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HomeMy WebLinkAboutSWG2021-00088 - SWG As-Built - 5/12/2023 Mason County OSS Installation Report pg. 1 C _ MASON COUNTY PUBLIC HEALTH APPLICANT! PERMIT INFORMATION Permit Number SWG 2021-00088 Parcel# 12105-52-00146 Applicant Name SHARON WESTON Subdivision (Name/Div/Block/Lot) Applicant Address 7507 16TH AVE NE City, State, Zip REDMOND,WA. 98052 Installer Name DANO SEPTIC Site Address 1344 E TREASURE ISLAND DR Designer Name CINDY WAITE INSTALLATION CHECKLIST • Full System Installation ❑Tank(s)Only ❑ Drainfield Only El Repair ❑Other System Type PRESSURE DIST Pretreatment Type BNR 500 >5 ft.from foundation? - -- - - ❑ N/A ®YES ❑ NO >50 ft.from wells? - - ❑ ® ❑ Z >50 ft. from surface water? - - 0 El ❑ H Cleanout between building and tank? - - ❑ ® ❑ U Tank baffles present? - - - ❑ El 0 a24"access risers over each compartment?- - ❑ ® ❑ W Effluent filter installed?- 1 ' - ❑ I ❑ co Ti Septic tank size 1000+ gal Manufacturer 'Hay 1--tikasv 0 D-box water level and speed levelers used? - - j N/A ❑ YES El NO oO Manifold/D-box accessible from surface?- - ❑ Ill cc Check valves installed? - - ❑ ❑ 0 CI et 2 Transport Line Size 2 Schedule/Class SCHEDULE 40 Bedrooms installed (check one) ® 2 ❑3 0 4 ❑ 5 ❑6 ❑Commercial/Other >10 ft. from foundation?- - ❑ NIA El YES ❑ NO CI >100 ft. from wells?- - ❑ ® 0 W >100 ft.from surface water? - - ❑ ❑I 0 ti >10 ft.from potable water lines?- - El 0 ❑ >5 ft.from property lines and easements?- - ❑ ❑ III > 30 ft.from downgradient curtain/foundation drains? ® El 0 ca Drainfield level and observation ports present - - ❑ a El ❑ Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ IN ❑ Pump tank setbacks consistent with septic tank? - - ❑ N/A ❑� YES ❑ NO ZPump tank size /0 C J gal Manufacturer f-I en-to„n Q 24"access riser(s)and accessible from surface?- - 0 © El F- a Alarm or Control Panel Installed? - - ❑ FA ❑ Control Panel equipped with Timer/ETM/Counter 0 ® ❑ `', a Pump installed in ❑ Bucket or ZOn Block or El Other O. Pump Make/Model L. 'i bi--Q-T-} 2 ' Ai Floats or ❑ Transducer 2 0. a Tank draw down in min Pump capacity qpm Squirt Height ft Pump on time 1 Pump off time '-{ Daily flow set at IfO gpd updated 821/2018 �,ufhajoi Ih✓ Ckevviek Mason County OSS Installation Report pg. 2 Parcel# 12105-52-00146 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - Q YES ❑ NO If yes, please describe: Were all components pumped out and properly abandoned per WAC246-272A-0300? - - El YES ❑ NO RECORD DRAWING Thls is a permanent record and must he accurate and descriptive enough to re-locate in the need of maintenance activities and future development. Typica'Record Drawings contain Drainfield&manifold orientation&layout.Septic/pump tank location.North arrow.reserve drainfield.existing and proposed bu::dings,location of wells.waterlines. wells.observation ports,cleanouts.and other maintenance access point,. Incomplete Record Drawings may creak additional delays in final installation approval and related permits a Nk 0 Cd//v Al /Y//a el feel /j,c 4.44 -Jai- 1 N 5—Id M& i by 2,ri trety t y Dta4 .."Zie Ti j Al r t d ije j Q r ff 4 C JP,/"f V ® 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 unty Codes. State and Mason County Codes I fu rtify Ma information c tained n this l further certify that all information contained on this rm d attec Re or Drawing t t. - te. form and attached RecordaRtmo accurate. 1 r/whootw wm.w 01%' �•.r.� \' . /Z /Z> �� 83NOIS30 C33SN3Dt1 ''' i q� ttt i, 1y 3111M 3 ACINID ' /Signature of Installer Date \rm a1 eooi.• ;,,; 7 Printed Name of Signee +f • y\,''~� /�� MASON COUNTY PUBLIC HEALTH �, .it ri- $ i The undersigned approves this Installation Report and 1 i 0 Record Drawing on behalf of Mason County Public - $ Health: Signature of Environmental Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE -tpated 812r1201e L @ 0 A Wvot,/1 ire- wo-S x 1 0 eok,m_ AQ11 a l lq i fed vi for o'cony\c(1 A \ ' 1 V kr‘ oirRail s/Izlz3 g r - 0r U— 77 /, Loa„, 0 a - yU .. Loa.., 69 3o /l,. /,t,,/,,,y L M 1. Existing residence 2. I Zaa p4,5y -/4,.,k 3. dAr ►Z SaU w/f-4 #E- 4. Audio/visual alarm ^t •p 5. Transport line /? V 6. Valve Box .11 INSON,, ' qr /2 �® 7. Primary drainfield(Bed Ie�,c3o, ;�IXt ) OWN i FN. 2O 8. Reserve area will need RFl oN�FNrq�y to go over repair system if needed. Eglly 9. Clean out 10. Waterline 11. Paved driveway 12. Existing septic tank a ..5- 0,2e i i lute .1 lkuk L - 20 ' i 4(0 • i Gi' i / J,= -uf �.. ,tA,,c‘b-,,, A 3 �tty y? G 51 B a Y E AITE LISED SIGNE Ex'IRES u5'10 dip '°R oNoo� 12? FQ Nry ?3 ����, Fr A(H�lty AP,& �T.,I1 , .,, 0$r 1" 211 ice : s ' Y 0 0 F10041 ' 1` 0 CI y E AIT . LICEN ESI JER tglek Wk. lift. look...0 L0'.KLS 0510 _ 1 amirn.. 1. 7 1 i VI 43' �N I 2 C1,'4N uk.4 6kr Pau 4) / C V. 4-eaN3t'0 g.4 live 0 - uSr' a-Los G ugt. 70° N 1 �s _ v 17s• Pu - (2) 5ltb • a3 y12" ' ______ \ ___ ', 2 2 ' 40 4ctykr -- 30 ' t