HomeMy WebLinkAboutSWG2026-00254-APPLICATION/ASBUILT - SWG Application / Design - 8/21/2026 MASON COUNTY 415N6SHELTON 0427-9 70 EXT 400
SHELTQN'.360-4D-96]q EXT 400
BELFAIR'. 360-275-4467,EXT 400
Public Health & Human Services ELMA:360-082-5269,EXT 400
FAX:360-427-7787
On-Site Sewage System Permit: SWG2026-00254
APPLICANT CRAWFORD JOHN LEW& MEAGAN C Phone:
Address: 21 NE ADMIRAL DR BELFAIR, WA 98528
OWNER CRAWFORD JOHN LEW& MEAGAN C Phone:
Address: 21 NE ADMIRAL DR BELFAIR, WA 98528
SEPTIC DESIGNER Dave Ghylin - Dave's Septic Service Inc. Phone: 360-710-2449
Address: PO BOX 301 SEABECK, WA 98380
Site Address: 21 NE Admiral Dr
Primary Parcel Number: 123305400002
Permit Description: Repair: SFR 3-bedroom gravity drainfield
Permit Submitted Date: 0811112026
Permit Issued Date: 08/21/2026
Issued By: David Anderson
Current Permit Fees Paid' $845.00 (additional fees may be required upon installation or system).
Permit Expiration Date: 08/14/2027 (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.
PHIS PERMIT MUST BE ONSITE DURING INSTALLATION OF CBS.
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/healthienvironmental/onsite/oss-inspection-request.php or call:
360-427-9670, extension 400.
OFFICIAL USE ONLY —
MASON COUNTY D,E'KCENE'
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AMOUNT RL(FNED ucBYED6t W M
Public Health & Human Services � �j pP gf`F 2 N
A15 N.6th SN Health 360-427-9670,WA SSTD.RRCWmBfiI}3TSiWJ.EIILiW SWG �ad�
A15 N.fiM nSHeet Shelton, 98584 670,e
ON-SITE SEWAGE SYSTEM APPLICATION 3 A
m �APPLICMJT PHONE - - r
John & Megan Crawford ,
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MAILINOADDRESS-STREET CRY.STATE,L PCODE I� Qf
21 NE Admiral DR Belfair, WA 98528 i o a z
SITE ADDRESS-STREET CITY ZIP COOS O
21 NE Admiral DR Belfair, WA 98528
NAME OF DESIGNER PHONE j� `1
Dave Ghylin C 7/Oo) 1 Lf
0,
NAME OF INSTALLER PHONE
PERMITTVPE(select me) DRINKING WATER SOURCE
RESIDENTIAL OSS ❑COMMUNITY OSS UCOMMERCIAL OSS Q PRIVATE INDIVIDUAL WELL Q PRIVATE TWO-PARTY WELL IZ I o
R PUBLIC WATER SYSTEM I
TYPE OF WORM(ANe �
O NEW CONSTRUCTION /I UPGRADES yi REPAIR I REPLACEMENT OTHER DETAIL6(wxtwwl wWq I] TABLEX REPAIR
DESIGN Q SURFACING SEWAGE • EXISTING FAILURE Q SHORELINE
SUBMITTALS O a
❑ FORM(REQUIRED) O SEPTIC DESIGN(REQUIRED) BEDROOMS LOT vzE wAstOT CREATeD AFTER 4f12 '
❑ WAIVER($)(IF APPLICABLE) 3 .25 Acr YES <9 T I
DIRECTONS TO SITE AND SITE CONpTION6.(ex AP— ee)
Turn off of NE Larson Lake onto NE Admiral DR. Home is on the left. I
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snEMImTGEMOOED RiDM MMW ROAD MID TESTNJE5 MUST SEaAOOEOINIM TEST HOLE MRYIRS.. fJ I
OFFICIAL USE ONLY BELOW THIS LINE
FINSPECTOR
RE SOURCE(M Iwa41q p1WN AR)
RY ❑MAINTE? EJPUMPING t] BUILDING PERMIT Q HOME SALE❑COMPLAINT❑OTHER'.
cd.MENTS I CWOm)NS
LOGS6" 6+d5 c17fe3) to bmHom
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RECORD DRAWING MID INSTALLATION REPORT
500.CODE6: REOUIREDECREVIALAPPROMAL.
