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HomeMy WebLinkAboutSWG2026-00088 - SWG Application / Design - 3/27/2026 MASON COUNTY 415 N 6TH STREET,SHELTON,-967 ,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 Permit: SWG2026-00088 APPLICANT BRADLEY MATTHEWS O &LYNNE E Phone: Address: 191 SE VIC KING RD SHELTON, WA 98584 OWNER BRADLEY MATTHEWS O & LYNNE E Phone: Address: 191 SE VIC KING RD SHELTON, WA 98584 SEPTIC DESIGNER CINDY WAITE* Phone: 360-701-0205 Address: 80 E PICKERING LANE SHELTON,WA 98584 Site Address: 191 SE Vic King Rd Primary Parcel Number: 320304300200 Permit Description: Permit Submitted Date: 03/27/2026 Permit Issued Date: 05/04/2026 Issued By: Jeff Wilmoth Current Permit Fees Paid: $845.00 (additional fees may be required upon installation of system). Permit Expiration Date: 04/07/2027 (based on date of inspection) 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 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 MASON COUNTY DATE RECEIVED: • • • _J C Cl) AMOUNT REC I ED: RECEIVED BY: Cn Public Health & Human Services v m Environmental Health 360-427-9670,ext.400 or 360-275-4467,ext.400 415 N.6th Street-Shelton,WA 98584 S W G L�f 1 �J vO O Z Cl) ON-SITE SEWAGE SYSTEM APPLICATION APPLICANT PHONE m m MATTHEW BRADLEY Q 301-332-2094 z C MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE E 191 SE VIC KING RD SHELTON WA 98584 m SITE ADDRESS-STREET,CITY,ZIP CODE CI 191 SE VIC KING RD SHELTON WA 98584 NAME OF DESIGNER PHONE I N CINDY WAITE 360-701-0205 NAME OF INSTALLER ® PHONE O W� C I PERMIT TYPE(select one) DRINKING WATER SOURCE - MiRESIDENTIAL OSS bICOMMUNITY OSS Itn]COMMERCIAL OSS Mi PRIVATE INDIVIDUAL WELL PRIVATE TWO-PARTY WELL Z I O TYPE OF WORK(select one) O1 PUBLIC WATER SYSTEM NEW CONSTRUCTION/UPGRADES p[1IREPAIR/REPLACEMENT OTHER DETAILS(select all that apply) ❑ TABLE X REPAIR SUBMITTALS O SURFACING SEWAGE 61 EXISTING FAILURE O SHORELINE MiDESIGN FORM(REQUIRED) SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE I WAS LOT CREATED AFTER 4/1/2025? O I C}WAIVER(S)(IF APPLICABLE) 4 3.87AC ❑ YES p NO I o DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.locked gate) GO SOUTH ON OLYMPIC HIGHWAY, TURN RIGHT ONTO VIC KING RD, PARCEL IS AT I THE END OF VIC KIN ROAD. ADDRESS ON THE DRIVEWAY. SOIL LOGS ARE BEHIND THE RESIDENCE. o N SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. I C) OFFICIAL USE ONLY BELOWTHIS LINE UPGRADE/FAILURE SOURCE(for reporting purposes) DVOLUNTARY ❑MAINTENANCE/PUMPING ❑BUILDING PERMIT ❑HO�ME-SALE DCOMPLAINT DOTHER: o INSPECTOR SOIL LOGS COMMENTS/CONDITIONS O L5 fo !- 5 ( , iv$ poO 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. RFO4"AY GNATURE DATE APPLICATION EXPIRATION DATE LI ATION APPROVED/ISSUED BY DATE (( 7 (g(g `��1-2� jj�a COUNTY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON WEBSIT) Revised:4/14/2025 DESIGN FORM—PAGE ONE Assessor's.Parcel Number: 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 IDENTI!)F'ICATION _ Permit Number: S WG Z.O J(_(J Designer's Name: CINDY WAITE Applicant's Name: MATTHEW BRADLEY Designer's Phone Number: 360-701-0205 Mailing Address: 191 SE VIC KING RD Designer's Address: 80 E PICKERING LANE SHELTON WA 98584 City State Zip SHELTON WA 98584 City State Zip Designer's Email cindyewaite@msn.com DESIGN Treatment Device 0 Glendon ❑ Sand Filter ❑Mound 0 Sand Lined Drainfield ❑ Recirculating Filter ❑ATU ❑Other Treatment Level(check