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HomeMy WebLinkAboutSWG2025-00213 - SWG Application / Design - 8/21/2025 MASON COUNTY 415 N 6TH STREET,SHELTON,WA 08584 SHELTON.360-427-8670. EXT 400 L BELFAIR.360-275-4467. EXT 400 Public Health & Human Services ELMA:360-482-5269.EXT400 FAX 360-427-7787 On-Site Sewage System Permit: SWG2025-00213 APPLICANT GLASER JACK R & NANCY L Phone: Address: V432 COUNTY ROAD 15 NAPOLEON, OH 43545 OWNER GLASER JACK R& NANCY L Phone: Address: V432 COUNTY ROAD 15 NAPOLEON, OH 43545 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. 816 W Lost Lake Rd Primary Parcel Number: 519015103001 Permit Description: table x repair-2br sand lined bed Permit Submitted Date: 06/04/2025 Permit Issued Date: 08/21/2025 Issued By: Jeff Wilmoth Current Permit Fees Paid: $825.00 (additional fees may be required Upon installation or system). Permit Expiration Date'. 06/12/2026 mused oo date or 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 ONSI-E 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 At. MASON COUNTY DATE REC"E ob - oq -2325 cn�I C (D/3 f� AMOUNT aECEIVE6It 7Z5 RECEIVED BY. y —.�- Public Health & Human Services G ��_{, VV o CO Environmental Health 360-427-9670,ext 400 or 360-P54467.ea.4W '^// ��\\ y 415 N 6th 5M1Pet- Shel,Oq WA 98584 SWG 2OL6 — 01J213 0 23 Z di ON-SITE SEWAGE SYSTEM APPLICATION 3 'z m n PHONE m APPLICANT r JACK GLASER 360-999-8623 c MAILING ADDRESS-STREET.CITY.STATE.ZIP CODE E V432 COUNTRY RD 1 _ j '„ I NAPOLEON OH 43545 03 SITE ADDRESS STREET CITY,ZIP CODE (, r'F 11 `t,.' =,, 816 W LOST LAKE Ra (1 I �p25 SHELTON WA 98584 I th VI\ O l NAME OF DESIGNER ., PHONE I , ` CINDY WAITE 360-701-0205 NAME OF INSTALLER pJ :� PHONE Q I (0 TBD fl < PERMIT TYPE(sore[)one) DRINKING WATER wATeR SOURCE O nI RESIDENTIAL OAS ftCOMMUNITY OSS h COMMERCIALOSS 7� PRIVATE INDIVIDUAL WELL b PRIVATE TWO-PARTY WELL Z I _, TYPE OF WORK lselec:one) Q PUBLIC WATER SYSTEM i1 NEW CONSTRUCTION/UPGRADES 7R REPAIR/REPLACEMENT OTHER DETAILS(select all(hal apply) 0 TABLE X REPAIR I N SUBMITTALS ❑ SURFACING SEWAGE 0 EXISTING FAILURE D SHORELINE m p r GIa DESIGN FORM(REQUIRED) W SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE WAS LOT CREATED AFTER 411 T2025; OI t Li WAIVER(S)(IF APPLICABLE) 2 10818 El YES Q/ NO Q x I Q DIRECTIONS TO SITE AND SITE CON°TIONS (ex lo[Led gate) GO OUT CLOQUALLUM RD, TURN RIGHT ONTO LOST LAKE RD, GO TO ADDRESS, 1 I w ON THE RIGHT SIDE OF LOST LAKE RD. r I p lc SITE MUST SE FLAGGED FROM MAW ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. OFFICIAL USE ONLY BELOW THIS LINE UPGRADE)FAILURE SOURCE(for rspgtng Wrpmes) 0 VOLUNTARY 0 MAINTENANCE/PUMPING 0 BUILDING PERMIT 0 HOME SALE ❑COMPLAINT 0 OTHER. INSPECTOR SOIL LOGS COMMENTS/CONDITIONS Yii-(21)1 -)1112- ) fft$ (BD c to f / /' 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 IN ECT R SIGNATURE DATE APPLICATION EXPIRATIONOL DATE APPLICATION4 APPROVED!ISSUED BY SDATE THIS AAEDANVA1LE FOf�UBLIL VIEWNTMA �O�TY WEBSRE / C��(I Revised'4I14 GUL5 nt(i &X DESIGN FORM—PAGE ONE Assessor's Parcel Number: 5 1 9 0 1 5 1 0 3 0 0 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. a Scaled layout sketch,including all applicable items on checklist. Scaled plot plan,including all applicable items on checklist <(loss-section