HomeMy WebLinkAboutSWG95-0753 - SWG Application / Design / As-Built - 10/27/1995 kSON,COUNTY-DEPARTMENT OF HEALTH SERVICES PERMIT NO. SWG 95- v y
zi 9p a
426 W. CEDAR/P.O. BOX 1666/SHELTON, WA 98584 Date = N
PHONE (360) 427-9670 Receipt N
Amount$ .Ld z �
w
i r _ _27- CHECK APPLICABLE ITEM �/ m
ING ADD ES : D YTI E PHONE: NEW SYSTEM q
REPAIR SYSTEM »'
C STATE: zIP: MAINTENANCE REVIEW m
SINGLE FAMILY
PROPERTY ADDRESS: OTHER z
SPECIFY: 3
PECIFIC DIRECTIONS FOR L CATING SITE: PRIVATE WELL
e1. r COMMUNITY WELUPUBLIC SYSTEM
SYSTEM WFI# W
}- r 2 d SYSTEM NAME IN
l APPLICANT
NAME -1.77 :J,-muImo,
Name of Lot ft. x ft. MAIUNG ADDRES : 2
Installer i
Size: s acres TELEPHONE
Name of Number of e2 o
Designer _ Bedrooms
PLOT PLAN h 1
Draw a dimensional plot plan, W� a fin/ J
including: ; 1 /T9�1 m
sf 1
❑Precise location of test
holes, showing
measured distances to I�L6f`1l�ll IIJI ��O{
property boundaries. M
❑Entry road;other roads, O r T 2 ] » 4
driveways. 92`
NOTE: DO NOT DRAW IN lO
SYSTEM DESIGN yEALTH SERVICES
OFFICIAL USE O Y. DO NOT WRITE BELOW DOUBLE LINE.
jSOIL LOGS V
3Z -6(1 G � 45'( y cn.P�c� 'fAr'c�,.u�
n Cyr S '
Depth from Original
Grade to Restrictive
t/ Layer or Water Table: ��(((.,
� In.
DESIGNER DESIGNATION SCOR S MINIMUM SYSTEM REQUIREMENTS
Finding Score Designer Leve ne Two
Soil Type �
Vertical Separation I ��in. Septic Tank Daily
i� Capacity: /M Gal. Flow: 2/0 GPD
Slope
Appl. Infilt.
Parcel Size O.iAc. � Rate 0,6 GPD/FT2 Area Q0 F�
Distance to Shoreline>to ft. Total Inspector Dat So
e
� ff- COMMfsNTS/CO DITIONS FOR APPROVAL
11 Af.3- 6
24
•All septic systems must be designed and installed by contractors certified by County Department of Health Service;, unless prior approval is
granted by the department, or the design is by a professional engineer.
•Septic permit approAl Aes not imply other building site requirements (i.e. C W er Adequacy) have been met.
•Any change from a ified use of the property or any site alteration affe in th system design may invalidate this pe mit.
•This permit expir 2 rs from the date of site review.Denial of this permit appealed to the Health Officer within 1 days of denial date.
SITE REVIEW: ',, , ESIGN REVIEW: pr Not Approved INSTAL 0 ro No rov
BY: DATE:9�j�— BY:
ner's Copy BOTTOM: Applicant's Copy
w ,
MASON COUNTY DEPARTMENT OF HEALTH SERVICES
C D POST OFFICE BOX 1666
SHELTON, WA 98584
(36
(340) 427-9470
FAX 42 7-7798
MAR 2 0 1996
APPLICATION FOR RE-INSPECTION
4FALTH SERVICEC - ON-SITE SEWAGE PROGRAM -
DIRECTIONS
1. Complete Part 1-3 and submit to the Director of Health Services, PO Box 1666, Shelton, WA 98584.
2. The on-site lead will make a determination in Part 4 whether a re-inspection is justified. When a re-
inspection is made, the findings of the second Environmental Health Specialist are written in Part 5. A
final determination by the lead is recorded in Part 6.
3. Applicants are billed $77 when a re-inspection is required, and are expected to pay for any necessary
Laboratory costs associated with soil tests, unless prior arrangements are made with the health depart-
ment.
4. Findings and determinations of the lead may be appealed to the Mason County Health Officer at the ad-
dress listed above.
