HomeMy WebLinkAboutSWG2025-00387 - SWG Application / Design - 9/25/2025 1.• MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584
SHELTON:360-427-9670,EXT 400
' Public Health & Human Services BELFAIR:360-275-4467,EXT 400
Y= AELMA:360-482-5269,EXT 400
FAX:360-427-7787
On-Site Sewage System Permit: SWG2025-00387 LO 1.J 1
APPLICANT LANDERS PAUL A & RUTH J Phone: 253-312-4263
Address: 10110 181ST AVE E BONNEY LAKE, WA 98391
OWNER LANDERS PAUL A & RUTH J Phone: 253-312-4263
Address: 10110 181ST AVE E BONNEY LAKE, WA 98391
SEPTIC DESIGNER CINDY WAITE* Phone: 360-701-0205
Address: 80 E PICKERING LANE SHELTON, WA 98584
Site Address: 708 E BURGUNDY RD
Primary Parcel Number: 220255090130
Permit Description: Repair 2bd pressure bed
Permit Submitted Date: 09/25/2025
Permit Issued Date: 10/09/2025
Issued By: Rhonda Thompson
Current Permit Fees Paid: $825.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 10/08/2026 (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.
OFFICIAL USE ONLY
MASON COUNTY DATE RECEIVED: 09 ^� ....
ac CA
AMOUNT RECEIVED: RECEIVED BY: W
--- Public Health & Human Services Ii 8),P5 ToP o m
Environmental Health 360-427-9670,ext.400 or 360-275-4467,ext.400 t� /1 - Cl)
415 N.6th Street- Shelton,WA 98584 S\l\/G 10 25 - 00 3 ' 7 g_ ❑
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ON-SITE SEWAGE SYSTEM APPLICATION
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APPLICANT PHONE m m
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PAUL LANDERS 253-307-9099 Z
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MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE
10110 181 ST AVE S BONNEY LAKE WA 98391 m
SITE ADDRESS-STREET.CITY ZIP CODE ,xi,
708 E BURGUNDY RD SHELTON WA 98584 I ("
NAME OF DESIGNER PHONE I N
CINDY WAITE 360-701-0205
NAME OF INSTALLER PHONE v I Q
TBD <
PERMIT TYPE(select one) DRINKING WATER SOURCE I Iv
M RESIDENTIAL OSS ff COMMUNITY OSS IF_l COMMERCIAL OSS b PRIVATE INDIVIDUAL W W ELL I2-PRIVATE TO-PARTY WELL Z 101
TYPE OF WORK(select one) 7 PUBLIC WATER SYSTEM
n-NEW CONSTRUCTION/UPGRADES M REPAIR/REPLACEMENT OTHER DETAILS(Select all that apply) ❑ TABLE X REPAIR 101
SUBMITTALS 0 SURFACING SEWAGE RI EXISTING FAILURE 0 SHORELINE
as
DESIGN FORM(REQUIRED) 1 o-
SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE WAS LOT CREATED AFTER 4/1/2025? O I Q
I
5-WAIVER(S)(IF APPLICABLE) 2 1AC ❑ YES Q NO Z
DIRECTIONS TO SITE AND SITE CONDITIONS.(ex locked gate)
GO ACROSS HARSTINE BRIDGE, TURN RIGHT AT TEE, TURN RIGHT AT NEXT TEE, I Q
TURN RIGHT ONTO BURGUNDY ROAD, DRIVEWAY IS ON THE RIGHT SIDE OF 1-
ROAD, THREE PROPERTIES ON THE DRIVEWAY AND THEN IT SPLITS OFF, THE 708 0
IS PRETTY FADED. ONE SOIL LOG IN THE MIDDLE OF PROPOSED DRAINFIELD. I (,0
SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. I Q
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
CIA\if . . �D \ i L{ii-�
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RECORD DRAWNG 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.
INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED/ISSUED BY DATE
c (\1 v A°°Ids oli)1.1,,63, Qcivaiveni cot cif 7 5
THIS FORM MAY BE SVANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE Revised:4/14/2025
DESIGN F(5RM—PAGE ONE Assessor's Parcel Number: (21 2J
0 2 515 0 i-910 j 1! 3' 0
j
A design will be reviewed when 3 co ies of each of the following
are submitted:
'1 Completed design form that has been signed and dated. '1 Scaled layout sketch, including all applicable items on checklist.