sketch,including all applicable items on checklist. This form may be scanned and available for public view on the Mason County Web site. .1/aximrun puper.sice. 11".F/-" PARCEL IDENTIFICATION Permit Number: SWG 20 -c—OOZ(3 Designer's Name: CINDY WAITE Applicant's Name: JOHN GLASER Designers Phone Number: 360-701-0205 Mailing Address: V432 COUNTRY RD 15 Designer's Address: 80 E PICKERING__LANE NAPOLEON CA 43545 City State Zip SHELTON WA 98584 City State Zip Designer's Entail cindyewaite©msn.com DESIGN PARAMETERS Treatment Device ❑Glendon 0 Sand Filter 0 .Mound feSand lined Draintcld 0 Recirculating Filter 0 All I__ 0 Other Treatment Level(check all that apply): 0 A ill 0 C' 9 BI.I 1I31 2 0 BI.3 0 E 0 N Drainfield Type ❑Gravity ('Pressure 0 Trench Bed 0 Sub Surface Drip Septic Tank/Drainfield Specifications Laterals Number of Bedrooms 2 (�S d !(�s\� SCHEDULE 40 Daily Flow:Operating Capacity 180 g rLrgt r 24 It Daily Flow: Design Flow 240 g DgrmNer� l ` 1.25 in Septic Tank Capacity(working) 1200 g Number _ 4 Receiving Soil Type(1-6) 1 Separaiti a , 2 ft Receiving Soil Appl. Rate 1 gpd/ft- 1 Orifices Required Primary Area 240 ft:' Total Num gi$TOr' 44 Designed Primary Area 240 ft Diamete m. ,"'"-" 3/16 in < . t.:'s m Designed Reserve Area 240+ 112 Spaci 1 e •� 24 in Trench/Bed Width 10 ft • y� �t mom, nifold ft Trench/Bed Length 24 ' e ul ,C$yI{�3®.IvunnE Z. f�CPN5f0 DESiGrvEp Elevation Measurements ft Original Drainfield Area Slope <1 We Diameter in New Slope, If Altered % Preferred manifold configuration used? 0 Yes 66No Depth of Excavation lb-slnpe 42 TO BOTTOM OF SAND in Transport Pipe from Original Grade Dmvn-slope 42 TO BOTTOM OF SAND in Schedule/Chas 3034 Designed Vertical Separation 36 in Length 160 ft Gravel-based Drainfield Required? fe Yes O No Diameter 4 in Pump Required? 54 0 No Dosing and Pump Chamber Pump/Siphon Specifications Number of dosestday 4 Diff. in Elevation Between Pump& Uppermost Orifice 5 ft Dose quantity 45 gal Drainfield Squirt Height/Selected Residual(head) 24 ft Chamber Capacity(flood) 1200 gal Uppermost Orifice 0 Higher 0 Lower than Pump Shutoff Pump controls: Please check those required. \%) Capacity @ Total Pressure Head 25.96 n I1 Timer )pm Elapse Meter Event Counter Calculated Total Pressure Head 8.9 ft If Timer: Pump on ,Pump off Comments CONCRETE TANKS REQUIRED, GRAVEL BASE DRAINFIELD REQUIRED, PUMP CONTROLS TO BE SET AT TIME OF INSTALLATION AT 180GPD, ENCASE TRANSPORT LINE IF CLOSER THAN 50 TO WELL Revis 6/I1:1025 DESIGN FORM-PAGE TWO Assessor's Parcel Number: 5 1 9 0 1 -- 5 1 -- 0 3 0 0 1 Permit Number: SWG DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch rg Test hole locations El Drainfield orientation and layout Reference depth from original grade: g Soil logs Pi Trench/bed dimensions and g Septic tank m Property lines //critical distances within layout M Drainfield cover la Existing and proposed welts oq®-Box/Valve box locations Reference depth from original grade �w/tthin 100 ft of property g Septic tank/pump chamber and restrictive strata: Nt°Measurements to cuts, banks,and locations 0 Laterals, trench/bed,top and surface water and critical areas 64 Observation port location bottom 01,ACocation and orientation of 0 Clean-out location ❑ Curtain drain collector curtain drain and