PART 1: REQUEST FOR RE-INSPECTION
Applicant's Name: qlA l�I7CLJP�k r�CO �N�S
Address: �
S VWLT�w f
• Telephone: (36o )4J6-w?i -
3 a k 3 0y Q oo LaT "
7fssessor's Parce= ITU er sunaivision Name ancl Lotu er
• Health Department finding being disputed by applicant:
r_1 14
r1
u Anticipated depth of watertable soil type/application rate u Depth or presence of mottling
n
u New drainfield area to evaluate Other (please specify)
C*INJ Z 'YQCJ`QLL- 1 N LIOM?04TE'D SOILS A6 5PFUf=feb 0 J Q9—%CY4 /SAL.
PART 2: AUTHORIZATION
APPLICANT „ y`- �J•�" 7"'�i� DATE 3
H:ON-SITE\RE-EVAL.W Revised 01107196
JIr
PART 3: PLOT PLAN
Use this space to draw a detailed plot plan, or attach one to this application. A detailed plot plan is one that
shows the precise location of the test holes, existing septic systems, dimensions of the property, and location of any
wells, roads, or other buildings on the property.
I
PART 4: DETERNIINATION OF LEAD
F-I
u Re-inspection is justified.
n
" Re-inspection is not justified, for the following reason(s) :
On-Site Lead Date
H:ON-SZTE\RE-EVAL.W Revised 01107196
PART 5: RE-INSPECTION FINDINGS
SOIL LOGS
TEST HOLE 41 TEST HOLE k2
t Jy"- p" _ old F11, low COPW 2�''° t=�\A
ti.000 C ,i3Oi1+ -y�gr,wh� r-Z k- 0
jb" 3b, - loawy }o v�eb S4 b 0 �o - 314,0 't 10A -
la�w.l s9k1
DESIGNER DESIGNATION SCORES
�p5} V„� Depth from original grade to restricl-ive layer: _� C,
o
Parameter Finding I Score f - Vr 3
X s1 \Slap Soil Type `I 13 ( 20
)L V� vertical Separation 2� in. lcp�a I 0'Ib 10✓{�-
ok Slope IS-Il ( 4pf•c
Parcel Size .u4Ac. 2-pts Ib-40 5/4,
Distance to Shoreline t200 ft. op�
Total : t � $gti0
SO �^
', �POJM^GU fim1K-n�
MI SYSTEM REQUIREMENTS
Parameter Requirement
Designer Level a
Septic Tank Capacity 1200 gal.
Daily Flow 360 gpd
Applicaition Rate 60o gpd/ft z
Infiltrative Area (coo ft2
i
OTHER COMMENTS
U 11Ui\2n., annwrs or dts'�o,`oo so'\. - ,a s:�l is ✓"s.iko' se�.au. r'p-k-4
le l t 11 tin" 13 v.wird (�StwK so 's 104— 0+l"V iwo 43' WA r4n lou}wti S
4-9-%
Environmental Health Specialist Date
PART 6: RE-INSPECTION DETERMINATION
—N Fec �, w
�Cr U�� sr,+l •- of rj'oe (✓� In Pr yr ,o nYw,�c . w4s were. Ouvc, v,
W In RBI I i\n RdQi}�a.,.q�j0t WU Vr sf ia&yN CAS G�
On-Site Lead Date
Billing Amount Receipt Number
H:ON-SITE\RE-EVAL.W Revised 01107196
DES/GN REt/IELf/ ;��q�`yy»
Mll
Wsm
1
DESIGN FORM - PAGE ONE � i,,, ,;,;./,<
A design wil re�(� n 3 copies of each of the following items are submitted:
` : Y �7 i orm that has been signed and dated
��le3ed�Ro Lands and Critical Areas Checklist attached
Ju scaled plot plan, including all applicable items on checklist
t?aa2ej A16ut sketch, including all ,applicable items on checklist
�CPDos-sec ion sketch, including all applicable items on checklist
�I 4F_ALT //y� 7 PARCEL IDENTIFICATION II
II Permit Number "1S' n-753 Designer's Name (AMMW6896'
II
II Applicant's Name 11. E '3bh)E.S Prop. Owner's Name
II Mailing Address e. 24 4G44 WP. Mailing Address
064uc kip City --jcaue zip
II 1 1-Tb IP II
II Assessor's Parcel No. -A%3(1: -00100 Subdivjsion )JOIJ�
IW 0 L19'it-'NIItP�BrT —7f7ame 1)3.'^'S'sTon/i''H13cjc7LUt -- II
I �
II DESIGN PARAMETERS _ I
✓ ✓ ,/ D --Ji
II �� �� �� Initials II
II u U U DateDesigned`Vertical II
II Separation II
II Mound Subsurface Pressure Gravity Bed Trench 2 4" t in I'
II septic Tank/Drainfield Specifications
No. Bedrooms .3 IE,i II Pressure Distribution? Yes U No
II Daily Flow 34o apd I: ...................... (If yes, proceed. . .) :II
............ ........ .......................
