HomeMy WebLinkAboutSWG2025-00244 - SWG Application / Design - 6/25/2025 at MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584
SHELTON: 7
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: SWG2025-00244
APPLICANT RUSSELL FRANK G & MARGARET A Phone: 360-427-8740
Address: 20 SE Court Rd SHELTON. WA 98584
OWNER RUSSELL FRANK G & MARGARET A Phone: 360-427-8740
Address: 20 SE Court Rd SHELTON, WA 98584
SEPTIC DESIGNER CINDY WAITE* Phone: 360-701-0205
Address: 80 E PICKERING LANE SHELTON, WA 98584
SEPTIC INSTALLER TBD Phone:
Address: 123 XXX XX, XX. 00000
Site Address: 20 SE Court Rd
Primary Parcel Number: 319015100021
Permit Description: Repair: 2-bedroom NuWater BNR500 drainfield bed
Permit Submitted Date: 06/25/2025
Permit Issued Date: 07/16/2025
Issued By: David Anderson
Current Permit Fees Paid: $825.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 06/30/2026 (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/health/environmental/onsiteloss-inspection-request.php or call:
360-427-9670, extension 400.
OFFICIAL USE ONLY
MASON COUNTY ::T:::: O
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`VED: Z5 RECEIVED B`: C U)
Public Health & Human Services O m
Environmental Health 360-427-9670,ext.400 or 360-275-4467,ext.400 , C
415 N.6th Street - Shelton,WA 98584 S W G �,QZ- - oZ i- � = 0
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ON-SITE SEWAGE SYSTEM APPLICATION
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APPLICANT PHONE m
FRANK RUSSELL �� _ 360-773-7472 z
MAILING ADDRESS-STREET.CITY,STATE,ZIP CODE g
PO BOX 2571 P OLYMPIA WA 98507 co
SITE ADDRESS-STREET,CITY.ZIP CODE 1--Z
20 SE COURT RD ELL SHELTON WA 98584 I W
NAME OF DESIGNER 2 .1 PHONE
CINDY WAITE /tali
360-701-0205
NAME OF INSTALLER CZ >s PHONE a
TBD CO R
PERMIT TYPE(select one) DRINKING WATER SOURCE I O
IW.RESIDENTIAL OSS F COMMUNITY OSS In COMMERCIAL OSS PRIVATE INDIVIDUAL WELL 0 PRIVATE TWO-PARTY WELL Z I
TYPE OF WORK(select one) Q PUBLIC WATER SYSTEM
I
h NEW CONSTRUCTION/UPGRADES h REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) ❑ TABLE X REPAIR I (xi
SUBMITTALS 0 SURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINE
Ca 1
h-DESIGN FORM(REQUIRED) i SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE WAS LOT CREATED AFTER 4I1/2025T O
2 82'X12� 0 YES Q NO '
❑ WAIVER(S)(IFAPPLICABLE) X I O
DIRECTIONS TO SITE AND SITE CONDITIONS.(ex locked gate)
GO SOUTH ON OLYMPIC HIGHWAY, TURN LEFT ONTO CRAIG RD, TURN LEFT ONTO I o
COLE ROAD, AT TEE, TURN LEFT, TURN RIGHT ONTO SELLS ROAD(SECOND r
ENTRANCE), TURN LEFT ONTO BAY EAST DR, TURN LEFT ONTO HIGH ROAD, TURN o 0
RIGHT ONTO COURT RD. LOT IS ON THE RIGHT. ONE SOILL LOG DUG. I N)
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 0 MAINTENANCE/PUMPING ❑BUILDING PERMIT ❑HOME SALE ❑COMPLAINT ❑OTHER:
INSPECTOR SOIL LOGS COMMENTS l CONDITIONS
-pi : 0- I y(76" L (Iyi '' 3)
17016_ 26/33- v(7 the; iryie3) ( efeq'
14S- Ct} Z6/33, Ar/vtid-
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 G RE DATE APPLICATION EXPIRATION DATE APPLI ON APPROVED/ISSUED BY DATE
6lldfouis 6(30fxZ6 7((6 jx IS
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE Revised:4/14/2025
.
1` I -�
DESIGN FORM—PAGE ONE Assessor's Parcel Number: 1 3 jr— r 1 i 91 01 11 5 1 1 iI O 10-T0 i 2 11
A design will be reviewed when 3 copies of each of the following are submitted:
'I Completed design form that has been signed and dated. Scaled layout sketch, including all applicable items on checklist.
'd 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"
1 1 P A R C E L IDENTIFICATION
Permit Number: SWG 2025-00244 Designer's Name: CINDY WAITE
Applicant's Name: FRANK RUSSELL Designer's Phone Number: 360-701-0205
Mailing Address: PO BOX 2571 Designer's Address: 80 E PICKERING LA
OLYMPIA WA City State Zip SHELTON 'A 98584
City State Zip Designer's Email cindyewaite@msn .m t.
