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HomeMy WebLinkAboutSWG2025-00269 - SWG Application / Design - 7/7/2025 r MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584 SHELTON:360-427-9670, EXT 400 J I■ 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: SWG2025-00269 APPLICANT LENOIR KENNETH G & JUIDY C Phone: Address: 600 SE TJ LN SHELTON, WA 98584 OWNER LENOIR KENNETH G &JUIDY C Phone: Address: 600 SE TJ LN SHELTON, WA 98584 SEPTIC DESIGNER CINDY WAITE* Phone: 360-701-0205 Address: 80 E PICKERING LANE SHELTON, WA 98584 SEPTIC INSTALLER B-LINE CONSTRUCTION Phone: 1.360.489.9169 Address: 2971 E PHILLIPS LAKE LOOP RD SHELTON, WA 98584 Site Address: 600 SE Tj Ln Primary Parcel Number: 320273190002 Permit Description: Repair 3BR Gravity Permit Submitted Date: 07/07/2025 Permit Issued Date: 07/17/2025 Issued By: Jeff Wilmoth Current Permit Fees Paid: $825.00 (additional fees may be required upon installation of system). Permit Expiration Date: 07/17/2026 (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 Drain field 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/healthlenvironmental/onsiteloss-inspection-request.php or call: 360-427-9670, extension 400. OFFICIAL USE ONLY MASON COUNTY DATE RECEIVED: -1 — -- Q cn egiNAIIII c cn AMOUNT RECEIVED: RECEIVED f 8a� Public Health & Human Services � co ( cn Environmental Health 360-427-9670,ext.400 or 360-275-4467,ext.400 .... 415 N.6th Street - Shelton,WA 98584 S W G . 5 - al o 2 Z 6 ON-SITE SEWAGE SYSTEM APPLICATION 3 m n APPLICANT PHONE m r KENNETH LENOIR C/O B-LINE 360-426-4221 z MAILING ADDRESS-STREET.CITY.STATE.ZIP CODE M 600 SE TJ LANE SHELTON WA 98584 0 5ITE ADDRESS-STREET,CITY,600 SE TJ LANE SHELTON WA 98584 I w NAME OF DESIGNER PHONE I N CINDY WAITE 360-701-0205 NAME OF INSTALLER PHONE I CD v B-LINE CONSTRUCTION 360-426-4221 4. PERMIT TYPE(select one) DRINKING WATER SOURCE — N IV( RESIDENTIAL OSS f1 COMMUNITY OSS In COMMERCIAL OSSM PRIVATE INDIVIDUAL WELL ❑ PRIVATE TWO-PARTY WELL Z I PUBLIC WATER SYSTEM TYPE OF WORK(select one) n NEW CONSTRUCTION/UPGRADES REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) 0 TABLE X REPAIR I i ❑ SURFACING SEWAGE II EXISTING FAILURE ❑ SHORELINE SUBMITTALS CO I I�(DESIGN FORM(REQUIRED) AS SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE WAS LOT CREATED AFTER 4/12025? O ❑ WAIVER(S)(IF APPLICABLE) 3 2.71 Aqi 0 YES p NO n I I a) DIRECTIONS TO SITE AND SITE CONDITIONS (ex locked gale) GO SOUTH ON OLYMPIC HWY SOUTH, TURN LEFT ONTO ARCADIA, TURN RIGHT I c) ONTO TJ LANE, DRIVEWAY IS ON THE RIGHT OFF TJ LANE o I o I I \ SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. I N OFFICIAL USE ONLY BELOW THIS LINE UPGRADE/FAILURE SOURCE(for reporting purposes) ❑VOLUNTARY ❑MAINTENANCEIPUMPING 0 BUILDING PERMIT CI HOME SALE ['COMPLAINT ❑OTHER: INSPECTOR SOIL LOGS /J COMMENTS/CONDITIONS / i 1,6 , v . , „..,_ , i --\ 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 APPLIOATION APPROVED'ISSUED BY DATE )LErc).--7.-IL-2s tLori\ T F MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE Revised:4/14/2025 DESIGN FORM—PAGE ONE Assessor's Parcel Number: 1 3# 2 0 217 3 1 9 0 0 0 2 1 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. 'l 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 c:4c S . co a(�, 1 Designer's Name: CINDY WAITE Applicant's Name: K LENOIR C/O B-LINE CONST Designer's Phone Number: 360-701-0205 Mailing Address: 600 SE TJ LANE Designer's Address: 80 E PICKERING LANE SHELTON WA 98584 City State Zip SHELTON WA 98584 City State Zip Designer's Email cindyewaite@msn.com DESIGN PARAMETERS Treatment Device ❑ Glendon 0 Sand Filter 0 Mound 0 Sand Lined Drainfield 0 Recirculating Filter 0 ATU 0 Other Treatment Level(check all that apply): ❑A ❑g ❑C ❑BL I ❑ BL2 ❑ BL3 ❑ E ❑N Drainfield Type 'Gravity 0 Pressure ill Trench 0 Bed ❑ Sub Surface Drip Septic Tank/Drainfield Specifications Laterals Number of Bedrooms 3 Schedule/Class ASTM 2720 Daily Flow:Operating Capacity 270 gpd Length 50 ft Daily Flow: Design Flow 360 gpd Diameter • 4 in