HomeMy WebLinkAboutSWG2026-00169 - SWG Application / Design - 5/29/2026 MASON COUNTY 415 N 6TH STREET,SHELTON, , 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: SWG2026-00169 (p) i-f '
APPLICANT LUIS FELIPE TORRES FAMILY TRUST Phone:
Address: LUIS FELIPE TORRES/MARGO GALVIN TORRES-CO TRSEES SEATTLE, WA
98112
OWNER LUIS FELIPE TORRES FAMILY TRUST Phone:
Address: LUIS FELIPE TORRES/MARGO GALVIN TORRES-CO TRSEES SEATTLE, WA
98112
SEPTIC DESIGNER CINDY WAITE* Phone: 360-701-0205
Address: 80 E PICKERING LANE SHELTON,WA 98584
Site Address: 41132 N US HIGHWAY 101
Primary Parcel Number: 224062200180
Permit Description: Table 10 repair 3bd ATU to pressure bed
Permit Submitted Date: 05/29/2026
Permit Issued Date: 07/08/2026
Issued By: Rhonda Thompson
Current Permit Fees Paid: $845.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 06/03/2027 (based on date of inspection)
Permit Conditions:
1 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.
M A,SO N COUNTY 415 N 6TH STREET,SHEL-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
8 Applicant to remove water spigot in drainfield area and any waterlines within 1Oft of septic
components.
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. O`/_ / C Cl)
• _ AMOUNT RECEIVED: (✓^ RECEIVED BY:J
Public Health & Human Services _ ARE v_ C6
Environmental Health 360-427-9670,ext.400 or 360-275-4467,ext.400 ≤ Cl)415 N.6th Street-Shelton,WA 98584 S W G _ O a ( 0 -
v v v z U,
ON-SITE SEWAGE SYSTEM APPLICATION
APPLICANT PHONE m m
LUIS FELIPE TORRES FAMILY TRUST 206-669-0286 z
C
MAILING ADDRESS-STREET,CITY STATE,ZIP CODE
2147EBROADMOOR DRIVE EAST SEATTLE WA 98112 M
41132 N HWY 101SITEADDR ��5d LILLIWAUP WA 98555 I
NAME OF DESIGNER PHONE
CINDY WAITE MAY 2 9-2026 360-701-0205 N�
NAME OF INSTALLER PHONE
TBD PERMIT TYPE(select one) DRINKING WATER SOURCE I
RESIDENTIAL OSS COMMUNITY OSS II!COMMERCIAL OSS 9T PRIVATE INDIVIDUAL WELL PRIVATE TWO-PARTY WELL Z
TYPE OF WORK(select one) PUBLIC WATER SYSTEM
f1 NEW CONSTRUCTION/UPGRADES j REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) TABLE X REPAIR I N
SUBMITTALS ❑ SURFACING SEWAGE Pf EXISTING FAILURE 0 SHORELINE
DESIGN FORM(REQUIRED) i„I SEPTIC DESIGN(REQUIRED) BEDROOMS LOTSIZE I rWAS LOT CREATED AFTER 4/1/2025? O I
5WAIVER(S)(IF APPLICABLE) 3 .79 ac O
YES ❑✓ NO I O
DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.locked gate)
GO NORTH ON 101, ADDRESS IS ON THE RIGHT SIDE OF HIGHWAY. THIS IS A I
DRIVE THROUGH DRIVEWAY. SOIL LOGS ARE ON THE WATER SIDE OF r I
RESIDENCE. 0
CcL _') r
SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS.
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE/FAILURE SOURCE(for reporting purposes)
❑VOLUNTARY ❑MAINTENANCE/PUMPING ❑BUILDING PERMIT ❑HOME SALE OCOMPLAINT ❑OTHER:
INSPECTOR SOIL LOGS COMMENTS/CONDITIONS ,1
J '
- -
SOIL CODES: RECORD DRAWING AND INSTALLATION REPORT
V=VERY G=GRAVELLY S=SAND L=LOAM SI=SILT C=CLAY E=EXTREMELY R=ROOTS REQUIRED FOR FINALAPPROVAL.
