HomeMy WebLinkAboutSWG2025-00417 - SWG Application / Design - 10/17/2025 MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584
J` 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: SWG2025-00417 CbU l\f) ‘(
APPLICANT Ben Phillips Phone: 360-951-1393
Address: 2311 E St Andrews Dr N SHELTON, WA 98584
SEPTIC DESIGNER JIM HUNTER* Phone: 360-753-1226
Address: PO BOX 162 OLYMPIA, WA 98507
Site Address: UNKNOWN
Primary Parcel Number: 321225000187
Permit Description: New 2bd Glendon M31
Permit Submitted Date: 10/17/2025
Permit Issued Date: 01/29/2026
Issued By: Rhonda Thompson
Current Permit Fees Paid: $725.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 11/12/2028 (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
ea, MASON COUNTY DATE RECEIVED: 1 // 7/2 5 C ,:.
N AMOUNT R IVED: RECEIVED BY: co w
s Public Health & Human Services , i 5 DQop OFF 4/.0Q o y
Environmental Health 360-427-9670,ext.400 or 360-275-4467,ext.400
415 N.6th Street-Shelton,WA 98584 S W G /Q - 0014O O 2
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CLEAR FORM ON-SITE SEWAGE SYSTEM APPLICATION
n
APPLICANT r -=------t=_
HONE m m
BEN PHILLIPS �] -1393 z
MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE u"f2311E ST ANDREWS DR N � HELTON WA 98584 mSITE ADDRESS-STREET,CITY,ZIP CODE2311 E ST ANDREWS DR IJ HELTON WA 98584
NAME OF DESIGNER HONE
JIM HUNTER 119� G.����� 360753-1226NAME OF INSTALLER ' HONE v I
` I PERMIT TYPE(select one) c ILJ DRINKING WATER SOURCE - VNJ
E.
RESIDENTIAL OSS COMMUNITY OSS COMMERCIAL OSS E"PRIVATE INDIVIDUAL WELL E PRIVATE TWO-PARTY WELL z
C E I ,
TYPE OF WORK(select one) I] PUBLIC WATER SYSTEMC'J'
E-NEW CONSTRUCTION/UPGRADES EREPAIR/REPLACEMENT OTHER DETAILS(select all that apply) 0 TABLE X REPAIR I I
SUBMITTALS 0 SURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINE CO `
DESIGN FORM(REQUIRED) INJ SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SI WAS LOT CREATED AFTER 4/1/2025? r I
O I
6WAIVER(S)(IF APPLICABLE) � 6,x O YES ❑J NO z
DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.locked gate) C . a,( .-C G
MASON LAKE RD, LEFT ON E ST ANDREWS DR N TO SITE ON RIGHT JUST PASTI
I
ADDRESS 2391. o
J
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 ❑MAINTENANCE/PUMPING ❑BUILDING PERMIT ❑HOME SALE ['COMPLAINT ❑OTHER:
INSPECTOR SOIL LOGS COMMENTS/CONDITIONS
1Wi '. b ., $b 4s L (ao 1---t-; 11
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
W1 t1 I\.7A1K << 17,171e'17,171e' ‘(Zit-i\kwyco/1 (1744
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THIS FORM MAYE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE Revised:4/14/2025
0
DESIGN FORM—PAGE ONE Assessor's Parcel Number: 32122-50-00187- -- ,S
A design will be reviewed when 3 copies of each of the following are submitted: Q
N.
" 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: 1I"X 17"
PARCEL IDENTIFICATION
Permit Number: SWG C),I0 1i 0L (-1 Designer's Name: ADAM HUNTER
Applicant's Name: BEN PHILLIPS Designer's Phone Number: 3607531226
Mailing Address: 2311 E ST ANDREWS DR N Designer's Address: PO BOX 162
SHELTON WA 98584 City State Zip OLYMPIA WA 98507
City State Zip Designer's Email JHANDASSOCIATES@HOTMAIL.COM
DESIGN PARAMETERS
Treatment Device
It Glendon 0 Sand Filter 0 Mound 0 Sand Lined Drainfield 0 Recirculating Filter 4TU ❑Other
Treatment Level (check all that apply): J A �J B J C J BL1 J BL2 J BL3 J E J N
Drainfield Type
0 Gravity Ef Pressure 0 Trench 0 Bed 0 Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 2 Schedule/Class <SLk4- 4p
Daily Flow:Operating Capacity 1, (S 0 gpd Length 14 A. ft
Daily Flow:Design Flow 'Z.Lk 0 gpd Diameter N\,1j,., in
Septic Tank Capacity(working) 1200 gal Number 1.t, L,.
