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HomeMy WebLinkAboutSWG2026-00071 TANK ONLY - SWG Application / Design - 3/13/2026 fillASON COU N1'Y 415 N 6TH STREET,SHELTON,-967 WA E 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: SWG2026-00071 APPLICANT Maples, Shane Phone: 3604638474 Address: 911 SE Arcadia Rd. SHELTON, WA 98584 OWNER FAUBION JEFFREY JOSEPH & BELINA Phone: MONTESCLAROS Address: 310 W G ST SHELTON, WA 98584 SEPTIC INSTALLER SHANE MAPLES* Phone: 360-463-8474 Address: 911 SE Arcadia Road SHELTON,WA 98584 Site Address: 1590 W Deegan Rd W Primary Parcel Number: 420253300020 Permit Description: New Zoeller 912 pump basin (Model#36)to connect RV site to the existing 2-bedroom septic system (SWG2024-00339) Permit Submitted Date: 03/13/2026 Permit Issued Date: 04/07/2026 Issued By: David Anderson Current Permit Fees Paid: $275.00 (additional fees may be required upon installation of system). Permit Expiration Date: 03/13/2027 (based on date of inspection) Type of Work Other Components being Replaced: Other Surfacing Sewage? No Existing Failure? No Shoreline? No Horizontal Setbacks Met? No Number of Bedrooms: 2 Drinking Water Source:, Private Well/Spring Additional Details: Zoeller 912 Pump basin (Zoeller model#36) 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. 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. 2 Horizontal setbacks per WAC246-272A-0210 must be maintained, unless prior approval is obtained 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 //// DATE RECEIVED: / 7a Z MASON COUNTY 1 b AMOUNT RECEIVED: RECEIVED BY: W cn COMMUNITY SERVICES z y(((am. ® M Public Health(Community Health/Environmental Health) �1! W' 3 G 60-027-9670,ext.400 or 360-27S-4467,exL400 SWG 7] 2 6 - U 0 415 N.6th Street-Telton,WA 99584 "v z Cl) ON-SITE SEWAGE TANK ONLY APPLICATION m m APPLICANT sefcii II f� s�yy. �//� alo on PHONE ® i SV MAILING ADDRESS-STREET.CITY,STATE,ZIP CODE A e U3 6 a ct \ •� 1 9q SITE ADDRESS-STREET,CITY,ZIP CODE Iø 'v' u-qav d, ��J� n, vSA s `YY N PHONEAME OF DESIGNER 2 niI NAME OF INSTALLER PHONE 3 -- gL L Ito TYPE F WORK(select one) DRINKING WATER SOURCE O NEW CONSTRUCTION!UPGRADES ❑ REPAIR 1 REPLACEMENT I2'PRIVATE INDIVIDUAL WELL ❑ PRIVATE TWO-PARTY WELL Z COMPONENT(S)TO BE REPLACED/INSTALLED ❑ PUBLIC WATER SYSTEM I t ❑SEPTIC TANK ❑ PUMP TANK ❑RV HOLDING TANK BEDROOMS LOT SIZE OJ 11OTHER Li f co 2• w ' OTHER DETAILS(select all that apply) TANK S)SETBACK CHECKLIST O ❑SURFACING SEWAGE O EXISTING FAILURE ❑SHORELINE I00FT+PUBLIC/COMMUNITY WELLS 0 I® 50FT+PRIVATE WELLS,SURFACE WATERS,STREAMS,RIVERS SUBM1 ALS ,f 10FT+DRINKING WATER SUPPLY LINES PLOT PLAN(REQUIRED) E TANK CROSS SECTION(REQUIRED) 5FF+PROPERTY/EASEMENT LINES,FOUNDATIONS,FOOTINGS PUMP DETAILS(IF APPLICABLE) ❑ WAIVER(S)(IF APPLICABLE) PLOT PLAN CHECKLIST O El PROPERTY LINES AND EASEMENTS ❑ EXISTING!PROPOSED STRUCTURES ❑ EXISTING/PROPOSED OSS COMPONENTS AND LINES I� ❑ WELLS WITHIN 100FT ❑WATER SUPPLY LINES ❑ DRIVEWAYS/PARKING ❑SURFACE WATERS,STREAMS,RIVERS,ETC... ❑ DIRECTION OF SLOPE!CONTOURS ❑ PERIMETER]CURTAIN DRAINS ❑ NORTH ARROW ❑SCALE BAR I� DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.locked gate) tn≤ht11 eMfarfl10dCt4 -39 Lff �Mlon -for OGlt�jonA( 1A FV D' (P OFFICIAL USE ONLY BELOW THIS LINE UPGRADE!FAILURE SOURCE(for reporting purposes) ❑VOLUNTARY ❑MAINTENANCEIPUMPING ❑BUILDING PERMIT ❑HOME SALE El COMPLAINT ❑OTHER: COMMENTS I CONDITIONS p j cl i(v Pump i3 i +v cannel V 1 $o t Qx t' T z -bedroom 5e bt SEWAGE TANKS MUST BE LISTED UNDER DOH°LIST OF REGISTER D 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 FINAL APPROVAL. INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLIC N APPROVED!ISS ED BY DATE THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 