........... .......................
........
II Septic Tarik Capacity 1].00 sal I
II Receiving Soil Type (1-6) 4
II Receiving Soil Appl. Rate Q. lo apd/ft° Laterals
II Trench/Bed Bottom Area (,,� ft3 Schedule/Class O
II Trench/Bed Width tie gth f
I
II Trench/Bed Length lK = t
II Diameter 1
II Elevation Measurements Number is in II
II Orig. Drainfield Area Slope Separation 0 ft II
II Final Drainfield Area Slope 1 t Orifices
II Depth of Bottom of Trench/Bed Total Number of Orifices 1 II<
II from Original Grade 1 in Diameter in II
II r1o�t: Agmeoct) r/u. Spacing X L'
in Manifold
IIwnslope
�S.chheed�u a/Class yO
r�,II engtn ZO ft
IIInfiltrator Used? Yes- ® No Diameter Z in II
Transport Pipe II
II Pump Required? Yes ❑ No Schedule/Class LA O
II................... (If yea, proceed. . .) ........................ en�gt i ft
II :::::: ::::::::::::::)II Diameter , OL in II
II Pump/Siphon Specifications Dosing and Pump Chambr
I II
II Difference in Elevation Between Pump Shutoff # Doses/Day II
II and Uppermost Orifice — 4 ft Dose Quantity 40 sal II
II n I Chamber Capacity _� I sal II
II Uppermost Orifice is U higher, lower II
II than Pump Shutoff Check the following components if they drain II
II Capacity 0 Tot. Pres. Head L43.9 1- opm between doses:
II Calculated Tot. Pres. Head ? ft II
(Attach Pump Curve) , Laterals Manifold 0 Transport II
DESIGN NORM - PAGE TWO
Rov i.oa oajxi/v+
DESIGN CHECKLISTS
II Scaled Plot Plan I Scaled Layout Sketch I Cross-Section Sketch I�
II I I II
II . I I Reference depth from orig- II
II Test hole locations I Drainfield orientation I inal grade:
II I and layout I
II Property lines I I M Septic tank lid and II
II IL YE2naWbed dimensions and i drainfield cover depth II
II Existing and proposed I critical distances within I II
II wells within 100 ft I layout I Reference depth from orig- II
II of property lines I I inal grade and restrictive
II I D-Box/"T"/"L" locations I strata: II
II � Critical distance �� �
II measurements to cuts, Septic tank/pump chamber I Laterals, trench/bed
II banks, surface water I location6gE Po 'PLAIJ , I top and bottom II
II Location and orientation I Observation port location I Curtain drain collector II
II of curabsorption
drain and all i L Cleanout location I Sand augmentation
II abso tion area II
II components I I II
II I - 23 Manifold placement I No external reference needed:Il
IILy Location and dimension I I II
ors an11
II of primary system and I Orifice placement I Observation td
II reserve area I I cleanouts 1 II
II I Lateral placement, with I II
II Buildings I distances to edge of bed I Additional moundinformation:ll
'may'
II Direction of slope I Audible/visual alarm tJ Upslope and downslope II
II indicator I referenced 70 1W bai*4104 fill width
II
II I i2�i I El II
II Waterlines I Scale of drawing shown I U Settled cap depth at II
II n I on scale bar I center and edge of bed II
II I--I Roads/easements/ II
II driveways/parking I Additional Mound Information: I I--I Sidewall slope II
II I critical resource lands I I--I Endslope width I I--I Up/downslope bed elevat. II
II (if applicable) I U I II
II I Overall fill dimensions I Completed Resource Lands and 11
II I I _ II North arrow and scale of Critical Areas Checklist
II drawing shown on bar
II DESIGN APPROVAL i��t�ais II
�I Date II
II The undersigned designer C does, Ufdoes not, waive the regirement to be notified by the II
II installer of the installation and gW 48 hours to performm a�fjnal inspection prior to II
II cover. �JJ II
II I'gnaEure o szgnCK waceII
II II
II The undersigned has reviewed and ved this design on behalf of Mason County of Health II
I) Services. }�r�
Head '1 II
II II
II CAUTION: THIS DESIGN IS ONLY VALID IF STAMPED "APPROVED" BY MASON Co. DEPT. OF HEALTH II
II II
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P. O. Box 2003
V Shelton, Wash. 98584
S N—/ 11 A 71JXiJr Oate \
Pressure istrtbutiOn Jystems \`
1 • Install laterals with contour of tine ground .
