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HomeMy WebLinkAboutSWG2026-00258 - SWG Application / Design - 9/21/2026 P MASON COUNTY 015"6SHELTON 60427-9670 EX95B° SHELTON.360aD-96]O. EXT 400 BELFAIR'.360-275-4467, EXT 400 Public Health & Human Services ELMA.360-482-5269 EXT 400 I_IFAX'.360-427-7787 On-Site Sewage System Permit: SWG2026-00258 APPLICANT LUSKEY STEVEN P Phone: Address: 31 E LEISURE LN GRAPEVIEW, WA 98546-9719 OWNER LUSKEY STEVEN P Phone: Address: 31 F LEISURE LN GRAPEVIEW, WA 98546-9719 SEPTIC INSTALLER CINDY WAITE* Phone: 360-701-0205 Address: 80 E PICKERING LANE SHELTON, WA 98584 Site Address'. 31 E Leisure Ln Primary Parcel Number: 321245100006 Permit Description: Repair: SFR 2-bedroom gravity trench system with Class 8 waiver (WA12026-00070) Permit Submitted Date: 08/13/2026 Permit Issued Date: 09/21/2026 Issued By: David Anderson Current Permit Fees Paid: $845.00 (additional fees may be.eq,J'red uponhstalanee of system). Permit Expiration Date: 08/14/2027 (based on date or 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: 360-027-9670,extension 400. ✓rJ- L ---- OFFICIAL USE ONLY - MASON COUNTY DATETECFIVF o ' Ii 31 L1A9D CA BECEIVFOBr`. Public Health & Human Services DUNTB. ° o m Environmental seal.h 360-427-96]C,ext.400 or 360-275446/,ea.41111 415 N.6th Street-Shelton,WA 98584 SWG 6�— O 0 Z N ON-SITE SEWAGE SYSTEM APPLICATION 3 A APPLICANT PIONS m ED STEVEN LUSKEY - - 360-888-2554 OR 360-427-1457 z I r --- I c MAILING ADDRESS-STREET.CITY,STATE ZIP CODE ITn 3 31 E LEISURE LANE . GRAPEVIEW WA 98546 BIT F ESS-STREET.CITY,ZI CODE 31 ERLEISURE LANE SRAPEVIEW WA 98546 Iw NAME OF DESIGNER \ ' PRONE CINDY WAITS I 362-701-0205 NAME OF INSTALL ER I PHONE TBD � L < N PERM/-TYPE(sRea on ORI NRIRC WATER SOURCE o 9?I Rt510EVTIALC55 fl COMMUNITY 055 n COMMERCIAL 055 h PRIVATE INDIVIDUAL WELL 0 PRIVATE TWO PARTY WELL 2 A TYPE OF WORK(R BX one) rg PUBLIC WATER SYSTEM -OF SS I I PIT r'IS NEW CONSTRUCTION I UPGRADES H REPAIR I REPLACEMENT OTTER DETAIIs(..<Irvvalnnal apply) ❑ TABLE X REPAIR SU5v,ITint9 ❑ SURFACING SEWAGE 0 EXISTING FAILURE 0 SHOREJNE ff DESIGN FORM(REQUIRED) 1`1 SEPTIC DESIGN REQUIRED) SUBSONIC Lm SIZE WAS LOT CREATED AFTER 4M11(25? 0 I ' I5 wAlvere(sl uF APPLICABLE) 2 -70 AC ❑ YES O NO DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.Inched Pale( GO NORTH ON HIGHWAY 3, TURN LEFT ONTO MASON LAKE RD, TURNRIGHT INTO I o EMERALD LAKE, STAY ON EMERALD LAKE DR, TURN LEFT ONTO LEISURE LAND, FIRST DRIVEWAY ON THE LEFT. o I o Io SITE MUST BE FLAGGED FROM MA IN ROAD AND TEST HOLES MUSTBE FLAGGED WITH TESTHOLE NUMBERS. OFFICIAL USE ONLY BELOW THIS LINE UPGRADE FAILJRE SOURCE(N 1OPOL g9 purposes) ❑VOLUNTARY O MAINTENANCEIPJMPING 0 BUILDING PERMIT ❑HONE SALE ❑COMPLAINT ❑OTHER'. _ INSPECTOR SOIL LOGS COMMENTS'CONDITIONS :o-35" Gst cry, ' L) IL(si +)S L ('( mo+r( 'l;(/l Pgr4g37).r r( weiC{ CAMP TIf3.'o -331i ci5t Rol ' f 3 !J H m0 it a'ne SOIL cmES RECORD DRAGINGAND INSTALLS ION REPORT V-VERY G=GRAVELLY S-SAND L=LOAM S1=SILT C=CLAY E=EXTREMELY R-ROOTS REOU:REO FOR FINAL APPROVAL NGP OR SIGNAtURE DATE APPLICATION EXPIRATION DATE APP TION APPR VEDIISSUED BY DATE 114 za76 8 `l of y zrlwzi( THIS FORM MAY BE SCANNED ANDAVAILABLE FOR PUBLIC VIE ON THE MASON COUNTY WESSITE Revised 414/2025 DESIGN FORM—PAGE ONE Assessor's Parcel Number: 3 21 2 4 5 1 0 0 0 0 6 A design will be reviewed when 3 copies of each of the following are submitted: Completed design form that has been signed