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Home My WebLink AboutSWG2026-00078 - SWG Application / Design - 4/13/2026 MASON COUNTY 415 N 6TH STREET,SHELTON, ,WA 98584 • 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 Tank Only Permit: SWG2026-00078 OWNER FERGUSON MARGARET M Phone: Address: PO BOX 2090 BELFAIR, WA 98528 APPLICANT FERGUSON MARGARET M Phone: Address: PO BOX 2090 BELFAIR, WA 98528 SEPTIC DESIGNER Dave Ghylin -Dave's Septic Service Inc. Phone: 360-710-2449 Address: PO BOX 301 SEABECK,WA 98380 SEPTIC INSTALLER DARREN MILLER* Phone: 360-871-5258 Address: PO BOX 809 MANCHESTER, WA 98353 Site Address: 80 E ROSE POINT LN Primary Parcel Number: 222125600005 Permit Description: Replace failed Biomax unit with Nuwater BNR500 Permit Submitted Date: 03/20/2026 Permit Issued Date: 04/13/2026 Issued By: Rhonda Thompson Current Permit Fees Paid: $275.00 (additional fees may be required upon installation of system). Permit Expiration Date: 03/23/2027 (based on date of inspection) Type of Work OSS Repair Components being Replaced: Other Surfacing Sewage? No Existing Failure? Yes Shoreline? Yes Horizontal Setbacks Met? No Number of Bedrooms: 2 Drinking Water Source: Public Water System Additional Details: BNR500 Permit Conditions: I Approval of this septic permit does not approve the building location. Building location is subject to approval from all applicable departments and regulations. 2 Horizontal setbacks per WAC246-272A-0210 must be maintained, unless prior approval is obtained 3 Permit must be installed by a Mason County Certified Installer unless prior written authorization from Mason County is obtained. 5 Proposed development subject to zoning requirements and approval by the planning department staff per Mason County Title 17. 4 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/OR 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 DATE RECEIVED: 03 V COMMUN}TY SERVICES AMOUNT RECE RECEIVED BY: `a. 1 V Jl W 1`a 2i b .CL SERVICES u1 ^ Public Health(Community Health/Environmental Health) r c CD ;dam~ 360-127-9670,c L400or360-275-4467,00.400 A /� 415 N.6th Street-Shelton,WA 98584 S'JV �, 6A — (:)( c:)'1 (�' T 0 C C!� �V/��ii�(,J) w t� ON-SITE SEWAGE TANK ONLY APPLICATION > c0 APPLICANT PHONE in M Vo, Bang Luong o e MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE C W PO BOX 809 MANCHESTER,WA 98353 Q Fo M SITE ADDRESS-STREET,CITY,ZIP CODE 80 E Rose Point LN Belfair WA 98528 (?0� z\ r+ N V --II NAME OF DESIGNER PHONE Sv I IV Dave Ghylin 360-710-2449 ° v NAME OF INSTALLER PHONE � I ti Darren Miller 360-871-5258 G I rn � TYPE OF WORK(select one) DRINKING WATER SOURCE ❑ NEW CONSTRUCTION!UPGRADES l REPAIR/REPLACEMENT ❑ PRIVATE INDIVIDUAL WELL ❑ PRIVATE TWO-PARTY WELL Z I N COMPONENT(S)TO BE REPLACED/INSTALLED ❑ PUBLIC WATER SYSTEM PUD 3 District 2 � ❑ SEPTICTANK ❑PUMPTANK ❑RV HOLDING TANK BEDROOMS I LOT SIZE (Si IN OTHER Replace Existing Biomax with a Nuwater BNR-500 2 .58 Acres Approx. OTHER DETAILS(select all that apply) TANK(S)SETBACK CHECKLIST 0 I O) ❑ SURFACING SEWAGE I]EXISTING FAILURE ❑SHORELINE ® 10OFT+PUBLIC/COMMUNITY WELLS O SUBMITTALS ❑ 50FT+PRIVATE WELLS,SURFACE WATERS,STREAMS,RIVERS I IN PLOT PLAN(REQUIRED) ®TANK CROSS SECTION(REQUIRED) 0 1OFT+DRINKING WATER SUPPLY LINES I O ❑PUMP DETAILS(IF APPLICABLE) ❑WAIVER(S)(IF APPLICABLE) O 5FT+PROPERTY/EASEMENT LINES,FOUNDATIONS,FOOTINGS PLOT PLAN CHECKLIST O I O