' Install trench bottoms level and at all times a mi
inches into the native soil nimLin of' sixy
= • Install locator tape on top of all drainfield laterals .
4 . Install observation ports as indicated on the clot Ulan
drainro k two per drainfield with bottom extending to the
\ native soil interface) .
5 • Install drainfield dry weat
during h
soil smearing must be el` er and soil conditions , any
6 • Install threaded c iminated'•bc hated raking .
(ca must extend to w lea n-Outs at the ends of all laterals
p ithin 6 inches of finished grade and be
marked with locator tape' ) ,
7 • Install audio/visual high water alarm .
Install 1/8 inch mesh non-corrosive Dump screen (mi'n . 2
soft , surface area , not to interfere with controls or
floats)
Instal check valve in pump nutlet line .to prevent system from
draining back into the pump chamber .
i0 . Tee to Tee construction between laterals and manifold! with
orifices oriented at 6 o ' clock . Install laterals to the
manifold with the orifices at 12 o ' clock , (do not clue
pressure test and Health Dept . approval , 'turn oriYices) dowtnt( 6
o ' clock) and .glue laterals to manifold .
ll . Filter fabric required Over drain rock prior to backfilling .
f the drain rock extends above natural grade run the filter
fabric at least 3 inches down the trench wa11 .
Divert a
system. 11 storm water run-off away from ott-site sewaY�
1 So curtain drains. allowed within 10 ft . of the Lip-Slope edgz
of . the drainfield and reserve area .
11 . :No curtain drains allowed within 30 ft . Of the down-slope edge
of the drainfield and reserve area ,
15 - Have the septic tank and pump 'i ti ey!a-ry three to five years . ch�m�er pumped or in- soec [ zd
16 • �I);tispect and clean pump screen every 6 - 13 months as needed .
r7 . '"' Inspect floats and test high water alarm every 6 - i3 months
as needed .
e''J'�18 • •111 materialwR YO�wraisrri�te/ must meet Countv and State
/- regulations .
19 • Ins ta'lI septic, tank and pump chambers so that inspect +
are within i2 inches of' fit: 'deeper then ish grade ; I ,r' ()!.is lids
required , inish g tank riser's
;, re 5er
inches from f '` rade ,
2 risers } ill be
0 . DeviationdesignenuindOMasons oun;Y l�3It1'Ir �Jrip: •appr?'.•a ; : mom t:ie
1 and COun ,
void . D .partment w:;, ;nege rhlS
SUBSURFACE PRESSURE SYSTEM COMPUTATIONS
Revision: 06/20/95
Copyright 1993-Guy Grayson
PERMIT #:SWG95-0753
DISTRIBUTION SYSTEM
ORIFICE SPACING (Ft. ) 3 - - - - - - - -M
LATERAL PIPE LENGTH (Ft . ) 33 .5 - - - - - - - -N
# ORIFICES/LATERAL 11 - - - - - - - -P
# LATERALS 6 - - - - - - - -0
TOTAL SYSTEM ORIFICES 66
PUMPING SYSTEM
(LAT. + MAN.+ TRANS. ) x 7 (Gallons) 184 . 00
(LAT. + MAN. ) x 7 (Gallons) 80 . 60
(LAT. + TRANS . ) x 7 (Gallons) 161. 01
(MAN. + TRANS . ) x 7 (Gallons) 126 .3
(LATERALS) X 10 (Gallons) 82 .4
LATERAL VOID VOLUME 0 . 041
VOLUME 82 . 08
ORIFICE DIAMETER ( " ) 0 . 1875
LATERAL PIPE DIAMETER ( ") 1. 00