V•VERY G-GRAVELLY S•SAND L•LOM1 SI-SILT C•CLAY E-EXTREMELY R-ROOTS DATE
INSF 61GNAnJ E GATE AP UCAMIN EXPIRATION DATE APPL OYFDI ISSUED BY
d11G. 20Z7Z
THI OR MAY BE SCANNED ANBAVAEAELE FOR PUBLIC VIEW ON THE MASON EDAM wcam¢
rises:01109a026
DESIGN FORM-PAGE ONE Assessor's Parcel Number: 1 2 3 3 0 5 4 0 0 0 0 2
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. 0 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.Muxinvno paper size: 11"X17'
PARCEL IDENTIFICATION
Permit Number: SWG 2026-00254 Designer's Name'. Dave Ghylin
Applicant's Name: John&Megan Crawford Designer's Phone Number: 360-710-2449
21 NE Admiral DR Designer's Address: PO Box 301
Mailing Address: _
Belfair, WA 98528 City State Zip Seabeck, A 98380
City State Zip Designer's Email dss9699@outlook m
DESIGN PARAMETERS
Treatment Device 4 7
Drainfield ❑Recirculating Filter ❑Ali; Other X16
Treatment Level(check all that apply)' ❑A ❑B ❑C ❑BLI 0 BL2 0 BL3 VIE ❑N
0 Glendon 0 Sand Filter 0 Mound 0 Sand Lined Drainfield
F/V
Drainfield Type
J Ip Gravity_ ❑Pressure 0 Trench ❑Bed ❑ Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 3 Schedule/Class 3034
Daily Flow:Operating Capacity 360 gpd Length 45' - ft
Daily Flow:Design Flow 360 gpd Diameter 4" in
Septic Tank Capacity(working) 1200 gal Number 3
Receiving Soil Type(1-6) 3 Separation 3.3 ft
Receiving Soil Appl.Rate .8 - gpd/fl' Orifices
Required Primary Area 450 fC Total NumbXd
of Orifices
Designed Primary Area 450 ft'- Diameterin
Designed Reserve Area Existing ftr Spacingin
Trench/Bed Width 10' - ft Manifold
TrenchBed Length 45' ft Schedule/Cl
Elevation Measurements Lengthft
Original Drainfield Area Slope 0-2% a/o Diameterin
New Slope.If Altered N/A % Preferred mfrgmati us ? 0 Yes 0 No
Depth of Excavation Up-slope 32' in Trans rt Pipe
from Original Grade Down-dope 32" in Schedule/Cl
Designed Vertical Separation 36" in Lengthft
Gravel-based Dminfreld Required? ❑Yes Id No Diameterin
Pump Required? ❑Yes Id No ' and Pump Ch ber
Pump/St on Specificatio Number of doses
Duff inElevation Between &Lipp ma Orifice ft Dose quantigal
Drainfield Squirt Height/Select ideal(head) _ft Chamber Cod) gal
Uppermost Orifice 0 Higher ow than Pump Shutoff
Pump contr check those required.
