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HomeMy WebLinkAboutSWG2026-00293 - SWG Application / Design - 9/11/2026 A® MASON COUNTY 415 N6TH LFAIR SHELT467 400 SHELTON.360-427-9670,EXT 400 BELFAIR'.360-276-4467,EXT 400 Public Health & Human Services ELMA:360-482-5269,EXT 400 FAX'.360-427-7787 On-Site Sewage System Permit: SWG2026-00293 (�? APPLICANT PAYSSE ROBERT H & PATRICIA Phone: 1.360.426.1803 Address: 3083 E MASON BENSON RD GRAPEVIEW, WA 98546-9704 OWNER PAYSSE ROBERT H &PATRICIA Phone: 1.360.4261803 Address: 3083 E MASON BENSON RD GRAPEVIEW, WA 98546-9704 SEPTIC DESIGNER BOB PAYSSE` Phone: 360-507-1498 Address: 3083 F Mason Benson Road GRAPEVIEW, WA 98546 Site Address: 1893 E PICKERING RD Primary Parcel Number: 221 331 290044 Permit Description: New 3bd pressure trench Permit Submitted Date: 09/08/2026 Permit Issued Date: 09/11/2026 Issued By: Rhonda Thompson Current Permit Fees Paid: $570.00 (additional fees may be required uVUUi installs ion of system). Permit Expiration Date: 09/09/2029 (based or date of inspection) Permit Conditions: I 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 Drainfield 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/environmentallonsiteless-inspection-request.php or call: 360-427-9670, extension 400. OFF CAL USE ONLY -- MASON COUNTY DATE 09 oy y AMWNT BECEIV '.NI RECEIVED BY: Public Health & Human Services 5 yo fh oFF_ ' y Environmental So Ste t-Health SSOiWASJD.ext.400 or 360-2J5�4fi1.exL400 SVVG — �� \ �. O A 415 N. martal -Sh 30- WA 67.C TC N 0 z N ON-SITE SEWAGE SYSTEM APPLICATION a a s APPLICANT PHONE Tn r ROBERT H. PAYSSE 360-507-1498 z C MAILING ADDRESS-STREET,CT',STATE,ZIP CODE - 3083E MASONBENSON RD GRAPEVIEW WA 98546 SITE ADDRESS ZIP ED 1893E PICKERING RD SHELTON WA 98584 ^� NAME OF DESIGNER a_ PHONE N ROBERT H. PAYSSE w 360-426-1803 NAME OF INSTALLER _ _ PHONE a TBD PERMIT TYPE(s&atl one) DRINKING WATER SOURCE oP RESIDENTIAL 055 �I COMMUNITY OSS BCOMMERCIAL OSS E PRIVATE INDIVIDUAL WELL IN PRIVATE TWO-PARTY WELL = TYPE OF WORK(se)ealone) PUBLIC WATER SYSTEM V NEW CONSTRUCTION I UPGRADES Ti REPAIR/REPLACEMENT OTHER DETAILS(selatlanlhffiapely) ❑ TABLE X REPAIR SUBMITTALS �T ❑ SURFACING SEWAGE ❑ EXISTING FAILURE ❑SHORELINE M DESIGN FORM(REQUIRED) MI SEPTIC DESIGN(REQUIRED) BEDROOMS LOTSIZE WAS LOT CREATED AFTER GPrz025i O IN F7 WAIVER(S)(IF APPLICABLE) 3 1.6 AC ❑ YES a NO A DIRECTIONS TO SITE AND SITE CONDIPIXIS:(ex.locked Bale) N HWY 3. RIGHT ON PICKERING RD. CONTINUE TO SITE ADDRESS ON LEFT. USE O ACCESS ROAD JUST AFTER FIRE STATION TO ACCESS, SEE SITE PLAN. c I o Ia SGE MUST SE FLAGGED FROM MAIN ROAD AND TEST HOLES MUSTBEFLAGGEO WIIN TESTHOEE NUMBERS, A OFFICIAL USE ONLY BELOWTHIS THIS LINE UPGRADE I FAILURE SOURCE(f ra,dtinp 0uryone) ❑VOLUNTARY O MAINTENANCE/PUMPING ❑BUILDING PERMIT OHOME SALE 000MPLAINT ❑OTHER: INSPECTOR SOIL LOSS COMMENTS/CONDITIONS o.5% (quhlti1 - loo- RECORD DRAWING AND INSTALLATION REPORT SOIL CODES: V=VERY G=GRAVELLY S=SAND L=LOAM Si SILT C=CLAY E=EXTREMELY R=ROOTS REQUIRED FOR FINALAPPROVAL. INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE PLICATICN APPROVED/ISSUED BY DATE KI'qiZ. ' qI ,T►zq '' ` �,l i THIS FORM MAY BE CANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE Revised'.411412025 DESIGN FORM—PAGE ONE Assessor's Parcel Number: 2 2 1 3 3 1 2 9 0 0 4 4 A design will be reviewed