TRANSPORT PIPE DIAMETER ( ") 2
TRANSPORT PIPE LENGTH (Ft. ) 90
MANIFOLD PIPE DIAMETER ( " ) 2
MANIFOLD PIPE LENGTH (Ft. ) 20
PUMP CHAMBER SIZE (Gals. ) 203 . 32
ORIFICE DISCHARGE RATE 0 . 59
PUMP CAPACITY (G. P.M. ) 38 . 78
Table #1 - K VALUE (Transport Pipe) 284 .5
TRANSPORT PIPE FRICTION HEAD 2 .25
ELEV. BET. PUMP/UPPER ORIFICE (Ft. ) 0
TOTAL DISCHARGE HEAD 4 . 85
i
ON-SITE SEWAGE INSTALLATION
FINAL INSPECTION
CLERICAL USE
DATE CALLED IN:
TIME:
INSTALLER: u pn) ,on,
PLIC /OWNER:
CALLER:
PHONE#OF CALLER: r
SWG#:
PARCEL NUMBER: 30 AL,
SUBDIVISION:
Div: Lot:
SYSTEM TYPE(CHECK ONE):
PRESSLE GRAN
INSPECTION SCHEDULE(CHECK ONE):
APPO NT PLUG IN
AS-BUILT ON-SITE(CHECK ONE): Ll
Es No
STAFF INITIALS:
NTH STAVPIISEONLY
APPOINTMENT DATE: r/y TIME: ),'C"Q
COMMENTS:
i
ON-SITE SEWAGE INSTALLATION
STAFF INSPECTION REPORT
STAFF CHRCK M -
Yes No Comments
I. SEPTIC TANK
A) >5 ft.from foundation? x
B) >50 ft from wells and surface water? x
C) Bldg stub-out to septic tank:clean-out if not 1-2%? X
D) Baffles intact and clean? ><
E) Dividing wall intact? X
F) Risers installed for access?
II. D-Box Leveled with water and/or speed leveler(circle)?
III. DRAMMLD
A) >10 ft from foundation and>5 ft from perceived property lines? K
B) >100 ft from wells and surface water? k
C) >10 ft from potable water lines?
D) Laterals level to±I inch&end caps present if not looped? }
E) Gravelless chambers utilized?
F) System dimensions the same as shown on the design?
G) Gravel clean,properly sized,and proper depth?
H) PREssuRE SYsTEms
1) Sand quality ASTM C-33? r �✓%{L
2) Head height uniform and 224 inches?
3) Clean-outs and observation ports present? �c
4) Mound: Side Slope IN /f
5) Owner informed electrical connections must be made _
by owner or licensed electrician and inspected by L&V
IV. PUMPIPUAW CHARM
A) Screen basket eftl - le one)installed? Ac
B) Riser installed for acccess?�(�uf x'
C) Alarm installed k
D) Pump on otra-timer mand c' e)7
V. As-BurLT REQUIRED?
VI. OTHER COMMENTSIOBSERVATIONS
The undersigned has reviewed this installation and verifies these findings on behalf of Mason C ty D/eppaartment of Health Services.
!�C
Sanitarian D
C NyFilesVinalcheckwpd
Revised 9/26/97
AS—BUILT FORM December 9,1997
/I/ PARCEL IDENTIFICATION
Applicant's Name Al Fred W,on4s 6R�r I`a rd
' Assessor's Parcel No.
Permit Number SWLZ - d 7S3 (Twelve-Digit Nut iber)
Installer's Name
Designer's Name Pao 1, 1 !'H-fiA Or
Subdivision r/V0
(Name/Division/Bl ck/L,ot)
INSTALLER CHECKLIST
N/A Yes Pt for to Completion
I. SEPTIC TANK
A) >5 ft.From foundation? . . .. . .. . .. .. . .. .. .. . .. . . . .. . .. .. ... .. . .. .
B) >50 ft from wells and surface water? .. .. .. . .. .. . .. . .. .. . . . .. .. . .. . .
C Bldg stub-out to septic tank:clean-out if not t-2"/o? . . . .. . .. ... .. .. . .. ..
D Baffles intact and clean? . .. . .. . .. .. . .. .. .. . . . . . . .. . . . .. ... .. .. . . .
