HomeMy WebLinkAboutSWG2020-00046 - SWG Design - 7/16/2026 DESIGN FORM —PAGE ONE ssessor's Parcel Number I ` Q c i1c- L1.� i_9_
A design will be revieHed when 3 cpies of each of the following are submitted:
O Completed design form that has been signed and dated. S 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 farm maybe scanned and available for public view on the Mason County Web site.Mat/mum paper size: 11'A17
PARCEL. DENTIFICATION ".
Permit Number'. SWG G 02. C- 9cc t\ Cc Designer's Name: Tom Weaver
Applicants Name: A d Peabody Designer's Phone Number: 360-620-7054
Mailing Address: PO Box 565 Burley, WA Designer's Address: 3912 Syeelhead Dr NW
Burley WA 98322 City State Zip Bremerton WA 98312
Citr State Zip Designer's Email tweaverl431 @gmail.com
DESIGN PARAMETERS
Treatment Device
0 Glendon 0 Sand Filter 0 Mound 0 Sand lined Drainfield ❑ Recirculating Filter 0 ATU BNR500 U Other_
Treatment Level (check all thin apply;. ❑A COB ❑ C ❑ BL 1 C BL2 ❑ BL? rl I fl N
Drainfield Type
0 Gravib, Rf Pressure 0 Trench Bed 0 Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 3 Schedule/Class SCH 40
Daily Flow: Operating Capacity x,10 360 gpd Length 30 ft
Dail-, Flow: Design Flow 360 gpd Diameter 1.25 in
Septic Tank Capacity (working) 500 gal Number 5
Receiving Soil Type(1-6) 3 Separation 2' between Beds ft
Receiving Soil Appl. Rate .8 gpd/fl' Orifices
Required Primary Area 450 fl' Total Number ofOrifices 30
Designed Primary Area 450 Diameter 3/16 in
Designed Reserve Area 450 fl- Spacing 60 in
Trench'Bed Width 6' & 9 ft Manifold
French Bed length 30 ft Schedule Class Sch 40
Elevation Measurements Length 6' & 9' fi
Original Drainfield Area Slope 18 ao Diameter 2 in
New Slope. Il'Altered % Preferred manifold configuration used? Yes O No
Depth of Excavation tln-+lore 32" & 32" in Transport Pipe
from Original Grade lh,%,,,-,lope 20" & 12" in Schedule class Sch40
Designed Vertical Separation 28 in Length 50 ft
Gravel-based Drainfield Required? ❑ Yes Ed No Diameter 2 in
Pump Required? Ef Yes 0 No Dosing and Pump Chamber
Pump/Siphon Specifications Number ofdoses day 6
DifT in Pleratio', Between Pump& I ppemu sl()ritice 9— 0 Dose quantity 60 gal
Drainfield Squirt Height, Selected Residual(head) - 2 ft Chamber Capacity(flood) 1,200 gal
Uppermost Orifice Higher 0 Loeer than Pump Shutoff Pump controls: Please check those required.
Capacity!if Total Pressure Head 24 gpm Ed Timer ❑ Filapse Meter ❑vt:vent Counter
Calculated Total Pressure Head 15 fl If Timer: Pump on 2±min Pump ofT 4 Hours
Comments
Revised: 414'2025
DESIGN FORM—PAGE TWO Assessors Parcel Number k 'Z7'
Z7SL)_ ¶Z. ®0OH_
Permit Number: SWG -0 3'? LCC'-4 L
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
0 Test hole locations 19 Drainfield orientation and layout Reference depth from original grade:
Ib Soil logs R1 Trench/bed dimensions and Rf Septic tank
66 Property lines critical distances within layout [9 Drainfield cover
❑ Existing and proposed wells 66 D-BoxfValve box locations Reference depth from original grade
within 100 ft of property R1 Septic tank/pump chamber and restrictive strata:
m Measurements to cuts, banks, and locations Gd Laterals. treneh/bed, top and
surface water and critical areas Observation port location bottom
m Location and orientation of Clean-out location ❑ Curtain drain collector
curtain drain and all absorption 9 Manifold placement ❑ Sand augmentation
components
� Orifice placement Other cross-section detail:
❑ Location and dimension of Rf Observation orts/clean-outs
primary system and reserve area Lateral placement with distanceP
to edge of bed Other Information
Buildings
� Audible,visual alarm referenced Yes No
21 Direction of slope indicator
l� Scale of drawing shown on scale O d Design staked out
6d Waterlines bar O lif Recorded Notices attached
la Roads, easements.drikeways. ❑ Elevation benchmark and relative Rf O Waiver(s)attached
parking elevations of system components fif ❑ Pump curve attached
North arrow and scale drawing ❑ G6 Evaluation of failure
shown on scale bar Non-residential justification
❑ ❑ Waste strength
❑ ❑ Floc
DESIGN APPROVAL
The undersigned designer must be not r installer at time of installation 21 Yes O No
Signature of Designer ' Dar
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: aSh Usor I;\'
Environmental Health , ecialist Date
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
✓ The design is stamped "Approved' by Mason County Public Health.
