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HomeMy WebLinkAboutSWG2023-00094 - SWG As-Built - 9/11/2023 Nt)S Mason County OSS Installation Report pg. 1 CC MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2023-00094 Parcel # 42123-76-90163 Applicant Name Scott Semanko Subdivision (Name/Div/Block/Lot) Applicant Address 14651 N US Hwy 101 LOT3 OF SP#2702 AF#622571 PTN OF NW SW S15/7 City, State, Zip Shelton, WA 98584 Installer Name Maples Excavating Site Address 310 E Fairchild Heights Rd Designer Name Arrow Septic Dsigns INSTALLATION CHECKLIST IS Full System Installation ❑Tank(s) Only ❑ Drainfield Only ❑ Repair ❑ Other System Type Shallow Pressure Pretreatment Type >5 ft. from foundation? - - ❑ N/A IN YES El NO >50 ft. from wells? - - ❑ L. ❑ Z >50 ft. from surface water? - - ❑■ ❑ ID • Cleanout between building and tank? L� t t�t 'J-I- - - - - ❑ ❑ U Tank baffles present? - L� '1 - - - ❑ UI ❑ a 24" access risers over each compartm rt ?-mt 2-4-2-on- - - - - ❑ 0 El W Effluent filter installed?- -OLA - ❑ ❑ ❑ Septic tank capacity (working) 1 530 al M.anufact rer Infiltrator 0 D-box water level and speed levelers used? - - 0 N/A ❑ YES ❑ NO oO Manifold/D-box accessible from surface?- - ❑ UI ❑ co-2 Check valves installed? ' f"` 'F. - ❑ ❑I ❑ oa E Transport Line Size 2 inch Schedule/Class 40 Bedrooms installed (check one) ❑ 2 ❑ 3 ❑4 ❑■ 5 ❑6 ❑Commercial/Other >10 ft. from foundation?- y N/A YESEl El NO >100 ft. from wells?- - --F- - E LI' Ei ❑ —J >100 ft. from surface water? - - - it ❑ ❑ W 5tr11illi >10 ft. from potable water lines?- - - - - - iiit 0 ❑ Z > 5 ft. from property lines and easements WENIV201\lti'1l=LlTL.HE►t" ❑■ ❑ W > 30 ft. from downgradient curtain/foundation drains?- J-BW- - - - - ❑ UI ❑ • Drainfield level and observation ports present - - ❑ 0 ❑ ❑ Graveless chambers or ® Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ 0 ❑ Pump tank setbacks consistent with septic tank? - - ❑ N/A ❑■ YES ❑ NO • Pump tank capacity (flood) 1,530 + gal Manufacturer Infiltrator z CI 0 El • 24" access riser(s) and accessible from surface?- - ~ Alarm or Control Panel Installed? - - ❑ El ❑ a E Control Panel equipped with Timer/ETM /Counter- - ❑ • ❑ D a Pump installed in ❑ Bucket or ❑■ On Block or ❑ Other a• Pump Make/Model AY McDonald 405011 FS-1/2hp, 115v ❑] Floats or ❑ Transducer a Tank draw down 2 in/min Pump capacity 70 gpm Squirt Height 6 ft Pump on time 2.1 min Pump off time 6 hrs Daily flow set at 600 gpd Updated El21201 8 Mason County OSS Installation Report pg. 2 Parcel#` Z12.3 --1 - CIO I (c,-5 ABANDONMENT RECORD Were existing septic components abandoned as part of :his protect? - - E YES VI NO If yes, please describe: NO Were all components pumped out and properly abandoned per WAC246-272A-0300? - YES 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: Drainreld E.manifold onentation&layout.Septic/pump tank location,North arrow,reserve drainfield,etsting and proposed buildings,locator,of wells,waterlines, wells,observation ports,cleanouts,and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and related permits. PPRO E Scr' 1 1 2„„ „,ASON COUNTY ENVIRONMENTAL HEALTH JBW 'Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ENGINEER l certify that I installed the system in accordance with l 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 l 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. !Signature of Installer Otte A Printed Name of Signee M • r} ° t,.l MASON COUNTY PUBLIC HEALTH .y The undersigned approves this Installation Report and '`' t Record Drawing on behalf of Mason County Public ' f� PAULA JOY�JOHNSON �� 49 H a/th � LICK�lSEt'SU�SIGtiEfi'`�J1 Expiiiiiii/ Sig at ry f nvironmental Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE upatec arz1rzot8 © m O 11-1 00 O t• �xi.S-f-in $x1 4'mob; It q O O� 9 FIKTtA —._ _ 0 FUTuteE © 2BR 38R S!-t OP / — St-NoF— — 33o'x40' / '3O Lko' / / 5(.7' ((e) 3x6(0 Pc;mar y � 1 d rai h-fifIA -}'f.e h Clnt,S Z•lnSbe' / i ___--, I ova loi7Q. c urvp d to ! �. �0°b5\0 1 C o h-}o u r k-0 1�e e ) ' ��� S~ t -'�v � e es le �.� ,ve Key: Pi Q5.eVJe acADOQ¢ , — 3'I OAudio-Visual Alarm 's 3, Cleanout O3 1 S00 Gallon Septic Tank 2-Compartment with Effluent Filter --)--- .4 4 1500 Gallon Pump Chamberisofpp4 . Vco4k /10 . 0 Valve Control Box d 4/4i ✓ewN/11F"ix.k , iFkiic . Wo,-reylkyle. 100'+"t'o 2--Par-4- IICnIntoocwtll -- — �— — ;t� > / iSo .to31 Of\ Parcel 42. 2-5-T9-9010t I' i� / a / r � Atil, 0 3 ��sEM>r q:/ / 0 55 30 45 Cr0 ,��(�A • SO.b`l' H IA bR\1i- �,a h , \ a tC,R1StlNi, SEMNN�O Ar r , `)—.-!- ,) p���-� 3dtZo?�D ')PRC .L�- r2\2 '16-clot(o5 ° . ;• .., -51V� .E aCg,w(\t V)HE1(Ts Rp P H N AULA JOY JOSGN _ _ — j. S C \ L'iC SIB 1 $16NMit _ _.—a