HomeMy WebLinkAboutSWG2026-00170 - SWG Application / Design - 5/29/2026 MMMAS0N CO N1 y 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: SWG2026-00170
APPLICANT KEMBER LOGAN & CHELSEA Phone:
Address: 320 E WAY TO TIPPERARY ST SHELTON, WA 98103
OWNER KEMBER LOGAN &CHELSEA Phone:
Address: 320 E WAY TO TIPPERARY ST SHELTON, WA 98103
SEPTIC DESIGNER CINDY WAITE* Phone: 360-701-0205
Address: 80 E PICKERING LANE SHELTON, WA 98584
Site Address: 320 E Way To Tipperary St
Primary Parcel Number: 321225000043
Permit Description: Repair: SFR 2-bedroom pressure system with trench drainfield
Permit Submitted Date: 05/29/2026
Permit Issued Date: 06/26/2026
Issued By: David Anderson
Current Permit Fees Paid: $845.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 06/11/2027 (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.
A OFFICIAL USE ONLY
MASON COUNTY DATE RECEIVED: C >
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AM0UNTRECEIVE RECEIVED BY:
Public Health & Human Services ®��pp - v Cl)
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 _- —
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z ON-SITE SEWAGE SYSTEM APPLICATION > >
APPLICANT PHONE m M
LOGAN KEMBER 360-867-3805 z
C
MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE ic
320E WAY TO TIPPERARY N SHELTON WA 98584 m
SITE ADDRESS-STREET,CITY,ZIP CODE
320 E WAY TO TIPPERARY SHELTON WA 98584 w
NAME OF DESIGNER PHONE I N
CINDY WAITE 360-701-0205
NAME OF INSTALLER A PHONE
Dl
TBD 00
PERMIT TYPE(select one) DRINKING WATER SOURCE - IO
pmtIRESIDENTIAL OSS !iICOMMUNITY OSS InICOMMERCIAL OSS 9]PRIVATE INDIVIDUAL WELL FñJ PRIVATE TWO-PARTY WELL z I
TYPE OF WORK(select one) PUBLIC WATER SYSTEM LAKE LIMERICK WS
El NEW CONSTRUCTION I UPGRADES EIREPAIR/REPLACEMENT OTHER DETAILS(select all that apply) ❑ TABLE X REPAIR I (.71
SUBMITTALS 69 SURFACING SEWAGE ❑ EXISTING FAILURE ❑SHORELINE
DESIGN
RI FORM(REQUIRED) ®SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE I WAS LOT CREATED AFT ER4/1/2025? I O
L_t]WAIVER(S)(IF APPLICABLE) 2 .36 AC ❑ YES ❑ NO C)
lc
DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.locked gate)
GO OUT HIGHWAY 3, TURN LEFT ONTO MASON LAKE ROAD, TURN LEFT INTO LAKE I o
LIMERICK, FOLLOW ST ANDREWS, TURN RIGHT ONTO WAY TO TIPPERARY. r I
PARCEL IS ON THE RIGHT SIDE OF THE ROAD. IT IS LAKE FRONT. 0 O
I4
SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. I
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE I FAILURE SOURCE(for reporting purposes)
❑VOLUNTARY ❑MAINTENANCE/PUMPING ❑BUILDING PERMIT ❑HOME SALE DCOMPLAINT ❑OTHER:
INSPECTOR SOIL LOGS COMMENTS/CONDITIONS
TL ?- O-33` ( $ CTy 3) (F Starter S`
Re5+ of 23" '-.f cony° ?rr'per�� tc ,. L4kr
T! 2.:0- 3 (7 $ LII' t1 4tP•C f '
[ f of 33 L Rr/ /)1 d C • _told// , 16 fc i,t ?
iO3:O�5I (ic s.,
PeO 04/ ( t1
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.
INS OR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLIC 0 APPROVED/ISSUED BY DATE.
L11 / Z0? 7
C/ 7≥ô?6 _
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE Revised:4/14/202.5
1 l
DESIGN FORM—PAGE ONE' Assessor's Parcel Number: 3121 1121 2 5 0 0 0 0 1 4 3
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 X 17"
PARCELTDENTWICAION
Permit Number: SWG 2o.C_ aO1 ZD Designer's Name: CINDY WAITE
Applicant's Name:
LOGAN KEMBER Designer's Phone Number: 360-701-0205
Mailing Address:
320 E WAY TO TIPPERARY 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 Treatment Device
D Glendon ❑Sand Filter ❑Mound 0 Sand Lined Drainfield ❑Recirculating Filter 0 ATU ❑Other
Treatment Level(check all that apply): ❑A ❑B ❑C ❑BLl 0 BL2 Q BL3 E. ❑N
Drainfield Type
❑Gravity 'Pressure Trench ❑Bed ❑Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number ofBedrooms 2 Schedule/Class SCHEDULE 40
Daily Flow: Operating Capacity 180 gpd Length 31,45,25 ft
Daily Flow:Design Flow 240 gpd Diameter 1.25 in
Septic Tank Capacity(working) EXISTING 1200 gal Number 3
Receiving Soil Type(1-6) 3 Separation 10+ ft
Receiving Soil Appl.Rate .8 gpd/ft2 Orifices
Required Primary Area 300 fe Total Number. )rifl ''. 21
Designed Primary Area 303 ft2 Diameter ,` of y. �Y 3/16 in
Designed Reserve Area 300 ft2 Spacingk �'~ ' �.�,. 60 in.
Trench/Bed Width 3 ft -_ 18 ifold
100
Trench/Bed Length 101 ft Sch CL� • SCHEDULE 40
�1DV E.WAKE .Y.
