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HomeMy WebLinkAboutSWG2025-00438 - SWG Application / Design - 11/19/2025 MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584 SHELTON:360-427-9670,EXT 400 J f. 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: SWG2025-00438 APPLICANT Nathan Hall Phone: 360-391-2747 Address: 5908 Birdseye Ct FERNDALE, WA 98248 OWNER PAYNE ET UX RONALD G Phone: Address: JANINE DUCHARME EST BURTON, WA 98013 SEPTIC DESIGNER PAULA JOHNSON* Phone: 360-898-2255 Address: 171 E VUECREST DRIVE UNION, WA 98592 SEPTIC INSTALLER SHANE MAPLES* Phone: 360-463-8474 Address: 911 SE Arcadia Road SHELTON, WA 98584 Site Address: 171 N Kokanee Cove Way Primary Parcel Number: 422165000083 Repair: SFR 2-bedroom pressure system with sand lined bed Permit Description: drainfield Permit Submitted Date: 11/04/2025 Permit Issued Date: 11/19/2025 Issued By: David Anderson Current Permit Fees Paid: $825.00 (additional fees may be required upon installation of system). Permit Expiration Date: 11/10/2026 (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. 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. MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584 SHELTON:360-427-9670,EXT 400 011,4, ': BELFAIR:360-275-4467,EXT 400 Public Health & Human Services ELMA:360-482-5269,EXT 400 FAX:360-427-7787 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 DATEuECEIveD '' log [ 0 26 C U) at''-. AMOUNTRECENED: U RECEIVED BY. CO m am Public Health & Human Services f�g' '� ��L�pOcF c�CU-Q Environmental1N.6hS Health h o• -9670,ext.400 or 360-275-4467,cut.400 S W G . ^ - r�P UJ o 41 S N.6th Street-Shelton,WA 9858E dt) C-11 Q o m Z U) ON-SITE SEWAGE SYSTEM APPLICATION z ? m n f-O\E r -'P;.ICANT Nathan & Christine Hall , (360) 391-2747 v z MAiLiNG ADDRESS-STREET.CITY.STATE.ZIP CODE C W 5908 Birdseye Ct Ferndale WA 98248 S:TE ADDRESS-STREET.CITY,ZIP COOS ,,,kN Way �,� -odsport WA 98548 171 N Kokanee �� q NAME OF DESIGNER 2,, VO PHONE 3 I N Arrow Septic Designs, Inc U O ` (360) 898-2255 _ NAME OF INSTALLER 0 P4CNE 0 I N Maples Excavating �,r� (360) 463-8474 N PERMIT TYPE(setea one: DRINKING WATER SOURCE 0 fif RESIDENTIAL OSS 51COMMUNITY OSS ECO RQ •:S E PRIVATE INDIVIDUAL WELL E PRIVATE TWO-PARTY WELL Z 10) Vv173 PUBLIC WATER SYSTEM TYPE OF WORK(select one) CO ENEW CONSTRUCTION I UPGRADES REPAIR I REPLACEMENT OTHER DETAILS(select all that apply) 0 TABLE X REPAIR (71 ❑ SURFACING SEWAGE Eg EXISTING FAILURE 0 SHORELINE ca SUBMITTALS � O I O DESIGN FORM(REQUIRED) KJiSEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE WAS LOT CREATED AFTER 4/112025?5WAIVER(S)(IF APPLICABLE) 2 .4 ac 0 YES 0 NO 00 i DIRECTIONS TO SITE AND SITE CONDITIONS (ex locker/gate) Take US-101 N toward Port Angeles and turn (L) onto N Lake Cushman Rd. Turn (L) onto I0 Cushman-Potlatch Rd/Lower Lake Rd. Turn (R) onto Lower Lake Rd. Turn (R) onto Dow ro 0 Creek Dr. Turn (L) onto N Kokanee Cove Way. Destination on (L). Address sign at driveway —I (on ground). co co (s.) I SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. (A) OFFICIAL USE ONLY BELOW THIS LINE UPGRADE/FAILURE SOURCE(V reporting purposes; ❑VOLUNTARY 0 MAINTENANCE/PUMPING 0 BUILDING PERMIT ['HOME SALE ['COMPLAINT ['OTHER: INSPECTOR SC1ILSLOGS j COMMENTS!CONDITIONS 14 0 IS'60 `` ACooS .0..* 4 frb° `1 1HL:o S V -6(1° ECG Co 4 S -to L 4o'3) RECORD DRAWING AND INSTALLATION REPORT SOIL CODES: REQUIRED FOR FINAL APPROVAL. V=VERY G=GRAVELLY 5=SAND L=LOAM Si=SILT C=CLAY E=EXTREMELY R=ROOTS INSPECTOR NATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED!ISSUED BY DATE (12 0( ��l 1(7O/i26 0-----\ t(11 (Zoz:5? ` THE MASON COUNTY WEBSITE Revised:4/14/2025 THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON DESIGN FORM—PAGE ONE Assessor's Parcel Number: 4 2 2 1 6 — 5 0 — 0 0 0 8 3 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.:llaximum paper size: 11 17" +.a y 'r i "PARCEL WE )f ' CATII, i!