Capacity @ Total Pressure ad gpm O Timer O Elapse Meter O Event Counter
Calculated Total Press cad a If Timer: Pump on Pump off
Comments
Revised:6/11/2025
DESIGN FORM—PAGE TWO Assessor's Parcel Number: 1 2 3 3 0 5 4 0 0 0 0 2
Permit Number: SWG 2026-00254
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
VI Test hole locations 6 Drainfield orientation and layout Reference depth from original grade:
9f Soil logs 9f Trench/bed dimensions and l ' Septic tank
iif Property lines critical distances within layout V Drainfield cover
❑ Existing and proposed wells lr D-Box/Valve box locations Reference depth from original grade
within 100 ft of property RI Septic tank/pump chamber and restrictive strata:
❑ Measurements to cuts,banks,and locations
Rl Laterals,trench/bed,top and
surface water and critical areas RI Observation port location bottom
❑ Location and orientation of ltI Clean-out location ❑ Curtain drain collector
curtain drain and all absorption ❑ Manifold placement ❑ Sand augmentation
components ❑ Orifice placement Other cross-section detail:
QI Location and dimension of 21 Lateral placement with distance ❑ Observation ports/clean-outs
primary system and reserve area to edge of bed
RI Buildings Other Information
Audible/visual alarm referenced Yes No
V Direction of slope indicator ' Scale of drawing shown on scale ❑ S'Design slaked out
Waterlines bar O ( 'Recorded Notices attached
RI Roads,easements, driveways, Q Elevation benchmark and relative ❑ idWaiver(s)attached
parking elevations of system components ❑ 'Pump curve attached
RI North arrow and scale drawing RI ❑ Evaluation of failure
shown on scale bar Non-residential justification
❑ ❑ Waste strength
❑ ❑ Flow
DESIGN APPROVAL
The undersigned designer must be n�``fred by installer at time of installation f�ifYes ❑ No
Signature of Designer 'Date
The undersigned has reviewed this design on behalf of Mason County Public Health and determined
compliance with state and local on-si ey1ations: A082/'? ??6__.
UG2 )
a; 2026
�o""/ire
Environmental Heal r Specialist Date ,0 �xMa
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
V The design is stamped"Approved"by Mason County Public Health. C, 7
✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: o
✓ 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
Mason County WA GIS Web Map
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General Designer Notes "'t.7`'p t`" 4 n.T La, �;
Owner Name: John & Meagan Crawford 4(/G
Reference: 12330-54-00002 u 2 1 #26
h"A
#1 —Soil logs have been dug on this site and are the responsibility of the property owner or owners agent to
have these soil logs buried after the inspection process has been completed.
#2—If during the construction process, soil conditions are found that may lead to premature failure of the
system,construction shall stop immediately and the designer shall be notified. Such soil conditions may
include but not limited to ground water, surface water, fill material, clay soil, bedrock, or excessively
permeable gravels.
#3 —Any substitutions or deviations from these plans shall be approved by the Health Department or the
designer prior to construction. All changes of the system components shall he documented by the designer
on the final As-built drawing.
#4—Peak design flow is 360-_g.p.d., Recommended daily flow should not exceed_284 g.p.d.
or premature failure may occur.
#5 —Backfill sewage disposal system immediately after final inspection process,cover soils should be
loamy sand or better. Seed final cover with grass or shallow rooting ground cover.
#6—Keep all maintenance access lids and ports accessible to ground surface.
#7—Installer should rake the finished grade smooth and slope it to divert all surface water runoff away from
tank and drainfield areas.
#8 — Setbacks from house foundation to drainfields and reserve areas are 10', septic tanks 5' and transport
lines 2' unless otherwise stated within the design.
#9—Driveways and parking areas must stay 5' from drainfield areas. Tanks may be located within parking
area and driveways if approved for this application.
#10-- Sewage waste strength should meet the following criteria or be lower Bod-5 = 130-174 mg/I,TSS
47-71 mg/I, FOG= 10-20 mg/l, PH =6.5-7.2 with microscopic life forms present.
#11 —Installer must adhere to all manufacturer installation requirements for all products used.
#12—The attached septic design does not represent a survey nor does it purport to show all easements or
encroachments, if any. Designer recommends property lines be located prior to any final installation occurs.
Surveys may be required to accomplish this.
#13 —Property lines and comers have been represented by owner or owner's agent, the designer is not
responsible for errors due to inaccurate measurements from property lines or comers that are inaccurate.
#14—If a curtain drain is required with this design it must meet all Health Department installation
requirements.
#15 —Developers, homeowners and installers, installations of on-site sewage disposal system should always
be installed in dry weather conditions. Irreparable soil damage may occur if systems are installed in wet
conditions. Planning the installation of system is very important and should be done as early in the building
development stage as possible. Wet weather conditions have caused delays in final approval dates.