✓ The Onsite Se age Permit has not expired. the Permit Expiration Date is:
✓ Drainfield site conditions hake not been altered to adversely atect 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:4'14:2025
Trash Tank is a 500 gallon poly tank
Schooner PI
Keep all tanks> 50'from water .36.1
Keep drain field > 75'from water .36d 30'
Valve box to have check valves due to location
Split Reserve
D W 1100
6'X 30 Pressure Bed
Water line
&Power to
run down South , 9' X 30' Pressure Bed
side of lot
away from Split Reserve 100%
drain field
SL#1 0-24"Tan Loamy Med. Sand 1 0D
24-60"Grey Med. Sand
SL#2 Same as SL#1
SL#3 Same as SL#1 / Three Bedroom r" /Valve B
r Home
75'fr at
Pump Tank
1
%
t-. 50'fro
5100533,�pyEP'
r V r
APPR® \%ED
UL 16 262E
65'
r7
sd
rface Water
116.75'
1"= 20'
Tel ' 12330-52-00019
x x
± I -
a
C
I J - � OI
I m
o ; o
IA
a
d Y
j
p / J
R
A ROVED
JUL 1 6 20116
W• S0 wl-. 4 -1TH
d C O !
o r
O C f R9
1
71 NE Schooner P1
12330-52-00019
500 gallon Trash tanks
NuWater BNR 500
1,200 Gallon Pump tanks
High Level Alarm & Low Level timer floats
All tanks fitted with water tight access to the surface
Drain field is to be constructed as two separate beds 30' long
One bed 6' wide and one bed 9' wide
Number of laterals -5 Two in the 6' bed and three in the 9' bed
Length of laterals 30'
Bed depth to be
12" downslope on 9' bed and 32" on upslope
20" downslope on 6' bed and 32" on upslope
Laterals to be 1 .25" Sch 40
Transport to be 2" Sch 40
Access ports for flushing on each lateral / a
Residual squirt height 24" / GlJ
51(IfA'il3 F)
1M�NivS E.N�cANEP- '
Orifices 3/16" with 60" spacing k rse^nE N•E9
Orifices at 12:00
End manifold
Covered valve box protected from burrowing critters
NuWater supplied controller with timer/counter/elapsed time
Time dosed set for 6 times per day at 60 gallons per dose
Pump Liberty 290 or equivalent
Check valve, valve, and union in pump tank tank APPROVED
Ji,JI 16 2G26
Performance Curve: 290-Series
50 16
e5
£0 — — — 12
35'
30
4 26
X20N N.
16
10 3
5
0 0
0 10 20 30 40 50 60 80 !10
Flow ((3PM)
I I —i I I 4 I
32 76 114 151 189 227 265 30.9 341
Liters Per Minute
Recommend Liberty 290 Pump �^
5100.193
3/16" Orifices @ 2' residual head = .59 HOMa Eot�"A;
2" Transport line @ 40gpm = .027' head/lineal ft
Every 900 = .162' head Every 45° = .07' head ,7/2 ? 6
Number of orifices 30 X .59 = 18 GPM
2 9
Transport loss 2 + Fitting loss _+ elevation life + 2' 15
residual =
.JUL 162026
1rA C5CS61''E1+' CSyEE',TA'. �EALT1
OWL PORT AERATOR
WATERTIGHT LIDVENT eyp) .
RISERG(TYPI
AIRLINE fMSTIC
AdLLNE
j ___ j ______
I
] COUPLING m.