E) Dividing wall intact? .. . . . . . . . . . . .. ... .. .. .. . .. . .. .. . .. .. ... .. . ..
F) Risers installed for access? . .. . .. . .. .. ... .. .. . . . .. . .. ... .. .. . .. .. .
II. D-BOX Leveled with water and/or speed leveler(circle)?
III. DRAINFIELD
A) >10 ft from foundation and>5 ft from property lines? . .. . .. . .. . . . .. .. .. ✓ '.
B) >100 ft from wells and surface water? . .. . .. .. .. ... .. . .. . .. .. .. . .. .. 7
C) >10 ft from potable water lines? . .. .. . .. . .. . .. .. .. . .. . .. .. .. . ..
D) Laterals level to±1 inch&end caps present if not looped?. ... .. ... .. .. .
E) Gravelless chambers utilized? . ... .. . .. ... .. .. .. . .. . .. .. ..
F) System dimensions the same as shown on the design? . . .. .. �'—
. .. . .. .. ... .
G) Gravel clean,properly sized,and proper depth? . ..... .. . .. . .. .. .. . .. ..
H) PRESSURE SYSTEMS
1) Sand quality ASTM C-33?.. .. ... .. .. ... .. . .. .. . .. .. .. . ..
2) Head height uniform and z24 inches? Actual head heightr"GG
3) Clean-outs and observation ports present? . .. . . . .. . .. .. ... .. ..
4) Mound: Side Slope 3:1? . .. . .. .. . .. .. .. . .. ... ... .. .. .. . ..
5) Owner informed electrical connections must be made by /
owner or licensed electrician and inspected by L&I? . . . . .. .. ... . V
IV. PUMP/PUMP CHAMBER
A) Pump make Me -PPS -Pump model 47 Z /O
B Screen basket ore uen[ t to circle one installed'! . . . . . .. . .. .. . . . .. . .
C) Alarmnstal installed!
access. . . .. . rcle one)
. .. .. . .. .. . .. . .. .. .. . .. ... ..
D) Alarm installed'( .. . .. . .. . .. . . . . .. ...
E) Pump gallons per minute S(7 . .. .. . .. .. .. . .. .. . .. . .. . . . .. .. ... .
F) Pump on timer or eman circle)? . . .. .. ... .. .. . .. .. . ... .. .. ... .. . .
1) If timer:Timer On ,Timer Off
AS-BUILT DRAWING
CHECKLIST
rFFlVe
rQ Pu11 out" ht pi }kr t�jll
❑ Drainfield&manifold Pf o p ose G{ia»s
orientation &layout
❑ Trench/bed dimensions and ",j, V IV-,c
critical distances within layout G oxes
t+
❑ Septic/pump tank placement.
❑ Location of buildings. 6 7 ! ICE
/
❑ Observation port&clean-out
location. b p{V e
W a
❑ Location of wells&roads. y ` y lR
❑
( cJ /
Undisturbed native soil between 6 ) 'y'O r ON% i^
trenches.
- Pc L ;I,
❑ North arrow G�f N OV7S
CAUT70N.Minor adjusonents to septic tank location and drainfield orientation made in the field bpv the installer are generally acceptable to bo the department and the
desionrr,bvt cm•.d me^ .et-rz.e^ - _ t._ t .• •aft.. k a' :..:: t.- r :i:o -..,:N.. „ :tie:.al. raval frurn e:r r the health deparrment
or the designer before making any deviattons from the de'stgn that affect the system vtabrGty Any deviatons from the approved sign must be s rown above.
CERTHWATION OF INSTALLATION
Installer: Check a box from Row"A"and"B",sign and date the certification
A. ❑ I certify that I installed the system without an deviation T� I certify that all deviations from the design stain ed"APPRove.D"by
from the design stamped"APPRovED"by MCDHS /T�MCDHS are shown above.
B. I certify that I contacted the designer and left the system ❑ I did not contact the desi tier prior to final cover because the
open for inspection up to 48 his prior to cover. designer waived the notification requirement.
I further certify that all information contained on this form is accurate. I understand that if the�i iformati contained herein is of accurate,there
will be just cause for immediate suspension of my installer certification. s C.
A
lgna re o ns er --DaTe Q
The undersigned approves this installation on behalf of Mason County Departmen alth Servi
5 23 ant art a