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HomeMy WebLinkAboutSWG2025-00372 - SWG Application / Design - 11/4/2025 MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584 SHELTON:360-427-9670,EXT 400 J L 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: SWG2025-00372 Co APPLICANT BORK BRUCE Phone: 360-556-9674 Address: 120 STATE AVE NE#209 OLYMPIA, WA 98501 SEPTIC DESIGNER ADAM HUNTER* Phone: 360-753-1226 Address: PO Box 162 OLYMPIA, WA 98507 SEPTIC DESIGNER Hunter, Adam Phone: 360 753-1226 Address: 2201 93rd Ave SW Olympia, WA 98512 Site Address: UNKNOWN Primary Parcel Number: 321275400082 Permit Description: New 2bd ATU to subsurface drip with Class A waiver Permit Submitted Date: 09/15/2025 Permit Issued Date: 11/04/2025 Issued By: Rhonda Thompson Current Permit Fees Paid: $720.00 (additional fees may be required upon installation of system). Permit Expiration Date: 09/24/2028 (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 Drainfield 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/onsite/oss-inspection-request.php or call: 360-427-9670, extension 400. ..- OFFICIAL USE ONLY MASON COUNTY DATE RECEIVED: D q ' a 0 D c cn AMOUNT RECCNC RECENED BY: W m r- Public Health & Human Services �5 ONLI NE Environmental Health 360-427-9670,ext.400 or 360-275-4467,ext.400 < Cl) 415 N.6th Street-Shelton,WA 98584 0 S W G (�'V✓`-/ J o O c, Z 73 CLEAR FORM ON-SITE SEWAGE SYSTEM APPLICATION 3 m C) APPLICANT PHONE rn I- BRUCE BORK //��/�� 3605561984 z MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE `J/ g 120 STATE AVE NE #209 r, OLYMPIA WA 98501 rn SITE ADDRESS-STREET,CITY.ZIP CODE /t,,Q �, � SHELTON E LTO N WA 98584 � �' 41 E KILMARNOCK RD N NAME OF DESIGNER Q / PHONE N ADAM HUNTER , 3607531226 0' o NAME OF INSTALLER PHONE v I t C CI i/PERMIT TYPE(select one) d� DRINKING WATER SOURCE O C I CO L- RESIDENTIAL OSS b COMMUNITY OSS E COMMERCIAL OSS 5-PRIVATE INDIVIDUAL WELL b-PRIVATE TWO-PARTY WELL Z N TYPE OF WORK(select one) I- PUBLIC WATER SYSTEM LAKE LIMERICK i 6-NEW CONSTRUCTION/UPGRADES 6 REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) ❑ TABLE X REPAIR SUBMITTALS ElSURFACING SEWAGE ElEXISTING FAILURE 0 SHORELINE co C L� DESIGN FORM(REQUIRED) RI SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE WAS LOT CREATED AFTER ann0257 r O 6wAIVER(s)(IF APPLICABLE) 2 0.31 E] YES YES El NO X DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.locked gate) MASON LAKE RD TO A RIGHT ON OLDE LYME RD TO A LEFT ON KILMARNOCK TO SITE ON THE LEFT. o --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 UPGRADE/FAILURE SOURCE(for reporting purposes) ❑VOLUNTARY 0 MAINTENANCE/PUMPING 0 BUILDING PERMIT ❑HOME SALE ❑COMPLAINT ❑OTHER: INSPECTOR SOIL LOGS V COMMENTS/CONDITIONS 7 -1A1\1: 0-3D eiS Li .5 ot ,J--- �pwNr.4\..t,-.1 *i Q --qv 2 S , (It+ n t-i gi\ ^0"- sp-ev "ct-k3= a -HV / L_,L( c---} 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. INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED'ISSUED BY DATE 6/%Nl.A1 I -1/1 lz5— at 1,.., I7,8 `6)11 ► c (q j—z THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE Revised:4/14/2025 DESIGN FORM—PAGE ONE Assessor's Parcel Number: 321275400082 -- -- 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 a s- by Lf Zi Designer's Name: ADAM HUNTER Applicant's Name: BRUCE BORK Designer's Phone Number: 3607531226 Mailing Address: 120 STATE AVE NE#209 Designer's Address: PO BOX 162 OLYMPIA WA 98501 City State Zip OLYMPIA WA 98507 CLEAR FORM JHANDASSOCIATES@HOTMAIL.COM City State Zip Designer's Email DESIGN PARAMETERS Treatment Device ❑Glendon 0 Sand Filter 0 Mound 0 Sand Lined Drainfield 0 Recirc lating Filter II ATU BNR600 U Other Treatment Level(check all that apply): J A J B J C J BLI BL2 J BL3 I E J N Drainfield Type ❑Gravity 0 Pressure 0 Trench 0 Bed Sub Surface Drip Septic Tank/Drainfield Specifications Laterals Number of Bedrooms 2 Schedule/Class DRIP Daily Flow: Operating Capacity 180 gpd ✓Length 150 ft Daily Flow: Design Flow 240 gpd Diameter 1/2 in I/ Septic Tank Capacity(working) 1060 gal Number 2 Receiving Soil Type(1-6) 4 Separation 1.71 ft Receiving Soil Appl. Rate 0.6 gpd/ft2 Orifices Required Primary Area 450 ft2 Total Number of Orifices 300 Designed Primary Area 450 ft2 Diameter DRIP in t/ Designed Reserve Area 600 ft2 Spacing 12 in 1--"*". Trench/Bed Width 12 ft ✓ Manifold Trench/Bed Length 37.5 ft Schedule/Class 40 Elevation Measurements Length 12 ft Original Drainfield Area Slope 0 % Diameter 1 in New Slope,If Altered 0 % Preferred manifold configuration used? 'Yes 0 No Depth of Excavation Up-slope 12 in Transport Pipe from Original Grade Down-slope 6 in I/ Schedule/Class 40 Designed Vertical Separation 2%-t /` in Length 50 ft Gravel-based Drainfield Required? 0 Yes fieNo Diameter 1 in Pump Required? M'Yes 0 No Dosing and Pump Chamber Pump/Siphon Specifications Number of doses/day 12 Diff.in Elevation Between Pump&Uppermost Orifice 0 ft Dose quantity 20 gal Drainfield Squirt Height/Selected Residual(head) DRIP ft Chamber Capacity(flood) 1060 gal Uppermost Orifice 0 Higher Lower than Pump Shutoff Pump controls:Please check those required. Capacity @ Total Pressure Head 6.1 gpm ISif Timer NI'Elapse Meter NEI Event Counter Calculated Total Pressure Head 86.2 ft If Timer: Pump on 9.52MIN ,Pump off 2HRS Comments SHIFTED RESERVE AREA AND DRIP FIELD TO MAINTAIN 15FT FROM ROADSIDE DITCH Revised:4/14/2025 DESIGN FORM—PAGE TWO Assessor's Parcel Number: 321275400082 -- -- Permit Number: SWG , DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch 2' Test hole locations 2' Drainfield orientation and layout Reference depth from original grade: 1 Soil logs l' Trench/bed dimensions and 2' Septic tank kg Property lines critical distances within layout ®' Drainfield cover 12 Existing and proposed wells D-Box/Valve box locations Reference depth from original grade within 100 ft of property l' Septic tank/pump chamber and restrictive strata: 1 Measurements to cuts,banks, and locations a Laterals,trench/bed,top and surface water and critical areas Observation port location bottom 62' Location and orientation of Clean-out location 12( Curtain