INSPECTOR SIGNATURE DATE APPLICATION AT EXPIRATION DATE APPLICATION APPROVED/ISSUED BY
DATE
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE Revised:4/14/2025
DESIGN FORM—FAGE ONE
Assessor's Parcel Number:
A design will be reviewed when 3 conies 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"X17
PARCEL,IDENTIFICATION
Permit Number: SWG (�}� f 00 f G Designer's Name: CINDY WAITE
Applicant's Name: LUIS FELIPE TORRES FAMILY TI Designer's Phone Number: 360-701-0205
Mailing Address: 2147 BROADMOOR DR EAST . Designer's Address: 80 E PICKERING LANE
SEATTLE WA 98584 City State Zip SHELTON WA 98584
City State Zip Designer's Email cindyewaite@msn.com
DESIGN PARAMETERS.
Treatment Device
❑Glendon ❑ Sand Filter ❑ Mound ❑ Sand Lined Drainfield ❑ Recirculating Filter ATU BRN 600
1 1 ..[ .1 1 O Other
Treatment Level(check all that apply): ❑A 1i0 B I C ❑ BL1 YJ BL2 1E:1 BL3 ii E KI N
Drainfield Type
❑Gravity Pressure ❑Trench O Bed ❑ Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 3 Schedule/Class SCHEDULE 40
Daily Flow: Operating Capacity 270 gpd Length 45 ft
Daily Flow:Design Flow 360 gpd Diameter 1.25
in
Septic Tank Capacity(working) 500 TRASH,BNR 600 gal Number 3
Receiving Soil Type(1-6) 3 Separation 3 ft
Receiving Soil App!.Rate .8 gpd/ft2 Orifices
Required Primary Area 450 ft2 Total of Orifices 27
Designed Primary Area 450 ft2 3/16
in
Designed Reserve Area VERY LIMITED ft2 Sp` �'Fq� 60
of.,s in
Trench/Bed Width 10 ft
Manifold
y. ,
Trench/Bed Length 45 its
ft . du as �
�
y t oi8 t�`
Elevation Measurements en ov WAITE
Original Drainfield Area Slope 1 % LICENSED Df ;IGNER
New Slope,If Altered o L ° �6s 10, in
/o Preferred manifold configuration used? O Yes Iit'No
Depth of Excavation Up-slope SEE PAGE 5 NOTE 1 in Transport Pipe
from Original Grade Down-slope SEE PAGE 5 NOTE 1
in Schedule/Class SCHEDULE 40
Designed Vertical Separation 24 in Length 30 ft
Gravel-based Drainfield Required? ❑Yes l6 No Diameter 2 in
Pump Required? I f Yes O No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day 6
Diff.in Elevation Between Pump&Uppermost Orifice -4 ft Dose quantity 45 gal
Drainfield Squirt Height/Selected Residual(head) 2 $ Chamber Capacity(flood) 1287 gal
Uppermost Orifice O Higher l 'Lower than Pump Shutoff Pump controls: Please check those required.
Capacity @ Total Pressure Head 15.93 gpm Timer 56 Elapse Meter If Event Counter
Calculated Total Pressure Head -1.85 ft If Timer: Pump on ,Pump off
Comments
CONTRACT DESIGNER PRIOR TO INSTALLATION, PUMP CONTROLS TO BE SET AT TIME OF
INSTALLATION
Revised:6/11/2025
DESIGN FORM—PAGE TWO Assessor's Parcel Number: 2 12 j 4j 016121 2 i 0 JO J 1L 8J 1 0
. .