all that apply): ❑A 0 B ❑C ❑ BLI ❑ BL2 ❑BL3 Y! E ❑N Drainfield Type 'Gravity ❑Pressure Trench 0 Bed 0 Sub Surface Drip Septic Tank/Drainfield Specifications Laterals Number of Bedrooms 4 Schedule/Class ASTM 2729 Daily Flow: Operating Capacity 360 gpd Length 50 ft Daily Flow:Design Flow 480 gpd - Diameter 4 in Septic Tank Capacity(working) 1200 gal Number 4 Receiving Soil Type(1-6) 3 Separation 5 ft Receiving Soil App!.Rate .8 gpd/ft2 Orifices Required Primary Area 600 ft2 Total Number of Orifices ASTM 2729 PERF Designed Primary Area 600 ft2 Diameter in Designed Reserve Area 600 ft2 Spacing in Trench/Bed Width 3 ft Manifold Trench/Bed Length 200 ft Sche Elevation Measurements Le .: u ft Original Drainfield Area Slope <1 % dieter -. in 5tn_n✓te New Slope,If Altered % ffl & ffi1f tion used? ❑Yes I 'No Depth of Excavation Up-slope 19 in sport Pipe from Original Grade T ••+HEs �o.+o. Down-slope 19 in Schedule/Class ASTM 3034 Designed Vertical Separation 36 in Length 50 ft Gravel-based Drainfield Required? I!.I Yes ❑No Diameter 4 in Pump Required? 0 Yes I 'No 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) f} Chamber Capacity(flood) gal Uppermost Orifice❑Higher 0 Lower than Pump Shutoff Pump controls: Please check those required. Capacity @ Total Pressure Head gpm Ti er 0 14, e etei 0 Event Counter Calculated Total Pressure Head ft If Ti en P mp on U ump off Comments MASON COUNTY ENVIRONMENTAL HEALTH N3 t, RPviePrl'A/I 1/xr,c • 1)UNI =1v KURM-PAGE TWO Assessor's Parcel Number:' 31 21 913 0141 3101 012 09 j Permit Number: SWG 21;. C® S' DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch Test hole locations t/ Drainfield orientation and layout/ � Soil logs � ElTrench/bed dimensions and Reference depth from original grade: 0 Property lines {/ critical distances within layout Septic tank ❑ Drainfield cover Mr Existing and proposed wells R( D-BoxNalve box locations ' �within 100 ft ofproperty � Reference. depth from original grade Septic tank/pump chamber I and restrictive strata: 9 Measurements to cuts, banks,and locations p1 {- t't surface water and critical areas G� Observation port location '' Laterals,trench/bed,top and bottom Location and orientation of VClean-out location ❑ Curtain drain collector curtain drain and all absorption l ti,Manifold placement ❑ Sand augmentation gmentation components / Gds Orifice placement Other cross-section detail: G7! Location and dimension of s1 12' Lateral placement with distance Observation ports/clean-a�tits primary system and reserve area El Building ✓ to edge of bed ✓ Other Information l�°Audible/visual alarm referenced Yes No lid' Direction of slope igdicatorv' V 1Z Waterlines ✓ Scale of drawing shown on scale 2" ❑ Design staked out bar ❑ ❑ Recorded Notices attached Roads,easements,driveways, 1 1iva$ nenchmark and relative. D ❑ Waiver(s)attached parking ✓ s ents ❑� ❑ Pump curve attached 1J North ar row and.scale awing �� 0 ❑Evaluation of failure shown on scale bar MAY 0 4 Non-residential justification MASON COUNTy 0 2026 ❑ Q Waste strength IRQNMEN - ❑ ` 0 Flow = DESIG'. PROVAL The undersigned designer must be notified by installer at time of installation' 09 Yes ❑ No Signature o Designer Date L 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 r lations: Enviro en ealth Specialist Date CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION: ✓ The design is stamped"Approved"by Mason County Public Health. j J ✓ 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:6/11/2025 p= CINDY E WRITE' �;` �;• C LICENI%D DFrSIGNER .a �, ,.1L5.U5l IOI ti T F tib bb ' C� V `bb ------- a--_-_------- O ca bb b' - 4 b�bb P _ -_--_- • u �, `, rho ..