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HomeMy WebLinkAboutSWG2026-00006 - SWG Application / Design - 1/7/2026 M MASON COUNTY 415 N 6TH STREET,SHELTON, ,WA 98584 SHELTON:360-427-9670,EXT 400 4 BELFAIR:360-275-4467,EXT 400 L.....----- � Public Health & Human Services ELMA:360-482-5269,EXT 400 FAX:360-427-7787 On-Site Sewage System Permit: SWG2026-00006 APPLICANT TATE ADAM R Phone: Address: 380 E BUCKTAIL VIEW BELFAIR,WA 98528 OWNER TATE ADAM R Phone: Address: 380 E BUCKTAIL VIEW BELFAIR,WA 98528 SEPTIC DESIGNER CINDY WAITE* Phone: 360-701-0205 Address: 80 E PICKERING LANE SHELTON,WA 98584 Site Address: 600 E Olympic View St Primary Parcel Number: 222125309001 Permit Description: New SFR 5-bedroom gravity system with Class B Waiver to reduce vertical separation Permit Submitted Date: 01/07/2026 Permit Issued Date: 02/13/2026 Issued By: David Anderson Current Permit Fees Paid: $845.00 (additional fees may be required upon installation of system). Permit Expiration Date: 01/13/2029 (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/environmental/onsite/oss-inspection-request.php or call: 360-427-9670, extension 400. OFFICIAL USE ONLY ` V MASON COUNTY O U N TH/ DATE RECEIVED: o I fo- '�0a� CYAMOUNTR VED: RECEIVED BY: Cn `.f-- l•I Public Health & Human Services �y� -t,RcpcFF „�v Environmental Health 360-427-9670,ext.400 or 360-275-4467,ext.400 G N 415 N.6th Street-Shelton,WA 98584 S W G a p t ce - c)c 0 O x apace V /V Z Co ON-SITE SEWAGE SYSTEM APPLICATION m n APPLICANT PHONE 171 ADAM TATE 360-517-3383 z c MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE �� ) JJJ E 380 E BUCKTAIL VIEW BELFAIR WA 98528 cm o SITE ADDRESS-STREET,CITY,ZIP CODE �� O FI 600 E OLYMPIC VIEW ST CZZ2:7 (NI BELFAIR WA 98528 I r\-) . NAME OF DESIGNER •---.. ® PHONE N CINDY WAITE 360-701-0205 NAME OF INSTALLER 7 PHONE v I IV TBD cz-. c-� R I � PERMIT TYPE(select one) W DRINKING WATER SOURCE I RESIDENTIAL OSS b]COMMUNITY OSS IFil COMMERCIAL OSS ff PRIVATE INDIVIDUAL WELL f PRIVATE TWO-PARTY WELL Z I N 2l PUBLIC WATER SYSTEM LAKEWOOD COMMUNITY WS TYPE OF WORK(select one) ' I NEW CONSTRUCTION/UPGRADES L_I,REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) ❑ TABLE X-REPAIR --_ I C,1 SUBMITTALS 0 SURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINE, al DESIGN FORM(REQUIRED) In!]SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE WAS LOT CREATED AFTER 4/1/2025? Q I CO t7�i Z-23 WAIVER(S)(IF APPLICABLE) 5 O YES Q NO X I I O DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.locked gate) GO OUT HIGHWAY 106, TURN RIGHT ONTO CEDAR ST, TURN RIGHT ONTO OLMPIC I o VIEW ST, GO AROUNT 90 DEGREE LEFT TURN, PARCEL IS ON THE LEFT SIDE OF THE STREET. SOIL LOGS ARE DOWN THE HILL. �- o 0 Ic) • 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 COMMENTS/CONDITIONS Ili: a- 246i3 I ' h L a (Tyl 9) (ecf V- zajAt' '4 kw?fl k,- WI Zdz6 '-0000 Z loll 0- 30" C7c.FS Poo- )0% wI moil. b.akm 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. INSPE R SIGNATURE, DATE APPLICATION EXPIRATION DATE APPLICA N APPROVED/ISSUED BY DATE Ii3jio . I ( l3( THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE Revised:4/14/2025 i (7 • I. DESIGN FORM—PAGE ONE Assessor's Parcel Number: 2 2 2 1 2 5 3 0 9 0 0 1 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 