-
s REOULER 6'
I —IF
Y TEE 1'PVC SLUDGE
12' RETURN LINE
2 PVC
TRASH CHAMBER DIGESTER CHAMBER CLARWER
OPEMTWG CAPACITY:417 GKLONS OPERATMG GPACm:421 CANONS CHAMBER
FLOOD CAPACITY:AN GALLONS FLOOD CAPACITY'.AN GALLONS I OALLON5
FLOOD 191 GAL
65' I,I 58
1
53'
. TEE
APp t
k 1pr 12'
i� O' MFFUSEROTM GI
II �. 2 .C PAWLLEL TO TANK WNL �.
I _ Al10GERElURN AL I
STONE-FREE NATIVE SOIL
OR COMPACTED SAND
RISTALLATIOW INSTRUCTIONS OVER STONY SOIL
1)Excavate INk hole with vertical wells l0 1 fool larger than
tank on all sides.
2) !bolbm of hole is stony,install 3'of dDrWi c1 send 6 level r"
out with saeed. — _
3)Ivtet tank n center of hole,keeping 111 void space on -- - - �LLLLLLr��-��-- - - -
all sides. 2M'RISER&E1.rl N'6LOWER
d)As tank is MIIng with water,fill in Vold space with canpaa III OP s
granular(sandy)s soil fret of large Nampa of day.
5)Instar rest of system.&affix ckr to adapters day.with
waterproof adhesive. II as
6)Po nn weterlightness lest in field as required by lopl y
jurisdiction.
1, 02-RISERIi
7)Upon approval to bald ll,carefaly baddill with native
soils over top of tank. T •cam n w R I DIGESTER I InaaiusaI
8)Final grade the surface to avoid chanetlirg surface L - - - - - - - - -- --
water toward tank. ' -'�
TOP VW
P^:an
AEROBIC TREATMENT TANK DETAIL FOR
Nu WATER BNR-500 TREATMENT UNIT
ENVIRO-FLO, INC. PEOr3/01/12
wastewater Treatment TechnologesP.O. BOX 321161. Flowood,MS 39232
(877) 836-8476 (601)8164716 fax 1" = 1.4 ft.
6 1
SECURED LID W RH GAS TIGHT SEAL
THREADED UNION
2E'DUMETER
ACCESS RISFR SERVICE --
FINISH GRADE VALVE'
SETIC
TANK
FROM TO DMINFIELO
EMERGENCY STORAGE
HIGHWATERALARMLEVEL - n
WORNIN6 VOLUME /p INDEPENDENT
FLOAT STEM
NORMAL TIMER OFF LEVEL — — — — FOR FLOAT
ENCLO52D PUMP MOUNTING
SEOIMENTSHROUD CHECK VALVE
or 4"block under pump
L SEDIMENTS SUBMERSIBLE
CENTRIFUGAL
PUMP
PUMP CHAMBER
(TYPICAL)
vq p///IV/s Nto OV F/C,J f,2eri MDNA�E WuvER .
JUL
e, 2626
F7
IM-Tanks
IM-540 In-Series Tank Application
Lightweight strong and durable septic/pump tank,
making it optimal for use in-series with other tanks.
This watertight tank design is offered with Infiltrators line of
custom-fit risers and heavy-duty lids. Infiltrator injection molded
tanks provide a revolutionary improvement in plastic tank design,
offering long-term exceptional strength and watertightness.
Benefits
M
Strong injection molded Lightweight plastic con- Integral heavy-duty green Structurally reinforced
polypropylene construc- struction and inboard lids that interconnect with access ports eliminate
tion lifting lugs allow for easy the EZsnap riser and pipe distortion during
delivery and handling riser solutions installation and pump-
outs
Reinforced structural Can be installed with 6"to Can be pumped dry No special water filling
ribbing offers additional 48"of cover during pump-outs requirements are
strength necessary
APPROVED
APPLICATIONS 16 206
Retrofit: The IM-540 can increase the
volume of an existing septic tank. `
R'T IM-540
New: Use the IM-540 in new in-series
installations with another tank.
Trash/Pump-Tank: Ideally-sized
for use as a trash-tank
or pump tank.
