for public view on the Mason County Web site.Maximum iaier size: 11' X 17'
This form may be scannedPARCEL IDENTIFICATION
ADAM HUNTER
2025-00256 Designer's Name: 3DAM HUNTER
Permit Number: SWG Designer's Phone Number: 6 BOX 162
ADAM HUNTER
Applicant's Name: Designer's Address: WA g8507
1226
PO BOX 162 OLYMPIA
Mailing Address: WA 98507 City State Zip
OLYMPIA JHANDASSOCIATES@HOTMAIL.COM
State Zi Designer's Email
Ci DESIGN PARAMETERS
Treatment Device 0 otheQSCA=
❑ Glendon 0 Sand Filter 0 Mound 0 Sand Lined Drainfield 0 RecircUBl at2 g Fil BL 3 0 ATI
E J N
Treatment Level(check all that apply): I A J B I C I BL1
Drainfield Type 0 Bed El Sub Surface Drip
OSCAR II 0 Pressure ❑Trench
❑Gravity Laterals
Septic Tank/Drainfield Specifications Number of Bedrooms OSCAR
3 Schedule/Class
270 gpd Length OSCAR ft
Daily Flow:Operating Capacity 360 gpd Diameter OSCAR in
Daily Flow: Design Flow 1500 gal Number OSCAR
Septic Tank Capacity(working) 3 Separation OSCAR ft
Receiving Soil Type(1-6) Orifices
0.8 gpd/ft2 OSCAR
Receiving Soil Appl.Rate 450 ft2 Total Number of Orifices
Required Primary Area Designed Primary Area OSCAR in
450 ft2 Diameter Designed Reserve Area OSCAR in
450 ft2 Spacing
Manifold
13 ft 40
Trench/Bed Width 35 ft Schedule/Class ft
35
Trench/Bed Length Length
Elevation Measurements Original Drainfield Area Slope 1 1 %% Diameter 1.25 in
Preferred manifold configuration used? ®'Yes 0 No
New Slope,If Altered Transport Pipe
Up-slope OSCAR in Pipe
Depth of Excavation OSCAR in Schedule/Class ft
from Original Grade Down slope40
425
24 in Length in
1.25
Designed Vertical Separation Diameter
Gravel-based Drainfield Required? ❑Yes P1 No Dosing and Pump Chamber
12(Yes ❑No 360
Pump Required? Number of doses/day
1 gal
Pump/Siphon Specifications ft Dose quantity
&Uppermost Orifice 3� 1200 gal
Diff.in Elevation Between Pump pp OSCAR ft Chamber Capacity(flood)
Drainfield Squirt Height/Selected Residual(head) Pump controls:Please check those required. Counter
Shutoff Timer Elapse Meter
UppermostOrifice Higher Head 0 Lower than Pumpgpm 22SEC pump off 3 Eventn Co
Capacityua @ Total Pressuree 53.165 ft If Timer: Pump on
8SEC
Calculated Total Pressure Head
Comments EH APPROVED
Rhonda Thompson 07103/2025
Revised:4/14/2025
DESIGN FORM—PAGE TWO Assessor's Parcel Number: 221325000045 — -- —————
2025-00256
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Layout Sketch
Cross-Section Sketch
Scaled Plot Plan Eg Drain field
dimensionsfi and Ef Septiceld orientation and layout Reference depth from original grade:
El Test hole locations tank
Q( Soil logs Ef critical distances within layout l ' Drainfield cover
l� Property lines a D-Box/Valve box locations Reference depth from original grade
Eg
within and of proposed wells a Septic tank/pump chamber and restrictive strata:
within 100 ft of property locations � Laterals,trench/bed,top and
� Measurements to cuts,banks,and bottom
Observation port location Curtain drain collector
surfacetiwater andncriticaln areas El Clean-out location 11 1 Sandurtaugmentation
Ef ur Location and orientation absorption of Ei Manifold placement
curtain drain and all
components Ef Orifice placement Other cross-section detail:
Eg Location and dimension of lig sii Observation Lateral placement with distance ports/clean-outs
Other Information
primary system and reserve area to edge of bed
12 Buildings EA Audible/visual alarm referenced Yes
No
❑ Design out
Eg Direction of slope indicator E r Scale of drawing shown on scale 0 0 Recorded staked Noticesu attached
bar ❑ 0 Waiver(s)attached
waterlines ds easements, curve attached
components Eg 0 Pump
� Roads, driveways, 0 Elevation benchmark
of system►r► elat�ve ❑ 0 Evaluation of failure
parking
Non-residential justification
El North arrow and scale drawing ❑ 0 Waste strength
shown on scale bar ❑ ❑ Flow
DESIGN APPROVAL
designer must be notifi• •y installer at time of installation Eg Yes ❑ No
The undersignedAil
6/5/25
Date
Si i , •f Designer
• • .n behalf of Mason County Public Health and determined it to be in
The undersigned has reviewed this de 7/3/25
compliance with state and local on-sit egulations: U4/1,
Environmental Health Specialist
Date
C
CAUTION: DESIGN
APPROVAL IS VALID ONLY UNDER THE FOLLOW12126 ONDITION:
✓ The design is stamped"Approved" by Mason County Public Health.
