HomeMy WebLinkAboutSWG2026-00258 - SWG Application / Design - 9/21/2026 (2) MASON COUNTY 415NfiSHELTON ,8427-960 EXT400
SHELTON. 360-0754467 EXT 400
BELFAIR:3fi0-275-44fi7,EXT 400
Public Health & Human Services ELMA:360-482-5269. EXT 400
FAX: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 E LEISURE LN GRAPEVIEW. WA 98546-9719
SEPTIC INSTALLER CINDY WAITS' 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 B waiver
(WA12026-00070)
Permit Submitted Date'. 08/13/2026
Permit Issued Date: 09121/2026
Issued By: David Anderson
Current Permit Fees Paid'. $845.00 (additional aes may be required upon installation of system).
Permit Expiration Date: 08114/2027 (based on dam of mspeofion)
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 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/environmental/onsiteloss-inspection-request.php or call:
360427-9670, extension 400.
OFFICIAL USE ONLY -
MASON COUNTY `ENFD
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Public Health & Human Services R 4Elntn � PIED o m
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En'ir,. ....Hl Health 3602/9670,ett.400 or 360275-046?,ext 400 y
415 N.6th Street- Shelton,WA 98584 SAG 6
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ON-SITE SEWAGE SYSTEM AF PLICATION 3 A
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APPLICANT PHONE
STEVEN LUSKEY _- 360-888-2554 OR 360-427-1457 z
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MAILING >PLODE
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31 LEISURE LANE
GRAF'EVIEW WA 98546sIrE A
31 ER LEISURE LANE IEVIEW WA 98546 10)
NAME OF DSIGNER
CINDY WAITE LK'_�_ t
701-0205
NAME OF INSTALLER i
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TBD Lcsi PERMIT 3RCE 5 N
TYPE(1116(11n=r _ _ O
M RESIDENTIAL OSS P1 COMMUNITY ORS r COMMERCIAL 055 b PRIVATE INC VIDUAL WELL ❑ PRIVATE TWO-PARTY WELL 2 A
TYPE OF WORK Rderl one) 2 PUBLIC WAT?R SYSTEM FMERAt
D LAKE WE
BE NEW CONSTRUCTION I UPGRADES 09 REPAIR/REPLACEMENT OTHER DETAILS(116 FD'aseaevb) ❑ TABLE X REPAIR 101
aM rrwts ❑ SURFACING SEWAGE S EXISTING FAILURE ❑SHORELINE
�I SEPTIC DESIGN{REQUIRED} BEDROOMS LOT SIZE WAS LOT cREA'ED AFTER 41112325? r
ES LH DESIGN FORM(REQUIRED) 1 O
WAIVER(SI(IF APPLICABLE) 2 -70 AC ❑ YES p NO A I 0
D]RECTONE TO SI fEAND SITE CONDITIONS.(nx.locked9ere)
GO NORTH ON HIGHWAY 3, TURN LEFT ONTO MASOt LAKE RD, TURNRIGHT INTO o
EMERALD LAKE, STAY ON EMERALD LAKE DR, TURN _EFT ONTO LEISURE LAND,
FIRST DRIVEWAY ON THE LEFT. o i o
Io
TE MUSTBE FLAGGED FROM MAIN ROAD AND TEST HOLES MUSTRE FLAGGED WITH TESTXOLE NOMBE IE
OFFICIAL USE ONLY BELOW THE LINE
UPGRADE I FAILURE SOURCE lID re+oning WDOSRal
❑VOLUNTANTARY OMAINTNTENAN0EIPVn1PING 0BUILDING PERMIT OH0ME SALE ❑e OMPLAINT O0THER.
INSPECTOR LOGS COMMEN]S 1 LON 9RloNS
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Ff1:a:o- 3 35" 4 SL (7Y
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, liz: 0-J3" "(75L
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Re54- a /- 3' wl madame
RECORD DRAW WOANN INSTRIATION REPORT
SOIL CODES
-VERY G=GRAVELLY S=SAND L-LOAN, 5! SILTC=CLAY C=EXTREMELY R-ROOTS ftWIIIREO FOR FINAL APPROVAL.
NSF OR SIGNATURE �o DATE. APPLgaN EXPIRATION APP TO Pz��D ��Y DATE
THIS FFOO(RMM MAYBE SCANNED AND AVAILABLLE FOR PUBLIC VIE ON THE MASON COUNTY IEBSITE Revised:4/14/2025
DESIGN FORM—PAGE ONE Assessor's Parcel umber: 2 1 2 4 5 1 0 0 0 0 6
A design will be reviewed when 3 conies of each of the following are subs dtted:
Completed design form that has been signed and dated. Scaled lay lot sketch,including all applicable items on checklist.