IM-1060 '?infiltrator
Water Technologies
Part af��
Inflltratorwater.com•(800)221.4436
IM-540 In-Series General Specifications and Illustrations
mcctss PORTS
.,�a.o,�T.P. ,a�a 1WRISERRIS Wi G TO
OROP
dPEn COOS
EIELG
I fj El
u COVER
aFCw;NINOEO
PER DESION
The IM-54O is an injection molded two piece mid-seam plastic
tank.The injection molded plastic design allows for a mid- A A
seam joint that has precise dimensions for accepting an .o
engineered EPDM gasket.Infiltrators gasket design utilizes _ I ]I
technology from the water industry to deliver proven means o ER WON
616
of maintaining a watertight seal. "n°TN
The two-piece design is permanently fastened using a series
of non-corrosive plastic alignment dowels and locking seam
clips.The IM-54O Is assembled and sold through a network of
certified Infiltrator distributors. a p?+61 EXTERIOR LENGT IFTING
CONNECTION
Must be backfilled and installed in accordance with
Infiltrator Water Technologies,Infiltrator IM-Series EETCONNECTION
Septic Tank General Installation Instructions and INLET
for shallow ground water conditions reference
the Infiltrator IM-Series Tank Buoyancy Control
Guidance.
16
Please visit www.infiltratorwater.com for the latest i aon
EXTERIOR
information. NEIc H.
WorkingCapacity 475ga1(1799L) _ }
Total Capacity 552 gal(2089 L)
1,In�ol a...cccsv ovzxnv w'x LGCR'NG LC
Airspace 16.2%
Length 64.9 (1648 mm)
INLET
Width 61.7"(1567 mm)
Height 54.6 (1387 mm)
Liquid Level ___________ 44"(1118 mm) _,
Compartments 1
Maximum Burial Depth 48 (1219 mm)
Minimum Burial Depth 6°(152 mm)
Maximum Pipe Diameter 4"(100 mm)
16
Weight 169 lbs(77 kg) "j)- 2U'6
Contact Infiltrator's Technical Services Department for assistance at
1-800-221-4436 or info@infiltratorwater.com
Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH
APPLICANT/PERMIT INFORMATION
Permit Number swG 2020-000 4W Parcel# 12330-52-00019
Applicant Name R J Peabody Subdivision (Name/Div/Block/Lot)
Applicant Address PO Box 565 Beards Cove Div 5 Lot 19
City, State, Zip Burley, WA 98322 Installer Name Final Vision
Site Address 71 NE Schooner PI Designer Name Tom Weaver
INSTALLATION CHECKLIST
• Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑Repair ❑Other
System Type Pressure Beds Pretreatment Type NuWater BNR 500
>5 ft. from foundation? - - - - - - - - - - - - - - - - - - - - - - - - - - - ❑ N/A •YES NO
>50 ft. from wells? - - - - - - - - - - - - - - - - - - - - ❑ ® ❑
>50ft. from surface water? - - - - - - - -- - - - - - ❑ U ❑
Cleanout between building and tank? - - -- - - -- - - - - - - - - - - - ❑ 0 0
U Tank baffles present? - - - - - - - - - - - - - - - - - - - ❑ 0 0
d24"access risers over each compartment?- - - -- - - - - - - -- - - - ❑ U ❑
WEffluent filter installed? - - - - -- - - - - - - - - - - - - - - - - - - - ❑ U ❑
Septic tank capacity(working) 500----gal Manufacturer Infiltrator
0 D-box water level and speed levelers used? - - - - - N/A ❑ YES ❑ NO
OLL Manifold/D-box accessible from surface?- - - - - - - - - - - - - - - - - ❑ U ❑
mz Check valves installed? ❑ U ❑
GQ
f Transport Line Size 2 Schedule/Class 5th 40
Bedrooms installed (check one) ❑ 2 •3 ❑4 ❑ 5 ❑6 ❑Commercial/Other
>10ft. from foundation?- - - - - - -- - - - - - - - - - - - - - - - - - - ❑ NIA UVES ❑ NO
O >100 ft. from wells?- -- - - - - - - - - - - - - - - - - -- -- - -- - - - ❑ U ❑
>100 ft. from surface water? - - -- - - - - - - - - - - - - - - - - - - - - 0 ❑
iI >10ft. from potable water lines?- - - - - - - - - - - - - - - - - - - - - - ❑ ❑
> 5 fi from property lines and easements?- - - - - - - - - - - - - - - - U ❑ 0
> 30 ft. from downgradient curtain/foundation drains? - - - - - - - - - - 0 ❑ ❑
Drainfield level and observation ports present - - - - - - - - - - - - - - ❑ ® O
• Graveless chambers or ❑ Clean gravel used? (check one)
Proper cover installed overdrainfield?- - - - - - - - - - - - - - - - - - - ❑ U ❑
Pump tank setbacks consistent with septic tank? - - - - - - - - - - - - - ❑ N/A U YES ❑ NO
Y Pump tank capacity(flood) 1250 gal Manufacturer Infiltrator
Q24" access riser(s) and accessible from surface?- - - - - - - - - - - - - ❑ U ❑
❑ ❑
Alarm or Conirol Panel Installed? - - - - - - - - - - - - - - - - - - - -
Control Panel equipped with Timer I ETM/Counter- - - - - - - ❑ ❑
L /Pump installed in ❑ Bucket or DCI On Block or • Other 0(\ Y'IIYI- 4L Jgl I
Pump
d Make/Model l i�b'e'rrty 290 U Floats or ❑ T ansducer'f I b)ZF?