/ The Onsite Sewage Permit has not expired,the Permit a adversely aaffection Dcond'rtions of design approval.
✓ Drainfield site conditions have not been altered to
Please Note: The system must be installed by a certified installer,
ed from Mason County Public Health
unless prior authorization is obtain
le for public view on the Mason County Web site. Revised:4/14/2025
An Installation Fee isra; ire .
M
This form may be scanned andd av
PAGE 1
MASON COUNTY HEALTH DEPARTMENT
ON-SITE SEWAGE DISPOSAL SYSTEM DESIGN PARCEL#:221325000045
SITE#: LEGAULOT#:
DATE SUBMITTED:512612025
SUBMITTED BY: ADAM HUNTER
APPLICANT: ANNA CUTLER
ADDRESS: 5334 N 78TH WAY
SCOTTSDALE,AZ 85250
I.CALCULATIONS 3
NUMBER OF BEDROOMS=
RESIDENTIAL GPD FLOW= 360
IF NO -RESIDE TIAL-GPD FLOW
WILL
GPD=
0.8 GPDlFT2
PLICTTION RATE=
REDUCTION=LEAVE BLANK IF NO REDUCTION TAKEN
DRAINFIELD SIZING FT2
ABSORPTION AREA= 450 PER OSCAR
TRENCH LENGTH OR BED CONFIG.= 13'0
35'
It.WATERPROOF SEPTIC TANK 1500 GAL-CONCRETE
COMPOSITION AND SIZE=
NEWWOR EXISTING= SEPTIC
TANK
CONCRETE
III.DRAINFIELD CROSS SECTION 0' 6"
SAND DEPTH=
IV.PRESSURE CALCULATIONS USING PIPE CLASS 40 ORIFICE NETAFIM DRIPLINE
LENGTH DIAMETER
FLOW FRICTION LOSS
(GPM)
(FT) (IN)
SECTION SUPPLY 425.00 12.000 8.6826
1.25
12.000 8.6826
1.25
425.00
RETURN TOTAL= 17.3652
"TOTAL HEAD LOSS "
17.365
1)FRICTION LOSS THROUGH SYSTEM= 7.365
2)ELEVATION DIFFERENCE = 35.800
s®
TOTAL= 53.165
EH APPROVED
/ 5/26125 Rhonda Thompson 07103/2025
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1 -� ADAIJ J.HUNTER '1
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V.CHECK THE PUMP CAPACITY.
PUMP. A.Y.MCDONALD 30GPM-3/4HP PUMP(MODEL#22050E2AJ) (PER OSCAR)
EXCESS TDH 80.00 (PER OSCAR)
TOTAL HEAD LOSS IN SYSTEM53.17
STANDARD PUMP CONFIGURATION IS SUFFICIENT? YES
EH APPROVED
Rhonda Thompson 07/03/2025
5/26/25
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