HomeMy WebLinkAboutSWG2025-00324 - SWG Application / Design - 8/13/2025 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: SWG2025-00324
APPLICANT Vlasak Homes Phone: 253-241-9218
Address: 328 199th Ct E SUMNER, WA 98391
OWNER Vlasak Homes Phone: 253-241-9218
Address: 328 199th Ct E SUMNER, WA 98391
SEPTIC DESIGNER BECKY RIEGER Phone: 360-219-3343
Address: 2041 Little Hanaford Road CENTRALIA, WA 98531
SEPTIC DESIGNER Rieger, Becky Phone: 3602193343
Address: 2041 Little Hanaford Road Centralia, WA 98531
Site Address: UNKNOWN
Primary Parcel Number: 320215601036
Permit Description: New 3bd Oscar X02
Permit Submitted Date: 08/13/2025
Permit Issued Date: 09/22/2025
Issued By: Rhonda Thompson
Current Permit Fees Paid: $555.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 09/17/2028 (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.
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OFFICIAL USE ONLY
A ; MASON COUNTY DATE RECENED: Q ci _ 1Li ` �� C x.
x.AMOUNT RECEI131655
{,11� RECEIVED BY.
s Public Health & Human Services o mEnvironmental Health 360-427-9670,ext.400 or 360-275-4467,ext.400 ,,/
415 N.6th Street -Shelton,WA98584 SWG n ),.5 - �,>l� - O Si
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ON-SITE SE 7 APPLICATION
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APPLICANT PHONE m r
Vlasak Homes ti , 253.241 .9218 z
C
MAILING ADDRESS-STREET,CITY,STATE.ZIP CODE n�7
328 199th Ct E Lake Tapps WA 98391 m
SITE ADDRESS-STREET.CITY.ZIP CODE
Panorama Drive Q Shelton WA I W
NAME OF DESIGNER PHONE I N
Becky Rieger - Environmental Desi CO 360.219.3343 0
NAME OF INSTALLER PHONE v
ry
PERMIT TYPE(select one) f� DRINKING WATER SOURCE o
KRESIDENTIAL OSS HCOMMUNITY OSS II I COMMERCIAL OSS 6 PRIVATE INDIVIDUAL WELL b PRIVATE TWO-PARTY WELL z
7 PUBLIC WATER SYSTEM Timberline I I
TYPE OF WORK(select one) ( I
ff NEW CONSTRUCTION/UPGRADES REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) 0 TABLE X REPAIR 01
El SURFACING SEWAGE CI EXISTING FAILURE 0 SHORELINE
SUBMITTALS co
IW-DESIGNFORM(REQUIRED) IF SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE WAS LOT CREATED AFTER4/12025? r 0)
O 5-WAIVER(S)(IF APPLICABLE) 3 0.23 0 YES Q NO 0 1 1
1
DIRECTIONS TO SITE AND SITE CONDITIONS:(en locked gate)
See Attached I o
1, O
IW
SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. I en
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE I FAILURE SOURCE(for reporting purposes)
0 VOLUNTARY 0 MAINTENANCE/PUMPING ❑BUILDING PERMIT OHOME SALE ['COMPLAINT ❑OTHER:
INSPECTOR SOIL LOGS COMMENTS/CONDITIONS
mil: 0 " (L S GL I IZ-f--m
tA\\ 1z-kS -NIL c
Weiv Ails
SOIL CODES: RECORD DRAWING AND INSTALLATION REPORT
V=VERY G=GRAVELLY S=SAND L=LOAM Si=SILT C=CLAY E=EXTREMELY R=ROOTS REQUIRED FOR FINAL APPROVAL.
INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED/ISSUED BY DATE
Cam q I n%z.jc /-71'0 M 6((zz fiT—
THIS FORM MAY B SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE Revised:4/14/2025
•
Mason County WA GIS Web Map
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I)r 320210060020
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3202156011I i
480 E PANORAMA DR
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320215601035 32021560103 7
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7/25/2025, 10:45:39 AM 1:384
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County Boundary l ' r r 1 "• ' ' I
0 0.01 0.01 0.02 km
121 No Filled
Site Address (Zoom in to 1:3,000)
Sources: Esn, HERE,Gannin, USGS, Intermap, INCREMENT P. NRCan,
ElEsri Japan, METI, Esn China (Hong Kong), Esri Korea, Esn (Thailand).
Tax Parcels (Zoom in to 1:30,000) NGCC,(c)OpenStreetMap contributors,and the GIS User Community
—
Contours 5 ft Mason County WA GIS Web Map Application
Mason County disclaims accuracy,reliability,or timeliness of website info,not liable for losses from reliance on it.https:/Avww.masoncountywa.gov/disdeimerphp
DESIGN FORM—PAGE ONE Assessor's Parcel Number: 3 2 0 2 1 — 5 6 -- 0 1 0 3 6
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: /1"X 17"
PARCEL IDENTIFICATION
Permit Number: SWG a026-0v3a} Designer's Name: Environmental Design-Becky Rieger
Applicant's Name: Vlasak Homes Designer's Phone Number: 360.219.3343
Mailing Address: 328 199th Ave Ct E Designer's Address: 2041 Little Hanaford Road
Lake Tapps WA 98391 City State Zip Centralia WA 98531
City State Zip Designer's Email becky@environmentaldesignll
DESIGN PARAMETERS
Treatment Device
❑Glendon 0 Sand Filter 0 Mound ❑S nd Lined Drainfield 0 Recirculating Filter 0 ATU LI Other OSCARX02
Treatment Level(check all that apply): p p B ❑C "BL I ❑BL2 ❑BL3 ❑ E ❑N
Drainfield Type
❑Gravity tiff Pressure 0 Trench 0 Bed lit1'Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 3 Schedule/Class Drip Tube
Daily Flow: Operating Capacity 360 gpd Length Mfg ft
Daily Flow: Design Flow 360 gpd Diameter Mfg in
Septic Tank Capacity(working) 1150 gal Number 6 Coils
Receiving Soil Type(1-6) 5 Separation N/A ft
Receiving Soil Appl.Rate 0.4 gpd/ft2 Orifices
Required Primary Area 900 ft2 Total Number of Orifices N/A
Designed Primary Area 900 ft2 Diameter N/A in
Designed Reserve Area 900 ft2 Spacing N/A in
Trench/Bed Width 26.1 ft Manifold
Trench/Bed Length 35.5 ft Schedule/Class N/A
Elevation Measurements Length N/A ft
Original Drainfield Area Slope 4 % Diameter N/A in
New Slope, If Altered 4 % Preferred manifold configuration used? 12(Yes 0 No
Depth of Excavation Up-slope 0 in Transport Pipe
from Original Grade Down-Slope 0 in Schedule/Class Schd 40
Designed Vertical Separation 12 in Length 40 ft
Gravel-based Drainfield Required? ❑ Yes 6t'i No Diameter Mfg in
Pump Required? el Yes ❑No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day Mfg
Diff. in Elevation Between Pump&Uppermost Orifice 7.9 ft Dose quantity Mfg gal
Drainfield Squirt Height/Selected Residual(head) N/A ft Chamber Capacity(flood) Mfg gal
Uppermost Orifice stf Higher 0 Lower than Pump Shutoff Pump controls:Please check those required.
