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HomeMy WebLinkAboutSWG2026-00058 - SWG Application / Design - 3/3/2026 MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584 SHELTON:360-427-9670,EXT 400 • BELFAIR:360-275-4467,EXT 400 - I/ Public Health & Human Services ELMA:360-482-5269,EXT 400 FAX:360-427-7787 On-Site Sewage System Permit: SWG2026-00058 APPLICANT DICKINSON CAROLINE J Phone: Address: PO BOX 265 BELFAIR, WA 98528 OWNER DICKINSON CAROLINE J Phone: Address: PO BOX 265 BELFAIR, WA 98528 SEPTIC DESIGNER CINDY WAITE* Phone: 360-701-0205 Address: 80 E PICKERING LANE SHELTON, WA 98584 SEPTIC INSTALLER TAYLOR TONEY* Phone: 360-489-9169 Address: 2971 E PHILLIPS LAKE RD SHELTON, WA 98584 Site Address: 810 E State Route 302 Primary Parcel Number: 122084190031 Permit Description: Repair 2-bedroom SFR gravity trench drainfield with designated reserve drainfield Permit Submitted Date: 03/03/2026 Permit Issued Date: 03/09/2026 Issued By: David Anderson Current Permit Fees Paid: $845.00 (additional fees may be required upon installation of system). Permit Expiration Date: 03/06/2027 (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. 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. IM " MASON COUNTY 415 N 6TH STREET,SHELTON, ,E 98584 SHELTON:360 427 9670,EXT 400 , BELFAIR:360-275-4467,EXT 400 `f ./ 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. g OFFICIAL USE ONLY_TiDATE RECEIVED: AMASON COUNTY ( / /a 0� T� AMOUNT RECEIV RECEIVED BY: 03 (n _,1-4---.-- _ Public Health & Human Services ��� Doze ®FF �v m _ Environmental Health 360-427-9670,ext.400 or 360-275-4467,ext.400 �y ;y 415 N.6th Street-Shelton,WA 98584 S W (i�,� \( _ - ©r1/ X O �L��� tJ V�J U Z 6 ON-SITE SEWAGE SYSTEM APPLICATION > m C) APPLICANT PHONE m BRIAN COLEMAN C/0 B-LINE CONS 360-229-0857 z MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE f E 810 E STATE ROUTE 302 t�4\ .\%, BELFAIR WA 98528 CO Xi SITE AD ESS-STREET,CITY,ZIP CODE \.\� ,,) •• 810 STATE ROUTE 302 �,�� \� ti�`�`o \ BELFAIR WA 98528 I NAME OF DESIGNER ® zi i� PHONE :�. I N DY WAITE s 4P2` , , �� 360-701-0205 N NAME;OF INSTALLER i$$N\`y PHONE IV iB-LINE• CONSTRUCTION \,l 360-426-4221 _ o PERMI T \.{.6),;,/YPE(select one); DRINKING WATER SOURCE - .. RESIDNT.IAL'OSS I i.iCOMMUNITY OSS li IICO/MMERCIAL OSS 5.;PRIVATE INDIVIDUAL WELL R.PRIVATE TWO-PARTY WELL Z TY00 PE OF'WORK(select one) PUBLIC WATER SYSTEM i • INEW CONSTRUCTION/UPGRADES ;REPAIR/REPLACEMENT OTHER DETAILS(select ell that apply) 0 TABLE X REPAIR -p SUBMITTALS -• 0 SURFACING SEWAGE Ii EXISTING FAILURE 0 SHORELINE W 1r!.DESIGN FORM(REQUIRED) 1N11 SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE WAS LOT CREATED AFTER 4/1/2025? r ' NAIVER(S)(IF APPLICABLE) 2 3.72AC o YES 0 NO 0 DIRECTIONS TO SITEAND SITE CONDITIONS:(ex locked gate) GO TOWARDS BELFAIR, TURN RIGHT ONTO STATE ROUTE 302, ADDRESS IS ON I o THE RIGHT SIDE OF THE ROAD, GO DOWN DRIVEWAY, SOIL LOGS ARE ON THE r BACKSIDE OF THE RESIDENCE o 0 Iw 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) ❑VOLUNTARY 0 MAINTENANCE/PUMPING ❑BUILDING PERMIT ❑HOME SALE ❑COMPLAINT ❑OTHER: INSPECTOR SOIL LOGS COMMENTS/CONDITIONS . rt+- 1 o- LI1= yfe3) �. LIB-- vCi V 4( CTy. ;l ��1 ,� • Ttit%0, 2« O j •5,.. 