and dated. v Scaled layout sketch, including all applicable items on checklist. Scaled plot plan,including all applicable items on checklist. I Cross-section sketch,including all applicable items on checklist. This form may be scanned and avallawe for public view on the Mason County Web site.Maximum paper size. 11"X17" PAR L 1AWT FlCATION Permit Number: SWG2o 2C. /,n �rY Designer's Name: CINDY WAITS Applicant's Name: STEVEN LUSKEY Designer's Phone Number: 360-701-0205 Mailing Address: 31 LEISURE LANE Designer's Address: 80 E PICKERING LANE GRAPEVIEW WA 98546 City Stale Zip SHELTON WA 98584 City Slate Zip Designer's Email cindyewahe©men.corn DESIGN PARAMETERS Treatment Device ❑Glendon O Sand Filter ❑Mound ❑Sand Lined Drainfield ❑Recirculating Filter ❑ATU Treatment Level(check all that apply): ❑A ❑B ❑C ❑BLI ❑BL2 ❑BL3 �E ❑N 1 �' L B'Gravity O Pressure WTrDrainfteld Type ench Bed ❑Sub LF/�6ri P Septic Tank/Drainfield Specifications Laterals Number of Bedrooms 2 Schedule/Class ASTM2729 Daily Flow:Operating Capacity 180 gpd Length 29 ft Daily Flow: Design Flow 240 gpd Diameter 4 in Septic Tank Capacity(working) EXISTING 1000 gal Number 5 Receiving Soil Type(1-6) 4 Separation 5 ft Receiving Soil Appl.Rate .6 gpd/ft2 Orifices Required Primary Area 400 ft2 Total N of es ASTM PERF Designed Primary Area 435 r fir Diam ._A 4 in Designed Reserve Area 400 ft2 Sp in Trench/Bed Width 3 ft {!^ o Manifold 4 Trench/Bed Length 145 ft Atya pmt Elevation Measurements r.oisas vm, - It Original Drainfield Area Slope 4 % Diameter in New Slope,if Altered % Preferred manifold configuration used? O Yes eNo Depth of Excavation Up-slope 15 in Transport Pipe from Original Grade Down-slope 13 in Schedule/Class ASTM 3034 Designed Vertical Separation 18 in Length 70 ft Gravel-based Drainfield Required? Ls(Yes D No Diameter 4 in Pump Required? ❑Yes Ef No Dosing and Pump Chamber Pump/Siphon Specifications Number of doses/day Duff,in Elevation Between Pump&Uppermost Orifice_ft Dose quantity gal Drainfleld Squirt Height/Selected Residual(head) ft Chamber Capacity(flood) gal Uppermost Orifice O Higher O Lower than Pump Shutoff Pump controls:Please check those required. Capacity®Total Pressure Head gpm ❑ Timer O Elapse Meter ❑ Event Counter Calculated Total Pressure Head ft If Timer: Pump on_____________,Pump off Comments RETRO FIT EXISTING SEPIC TANK WITH EFFLUENT FILTER AND RISERS. Revised:6/11/2025 DESIGN FORM—PACE TWO Assessor's Parcel Number: 3 2 1 2 . 4 5 1 . 0 0 00 6 Permit Number; SWG DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch of Test hole locations Er Drainfield orientation and layout Reference depth from original grade: t2( Soil logs Pl• Trench/bed dimensions and S&septic tank tr Property lines critical distances within layout V Drainfield cover E(isting and proposed wells Ef D-Box/Valve box locations roe ..1 Reference depth from original grade within 100 ft of property �epti tank/pump chamber and restrictive strata: 0k4Aeasurements to cuts,banks, W and locations Laterals,trench/bed,top and surface water and critical areas Observation port location bottom (Location and orientation of LClean-out location ❑ Curtain drain collector curtain drain and all absorption 914danifold placement ❑ Sand augmentation components O Orifice placement Other cross-section detail: f� Location and dimension of Observation primary system and reserve area Lateral placement with distance ports/clean-outs to edge of bed a Other Information