I PROPERTY LINES AND EASEMENTS II EXISTING!PROPOSED STRUCTURES IN EXISTING/PROPOSED OSS COMPONENTS AND LINES ❑ WELLS WITHIN 10OFT 0 WATER SUPPLY LINES ❑� DRIVEWAYS/PARKING IN SURFACE WATERS,STREAMS,RIVERS,ETC... I O IN DIRECTION OF SLOPE/CONTOURS ❑ PERIMETER/CURTAIN DRAINS I NORTH ARROW ®SCALE BAR11 (31 DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.locked gate) Turn off of E WA-1 06 onto E Rose Pont LN The lot is on the right. This is a repair with very limited space. APPROVED APR 13 2026 H LTH OFFICIAL USE ONLY BELOW THIS LINE RET UPGRADE!FAILURE SOURCE(for reporting purposes) ❑VOLUNTARY ❑MAINTENANCEIPUMPING ❑BUILDING PERMIT ❑HOME SALE ❑COMPLAINT ❑OTHER: COMMENTS/CONDITIONS - i1rrt JY - A V () )n pv( hC4#A SEWAGE TANKS MUST BE LISTED UNDER DOH'LIST OF REGISTERED SEWAGE TANKS'.TANKS MUST MEET CURRENT MINIMUM SIZE REQUIREMENTS,EQUIPPED WITH RISERS AND LIDS TO SURFACE,AND INCLUDE AN EFFLUENT FILTER(IF APPLICABLE). RECORD DRAWING AND INSTALLATION REPORT REQUIRED FOR FINALAPPROVAL. INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED/ISSUED BY DATE 113126 THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 1217/2015 Dave's Septic Services, Inc. P.O. Box 301 Seabeck, WA 98380 (360) 710-2449 Customer Information: Date: 2/25/26 Applicants Name: VO, Bang Luong Site Address: 80 E Rose Point LN Belfair WA Tax ID #: 22212-56-00005 OSS Failure Report: ❑ Hydraulic Overload ❑ Abnormal Waste ❑ Physical Damage 0 Age/Other Dave's Septiic SeMces, Inc. Licensed On-site Sewage Disposal Consultant Percolation Test and Engineering Designs Licensed Operation & Maintenance Specialist E-mail: dss9699@outlook.com OSS Faiilure Investigation Report Site Address of OSS Failure: 80 E Rose Point LN BelfairWA Designer: Dave Ghylin / Dave's Septic Services, Inc. Date of Investigation: 2/25/26 The OSS at the above address has failed due to: ❑ Hydraulic Overload (e.g., OSS flooded out due to leaking OSS components, excessive groundwater, or surface water intrusion, leaky household fixtures, or water use above the what the OSS was designed to handle, etc.) �p p6 ApR 13 202 UN��,NY1RpNMENZA�N��'Th JASON c0 RED ❑ Abnormal Waste Strength I Water Characteristics (e.g., normal OSS operation appears to have been adversely impacted by household use of pharmaceuticals, disinfectants, fats/oil/grease, or additives, etc.) ❑ Physical Damage (e.g., OSS was damaged due to vehicular traffic, new construction, or animal intrusion, etc.) 0 Age or Other (e.g., OSS does not exhibit any signs of the above. However, failed due to age, system type, or site condition, etc.) ' S e cJCEn n sS Le ,.1 , NuWater BNR-500 GPD Treatment Unit 3. 4. 5. 6. 7. 11 6' _ 3 7 1. Inlet from house ® • 9O 10 2. Double sweep cleanout Ig '• 3. Inspection port 4" PVC 4. 24"diameter riser 5. 24" diameter riser with vented lid (NTS) 6. 24"diameter riser 7. Trash chamber 8. Digester Chamber APPROVED O 9. Clarifier Chamber APR 13 2026 10. Out to drainfield or pump chamber TOP VIEW MASON COUNTY ENVIRONMENTAL HEALT 11. Air motor to be located next to home in dry riser location with vented RET chamber Applicant's Name: Dave's Septic Services, Inc. VO, Bang Luong P.O. Box 301 .I VAU,�F Tax ID#: `" Seabeck, WA 98380 [3H N '•. 