all absorption HI Manifold placement l Sand augmentation components lid Orifice placement Other cross-section detail: Pi Location and dimension ofIt Observation ports/clean-outs primary system and reserve area to al placement with distance to edge of bed Other Information m Buildings lid Audible/visual alarm referenced Yes No la Direction of slope indicator Scale of drawing shown onir [,� scale Eli ❑ Design staked out It Waterlines bar 9(vi nrw 0 0 Recorded Notices attached m Roads,easements,driveways, p Elevation benchmark and relative 0 0 Waiver(s) attached parking vapnpl�isen lino Ed 0 Pump curve attached m North arrow and scale drawing �` �A [j qxl 0 ❑ Evaluation of failure shown on scale bar n Non-residential justification AUG 2 1 2025 .R✓ 0 0 Waste strength 1. ;i'." `- : 1: _ ❑ ❑ Flow DESIGIJ4OVAL The undersigned designer must be notified by installer at time of installation ❑ Yes ❑ No Signature ar 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 c regulations: C1 C/�'�xj W4kA D -Zt -2S End onMt�Ynl 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: tp" 12.- Z7 ✓ Drainfield site conditions have not been altered to adversely affect conditions of design approval. 2: 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:4/3/2025 \ \ 1a$ ° ��/ � � a� ■{\ � a- E Li" 73P. � co , ( -';D° & S / 01 -D. - � I c il /® ` r # es viag 5. ca & $ u a • � / / / tC 7 |2-1 ` ° cc ! 4 { / IC 7.0 ; - ID A \ * > { � $ if co { / ! } * f ® / lti ' Z a ® ` = © a18a / - \ CD- / ¢4 ƒ 7 \ ¥ / / . y 2 ePo 1 § Cr 0m _ $ f ' - » { `} J ° )\ ¥ ei 03 co_ x $APPS § � ( \ _ ( Z . . a5 If " . ram, j\\ ORIFICE SPACING 2 Lateral # Length Length Orifice # Distance from Distance from end Length# # (Feet) (Inches) Spacing " Orifices feeder line of end of lateral 1 24 288 60 11 2 2 24 - 2 24 288 60 11 2 2 24 3 24 288 60 11 2 2 24 4 24 288 60 11 2 2 24 96 44 86 TRANS LENGTH 160 GPM 25.96 K (2" SCHEDULEN 40) 284.5 FRICTION LOSS 1.9077939 Squirt 2 Elevation difference i' I TDH .j 7`�i 2qv f' . Q. 1 vyi .t.nc, T�' ll y try.. V11,r,Y t,y18 p TN E WAITE "1 TRENCH CROSS SECTION 7 ° "'• ` °`s'°"Ea y 4 ,r 1� PPP 1 + AUG 2 1 r •, /."-- / 1 J2W 3o M , f Poe bail ., on7 .T/ J-P o/ bed 6 ', i Lift L' 33 Sa.4 DRAINFIELD LAYOUT t _. IL. a' fl ' V 1 r.,.-a., ' . Z - L. - ! . s P Pn¢ TA Ati Ft P4It, 1 V( C:"1I9 1 L11BWA4\4' X1=CLEANOUT/OBS PORTS (1-7/ ) 1 .J r, _ I _ l-f ° un sr °esicNen X2=D BOXNALVE BOX ,v.„.742-= . X3=Check Valves/f/, ; ,-i X4=Flow Control Valves , X5=Soil Logs X6 oh: fo.i z , --,, 5 \ I ) PPRovFr - -- THREADED CAP OR PLUG r `� I�Qu(T i "-� -- 8"PVC LAST ORIFICE;WITH ;/ / ORIFICE SHIELDS IF \ ORIFICE ORIENTATION IS BACKFILL I UPWARD MATERIAL `% ' r / \ \ oFf O01O '/ p ,b U00 PRESSURE LATERAL PVC HOSE OR �/.\\ °o '-► i. �Qoo o AS SPECIFIED LONG SWEEP V/�;o t�_ j7O°° \ ELBOW --\\- \\�\j` \� DRAIN ROCK;6"MIN. \�\ \ ,\\\ \�\� BELOW PIPE UNDISTURBED SOIL --/ v\ - - --- 8"PVC WITH DRAIN HOLES; EXTE:jr TO BOTTOM OF G ti. L TO MONITOR ND\' c IL INFILTRATIVE SURFACE '� „S'ill.11 6,14 MONITORING/CLEANOUT POR t ' T 'e 4-' (EXAMPLE) III SIGGNER A; - - -AUG 2 I 292 It : , JF'Vl 1 2 0.) 3 , SECURED LID WITH GAS TIGHT SEAL I .,..�. 24'DIAMETER ACCESS RISER AMMMMMSAA� FINISH GRADE III amen ea' •ni 1 .