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Home My WebLink AboutSWG2025-00248 - SWG Application / Design - 6/26/2025 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 Tank Only Permit: SWG2025-00248 OWNER WOOD ET AL BREANNA LYNN Phone: Address: 3261 E STATE ROUTE 106 UNION, WA 98592 APPLICANT WOOD ET AL BREANNA LYNN Phone: Address: 3261 E STATE ROUTE 106 UNION, WA 98592 SEPTIC DESIGNER CINDY WAITE* Phone: 360-701-0205 Address: 80 E PICKERING LANE SHELTON, WA 98584 Site Address: 3261 E STATE ROUTE 106 Primary Parcel Number: 321063400040 Permit Description: Septic tank replacement-adding trash tank and Nuwater BNR500 Permit Submitted Date: 06/26/2025 Permit Issued Date: 07/11/2025 Issued By: Rhonda Thompson Current Permit Fees Paid: $270.00 (additional fees may be required upon installation of system). Permit Expiration Date: 06/26/2028 (based on date of inspection) Type of Work OSS Repair Components being Replaced: Septic Tank Only Surfacing Sewage? No Existing Failure? Yes Shoreline? Yes Horizontal Setbacks Met? Yes Number of Bedrooms: 0 Drinking Water Source: Public Water System Additional Details: Trash tank and Nuwater BNR500 Permit Conditions: 1 Horizontal setbacks per WAC246-272A-0210 must be maintained, unless prior approval is obtained 3 Mason County Asbuilt Form, Record Drawing. and Installation fee must be submitted for final installation approval. 4 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. 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/environmental/onsite/oss-inspection-request.php or call: 360-427-9670, extension 400. OFFICIAL USE ONI.Y MASON COUNTY' DATER OUI — 2(0 - 2025 co a 07 COMMUNITY SERVICES AMOUNT Mani_ RECEIVED BY: i CO e..., C ca m CA Public Health(Community Health/EnvIronmentallHealth) N 360.477-9670,e4.400 or 366 a.775.4467.e 400 415 N.6th Street•Shelton,WA 98564 SWG 20z6 Ooz [ g O S V\r/ • ON-SITE SEWAGE SYSTEM APPLICATION p APPLICANT BRIANNA WOOD ( � PHONE360-688-8175 m z MAILING ADDRESS STREET,CITY,STATE,ZIP CODE I C 3261 STATE ROUTE 106 I!1-11-11 3 UNION WA 98592 to m SITE ADDRESS-STREET.CITY ZIP CODE Cam A 3261 STATE ROUTE 106 � " UNION WA 98592 w NAME OF DESIGNER I tt" ,-,-, PHONE CINDY WAITE e= -G 360-701-0205 I" NAME OF INSTALLER PHONE PERMIT TYPE(select one) DRINKING WATER SOURCE CA 0 VI RESIDENTIAL OSS n COMMUNITY OSS 'n COMMERCIAL OSS ipRIVATE INDIVIDUAL WELL ❑ PRIVATE TWO-PARTY WELL Z TYPE OF WORK(select one) CI NEW CONSTRUCTION I UPGRADES I t�REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) r 0 TABLE IX REPAIR 03 SUBMITTALS 0 SURFACING SEWAGE ®EXISTING FAILURE 21 SHORELINE IIV(DESIGN FORM(REQUIRED) wl SEPTIC DESIGN(REQUIRED) BEDROOMS I LOT SIZE Or 41. CI WAIVER(S)(IF APPLICABLE) D ,� I j 1 0 DIRECTIONS TO SITE AND SITE CONDITIONS.(ex.locked pale) "� GO OUT US 101, TURN RIGHT ONTO STATE ROUTE 106, SITE IS ON THE LEFT o (CANAL SIDE). RESIDENCE BURNEE4, DOWN. WILL BE USING THE EXISTING o 0 DRAINFIELD FOR A RECREATIONAL VEHICLE . .p SITE MUST SE FLAGGED FROM MANY ROAD AND TEST HOLES MUST BE l LAGGED WITH TEST HOLE NURSERS. o —" " --- ---OFFICIAL USE ONLY BELOW THIS LINE- - UPGRADE/FAILURE SOURCE(tor repo**purposes) -- -- - -. -- ,"� ti 0 VOLUNTARY ❑MAINTENANCE/PUMPING 0 BUILDING$ERMIT 0 ❑HOME SALE ❑COMPLAINT OTHER; INSPECTOR SOIL LOGS COMMENTS/CONDITIONS r i 11\V\\L Can 301E CODES: RECORD DRAWING AND INSTALLATION REPORT V=VERY G=GRAVELLY S=SAND L=LOAM SI•SILT C=CLAY =EXTREMELY R e ROOTS REQUIRED FOR FINAL APPROVAL. INSPECTOR SIGNATURE DATE APPLICATION