HomeMy WebLinkAboutSWG2025-00331 - SWG Application / Design - 8/18/2025 MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584
SHELTON:360-427-9670,EXT 400
I, 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: SWG2025-00331
APPLICANT MELVARD JEFFREY & MEGAN Phone:
Address: 15405 133RD AVE E PUYALLUP, WA 98374
OWNER MELVARD JEFFREY& MEGAN Phone:
Address: 15405 133RD AVE E PUYALLUP, WA 98374
SEPTIC DESIGNER CINDY WAITE* Phone: 360-701-0205
Address: 80 E PICKERING LANE SHELTON,WA 98584
SEPTIC INSTALLER B-LINE CONSTRUCTION Phone: 1.360.489.9169
Address: 2971 E PHILLIPS LAKE LOOP RD SHELTON, WA 98584
Site Address: UNKNOWN
Primary Parcel Number: 220055000908
Permit Description: New 4BR SFR - Pressure
Permit Submitted Date: 08/18/2025
Permit Issued Date: 09/22/2025
Issued By: Jeff Wilmoth
Current Permit Fees Paid: $825.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 09/04/2028 (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.
PIN
OFFICIAL USE ONLY
MASON COUNTY DATE RECEIVED /\ (� — I - O �/l-
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AMOUNT RECEIVED RECEIVED BY:
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Environmental Health 360-427-9670,ext.400 or 360-275-4467,ext.400 O
415 N.6th Street -Shelton,WA 98584 SWG /oa �2S 1 -
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ON-SITE SEWAGE SYSTEM APPLICATION
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APPLICANT PHONE m rn
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JEFFERY MELVARD CIO B-LI r _ 360-426-4221 z
MAILING ADDRESS-STREET.CITY,STATE ZIP CODE n(T q
1405 133RD AVE E PUYALLUP WA 98374 m
SITE ADDRESS-STREET.CITY,ZIP CODE N
XXX E PHILLIPS LAKE LOOP W SHELTON WA 98584 I N
NAME OF DESIGNER PHONE N
CINDY WAITE ' 360-701-20205
NAME OF INSTALLER PHONE v1 CD
_B-LINE CONSTRUCTION c:::, >, 360-426-4221 <
PERMIT TYPE(select one) ,_ 'KING WATER SOURCE - I O
RESIDENTIAL OSS COMMUNITY OSS E'�COMMERCIAL OSS 110 PRIVATE INDIVIDUAL WELL PRIVATE TWO-PARTY WELL Z
TYPE OF WORK(Select one) Q PUBLIC WATER SYSTEM I
IgI NEW CONSTRUCTION/UPGRADES ffREPAIR/REPLACEMENT OTHER DETAILS(select all that apply) ❑ TABLE X REPAIR I (.31
SUBMITTALS El SURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINE co
LLn DESIGN FORM(REQUIRED) VSEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE WAS LOT CREATED AFTER 4/1/2025/ r0 O
6WAIVER(S)(IF APPLICABLE) 4 .33 ACg ❑ YES 0 NO n 1
Q
DIRECTIONS TO SITE AND SITE CONDITIONS(ex locked gate)
GO NORTH ON HIGHWAY 3, TURN RIGHT ONTO PICKERING RD, TURN RIGHT ONTO 1 O
PHILLIPS LAKE RD, TURN LEFT TO GO AROUND LAKE, LOT IS ON THE LAKE SIDE r
OF ROAD, NEXT TO 350 E PHILLIPS LAKE LOOP RD. -I
IO
SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. I CO
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE/FAILURE SOURCE(for reporting purposes)
0 VOLUNTARY 0 MAINTENANCE/PUMPING 0 BUILDING PERMIT ❑HOME SALE ❑COMPLAINT ['OTHER'
INSPECTOR SOIL LOGS COMMENTS/CONDITIONS
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RECORD DRAWING AND INSTALLATION REPORT
SOIL CODES:
V Y G=GRAVELLY S=SAND L=LOAM Si=SILT C=CLAY E=EXTREMELY R=ROOTS REQUIRED FOR FINAL APPROVAL.