Capacity @ Total Pressure Head Mfg gpm g Timer 0 Elapse Meter 0 Event Counter
Calculated Total Pressure Head 10.2 ft If Timer: It1 Rnprp V En off Mfg
Comments /"' �j
SEP 2 2 2025
MASON COUNTY ENVIRONMENTAL HEALTH
RET Revised:4/14/2025
DESIGN FORM—PAGE TWO Assessor's Parcel Number: 3 2 0 2 1 -- 5 6 -- 0 1 0 3 6_
Permit Number: SWG Q025 — 60 3gti
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
Test hole locations Drainfield orientation and layout Reference depth from original grade:
1 Soil logs g Trench/bed dimensions and M' Septic tank
21 Property lines critical distances within layout M� Drainfield cover
• Existing and proposed wells D-Box/Valve box locations Reference depth from original grade
within 100 ft of property g Septic tank/pump chamber and restrictive strata:
Measurements to cuts, banks,and locations l 1 Laterals,trench bed,top and
surface water and critical areas 6d Observation port location bottom
21 Location and orientation of g Clean-out location 0 Curtain drain collector
curtain drain and all absorption g Manifold placement 0 Sand augmentation
components Orifice placement Other cross-section detail:
B1 Location and dimension of Lateral placement with distance t Observation ports/clean-outs
primary system and reserve area to edge of bed
64 Buildings Other Information
B1 Audible/visual alarm referenced Yes No
Direction of slope indicator RI Scale of drawing shown on scale ❑ d Design staked out
Bj Waterlines bar 0 11 Recorded Notices attached
Roads,easements,driveways, CI Elevation benchmark and relative 0 Gl Waiver(s)attached
parking elevations of system components 21 0 Pump curve attached
21 North arrow and scale drawing 0 21 Evaluation of failure
shown on scale bar Non-residential justification
❑ El Waste strength
❑ El Flow
DESIGN APPROVAL
The undersigned designer must be notified by installer at time of installation El Yes 0 No
08.13.2025
Sig re of&signer 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:
Gt Oil/ft
Environmental Hea th 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
Environmental Design, LLC.
Septic Design v Wetlands Site Planning vExcavation
2041 Little Hanaford Road, Centralia, WA 98531 Phone:(360)219-3343
August 13, 2025
Prepared For: ) : �•
Vlasak Homes
328 199`h Ave Ct E y'' sit
Lake Tapps, WA 98391 '
Becky J.Rbeger..;. �l
Site Address:
!>H
Panorama Drive, Shelton b. t-3."LS
County: Mason
Tax Parcel Number: 32021-56-01036
Purpose:
A site and soil evaluation was completed for the property located at Panorama Drive in Shelton on June
12, 2025 by Environmental Design, LLC.The purpose of the site and soil evaluation is to determine the
suitability of an On-Site Wastewater system. In order to determine if a site is suitable a minimum of
three test pits were dug and evaluated for suitability.The site was evaluated to determine that the slope
and size were suitable and to determine if the proposed on-site wastewater would be able to meet
county and Washington State WAC 246-272A regulations.
Proposal:
The client is proposing a 3-bedroom residence on the site to be served by an on-site septic system. For a
3-bedroom system the estimated wastewater produced is 360 gallons per day based on the calculation
of each bedroom producing 120 gallons per day.
Site Description:
The site is currently vacant land.The site is located in Section 21,Township 20 North of Range 03 West.
Hydrology:
The site appears to be well drained.There did not appear to be any areas of ponding at the site or in the
area of the proposed drainfield.
Water Source:
The water source will be a city water connection. The water line will be located 10 feet away from the
proposed On-Site Wastewater system or the transport line will be sleeved to meet the requirements of
WAC 246-272A.
Soil Description:
According to the Natural Resources Conservation Service (NRCS)the property soil is mapped as
Bellingham Silt Loam and Cloquallum Silt Loam. The test pit profile did appear to be consistent with the
Cloquallum mapped series.
APPROVED
SEP 2 2 2025 Job Number:2025-089
MASON COUNTY ENVIRONMENTAL HEALTH client Name:B&C
RET
The NRCS describes the Cloquallum series as moderately well drained soil located in uplands. The
surface layer is a medium acid, friable, moderately granular pale brown to brown silt loam for about 8-
12 inches. The following layer is more coarsely granular brown to reddish brown ranging from 1 to 12
inches in thickness.The next layer grades to a subsoil of light brown to brown silt loam that is mottled
and extends to depths of 24 to 28 inches.
