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HomeMy WebLinkAboutSWG2022-00329 - SWG As-Built - 6/13/2022 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT! PERMIT INFORMATION Permit Number SWG 2022-00329 Parcel# 32033-44-90021 Applicant Name Alexander Cox Subdivision (Name/Div/Block/Lot) Applicant Address 100 SE Rosewood Ct City, State, Zip Shelton, WA 98584 Installer Name Maples Excavating Site Address same Designer Name Arrow Septic Designs, Inc INSTALLATION CHECKLIST ❑ Full System Installation ❑Tank(s)Only ® Drainfield Only 0 Repair ❑Other System Type Pressure Bed Pretreatment Type >5 ft. from foundation? - - ❑ N/A 0 YES ❑ NO >50 ft.from wells? - -((- - - - - - - ❑ 0 ❑ >50 ft. from surface water? - - - - - U Imo- - - - ❑ El ❑ H Cleanout between building and tank JUL. 1 3 ?_027 ❑ El ❑ U Tank baffles present? - - - - - ❑ 0 ❑ F- 24" access risers over each compart ent?- - - - ❑ 0 ❑ O. W Effluent filter installed?- -By--- .-_ - - - - ❑ 0 ❑ co Septic tank capacity(working) 1,200 gal Manufacturer Existing-Kurt's Precast rn D-box water level and speed levelers used? - - ■❑ N/A ❑ YES ❑ NO oOJ Manifold/D-box accessible from surface?- - 0 ❑ ❑ m Z Check valves installed? - - - - - -,164-15-P3 _t°"A"*' - ❑ ❑■ ❑ dQ 2 Transport Line Size 2" Schedule/Class 40 (existing) Bedrooms installed (check one) ❑ 2 0 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10 ft.from foundation?- - ❑ N/A 0 YES ❑ NO 0 >100 ft. from wells?- - ❑ 0 ❑ W >100 ft. from surface water? - - El0 ❑ ti >10 ft.from potable water lines?- - ❑ 0 ❑ Z > 5 ft. from property lines and easements?- - ❑ 0 ❑ Q 0 ❑ CI > 30 ft. from downgradient curtain/foundation drains?- - 0 Drainfield level and observation ports present -mil e�cv�� - ❑ 0 ❑ ❑ Graveless chambers or • Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ 0 ❑ Pump tank setbacks consistent with septic tank? - - ❑ N/A 0 YES ❑ NO Pump tank capacity (flood) 1,000+ gal Manufacturer Existing- Kurt's Precast < 24" access riser(s) and accessible from surface?- - ❑ I. ❑ H 0. Alarm or Control Panel Installed? - - ❑ 0 El 2 Control Panel equipped with Timer/ETM/Counter- - ❑ © ❑ d Pump installed in ❑ Bucket or 0 On Block or ❑ Other a- Pump Make/Model Hydromatic SP40 (existing) 0 Floats or ❑ Transducer a. a Tank draw down 3 in/min Pump capacity 57 gpm Squirt Height 6 ft Pump on time 1.5 min Pump off time 6 hr Daily flow set at 342 gpd Updated 8/21l2018 Mason County OSS Installation Report pg. 2 Parcel# 32 0 S3- �F'k- `i oo-z.), ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - IR YES ❑ NO If yes, please describe: Q� ,"-v s Were all components pumped out and properly abandoned per WAC246-272A-03OO? - - ❑ YES ❑ NO RECORD DRAWING This is a permanent record and must be accurate and descriptive enough to re-locate in the need of maintenance activities and future development. Typical Record Drawings contain: Drainfield&manifold orientation&layout.Septic/pump tank location,North arrow,reserve drainfield,epsting and proposed buildings,location of wets,waterlines, wells,observation ports,cleanouts,and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and related permits. S4Ze_ , -'ck-a c-, tig 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 I further certify that all information contained on this form and attached Record Drawing is accurate. form and attached Record Drawing is accurate. t�-- /Signature of Installer Date Printed Name of Signee MASON COUNTY PUBLIC HEALTHb.i0 ;�� �� '•� yyr • The undersigned approves this Installation Report and (`%, s,00a,t a�? Record Drawing on behalf of Mason County Public PAULA JOY J2?HNSON': �c�ws�bsItArk Health: Signature of Environmental Health Specialist Date (stamp, signature and date) ( p� g THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Updated erzmrzote 32033- Lf j- 90olq I30 SF RGS� N00a C " ftt-ex >lde o Parctf 32�33-4y 9002 1 Pro?osec draivi-ie1 d 1 oca-tooV! 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