HomeMy WebLinkAboutSWG2026-00209-APPLICATIO/DESIGN - SWG Application / Design - 7/8/2027 MASON CO N TV 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: SWG2026-00209
APPLICANT GLORIOUS DAY PROPERTIES LLC Phone:
Address: 3543 DILEUCA ST PUNTA GORDA, FL 33950
OWNER GLORIOUS DAY PROPERTIES LLC Phone:
Address: 3543 DILEUCA ST PUNTA GORDA, FL 33950
SEPTIC DESIGNER CINDY WAITE* Phone: 360-701-0205
Address: 80 E PICKERING LANE SHELTON, WA 98584
Site Address: 141 NE WAGON WHEEL RD
Primary Parcel Number: 222025402004
Permit Description: Repair 3BR gravity-no reserve
Permit Submitted Date: 07/02/2026
Permit Issued Date: 07/09/2026
Issued By: Jeff Wilmoth
Current Permit Fees Paid: $845.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 07/08/2027 (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 instalation 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.
. I
DESIGN FORM—PAGE ONE i Assessor's Parcel Number:
� �2151410i21010 4
A design will be reviewed when 3 copes f each of the following are submitted:
"Completed design form that has been signe and dated. "Scaled layout sketch,including all applicable items on checklist.
Scaled plot plan,including all applicable it ms on checklist. "Cross-section sketch,including all applicable items on checklist.
This form may be scanned and avai able for public view on the Mason County Web site.Maximum paper size: 11"X17"
PARCEL IDENTIFICAION___
Permit Number: SWG I_ Designer's Name:
CINDY WAITE
Applicant's Name: MIKE BACON/GLORIOUS DAY P Designer's Phone Number: 360-701-0
I 205
Mailing Address: 3543 DILEUCA ST i Designer's Address: 80 E DICKERING LANE
PUNTA GORDA FL 33950 City State Zip SHELTON WA 98584
City State Zip Designer's Email cindyewaite@msn.com
Treatment Device
❑Glendon ❑ Sand Filter ❑Mound ❑ and Lined Drainfield ❑Recirculating Filter ❑ATU
❑Other
Treatment Level(check all that apply): p ❑B ❑ C ❑BLI ❑BL2 0 BL3 1'E ❑N
Drainfield Type
& 'Gravity 0 Pressure j 0 Trench ed 0 Sub Surface Drip
Septic Tank/Drainfield Speci cations Laterals
Number of Bedrooms I3 Schedule/Cl 4: ASTM 2729
Daily Flow: Operating Capacity 70 gpd Length �s'o qty, 45
Daily Flow:Design Flow 360 gpd Diamet .�. 1a, ti 4
in
Septic Tank Capacity(working) EXISTING 1 00 PREMIER gal Num jioa@ 1' 3
Receiving Soil Type(1-6) Se a CEIN Y S1GNER 3
.Y ft
Receiving Soil Appl.Rate 8 gpd/ft2
os,n, es
Required Primary Area 4o ft2 Total Number of Orifices ASTM 2729 PERF
Designed Primary Area 40 ft2 Diameter
in
Designed Reserve Area VERY IJMITED ft2 Spacing
in
Trench/Bed Width 10 ft Manifold
Trench/Bed Length 5 ft Schedule/Class
Elevation Measurements Length ft
Original Drainfield Area Slope % Diameter in
New Slope,If Altered % Preferred manifold configuration used? ❑Yes ❑No
Depth of Excavation Up-slope SEE NOTE 1,PAGE 4 in Transport Pipe
from Original Grade Down-slope SEE NOT 1,PAGE 4
in Schedule/Class ASTM 3034
Designed Vertical Separation 6 in Length 10-15 ft
Gravel-based Drainfield Required? Yes No Diameter q
in
Pump Required? 0 Yes No Dosing and Pump Chamber
Pump/Siphon Specificati ns Number of doses/day
Diff. in Elevation Between Pump&Uppermos Orifice ft Dose quantity
gal
Drainfield Squirt Height/Selected Residual(h ad) ft Chamber Capacity(flood)
�, ..1 � `t;! r'i �r gal
Uppermost Orifice 0 Higher ❑Lower than P mp Shutoff 'u np conij rols >l?lease cl ec th se required.