when 3 copies of each of the following are submitted: V 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 form may be scanned and available for public view on the Meson County Web site.Maximum paper size: 11"X!7" PARCEL IDENTIFICATION Permit Number: SWG ca-C - Cad-C/3 Designer's Name: Bob Paysse Applicant's Name: Robert H. Paysse Designer's Phone Number: 360.507.1498 3083 E.Mason Benson Rd. Designer's Address: 3083 E.Mason Benson Rd Mailing Address: Grapeview We 98546 City State Zip Grapeview Wa 98546 City State Zip Designer's Email pioneerdigging@yahoo.com DESIGN PARAMETERS Treatment Device ❑Glendon ❑ Sand Filter ❑Mound O Sand Lined Drainfield 0 Recirculating Filter O ATU 0 Other Treatment Level(check all that apply): ❑ A ❑B ❑C ❑BLl ❑RL2 ❑BL3 VE ❑N � Drainfield Type G/❑Gravity Pressure Trench 0 Bed ❑ Sub Surface Drip Septic Tank/Drainfield Specifications Laterals Number of Bedrooms 3 Schedule/Class 40 Daily Flow: Operating Capacity 270 gpd Length Varies ft Daily Flow: Design Flow 360 gpd Diameter 1.25 in Septic Tank Capacity(working) 1500 gal Number 4 Receiving Soil Type(1-6) 3 Separation 9 ft Receiving Soil Appl.Rate .8 gpd/ft2 Orifices Required Primary Area 450 g2 Total Number of Orifices 50 Designed Primary Area 450 ftc Diameter 3/16 in Designed Reserve Area 450 ft2 Spacing 36 in Trench/Bed Width 3 ft Manifold TrenchBed Length 150 ft Schedule/Class 40 Elevation Measurements Length 30 ft Original Drainfield Area Slope 8 % Diameter 1.25 in New Slope,If Altered N/A % Preferred manifold configuration used? gYes O No Depth of Excavation Up-slope 24 in Transport Pipe from Original Grade Down-slope 21 in Schedule/Class 40 Designed Vertical Separation 24+ in Length 110 If Gravel-based Drainfield Required? 'Yes 0 No Diameter 2" in Pump Required? PJ Yes ❑No Dosing and Pump Chamber Pump/Siphon Specifications Number of doses/day 6 Diff.in Elevation Between Pump&Uppermost Orifice 10 ft Dose quantity 60 gal Drainfield Squirt Height/Selected Residual(head) 2 ft Chamber Capacity(flood) 1500 gal Uppermost Orifice P'Higher O Lower than Pump Shutoff Pump controls:Please check those required. Capacity @ Total Pressure Head 29.5 gpm C( Timer Iff Elapse Meter B Event Counter Calculated Total Pressure Head 20'62 R if Timer: Pump on 2 also' Pump off 4 hrs. Comments Revised'.6/11/2025 DESIGN FORM—PAGE TWO Assessor's Parcel Number: 2 2 1 3 3 1 2 9 0 0 4 4 Permit Number: SWG ,Q c,Lf n— C% )J ) DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch V Test hole locations Or Drainfield orientation and layout Reference depth from original grade: V Soil logs 9 Trench/bed dimensions and a Septic tank Ir Property lines critical distances within layout V Drainfield cover • Existing and proposed wells V D-BoxNalve box locations p P Reference depth from original grade within 100 ft of property V Septic tank/pump chamber and restrictive strata: M' Measurements to cuts,banks, and locations V Laterals,trench/bed,top and surface water and critical areas V Observation port location bottom Ir Location and orientation of 9 Clean-out location curtain drain and all absorption e Manifold placement ' flr components V Orifice placement Other cross-section detail: (r Location and dimension of a Lateral placement with distance V Observation ports/clean-outs primary system and reserve area to edge of bed Other Information Ile