Elevation Measurements L 1-2 ft
EXPIRES:05/10',
Original Drainfield Area Slope 8 % Diameter 2 in
New Slope,If Altered % Preferred manifold configuration used? I Yes O No
Depth of Excavation Up-slope 9 in Transport Pipe
from Original Grade Down-slope 6 in Schedule/Class SCHEDULE 40
Designed Vertical Separation 24 in Length 50 ft
Gravel-based Drainfield Required? Id Yes ❑No Diameter 2 in
Pump Required? Yes ❑No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day 4
Diff.in Elevation Between.Pump&Uppermost Orifice 18 ft Dose quantity 45 gal
Drainfield Squirt Height/Selected Residual(head) 2 ft Chamber Capacity(flood) 1455 gal
Uppermost Orifice iI Higher ❑Lower than Pump Shutoff Pump controls:Please check those.required.
Capacity @ Total Pressure Head 12.39 gpm if Timer Rf Elapse Meter I9 Event Counter
Calculated Total Pressure Head 20.15 ft If Timer: Pump on ,Pump off
Comments
MAINTAIN 10' FROM TRANSPORT AND LATERALS LINE TO WATER LINE, PUMP CONTROLS TO
BE SET AT TIME OF INSTALLATION, PUMP TANK TO HAVE INLET BAFFLE
Revised:6/11/2025
DESIGN FORM-PAGE TWO Assessor's Parcel Number:I 3121 1121215101010101413
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
if Test hole locations ( Drainfield orientation and layout Reference depth from original grade:
if Soil logs Trench/bed dimensions and Ed Septic tank
if Property lines critical distances within layout V Drainfield cover
❑ Existing and proposed wells D-Box/Valve box locations
p P Reference depth from original grade
within 100 ft of property id Septic tank/pump chamber and restrictive strata:
❑ Measurements to cuts,banks,and locations
' Laterals,trench/bed,top and
surface water and critical areas 121 Observation port location bottom
❑ Location and orientation of 14 Clean-out location ❑ Curtain drain collector
curtain drain and all absorption 121 Manifold placement 0 Sand augmentation
components
i Orifice placement Other cross-section detail:
Location and dimension of i1Lateral placement with distance 121 Observation ports/clean-outs
primary system and reserve area to edge of bed
Buildings Other Information
i� Audible/visual alarm referenced Yes No
121 Direction of slope indicator
Scale of drawing shown on scale 0 Design staked out
Waterlines bar 0 0 Recorded Notices attached
❑ Roads,easements,driveways, 7 Elevation benchmark and relative ❑ 0 Waiver(s)attached
parking elevations of system components ' ❑Pump curve attached
❑ North arrow and scale drawing 0 0 Evaluation of failure
shown on scale bar Non-residential justification
0 0 Waste strength
0 ❑ Flow
DESIGN APPROVAL
The undersigned designer must be notified by installer at time of installation 'Yes ❑ No
CjL 6 -2 3 2026
Signs of Designer Date
p ,
The undersigned has reviewed this design on behalf of Mason County Public Health and determined i Mokezin�?
compliance with state and local on-site lations: JO 1 G�
z z SON 2 6 2026
Envi onmental Health Specialist Date EIVVIRO
oj N�yENrA
LHE
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION: 11
✓ 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 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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BENCH f,Pl €gin 10 tou MARK4 S Grade at nevi pump tank 1 100.00
Pam Tank 2 )9:50
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j EXP,HLS 05,101 7 Primarytreserve drainfield
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ORIFICE SPACING 5
Lateral# Length Length Orifice # Distance from Distance from end Length#
# (Feet) (Inches) Spacing" Orifices feeder line of end of lateral
1 31 372 60 7 0.5 0.5 31
2 45 540 60 9 2.5 2.5 45
3 25 300 60 5 2.5 2.5 25
-5
1
101 21 100
TRANS LENGTH 50
GPM 1.2.39:
K (2"SCHEDULEN 40), 84;-5;
FRICTION LOSS 0.15 X7399,
Squirt I 2
Elevation difference 18
TDH 20.15174
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Installation Notes
*430
N00ON�
Pressure Distribution System: �0?6
R�N'�FN 32122-50-00043 330 E Way to Tipperary St d✓� T4�
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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.
ta e sns
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6. Keep wheeled vehicles off the drainfield area before, during and after installation.
tracked equipment only
7. All 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.
8. Curtain drains can be no closer than 10' upgradient and 30' down gradient of the
drainfield
9. Exposed restrictive layers, cuts, banks, etc. can be no closer than 50' downhill from the
drainfield.
10. Install access risers on the septic tanks, valve box and ends of laterals.
11. Make sure septic tank risers are epoxied or caulked to cast in riser rings on tank.
I?-Spz. k b3roe nus m
•Isa 111
14. Lids must form a water and gas tight seal with the access risers.
15'. Install effluent filter at the septic tank outlet.
16. This system must be installed by a Mason County Certified installer.
17. Deviation from this design without prior approval from the designer and Mason County
Health Department will make this design null and void.
18.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.
19. Install laterals with contour of the ground.
20. Install trench bottoms level and always maintain a minimum of six inches into native
soil..
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EXPIRES 05,101
System Owner Responsibilities:
1. Operation and Maintenance is required by Washington State Department of Health and.
Mason County Health Department.
2. The septic tank and pump tank should be pumped every three to five years or as
needed.
3. System owners are responsible for having maintenance performed annually.
4. System owners are responsible for responding to septic issues in a timely manner.
5. System owners shall not at any time change or alter settings in the control box.
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.
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