INSPE 0 SIGNA URE DATE APPLICATION EXPIRATION DATE•-___ LAI ( i_ ki A P ICATI APPRO D ISSUED BY DATE
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TH F AY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE Revised:4/14/2025
DESIGN FORM—PAGE ONE Assessor's Parcel Number: 2 ? 2_1 01 01 5I 51 0 1 0 l 0' 9 0 8
A design will be reviewed when 3 copies of each of the following are submitted:
v 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 ,..)p_5 _ 003-7,1 Designer's Name: CINDY WAITE
Applicant's Name: JEFFERY MELVARD C/O B-LINE Designer's Phone Number: 360-701-0205
1403 133RD AVE E Designer's Address: 80 E PICKERING LANE
Mailing Address: g
PUYALLUP WA 98374 City State Zip SHELTON WA 98584
City State Zip Designer's Email cindyewaite@msn.com
' DESIGN PARAMETERS
Treatment Device
0 Glendon 0 Sand Filter 0 Mound 0 Sand Lined Drainfield 0 Recirculating Filter 0 ATU 0 Other
Treatment Level(check all that apply): 0 A FIB 0 C 0 BLI 0 BL2 0 BL3 0 E 0 N
Drainfield Type
0 Gravity 0 Pressure 0 Trench 0 Bed ❑ Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 4 Schedule/Class SCHEDULE 40
Daily Flow: Operating Capacity 360 gpd Length 23 ft
Daily Flow: Design Flow 480 gpd Diameter 1.25 in
Septic Tank Capacity(working) 1250 gal Number - 9
Receiving Soil Type(1-6) 3 Separation 9 ft
1rifices Receiving Soil Appl.Rate .8 gpd/ft2
Required Primary Area 600 ft2 Total Number o o ss,,q, 45
Designed Primary Area K K.2 x3 621 ft2 Diameter <' ± ti sZ� 3/16 in
Designed Reserve Area 600 ft2 Spacing � = 60 in
co Trench/Bed Width 3 ft O1 INDY �,, nit
Length 7.617 200 ft Sche . LlceNst �Q vl DULE 40
Ext>IRtS u5d4o,
Elevation Measurements Length 1-2 ft
Original Drainfield Area Slope 1 % Diameter 2 in
New Slope, If Altered % ke
t
figuration used? Yes 0 No
Depth of Excavation Up-slope 16hp p .� Transport Pipe
from Original Grade Down-slope 15n pS haduMass ��; SCHEDULE 40
Designed Vertical Separation 24n SE LL ' .
L ngth 45 ft
QNMENTAL HEALT H
Gravel-based Drainfield Required? Yes 0 NoMASON COUNT(BACIketer 2 in
Pump Required? Eilf Yes 0 No JIMAI Dosing and Pump Chamber Pump/Siphon Specifications Number of doses/day 4 \\1 v
Diff. in Elevation Between Pump&Uppermost Orifice 10 ft Dose quantity 90 gal
Drainfield Squirt Height/Selected Residual(head) 2 ft Chamber Capacity(flood) 1455 gal
Uppermost Orifice Higher ❑Lower than Pump Shutoff Pump controls:Please check those required.
Capacity @ Total Pressure Head 26.55 gpm Gtf Timer Elapse Meter if' Event Counter
Calculated Total Pressure Head 14.49 ft If Timer: Pump on ,Pump off
Comments
DESIGNER AND INSTALLER WILL STAKE OUT DRAINFIELD AFTER CLEARING, PUMP
CONTROLS TO BE SET AT TIME OF INSTALLATION, %/,s-,,y._ -1--D be s ,-I d, 364) Cpp
Revised: 6/11/2025
DESIGN FORM—PAGE TWO Assessor's Parcel Number 2 J 2 0 0 515101010 1 9 01 8 i
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
itf Test hole locations it Drainfield orientation and layout Reference depth from original grade:
91 Soil logs it Trench/bed dimensions and
Septic tank
I Property lines critical distances within layout Wr Drainfield cover
i ' Existing and proposed wells it D-Box/Valve box locations Reference depth from original grade
i within 100 ft of property l ' Septic tank/pump chamber and restrictive strata:
iJ Measurements to cuts, banks,and locations 1.( u I may
V Laterals,trench/bed,top and
surface water and critical areas Vi Observation port location bottom
Kt A'Location and orientation of G:' Clean-out location 0 Curtain drain collector
curtain drain and all absorption It Manifold placement 0 Sand augmentation
components
pf Orifice placement Other cross-section detail:
Qf Location and dimension of Lif Lateral placement with distance i/r Observation ports/clean-outs
primary system and reserve area
if to edge of bed Buildings Other Information
he Audible/visual alarm referenced Yes No
{� Direction of slope indicator 121 Scale of drawing shown on scale 0 0 Design staked out
l ' Waterlines bar 0 0 Recorded Notices attached
if Roads, easements,driveways, V Elevation benchmark and relative 0 0 Waiver(s)attached
parking ele at' s s to c . .is l 0 Pump curve attached
it North arrow and scale drawing 0 `•` '1. 0 0 Evaluation of failure
shown on scale bar Non-residential justification
SEP 2 2 2025 ❑ ❑ Waste strength
yt : 0 ❑ Flow
luimuN DESIG NJROVAL WEALTH
The undersigned designer must be no •' d by ins Iler at time of installation 0 Yes 0 No
ebch / lY/ zo-Zr.