#16—Maintenance is required will all sewage disposal systems. Owners will receive details of this in the
designer manual with the final approval of the application.
#17—Adhere to all designer notes located on design layout page.
#18—If development exceeds 10,000 square feet of impervious surface an engineered drainage plan may
need to be submitted. Options are available to reduce square footage requirements, such as wagon wheel
driveways, contact DCD for further details. Owners are responsible for any fee for redesigns or revisions
that may be needed after BSA submittal not due to designer error.
#19—Low flow water fixtures are recommended within the home to help lower the hydraulic load to the
system.
#20—Watertight components are a must for all onsite sewage systems. Installers are required to ensure all
components are watertight, extreme care should he used during backfilling of these components to prevent
settling and or water intrusion issues. If leaking components are not fixed in a timely manner, the designers
warranty may be void.
#21 —Installation of this design must meet all Health Department regulations and all adopted policies by the
Health Department that may apply. Installer is required to he versed in these regulations, if any questions
contact designer.
#22— All components used must be on State Department of Health approved products list for use with
residential waste.
#23 —Installer must inspect all tanks used at time of delivery and any tanks with defects must be rejected
and not used. When using any existing tank, the installer must due a 24 hour leak test to ensure all tanks
used are watertight.
#24—All plumbing must be routed into the new sewage system that has been designed. It is the property
owners responsibility to show the designer all plumbing stub outs and all gray and black water discharge
points. A plumber may be needed on old homes to ensure that all stub out locations are connected to the
new proposed sewage disposal system. An inside pump basin may be needed in some cases where
plumbing is located in basements and elevations for a gravity discharge cannot be maintained.
#25 —Do not use low profile chambers or the system will be red tagged. All lateral lines must be a
minimum of 6" off the infiltrative surface. Lateral ends must be secured at the cleanout and must he in the
center of the port.
#26—Gravel trenches are recommended,but Arc 36" chambers are allowed.
Specific Designer Notes:
#1-Phis application is for a repair on an existing 3-bedroom home.
#2-A new gravity system is proposed with 450 SQFT of drainfield. A 10' x45' gravity bed is proposed.
#3- Existing septic tank to be certified or must be pumped, decommissioned and replaced.
TP#1 0-68" LT brown medium sand. Soil type 3
TP#2 0-68" LT brown medium sand. Soil type 3
4l/c2
4 t.
Dave's Septic Services, Inc.
P.O. Box 301
Seabeck,WA 98380
(360) 710-2449
Customer Information'
Date: 8117126
Applicants Name: John&Meagan Crawford
Site Address: 21 NE Admiral DR Belfair,WA 98528
Tax ID #: 12330-54-00002
OSS Failure Report:
o Hydraulic Overload
o Abnormal Waste
o Physical Damage
Age/Other
AS°N 1 y 10
N F4/ e 76
D✓q �:,,bLyai,,.
Dave's Septic Services, Inc.
Licensed On-site Sewage Disposal Consultant p•.•,;
Percolation Test and Engineering Designs
Licensed Operation & Maintenance Specialist qUG�
E-mail: dss9699(a�outlook.com
OSS Failure Investigation Report
Site Address of OSS Failure: zt NE Admiral DR aeiratr,WA 98528
Designer: Dave Ghylin / Dave's Septic Services, Inc. Date of Investigation: 8/17/26
The OSS at the above address has failed due to:
o Hydraulic Overload (e.g., OSS flooded out due to leaking OSS components,
excessive groundwater, or surface water intrusion, leaky household fixtures, or water
use above the what the OSS was designed to handle, etc.)
O Abnormal Waste Strength I Water Characteristics (e.g., normal OSS operation
appears to have been adversely impacted by household use of pharmaceuticals,
disinfectants, fats/oil/grease, or additives, etc.)
o Physical Damage (e.g., OSS was damaged due to vehicular traffic, new construction,
or animal intrusion, etc.)
0 Age or Other(e.g., OSS does not exhibit any signs of the above. However, failed due
to age, system type, or site condition, etc.) Bc pocki gr;Ls i,J
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