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HomeMy WebLinkAboutSWG2023-00147 - SWG As-Built - 5/3/2024 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2023-00147 Parcel# 32134-41-00040 Applicant Name Patrick Walters Subdivision (Name/Div/Block/Lot) Applicant Address 9126 Mullen Rd BE NE114 NWi/4 NE1/4 SEt/4 S 531139 City, State, Zip Olympia WA 98513 Installer Name Mason County Excavating Site Address 370 E Gmenview Ln, Shehon Designer Name Arrow Septic Designs Inc INSTALLATION CHECKLIST 0 Full System Installation ❑Tarl Only ❑ Drainfield Only ❑Repair Other soo galm pn,- a hwink System Type Shallow Pressure Pretreatment Type NuWater BNR-500 >5ft. from foundation? -- ------ -- --- --"" -----' -- ' ❑ NIn ❑� YES ❑ NO >50 ft,from wells? -- ---------- - - ------ "- - ----- ❑ Cl Z >50ft.from surface water? -- - --- -- - -- - - - --- - --- - -- ❑ ❑� ❑ Q Clesnout between building and tank? - -- -.-- -------- - -- -- ❑ � ❑ U Tank baffles Present? - - - - - -- - ---- - ---- --- - --- "- ❑ t•❑ ❑ f- 24"access nsers over each compartment?- ------- - ------- ❑ ❑� ❑ WEffluent filter installed?-- -- - -- - - - - - - - - - --- ---"- - - - ❑ ❑ rn Septic tank capacity(working) NuWater BNR gal Manufacturer Infiltrator o D-box water level and speed levelers used? - - - - --------- -- ❑ NIA ❑ YES No DO Manifold/D-box accessible from surface?- - - - - - - - - - - - - - --- ❑ ® ❑ mZ Check valves installed? -- --.Cg '� n1F--- -- - "-. ❑ ® ❑ oQ Transport Line Size 2inch Schedule/Class 40 Bedrooms installed(check one) ❑ 2 ®3 ❑4 ❑ 5 ❑6 ❑CommerciallOther soft,from foundation?-- - - - - - ---- - - - - ---- - - - - - - - ❑ NIA AYES ❑ NO >1ooft.fromwells?---- ---------------- -- - --- -- ❑ 0 ❑ m >100 ft.from surface water?- -- ---- - ---- ------ - -- - - - ❑ ❑ LL >10 ft.from potable water lines?- - --- - ------ ----- - -- - - ❑ ❑ z > 5ft.from property lines and easements?--- -- --- -- - -- - - - ❑ ❑ Q IY > 30 ft.from tlowngratlient curtain/foundation drains?-- - - - - - --- ❑ � o Drainfield level and observation ports present -- ---- - - - ----- ❑ 0 Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?--- - - -- -- - ----- - - ❑ �❑ Pump tank setbacks consistent with septic tank?- ----- - --- --- ❑ NIA ® ves � ❑ NO y 1 Y Pump tank capacity(flood) 1,060 gal Manufacturer Infiltrator 2 Q 24"access riser(s)and accessible from surface?-------- ---- ❑ I ❑ r a Alarm or Control Panel Installed? - - ----- ----- --- - - -- -- ❑ ❑ 2 Control Panel equipped with Timer/ETM/Counter- - -- - ---- -- ❑ ❑ 7 a Pump installed in ❑ Bucket or M On Block or ❑ Other a Pump Make/Model Liberty 280 ® Floats or ❑ Transducer a Tank draw down 2 in/min Pump capacity 38 bpm Squirt Height 5 ft Pump on time 2.3 min Pump off time 6 hours Daily flow set at 360 gpd U�letl6l: a Mason County OSS Installation Report pg. 2 Parcel ABANDONMENT RECORD I NO Were existing septic components abandoned as part o(tM1is project _ ______ YEa If yes, please describe: NO Were all components pumped out and property abandoned per WAC246-272A-MOO _______ _ YES RECORD DRAWING .0 a y in Nz neea or mantenance activities and N m enNapment Tr I R.. Vcn,,.nmr aaoN.ne muu ec attumu•.ne daunpwc:n s Ra°ca� e'M`ns.lw of wada.wauNnea. omdn,.mna in: o,,nn.d8manRdO nnenl ,aiaYW1.secdw�mo ianxio as e.a+mr.P—Y aad—@ai�ad,eNmnyna pn WXC weaa.manwdenp eeanwu,and dmn mahunana alias.ooiire. inwrt¢iale Raced orawnys mar�Yamnurel ease in nnn inswrao.n apd�va and^A'ed panni°. [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'APPRQVED'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 crearedrapproved 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 /further certify that all information contained on this I further certify that all information contained on this form and all& .edd ecord Drawing is accurate. form and attached Record Drawing is accurate. Signat oflns1ta/ller Date �1,G� KtY Ponied Name of signee `aLLL���aaA MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and 3 a• 10 34 ? 'f t Record Clawing on behalfofMason County Public ''t' neULAJOYJOHNSONY'� Health: <S pp" -rpm .< �4Y�Pa w�cv' j S�3 �Z� Signature of Environment Health Spedalist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE aena.e amrzom �PPROVEDV' 1 trsAV 03 2024 c5CNCOUtirENRET 4ENTALNt4LTN Gr Gh I N m (5�3z40' �rin�ary/© drarnF;rsd }renChFs 5' OL. WjreS`rveU � DRtv�wk>J below o _ o OY.S{oQc fA-10 -Yntr•r° t�.Yo ral+x5 316' SCALE•l" SO' Q Audio-Vlaual Alann e s Se 1s `oo O2 Cleanont P�s '-T 500 Gallon Pr Traah tank -k>C-Am� f'1&��RrS O NLWa1er BNR-500 ATU Tank oa.erct svxltS4.4t-60040 3 to E GREeNvlew LN. c h Q l,000 Gallon Pump Chamber r, 3Ve?ve Con uoi Boa s,o a.. O PAM JOY JOHNSON