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
if Test hole locations Drainfield orientation and layout
Soil logsy Reference depth from original grade:
g f7J Trench/bed.dimensions and ld Septic tank
f Property lines critical distances within layout
¢1 Drainfield cover
❑ Existing and proposed wells O D-Box/Valve box locations Reference depth from original grade
within 100 ft of property Septic tank/pump chamber and restrictive strata:
❑ Measurements to cuts, banks,and locations
surface water and critical areas Laterals,trench/bed,top and
Observation port location bottom
❑ Location and orientation of l0 Clean-out location O Curtain drain collector
curtain drain and all absorption it Manifold placement ❑ Sand augmentation
components
i0 Orifice placement Other cross-section detail:
Location and dimension of. DI Observation
primary system and reserve area it! Lateral placement with distance ports/clean-outs
to edge of bed
Buildings Other Information
Of Audible/visual alarm referenced Yes No
Direction of slope indicator
i9 Scale of drawing shown on scale If ❑ Design staked out
Waterlines bar ❑ ❑ Recorded Notices attached
Roads, easements,driveways, i7 Elevation benchmark and relative ❑ ❑Waiver(s)attached
parking elevations of system components RI ❑ Pump curve attached.
North arrow and scale drawing O ❑ Evaluation of failure
shown on scale bar Non-residential justification
❑ ❑ Waste strength
❑ ❑Flow
DESIGN APPROVAL --``
The undersigned designer must be not' d by installer at time of installation ITYes O. No
Signatu a of Designer Date
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 regulations: r�
Environmental Health Specialist Date
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
✓ The design is stamped"Approved"by Mason County Public Health. (3j2- //'VThe 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
,,41132-US-1013 Lilliw tip WA.,98555, USA,West Mason Township, Parcel Id: 224062200180
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8.50 94.00
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//'/ ' ,5L aJ Parcel Lines,Bufek5ft/1 j l . ry°
'
Jig
_fie I Residence
�� 3O ! `'i 2 Audible/visual alarm
3 Clean out
° 4 500-1000 infltratorTrash tank
f fit. 2�er° - 5 BNR 600 in infiltrator tank
Gss deg end
, ° Zg 6 1060 Infilitrator pump tank
Measure Area f ' ti° ' 7 Primary drainfield rs
�r r
Measure Length f' tea 8 Waterline
WA Mason 10 ft- Contours (.P s`` 9 Out buildings
bt: YY + 4f___ ___ Scale=> 1 in 30 ft � d'\•
ORIFICE SPACING 5
Lateral# Length Length Orifice # Distance from Distance from end Length#
# (Feet) (Inches) pacing" Orifices feeder line of end of lateral
1 50 600 J 60 9 2.5 2.5 45
2 50 600 60 9 2.5 2.5 45
3 50 600 60 9 2.5 2.5 45
150 27 130
TRANS LENGTH 3.0
GPM I 15.93;
K (2"SCHEDULEN 40) 284.5
FRICTION LOSS Iø1333,
Squirt I 2
Elevation difference -4
TDH -1.8550667
APPROVED
JUL 082026
MASON COUNTY ENVIRONMENTAL HEALTH
TRENCH CROSS S RET CTION
12"- 2-7 '°
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S ivy 1 Paq e L./
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D AINFIELD LAYC UT
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- £
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X1=CLEANOUT/OBS PORTS C3 EXPIRES 051101
X2=D BOXIVALVE BOX
X3=Check Valves
X4=Flow Control Valves (3) /
X5=Soil Logs Vd q- . 3
1 ` ,3
sPA here i nu n hy�
yep oy�FN�AI
y�`Tti
THREADED CAP OR PLUG
P P V& / _____ 6"PVC
LAST ORIFICE;WITH
ORIFICE SHIELDS IF
ORIFICE ORIENTATION IS
BACKFILL UPWARD
MATERIAL — N / < /�'--- J. n
II
��� oO°c$o O O �- PRESSU E
R LATERAL
OoopAp o AS SPECIFIED
LONG SWEEP / Cf
DRAIN ROCK;6"MIN.
UNDISTURBED SOIL --/
6"PVC WITH DRAIN
HOLES; EXTEND TO
BOTTOM OF GRAVEL TO
MONITOR PONDING
£ ') INFILTRATIVE SURFACE
tit �.pF/Xt^.Syj29�, .
l 5tana�a: b1TORING/CLEAN0UT PORT \'02 LICENSED DFASIGNE� (EXA PLE) \
APPROVED
EXF'HES'U51101
MASON COUNTY ENVIRONMENTAL HEALTH
RET
7 cti r:
FINISHED GRADE
/ CLEAN UT 24"RISERS WITH BOLT ON LIDS
iT MIN.
