HomeMy WebLinkAboutSWG2026-00116 - SWG Application / Design - 4/20/2026 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 Permit: SWG2026-00116
APPLICANT FITZPATRICK SAGE &THOMAS Phone:
Address: 8838 16TH AVE SW SEATTLE, WA 98106
OWNER FITZPATRICK SAGE &THOMAS Phone:
Address: 8838 16TH AVE SW SEATTLE, WA 98106
SEPTIC DESIGNER DALE TAHJA* Phone: 360-463-8023
Address: 2450 W DEEGAN ROAD WEST SHELTON, WA 98584
SEPTIC INSTALLER TJ GOOS* Phone: 360-490-0217
Address: 150 E MARISA PL SHELTON, WA 98584
Site Address: 282 N Will Webb Rd
Primary Parcel Number: 324233390012
Permit Description: 3BR Nuwater
Permit Submitted Date: 04/20/2026
Permit Issued Date: 06/08/2026
Issued By: Jeff Wilmoth
Current Permit Fees Paid: $845.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 05/20/2029 (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.
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 parer size: 11"X 17"
PermhNumber. SVdG — ccD(( Designer's Name: Date L.Tahya
Applicant's Name: Sage&Tom Fitzpatrick Designer's Phone Number: (360)463-8023
Mailing Address: 8838 16th Ave.SW Designer's Address: 2450 W. Deegan Rd.W.
Seattle WA 98106 City State Zip Shelton WA 98584
City State Zip Designer's Email daletahja@gmail.com
Treatment Device
❑ Glendon ❑Sand Filter ❑Mound ❑ Sand Lined Drainfield ❑Recirculating Filter 0 ATU NuWater BNR-500 ❑Other
Treatment Level(check all that apply): ❑A 1Jrc B fC 0 BLI zl BL2 'BL3 f E 'N
Drainfield Type
❑Gravity 'Pressure Trench 0 Bed ❑ Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Dumber of Bedrooms 3 Schedule/Class Sch.40
Daily Flow:Operating Capacity 270 gpd Length 40,45,50,65 ft
Daily Flow:Design Flow 360 gpd Diameter 1.25 in
Septic Tank Capacity(working) 1,000 gal Number 4
Receiving Soil Type(1-6) 4 Separation 10-15 ft
Receiving Soil Appl.Rate 0.6 gpd/ft2 Orifices
Required Primary Area 600 ft2 Total Number of Orifices 52
Designed Primary Area 600 ft2 Diameter 1/8 in
Designed Reserve Area 600 ft2 Spacing 48 in
Trench/Bed Width 3 ft Manifold
Trench/Bed Length 200 ft Schedule/Class Sch.40
Elevation Measurements Length 100 ft
Original Drainfield Area Slope 14 % Diameter 1.25 in
New Slope,If Altered 12 % Preferred manifold configuration used? ❑Yes IH'No
Depth of Excavation Up-slope 18 in Transport Pipe
from Original Grade Down-slope 12 in Schedule/Class Sch.40
Designed Vertical Separation 12 in Length 80 ft
Gravel-based Drainfield Required? ❑Yes !1 No Diameter 2 in
Pump Required? I 'Yes ❑No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day 4
Diff.in Elevation Between Pump&Uppermost Orifice 10 ft Dose quantity 67.5 gal
7 Chamber Capacity(flood) 1,150
Drainfield Squirt Height/Selected Residual(head) ft p h' gal
Uppermost Orifice I 'Higher ❑Lower than Pump Shutoff Pump controls:'Please check those required.
Capacity @ Total Pressure Head 26 gpm l!1' Timer EI Ela s ter Ili Even Counter
6fi / ((9 _ min
Calculated Total Pressure Head 22 2. in$ If Timer: Pump our: Elm h�;l
Comments JUN 082026
8 2026
MASON COUNTY ENVIRONMENTAL HEALTH
t)
Revised:6/11/2025
ii ]DESIGN FORM—PAGE TWO Assessor's Parcel NumbeV3 ,2 �4 2 3 3 3 9 0 0 1 2
Permit Number: SWG f OO I I p
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
V Test hole locations V Drainfield orientation and layout Reference depth from original grade:
V Soil logs V Trench/bed dimensions and Q( Septic tank
9 Property lines critical distances within layout 0' Drainfield cover
V( Existing and proposed wells V D Box/Valve box locations Reference depth from original grade
within 100 ft of property V Septic tank/pump chamber and restrictive strata:
❑ Measurements to cuts,banks,and locations 9 Laterals,trench/bed,top and
surface water and critical areas V Observation port location bottom
Q! Location and orientation of V Clean-out location ❑ Curtain drain collector
curtain drain and all absorption 9 Manifold placement ❑ Sand augmentation
components Id Orifice placement Other cross-section detail:
if Location and dimension of V Lateral placement with distance 9 Observation ports/clean-outs
primary system and reserve area to edge of bed Other Information
If?i Buildings V Audible/visual alarm referenced Yes No
lT Direction of slope indicator V Scale of drawing shown on scale t� 0 Design staked out
V Waterlines bar ❑ ❑Recorded Notices attached
Roads,easements,driveways, le tion benchmark and relative O ❑Waiver(s) attached
parking 1 e�i ns of ys f oipiiei1ts ❑Pump curve attached
V North arrow and scale drawing 0 ❑Evaluation of failure��
shown on scale bar i1 JUN 08 2026 , Non-residential justification
❑ ❑Waste strength
MASON COUNTY ENVIRONMENTAL HEALTH ❑ ❑Flow
DESIGN
The undersigned designer must be notified installer at time of installation FrYes ❑ No
Signature o Designer 1 Date
The undersigned has reviewed this design on behalf of Mason County Public Health and de to
compliance with state and local on-site regulations: '�' Ito" w. r
En ' o to eal Speciall - Date
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITI
✓ The design is stamped"Approved"by Mason County Public Health. r
✓ 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
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JUN 0 8 207
OUNTY ENVIRONMENTAL HEALT `
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WATERTIGHT LID VENT(typ) DUAL PORT AERATOR
RS
36"MAX. 1"PVC(11fP) i )
AIRLINE MASTiC
4"
2'COUPLING
&REDUCER 6"
t2" 1"PVC SLUDGE
RETURN LBVE
2"PVC
TRASH CHAMBER DIGESTER CHAMBER CLARIFIER
OPERATING CAPACITY:417 GALLONS OPERATING CAPACITY:421 GALLONS CHAMBER
FLOOD CAPACITY:490 GALLONS FLOOD CAPACITY:494 GALLONS 160 GALLONS
FLOOD:191 GAL.
