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HomeMy WebLinkAboutSWG2025-00300 TANK ONLY - SWG Application / Design - 7/28/2025 415 N 6TH STREET,SHELTON,WA 98584 , tim. MASON COUNTY SHELTON:360.427-9670,EXT 400 BELFAIR:360.275-0467,EXT 400 ELMA:360.482-5269,EXT 400 Public Health & Human Services FAX:360-427-7787 • On-Site Sewage System Tank Only Permit: SWG2025-00300 APPLICANT Hunter,Adam Phone: 360 753-1226 Address: 2201 93rd Ave SW Olympia,WA 98512 OWNER BROWN ROYLANNE L Phone: Address: 622 SOUTH 193RD PLACE DES MOINES,WA 98148 Site Address: 201 E AUSETH LN � Primary Parcel Number: 320231400010 Permit Description: SEPTIC TANK PLACEMENT, REPLACING FAILED TANK Permit Submitted Date: 07/29/2025 Permit Issued Date: 08/05/2025 Issued By: Rhonda Thompson Current Permit Fees Paid: $270.00 (additional fees may be required upon Installation of system). 07/29/2028 (based on date of Inspection) Permit Expiration Date: 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: 4 Drinking Water Source: Private Well/Spring Additional Details: Roth 1250g Permit Conditions: 1 Approval of this septic permit does not approve the building location. Building location is subject to approval from all applicable departments and regulations. 4 Mason County Asbuilt Form, Record Drawing, and Installation fee must be submitted for final installation approval. 2 Horizontal setbacks per WAC246-272A-0210 must be maintained, unless prior approval is obtained 5 Proposed development subject to zoning requirements and approval by the planning li department staff per Mason County Title 17. 3 Permit must be installed by a Mason County Certified Installer unless prior written authorization from Mason County is obtained. 6 Installer to correct all other outstanding deficiencies documented in RME from 7/23/25. 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 FINAL INSTALLATION APPROVAL IS REQUIRED PRIOR TO TEMPORARY OR FINAL OCCUPANCY OF ANY RELATED STRUCTURES. I For Final Inspection visit: masoncountywa.govlhealth/environmentallonsiteloss-inspection-request.php or call: 360-427-9670, extension 400. OFFICIAL USE ONLY— ' DATE RECEIVED: I\ •1 , `O ^ Ca� D MASON COUNTY U 1 J OA co Cl, AMOUNT RECEIs,* ��O HECENF O BY: O m COMMUNITY SERVICES Os - 0 Public Health(Community Health/Endronmental Health) s _ 36041796 treat-t00a M0-7 7 5 416 7.ert 100 (-'\Jt J� �O�f� — O��f�� O 41S N.6th Streit-Sheiton,WA 93591 J V\V/ �/ z cA ON-SITE SEWAGE TANK ONLY APPLICATI _ m rw PHONE rn ---_ r APPLICANT Z LYNNE BROWN 3607011300 ,� MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE O CO _ c J 203 E AUSETH LN, SHELTON,WA 98584 � I SITE ADDRESS-STREET,CITY,ZIP CODE LL.:/201/203 E AUSETH LN, SHELTON,WA 98584 NIPHONE j NCD NAt.IE OF DESIGNER3607531226 >. I N ADAM HUNTER _-_____a ea O I o NAME OF INSTALLER PHONE C I O TBD TBD N 0 TYPE OF WORK(select one) DRINKING WATER SOURCE Q O ❑ NEW CONSTRUCTION/UPGRADES 0 REPAIR/REPLACEMENT III PRIVATE INDIVIDUAL WELL 0 PRIVATE TWO-PARTY WELL Z O PUBLIC WATER SYSTEM - I COMPONENT(S)TO BE REPLACED/INSTALLED 0 SEPTIC TANK ❑ BEDROOMS LOT SIZE PUMP TANK 0 RV HOLDING TANK❑ OTHER__ 4 2.5 ppr OTHER DETAILS(select DU that apply) TANK(S)SETBACK CHECKLIST 1 ❑ SURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINE CI 100FT+PUBLIC!COMMUNITY WELLS 0 O SOFT+PRIVATE WEL I S,SURFACE WATERS,STREAMS,RIVERS SUBMITTALS 131 1pFT+ WATER SUPPLY LINES I 0 PLOT PLAN(REQUIRED) 0 TANK CROSS SECTION(REQUIRED) 0 IOFT PROPERTY/DRINKING!EASEMENTSU LINES,FOUNDATIONS,FOOTINGS ❑ PUMP DETAILS(IF APPLICABLE) 0 WAIVER(S)(IF APPLICABLE) r- PLOT PLAN CHECKLIST 0 0 PROPERTY LINES AND EASEMENTS 0 EXISTING/PROPOSED STRUCTURES 0 EXISTING/PROPOSED OSS COMPONENTS AND LINES O WELLS WITHIN 100FT 0 WATER SUPPLY LINES 0 DRIVEWAYS/PARKING 0 SURFACE WATERS,STREAMS,RIVERS,ETC... O DIRECTION OF SLOPE/CONTOURS © PERIMETER/CURTAIN DRAINS 0 NORTH ARROW III SCALE BAR DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.locked