Buildings V Audible/visual alarm referenced Yes No V Direction of slope indicator 9 Scale of drawing shown on scale O Design staked out 69 Waterlines bar O O Recorded Notices attached p1' Roads,easements,driveways, V Elevation benchmark and relative O ❑ Waiver(s)attached parking elevations of system components V O Pump curve attached er 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 notified by installer at time of installation O Yes O No (1r1 Ito �R y._f�g, _918 L AI, Signature of Designer 0 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: Rr �w Environmental HeaKh Date CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION: ✓ The design is stamped"Approved"by Mason County Public Health. °i Z 1 —✓ 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 110' SETACK FROM WETLAND PROPOSED 3 BEDROOM - _ ____ PRIMARY& RESERVE 3 - - cfr 9y5 0 to / -'ti N DW I , . / FUTURE / I / \ 2-PARTY WELL \ 1 j-- R50' I / e DW © O \ / FUTURE // / BUILDING oo / / AREA U ACCESS E UTILITY EASEMENT AQ = CLEANOUT © CONTROL PANEL © = 1500 S/T& 1500 P/T / // © = 150' - 2NSCH. 40 T. LINE (DBL SLEEVE UNDER ROAD) / \V/ B rJ`f. RCEERih WY66E � EXPIRES \ CUSTOMER:ROBERT H.PAYSSE TEST HOLE 1 TEST HOLE 2 TEST HOLE 3 CA ) PIONEER PARCEL: 221 33 - 1 2 -9 0 0 6 d 0-38 OLS 0-60 GLS 0-63 GLSDIGGING INC. 38-53 GS ROOTS 44 ROOTS CEO 54 SITE: 1893 E PICKERING RD ROOTS @ 53 ROBERT II.PAYBOE,DESIGNER SHEET: SITE PLAN SCALE: 1'=50' nSCLAOIER. This IS Nm A SURVEY REFERENCES IN LICFNTIWUNTY PROVIDED PATS OR 3083 E MASON BENSON RD SURVE V.FIELD 4LAs UREMENTs NC LWM,OIS. O MMEO FOR SEPTIC PURPOSES ONLY. GMPEVIEW WA 98546 PRCQORESPOKMIBLE FOR SETBACKS UNRELATED TO SEFNG CC4 N1 Mat SE stejEct TO OTHER OPA Excv O[si xE R NOT N0�361BOI 110' SETACK \ - r FROM WETLAND RMPUMP ELEVATION OB PORTS & PUMP ELE. 100.V CLEANOUTS \r✓ IATERALS _ 3 \ IATERAL .2 I IATERAL3 992S I LATERAL S00.tl I w H 13 r�LO � m r5' 2 I 9 9m I LPI J . / I 1.25" .. / SCH. 40 / I / I VALVE BOX J 2" SCH. 40 (DBLSLEEVE / UNDER ROAD) F / I q"S I '.L I s4mn Y AFCP.E[a�F WISSE � EXRinw / / CUSTOMER: ROBERT H.PAVSSE TEST HOLE 1 TEST HOLE 2 TEST HOLE 3 /N\ PIONEER PARCEL: 2 2 1 3 3 - 1 2 - 9 0 0 4 4 0-38 GLS 0-60 GLS 0-63 GLS / A DIGGING INC. 38-53 GS ROOTS @ 44 ROOTS @ 54 SITE:1893 E PICKERING RD ROOTS @ 53 ROBERT H.PAva5E,DESIGNER SHEET'DF DETAIL SCALE: 1"=10' nuuRSR: T 'SNOT A SURVEY. REFERENCES INCLUDE.AP CNPUCCUN1Y PROVIDED PUTS OR 3053E 4ASON BENSON RD D MFASUPFNENTS 6v cdINTY C'S. DESIGN INTENDED Fd SEPTIC E` PURPOSES URP SEED xLV. GRPPEVIEW WP 98516 IED EFFOP SETBACKS NREL1EDECT rO OTHER TO SEPTIC COMPONENTS Fry CV JWJ35-1B0] ( �T 1I lE LATERAL DIST. TO TOTAL LATERAL# LENGTH 1ST ORIFICE mmh �:O..�Y. • (feet) (inches) ORIFICES IkII II�� `"'''��YY''�a _ 1 30 18 10.00 2 45 18 15.00 3 45 18 15.00 4 30 18 10.00 DRAINFIELD HEAD (feet) 1.35 TRANSPORT LINE HEAD (feet) 2.27 ELEVATION CHANGE (feet) 10.00 RESIDUAL!SQUIRT(feet) 2.00 € EXTRA LOSS/FITTINGS (feet) 5.00 TOTAL DYNAMIC HEAD (feet) p0.62 T( AL GALLONS PER MINUTE 29.50 I I ORIGINAL & us J Oy are To- w 65E OB PORT FINAL GRADE RISER/LID OR � VALVE BOX CLEANOUT /// FOR ACCESS *ADJUST TO# OF LATERALS 6"+ SANDY FILTER COVER FABRIC \ ' 'a N BALL L �' ; CHECK VALVE VALVES (AS NEEDED) L WASHED ROCK THREADED CAP c 6" ORIFICES @12:00 • N W/ SHIELDS 900 • REST. LAYER SWEEP GLUED TEE CUSTOMER:ROBERT H.PAYSSE TEST HOLE 1 TEST HOLE 2 TEST HOLES ,.