121712015 PP 0 fa I L) \ A-m -r O / ô1Z \ a +5 ±C sec ,�1� Axa o-visual a i Ciea=out <a A j 3 1Q00 Gon et1c? 54 o , 2-Co a;-taxe'zt wig? +"4 PAULA JOY JOHNSON '. Lt1S i_G t• //,,�� , _� i Eruent Filter !000 Gallon Pur. P C4azi?be; j2or�Dr^.51`1F �• \ / i c lo'x 3c' reserre rY� ur { e 'mod+ j „ fr-f + '— \ 4 Vim+ 1. APPRof C't APR 6J / �91a• MAS0t 'Trusted.Tested.Tough® /j1 SECTION:2.45.054 7ELLER FM3292 Product information presentedZ ® 1023 here reflects conditions at time of publication.Consult factory Supersedes regarding discrepancies or PUMP COMPANY 0523 inconsistencies. TECHNICAL DATA SHEET 912 PACKAGE SYSTEMS PREASSEMBLED SEWAGE SYSTEMS FOR FAST INSTALLATION. PUMP SPECIFICATIONS Horse Power 0.4&0.5 I28-3/4 ii Voltage 115 0 Phase 1 Q Hertz 60 RPM 1725 Amps 9.4 + ° 4-1/2 Auto On/Off Varies based on package e Discharge Size 2"NPT Solids Handling 2"(50 mm)spherical solids ♦�� ° Cord Length 20'(6 m)standard Cord Type UL listed 3-wired plug Max.Operating Temp. 130°F(54°C) Cooling Oil filled Motor Protection Auto reset thermal overload �—22 5l8 Cap Cast iron ii f Motor Housing Cast iron �1 Pump Housing Cast iron 9-1/4 Base Engineered plastic ..J Upper Bearing Sleeve bearing ccLower Bearing Sleeve bearing 25-1/2 } LLA Mechanical Seals Carbon/ceramic Q Impeller Type Non-clogging vortex Impeller Engineered plastic Hardware Stainless steel SK3308 Motor Shaft AISI 1215 cold rolled steel 24"x 24"(61 x 61 cm)shown,18"x 30"(46 x 76 cm) Gasket Neoprene and 24"x 36"(61 x 91 cm)also available. A CAUTION All installation of controls,protection devices and wiring should be done by a qualified licensed electrician. All electrical and safety codes should be followed including the most recent National Electrical Code(NEC)and the Occupational Safety and Health Act(OSHA). APPROVE. - APR 07 2fl2 MASON coU 'T I a WARNING IThese systems are not designed Ifor hazardous environments.Please consult Q �GH factory for special options and requirements. ©Copyright 2023 Zoeller®Co.All rights reserved. 502-778-2731 800-928-7867 1 3649 Cane Run Road I Louisville,KY 40211-1961 1 zoellerpumps.com • PPRovD TdTAL DYNAMIC HEAD FLOW PER MINUTE A uJ PUMP PERFORMANCE CURVE APR O FIP� 264/266 MODELS TOTAL DYNAMIC H /FLOW J 2fl2fl 25- PER MIND ®N COUNT V: . . SEWAGE AND DEWATERING 6- 20 15- MODELS 264 266 Z 4 Feet Meters Gal. Liters Gal. Liters 10 ST 5 1.5 90 341 115 435 2- 264 266 10 3.0 60 227 85 322 15 4.6 23 87 45 170 Shut-off Head; 18 ft.(5.5m) 20.5 ft.(6.2m) 20 40 60 80 100 120 140 GALLONS 009969 LITERS 0' 80 160 240 320 360 400 FLOW PER MINUTE Location 10 Stack Simplex/Duplex Basin AFD Vent Materiel Float Switch Pump HP Alarm Part Number No 912-1141" .4 HP Yes 912-1147 Integral No 912-1143" .5 HP Yes 912-1149 24'x 24' Yes 2- Poly No 912-1142" .4 HP Yes 912-1148 Piggyback No 912-1144" .5 HP Yes 912-1150 No 912-0007 .4 HP Yes 912-1007 Integral No 912-0010 .5 HP Yes 912-1010 2' PSF No 912-0005 .4 HP Yes 912.1005 Piggyback Simplex No No 912-0017 No .5 HP Indoor Yes 912-1017 Integral .5 HP No 912-0070 No 912-0055 18x30' .4 HP 2°" Poly Yes 912-1055 Piggyback No 912-0056 .5 HP Yes 912-1056 No 912-0086 .4 HP Yes 912.1086 Integral No 912-0088 .5 HP Yes 912.1088 Yes 2° PSF No 912-0087 .4 HP Yes 912-1087 Piggyback No 912-0089 .5 HP Yes 912-1089 Duplex 24x24' Yes 2- Poly Integral .5 HP Yes`" 912.1161 .4 HP No 912-0016 Yes L.A.Code Simplex 18x30' No 2' Fiber-glass Piggyback .5 HP No 912-0020 No 912-0082 .4 HP Yes 912-1082 Integral No 912-0084 .5 HP Yes 912-1084 Outdoor No Simplex 18x30' No NA PSF No 912-0083 .4 HP Yes 912-1083 Piggyback No 912-0085 .5 HP Yes 912-1085 ©Copyright 2023 Zoeller Co.All rights reserved. 502-778-2731 1 800-928-7867 1 3649 Cane Run Road I Louisville,KY 40211-1961 1 zoellerpumps.com