z p � Designer's Name: CINDY WAITE Applicant's Name: ADAM TATE ©O4d6 Designer's Phone Number: 360-701-0205 Mailing Address: 380 E BUCKTAIL VIEW ST Designer's Address: 80 E PICKERING LANE BELFAIR WA 98528 City State Zip SHELTON WA 98584 City State Zip Designer's Email cindyewaite@msn.com DESIGN PARAMETERS Treatment Device ❑ Glendon O Sand Filter O Mound O Sand Lined Drainfield O Recirculating Filter O ATU O Other Treatment Level(check all that apply): O A O B O C O BL1 O BL2 O BL3 irE O N i/ Drainfield Type i Gravity O Pressure O Trench I�ed O Sub Surface Drip Septic Tank/Drainfield SpecificationsLZA / aterals Number of Bedrooms 5 Schedule/ llss� ASTM2729 .- Daily Flow: Operating Capacity 450 J gpd Length 67 ft Daily Flow: Design Flow 600 V gpd Diamet �'7 o•••. 4 - in Septic Tank Capacity(working) 1800 gal Num t 5 1 Receiving Soil Type(1-6) 4 l Sep 9 ft Receiving Soil Appl.Rate .6 , gpd/ft2 Q Orifices Required Primary Area 1000 / ft2 Total Number ifte ASTM 2729 PERF Designed Primary Area 1005 r ft2 Diameter in Designed Reserve Area 1000 ' ft2 Spacing in - Trench/Bed Width 3 ft Manifold Trench/Bed Length 335 , ft Schedule/Class Elevation Measurements Length ft Original Drainfield Area Slope 9 % Diameter in New Slope, If Altered % Preferred manifold configuration used? O Yes i 'No Depth of Excavation Up-slope 12 in Transport Pipe from Original Grade Down-slope 8 in Sched / 3034 i Designed Vertical Separation 18 . in Len 230 ft Gravel-based Drainfield Required? I 'Yes O No D: tg s 0i5, 4 in y Pump Required? O Yes I�No ,w �f '_ ' -., 'sinwand Pump Chamber Pump/Siphon Specifications umber do s i) l. _, �? 100 18' Diff. in Elevation Between Pump&Uppermost Orifice ! `�... ` gal LICEN D DE IGNER. Drainfield Squirt Height/Selected Residual(head) gal Uppermost Orifice O Higher O Lower than Pump Shutoff Pumptcontrols: Please check those required. Capacity @ Total Pressure Head gpm O Timer O Elapse Meter O Event Counter Calculated Total Pressure Head . Q 1 ft . If Timer: Pump on ,Pump off Comments y Revised: 6/11/2025 DESIGN FORM—PAGE TWO Assessor's Parcel Number: 2 12 + 21 1 121 51 31 0 19 1 01 01 11 Permit Number: SWG DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch ier Test hole locations V Drainfield orientation and layout y Reference depth from original grade: ce Soil logs V Trench/bed dimensions and Septic tank 1' Property lines critical distances within layout Drainfield cover Ctilvkxisting and proposed wells Elf D-Box/Valve box locations within 100 ft of roe Reference depth from original grade property rty Q� Septic tank/pump chamber and restrictive strata: • °'Measurements to cuts, banks,and locations P /a1 ,,•r surface water and critical areas Laterals,trench/bed,top and G� Observation port location bottom 1h(4'cation and orientation of V Clean-out location ❑ Curtain drain collector curtain drain and all absorption ii Manifold placement O Sand augmentation components Irk Location and dimension of o V Orifice placement "Z2q' PoV Other cross-section detail: primary system and reserve area tlf Lateral placement with distance fe Observation ports/clean-outs to edge of bed V Buildings Other Information � udible/visual alarm referenced Yes No V Direction of slope indicator Ur Scale of drawing shown on scale lie O Design staked out