- PIONEER PARCEL: 2 2 1 3 3 - 1 2 - 9 0 0 4 4 i0-380 0-6O GLS 0O3 GLS DIGGING INC. 38-53 GS ROOTS @ 44 ROOTS @ 54 \ A� SITE:1893 E PICKERING RD ROOTS Q 63 ROBERT H.PAYSSE.DESIGNER SHEET:DF DETAIL(2) SCALE: NA oreOLJM IS NOT A SURVEY REFERENCES R1V PROM 3083 E MSON BENSON 0.0 SURVEYS FIELD IUEn6GNEUEWTS nD COUNTY GITM. GE ON SEPTIC PURPOSES GRAPEVIEW WA 96546 _lSFTaACUCSUIRELA1 IAGENCV N DESIGnER NOT 36542 .15W 0 II Ix [ RESPONSIBLE FOR CLEANOUREOED T CAP 1/ ENSURE 24°RISER a LID TO FINISHED GRADE RISER 14EEµEDTOT3 dWAIER.xGXRPYKLTIDMI FINISHED GRAD TO PUMP JANK OR DF t FROM BUILDING ( WATER-TIGHT JOINTS15MUMR STON SEPTICTF_TANK— INSTALL CTLER 4*ORENCOJ OUTLETDFN R I: Qa`w' "`w•s ;, 1 . E - symn G� FCCG.C } {q{58E iw� Tj/L2�[ ERIS ER LID 10NKS WATE EDGmx�pnr�EP,Ru.SG ELECTRICALWORK [N.NIT�R.�IIANEFAELTLII LEL LOAT TREE IA:J ON UALALAPMI TRANSPORT FNGRADE LINE TO Off IFR0M JI SEPTI TANKC UNION& BALL VALVE EUEncExcr STAGE HIGH WATER ALARM FLOAT INSTALL I ANTI-SIPHON WATER-TIGHT) C VN V SDCDE JOINTS 4 - Orwwwlxovwu.e 1500T5€S sOe IMSTLLTN XP�wxDTANIC nOFTAxuEI`ooE STAa1MdJffACTURER HECK VALVE TITRUOTS EXTEND S OUT TO GIttAL ONIOFF FLOAT EFFLUENT PUMPW/BUCKET (SEE PUMP CURVE FOR TYPE) CUSTOMER:ROBERT H.PAYSSE TEST HOLE 1 TEST HOLE 2 TEST HOLE 3 N rnPInOiNw�EnER PARCEL: 2 2 1 3 3 - 1 2 - 9 0 0 4 4 0-38 GLS 0-60 GLS 0-63 GLS nTr n n.. lI INC. 38 53 G5 ROOTS©44 44 ROOTS©54 54 SITE:1893E PICKERING RD ROOTS @53 53 ROEERT H.PAYSSE.DESIGNER SHEET:TANK DETAIL SCALE: NA THIS 5$OOTAEII nxo REA RZNCE INcwma APPuc TF OUNTY PROVIDED PLATA OR 300]E MASON BENSON RD Deew INTENDED O SEPnc DESE GRAPEVIEW WA 985E6SETBACK PROPOSED DEVELOPMENT MAY BE SUEJEOT TO OTPEREPTIC �ODE>APTT.I1W3ENDY REVIEW. DESIGNER NOT 56o n.-1EOJ os I I, REEeaNsItE FOR General Installation & System Notes 1. Installer must contact designer for final inspection of the installation prior to cover. All components,including tanks, lids,transport line, drainfield,and water lines must be open for inspection. A$350.00 fee will be charged for time involved with the inspection of the installation and creation of the record drawing. The designer reserves the right to charge additional fees if multiple visits are needed due to installation errors or inaccessible components. 2.This septic design must be installed by a certified installer with the local health department. All components shall be installed according to state,county, and manufacturer requirements. For Homeowner Installs,the owner must get approval from the designer and local health department prjgr to attempting installation. 3. Designer is not a surveyor. Installer must familiarize themselves with property line locations prior to installation. Any confusion or conflicts with line locations should be reported to the property owner. A licensed surveyor may be necessary prior to installation to confirm all line locations. Any discrepancies found must be reported to the designer immediately. 4. Drainfield area may only be cleared by a licensed installer familiar with sensitive drainfield area preservation. The builder, lot developer, or property owner shall not clear the drainfield area. Any clearing required for drainfield installation shall not remove or disturb any top soil in Primary and Reserve areas. Removal or disturbance to drainfield soils could render design void. 5.The property owner and installer are responsible for locating all underground utilities(ex.water,gas,electric)prior to installation. Any utility locations shown within design drawings are likely approximate and may not be exact. 