Test Pit Description:
In order to complete a site and soil evaluation according to WAC 246-272A a minimum of three test pits
need to be evaluated. For this site a total of 3 test pits were evaluated and labeled in the field for the
locations of the On-Site Wastewater System. The test pits are as described below:
4
Test Pit#1
0-19" Brown silt loam, moderate subangular blocky structure
19"+ Water
Restrictive at 19"due to water
Test Pit#2
0-16" Brown silt loam, moderate subangular blocky structure
16-20" Brown silt loam, strong subangular blocky structure,common distinct medium mottles
Restrictive at 16"due to high water table
Test Pit#3
0-16" Brown silt loam, moderate subangular blocky structure
16"+ Water
Restrictive at 16"due to water
Test Pit#4
0-16" Brown silt loam, moderate subangular blocky structure
16"+ Water
Restrictive at 16"due to water
Test Pit#5
0-16" Brown silt loam, moderate subangular blocky structure
16-28" Brown silt loam, strong subangular blocky structure,common distinct medium mottles
Restrictive at 16"due to high water table
Test Pit#6
0-14" Brown silt loam, moderate subangular blocky structure
14-20" Brown silt loam, strong subangular blocky structure,common distinct medium mottles
Restrictive at 14"due to high water table
Soil Loading Rate:
The type of soil appears to be a Type 5 with a soil loading rate of 0.4 according to WAC 246-272A.
System Requirements: S:••p�
The site appears to be suitable for a OSCAR X02 system in the proposed drainfield location. • I,.�
The system requirements are concluded based on the suitability of the soil, the slope .:��,fr • • s
of the site and the site conditions. �•
i
APPROVED `;:e Beck,J•Rie Nr ;���fl
F T
2
SEP 22 2025 �.!3-Z5
Job Number:2025-089
MASON COUNTY ENVIRONYE'rTAL HEALTH Client Name:B&C
RET
Conclusion:
The site described as PanoramaDrive in Shelton appears to have a slope of about
0-5%in the proposed drainfield area.The site has a suitable soil depth of 16" in the proposed
drainfield location and is suitable for a OSCAR X02 system to serve the proposed residence.
Report Completed by:
Fed" Rce9eit
Becky Rieger
Licensed Designer
APPROVED •
-b
SEP 2 2 2025 vir •
MASON COUNTY ENVIRONMENTAL HEALTH c ;7.- •� fr �4
RET BeckyJ R i
4
-15
3 Joh.\umher:2025-0X9
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OSCAR II Flat Site
Calc Sheet
3 BEDROOMS X 120 GAL/ BDRM = 360 GPD Depth
16
360 GPD/ 0.4 SOIL LOADING RATE FT2 = 900 FT2
Minimum Shoulder Length (See Table III of Man.)= 34.5
SLOPE: RISE 0 0 % SLOPE FOR DRAINFIELD
RUN 25
Flat Site-0-5%:
MIN SHOULDER WIDTH @ 6"(2 X 6"=1')=1' MIN SIDE SLOPES 1:1 SLOPE @ 6"(2 X 6")=1'=1'
Minimum Basal Length:
34.5 Shldr Lngth + 1 Side Slopes= 35.5 Basal Length
Basal Area Width:
900 FT2 Req./ 35.5 Basal Length = 25.4 Basal Width
House Cleanout Elevation:
Septic Tank Inlet: 96.6841667
Distance From House to Tank: 5
Rise to Inlet: 0.10416667
Septic Tank Elevation:
Ground Elevation: 98
Inlet Elevation: 96.58 APPROVED
Outlet Elevation: 94.65
SEP 2 2 2025
Pump Chamber: MASON COUNTY ENVIRQN;MENTAL HEALTH
Inlet Elevation: 92.65
Pump Elevation: 92.6 RET
Pump Lift:
Lateral Inlet: 100.5
Pump Elevation: 92.6
Lift: 7.9 Minimum 5' Lift 10.2
TDH: F= Friction
2.3 Friction Loss+7.9 Lift= 10.2 TDH L= Length of supply line
Q= Flush GPM
K=47.8 (1" sch 40 pvc)