65" 56•
54" 90"
b3'
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COUNTY ENVIRONME DIFFUSERBARS(2) 12'
MASON n4 • • PARALEL TO TANK WALL 4"
3" SLUDGE RETURN
1.6"TAPER
1 °�' STONE-FREE NATIVE SOIL
OR COMPACTED SAND
INSTALLATION INSTRUCTIONS I OVER STONY SOIL
1)Excavate tank hole with vertical walls to 1 foot larger than
tank on all sides.
2)If bottom of hole is stony,Install 3"of compact sand&level
out with screed.
3)Install tank in center Of hole,keeping 1 ft.void space on 1 E
all sides. I 24"RISERS! ) 24"BLOWER
4)As tank is filling with water,fig in void space With compact I IUSING CA$
granular(sandy)soil free of large clumps of day. I (I N TOP OF
5)Install rest of system,&affix risers to adapters with
waterproof adhesive. I3 4$"
6)Perform watertightness test In field as required by local I I I I I 1
jurisdiction. I I I I I
7)Upon approval to baddill,carefully back ill with native I II 12"RISER I I I
soils overtop of tank. I I TRASHCHAMBER II . FAIG STER I IC.eRIFJERI
0)Final grade the surface to avoid c hanellir g surface L______ L_______J L__J
Water toward tank
TOItVIEW
•
AEROBIC TREATMENT TANK DETAIL FOR
Nu WATER BNR-500 TREATMENT UNIT
ENVIRO-FLO, INC. 18E0:Wastewater 0'/'2
1 f•*�` P.O. Treatment
BOX 32 61,Flowood,MS 39232
(877)836-8476 (601)8454716 fax SCALE, ./ f 4 ,µ
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Media Gallery X
Liberty Pumps 280 - 1/2 HP Cast Iron Submersible Sump/Effluent Pump (Non-
Automatic)
Performance Curve:
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0 5 10 15 20 25 30 35 40 45 50 55 60 65 70
U.S. Gallons Per Minute
Installation/Maintenance
Pressure Distribution/Trench Systems
1. Install trench bottom level and in contour with the ground.
2. Install drainfield during dry weather and soil conditions.Any soil smearing must be
eliminated by hand raking any areas that get smeared.
3. Install audio/visual high water alarm.
4. Install effluent filter in septic tank outlet or pump vault with 1/16 inch maximum
filtration mesh size.
5. Install check valve in pump outlet line to prevent back-flow into the pump chamber.
6. Install 1/8 inch orifices on 4ft. centers. Install the orifices pointing straight up( 12:00 o'
clock).
7. Divert all storm water run-off away from septic system components.
8. No curtain (french) drains allowed within l Oft. of the up-slope edge of the drainfield and
reserve area.
9. No curtain(french) drains allowed within 3011. of the down-slope edge of the Grainfield
and reserve area.
10.Have the septic tank and pump chamber pumped or inspected every 3 to 5 years.
11.Inspect and clean pump screen as needed.
12.Inspect floats and test high water alarm every 6 to 12 months or as needed. 11
13.All material and workmanship must meet County and State requirements.
14.Install risers on septic tank and pump chamber.
15.Deviation from this approved design without prior approval from the Designer"and
Mason County Health Department will make this design null and void.
16.The prepared Site Plan is not a survey, it is the owner's responsibility to verify property
line locations prior to installation. Any discrepancies must be reported to the Designer
immediately.
17.Locate all utilities prior to starting installation.
18. The Designer may have additional charges for rede ign work and Final Inspection.
19.The installer must notify the designer -Dale L.Tatja—(360)463-8023) at least 48 hours
prior to installation.
5100244 c�3
o Dale.L:Tahjaa
LICENSED DESIGNER
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