Septic Tank Capacity(working) EXISTING 1200 gal Number 3 Receiving Soil Type(1-6) 3 Separation Qe 9 ft Receiving Soil Appl. Rate .8 gpd/ft2 W` : ." Qrifices Required Primary Area 450 ft2 Tota er . ASTM 2720 PERF tP Designed Primary Area 450 ft2 DiaC°N1k° s A`(' 1. Designed Reserve Area 450 ft2 Sp n° LICENSED DESIGNER to in Trench/Bed Width 3 ft Lx.,I LS U510/ Manifold Trench/Bed Length 150 ft Schedule/Class NA Elevation Measurements Length ft Original Drainfield Area Slope 12 % Diameter in New Slope, If Altered % Preferred manifold configuration used? 0 Yes 6/1No Depth of Excavation Up-slope 25-23 in Transport Pipe from Original Grade Down-slope 21-19 in Schedule/Class 3034 Designed Vertical Separation 36+ in Length 20 ft Gravel-based Drainfield Required? re Yes ❑No Diameter 4 in Pump Required? 0 Yes gNo Dosing and Pump Chamber Pump/Siphon Specifications Number of doses/day Diff. in Elevation Between Pump& Uppermost Orifice ft Dose quantity gal Drainfield Squirt Height/Selected Residual (head) ft Chamber Capacity(flood) gal 1\ Uppermost Orifice 0 Higher 0 Lower than Pump Shutoff Pump controls: Please check those required. Capacity @ Total Pressure Head gpm • + Q ElaIse Meter 0 Event Counter Calculated Total Pressure Head 12.56 ft If r: it o IIY ; k',•' Y',• p off Comments ' , JUL 1 7 2025 ; , MASON COUNTY ENVIRONMENTAL HEALTI JBW DESIGN FORM—PAGE TWO Assessor's Parcel Number 3 j 2( 012 17131119 I 0 I of 0121 Permit Number: SWG DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch it Test hole locations Vir Drainfield orientation and layout Y Reference depth from original grade: Gd Soil logs 121 Trench/bed dimensions and 0 Septic tank Q( Property lines critical distances within layout Of Drainfield cover 1' Existing and proposed wells 121 D-Box/Valve box locations Reference depth from original grade within 100 ft of property iir Septic tank/pump chamber and restrictive strata: gr Measurements to cuts, banks, and locations p l.4 ref o, ill Laterals, trench/bed,top and surface water and critical areas Observation port location bottom gtr Location and orientation of W Clean-out location 0 Curtain drain collector curtain drain and all absorption 0 kManifold placement 0 Sand augmentation components IIKOrifice placement Other cross-section detail: 121 Location and dimension of Observation primary system and reserve area 2i Lateral placement with distance ports/clean-outs to edge of bed Other Information ef Buildings A Midible/visual alarm referenced Yes No at Direction of slope indicator Gll Scale of drawing shown on scale i 0 Design staked out iti Waterlines bar 0 0 Recorded Notices attached ef Roads, easements,driveways, ppi e .,r;p tentsPump a a, :.•lative 0 0 Waiver(s) attached parking , 0 0 curve attached -.. ' North arrow and scale drawingJU 0 0 of failure shown on scale bar 1 7 20?.5p. Non-residential justification MASON COUNTY ENVIRONMENTAL HEALTH 0 0 Waste strength JBW ❑ 0 Flow DESIGN APPROVAL The undersigned designer must be notified by installer at time of installation fitiYes 0 No IN Gt ti tt, j Ze Signal 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 locallron-site regulations: —7 / C L ' 4/o /'r!�—�`) vi vmental Health Specialist Date CAUTION: DESIGN APPROVAL 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: 7 — I6 "•�� ✓ 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:6/11/2025 • 44 . 4<zi �, et * V o. ` °fie /. �h P`� di4C * *\ Oa O Ttl, 1. )\1/ �I' t i 'I ' �� %� 'UI'Sn S?tii,:�c3 .+,��\�Q. ` IL'►lis O� 07� it,t\ 1y 213N'JIS3aOSSN331 • •"w. .SA ' • If 1dp �jt S•i; l t is , r e `�sa '�~� 4 e4 .r.. • g • v M $ 11 - ' i , us • ' ` ! 4 1 I , $ r . r ' i r ....t , 1 1 11 , 1 �� r a i C to ,___________.____________________________t_ t ci i 1 co i °/' ,' Q r r r �, r 1 If r 1r a O f� r �S _1 1 ^• i 1 r v 1 3 r 1 r - r r r r r ' - , c gi a TD-5 IL , 88 `gg8 i rA c O c Ai I -- = — �� — ! ,� • 1 C — mI ,rl G ,• m I - _ _N c c x C! 1-- NM ,,, 3‘. . Z C I ii i14 i _r-I M N _ T i r LE-- 1 -7,7 __i'D Lill c:1 )62D- vS)A4‘4/ 0 1 I , v, , ,..2... 