`.", ., PS,+'"``? , Permit Number: SWWG 2025-00438 — Designer's Name: Arrow Septic Designs, Inc Applicant's Name: Nathan&Christine Hall Designer's Phone Number: (360)898-2255 Mailing Address: 5908 Birdseye Ct Designer's Address: 171 E Vuecrest Dr Femdale WA 98248 City State Zip Union, WA 98592 City State Zip Designer's Email paulaj@hctc.co • ,!•DESIGN.PARAMETERS Treatment Device 4/0/ ❑Glendon 0 Sand Filter 0 Mound 0 Sand Lined Drainfield ❑ Recirculating Filter 0 AM Li O her J, Treatment Level (check all that apply): ❑A p B 0 C. Bt.l 0 BL2 0 BLS M E El "rFC'F� '' 5' Drainfield Drainfield Type �0 ❑Gravity RI Pressure 0 Trench (if Bed 0 Sub Surface : ip Septic Tank/Drainfield Specifications Laterals .- NumberofBedrooms 2 , Schedule/Class 40 Daily Flow: Operating Capacity 180 , gpd Length 30 ft Daily Flow:Design Flow 240 - gpd Diameter 1.25 in Septic Tank Capacity(working) 1,000 gal Number 4 Receiving Soil Type(1-6) 1 (sized as 3) Separation 2.5 ft Receiving Soil Appl.Rate 0.8 i gpd/ft2 Orifices Required Primary Area 300 "' ft2 Total Number of Orifices 52 Designed Primary Area 300 v ft2 Diameter *5/32* in Designed Reserve Area 300 e- ft2 Spacing *28* in Trench/Bed Width 10 ft Manifold Trench/Bed Length 30 ' ft Schedule/Class 40 Elevation Measurements Length header ft Original Drainfield Area Slope 0 % Diameter 1.25 in New Slope. If Altered 0 r % Preferred manifold configuration used? [tif Yes 0 No Depth of Excavation Up-slope 18+24=42 - in Transport Pipe from Original Grade Down-slope 18+24=42 ' in Schedule/Class 40 ' Designed Vertical Separation 18+ ' in Length 40 ft Gravel-based Drainfield Required? ii Yes 0 No Diameter 2 in Pump Required? Flf Yes ❑No Dosing and Pump Chamber Pump/Siphon Specifications Number of doses/day 4 Din: in Elevation Between Pump& Uppermost Orifice 8 ft Dose quantity 60 ,gal Drainfield Squirt Height/Selected Residual(head) 5 ft Chamber Capacity(flood) 1.,000 gal - Uppermost Orifice Higher 0 Lower than Pump Shutoff Pump controls:Please check those required. Capacity @ Total Pressure Head 33.28 gpm RI Timer 0 Fil'apse Meter OvEvent Counter Calculated Total Pressure Head 14.83 ft If Timer: Pump on 1.5 minutes ,pump off 6 hours Comments t 9 Revised:4/14/2025 DESIGN FORM—PAGE TWO Assessor's Parcel Number:4 2 2 1 6 — 5 0 -- 0 0 0 8 3 t Permit Number: SWG 2025-00438 DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch Et Test hole locations 64 Drainfield orientation and layout Reference depth from original grade: g Soil logs g Trench/bed dimensions and ' Septic tank fii1 Property' lines critical distances within layout gDrainfield cover 0 Existing and proposed wells 0 D-Box/Valve box locations Reference depth from original grade within 100 ft of property g Septic tank/pump chamber and restrictive strata: g Measurements to cuts,banks,and locations Elf Laterals,trench/bed,top and surface water and critical areas 64 Observation port location bottom ❑ Location and orientation of g Clean-out location 0 Curtain drain collector curtain drain and all absorption Et Manifold placement 64 Sand augmentation components g Orifice placement Other cross-section detail: dimensionfii of g Observation ports/clean-outs Location and 21 Lateral placement with distance primary system and reserve area to edge of bed Other Information 0 Buildings g Audible/visual alarm referenced Yes No g Direction of slope indicator RI Scale of drawing shown on scale g 0 Design staked out g Waterlines bar 0 g Recorded Notices attached g Roads,easements,driveways, CI Elevation benchmark and relative 0 l Waiver(s)attached parking elevations of system components 0 Pump curve attached North arrow and scale drawing M 0 Evaluation of failure shown on scale bar 4'1. Non-residential justification 0 lI Waste strength t 0 C 'Flow 1 D I VAL The undersigned designer must be notified b i allation el Yes 0 No rr Y:�.