22212-56-00005 (360) 710-2449 IXH E67G�1& Mason County WA GOS Web Map N N N / - rr i�S9 V . LHH 4rJ�;9 2/18/2026, 11:59:07 AM 1:3,060 0 0.03 0.05 0.1 ml County Boundary 0 0.04 0.08 0.16 km No Filled O Tax Parcels (Zoom in to 1:30,000) Sources:Esri,HERE,Garin,Intermap,increment P Corp.,GEBCO,USGS, FAO.NPS.NRCAN,GeoBase,IGN,Kadaster NL,Ordnance Survey,Esri Japan,METI,Esri China(Hong Kong),(c)OpenStreetMap contributors,and the GIS User Community Mason County WA GIS Web Map Application Mason County disclaims accuracy,reliability,or timeliness of website Info,not liable for losses from reliance on iL httpsJMnvw.masoncounrywa.gov/disdaimer.php DA VE'S SEPTIC SERVICES INC. 2830 N. Mission Rd. W, Bremerton, WA. 98312 PHONE (360)710-2449 LICENSED ON-SITE SEWAGE DISPOSAL CONSULTANT PERCOLATION TEST AND ENGINEERING DESIGNS LICENSED OPERATION&MAINTENANCE SPECIALISTS e-MAIL; dss(a)wavecable.com Designer Notes/requirements Site Location : 80 East Rose Point LN Belfair Parcel Number : 22212-56-00005 #1- This application is to replace the existing treatment tank with a new tank in same location. There is no room to locate a tank in a different location due to house location, property line and parking area. #2- The new treatment tank proposed is a BNR-500 unit that will be located in an infiltrator tank supplied by Hagerman precast. #3- The treatment tank must be sealed on the outside at all inlet, outlet locations and riser locations with a bentonite seal. #4- Tank backfill must be done with sand or a small pea gravel and per the manufacture's requirements. If there are any questions or changes to this application the installer must stop and contact the designer immediately. No changes are allowed. David A Ghylin APPROVED APR 13 2026 MASON COUNTY ENVIRONMENTAL HEALTH RET 4V ��•' P--OmR�e C-OTLDS co W'4-h }, NEW &iR-SCo T/Z rrn WELL RADII INDEX: R-10 A10'RADII INDICATING THE AT BACK TO DRIVINGIPARKING AREAS OR SPLASH BLOCKS. R-30 A 30'R4DII INDICATING THE SETBACK TO INDIVIDUAL LOT INFILTRATION SYSTEM. R-5 A 50'RADII INDICATING THE SETBACK TO INDIVIDUAL L DISPERSION SYSTEM,RAIN GARDENS,OR UNLINED ,/ 10) OETENTION O DS. 15) w�.tCl Do not Damage OrDisturb Soils When Clearing Drainfield NOTE. Area ADDITIONAL FEES ARE REQUIRED CONTACT DESIGNER FOR DETAILS. PPROVED 0) 'Pump is required RFq 5) LF 'Pump alarm is required S'U NO WELLS WITHIN 100'♦ �, � � \ TANK INSTALCOMPON ENSURE ENTS MALL T BE WON-SAT R GHI'TO SURFACE COVER TO BEs 5MIWINCH SAS OUN APR�� 3 2026 's'T SURr�F (j �1 30) DIVERTALL SURFACE WATERAWAY ENVIRONMENTAL HEALTH 00'4cF�, 35) FROM DRAINFIaD AREA. RET Tps, F / V PREPARE SITE&INSTALL DRAINFIELD U FgCF jry �p / 40) DURING DRY CONDITIONS �qTF S� 45J DISCLAIMER - - - This map does not represent a survey Normal usage must meet the following _ - nordoes d purport to show all easements -----, orencmachments,ifany. - - = criteria or be lower - — Biochemical oxygen demand 130-174 MG/LP _t��— - Additional Drains May Be Required (�J To Divert Surface Or Subsurface Water Problems T5S: 47-71 MG/L - - - FOG: -- - - ---- - -___�. ------ 10-20 MG/1 DO: 0-1.0 MG/L PH: 6.5-7.2 OWNER: SCALE: STUMP SPLI TING OR STUMP TEMP: 48-70" DAVE'S SEPTIC SERVICES INC. 1"= 30' GRINDING IS RECOMMENDED VO BANG LUONG With microscopic life forms present � DATE: IND TMETE WITHINRTHAN iY 80 E ROSE POINT LN '� P.O. BOX 301 2/22/2026 IN DIAMETER WITHIN DRAINFlELD "Higher waste strengths will result in MASON PROTECT SOILS WHEN CLEARING premature failure of the septic system. MASON COUNTY, WA. x° '�c SEABECK, WA 98380 O, 30' 60, TAX ID. 22212-56-00005 a �' (360) 710-2449 EX%fi'a9 1.