- /,-, ,, !T
BAFFLE
CLARIFIED ZONE
EFFLUENT FILTER
APPROVED
per• CINDY E.'WA17E'' rr;`
LICEWSW DfrSJG ER
. Exai�2�ruf5;1 ; ^
JUL 08 2026
MASON COUNTY ENVIRONMENTAL HEALTH
RET
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`Length' 127"(3226 mm) 0411011- -. 1 02418101ACCFSSOPENI 5wiTHIACIGNGl105(2l
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Pumps°
Installation Notes
Pretre ted Pressure.Distribution System:
22406-22-00180 41132 U S 101
1. The prepared site Ian is not a survey. It's the owner's responsibility to verify property
lines, utility lines (w ter, sewer, power, phone and gas) prior to installation.
2. After clearing, insta ler and designer will meet on site to stake out drainield.
3. Install system duain dry weather with acceptable soil conditions
4. 500-1000 gallon tr sh tank if feasible
5. BNR 600 System
6. 1060 ifiltrator pump tank
7. Keep wheeled vehi les off the drainfield area before, during and after installation.
Tracked equipment only,
8. All ground, surface ater and roof drains must be diverted away from the septic tanks
and drainfield. Ens re the final grade slopes away from these areas and water
doesn't collect on o around them. Use swales, berms, catch basin and tight lines,
curtain drains, etc. t divert all waters.
9. Curtain drains can a no closer than 10' upgradient and 30' down gradient of the
drainfield
10. Exposed restrictive ayers, cuts, banks, etc. can be no closer than 50' downhill from
the drainfield.
11. Install access risers on the septic tanks, valve box and ends of laterals.
12. Make sure septic to k risers are epoxied or caulked to cast in riser rings on tank.
13. Lids must form a w ter and gas tight seal with the access risers
14. This system must b installed by a Mason County Certified installer or
15. Deviation from this esign without prior approval from the designer and Mason
County Health Dep rtment will make this design null and void.
16. This design was siz d per Washington Administrative CodeWAC246-272A-0230. The
operating capacity i based on 45 gallons per day per capita with two persons per
bedroom. The mini um design flow per bedroom per day is the operating capacity of
ninety gallons multi Tied by 1.33. This results in a minimum design flow of one
hundred twenty gall ns per day. This creates a surge factor of 33% but anticipated
flow is ninety gallon per bedroom per day.
17. Install bed or trench�s with contour of the ground
18. Install trench bottoms level and always maintain a minimum of six inches into native
soil
19. Install locator tape o top of all drainfield laterals.
20. Install threaded clea outs at the ends of all laterals (caps must extend to within six
inches of finish grad and be in a valve box as shown on diagram.
21. Install audio/visual a arm
22. Filter fabric requir d over drain rock prior to backfilling. If the, , `in= 'c�C
extends above the riginal grade, run the filter fabric at least the own the
trench wall.
23. A PROVE D t,/ . :
8 2026 I �NSED�r�sicN k MASON BOUNTY ENVIRONMENTAL HEALTH EXPIRES 05r,°'
RET
S stem Owner Responsibilities:
1. Operation and Mainte ance is required by Washington State Department of Health and
Mason County Health Department.
2. The septic tank and p mp tank should be pumped every three to five years or as
needed.
3. System owners are re ponsible for having maintenance performed annually.
4. System owners are re ponsible for responding to septic issues in a timely manner.
5. System owners shall of at any time change or alter settings in the control box.
6. System owner agree to read and abide by information regarding their system in the
User Manual provided by Mason County Public Health.
7. Keep the flow of sews a at or below the approved design operating capacity.
8. Keep waste strength t residential waste strength parameters.
9. Spread loads of laund through the week.
10. Do not use excessive leach or detergents with added whiteners.
11. Do not shower, do lau dry and dishwasher at the same time
12.Antibiotics can kill or i pair the biological process in the septic tank.
13. Leaky plumbing can h draulic overload your on-site septic system.
o As Y:
LICENSED D pSJGN�R
APPROVED
JUL 0
6 2026
MASON COUNTY ENVIRONMENTAL HEALTH
RET