'1 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 Qc.oo 3 27 Designer's Name: CINDY WAITE
Applicant's Name: PAUL LANDERS Designer's Phone Number: 360-701-0205
Mailing Address: 10110 181ST AVE S Designer's Address: 80 E PICKERING LANE
BONNEY LAKE WA 98391 City State Zip SHELTON WA 98584
City State Zip Designer's Email cindyewaite@msn.com
DESIGN PARAMETERS
Treatment Device
❑Glendon 0 Sand Filter ❑Mound 0 Sand Lined Drainfield 0 Recirculating Filter ❑ATU
Treatment Level(check all that apply): 1 ❑Other
❑A ❑ B ❑C ❑ BLI 0 BL2 0 BL3 YJE ❑N
0 GravityDrainfield Type
Pressure 0 Trench }3ed
0 Sub Surface Drip
Septic Tan rainfield Specifications Laterals
Number of Bedrooms 2' Schedule/Class
SCHEDULE 40
Daily Flow:Operating Capacity 180 gpd Length 15
ft
Daily Flow:Design Flow 240
gpd Diameter 1.25 in
Septic Tank Capacity(working) EXISTING 1200 gal Number 3
Receiving Soil Type(1-6) 3 Separation 3
ft
Receiving Soil Appl. Rate .8 2 %i
_ gpd/ft 11•
. Orifices
•
Required Primary Area 300 ft2 Total Nu 00.of its es 18
Designed Primary Area 300 ,i
ft2 Diamet �,�Q' '.i 3/16 in
Designed Reserve Area 300 ft2 Spaci 0,',.,�. ', i. 0. 1�, ' 60
in
Trench/Bed Width 10 ft i`�� ? I
0. " .�.r. 0 11 Manifold
Trench/Bed Length 30 ft •S 1 •u e/Clasar•+t; 'cp�/I` .
4.Elevation Measurements o CN SEDDY SIGNAliE'
�.engtNICENSED DESIGNER � 1/ ft
Original Drainfield Area Slope 13 % �:" ��T a lk���vi
tit.:, ..10, in
New Slope,If Altered % Preferred manifold configuration used? ❑Yes 12iNo
Depth of Excavation Up-slope 9(PAGE 5) in Transport Pipe
from Original Grade Down-slo e
a 36(PAGE 5) _ in Schedule/Class SCHEDULE 40
Designed Vertical Separation 2y.f—/26( in Length 15 ft
Gravel-based Drainfield Required? ITS Yes 0 No Diameter 2 in
Pump Required? VI Yes 0 No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day 4
Diff. in Elevation Between Pump& Uppermost Orifice 8 ft Dose quantity 45 gal
Drainfield Squirt Height/Selected Residual(head) 2 ft Chamber Capacity(flood) 1287(INFIL 1060) gal 1 \I\
Uppermost Orifice(Higher 0 Lower than Pump Shutoff Pump controls: Please check those required. `
Capacity @ Total Pressure Head 10.62 gpm 174 Timer fig Elapse Meter fiff Event Counter
Calculated Total Pressure Head 10.03 ft If Timer: Pump on ,Pump off
Comments
TIMER TO BE SET AT TIME OF INSTALLATION, EXISTING TANK TO BE RETROFITTED WITH
RISERS AND EFFLUENT FILTER 1 b•D 6-Pj2
Revised:6/11/2025
DESIGN FORM—PAGE TWO Assessor's Parcel Number 2 2 012 5 5 0 s I 0 1 3 0
Permit Number: SWG 2Ga.' -00387
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
li Test hole locations V Drainfield orientation and layout Reference depth from original grade:
{f Soil logs V Trench/bed dimensions and
Septic tank
l ' Property lines critical distances within layout Qf Drainfield cover
l, 1 Existing and proposed wells ' D-Box/Valve box locations
,,��` ithin 100 ft of roe Reference depth from original grade
`� property rty i� Septic tank/pump chamber and restrictive strata:
el Measurements to cuts,banks, and locations
rface water and critical areas V Laterals,trench/bed,top and
G� Observation port location bottom
fkrLocation and orientation of V Clean-out location 0 Curtain drain collector
curtain drain and all absorption Qf Manifold placement 0 Sand augmentation
components
ix Orifice placement Other cross-section detail:
it Location and dimension of
primary system and reserve area Er Lateral placement with distance IXObservation ports/clean-outs
to edge of bed
V Buildings Other Information
le Audible/visual aI m referenced Yes No
gi Direction of slope indicator " e,s
tif V Scale of drawing shown on scale i 0 Design staked out
Waterlines bar ❑ 0 Recorded Notices attached
i! Roads, easements, driveways, V Elevation benchmark and relative 0 0 Waiver(s)attached
parking elevations of system components c' 0 Pump curve attached
North arrow and scale drawing 1--1 V 0 Evaluation of failure
shown on scale bar f of e
i p Non-residential justification
❑ 0 Waste strength
❑ ❑ Flow
DESIGN APPROVAL
The undersigned designer must be ified by i staller at time of installation itrYes 0 No
t
Sign re o esigner ate
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 egulations:
P1 \.olif?-S--
Environmental Health pecialist Date
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
V The design is stamped "Approved"by Mason County Public Health. V✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: V f V
V Drainfield site conditions have not been altered to adversely affect conditions of design approval.