gale) AGATE SOUTH TO A RIGHT ON CRESTVIEW TO A LEFT ON AUSETH CONTINUE STRAIGHT TO SITE AT THE END. OFFICIAL USE ONLY BELOW THIS LINE - — UPGRADE/FAILURE SOURCE(loe reporting purposes) 0 VOLUNTARY 0 MAINTENANCE/PUMPING 0 BUILDING PERMIT OHOME SALE ['COMPLAINT CI OTHER: COMMENTS/CONDITIONS %fin „�}r' Gt t f __tf*,16 stetiL SEWAGE TANKS MUST BE LISTED UNDER DOH'LIST OF REGISTERED SEWAGE TANKS',TANKS MUST MEET CURRENT MINIMUM SIZE REQUIREMENTS,EQUIPPED WITH RISERS AND LIDS TO SURFACE,AND INCLUDE AN EFFLUENT FILTER(IF APPLICABLE). RECORD DRAWING AND INSTALLATION REPORT REQUIRED FOR FINAL APPROVAL. DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED/ISSUED BY DATE ...------.. ti ici7j0 INSPECTOR SIGNATUREuty ,,o vell (6'c/ THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12l7n015 pd` 0 t Ink§ J JII i s< o• . i 11 „,,,, „ ligi Pli . 3 i `� ` Sill ul a 2WO a . , 1 < htileg __ 7 V -J Z ^z o z . sc < ch§ l7 � a c oN fi 0 a o uuu��� d / 3 g `6S:( _ jyi. cc: . r ii i yr u• ' W Q U W 41 8 T o 'Y 1 ry u u °� t z a O i O a 'tl._ a a a b c o g g o C o LL i 0 z 5 a c><:�a® ______f_ .o_ b U O © LY 11111 V rirc a5,43 a _ , §- g PN 29 = NlaIM 1 0 „LZ'91. CA "`�N� o° u z lilt w : OP co "(7) t 2> r-Ii: a _ . ,\_ , (os _ _c____<-__-9,______ , 9 Thi - ---- --1,F1 a ,,,,, I �' �1 Tr ) CQ z, C I D j@ 1, II F=- „1,9 = 11-10I3H a t. @ z' W I i a ,.., 0 NJ rfJ al a :-' ' i!I C ...., -IC a: r (1)Luf: It: E z D 0 fr) 5 9 L1J c, IliaN,,, N ‘_. a_ U W N (/) J Q I— u_ V \ 21) O 0 z5 U 0u) z ° 0 'dill „9ZT a 0 O _, C� Q cn Z E. 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Hoodsport,WA 98548 360-790-3021 Serviced:07/23/2025 by: Darin Ogg Submitted 07/24/2025 by:Darin Ogg Jurisdiction ID:320231400010 Dump�ocatlon:8lo-Recycling COMMENTS both tanks flooded pump,floats,and alarm are inoperable visible crack in main tank unable to remove filter in main tank to clean ANK:Septic Tank-2 Compartment Tank Pumped: YES YES Tank Size(Gallons)(Number only,no text): 1150 Deficient Effluent level within operational limits(if NO explain in comments): NO Total Gallons pumped from tank(Number only,no text): 1150 Effluent returning back into tank after pumping: NO 24 Tank depth below grade(inches): YES Access Risers installed to grade(N/A if not present): Concrete Tank Construction Material: NO Deficient Tank Condition Good: YES Baffles In good condition(N/A if not present): Effluent screen cleaned(N/A if not present): YES Effluent surfacing around site components(N/A if not checked): NO NO Tank abandoned after pumping: NO Were repairs made to the Tank or Tank Components?(if YES explain in comments): 4 Compartment 1 Scum accumulation(Inches,if other specify): Compartment 1 Sludge accumulation(Inches,if other specify): 77 Compartment 2 Scum accumulation(Inches,if other specify): 7 Compartment 2 Sludge accumulation(Inches,if other specify): Tank Pumped: YES YES Tank Size(Gallons)(Number only,no text): 1150 YES Effluent level within operational limits(if NO explain in comments): YES Total Gallons pumped from tank(Number only,no text): 1150 Tank depth below grade(inches): 24 Access Risers installed to grade(N/A If not present): YES Tank Construction Material: Concrete Tank Condition Good: YES Effluent screen cleaned(N/A if not present): N/A Effluent surfacing around site components(N/A if not checked): NO Pump operating as intended: NO Deficient Controls operating as intended: NO Deficient Alarm working as intended: NO Deficient Tank abandoned after pumping: NO Were repairs made to the Tank or Tank Components?(if YES explain in comments): NO Compartment 1 Scum accumulation(Inches,if other specify): 0 Compartment 1 Sludge accumulation(Inches,if other specify): 7 I I Ths,pia indrates tartan characlerisres or the onsre se,,ape syskm al Mt tine of sisf.M no way is No report a guarantee of operatvn or future perF.murce. ReportlD:820249 View pump reports online at w w.onlinerme.com Page 1 of 1