6.All proposed tanks must be installed on original soils or compacted gravels. Extend all tank connection lines out onto original soil to avoid settling issues. Risers and lids must be brought to finished grade and left accessible for future operations and maintenance. Component manufacturers(ex.ATU, Glendon,)may have other requirements not listed within this design. 7. All electrical wiring shall be done by a licensed electrician or homeowner(if allowed)and must be permitted through Labor and Industries. Designer not responsible for electrical permitting or other electrical specific code requirements. 8.The proposed septic system should be installed in dry weather conditions. Any failed attempts at installation during wet weather conditions may render this design void. 9. Maintain 1 Oft to waterlines with all septic components&lines, unless approval within design/permit provides a reduced setback. Additional sleeving 8,install details may apply on reduced setbacks granted. 10.This design may include waiver applications with specific mitigation measures pertaining to installation,operation and maintenance of the proposed components. 11. Stormwater runoff,footing drains, roof drains must be diverted away from any septic system components. No curtain,foundation, perimeter drains shall be installed 30ft downslope and 1Oft upslope of drainfield areas. 12. Field staking and measurements taken are approximate. Installer may need to re-stake/layout drainfield laterals/beds prior to installation, level w/contours using a laser level in order to maintain the approved depth of excavation. Contact designer w/any problems related to drainfield layout prior to attempting installation. 13. Ali onsite septic systems require regular maintenance to verify satisfactory operation. The system owner/operator is responsible for the continuous operation and maintenance of the system per WAC 246-272A. For operation and maintenance information, refer to Mason County Public Health Homeowner's Manual,which should be received after installation approval. 14. System owner should be cautious of landscaping around septic components. Root intrusion can cause premature failure of the drainfield area. In addition,bushes and trees should be kept away from lids and other septic maintenance points. 15. Changes made at time of installation may impact designer calculations, pump sizing, and compliance w/county and state requirements. Contact design prior to install w/any proposed variations from design. Changes may result in additional fees& permitting. 16.This design is site specific and intended to meet state and county requirements that are related to the system components being proposed. Any placement of proposed buildings, proposed wells or other non-related items on these drawings mayor may not meet other requirements. ? Ty CUSTOMER:ROBERT H.PAYSSE PIONEER PARCEL: 22133 - 12 - 90044 DIGGING INC. SITE: 1893 E PICKERING RD S;"0317 Y �) RCEaiN WYSSE ROBERT H.PAYBBE,DESIGNER SHEET: NOTES SCALE: NA ^E'+4y1^f•,'`I:R 3083 E WuION BENSON RD i>-GT` GRPPEAEW WASG.1 EXF.n i 36oJ2'i �—Tp—� Iz