r)111I
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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ORIFICE SPACING
5
Lateral# Length Length Orifice #
Distance from Distance from end Length#
# (Feet) (Inches) Spacing " Orifices feeder line of end of lateral
1 30 360 60 6 2.5
2 30 360 60 2.5. 30
6 2.5 2.5 30
3 30 360 60 6 2.5 2.5 30
90 18 90
TRANS LENGTH 15
GPM I 10.62
K (2"SCHEDULEN 40) 284.5
FRICTION LOSS 0.034227
Squirt I 2 "
Elevation difference 8
TDH 10.034227
APPROVED -
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OCT 0 9 2025 ;� 1 ',L, • 2I
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MASON COUNTY ENVIRONMENTAL HEALTH o� v E w /1�`�
RET ICEN D DE ER
TRENCH CROSS SECTION
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X4=Flow Control Valves 0) r a vd !+s
X5=Soil Logs pc1 e 3
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APPROVED
OCT 09 2025
MASON COUNTY ENV RObMENTAL HEALTH
RET
•
APPROVED
O C T 0 9 2025
MASON COUNTY ENVIRONMENTAL HEALTH
RET
THREADED CAP OR PLUG
6"PVC
LAST ORIFICE;WITH
ORIFICE SHIELDS IF
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MFILTRATOR /akv. IM-1060
septic tanks '!'
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• Strong Injection molded polypropylene
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• ;- I i I o Inboard lifting lugs allow for easy
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'� ( -i Integral heavy-duty green lids that
CDrrn ";. interconnect with TWTM risers and pipe
co riser solutions
mt 1f >M II i o r • Structurally reinforced access ports
I + No eliminate distortion during Installation
y and pump-outs
z (J• Reinforced structural ribbing and
512
fiberglass bulkheads offer additional
strength
• Can be Installed with 6"to 48"
of cover
The Infiltrator IM-1060 is a lightweight strong and durat)le septic tank. during
• Can be pumped dry
This watertight tank design is offered with Infiltrator's Itie of custom-fit pump-outs
risers and heavy-duty lids. Infiltrator injection molded tanks provide a • Suitable for use as a septic tank, pump
revolutionary improvement in plastic septic tank design, offering long-term tank, or rainwater(non-potable)tank
exceptional strength and watertightness.
• No special water filling requirements
Inlet Side are necessary
TANK CUTAWAY Infiltrator • The tank may be backfilied with suitable
TW Riser • native soil.See installation instructions
System for guidance.
Partition
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gasket connection
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IM-1060 General Specifications and Illustrations
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The IM-1060 Is an injection molded two piece mid-seam ` )
plastic tank.The IM-1060 injection molded plastic design :�'�I �'. ru •'
allows for a mid-seam joint that has precise dimensions A 't' E,,;, IIC� �I��j;,n i•
for accepting an engineered EPDM gasket. Infiltrators A ii is oo �) o ! �.'.l A
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to deliver proven means of maintaining a watertight seal. �--- °o "`~ 'moo"o���'I �, ,
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The two-piece design is permanently fastened using a ►:,+__'E. it- ■P� t,� = '
series of non-corrosive plastic alignment dowels and �.1I� ,► �I I ��f
locking seam clips.The IM-1060 is assembled and sold i i 1 1 �..t 1
through a network of certified Infiltrator distributors.