� 1/IIII — _ TO PUMP __ L� _ -. CHAMBER FROM SEWAGE SOURCE ' ' I SOURCEFLOATING MAT APPROVED EFFLUENT FILTER SEDIMENTS `�_� SEPTJCSANIg (TYPICAL) SECURERJFID WITH GAS TIGHT SEAL THREADED UNION 24'DIAMETER ACCESS RISER SERVICE FINISH GRADE rim VALVE• 1 it FROM SEPTIC /i.Au .m. M TANK \ Ik I TO OINFIELD pj II EMERGENCY STORAGE I ItI ANTI SIPHON HIGH WATER ALARM LEVEL 1 .y] VALVE' WORKING VOLUME III} INDEPENDENT( FLOAT STEM NORMAL TIMER OFF LEVEL - I FOR FLOAT ENCLOSED PUMP — L� MOUNTING SEDIMENT SHROUD' ! CHECK VALVE 1r i— __— SEOIMENTS IIMI wmommoi BU :j CENTRIFU NTRIFU t^�( PUM1 2) PUMP�HAM$ER See ail (T_YPJCAL) - I; Tny•T )� t . i1 d �1 LI�' a IGNER ii ' I12i225 • 1 Jaw vber Pumps Pump Specifications I , 250-Series Submersible . . I � --/AN Sump / Effluent Pump ,, ,. LITERS PER MINUTE 0 20 60 60 80 100 '20 140 160 180 25 —.. 7 I` . — . . -- 28 11 _I- _ bolo 5 w P.w iu ~ w s 0 mak g S 6 s 'a HO - 10 Y__._ _ ._ __ ® __ _ . II L / 1 V i gra .mot /w 9J }I1 /9 ,-4 0 2`4 F j. WAITE 2 L( L DESIGNER ,Ni. - i - - pa]{ yp i I;) 0 0 0 r ' 2 r R e ' V �i i 500 '_S1 PI RI n2OI 4(op‘rik 2C118 I Mon Pump E1W iin.4wI sintimiopi4.ui61[ m onoix‘aout aou.e ,9 SW Pumps Installation Notes Sand Augmented Pressure Distribution System: 51901-51-03001 816 W Lost Lake Rd 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. Pump controls to be set at time of installation 135 GPD 3. Install system during dry weather with acceptable soil conditions 4. Gravel based drainfield required. 5. Clean C-33 or coarse sand to be used. 6. The tanks may be moved as necessary to accommodate building requirements. Septic tank location must meet all required setbacks. 7. Keep wheeled vehicles off the drainfield area before, during and after installation. Tracked equipment only, 8. 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. 9. Curtain drains can be no closer than 10' upgradient and 30' down gradient of the drainfield 10. Exposed restrictive layers, cuts, banks, etc. can be no closer than 50' downhill from the drainfield. 11. Install access risers on the septic tanks, valve box and ends of laterals. 12. Make sure septic tank risers are epoxied or caulked to cast in riser rings on tank. 13. Lids must form a water and gas tight seal with the access risers 14. Install effluent filter specified in this design at the septic tank outlet. 15. This system must be installed by a Mason County Certified installer. 16. Deviation from this design without prior approval from the designer and Mason County Health Department will make this design null and void. 17. 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. 18. Install laterals with contour of the ground 19. Install trench bottoms level and always maintain a minimum of six inches into native soil 20. Install locator tape on top of all drainfield laterals. 21. Install threaded clean outs at the ends of all laterals (caps must extend to A;T''IY n six inches of finish grade and be in a valve box as shown on diagram. ilt 22. Install audio/visual alarm ,� $, 23. Filter fabric required over drain rock prior to backfilling. If the drain ro 01,aac{s`1.�s•ve the original grade, run the h r rittperil n the tre hvBM" 2a, AUG 2 ) 2(,2S �'�02 L LIN AITE ��,� • sok i 24 IN 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. * N4 CVA et LD PPP ° VA.,. .. `ti r �v �. , AUG21 �Qti , . 7