drain collector curtain drain and all absorption Eli Manifold placement a Sand augmentation components ®' Orifice placement Other cross-section detail: • Location and dimension of RI Lateral placement with distance 2' Observation ports/clean-outs primary system and reserve area to edge of bed Other Information 1 Buildings ticAudible/visual alarm referenced Yes No 62V' Direction of slope indicator &I Scale of drawing shown on scale EC ❑ Design staked out 2' Waterlines bar 0 0 Recorded Notices attached 2' Roads, easements,driveways, 0 Elevation benchmark and relative 0 0 Waiver(s)attached parking elevations of system components 11 0 Pump curve attached 1 North arrow and scale drawing 0 0 Evaluation of failure shown on scale bar Non-residential justification ❑ 0 Waste strength ❑ ❑ Flow DESIGN APPROVAL The undersigned designer must be no • tee y installer at time of installation M'Yes 0 No ALVA a 10/22/25 re o Designer Date a n behalf of Mason County undersigned has reviewed this :.i_ Public Health and determined it to be in compliance with state and local on-site regulations: 9 , ill S-- Environmental Health Sp ialist Date CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION: ✓ The design is stamped"Approved"by Mason County Public Health. l•-lvt (,g3 ✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: I Drainfield site conditions have not been altered to adversely affect conditions of design approval. 111 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 N N N O T eye 401 4 �y IOU-p �" 4 20�5 h ,.,` _r%'' MASGN CGUNIYENVIRGHh4ENTAl NEALT f , `,V E€_51 aRgi s;; „. on« •go o `EaE,s._ b o m ?p ,g_ce iv `, `U e c x in :,_= _2 2. i= 1a8 al31 C Ag S� -` F'-.c o8•,2 aspp 3s"-i;`o� a ,"2C a e..- ar3•- m uJ a�Q§^ ign2 a" -•, ale. :� -- Y Z.a$ �,a' $g;a o$ .p _ use a ..< ti °S r f6 N O • m i ° mt .are Vs' 'ay o OW ' c b' g r._ a iLL t O - -�gg n o^8.a4 ,1 _ 5 �_ _ 15t ao IUI a$ § s3Hr'! sa+o sh t' ;�1 S we E ' •;off .g O c 5 �• a^i w �f'n: N o° S E .2.. "O 1 -" N F s so` uy i' LL2il.tt; b F .3C f.Y $D �m U O ,1 Ov j .;$ m a 3 y -S2 12» SEBS C 8a i.E.i c':e O r. i E55_ •-. $1:1 d 8 so3o LL ti2i » E E 0 U S ce J. 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Pump Curves 500 400 I i i I 1 i i 1 jj1[PF10 Series,60 Hz,0.5-1.0 hp PF20 Series,60 Hz,0.5-1.5 hp — 400 ■■ mwmomm 350 PF2015 ■■■■■■■ ■■■ 1 _ co 350 PF101�■.■■■■■■■■■■ ■■■■■■■■■■■■ C 300 i ■■■■■■■■■■■■ = 300 � � (PF2010� p PF10 rumeg■■■■■■■■ 250 .... '0 2500,■■a��■■■■■■■■■ . ;\ `° inomil■■■maa■■■■■■■■� CO1:13 Rs 200 - 200 ■■■ ■■�■■01■■■■■■■ ■■■■ MO'�"■■■■■■■ m 150.PF2005.....'....: c 150■■■■■■■�\��. ■■■ 111111■■■■1 i■■1MINN■■■■■ m i nn.!.■�■�I�■■ I,I ■■■■■ w 100 IG ■ 101■■■ 50■■■■■■� ■■■■■01■■ ~ 50 . SSE:■■■■■■■■■■■ 0 0 2 4 6 8 10 12 14 16 18 0 5 10 15 20 25 30 35 40 Flow in gallons per minute (gpm) Flow in gallons per minute (gpm) 900 I I i i PF30501 PF30 Series,60 Hz,0.5-5.0 hp — ::: t•...[ i m . e 10/22/25 C 600 PF3030 I:•.• R 500 . m '_ c.) 400-1PF30201 ♦ 1;, .r...l......... ..PF3015 L. 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