11/ ‘- 195 ,00'-' \ _____ k____. (42).... 0 i 40 0 AO 44 \ 1 &-;) 012..revwe...1-- „,,, i —14 _ _______ k______ ,............ ivy Gie , s t }.0 © D- /. . y' W40'!44;. �e 8 U' bd` I "O ENSCIN ErWi11T ` y.,`. b I ci ' ►J ; • LICENSED D 4 It. " ' t►t %%�� 1 LXPiRLS 05/10, O"`+ 44 %/"‘ , , ..,,, ,r,,,/ Ft .1) d &it 1 ookf I ' P.1* 1 i 04 r+ I t e� rat 4.,EI FT I+e•t - 4 it•G Z it- L ;s T G 3 44 `3z s-e el j,d,4 .3C y 24 V�° ,o Sc " Lie to _I s . I 1... red.erd,, P\)v Scam N \/1' r , Installation Notes Gravity Distribution System: 581 SE TJ LANE 32027-31-90032 1. The prepared site plan is not a survey. It's the owner's responsibility to verify property lines, utility lines (water, sewer, power, phone and gas) prior to installation. 2. Install cleanout between residence and septic tank 3. Gravel based drainfield required 4. Install system during dry weather with acceptable soil conditions 5. Keep wheeled vehicles off the drainfield area before, during and after installation. Tracked equipment only 6. All ground, surface water and roof drains must be diverted away from the septic tanks and drainfield. Ensure the final grade slopes away from these areas and water doesn't collect on or around them. Use swales, berms, catch basin and tight lines, curtain drains, etc. to divert all waters. 0 7. Curtain drains can be no closer than 10' upgradient and 30' down gradient of the drainfield 8. Exposed restrictive layers, cuts, banks, etc. can be no closer than 50' downhill from the drainfield. 9. Install access risers on the septic tank, D-box and observation ports. 10. Make sure septic tank risers are epoxied or caulked to cast in riser rings on tank. 11. Lids must form a water and gas tight seal with the access risers 12. Install effluent filter at the septic tank outlet. 13. This system must be installed by a Mason County Certified Installer. 14. Deviation from this design without prior approval from the designer and Mason County Health Department will make this design null and void. 15. This design was sized per Washington Administrative CodeWAC246-272A-0230. The operating capacity is based on 45 gallons per day per capita with two persons per bedroom. The minimum design flow per bedroom per day is the operating capacity of ninety gallons multiplied by 1.33. This results in a minimum design flow of one hundred twenty gallons per day. This creates a surge factor of 33% but anticipated flow is ninety gallons per bedroom per day. 16. Install laterals or bed with contour of the ground 17. Install trench bottoms level and always maintain; inimum of six inches into native soil 18. Filter fabric required over drain rock prior !• .i kfilling. If the drain rock extends above the original grade, run the filter fab at I l st 2 inches down the trench wall P• e y. �/�y N d p R o s�oe• ,UL 11 2025 o DY GNL e� / `\ r UCENSEA D GN d TY:::„..\RNMEKVNI-6E4 ALT �:�""�"` ` vserr.•4;1 MASON COON EXPIRES OS tfii W , . , System Owner Responsibilities: 1. Operation and Maintenance is required by Washington State Department of Health and Mason County Health Department. 2. The septic tank should be pumped every three to five years or as needed. 3. System owners are responsible for having maintenance performed every three years as per WAC246-272A. 4. System owners are responsible for responding to septic issues in a timely manner. 5. System owner agrees to read and abide by information regarding their system in the User Manual provided by Mason County Public Health. 6. Keep the flow of sewage at or below the approved design operating capacity. 7. Keep waste strength at residential waste strength parameters. 8. Spread loads of laundry through the week. 9. Do not use excessive bleach or detergents with added whiteners. 10. Do not shower, do laundry and dishwasher at the same time 11. Antibiotics can kill or impair the biological process in the septic tank. 12. Leaky plumbing can hydraulic overload your on-site septic system. �c 2tAsy 9� e. `•� 51004 LICENS INDYEDI$$$II GNE LXPiRES 05n0,