EIPIRATION DATE APPLICATION APPROVED/'SUUED BY DATE 1L1 )1, m7n1 -711I (?tI SG THIS FORM MAY BE ARMED AND AVAILABLE FOR PUBLIC VIE V ON THE MASON COUNTY WEBSITE REVISED 12/7/2015 DESIGN FORM—PAGE ONE Assessor's Parcel Number: 3 2 1 0 6 — JY — 0 0 0 4 0 A design will be reviewed when copies of each bf the following are submitted: Completed design form that has been signed and 4ted. Scaled layout sketch,including all applicable items on checklist 0 Scaled plot plan,including all applicable items on hecklist, 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 2025— CO2c4 Designer's Name; CINDY WAITE Applicant's Name: BRIANNA WOOD Designer's Phone Number: 360-701-0205 Mailing Address: 3281 STATE ROUTE 106 Designer's Address: 80 E PICKERINTG LANE UNION WA 98592 SHELTON WA 98584 City State Zip City State Zip DESIGN PARAMETERS Treatment Device CI Glendon Biotllter ❑Sand Filter ❑ Mound ❑ Sand Lined Draintield ❑ Recirculating Filter,Type: Cl Aerobic Unit Make/Model BNR500 ❑Disinfection Unit Make/Model Other: Drainfleld Type I 'Gravity 0 Pressure ❑Trench ❑ Bed 0 Sub Surface Drip Septic Tank/Drainfleld Specifications Laterals Number of Bedrooms Schedule/Class Daily Flow: Operating Capacity gpd Length ft Daily Flow: Design Flow gpd Diameter in Septic Tank Capacity(working) TWO TAN4 gal Number Receiving Soil Type(1-6) l Separation ft Receiving Soil Appl. Rate I gpd/ft'- Orifices Required Primary Area I ft Total Number of Orifices Designed Primary Area ft2 Diameter in Designed Reserve Area i ft2 Spacing in Trench/Bed Width ; ft Manifold Trench/Bed Length 1 ft Schedule/Class Elevation Measurements Length ft Original Drainfield Area Slope % Diameter in New Slope,If Altered % Preferred manifold configuration used? 0 Yes 0 No Depth of Excavation Up-slope ! in Transport Pipe from Original Grade Down-slope ; in Schedule/Class 3034 Designed Vertical Separation in Length 45 ft Gravelless Chambers Required? 0 Yes 0 No ii Optional Diameter 4 in Pump Required? 0 Yes Is 'No Dosing and Pump Chamber Pump/Siphon Specifications Number of doses/day Diff in Elevation Between Pump&Uppermost Orifice_ ft Dose quantity gal \ \b Drainfleld Squirt Height/Selected Residual(head) ft Chamber Capacity(flood) gal Uppermost Orifice A Higher CI Lower than Pump Shutoff Pump controls: Please check those required. Capacity @ Total Pressure Head - gpm OTimer ❑Elapse Meter 0 Event Counter Calculated Total Pressure Head . , ft If Timer: Pump on ,Pump off Comments ADDING A 1200 CONCRETE SEPTIC TAiNK AND AND A BNR 500 IN A CONCRETE SEPTIC TANK. THESE WILL FEED THE EXISTING DRANFIELD TO ALLOW AN RV TO BE PUT ON SITE. ----. 1.L.flun- A(a TWO Assessor's Parcel Number: 3 2 1 0 6 4 3 — 0 0 0 4 0 Permit Number: SWG DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch 0 Test hole locations Cross-Section Sketch Drainfield orientation and layout Reference depth from original grade: ❑ Soil logs ❑ Trench/bed dimensions and g+d Property lines critical distances within layout CI Septic tank 0 Existing and proposed wells 0 D-Box/Valve box locations Drainfield cover efwithin 100 ft of property Septic tank/pump chamber Reference depth from ositnal grade t-Measurements to cuts, banks,and 'locations and restrictive strata: I"W 0 Laterals,trench/bed,top and surface water and critical areas observation port location bottom 10''Location and orientation of pk kelean-out location curtain drain and all absorption CI Curtain drain collector components &)v1anifold placement 0 Sand augmentation Orifice placement Other cross-section detail: Fa/Location and dimension of primary system and reserve area ttlrateral placement with distance 0 Observation ports/clean-outs Gl Buildin s to edge of bed Other Information g NUa P. 66 iAudible/visual alarm referenced Yes No St Direction of slope indicator 0 Waterlines kale of drawing shown on scale 0 0 Design staked out bar 0 0 Recorded Notices attached Rd Roads, easements,driveways, parking Houle 0 0 Waiver(s)attached !