HomeMy WebLinkAboutSWG2025-00267 - SWG Application / Design - 7/5/2025 MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584
SHELTON:360-427-9670,EXT 400
A .: 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: SWG2025-00267
APPLICANT Hunter, Adam Phone: 360 753-1226
Address: 2201 93rd Ave SW Olympia, WA 98512
OWNER EXODUS ACRES LLC Phone:
Address: P 0 BOX 76 ALLYN, WA 98524
SEPTIC DESIGNER ADAM HUNTER* Phone: 360-753-1226
Address: PO Box 162 OLYMPIA, WA 98507
Site Address: 70 E OLDE LYME RD
Primary Parcel Number: 321275300179
Permit Description: New 2bd Oscar X02
Permit Submitted Date: 07/05/2025
Permit Issued Date: 12/31/2025
Issued By: Rhonda Thompson
Current Permit Fees Paid: $555.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 08/06/2028 (based on date of inspection)
Permit Conditions:
1 Proposed development subject to zoning requirements and approval by the planning
department staff per Mason County Title 17.
2 Permit must be installed by a Mason County Certified Installer unless prior written
authorization from Mason County is obtained.
3 Drainfield installation not to exceed designed upslope and downslope depth specified on
design form.
4 Installer is responsible for obtaining Mason County installation approval prior to backfill of
system components.
5 Installer is responsible for obtaining Septic Designer/Engineer installation approval prior to
backfill of system components.
6 Mason County Asbuilt Form, Record Drawing, and Installation fee must be submitted for
final installation approval.
7 This permit is for Septic Only. The structure depicted on the site plan will require a
Shoreline Variance. You can contact Julie in the Planning Department to discuss the
Variance process.
8 Approval of this septic permit does not approve the building location. Building location is
subject to approval from all applicable departments and regulations.
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
COUNTY DATE RECEIVED: /I11 I
: MASON
- CP
I 1 AMOUNT REC D: '� W a mPublic Health & Human Servicesa
�� N
Environmental Health lion, ,ext.400 or 360 275-4467,ext.400 S W G �� - O
415 N.6th Street Shelton,WA 98584 ��p Z cii
CLEAR FORM ON-SITE SEWAGE SYSTEM APPLICATION 3
m
PHONE r
APPLICANT Z
THOMAS WOLTER 2062003325
MAILING ADDRESS STREET,CITY,STATE.ZIP CODE ALLYN WA 98524 co
PO BOX 76 ••
SITE ADDRESS-STREET.CITY,ZIP CODE SHELTON WA 98584 ' Ni
70 E OLDE LLYME RD PHONE
Ni' Ni
NAME OF DESIGNER ADAM HUNTER 3607531226 01
01
PHONE � I O
NAME OF INSTALLER I
TBD - i
DRINKING WATER SOURCE Q
PERMIT TYPE(select one)
q PRIVATE INDIVIDUAL WELL PRIVATE TWO-PARTY WELL Z
L�7 RESIDENTIAL OSS COMMUNITY OSS ILJ COMMERCIAL OSS a PUBLIC WATER SYSTEM LAKE LIMERCK I
TYPE OF WORK(select one)
v6 NEW CONSTRUCTION/UPGRADES 6 REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) ❑ TABLE X REPAIR
CI
SEWAGE 0 EXISTING FAILURE 0 SHORELINE CO
c
SUBMITTALS r
� LOT SIZE WAS LOT CREATED AFTER 4/1/20257 Q I
lJ DESIGN FORM(REQUIRED) INJ SEPTIC DESIGN(REQUIRED) BEDROOM�ZS I O 3 0 YES �✓ NO � I Il
6WAIVER(S)(IF APPLICABLE)
DIRECTIONS TO SITE AND SITE CONDITIONS.(ex.locked gate)
E MASON LAKE RD TO A RIGHT ON OLDE LYME RD TO SITE ON THE RIGHT. \ I
oI
I
SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS.
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE/FAILURE SOURCE(for reporting purposes)
0 VOLUNTARY ❑MAINTENANCE/PUMPING 0 BUILDING PERMIT ❑HOME SALE ❑COMPLAINT ❑OTHER
COMMENTS I CONDITIONS
INSPECTOR SOIL LOGS
t 1 Z = o -c b ,S L- ►L1-t -f-it 1 (,t\o -k.)