V' Buildings gLAudible/visual alarm referenced Yes No g Direction of slope indicator Scale of drawing shown on scale if ❑Design staked out Waterlines bar ❑ O Recorded Notices attached V Roads,easements,driveways, f7 Elevation benchmark and relative O ❑ Waiver(s) attached parking elevations of system components ❑ ❑ Pump curve attached V North arrow and scale drawing ❑ Cl Evaluation of failure shown on scale bar Non-residential justification ❑ O Waste strength ❑ ❑Flow DESIGN APPROVAL The undersigned designer must be noti ied by installer at time of installation &Yes O No ��Signs re 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 regul ' as: MistEnvrro tai Health pecialist 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 system must be installed by a certified installer, unless prior authorization is obtained from Mason County Public Health. An Installation Fee is required. X� This form may be scanned and available for public view on the Mason County Web site. Revised:6/11/2025 .•-Q 00V.Oliq a W N - ..N ft r�Q vi a O. -n' .a a i s j At s a e \':* .t & ' Cr y < o = a. .n. •. i:-' -. Po A o O O g r cD ti/,,./a1 Laj ' _ _._ _ ._._"_—.---fff , yam. si .. K'Kr� s' ) 'Iz 2'? r' is . , , O bs Lai Li Ic 4n IJi rn..) � lIruU+�ra✓ LINCY SITE Y �' -,GN� LICENSEDpESICNER U`^s ^Ok ,t 7 lu 5f, naEs Ov10. V f 1 V�N�,c20 St,brc{�o.✓ Mltvii�6B W0Y000Un j\\Ql �Pri ww.�PrN�. LOYNIrg, _ . Distributlon Box(No 1$•6 �y s��'y[�Is O clno�[�wAITE a i IICEN5E fF SIGN[R Installation Notes Gravity System 31 E Leisure Lane 32124-51-00006 1. The prepared site plan is not a survey. It's the owners responsibility to verify property lines, utility lines (water, sewer, power, phone and gas) prior to installation. 2. Retrofit septic tank with risers and effluent filter. 3. Replace broken baffle in septic tank 4. Gravel based drainfield required 5. Install system during dry weather with acceptable soil conditions 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 tank, D-box and observation ports. 11. Make sure septic tank risers are epoxied or caulked to cast in riser rings on tank. 12. Lids must form a water and gas tight seal with the access risers 13. Install effluent filter at the septic tank outlet. 14. This system must be installed by a Mason County Certified Installer. 15. Deviation from this design without prior approval from the designer and Mason County Health Department will make this design null and void. 15. This design was sized per Washington Administrative CodeWAC248-272A_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. 17. Install laterals or bed with contour of the ground 18. Install trench bottoms level and always maintain a minimum of six inches into native soil 19. Filter fabric required over drain rock prior to backfllling. If the drain r extends above the original grade, run the filter fabric at least 2 Inches down nch wall P' Y`psr .Wks ' 8' c1Nor E1 "-J LCENSED DE E� a�s u.io System Owner Responsibilities: 1. Operation and Maintenance is required by Washington State Department of Health and Mason County HealthDepartment. 2. The septic tank should be pumped every three to five years or as needed. 3. System owners are responsible 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 agrees to read and abide by Information regarding their system in the User Manual provided by Mason County Public Health. 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. �xx ��cF C.. LxPIk s osn 1 1 ^