HomeMy WebLinkAboutSWG2025-00281 - SWG Application / Design - 7/14/2025 MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584
SHELTON:360-427-9670,EXT 400
M ‘:
BELFAIR:360-275-4467,EXT 400
-1—' Public Health & Human Services ELMA:360-482-5269,EXT 400
FAX:360-427-7787
On-Site Sewage System Permit: SWG2025-00281
APPLICANT VIZINA LISA DAWN &STEPHEN JOHN Phone:
Address: 150 SE SISTER MEADOWS LN SHELTON, WA 98584
OWNER VIZINA LISA DAWN &STEPHEN JOHN Phone:
Address: 150 SE SISTER MEADOWS LN SHELTON, WA 98584
SEPTIC DESIGNER JIM HUNTER* Phone: 360-753-1226
Address: PO BOX 162 OLYMPIA, WA 98507
Site Address: 150 SE Sister Meadows Ln
Primary Parcel Number: 319041190020
Permit Description: New 2BR adu -shallow pressure w/class b waiver
Permit Submitted Date: 07/14/2025
Permit Issued Date: 09/02/2025
Issued By: Jeff Wilmoth
Current Permit Fees Paid: $555.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 07/31/2028 (based on date of inspection)
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.
2 Proposed development subject to zoning requirements and approval by the planning
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.
4 Drain field installation not to exceed designed upslope and downslope depth specified on
design form.
5 Installer is responsible for obtaining Mason County installation approval prior to backfill of
system components.
6 Installer is responsible for obtaining Septic Designer/Engineer installation approval prior to
backfill of system components.
7 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.
Pm
OFFICIAL USE ONLY I
a', MASON COUNTY DATE RECEIVED: al'
l/ Ul I A5. C D
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f - AMOUNT RECEN 555 R[CF.NF.^,BY: '/„ n v
Public Health & Human Services Tr`(m GIXv(VLy` W N
Environmental Health 360-427-9670,ext.400 or360-275-4467,ext.400 <
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415 N.6th Street- Shelton,WA 98584 5 W V /Q�� - �Jb2�/►I a �1 1
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CLEAR FORM ON-SITE SEWAGE SYSTEM APPLICATION z
m70
n
APPLICANT 'HONE m ,
. r
DAN HESS •
360 790-8007
MAILING ADDRESS-STREET.CITY,STATE,ZIP CODE ` g ,
18623 ELDERBERRY ST SW — 'OCHESTER WA 98579
03
SITE AD ESS-STREET,CITY,ZIPCODE
15ISTERS MEADOW LN e� SHELTON WA 98584 I
NAME OF DESIGNER n^ n PHONE 0
JIM HUNTER 'u`L 360 753-1226 I
•
NAME OF INSTALLER CO PHONE v I _ I
( c
PERMIT TYPE(select one) DRINKING WATER SOURCE o
IiiiRESIDENTIAL OSS ECOMMUNITY OSS ECOIAMERCIAL OSS El PRIVATE INDIVIDUAL WELL ]PRIVATE TWO-PARTY WELL Z 118 I
TYPE OF WORK(select one) ®PUBLIC WATER SYSTEM ,
NEW CONSTRUCTION/UPGRADES ElREPAIR/REPLACEMENT OTHER DETAILS(select all that apply) 0 TABLE X REPAIR
SUBMITTALS El SURFACING SEWAGE 0 EXISTING FAILURE ❑SHORELINE I I
r
DESIGN FORM(REQUIRED) SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE WAS LOT CREATED AFTER 4/1T2025� O
r
�VJAIVER(S)(IF APPLICABLE) 2 A.D.U. 5 • CI YES El NO I I
• DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.locked gate)
I
EAST ON COLE RD PAST FAWN LK. LEFT ON ELLIS, LEFT AT SISTER MEADOW TO 1 I
SITE ON RIGHT AT ADDRESS o
-1
I
SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. I
OFFICIAL USE ONLY BELOW THIS LINE
I
UPGRADE/FAILURE SOURCE(for reporting purposes)
❑VOLUNTARY 0 MAINTENANCE/PUMPING 0 BUILDING PERMIT ❑HOME SALE ❑COMPLAINT ❑OTHER:
INSPECTOR SOIL LOGS COMMENTS/CONDITIONS
v Aplil /4 .
w
2-fi 41
r 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.