- i-rs::: 0 --Li ftt, (__ ,-7__ H-- tw (071-"")
" -p \-\60-Q. 60\ack 1 14- ,i-t- "- .
uovt Gl in - !mod ,'\ hkk (fAAAit-)21/_, A)
-r-v •
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.
DATE
INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED/ISSUED BY Z--j.cNiArvo,
'� RI JZ�
Y`���, `r col �i /-7 giL /74) Revised:4/14/2025
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE
DESIGN FORM—PAGE ONE Assessor's Parcel Number: 321275300179 -- --
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
^,� r� Designer's Name: ADAM HUNTER
Permit Number: SWG /,� 1/"7' D O�� ADAM UN
THOMAS WOLTER Designer's Phone Number:
226
Applicant's Name:Mailing Address: PO BOX 162
PO BOX 76 Designer's Address:ALLYN WA 98524 City State Zip OLYMPIA WA 98507
City State Zip Designer's Email JHANDASSOCIATES@HOTMAIL.COM
DESIGN PARAMETERS
Treatment Device
❑Glendon 0 Sand Filter 0 Mound 0 Sand Lined Drainfield 0 Recirculating Filter l 'ATU X
U Other
Treatment Level(check all that apply): J A J B J C IBM .J BL2 J BL3 _I E J N
Drainfield Type OSCAR XO2
❑ Gravity
0 Pressure 0 Trench ❑ Bed 0 Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms
2 Schedule/Class OSCAR
Daily Flow:Operating Capacity
180 gpd Length OS100 ft
Daily Flow: Design Flow 240 gpd v
Diameter 1/2 in
Septic Tank Capacity(working)
1200 gal Number 3
Receiving Soil Type(1-6)
4 Separation 0.5 ft
Receiving Soil Appl.Rate 0.6 gpd/ft2 Orifices
Required Primary Area
400 ft2 Total Number of Orifices OSCAR
Designed Primary Area
400 ft2 Diameter OSCAR in
Designed Reserve Area
400 ft2 Spacing OSCAR in
Trench/Bed Width 15 ft I Manifold
Trench/Bed Length
27 ft Schedule/Class 40
Elevation Measurements
Length 22 ft
Original Drainfield Area Slope
0 % Diameter 1 in
New Slope,If Altered 0 % Preferred manifold configuration used? ISYYes 0 No
Depth of Excavation Up-slopc 0 in Transport Pipe
from Original Grade Down-slope 0 in Schedule/Class 40
Designed Vertical Separation
18 in / Length 25 ft
Gravel-based Drainfield Required? 0 Yes 121 No
Diameter 1 in
Pump Required? dYes 0 No Dosing and Pump Chamber
Pump/Siphon Specifications
Number of doses/day 360
Diff. in Elevation Between Pump&Uppermost Orifice 6.7 ft Dose quantity
0.67 gal
Drainfield Squirt Height/Selected Residual(head)
OSCAR ft Chamber Capacity(flood) 1200 gal
Pump controls: Please check those required.