DESIGN PARAMETERS ,/e/ jL;
Treatment Device M/tr0( ', /s VV
❑Glendon 0 Sand Filter 0 Mound 0 Sand Lined Drainfield 0 Recirculating Filter 10 ATU 0&',/)0a 1 / �D�s
Treatment Level(check all that apply): 0 A ltl1 B ❑ C 0 BL 1 0 BL2 i�BL3v 0 E L7 N ` `F,0
Drainfield Type
❑Gravity Pressure 0 Trench I 'Bed 0 Sub Surface Dri.
Septic Tank/Drainfield Specifications Laterals 2 'k ' & il,
Number of Bedrooms 2 Schedule/Class SCHEDULE 40
Daily Flow: Operating Capacity 180 gpd Length 19.5 ft
Daily Flow: Design Flow 240 gpd Diameter 1.25 in
Septic Tank Capacity(working) BNR 500 gal Number 4, 6
.arReceiving Soil Type(1-6) 3 Separation ..jr $ 2.5 ft
dor
Receiving Soil Appl. Rate .8 gpd/ft2 A la TO Orifices
Required Primary Area 300 ft2 Total Num•lie Ki�r s9 f0 24
Designed Primary Area 300 ft2 Diametep'* •4.1.:
_ . E@ 3/16 in
11
Designed Reserve Area LIMITED
g ft2 t Spac, � f 5 ona t 1. 60 in
Trench/Bed Width 8a
`'��i 0 AITE' r
ft Zi y LICE : DESIGN l, an ws.ld
Trench/Bed Length 19.5 ft S•-T_�:n:w..:x..r.. v. *.lo.►.,iN.r. HEDULE40
xt'iR u ,u
Elevation Measurements Length / tV 2-5' ft
Original Drainfield Area Slope >1 % Diameter •2 in
New Slope, If Altered % Preferred manifold configuration used? ❑ Yes 6 'No
Depth of Excavation Up-slope 6 in Transport Pipe
from Original Grade Down-slope 6
in Schedule/Class SCHEDULE 40
Designed Vertical Separation 12 in Length 10 tt
Gravel-based Drainfield Required? 0 Yes 0 No Diameter 2 in
Pump Required? Eef Yes 0 No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day 4
Diff, in Elevation Between Pump& Uppermost Orifice 6 ft Dose quantity 45 gal
Drainfield Squirt Height/Selected Residual(head) 2 ft Chamber Capacity(flood) 1200 gal 1 1,1,/
Uppermost Orifice Fif Higher 0 Lower than Pump Shutoff Pump controls: Please check those required.
Capacity @ Total Pressure Head 35.4 gpin l Timer 121 Elapse Meter lif Event Counter
Calculated Total Pressure Head 12.56 ft If "Rimer: Pump on ,Pump off
Comments
TANKS MAY NEED TO BE TRAFFIC RATED, PUMP CONTROLS TO BE SET AT TIME OF INSTALLATION.PUMP CONTROL TO BE
AT 180GPD
Revised:6/1 1/2025
DESIGN FORM—PAGE TWO Assessor's Parcel Number! 3 T 1 9 T 0� 1 i 5 1 0 010 2 i 1 i
Permit Number: SWG 2025-00244
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
1f Test hole locations d Drainfield orientation and layout Reference depth from original grade:
v Soil logs {/i Trench/bed dimensions and
gf Septic tank
v Property lines critical distances within layout wr Drainfield cover
v Existing and proposed wells 4WD-Box/Valve box locations Reference depth from original grade
within 100 ft of property lir Septic tank/pump chamber and restrictive strata:
itf Measurements to cuts, banks, and locations eh, f* "IL"
ix Laterals,trench/bed,top and
surface water and critical areas i1 'Observation port location bottom
10 Location and orientation of lirClean-out location 0 Curtain drain collector
curtain drain and all absorption [yam Manifold placement 0 Sand augmentation
components
NeOrifice placement Other cross-section detail:
Rf Location and dimension of p'jLateral placement with distance it Observation ports/clean-outs
primary system and reserve area
to edge of bed Other Information
91 Buildings
iif Audible/visual alarm referenced Yes No
It Direction of slope indicator (,,� w.
it Scale of drawing seo�n on scIe i 0 Design staked out
v Waterlines bar 0 0 Recorded Notices attached
1t Roads,easements,driveways, Cif Elevation benchmark and relative 0 0 Waiver(s)attached
parking elevations of system components PC 0 Pump curve attached
Vf North arrow and scale drawing 0 0 Evaluation of failure
shown on scale bar Non-residential justification
❑ 0 Waste strength
❑ ❑ Flow
DESIGN APPROVAL
The undersigned designer must be notified by in Iler at time of installation RYes 0 No
' —7/1 y (2a zr-
Signatu(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-si gulations: '' ,
7
th
l 7 zS MA,� 44 16 L`
Env nmental Hea Spe ialist Date NCO0N ��?Jr
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING COND TfI N: &VTq
✓ The design is stamped"Approved" by Mason County Public Health. C(WX✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is:
/ Drainfield site conditions have not been altered to adversely affect conditions of design approval.