�tdtu't +tp � � 0 CI Pump curve attached RI North arrow and scale drawing jil shown on scale bar 574.0 %c, Tee Alic- 0 Evaluation of failure Non-residential justification ❑ 0 Waste strength ❑ ❑ Flow DESIGN APPROVAL The undersigned designer must be noti d by ins er at time of installation 0 Yes ❑ No 3 Signatur of Designer to 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: -7 1 ( 1 12—c Environmental Health S cialist Date CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION: I The design is stamped"Approved"by Mason County Public Health. (✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: 7/i ( I _6 ✓ Drainfield site conditions have not been altered to adversely affect conditions of design approval. Z\ C 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. Updated Date: 12/7/2015 • lr-. ! . i .ter. `� ..... i • i APPROVED AJUL 1 1 2025 5 '+lE MASON COUNTYENVI RONME EA �� • Or•P . ',I f„, , ,- ,,:I, (\o 'I' o • Fri ss 1 � C 4,,,,, 51 41 vN CT C E W ITE 'ail V , , ' LICENSED DESIGNER aI„ Z�\ \\ \ 'ate•►\\`� C • • 2. 16 • r • i • • �' } I IT • • y1 , • W W i al • 4t,1 RI.) 1 v F13 T � IN es C1� N —� v1 1 O, (th a) 3 7] 5 = 63 a 7z, t. , 4 � ' 1- Q, N 0m.,_. a 8 cri ca 4:I S. -k . , k ,-r..-..-----------..,...... _, , 0 .! - :th i ‘‘ [ • j ... IN ; •. • 1200 Gallon Double Compartment Septic Tank 3'.%.rii i ±l cil • OUTLET FILTER REQUIRED i J scum dayer _ ?!41 cuiv ti 1;,,nl .t'J Vllfp ; awe u SEPTIC TANK MUST BE ON DOH APPROVED LIST 1i11 l I a.//Q'.J .Ld: Derr �.�r+v 'c. 43- APPROVED �P �� 4 YyAs 9� lifiA .‘( J Y" 1 JUL 1 1 2025 r MASON COUNTY ENVIRONMENTAL HEAL �� E�CE VSF`�`CESIC E` RET :... « WATERTIGHT LID VENT(lyp) DUAL PORT AERATOR • RISERS(TYP) I I I I 36"MAX. V� 1/Z 1'PVC(TYP) .eft 1/2'PVC ri1uw:= -•�"'-,1 AIRLINE MASTIC 11111111111 1 * J — 2"COUPLING S &REDUCER 8"I - i, II 1111 2'TEE \ 12" 1"PVC SLUDGE RETURN LINE 2"PVC -/ ow TRASH CHAMBER A OPERATING CAPACITY:417 GALLONS DIGESTER CHAMBER CLARIFIER FLOOD CAPACITY:490GALLONS OPERATING CAPACITY: GALLONS `" R FLOOD CAPACITY:ITY:4 4p1 GALLONS Bg" 100 GALLONS FLOOD;191 GAL. 44* ( ) 504 APPROVED. ° 53 ' JUL 1 1 2025 4TEE 'n" MASON COUNTY ENVIRONMENTAL N L H . • •. RET "' DIFFUSER BARS(2) 1r PARALEL TO TANK WALL \ y3 4" \ —�"'"""'�` SLUDGE RETURN y \ d r�t• 4 /�• 1.6'TAPER -s-r4 \ 4. Ar IA • STONE-FREE NATIVE SOIL so • A OR COMPACTED SAND INSTALLATION INSTRUCTIONS , ta ll"Ap OVER STONY SOIL 1)Excavate tank hole with vertical walls to 1 foot larger 1-''.�' c�1 �, tank on ail sides• ��P N v- At 2)If bottom of hole is stony,install 3"of compact sal'.•St4 ' Tyxt 9'-2" 4, out with screed. �� 3)Install tank in center of hole,keeping 1 ft.voi• mate onG SY E a I E — —�`all 81des. rr LICENSED DESIGN � �� — ——— — 4)As tank Is filling with water,fill In void .•-•:•.".147u. •!:,•6O�� 24'RISERS YP) 24•BLOWER granular(sandy)soil free of large clumps of clay. L•,I;I', (;,,•„ ' %' 'V i I .N s 5)Install rest of system.&affix risers to adapters with waterproof adhesive. 