- .4. Signatur • titiEMONER' + Date The undersigned has reviewed this design on behalf of Mason County Public Health and detern#%14 in compliance with state and local on-si r gulations: NO E'i AZ' !( ( ( ? /Z f,,� v 192 Environmental Health Specialist ft"�CO(/N�}'fN ?5 CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONOI� rAC HFq/ ✓ The design is stamped'`Approved"by Mason County Public Health. MO I ZO✓ Ze 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 Arrow Septic Designs 171 E.Vuecrest Dr. Union, WA 98592 November 14,2025 Mason County Department of Health Services 415 N 6th St Shelton,WA 98584 RE:Nathan&Christine Hall Property(Parcel#42216-50-00083) Evaluation of Failure&Upgrade Dear Inspector: Attached is a septic tank permit for a property located at 171 N Kokanee Cove Way, Hoodsport, WA 98548. The existing septic system was installed with a permit in 1972. It has a 750-gallon septic tank followed by a 40' drainfield trench. The existing septic was recently inspected for a home sale.The pumper did a flow test on the drainfield and it did not accept water. The old tank is to be decommissioned or removed and the old drainfield is to be abandoned. Proposed is a new 1,000-gallon 2-compartment septic tank with effluent filter, a 1,000 gallon pump chamber and a 10' x 30' (300 s.f.)sand-lined pressure bed. This is a compliant 2-bedroom repair/ replacement septic system. All septic components are over 100' from the creek at the back of the property. We have designated a full reserve drainfield area. The property owner's contact information is as follows: Nathan&Christine Hall 5908 Birdseye Ct Ferndale, WA 98248 Phone: (360)391-2747 If you need further information,please contact my office at(3698-2255. 12) J -= aV C J. Sincerely,jas NOV 19 2025 ON COUNTY ENVIRONM MEN AL HEA LT! , DJA r4°1 •04'%. aJ%'. 510.134 9 +'7c. PAULA JOY JOHNSON e uc SE01)Eglai N. '+ Pau �st ( f.-Z'S Licensed Onsite Wastewater Treatment System Designer 2giot , . i • Vo he hi e. )7 eq e. R5 ...i LAKE CUSHMAN NO. 9 n SECTION 9 a 16, TWP 22 N.,.R.4 W, W.M. • MASON COUNTY ,WASHIRSTON 47 \ \ , 4 ...(......::........,„.:*., N ;\ -•-••T 1".n!.'. % \ ; . . / I.. tiNPLATTE .,k it,,-..E.: /At tirri - It -- \ ,X \ . -..\*t.:2• 1 yi ••• C....."-- \ 0\ A, •,•\(‘ \ .E__4!"....-4.0.t.r..4--1:7 ,..... .../.‹.i.. ._ • .. . . 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D. ---g..&- -t-s 1 24 —Vg;; \) tR� G Ew1 no. 5p V .►------ Ni GMS sg 1,.-kk ca e Ac-1" PG(-V E'C5) o % Al 5 5--6 1p GtN 5 \v`x3C' FRt - 8ei' w i ‘o' xso -D S1JRV 2e.b5i 5TPx 1‘3 G ,oho Ser LINE In 0 Audio-Visual Alarm 4)49 ttZ)o Cleanout ® _ ��`� n 1000 Gallon Septic Tank `JJ 2-Compartment with Er iX :r!C, r luent Filter ` 25tt. 4 1000 Gallon Pump Chamber d ..larzErsmin0 Olc. - ..�..lk 4 b4 1 - or ---,, 1 decow�y,155icr+ � ��- re,w.oaed 0�NI i ©, '�` 7 �P*)) M .cy.0. tee_ a.1.0 o-"A-k I x 1 tx. kiou ). ' Lw n NOV19 _J 2025 �� c 4� PAULA JOY JOHNSON � MASON �oSStBLF 1e wv 145148.5ti•LESiGNEt• ' ry wRTF.A eV L► .� �a �_ 1-. on ENI8R,;,,,,_� f o°le SI DPE ? ExemEs 69iiiil w� JTgL yE L'$r ((.-(�- **Note to installer** gLTy A ss tea, ur-,�.. w�j A leeve waterline when within 10' E-j, 53' of septic transport line. Maintain 10A•Tt2 i 10' minimum between water N olf-,A N E E Gov u;'y -_ line and septic tanks/drainfield.