0- ?3` voftt to 6.o4ft . v. RECORD DRAWING AND INSTALLATION REPORT SOIL CODES: o V=VERY G=GRAVELLY S=SAND L=LOAM 'Si=SILT C=CLAY E=EXTREMELY R=ROOTS REQUIRED FOR'FINALAPPROVAL. INSPECTOR SIGNATURE. DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED/ISSUED BY . DATE 3�6 ' Z" . 11--- . N z( - r . THIS FORM,MAY BE CAN ED AND AVAILABLE FOR PUBLIC VIEW'ON THE MASON COUNTY WEBSITE Revised:4/14/2025., DESIGN FORM—PAGE ONE Assessor's Parcel Number: 1 2 2 0 8 4 1 9I0 0 0 3 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. '1 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: II"X 17" PARCEL IDENTIFICATION //}}Permit Number: SWG Z l/ZG"O0V1�qq 5q Designer's Name: CINDY WAITE Applicant's Name: BRIAN COLEMAN Designer's Phone Number: 360-701-0205 Mailing Address: 810 E STATE ROUTE 302 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 O Glendon O Sand Filter O Mound O Sand Lined Drainfield O Recirculating Filter O ATU O Other Treatment Level(check all that apply): ❑ A ❑ B ❑C O BL I O BL2 O BL3 ❑ E O N 0 grainfield Type Gravity O Pressure lai Trench ' Bed O Sub Surface Drip Septic Tank/Drainfield Specifications Laterals Number of Bedrooms 2 / Schedule/Class ASTM 2729 Daily Flow: Operating Capacity 180 / gpd Length 35 ft Daily Flow: Design Flow fi7\9 at gpd Diameter 4 ' in Septic Tank Capacity(working) EXISTING 1000 gal Number 3 Receiving Soil Type(1-6) 3 r Separation 9 . ft Receiving Soil Appl.Rate .8 ' gpd/ft2 Orifices Required Primary Area 300 — ft2 Total Number of Orifices ASTM 2729 PERF Designed Primary Area 315 - ft2 Diameter in Designed Reserve Area 300 - ft2 Spacing in Trench/Bed Width 3 ,, ft Manifold Trench/Bed Length 35 ft Schedule/Class , Elevation Measurements Length ft Original Drainfield Area Slope <1 % Diameter in New Slope,If Altered % Preferred manifold configuration used? O Yes C'No Depth of Excavation Up-slope 36 in Transport Pipe from Original Grade Down-slope 36 in Schedule/Class ASTM 3034 Designed Vertical Separation 36 in Length 20 . ft Gravel-based Drainfield Required? IYI Yes ❑No Diameter 4 _ in Pump Required? O Yes Ii6No Dosing and Pump Chamber Pump/Siphon Specifications Number of doses/day Diff. in Elevation Between Pump&Uppermost Orifice ft Dose quantity gal Drainfield Squirt Height/Selected Residual(head) ft Chamber Capacity(flood) gal Uppermost Orifice O Higher O Lower than Pump Shutoff Pump controls:Please check those required. Capacity @ Total Pressure Head gpm O Timer O Elapse Meter 0 Event Counter Calculated Total Pressure Head —4156 ft If Timer: Pump on ,Pump off Comments GRAVEL BASE DRAINFIELD REQUIRED, RETRO FIT EXISTING TANK WITH EFFLUENT FILTER AND RISERS Revised: 6/11/2025 ' DESIGN FORM—PAGE TWO Assessor's Parcel Number:1 1 2 i 2 [0 18141 1 919 j 0 13 L 1i Permit Number: SWG DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch ii Test hole locations Wr Drainfield orientation and layout Reference depth from original grade: it Soil logs 21 Trench/bed dimensions and Er Septic tank 1' Property lines critical distances within layout 10 Drainfield cover it Existing and proposed wells it D-Box/Valve box