HomeMy WebLinkAboutSWG2025-00365 - SWG Application / Design - 9/10/2025 iraMASON 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: SWG2025-00365 WO
APPLICANT SCHUMOCK LOUISE M Phone:
Address: 8801 27TH ST W UNIT 16A TACOMA, WA 98466
OWNER SCHUMOCK LOUISE M Phone:
Address: 8801 27TH ST W UNIT 16A TACOMA, WA 98466
SEPTIC DESIGNER CINDY WAITE* Phone: 360-701-0205
Address: 80 E PICKERING LANE SHELTON, WA 98584
SEPTIC INSTALLER TAYLOR TONEY* Phone: 360-489-9169
Address: 2971 E PHILLIPS LAKE RD SHELTON, WA 98584
Site Address: 1160 E PHILLIPS LAKE LOOP RD
Primary Parcel Number: 220055100028
Permit Description: Repair 2bd Drainfield only pressure trench
Permit Submitted Date: 09/10/2025
Permit Issued Date: 09/19/2025
Issued By: Rhonda Thompson
Current Permit Fees Paid: $825.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 09/17/2026 (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/environmentallonsite/oss-inspection-request.php or call:
360-427-9670, extension 400.
OFFICIAL USE ONLY
MASON COUNTY DATE RECEIVED: Vq - io _ g�
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Environmental Health 360-427-9670,ext.400 or 360-275-4467,ext.400 /� � —
415 N.6th Street- Shelton,WA 98584 S V V\��G ' /c "5 — c(�cc ✓ Z
ON-SITE SEWAGE SYSTEM APPLICATION
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APPLICANT PHONE m
LOUISE SCHUMOCK �� 360-426-4221 z
MAILING ADDRESS-STREET,CITY,STATE.ZIP CODE E
8801 27TH ST W, UNIT 16A c� TACOMA WA 98466 m
Ca
SITE ADDRESS-STREET,CITY.ZIP CODE ��
1160 E PHILLIPS LAKE LOttii SHELTON WA 98584 I N
NAME OF DESIGNER Q � PHONE N
CNDY WAITE & ` 360-701-0205
NAME OF INSTALLER C PHONE 0
B-LINE CONSTRUCTION �� 360-426-4221 <
PERMIT TYPE(select one) DRINKING WATER SOURCE - I 0 5
6RESIDENTIAL OSS COMMUNITY OSS VI-COMMERCIAL OSS I PRIVATE INDIVIDUAL WELL b PRIVATE TWO-PARTY WELL Z I ,.31
TYPE OF WORK(select one) I] PUBLIC WATER SYSTEM 1
E NEW CONSTRUCTION/UPGRADES lt!I REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) ❑ TABLE X REPAIR I Cal
SUBMITTALS 0 SURFACING SEWAGE Id EXISTING FAILURE CI SHORELINE
co
[jr.DESIGN FORM(REQUIRED) SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE WAS LOT CREATED AFTER 4/12025? To I
5WAIVER(S)(IF APPLICABLE) 2 .21 ACg ❑ YES Q NO n I I
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DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.locked gate)
GO NORTH ON HIGHWAY 3, TURN RIGHT ONTO PICKE.21 ACRESRING RD, TURN I 0
RIGHT ONTO PHILLIPS LAKE RD, TURN LEFT ONTO PHILLIPS LAKE LOOP RD, r
PARCEL IS ON THE RIGHT SIDE(LAKE SIDE) OF ROAD o 0
IN
SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST HFFLIt�,GED WIT/HEST HOLE NUMBERS.
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE/FAILURE SOURCE(for reporting purposes)
❑VOLUNTARY 0 MAINTENANCE/PUMPING ❑BUILDING PERMIT ['HOME SALE ['COMPLAINT ['OTHER:
INSPECTOR SOIL LOGS COMMENTS/CONDITIONS
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Or Art S U Si— -- ( i
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,
INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED/ISSUED BYji
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THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE Revised:4/14/2025
(r 4 —I-7DESIGN FORM—PAGE ONE Assessor's Parcel Number: 1212 O i 0 � 515 i 1 0 O ` 0 2 8 I
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.