Receiving Soil Type(1-6) Lk Separation K I.A ft
Receiving Soil Appl.Rate 0. (,Q gpd/ft2 Orifices
Required Primary Area Opp ft2 Total Number of Orifices fs ( A
Designed Primary Area 4-O 0 ft2 Diameter ).� b. in
Designed Reserve Area 400 ft2 Spacing )y ia in
Trench/Bed Width SEE GLENDON ft Manifold
Trench/Bed Length SEE GLENDON ft Schedule/Class N. (A
Elevation Measurements Length >`L C 1k ft
Original Drainfield Area Slope (rL % Diameter ,A in
New Slope,If Altered 1-4. LL % Preferred manifold configuration used? D'Yes O No
Depth of Excavation Up-slope SEE GLENDON in Transport Pipe
from Original Grade Down-slope SEE GLENDON in Schedule/Class 40
Designed Vertical Separation in Length 15 ft
Gravel-based Drainfield Required? 0 Yes P1 No Diameter 1 in
Pump Required? 'Yes 0 No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day t 44
Diff. in Elevation Between Pump&Uppermost OrificeRl/' ft Dose quantity l ,:1—S gal
Drainfield Squirt Height/Selected Residual(head) tJ, ( p, ft Chamber Capacity(flood) 1 -O O gal
Uppermost Orifice 0 Higher 0 Lower than Pump Shutoff Pump controls: Please check those required.
Capacity @ Total Pressure Head I'LL A gpm 63/ Timer D'Elapse Meter Event Counter
Calculated Total Pressure Head 1 - (I% ft A ��,JJ �`//PPR- aty E b C I ,Pump off 1oCa. ,--1
Comments RR
JAN 292026
MASON COUNTY ENVIRONMENTAL HEALTH
RET Revised: 4/14/2025
DESIGN DORM—PAGE TWO Assessor's Parcel Number: 32122-50-00187--
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
Ii Test hole locations O' Drainfield orientation and layout Reference depth from original grade:
O Soil logs 9' Trench/bed dimensions and 9' Septic tank
O Property lines critical distances within layout O' Drainfield cover
9' Existing and proposed wells 9' D-Box/Valve box locations Reference depth from original grade
within 100 ft of property 9' Septic tank/pump chamber and restrictive strata:
O' Measurements to cuts, banks,and locations Laterals,trench bed,top and
surface water and critical areas l' Observation port location bottom
O Location and orientation of Er Clean-out location 9' Curtain drain collector
curtain drain and all absorption 9' Manifold placement El' Sand augmentation
components l' Orifice placement Other cross-section detail:
0 Location and dimension of E' Lateral placement with distance 9' Observation ports/clean-outs
primary system and reserve area
to edge of bed Other Information
9' Buildings
g Audible/visual alarm referenced Yes No
0 Direction of slope indicator ❑' Scale of drawing shown on scale I2' 0 Design staked out
0 Waterlines bar 0 0 Recorded Notices attached
0 Roads,easements,driveways, E Elevation benchmark and relative 0 0 Waiver(s) attached
parking elevations of system components l' 0 Pump curve attached
0 North arrow and scale drawing 0 0 Evaluation of failure
shown on scale bar Non-residential justification
❑ ❑ Waste strength
❑ ❑ Flow
DESIGN APPROVAL
The undersigned designer must be notified inst t' stallation Er Yes E t No
Signature o esigner Date
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:
c— f 17_4,
Environmental Health Sp cialist Date
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
✓ The design is stamped"Approved"by Mason County Public Health. I. i'24-776
✓ 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
PAGE 1
( •
MASON COUNTY HEALTH DEPARTMENT
ON-SITE SEWAGE DISPOSAL SYSTEM DESIGN
SITE#: PARCEL#: 32122-50-00187
DATE SUBMITTED:1/21/2026 LEGAL/LOT#: LAKE LIMERICK
BLK 3 LOT 187
SUBMITTED BY: JIM HUNTER
APPLICANT: BEN PHILLIPS
ADDRESS: 2311 E ST ANDREWS DR N
SHELTON,WA 98584
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
ABSORPTION AREA= 400 FT2
TRENCH LENGTH OR BED CONFIG.= PER GLENDON
II.WATERPROOF SEPTIC TANK
COMPOSITION AND SIZE= 1200 GAL.CONCRETE
NEW OR EXISTING NEW
III.DRAINFIELD CROSS SECTION
DEPTH TO DRAINROCK BOTTOM= N/A
ROCK DEPTH BELOW PIPE= N/A
SEPARATION FROM TRENCH BOTTOM TO IMPERMEABLE -
MATERIAL/SEASONAL SATURATION= N/A
FILL DEPTH= N/A
TRENCH WIDTH= N/A
APPROVED
JAN 292026
D `, MASON COUNTY ENVIRONMENTAL H
JAN 21 2026 T
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NO SLALE
A FEE WILL BE CHARGED AFTER INSTALLATION FOR FINAL INSPECTION &RECORD DRAWING
-` S‹- 'V,O )., .,4 T �- MASON LAKE RD, LEFT ON E ST ANDREWS DR N TO JIM HUNTER AND ASSOCIATES
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- ACCEuRIs RS ,a TM SITE ON RIGHT JUST PAST ADDRESS 2391. P.O.BOX 162,OLY,WA 98507 753-1226 IHANDASS0CIATES@H0TMAILC0M
SERVICE FINISH GRACE _�� DESIGNER-JIM HUNTER
• FROM SEPTIC TANK TO ._.ELC
U ' •si�a SEPTIC SYSTEM DESIGN FOR-
Ea D R�• -' R.ciATIHGM,T wG� ,ER . ,1 EMERGENCY�RAGE � �, BEN PHILLIPS
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2311 E ST ANDREWS DRIVE N
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LAKE LIMERICK BLK 3 LOT 187 OF
SEPTIC TANK(TYPICAL) PUMP CHAMBER(TYPICAL)
TN 32122-50-00187 SITE