�� �• ° 1 '1 _.off Jt 1: a 2 -- - - ---s— a RAY 0 4 226 MASON COUNTY ENVIRONMENTAL HEALTH jaw". z "melee - �r , 1.71. SE Vic King Rd, Shelton, WA 98584, USA, Shelton Township, Parcel Ida 320304300200 BBENC MARK _ ! �►' iJ 1L4 eq eC� %''1 coundation 1 100.00 ' I l Residence Septic tank-- 2. 98.00" , i ij Jc iJ�'io t'� mzee 2 Lined small artifical pond -box i ' 3' 97_ ' 3 Lined artificial pond _ y t Softome of drainfield 4, 95.00 , (V's" 4 1200 Septic tank 5 Clean out 6 Transport I ffi M __ 7 primary drainfield I ' f 4 t 8 Reserve drainfield 9 Decommission existing septic tank ' t 10 Failed drainfield 11 l Well � 12 Water;oiiiIIIIJIIIIIJ7 me �- 13 D-box �• r z S 7 r11AL AY 06 2026 a ` ii a S� k MAY 0 'i2:2 By _ r. MASON COUNTY ENVIRONMENTAL`HEALTH2�.Q lead ''f £ - � rY GIS Legend Buffers "��` Parcel Lanes Buffer 5 ft •�' �° K WA Mason 10 ft. Contours Scale => 1 in $11ff` ~+ '°?_ 4 ,iL ® � � r ( ) tLQ ' i Zo' a 3y I /0 ' � g ? e „ I AAt1 MAY 04 4 2026 V �c�� � a, MASON COUNTY ENVIRONMENTAL.HEALTH Jaw • -& • 4 / 1 `� •:8 cPJ, 7�� tie4ITE �� LIC, ' '•GNER Access &.r To Qmde Inlet with 45 8 Facb�g Down Leveling Pad • Distribution Box(No Scale) MAY 0 4 20?fi MASON COUNTY ENVIRONMENTAL HEAL �a has Jaw 51 'g O CINDY E WAITS `�..' CICEVJED DESIGNF�R 1200 Gallon Double Compartment Septic Tank k Lid Ground Level Lid www wwss���wwww�w e��swwa 1 H LU Se::age fforr house f r I Lrquld Level To 3rarrfield -- Sou Layer• Inlet Top _ Baffle -. I lst Compartment 12" ©1110;Tee Baffle aaving 2nd Compartment W&4 V-e riot to scale, Y 11 ��. I . MAY042016 MASON COUNTY L ENVIRONMENTAL HEATH -1 ) f'�'SIGNER Installation Notes Gravity Distribution System: 171 SE Vic King Rd. 32030-43-00200 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. Gravel based drainfield required 4. Install system during dry weather with acceptable soil conditions 5. Keep wheeled vehicles off the drainfield area before, during and after installation. Tracked equipment only 6. Al! 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. 7. Curtain drains can be no closer than 10' upgradient and 30' down gradient of the drainfield 8. Exposed restrictive layers, cuts, banks, etc. can be no closer than 50' downhill from the drainfield. 9. Install access risers on the septic tank, D-box and observation ports. 10. Make sure septic tank risers are epoxied or caulked to cast in riser rings on tank. 11. Lids must form a water and gas tight seal with the access risers 12. Install effluent filter at the septic tank outlet. 13. This system must be installed by a Mason County Certified Installer. 14. Deviation from this design without prior approval from the designer and Mason County Health Department will make this design null and void. 15. 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. 16. Install laterals or bed with contour of the ground 17. Install trench bottoms level and always maintain a minimum of six inches into native soil 18. 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 do n t e trench wall p MAY 0 4 2tv s MASON COUNTY ENVIRONMENTAL HEALTH O CINDY E "Pit . LICENSED DFSIGNER 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. of i1�Sy��9� y�� _ a18 F O= .uVCY E W ` \6