HomeMy WebLinkAboutSWG2025-00247 - SWG Application / Design - 6/26/2025 MASON COUNTY 415 N 6TH STREET, SHELTON,WA 98584
SHELTON:360-427-9670,EXT 400
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: SWG2025-00247
APPLICANT EAGER JAMIE & RYAN Phone: 206-793-2735
Address: 5312 PARK RD E LAKE TAPPS, WA 98391
OWNER STUTZKE ALDEN L & MARGARET L Phone:
Address: PO BOX 294 HOODSPORT, WA 98548
SEPTIC DESIGNER DALE TAHJA* Phone: 360-463-8023
Address: 2450 W DEEGAN ROAD WEST SHELTON, WA 98584
SEPTIC INSTALLER TJ GOOS* Phone: 360-490-0217
Address: 150 E MARISA PL SHELTON, WA 98584
Site Address: 150 Glenwood Rd
Primary Parcel Number: 422165000006
Permit Description: New 2-bedroom SFR pressure system with sand-lined bed
Permit Submitted Date: 06/26/2025
Permit Issued Date: 07/28/2025
Issued By: Jeff Wilmoth
Current Permit Fees Paid: $825.00 (additional fees may be requi'ed upon installation of system).
Permit Expiration Date: 07/28/2028 (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 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 -
a .... MASON COUNTY DATE RECEIVED: (0 /4,_,‘„ lay- c
AMOU RECENED RECEIVED BY:
' =' " Public Health & Human Services a� o m
Environmental Health 360-427-9670,ext.400 or 360-275-4467,ext.400 < CA
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415 N.6th Street-Shelton,WA 98584 D(,RG -0 oa) ( ' O 2
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ON-SITE SEWAGE SYSTEM APPLICATION
APPLICANT PHONE m m
Jamie & Ryan Eager (206)793-2735 z
MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE 0) 3
5312 Park Rd. E. Lake Tapps WA 98391 m m
SITE ADDRESS-STREET,CITY,ZIP CODE C
150 N. Glenwood Rd. Hoodsport WA 98548 s
.46
NAME OF DESIGNER PHONE
0.) N
Dale L. Tahja (360)463-8023
NAME OF INSTALLER PHONE O N
T.J. Goos (360)490-0217 <
PERMIT TYPE(select one) DRINKING WATER SOURCE
R.jRESIDENTIAL OSS E COMMUNITY OSS ff.COMMERCIAL OSS 67 PRIVATE INDIVIDUAL WELL l]PRIVATE TWO-PARTY WELL Z
PUBLIC WATER SYSTEM Lake Cushman Water Co.
TYPE OF WORK(select one) I
co
KNEW CONSTRUCTION/UPGRADES REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) 0 TABLE X REPAIR CTl
SUBMITTALS 0 SURFACING SEWAGE 0 EXISTING FAILURE ❑SHORELINE Ce
DESIGN FORM(REQUIRED) ISEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE WAS LOT CREATED AFTER 4/1/2025? 0 0
ffWAIVER(S)(IF APPLICABLE) 2 0.22acre ❑ YES Q✓ NO n I
-
DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.locked gate) 0
Go down to Lake Kokane, go past boat launch, keep right onto Glenwood Rd., property on o
the right, gated, not locked.
0 0
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0
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SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. 0)
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE/FAILURE SOURCE(for reporting purposes)
❑VOLUNTARY ❑MAINTENANCE/PUMPING ❑BUILDING PERMIT ❑HOM SALE ❑COMPLAINT ❑OTHER:
INSPECTOR SOIL LOGS A / COMMENTS/CONDITIONS i
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RECORD DRAWING AND INSTALLATION REPORT
SOIL CODES:
V=V 'V G=GRAVELLY S=SAND L=LOAM SI=SILT C=CLAY E=EXTREMELY R=ROOTS REQUIRED FOR FINAL APPROVAL.
INS' • OR SIGNATURE DATE APPLICATION EXPIRATION DATE AP LI TION APP OV D!ISSUED BY DATE
1 ik)bt-(10.\1\ 1-34- .-2-5
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TM' FOR• . BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE Revised:4/14/2025
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DESIGN FORM—PAGE ONE Assessor's Parcel Number: --Sb -- Q C?a lei
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.
'0 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 IDENTIF:ICATIO/s
Permit Number: SWG a02.$- boa''y7 Designer's Name: Dale L.Tahja
Applicant's Name: Jamie& Ryan Eager Designer's Phone Number: (360)463-8023
Mailing Address:
5312 Park Rd.e. Designer's Address: 2450 W. Deegan Rd.W.
Lake Tapps WA 98391 City State Zip Shelton WA 98584
City State Zip Designer's Email daletahja@gmail.com
DESIGN PARAMETERS
Treatment Device
❑ Glendon 0 Sand Filter 0 Mound 0 Sand Lined Drainfield 0 Recirculating Filter 0 ATU Li Other
Treatment Level(check all that apply): O A El B ❑ C 0 BLl El BL2 ❑BL3 C7 E 0 N
Drainfield Type
❑ Gravity le Pressure 0 Trench IgBed Cl Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 2 Schedule/Class Sch.40
Daily Flow: Operating Capacity 180 gpd Length 24 ft
Daily Flow: Design Flow 240 gpd Diameter 1.25 in
Septic Tank Capacity(working) 1,000 gal Number 3
Receiving Soil Type(1-6) 1 Separation 3.33 ft
Receiving Soil Appl.Rate 1.0 gpd/ft2 Orifices
Required Primary Area 240 ft2 Total Number of Orifices 36
Designed Primary Area 240 f}& Diameter 1/8 in
Designed Reserve Area 240 ft2 Spacing 21 in
Trench/Bed Width 10 '. ft Manifold
Trench/Bed Length 24 ft Schedule/Class Sch.40
Elevation Measurements Length 6.7 ft
Original Drainfield Area Slope 0 % Diameter 2 in
New Slope,If Altered 0 % Preferred manifold configuration used? 0 Yes 0 No
Depth of Excavation Up-slope 46 in Transport Pipe
from Original Grade Down-slope 46 in Schedule/Class Sch.40
Designed Vertical Separation 24 in Length 50 ft
Gravel-based Drainfield Required? It(Yes 0 No Diameter 2 in
Pump Required? Lot Yes 0 No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day 4
Diff. in Elevation Between Pump&Uppermost Orifice 8 ft Dose quantity 45 gal
Drainfield Squirt Height/Selected Residual(head) 6 ft Chamber Capacity(flood) 1,000 gal
Uppermost Orifice 0 Higher 0 Lower than Pump Shutoff Pump controls:Please check those required.
Capacity @ Total Pressure Head 20 gpm F1 Timer g Elapse Meter V Event Counter
Calculated Total Pressure Head 20 ft I imp I r ' off 5 hrs. 57.75 min.
Comments
JUL 2 85(1 :�,
22
MASON COUNTY ENVIRONMENTAL HEALTH
J B W Revised:4/14/2025
DESIGN FORM—PAGE TWO Assessor's Parcel Number: 1,4,1(p -- -s a --
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
g Test hole locations I$ Drainfield orientation and layout Reference depth from original grade:
E1 Soil logs Ef Trench/bed dimensions and Ig Septic tank
1E1 Property lines critical distances within layout p' Drainfield cover
E1 Existing and proposed wells g D-Box/Valve box locations Reference depth from original grade
within 100 ft of property g Septic tank/pump chamber and restrictive strata:
0 Measurements to cuts,banks, and locations lid Laterals,trench bed,top and
surface water and critical areas g Observation port location bottom
El Location and orientation of El Clean-out location 0 Curtain drain collector
curtain drain and all absorption w( Manifold placement Id Sand augmentation
components B Orifice placement Other cross-section detail:
g Location and dimension of g Lateral placement with distance 0 Observation ports/clean-outs
primary system and reserve area to edge of bed
El Buildings Other Information
L( Audible/visual alarm referenced Yes No
P1 Direction of slope indicator Q Scale of drawing shown on scale Er 0 Design staked out
ES Waterlines bar 0 0 Recorded Notices attached
P1 Roads, easements,driveways, 0 Elevation benc 4 • 'i • ' ❑ ❑Waiver(s) attached
parkingA �, ; ' > C�' ❑ Pump curve attached
.11
gNorth arrow and scale drawingP 0 0 Evaluation of failure
shown on scale bar r:
JUL 2 6 2O7`.l ��-
,.' Non-residential justification
0 0 Waste strength
n'.��Cl�COUNTY ENVIRONMENTAL ' 0 0 Flow
DESIGN AWVAL
The undersigned designer must be notified by installer at time of installation gYes 0 No
Signature of Designer Date
The undersigned has reviewed this design on behalf of Mason County Public Health and dete ' loe... e7c,
compliance with state and local o ite regulations: o oh `O
� bra. N~0 E�
E vi ental Health Specialist Date 4.1.z)1 ` "'a z
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDI
V The design is stamped"Approved"by Mason County Public Health.
V The Onsite Sewage Permit has not expired,the Permit Expiration Date is: -7- 2$-AS
V 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
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APPROVE
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JUL 2 8 21175
MASON COUNTY ENVIRONMENTAL HPALTI,
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Installation/Maintenance
Pressure Distribution/Bed Systems
1. Install bed bottom level and in contour with the ground.
2. Install drainfield during dry weather and soil conditions.Any soil smearing must be
eliminated by hand raking any areas that get smeared.
3. Install audio/visual high-water alarm.
4. Install effluent filter in septic tank outlet or pump vault with 1/16-inch maximum
filtration mesh size.
5. Install check valve in pump outlet line to prevent back-flow into the pump chamber.
6. Install 1/8-inch orifices on 21-inch centers. Install the orifices pointing straight down
(6:00 o' clock).
7. Divert all storm water run-off away from septic system components.
8. No curtain (french) drains allowed within l Oft. of the up-slope edge of the drainfield and
reserve area.
9. No curtain(french) drains allowed within 30ft. of the down-slope edge of the drainfield
and reserve area.
10.Have the septic tank and pump chamber pumped or inspected every 3 to 5 years.
11.Inspect and clean pump screen as needed.
12.Inspect floats and test high water alarm every 6 to 12 months or as needed.
13.All material and workmanship must meet County and State requirements.
14.Install risers on septic tank and pump chamber.
15.Deviation from this approved design without prior approval from the Designer and
Mason County Health Department will make this design null and void.
16.The prepared Site Plan is not a survey, it is the owner's responsibility to verify property
line locations prior to installation. Any discrepancies must be reported to the Designer
immediately.
17. Locate all utilities prior to starting installation.
18. The installer must notify the designer at least 48 hours prior to starting installation.
19.The Designer may have additional charges for redesign work and final inspection.
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14 # APPROVEr.
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