Of Waterlines bar O O Recorded Notices attached V Roads, easements, driveways, V Elevation benchmark and relative it O Waiver(s)attached parking elevations of system components O O Pump curve attached ilf North arrow and scale drawing O O Evaluation of failure shown on scale bar Non-residential justification ❑ O Waste strength ❑ ❑ Flow D;ESIGN;APPROVA.: The undersigned designer must be noti ,d by ins Her at time of installation t2l'Yes 0 No ` Cal, I l ?g Z62� Signature If Designer pate 41440 The undersigned has reviewed this design on behalf of Mason County Public Health and determined it t.f ee n compliance with state and local on-sit re_ulations: a/157zo 76 yqf, coo vs. iii)Envi onmental Health Specialist Date 40,/01? $<D < D CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:'414 ✓ The design is stamped"Approved"by Mason County Public Health. ✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: / ///7O,/Z y�� C� ✓ Drainfield site conditions have not been altered to adversely affect conditions of design approval. Please Note: The system must be installed by a certified installer, unless prior authorization is obtained from Mason County Public He lth. An Installation Fee is required. This form may be scanned and available for public view on the Mason County Web site. Revised:6/11/2025 • AC a e 57 • 1 IPROPOSEDD RESIDENCE 3 2 PROPOSED WORK SHOP' 3 1800 GALLON SEPTIC TANK 4 CLEAN OUT 1 03 5 TWO WAY CLEANOUT 6 TRANSPORT LINE 7 DBOX I I 8 I PRIMARY/RESERVE DRAINFIELD 9 {ATTENUATION ZONE 10 WATERL LINE SL C) -3/ �LFr 1711-(6 f 5SL 2. G -•3U " 6.L571 -Hew "Octitiif4 41- i/ V f k � 6 P&,042. -h It" FEB i ." S{+no l k,e ya/Ai( r Ail() !-9O- 3 2026 MASON UN 1 ( !e 1-e.e/ So'ENVIRONMENT 'vNEAt'.4y S�� e,u �r • DJAcve- �- b 13e� A � III, a. _ • l�JryDY E WAITE'. sY' LICEN D DESIGNER r 4 ExPIKt_5_d,,,0, f�P�ZZ;d86z SL it Z p —37 1/t LG 161.5 so, I /00, 1 (BENCH MAR _ 1 3 V 'FOUND 1 100.00 SEPTIC'TANK 2 !99.00 ID BOX 1 3 ,55X00 LATERALS 4 ,54000 C fS 2 ciit,e,4, 2- °44 •1 d. Y„a e14j, „�•�4�� R• eT 70 O bstea.a e 41 Pe t/j" +-4 0 ---ems' •�� �� D e s a f 1 ; Icpz.� /Memel a Zags Za G ' 2d/ i Bpi • • i. A e• l� • FEB 13 2026 ' �„ ,f;"' MASON.COUNTY ENVIRONMENTAL HEALTH 11 6k rV'L�DJAIrc� � ��= Ee. ?�. UCEN$ED DESI �R Ii r; `� M _j LXPIKES ISi1Ol 1 • CSr Des P®d '' ,ti 12 1. O tp, _. er Iva TC Ise �' (' u I lurivg'1 APPRiim • FEB 1 3 2026 MASON COUNTY ENVIRONMENTAL HEALTH e DJA 6��� (14, . 12 O? LICENSED DESIGNER 1—Access Riau To Grades • I Inlet wwh 45®Facing Down .- —- -- - - � Speed Lave or equal)recgreci Leveling Distribution Box(No Scale) P ROVE D �� 2� y " I8, Ya 'P „ay. `v �1 51 FEB 1 3 2026 v E AIT -., LICEN.k D E I�jTKR MASON COUNTY ENVIRONMENTAL HEALTH DJA q��► -Tatik LW s -. c >uclet 1_ �a — >is,LFCC -' Liquid Level from _ ..,..7-Hou ri.t,,,,. >s� f �unr� Lair 1 Inlet Tee �� Tee z Millet �1�Pte! 2nd with 1/-At-, 1st Compartment r Compartment :!. S."I Wi i . 1.0 ) 6 t -4/1C-4(1.4-- PR ',,rye_ . FEB 13 2026 MASON COUNTYENVIRON DJA MENTAL HEALTH 1 0: . • • .. t, 8: .'1 , ',, 482 ..Q� CI A17E' '.•. LICE DESIGN R • EXPIRES I ' . Installation Notes GRAVITY OSS 600 E Olympic View St 22212-53-09001 1. The prepared site plan is not a survey. It's the owner's responsibility to verify property lines, utility lines(water, sewer, power, phone and gas) prior to installation. 