7SP TO' I NATUR DATE APPLICATION EXPIRATION DATE APP TION APPROVED/ISSUED BY DATE
10
7.31 -01.5 7,-3( -2s6 w
THI FOR AY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE Revlsed:4/14/2025
DESIGN FORM—PAGE ONE Assessor's Parcel Number: 31904-11-9002G- --
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.
`' 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 20 °5- COA 1 Designer's Name: ADAM HUNTER
Applicant's Name: DAN HESS Designer's Phone Number: 3607531226
Mailing Address: 18623 ELDERBERRY ST SW Designer's Address: PO BOX 162
ROCHESTER WA 98579 City State Zip OLYMPIA WA 98507
City State Zip Designer's Email JHANDASSOCIATES@HOTMAIL.COM
DESIGN PARAMETERS
Treatment Device
❑ Glendon 0 Sand Filter 0 Mound 0 Sand Lined Drainfield 0 Recirculating Filter 0 ATU U Other
Treatment Level(check all that apply): IA J B J C I BL 1 J BL2 J BL3 J E J N
Drainfield Type
❑ Gravity l 'Pressure 'Trench 0 Bed 0 Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 2 Schedule/Class SCH40
Daily Flow:Operating Capacity (60 gpd Length 67 ft
Daily Flow:Design Flow '2,4 O gpd Diameter 1 1/2 in
Septic Tank Capacity(working) 1200 gal Number 2
Receiving Soil Type(1-6) 4 Separation (o ft
Receiving Soil Appl.Rate 0.6 gpd/ft2 Orifices
Required Primary Area 4 0 v ft2 Total Number of Orifices 68
Designed Primary Area 4 0'L ft2 Diameter 3/16 in
Designed Reserve Area 4Q 1— ft2 Spacing 24 in
Trench/Bed Width 3 ft Manifold
Trench/Bed Length 134 FT ft Schedule/Class SCH40
Elevation Measurements Length Co. ft
Original Drainfield Area Slope 1 % Diameter 2 in
New Slope,If Altered 0 I % Preferred manifold configuration used? 0 Yes 0 No
Depth of Excavation Up-slops ,ti" in Transport Pipe
from Original Grade Down-slope /'' in Schedule/Class SCH40
Designed Vertical Separation 12 in Length 300 ft
Gravel-based Drainfield Required? 0 Yes El No Diameter 2 in
Pump Required? 6 'Yes 0 No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day 6
Diff. in Elevation Between Pump&Uppermost Orifice 6 ft Dose quantity 40 gal
Drainfield Squirt Height/Selected Residual(head) 2 ft Chamber Capacity(flood) 1200 gal
Uppermost Orifice( Higher 0 Lower than Pump Shutoff Pump contro. ; 'lease check those required.
Capacity @ Total Pressure Head 39.860 gpm r, Elapse Meter S.Event Counter
Calculated Total Pressure Head 17.669 VIWU' • r: ' s''•'• /2.1-- ,Pump off q 2•J
Comments 25
P� �N��ENvo
NC° 30
Revised:4/14/2025
DESIGN FORM—PAGE TWO Assessor's Parcel Number: 31904-11-90020-- --
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
Elf Test hole locations ' Drainfield orientation and layout Reference depth from original grade:
g Soil logs g Trench/bed dimensions and if Septic tank
l2E Property lines critical distances within layout Ef Drainfield cover
a Existing and proposed wells a D-Box/Valve box locations Reference depth from original grade
within 100 ft of property Ef Septic tank/pump chamber and restrictive strata:
a Measurements to cuts,banks, and locations E ' Laterals,trench/bed,top and
surface water and critical areas ' Observation port location bottom
a Location and orientation of Ed Clean-out location g Curtain drain collector
curtain drain and all absorption Ef Manifold placement E Sand augmentation
components l' Orifice placement Other cross-section detail:
E2E Location and dimension of Ef Lateral placement with distance &( Observation ports/clean-outs
primary system and reserve area to ed a of bed
Buildings g Other Information
Ef
if Audible/visual alarm referenced Yes No
Direction of slope indicator El Scale of drawing shown on scale ER( 0 Design staked out
12f Waterlines bar 0 0 Recorded Notices attached
Roads,easements,driveways, A Elevation benchmark and relative 0 0 Waiver(s)attached
parking epire s ❑ umury attahed
North arrow and scale drawing v� ` .4 ❑ ❑ Pump
uationc e of failurerzi
shown on scale bar
AUG 2 8 2025 '.; .=7 ❑ n❑Wa se strength justification
MASON COUNTY ENVIRONMENTAL HEALTH 0 0 Flow
DESId' ROVAL
The undersigned designer must be notified b ' ller at t' e of installation 0 Yes 01 No
'l- lD -2S
Signatur f esigner 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-site regulations:
Environmental 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:
✓ 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
PAGE 1
MASON COUNTY HEALTH DEPARTMENT
ON-SITE SEWAGE DISPOSAL SYSTEM DESIGN
SITE#: PARCEL#: 31904-11-90020
DATE SUBMITTED: 07/08/25 LEGAL/LOT#: LOT 2
AFN2169562
SUBMITTED BY: JIM HUNTER
APPLICANT: DAN HESS
ADDRESS: 18623 ELDERBERRY ST SW
ROCHESTER,WA 98579
I.CALCULATIONS
NUMBER OF BEDROOMS= 2 A.D.U.