)17.0(32261 EXTERIOR LENGTH
Must be backfilled and installed in accordance with cu ,,rl i TOP VIEW
Infiltrator Water Technologies,Infiltrator IM-Series Septic z ,'
Tank General Installation Instructions and for shallow ' 0 U i _
ground water conditions reference the Infiltrator IM- z o -.1 i � 1-
Series Tank Buoyancy Control Guidance. 1 -n-I V. ., . i
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Please visit www.Inffltratorwater.com/images/pdf/ _ _ _ •—_ _�Il„ ,
ManualsGuides/TANK01.pdf for the latest information. o ^, ! ,lodritily 3GPI
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Working Capacity 1094 gal(4141 L a �i7 �`_.-.._ _.._.
Total Capacity 1287 gal(4872 L.) m�*+ ® I END VIEW
Airspace 16.5% i
Length 127"(3226 mm) PVC OR a 4llaAssil 0 241LOOMSoI ACCESS OPENINGS WITH LOOMS UM R1
Width 62.2"(1580 mm) INLET TEE _10212601 FREEBOARD 0121T' A
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Length-to-Width Ratio 2.3 to 1 4,
Height 54.7"(1389 mm) 'rPm L l IHIET I 16.596AIR SR.CE OUTLET
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Liquid Level 44"(1118 mm) _,, (as `L
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Compartments 1 or2 �iI "-T-'� Lr*‘L�rt
Maximum Burial Depth 48" 1219 mm) ' Ay ,
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Minimum Burial Depth 8"(152 mm) ' ee 1�1.,
Maximum PipeDiameter 0* F Yt!s '9� I'
6"(152 mm) . i wQ 4�, �. CONTINUOUS
Weight 320 lbs(145 kg) �.:�� Ne.- _ '��sra. GASKET
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P.O.Box 768
Old Saybrook,CT 06475
INFILTRATOR' 860-577-7000•Fax 880-677-7001 1MID-HEIGHT SEAM SECTION 1
,. -221-4436 \ 1
water technologies www•InBltratorawater.com
U.S.Patella:4,759,681;5,017,041;5,156,488;5,338,017;5,401,116;5,401,458;6,511,903;5,716,103;5,568,776;5,839,844 Canadian PAtents:1,329,959;2,004,564 Other patents pendrg.inflamer,Equalizer,
Oukh4,and SldeWinder are registered trademarks of Infiltrator Water Technologies.Inatator Is a registered trademark in France.Infetratot Water Techrak gies Is a registered trademark In Mexico.
Contour.MkcoLaathng.PoryTuff.ChemberSpacer.MuhiPort.Poea.ock.Oulel4Cut,OWakPty.SnaapLock and StraightLack ate trademarkp of Inletrator Water Technologies.
PolyLok Is a trademark of PolyLok,Inc.TUF-TITE la a registered trademark of TUF•TITE,INC.Ultra-Ho Is a trademark of IPEX Inc.
0 2016 Irlllltrator Walls Technologies,LLC.Al rights reserved.Printed in U.S.A.
IM02 1116
Contact Infiltrator Water Technologies' Technical Services Department for assistance at 1-800-221-4436
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Pump Specifications �
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Installation Notes
Pressure Distribution System:
22025-50-90130 706 E BURGUNDY 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. Drainfield filled with roots.
2. Dug one soil log in the middle of proposed bed, did not want to disturb any more soil.
3. Timer to be set at 180GPD
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 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
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 mus extend to within six
inches of finish grade and be in a valve box as shown on dia
18. Install audio/visual alarm.
19. Filter fabric required over drain rock prior to backfilling. If rain ck extends above
the original grade, run the filter fabric at least 2 inches tla04 wall into original
grade. :1 12.
4P 1A11
APPROVED e CLi17,te,t4
E ED SIGNE
OCT 09 2025
MASON COUNTY ENVIRONMENTAL HEALTH
RET
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.
IY!ASF, 94,
St .
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CI v
APPROVED
O C T 09 2025
MASON COUNTY ENVIRONMENTAL HEALTH
RET