Uppermost Orifice dHigher 0 Lower than Pump Shutoff
Capacity @ Total Pressure Head 12 gpm I5( Timer Isi Elapse Meter .0 Event Counter
Calculated Total Pressure Head 14.454 ft If Timer: Pump on
30SEC Pump off 3MIN
Comments APPROVED
DEC 31 2025
tN�I
MASON COUNT( RONMEIISA4.RAIN
Revised:4/14/2025
RET
DESIGN FORM—PAGE TWO Assessor's Parcel Number: 321275300179 -- --
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
Test hole locations a Drainfield orientation and layout Reference depth from original grade:
Ea Soil logs ' Trench/bed dimensions and @( Septic tank
ES Property lines
critical distances within layout ®' Drainfield cover
121 D-Boxalve box locations Reference depth from original grade
within 100 ft of property El /V
Existingand proposed wells Septic tank/pump chamber and restrictive strata:
a Measurements to cuts, banks,and locations ®' Laterals,trench/bed,top and
surface water and critical areas 0' Observation port location bottom
� drain collector
0' Location and orientation of 0 Clean-out location a Sand Curtaina drain collector
curtain drain and all absorption Manifold placement
on
components a Orifice placement Other cross-section detail:
ES Location and dimension of g Lateral placement with distance
ES Observation ports/clean-outs
primary system and reserve area to edge of bed Other Information
0 Buildings ES Audible/visual alarm referenced Yes No
0 Direction of slope indicator Ei Scale of drawing shown on scale 121 0 Design staked out
0 0 Recorded Notices attached
� Waterlines bar 0 0 Waiver(s)attached
El Roads, easements,driveways, 0 Elevation benchmark and relative 0 Pump curve attachedhed
parking elevations of system components 0 ❑ Evaluation of failure
IINorth arrow and scale drawing Non-residential justification
shown on scale bar
❑ 0 Waste strength
❑ ❑ Flow
DESIGN APPROVAL
The undersigned designer st be not by installer at time of installation 0 Yes 0 No
'f 7/5/25
Si . ,, re of Designer Date
The undersigned has reviewed this .ign on behalf of Mason County Public Health and determined it to be in
compliance with state and local on e regulations:
IZI3tI2�
taI Health S eciali t Date
Environmen P
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
✓ The design is stamped"Approved"by Mason County Public Health. Q / �2�
/ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: Z.JJ b
✓ 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
W.
PAGE I
I
MASON COUNTY HEALTH DEPARTMENT
ON-SITE SEWAGE DISPOSAL SYSTEM DESIGN
PARCEL#:321275300179
SITE#:
LEGAULOT#:LAKE LIMERICK
DATE SUBMITTED:7/5/2025 D4 TRACT 179
SUBMITTED BY: ADAM HUNTER
APPLICANT: THOMAS WOLTER
ADDRESS: PO BOX 76
ALLYN,WA 98524
I.CALCULATIONS
NUMBER OF BEDROOMS= 2
RESIDENTIAL GPD FLOW= 240
IF NON-RESIDENTIAL-GPD FLOW
WILL BE AS FOLLOWS:
GPD=
APPLICATION RATE= 0.6 GPD/FT2
REDUCTION=LEAVE BLANK IF NO REDUCTION TAKEN
DRAINFIELD SIZING
0 FT2
ABSORPTION AREA= 40 40 '
TRENCH LENGTH OR BED CONFIG.= PER2 OSCAR 015 15
II.WATERPROOF SEPTIC TANK
COMPOSITION AND SIZE= 1200GAL-X02 TANKNEW
NEW OR EXISTING=
III.DRAINFIELD CROSS SECTION
0'-6"
SAND DEPTH=
IV.PRESSURE CALCULATIONS USING PIPE CLASS 40
ORIFICE NETAFIM DRIPLINE
LENGTH DIAMETER FLOW FRICTION LOSS
SECTION (FT) (IN) (GPM) (FT)
SUPPLY
50.00 1.00 12.000 3.8772
RETURN
50.00 1.00 12.000 3.8772
TOTAL= 7.7543
""TOTAL HEAD LOSS "
1)FRICTION LOSS THROUGH SYSTEM=
7.754
2)ELEVATION DIFFERENCE = 6.700
TOTAL= 14.454
../._ 0.
.,V,_Op25 APPROVED
:le/1
-./•?�+, DEC 31 2025
,..,,,,::...A.,,,...„I MASON COUNTY ENVIRONMENTAL HEALTH
*Z ` "`'��' RET
-T.. ADAM J HUNTER •
,,
of '1:I'iigfiliFS"i:�7�'�:'" I.
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' . PAGE 2
V.CHECK THE PUMP CAPACITY.
PUMP: A.Y.MCDONALD 30GPM-1/2HP PUMP(MODEL#22050E2AJ) (PER OSCAR)
EXCESS TDH 50.00 (PER OSCAR)
TOTAL HEAD LOSS IN SYSTEM 14.45
STANDARD PUMP CONFIGURATION IS SUFFICIENT? YES
0• .12/30/25
!<-,'''.- 0 :,' Il it
0'.` . If
��`
APPROVED
'.�'.' AWg NHUNTER . Tt DEC 31 2025
.. �S.l'�6 A
MASON COUNTY ENVIRONMENTAL HEALTH
RET
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