Capacity @ Total Pressure Head =
gpm ❑ Timer 0 ElapselMeter ❑ Event Counter
Calculated Total Pressure Head ft rmer:,� umo
f : n0
�. P _=:� Pump off
Comments
MASON COUNTY ENVIRONME SAL HtJLI r'
STAKE OUT DRAINFIELD AFTER AREFUL CLEARING, VERIFSYKSLIFT FROM PUMP TANK TO
OSCARS,
cr, ,I't,',e
DESIGN FORM—PAGE TWO Assessor's Parcel Number.-t+ 2 2 L 2 01 2 e 51 41 01 2 1 0 1 0 4
Permit Number: SWG ��.Q - bQR Oq
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
1f Test hole locations 10 Drainfield orientation and layout Reference depth from original grade:
if Soil logs Trench/bed dimensions and
❑ Septic tank £',t p r f r''t
1 Property lines critical distances within layout it Drainfield cover
existing and proposed wells f D-BoxNalve box locations
within 100 ft of roe Reference depth from original grade
property rty Septic tank/pump chamber and restrictive strata:
lLMMeasurements to cuts,banks, an locations ^7 a'Jo
10 Laterals,trench/bed,top and
surface water and critical areas
Observation port location bottom
ocation and orientation of 0214'lean-out location 0 Curtain drain collector
curtain drain and all absorption OPT(lanifold placement ❑ Sand augmentation
components
[8'109'rifice placement Other cross-section detail:
1 Location and dimension of Lateral placement with distance ❑ Observation ports/clean-outs
primary system and reserve area V
to edge of bed
1f Buildings Other Information
A-Audible/visual alarm referenced Yes No
Direction of slope indicator
l� Scale of drawing shown on scale ❑ Design staked out
I Waterlines bar ❑ ❑ Recorded Notices attached
if Roads, easements, driveways, L ' Elevation benchmark and relative ❑ ❑ Waiver(s)attached
parking I elevations of system components ❑ 0 Pump curve attached
Df North arrow and scale drawing ❑ 0 Evaluation of failure
shown on scale bar
Non-residential justification
❑ 0 Waste strength
❑ ❑Flow
DESIGN APPROVAL
The undersigned designer must be no d by installer at time of installation 'Yes 0 No
-7i , 202,
Sign tare of Designer Date
The undersigned has reviewed this de ign on behalf of Mason County Public Health and determined it to be in
compliance with state and local on-sit r ulations:
Enviro a ealth Specia 1st Date
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
✓ The design is stamped"Approved' by Mason County Public Health.
✓ 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 syst tn must be installed by a certified installer,
unless prior authorizati n is obtained from IV1ason County Public Health.
f�, j✓ p'�-' i �f�j Div
An Installation Fee is rc quired.
r1 '-+r
This form may be scanned and available for public view on p0 9YYY n County` ili sit ti evised: 6/11/2025
��1�in1 fY ENVIHON�4ENTAL HEALTH
141 NE Wagon Wheel Rd, Belfair, WA 98528, USA, Beltair-Tahuya Township, Parcel Id: 222025402004
GIS Legend
Measure Area
WA Mason 10 ft. Contours BENCHMARK
Top of tank 1 10®00®�
Septic outlet 68075_
p Bo tom of drainfiel 67.25 S LI
1 1 esidence/decks
2 fxistingy1300 gal Primier tank
Tsanport li' e
f,nm rydTQt Iiiefd_ f
6 Failed:drarnfield
7 Reseivedramfield;. ' 2 r
. �
8 Waterline
e
9 Tranporf line i Q o/ .,, . . / / /1 / / i/ . L* kd L1J
t9 // '/
/ 4.P
.� �s .
I
u a ,
2 p art
Scale => 1 in 20 ft
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MASON COUNTY ENVIRONMENTAL.HEALTH
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Installation Notes
Gravity System
22202 54-02004 141 NE WAGON WHEEL
1. The prepared site pl n 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. To observation po to be installed on both ends of bed
3. Gravel based drainff Id required
4. Install system during cry weather with acceptable soil conditions
5. Keep wheeled vehicle off the drainfield area before, during and after installation.
Tracked equipment only
6. All ground, surface wa er and roof drains must be diverted away from the septic tanks
and drainfield. Ensure he final grade slopes away from these areas and water doesn't
collect on or around th m. Use swales, berms, catch basin and tight lines, curtain drains,
etc. to divert all waters
7. Curtain drains can be o closer than 10' upgradient and 30' down gradient of the
drainfield
8. Exposed restrictive lay rs, 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 isers 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 t e septic tank outlet.
13. This system must be installed by a Mason County Certified Installer.
14. Deviation from this des gn without prior approval from the designer and Mason County
Health Department will make this design null and void.
15. This design was sized er Washington Administrative CodeWAC246-272A-0230. The
operating capacity is b sed 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 p r day.
16. Install laterals or bed w th contour of the ground
17. Install trench bottoms I vel and always maintain a minimum of six inches into native soil
18. Filter fabric required var drain rack prior to backfilling. If the drain rock extends
above the original gre e, run the filter fabric at least thee din the trench wall
Cft, 1, ry•_
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MASON COUNTY ENVIRONMENTAL HEALTH
S stem Owner Responsibilities:
1. Operation and Maint nance is required by Washington State Department of Health and
Mason County Healt Department.
2. The septic tank shout be pumped every three to five years or as needed.
3. System owners are r sponsible 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 agree to read and abide by information regarding their system in the
User Manual providec by Mason County Public Health.
6. Keep the flow of sew ge at or below the approved design operating capacity.
7. Keep waste strength t 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 lau dry and dishwasher at the same time
11. Antibiotics can kill or i pair the biological process in the septic tank.
12. Leaky plumbing can h draulic overload your on-site septic system.
•�of�^gyi 9J..
CIN E. AITE
EXPIRES A5/101
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L J
MASON COUNTY ENVIRONMEN fAL HEALTH