Scaled plot plan,including all applicable items on checklist. °Cross-seci on sketch,including all applicable items on checklist.
This form may be scanned and available for public view on the Msao 'County Web she.Maximum paper size: 11"X 17• "
' < - PARL.D} 1FIC. TIGN
Permit Number: SWG Zo91 Designer's Na le: CINDY WAITE
Applicant's Name: STEVEN LUSKEY Designer's Phi ie Number: 360-701-0205
Mailing Address: 31 LEISURE LANE Designer's Ad ress: 80 E PICKERING LANE
GRAPEVIEW WA 98546 City State Zip SHELTON WA 98564
City State Zip Designer's E ;1 cindyewaae@msn.eom
DES GN PA1AME1hRS
Treatment Device
❑Glendon ❑Sand Filter ❑Mound ❑Sand Lined Drainfield ❑Recirculating Filter 0 ATU ❑ r
Treatment Level(check all that apply): ❑A ❑B ❑C ❑BLI ❑BL2 0 BL3 IfE ❑N
Drainfield Type CFI -
Ii'Gravity ❑Pressure tTrench 0 Bed ❑Sub Vrip
Septic Tank/Drairfteld 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 Appi.Rate .6 gpd/ft2 Orifices
Required Primary Area 400 R2 Total N r of es ASTM PERF
Designed Primary Area 435 Rr Diam c0 4
in
Designed Reserve Area 400 ft2 SP ei in
Trench/Bed Width 3 R
Trench/Bed Length 145 8
Elevation Measurements axpiaas vw ft
Original Drainfield Area Slope 4 % Diameter in
New Slope,If Altered % Preferred manifold configuration used? O Yes ErNo
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 g
Gravel-based Drainfield Required? tYes ❑No Diameter 4
in
Pump Required? 0 Yes YNo Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day
Diff.in Elevation Between Pump&Uppermost Orifice f Dose quantity gal
Drainfield Squirt Height/Selected Residual(head) f Chamber Capacity(flood) gal
Uppermost Orifice 0 Higher ❑Lower than Pump Shutoff Pump controls:Please check those required.
Capacity @ Total Pressure Head gpm ❑ Timer 0 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—PAGE TWO Assessor's Parcel Number: 3 2 1 2 . 4 61 0 0 0 0 6 ,
Permit Number: SING
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
Test hole locations 0 Drainfield orientation and layout Reference depth from original grade:
Soil logs le Trench/bed dimensions and Hrf'septic tank
V Property lines critical distances within layout V Drainfield cover
d Fisting and proposed wells ,et D-BoxNalve box locations Reference depth from original grade
Q within 100 ft of property t&Septic tank/pump chamber and restrictive strata:
j�kvteasurements to cuts, banks, and locations V Laterals,trench/bed,top and
surface water and critical areas 0 Observation port location bottom
Location and orientation of tClean-out location ❑ Curtain drain collector
curtain drain and all absorption Ff IManifold placement ❑ Sand augmentation
components O Orifice placement Other cross-section detail:
if Location and dimension of Observation
primary system and reserve area to edge placement with distance ports/clean-outs
edge of bed Other Information
li? Buildings
V Direction of slope indicator W Scale
germ referenced non Yes No
B� Scale of drawing shown on scale !f 0 Design staked out
0' Waterlines bar ❑ ❑ Recorded Notices attached
Roads,easements,driveways, t Elevation benchmark and relative ❑ ❑ Waiver(s)attached
parking elevations of system components O ❑ Pump curve attached
V North arrow and scale drawing O O Evaluation of failure
shown on scale bar Non-residential justification
❑ O Waste strength
❑ ❑ Flow
DESIGN APPROVAL
The undersigned designer must be noti ted by installer at time of installation E'Yes ❑ No
2 b Q, sl /Y/ B
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 regal ns:
f7i( (Zo tG
Enviro tal Health Specialist 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: `r
✓ 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. A�
This form may be scanned and available for public view on the Mason County Web site. Revised:6/11/2025
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Installation Notes
Gravity System
31 E Leisure Lane 32124-51-00006
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.
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 deer 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.
16. 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.
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 extends
above the original grade, run the filter fabric at least 2 Inches down nch wall
/,? CINDY EI �
".j LICENSED Or
System Owner Responsibilities:
1. Operation and Maintenance is required by Washington State Department of Health and
Mason County Health Department.
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.
B. 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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