2
Tank draw down 1.25 in/min Pump capacity 30 gpm Squirt Height 6 ft
Pump on time 2 Min Pump off time 4 hours Daily flow set at 360 gpd
Upaed enlrzwe
Mason County OSS Installation Report pg. 2 parcel# 12330-52-00019
ABANDONMENT RECORD
Were existing septic components abandoned as part of this project? - - - - - - - - - - - - - - - ❑ YES NO
If yes, please describe:
Were all components pumped out and property abandoned per WAC246-272A-0300? - - - - - - - - fl YES NO
RECORD DRAWING
This Is a p.rm.unt rucord.nd must be accunn and descllptlr.enaph to rNouu In the noted a mnntenan..actvlba and Mum Gwalopmmt Typical Record
Dmwngs adman. Dmmm a&mandold orientatan&layaul,Septic/pump tank station,Nash anew.meerve dravi a,ex'gng hd pnposed Wlags.button a velI.wetalmes.
waub,obsenaton port.,'an"',.and W.maintenance access points Incomplete R.Dreairqs may cream additional delays at rnal In.I.11adon approval and related permits.
19 cob
7 5 u� G�Jh a 11�
C v jy eft -� � s .
• Record Drawing Attached
CERTIFICATION OF INSTALLATION
INSTALLER DESIGNER!ENGINEER
I certify that I installed the system in accordance with I certify that the system has been installed in accor-
the septic design stamped "APPROVED"by Mason dance with the septic design stamped"APPROVED"by
County Public Health and that any deviations shown Mason County Public Health and that any deviations
here have been cleared/approved by both the designer shown here have been cleared/approved by both
and Mason County Public Health and meet all State myself and Mason County Public Health and meet all
and Mason County Codes. State and Mason County Codes
I further certify that all information contained on this 1 further certify that all information contained on this
form and attached Record Drawing is accurat& form and attached Record Drawing is accurate.
Sigof Insfaller Date
Jason Schauer
Printed Name of Signee ti ot'""y;. �'.�L
MASON COUNTY PUBLIC HEALTH
The undersigned approves this Installation Report and l 5 Howl EwFAVEa`.
Record Drawing on behalf of Mason County Public ^C NSE6 DFSIaNEa
Health:
Signature of Environmental ealth Specialist Date (stamp, signature and date)
THIS FORM MAY BE SCANNED AND AVAIIABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE uper.a ealadle
Trash Tank is a 500 gallon poly tank
As-Built 03/28/2021
Schooner Pt
Keep all tanks >50'from water ♦wel
Keep drain field> 75'from water +3 el 30'
Valve box to have check valves due to location
Split Reserve
DIW 100%
6' X 30' Pressure Bed
Water line
&Power to
run down South 9' X 30' Pressure Bed I
side of lot
away from Split Reserve 100% Q
drain field
SL#1 0-24"Tan Loamy Med. Sand M
24-60"Grey Med. Sand
SL#2 SameasSL#1
SL#3 Same asSL#1 Three Bedroom ra /.Valve&
75'fr at - r Home
Pump Tank
50'fro
`iitt SFnOF i NEa
y/j �� APPROVED
'LL 1 6 2G16
65' u?SC'i c: :-r° :ALTh
RE tlel
dace Water
116.75'
1"= 20'
I'
2'e4 12330-52-00019