6)Perform watertightness test in field as required by local I I ] a'-s" /CDJurisdiction. I 7)Upon approval to backfill,carefully backfill with native I 12•RISER I I soils over top of tank. 8)Final grade the surface to avoid chanelling surface TRASH CHAMBER J L P1GF�ZEt3 I l glitanfal water toward tank. L J L_,J TOP VIEW -51 "5 1'■2.8 N. AEROBIC TREATMENT TANK DETAIL FOR ,ifi-i- NP Nu WA TER BNR-500 TREATMENT UNIT ENVIRO-FLO, INC REVISED. °4n „ad. .;::.. astewater Treatment Technologies 3/01/12 RI 0.BOX 321161, Flowood, MS 39232 ;r (877) 836-8476 (601)845-4716 fax SCALE. ,r = f Www.envlro-nr�net1"4 ff. Bamford septic Repair,LLC 13607902364 301 E. Wallace Kneeland Blvd STE#224-332 Shelton, WA 98584 PROPERTY INFORMATION Location:3261 E STATE ROUTE 106 Union Tax ID:321063400040 Mali To BREANNA LYNN WOOD ET AL 3261 E STATE ROUTE 106 Use: UNION,WA 98592-9501 GENERAL SYSTEM TYPE:Conventional (Non-Pressurized) ON ID:321063400040 County Area:Hood Canal MRA(wlin 1100 ft) Fold FoiA '- ON-SITE WASTEWATER TREATMENT SYSTEM INSPECTION REPORT Here Inspected:04/26/2024 - Inspection Type:ROUTINE - Correction Status:Corrections in progress Company: Work Performed By: Submitted C4/27/2024 by: Bamford septic Repair,LLC Thaddeus Bamford Thaddeus Bamford COMMENTS&GENERAL INSPECTION NOTES Deficiencies Were Noted:Corrections are in progress. House burned down. Used camera to inspect and locate drain field. From exposed pipe it has 4'ABS pert pipe. It goes @20'towards water and 20'to the south. Ran water to field accepting all water. No tank due to fire. GENERAL SITE&SYSTEM CONDITIONS The General Site and System Conditions were: Fully Inspected YES Components accessible for service:All required service performed(if no-specify omitted inspection items in notes): YES ES Surfacing effluent from any component(including mound seepage): NO NO.In Progress Components appear to be watertight-no visual leaks:Improper encroachment(structures/impervious surfaces) NO N/A All riser lids securely fastened upon departure:Electrical repairs needed. If YES describe in comments: N/A/A-In Progress Inspected components appear to be in good physical condition: NONO Root intrusion on any components. If YES describe in comments: NO Settling problems observed. If YES describe in comments: NO The house/structure was vacant or used infrequently,assessment of the drainfield was not possible. ONSITE SEWAGE SYSTEM INSPECTION DETAIL ANK:Septic Tank-2 Compartment Not Inspected This component was: Effluent level within operational limits(if NO explain in comments): All required baffles in place(N/A=No baffles required): Compartment 1 Scum accumulation(Inches,if other specify): Compartment 1 Sludge accumulation(Inches,if other specify): Compartment 2 Scum accumulation(Inches,if other specify): Compartment 2 Sludge accumulation(Inches,if other specify): Pum•in•recommended: distribution:D-Box Not Inspected This component was: D-Box in good condition: D-Box outlets set to allow e•ual effluent distribution: a rainfield(disposal):Gravity Fully Inspected This component was: S Component appears to be functioning as intended: YE E Ponding present?If YES explain in comments: NO NO Drainfield was vacuumed,flushed or h dro'tatted? If YES ex lain in comments Fully Inspected This component was: NO Pumping recommended: This report indicates certain characteristics of the onsdo sewage system at the time of visa.In no way is this report a guarantee of operation or future performance. ReportlD:1282614 View inspection reports online at www.onlinerme.com Page 1 of 1