Please Note: The by
system must be installed a certified installer, �I
y
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
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Lateral# Length Length Orifice # Distance from Distance from end Length#
# (Feet) (Inches) Spacing " Orifices feeder line of end of lateral
1 , 19.5 234 60 4 2 2.5 19.5
2 19.5_ 234 60 4 2 2.5 19.5
3 19.5 234 60 4 2 2.5 19.5
4 19.5 234 60 4 2 2.5 19.5
5 19.5 234 60 4 2 2.5 19.5
6 19.5 234 60 4 2 2.5 19.5
117 24 115
TRANS LENGTH 10
GPM 14.16
K (2"SCHEOULEN 40) 284.5
FRICTION LOSS 0.0388521
Squirt 2
Elevation difference 6�
TDH 8.0388521
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TRASH CHAMBER DIGESTER CHAMBER CLARIFIER
OPERATING CAPACITY:417 GALLONS OPERATING CAPACITY:421 GALLONS CHAMBER
FLOOD CAPACITY:490 GALLONS FLOOD CAPACITY:494 GALLONS 160 GALLONS
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INSTALLATION INSTRUCTIONS OVER STONY SOIL i+ 1
1)Excavate tank hole with vertical walls to 1 foot larger than gSONC0// ,6Z026
tank on all sides. 1 ENV/P
2)If bottom of hole is stony,install 3"of compact sand&level g-2" Idir1
out with screed.j _ _ auA rAZ y_
3)Install tank In nter of hole,keeping 1 ft.void space on P 7 I—
all sides. i 24"FUSERS' P) 24'BLOWER
4)As tank is filling with water,fill in void space with compact ! I OUSING CAS
granular(sandy)soil free of large clumps of clay. %44. I I N TOP OF LI
5)Install rest of system,&affix risers to adapters with
waterproof adhesive.
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6)Perform watertightness test in field as required by I.,q ,/# I I I I a e•
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jurisdiction. 4/Pti �,/ I I I
7)Upon approval to backfill,carefully backfill with n- .41' ,,r,.± ,.s v,,t4 I — I I 12"RISER
soils over top of tank. �; L�i T� • -•SH CHAMBER I I DIGESTER I I cLAR/FIEB
8)Final grade the surface to avoid chanelling s ,o,:«:. --1 . 0 ., V
water toward tank. ' 7 1 t?"II A. J L — — — —— — —
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AEROBIC TREATMENT TANK DETAIL FOR
Nu WA TER BNR-500 TREATMENT UNIT
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`♦ ENVIRO-FLO, INC. REVISED:
4' Wastewater Treatment Technologies 3/01/12
• ^-Tw° -r%'` P.O.BOX 321161, Flowood, MS 39232
(877) 836-8476 (601)845-4716 fax SCALE: —
www.enviro-flo.net ',I ''4 I`#
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SECUREDJ4O WITH GAS TIGHT SEAL
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ACCESS RISER SERVICE
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Pump Specifications
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LITERS PER MINUTE
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Installation Note
Pretreated Pressure Distribution System:
31901-51-00021 20 SE Court Road
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. Concrete tanks required
3. 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.
. Curtain drains can be no closer than 10' upgradient and 30' down gradient of the
drainfield
Exposed restrictive layers, cuts, banks, etc. can be no closer than 50' downhill from
the drainfield.
6 Install access risers on the septic tanks, valve box and both ends of laterals.
7 Make sure septic tank risers are epoxied or caulked to cast in riser rings on tank.
8 Lids must form a water and gas tight seal with access risers
9 This system must be installed by a Mason County Certified installer or
1 . Deviation from this design without prior approval from the designer and Mason County
Health Department will make this design null and void.
1 . 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.
12. Install trenches or bed with contour of the ground
13. Install trench bottoms level and always maintain a minimum of six inches into native
soil
14. Install locator tape on top of all drainfield laterals.
15. Install threaded clean outs at the ends of all laterals (caps must extend to within six
inches of finish grade and be in a pit vault.
16. Install audio/visual alarm
17. Filter fabric required over drain rock prior to backfilling. If the drain rock extends
above the original grade, run the filter fabric at least 2 inches dow the trench
wall.
411
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System Owner Responsibilities:
1. Operation and Maintenance is required by Washington State Department of Health and
Mason County Health Department. -
2. The septic tank and pump tank should be pumped every three to five years or as
needed.
3. System owners are responsible for having maintenance performed annually.
4. System owners are responsible for responding to septic issues in a timely manner.
5. System owners shall not at any time change or alter settings in the control box.
6. System owner agrees to read and abide by information regarding their system in the
User Manual provided by Mason County Public Health.
7. Keep the flow of sewage at or below the approved design operating capacity.
8. Keep waste strength at residential waste strength parameters.
9. Spread loads of laundry through the week.
10 Do not use excessive bleach or detergents with added whiteners.
11 Do not shower, do laundry and dishwasher at the same time
12 Antibiotics can kill or impair the biological process in the septic tank.
13 Leaky plumbing can hydraulic overload your on-site septic system.
RA say JUG 16 2625
CoUNrYENVIRp
D JA N HEALTH
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CIND WAE ��
CENFIED SIGNER