'I 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 .2DVS—00.763-- Designer's Name: CINDY WAITE
Applicant's Name: LOUISE SCHUMOCK Designer's Phone Number: 360-701-0205
Mailing Address: 8801 27TH ST W UNIT 16A Designer's Address: 80 E PICKERING LANE
TACOMA - �WA 98466 City State Zip SHELTON WA 98584
City State Zip Designer's Email cindyewaite@msn.com
DESIGN PARAMETERS
Treatment Device
❑ Glendon 0 Sand Filter 0 Mound 0 Sand L'ned Drainfield 0 Recirculating Filter 0 ATU 0 Other
Treatment Level(check all that apply): 0 A B 0 C 0 BL I 0 BL2 0 BL3 A`" 0 N
Drainfield Type
❑Gravity 1iPressure lig Trench ❑ Bed 0 Sub Surface Drip
Septic Tank/Drainfield 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 6
Receiving Soil Type(1-6) 3 Separation - 3 ft
Receiving Soil Appl. Rate ' .8 gpd/ft2 r Orifices
Required Primary Area 300 ft2 Total Number -Drib 30
Designed Primary Area 1 300 ft2 Diameter eV. S • 3/16 in
Designed Reserve Area VIEIRY LIMITEDSpacing
ft2 } M= d^ 36 in
Trench/Bed Width 10(two beds) ft • 4" tat nifold
Trench/Bed Length 15 ft Sch ./Classic TE
LICENS DESIGNER
Elevation Measure it ents L Z=, ft
LS .I•.
Original Drainfield Area Slope <1 % Diameter in
New Slope, If Altered % Preferred manifold configuration used? 0 Yes G'No
Depth of Excavation Up-slope 16 in Transport Pipe
from Original Grade Down-slope 16 in Schedule/Class SCHEDULE 40(EXISTINGO
Designed Vertical Separation 24 in Length 25 ft
Gravel-based Drainfield Required? L 'Yes 0 No Diameter 2 in
Pump Required? EnYes 0 No Dosing and Pump Chamber k11
Pump/Siphon Specifications Number of doses/day 4
Diff. in Elevation Between Pump& Uppermost Orifice 15 ft Dose quantity 45 gal
Drainfield Squirt Height/Selected Residual(head) 2 ft Chamber Capacity(flood) 1275 gal
Uppermost Orifice if Higher 0 Lower than Pump Shutoff Pump controls: Please check those required.
Capacity @ Total Pressure Head 17.7 gpm lif Timer Ili Elapse Meter lif Event Counter
Calculated Total Pressure Head — 17.14 ft If Timer: Pump on ,Pump off
Comments
SEPIC AND PUMP TANK INSTALLED 2006(SWG2006-00370), USING EXISTING TRANSPORT LINE,
PUMP CONTROLS TO BE SET AT TIME OF INSTALLATION,
Revised: 6/11/2025
DESIGN FORM—PAGE TWO Assessor's Parcel Number: 21 2 , 0 I 0 i 5 5 1 � 0 i 0 0 2 8
Permit Number: SWG F
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
ii Test hole locations VI Drainfield orientation and layout Reference depth from original grade:
cif Soil logs it Trench/bed dimensions and ❑ Septic tank
cif Property lines critical distances within layout 1Wr Drainfield cover
it Existingand proposed wells it D-Box/Valve box locations
P p Reference depth from original grade
within 100 ft of property it Septic tank/pump chamber and restrictive strata:
❑ Measurements to cuts, banks, and locations
liti Laterals,trench/bed,top and
surface water and critical areas Observation port location bottom
❑ Location and orientation of it Clean-out location 0 Curtain drain collector
curtain drain and all absorpton it Manifold placement 0 Sand augmentation
components
It Orifice placement Other cross-section detail:
❑ Location and dimension of V Observation ports/clean-outs
primary system and reserve area Lateral placement with distance
to edge of bed Other Information
1 Buildings
it Audible/visual alarm referenced Yes No
1' Direction of slope indicator
Qi Scale of drawing shown on scale i ❑ Design staked out
wf Waterlines bar 0 0 Recorded Notices attached
it Roads, easements,driveway , ' Elevation benchmark and relative 0 0 Waiver(s)attached
parking elevations of system components V 0 Pump curve attached
it North arrow and scale drawing iI 0 Evaluation of failure
shown on scale bar Non-residential justification
❑ 0 Waste strength
0 ❑ Flow
DESIGN APPROVAL
The undersigned designer must by notified , installer at time of installation 0 Yes 0 No
LJ GA lu! r l
Signature of) esigner „oilyDa e
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: CM
I ,`t 4 11-
Environmental Health Sp ialist Date