locations Reference depth from original grade within 100 ft of property it Septic tank/pump chamber and restrictive strata: I Measurements to cuts, banks,and locations pl0f rho pf Laterals,trench/bed,top and surface water and critical areas Observation port location bottom , akocation and orientation of iirClean-out location 0 Curtain drain collector curtain drain and all absorption iIL.Manifold placement 0 Sand augmentation components Pk/Orifice placement Other cross-section detail: fif Location and dimension of Q( Observation primary system and reserve area it Lateral placement with distance ports/clean-outs VI Buildings to edge of bed Other Information el& edible/visual alarm referenced Yes No ii Direction of slope indicator lar Scale of drawing shown on scale i 0 Design staked out V Waterlines bar 0 ❑ Recorded Notices attached it ' Roads, easements, driveways, Vr Elevation benchmark and relative 0 0 Waiver(s)attached parking elevations of system components 0 0 Pump curve attached US 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 not' ed by installer at time of installation it Yes 0 No 44.- 2PC•12o2.6 Signature Designer Date 4,44,,The undersigned has reviewed this design on behalf of Mason County Public Health and determined it to b) 4 - compliance with state and local on-site • ulations: OP 4 b 3/ e/, 'OC '4SoNCp ��0,9 Envi o mU4/7),,, ��on mental Hedlth Specialist Date �� �f) CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITIOo���E�T•44y ✓ The design is stamped"Approved"by Mason County Public Health. ��� FglTi, ✓ The Onsite Sewage Permit has not expired,the Permit Expiration,Date is: ,3� 7- ✓ 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. i)i, 1 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 810 WA-302, Belfair, WA 98528, USA, Union-Grapeview To ' ip, Ra Id: 122084190031 r------ }` ?,� 1 I Existing residence \ - -� r.Y \ . . 2 Existing garage m 3 Existing out building ,� �# to 0. ^05 �. 4 Clean out l j .° = 00 c °. jam` . ,�ciL- . �toy„ d 7 5 Existing 1000 gallon septic tank � C'' .� 6 Primary drainfield. ft 9#�2Q76 �; _';2 t 0 � 'fib' 31b15 h p W I. " 7 I Reserve drainfield// �pR ,, ���'����`�� ���sb W ' 8 Existing well u�.i ZI"\\I 1 � 1�1 ;, .<9,... ow J .5)°' - r 9 Waterline 7 �Pg�N co �, T to jj. 10 'Failed drainfield `\ • 11 j Transport line `k }�. , IG . ,Y' i 52?/ ' Vl . iiii Y _ 0 0 d 0 t 1 (*176*.' 'Thl, .., y, O ‘11 \ i '5........„ : 11 —�� F W. — —ya. }=-- s(t'Q. � _ •, qq �' _ o` . I _<ai A Joe E. 1.52// a BENCH MARK --i—GIS Legend Outlet of septic tanl� 1 1:01:630...:0:01 l '` 5-W Inlet of®-box 2 ''WA Mason 10 ft_ Contours _ �i Bottom of drainfiel 3i . I. y -- Scale=' 1 in . 50 ft ;' N I... 1-( 0/CifINSON SHORT PLAT (Iiiii(- + ( -- 2 - 2�s -3 �, Cam- 7, f ' — — 489°2s//b"w 668. ar i;tA a/31tii Kr�i 30 • • ` ioo.Q1 -A` 9o.a -. y77./® / 8 / 1 1 8=32'55'49" R= 227.85' -VI- I. /30.$Z � L %C. c. N ,....34e).Q •s9 4; t'. 0 G VI W °0 % 0 � a O Al 0 0 ° N 4s IV?y'Z4" V `0 Rs �1S.f.1' N in F. M 2' L= 245.31 O a O 0 v it cn ' O 3.72 Ac 1 trl , . 1 fie, 'v •N 4. -450. .,..7,/t/6; a� 0 •lo zi of . . $ �jd -' 470 5.9°o9'ZZ/"E L �1 �y 1�iWt..L. 1 `- 3 , r c° kt,In C) a - Iii N (1...4D- %In _ .71Ac. a ° .7/ Ac . %a .... ® /9/.7 y` - 1 s 8 I 235 - y.?