RESIDENTIAL GPD FLOW= 240
IF NON-RESIDENTIAL-GPD FLOW
WILL BE AS FOLLOWS:
GPD=
APPLICATION RATE= 0.6 GPD/FT2
REDUCTION=LEAVE BLANK IF NO REDUCTION TAKEN
DRAINFIELD SIZING
ABSORPTION AREA= 402 FT2
TRENCH LENGTH OR BED CONFIG.= 134 FT
II.WATERPROOF SEPTIC TANK
COMPOSITION AND SIZE= 1200 GAL.CONCRETE
NEW OR EXISTING= NEW
III.DRAINFIELD CROSS SECTION
DEPTH TO DRAINROCK BOTTOM= GRAVELLESS CHAMBERS
ROCK DEPTH BELOW PIPE= GRAVELLESS CHAMBERS
SEPARATION FROM TRENCH BOTTOM TO IMPERMEABLE
MATERIAUSEASONAL SATURATION= >1'-0"
FILL DEPTH= 1'-0"
TRENCH WIDTH= 3'-0"
IV.PUMP REQUIREMENT
DOSING VOLUME IN GALLONS= 40
NUMBER OF DOSES PER DAY= 6
PPR ® VE As, .,_, 1cv 1-5
64
MASON COUNTY ENVIRONMENTAL HEALT M
S100273 •� �
� +
.� O? LAMES R.HUNTER
LICFNSEb bfcK;NFR
EXP .S: 01/22/'L C.
I
•
PAGE 2
V.PRESSURE CALCULATIONS
USING PIPE CLASS= 40
ORIFICE DIAMETER= 3/16
LATERAL#1 =
SQUIRT HEIGHT(FT)= 2.00
(NOTE(2):ORIFICE DISCHARGE RATE_(11.79)X(ORIFICE DIAMETER)S02 X
SO ROOT OF(TOTAL PRESSURE HEAD)
ORIFICE DISCHARGE RATE= 0.58618
LATERAL LENGTH IN FEET= 67.00
ORIFICE SPACING= 2'0"
DISTANCE FROM END CAP= 0'6"
NUMBER OF HOLES= 34
LATERAL DISCHARGE RATE= 19.930
LATERAL#2=
SQUIRT HEIGHT(FT)= 2.00
ORIFICE DISCHARGE RATE= 0.58618
LATERAL LENGTH IN FEET= 67.00
ORIFICE SPACING= 2'0"
DISTANCE FROM END CAP= 0'6"
NUMBER OF HOLES= 34
LATERAL DISCHARGE RATE= 19.930
LENGTH DIAMETER FLOW FRICTION LOSS
SECTION (FT) (IN) (GPM) (FT)
AB 300.00 2.00 39.860 7.9080
BC 15.00 2.00 19.930 0.1097
-t CD 67.00 1.50 19.930 1.6516
TOTAL= 9.6693
"TOTAL HEAD LOSS
1)FRICTION LOSS THROUGH SYSTEM= 9.669
2)ELEVATION DIFFERENCE = 6.000
3)RESIDUAL = 2.000
TOTAL= 17.669
APA!G! Y5EDO
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MASON COUNTY ENVIRONMENTAL HEALTH s'" Z
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O FAMES R.HCMTER
LICENSED f*IG/VER
EXP-OFS 03/22/Z (,
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MYERS ME3 SERIES
CAPACITY LITERS PER MINUTE
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