2. Concrete tank required 3. Gravel base drainfield required 4. Two two way ts to be installed in transport line due to the length of the transport line. 5. Ten feet prior to transport line entering fine needs to be level to slow down entry into the D-Box 6. Keep wheeled vehicles off the drainfield area before, during and after installation. Tracked equipment only, 7. All ground, surface water and roof drains must be diverted away from the septic tanks and drainfield. Ensure the final grade slopes away from these areas and water doesn't collect on or around them. Use swales, berms, catch basin and tight lines, curtain drains, etc. to divert all waters. 8. Curtain drains can be no closer than 10' upgradient and 30' down gradient of the drainfield 9. Exposed restrictive layers, cuts, banks, etc. can be no closer than 50' downhill from the drainfield. 10. Install access deers on the septic tank,D-Box and both ends Wine laterals. 11. Make sure septic tank risers are epoxied or caulked to cast in riser rings on tank. 12. Lids must form a water and gas tight seal with the access risers 13. Install effluent filter specified in this design at the septic tank outlet. 14. This system must be installed by a Mason County Certified installer. 15. Deviation from this design without prior approval from the designer and Mason County Health Department will make this design null and void. 16. 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 minimum design flow per bedroom per day is the operating capacity of ninety gallons multiplied by 1.33. This results in a minimum design flow of one hundred twenty gallons per day. This creates a surge factor of 33% but anticipated flow is ninety gallons per bedroom per day. ' 17. Install laterals with contour of the ground 18. Install trench bottoms level and always maintain a minimum of six inches into native soil 19. Install locator tape on top of all drainfield laterals. 20. Install threaded clean outs at the ends of all laterals (caps must extend to within six inches of finish grade and be in a valve box as shown on diagram. p,,f1 21. Install audio/visual alarm 22. Filter fabric required over drain rock prior to backfilling. If the �On'r;t=k.extends above the original grade, run the filter fabric at least 2.inches down th :S..nch ^ y. +ss ,- 1 ,," :1z. . LICE . DESK . or..,, \`\�'►�\\���S X1.10 \`a.\ '� Exc'I' , i.1') System Owner Responsibilities: 1. Operation and Maintenance is required by Washington State Department of Health and Mason County Health Department. 2. The septic tank and 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. System owner agrees to read and abide by information regarding their system in the User Manual provided by Mason County Public Health. 7. Keep the flow of sewage at or below the approved design operating capacity. 8. Keep waste strength at residential waste strength parameters. 9. Spread loads of laundry through the week. 10. Do not use excessive bleach or detergents with added whiteners. 11. Do not shower, do laundry and dishwasher at the same time 12.Antibiotics can kill or impair the biological process in the septic tank. 13. Leaky plumbing can hydraulic overload your on-site septic system. FcA ,S • a (FiNY 'AI.T .. • LIC NS_ OESI