Signature of 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 o •' regulations:
, i ki,4,
Envi on. I Health Specialist Date
CAUTION: DESIGN APPRO AL 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: — Y
/ 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:6/11/2025
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8 �Primary/reserve drainfield ® . �0 r ` �t.,Q,
9 j Owners well V► V
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11 Neighbors well
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FOUNDATION 1, 100.00Are `�
Septic tank - 3 99.00 6 �''�"�,;4
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ORIFICE SPACING 5
Lateral# Length Length Orifice # Distance from Distance from end Length #
# (Feet) (Inches) Spacing " Orifices feeder line of end of lateral
1 23 276 60 5 1.5 1.5 23
2 23 276 60 5 1.5 1.5 23
3 23 276 60 5 1.5 1.5 23
4 23 276 60 5 1.5 1.5 23
5 23 276 60 5 1.5 1.5 23
6 23 276 60 5 1.5 1.5 23
7 23 276 60 5 1.5 1.5 23
8 23 276 60 5 1.5 1.5 23
9 23 276 60 5 1.5 1.5 23
207 45 207
TRANS LENGTH 40
GPM 26.55
K (2"SCHEDULEN 40) 284.5
FRICTION LOSS 0.4971955
Squirt 2
Elevation difference 12
I TDH 14.497195
TRENA 9 ...
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Pump Specifications
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280 Series 1 /2 hp A di
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LITERS PER MINUTE
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40 - I - 1 1- - 1 - —1 12
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Installation Notes
Pressure Distribution System:
2200550-00908 XXX E Phillips Lake Loop Rd
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.
1. Concrete tanks required
2. Gravel base drainfield required
3. Timer to be set at 360GPD
4. Keep wheeled vehicles off the drainfield area before, during and after installation.
Tracked equipment only
5. 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.
6. Curtain drains can be no closer than 10' upgradient and 30' down gradient of the
drainfield
7. Exposed restrictive layers, cuts, banks, etc. can be no closer than 50' downhill from the
drainfield.
8. Install access risers on the septic tanks, valve box and ends of laterals.
9. Make sure septic tank risers are epoxied or caulked to cast in riser rings on tank.
10. Lids must form a water and gas tight seal with the access risers.
11. Install effluent filter specified in this design at the septic tank outlet.
12. This system must be installed by a Mason County Certified installer.
13. Deviation from this design without prior approval from the designer and Mason County
Health Department will make this design null and void.
14. This design was sized per Washington Administrative CodeWAC246-272A-0230. The
0 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.
15. Install laterals with contour of the ground.
16. Install trench bottoms level and always maintain a minimum of six inches into native
soil.. \�,,�
17. Install threaded clean outs at the ends of all laterals (caps must extend to within six \\\\
of finish grade and be in a valve box as shown on diagram.
18. Install audio/visual alarm. •13.
19. Filter fabric required over drain rock prior to backfilling. If the drain rock extef s a�l eve
the original grade, run the filter fabric at least 2 inches down the trench waJ o o :.st al
grade. .* q �
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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. Keep the flow of sewage at or below the approved design operating capacity.
7. Keep waste strength at residential waste strength parameters.
8. Spread loads of laundry through the week.
9. Do not use excessive bleach or detergents with added whiteners.
10. Do not shower, do laundry and dishwasher at the same time
11. Antibiotics can kill or impair the biological process in the septic tank.
12. Leaky plumbing can hydraulic overload your on-site septic system.
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