- 235 % �. �/� IhCe A76.4Z S®4o®4"22"E -7 ' 77.®/ ' • LE/1PTeOT7 ®WELL / 589°nyB"e NOTE. • s 1($° RE•BAR SST ON R. LoVITT BURNS') REccpl‘tato 9/22/80 Book 7 dr s i vEY.PAGE 6.3 MASoW Co. .WA. 4 1 DANL III SCRLE,/"e /00' MAR 0 92026 l�MAS0N r 1'\ ` lted From Mason a, >>u ,u a i{ U� ' arri►, P�; H wrsnte.d-. ti OM rk4lrasutr r,...Junty rThAS -,1A Acf4cr,,r • c.L® ®-,72. ��' 51 6 — 7S'' L-5' ..7, :/ Y'¢/ ��_, 124, 1 S-7)7. e. ______ 'O'___________t- ______ ... _ _ fi'D ______ ("*.D _ . ,,..,., ,_ . ...--- I „.. l4i,......r, -, 0 V FIZ ro-') MAR 0 9 2026 0 ti'-'c Q C� ..eLe,Y PA r+ , -.1 'I.1 it Q_,y MASON COUNTY E ,......).„. T tV 0 5-',6 ate .__ _ i a.. k4'it,c_. 367 depth lev I c, 1 ' . i 1, rit, 71" - lw N ' sre kV QE. $ • ' ;:: ; LICENSQD DESIGNER • ExPiRLS 05nm/ • • • 6` Access Riser To Grade -- 1 Net with 45 En Fs 9 -• i Spud L�retetsgor•equel9 re�guired.. • Leveling Pad . I , 1i• • Distribution Box(No Scale)APPROVED C, .' 49 MAR 0 9 2026 �' . 5 .t '-11/ 'ln• �'�" O2 CINDY E.WAITE '�.:. MASON COUNTY ENVIRONMENTAL HEALTH LICENSr D DESIGNER Z I 5.10, DJA Installation Notes Gravity Distribution System: 810 E State Route 302 12208-41-90031 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. Install cleanout between residence and septic tank 3. Retro fit existing septic tank with risers and effluent filter 4. Gravel based drainfield required 5. Install system during dry weather with acceptable soil conditions 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 risers on the septic tank, D-box and observation ports. 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 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 or bed with contour of the ground 18. Install trench bottoms level and always maintain a minimum of six inches into native soil 19. Filter fabric required over drain rock prior to backfilling. If the drain rock extends above the original grade, run the filter fabric at least 2 inches own the trench wall \ Li MASON �Uj}' G' COUNTY ENVIRONIvIEtj • SIGNER DJ N�ENTAL q HEALTH System Owner Responsibilities: 1. Operation and Maintenance is required by Washington State Department of Health and Mason County Health Department. 2. The septic tank should be pumped every three to five years or as needed. 3. System owners are responsible for having maintenance performed every three years as per WAC246-272A. 4. System owners are responsible for responding to septic issues in a timely manner. 5. System owner agrees to read and abide by information regarding their system in the User Manual provided by Mason County Public Health. 6. Keep the flow of sewage at or below the approved:design operating capacity. 7. Keep waste strength at residential waste strength parameters. 8. Spread loads of laundry through the week. 9. Do not use excessive bleach or detergents with added whiteners. 10. Do not shower, do laundry and dishwasher at the same time 11. Antibiotics can kill or impair the biological process in the septic tank. 12. Leaky plumbing can hydraulic overload your on-site septic system. • ? �f� fr co p� �I �vvri ITE LIC. ti.,',:1 FSIGNER