CAUTION: DESIGN APPR VAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
✓ The design is stamped"Appr ved" by Mason County Public Health. ICI I n ,4
✓ The Onsite Sewage Permit h not expired,the Permit Expiration Date is:
✓ Drainfield site conditions ha not been altered to adversely affect conditions of design approval. /Ai
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 3
Lateral# Length Length Orifice # Distance from Distance from end Length#
# (Feet) (Inche$) Spacing " Orifices feeder line of end of lateral
1 15 3r80 36 5 1.5 1.5 15
2 15 ii80 36 5 1.5 1.5 15
3 15 180 36, 5 1.5 1.5 15
4 15 180 36 5 1.5 1.5 15
5 15 180 36 5 1.5 1.5 15
6 15 380 36 5 1.5 1.5 15
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TRANS LENGTH '25
GPM 17.7
K (2" SCHEDULEN 40) 284.5
FRICTION LOSS 0.14677 44
Squirt 2
Elevation difference 15
TDH 17.14677
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Are, 0.411
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APPROVED
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MASON COUNTY ENVIRONMENTAL HEALTH
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DRAINFIELD LAYOUT
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41144.X1=CLEANOUT/OBS P �� " Vae�lf f a� p
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X2=D BOX/VALVE BOX �(�- � "d. _ . N�F•
X3=Check Valves 0) .'a �_,/c Tq ,%�' CINDv0E f8 E t'!`i\
X4=Flow Control Valves (c) �'N P.� i LICENSI n DESIGNER �4
XS=Soil Logs '"%
APPROVED
OCT 16 2025
MASON COUNTY ENVIRONMENTAL HEALTH
RET
Installation Notes
Pressure Distribution System:
22005-51-00028 1160 E Phillips Lake Loop Rd
Prepared site plan is nt a survey. It's the owner's responsibility to verify property lines, utility
lines (w ter, sewer, power, phone and gas) prior to installation.
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1. Waterline and tra'isport line are existing
2. Gravel base drainfield required
3. Timer to be set at 180GPD
4. Keep wheeled vehicles off the drainfield area before, during and after installation.
Tracked equipmeit only
5. All ground, surfs ' water and roof drains must be diverted away from the septic tanks
and drainfield. Enure the final grade slopes away from these areas and water doesn't
collect on or arou d them. Use swales, berms, catch basin and tight lines, curtain drains,
etc. to divert all w ters.
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.
4443. Install access ris s
on the septic tanks, valve box and ends of laterals.
9. Make sure septic ank risers are epoxied or caulked to cast in riser rings on tank.
10. Lids must form a ater 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 mi imum design flow per bedroom per day is the operating capacity of
ninety gallons muI iplied by 1.33. This results in a minimum design flow of one hundred
twenty gallons pe day. This creates a surge factor of 33% but anticipated flow is ninety
gallons per bedro m per day.
15. Install laterals wit contour of the ground.
16. Install trench bolt s 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 s %, - .
inches of finish grade and be in a valve box as shown on diagram. ,
18. Install audio/visual alarm. r° �k t
19. Filter fabric required over drain rock prior to backfilling. If the drain rock exte .•`'. :bov S
the original grade, run the filter fabric at least 2 inches down the trench wal '. 7-1��
grade. 4f Nv:. �+ =°° Q,e�i
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APPROVED ... I
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MASON COUNTY ENYIRONM.ENTAL HEALTH
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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 nd 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 kil or impair the biological process in the septic tank.
12. Leaky plumbing can hydraulic overload your on-site septic system.
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• APPROVED
OCT 16 2025
MASON COUNTY ENVIRONMENTAL HEALTH
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