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HomeMy WebLinkAboutSWG2001-00384 - SWG Application / Design / As-Built - 10/12/2001 MASON COUNTY DEP TMENT_OF HEALTH S ICES PERMIT NO. SWG — m D C L�-1 a- ) a 426 W. CEDAR/P.O. BOX 1666/SHELTON, WA 98584 Date y o PHONE60k42�9�7 w T - Receipt No. n E •r -r- Amount$ Z PROPgBTY OWNER: DATE: p1 S /el_ CHECK APPLICABLE ITEMS �/ m MAILING D ES YTIME PHONEtoe. NEW SYSTEM o REPAIR SYSTEM CI STATE: IP: TABLE 6 REPAIR r r o� MAINTENANCE REVIEW N PROPERTY ADDRESS: SINGLE FAMILY Z OTHER: 3 PRIVATE WELL PECIFIC IRECTIONS FOR LOCATING SITE: CDL r,,LAyn .'. COMMUNITY WELUPUBLIC SYSTEM I'r,- SYSTEM WFIN _U 9A , GZ OPMA 3 riqlxf. SYSTEM NAME APPLICANT NAMEi ryxI � Name of Lot ft.x ft. MAILING ADDRESS Ir i1 Installer CA Size: U-V pZ- acres 4 TELEPHONE Designer Q- Aum Number o SIG E 0-M Bedrooms X 4 OFFICIAL USE ONLY BELOW THIS LINE L DEPARTMENTAL SOIL LOGS DEPARTMENTAL COMMENTS/CONDITI NS O '� /G�L..lc l•..y I� j H 2- v- a L( 6 S c. .G �a 4 " 0r< uJ-1 t I N- j a -30 ` 3u SOIL TEXTURE CODES: V=Very G=gravelly S=sand L=loam Si=silt C=clay E=Extremely INSP R(print name IN EC I SIG RE DATE PERMIT EXPIRATION D ATE f r �^`� u�,lo to (01 1 a 41 10 •All systems require ongoing Operation and Maintenance(O&M)as specified in Mason County On-Site Standards. •All on-site sewage systems must be designed by a Mason County Certified Designer or a Professional Engineer,unless prior approval is granted otherwise •All on-site sewage systems must be installed by a Mason County Certified Installer,unless prior approval is granted otherwise.In such ca es a preliminary on-site meeting between health department staff and the homeowner is required. •On-site sewage system design approval does not imply other building site requirements(i.e.RLC,Water Adequacy)have been met. •Any change from the specified use of the property or any site alteration affecting the system design may invalidate this permit. •This pelmit expires 3 years from the date of site review.Denial of this permit may be appealed to the Health Officer within 10 days of denial Jate. D IGN R VIEW 0 AL BYl:_l^ DATE: INST I N APPR Y: DATE: �"� ()Z 0 OTTOM: Applicant's Copy TOP: Health Dept. Copy MIDDLE: Designer's Copy MASON COUNTY DEPARTMENT OF HEALTH SERVICES February 01, 2002 PO BOX 1666 SHELTON, WA 98584 SHELTON (360)42 -9670 FAX (360)42 -7798 Mason County Septic ELMA (360)48 -5269 PO Box 1341 BELFAIR (360) 27 -4467 SEATTLE (206)46 -6968 Shelton WA 98584 RE: Design for MASTERS Case No: SWG2001 -00384 Parcel No: 321347500040 Your design for the above referenced parcel has been review and is APPROVED. Please refer to the comments section of this letter for an Please call me at (360) 427-9670, ext. 353 if you have any questions. Sincerely, Cindy Waite Environmental Health Mason County Health Services COMMENTS: 2/1/2002 1 of 1 SWG200 -00384 MASON COUNTY DEPARTMENT OF HEALTH SERVICES October 31, 2001 PO BOX 1666 SHELTON, W 98584 SHELTON (360)42 -9670 FAX (360)42 -7798 Mason County Septic ELMA (360)48 -5269 PO Box 1341 BELFAIR (360) 27 -4467 Shelton WA 98584 SEATTLE (206)46 -6968 RE: Design for MASTERS Case No: SWG2001-00384 Parcel No: 321347500040 Your design for the above referenced parcel has been reviewed and is NOT APPROVED. It does not meet the requirements or needs additional information. Please see the comments section of this letter for more information. Please call me at (360) 427-9670, ext. 353 if you have any questions. Sincerely, Cindy Waite Environmental Health Mason County Health Services COMMENTS: / �. 4- a � " �� v " ,1h le., G +l, n a g 7 ly h 1 c ti 00 10/31/2001 1 of 1 SWG2001-00384 On-Site Sewage Systems (Chapter 246-272 WAC) Request For Waiver From State Regulations SECTION i. s COt. IXTED BY APPUCANr Name:(1) Local Health Department/District(2) Ad s: fi Jt )1 '1_l U4 9 z;-'7 o t Telephone: Signature: 4:0t I N�' S Property identification:(3) a SECDON IL COMPMED BY APPUCANr WAC Number:(4) WAC Requirement: (5) Waiver Sought:(6) 246-272- //� / Q Subsectiobzc� Justification itigation myasures to be provided):(7) Mar- SF.CIiON�. CONGWIFDBY HEALTH OFFICER Review Criteria(8) Mitigation Measures(m addition to Shoe prop sod):(9) Comments/Conditions:(10) Typeof Waiver:(11) OCt=A ClassB OCtmC-Regsw&DOHrevlewhdgmgraruing7 Yes_ No_ Neighbor Notification:(12) Required? Yes_ No_ tfineded are agreements,easements,eta pmpertyJdeW Yes No_ SECi10NIV. COMEIIDBYHEALIHOFFICER This Request For Waiver From State Regulations has been reviewed according to the provisions of Chapter 246-272 WAC On-She -c Systems^ The review criteria applied,and the mitigation measures proposed and/or requited,have been evaluated for their ability to provide I ublie health protection at teat equal to that provided by this chapter WAC. Approved/Granted-Subject to all comments,conditions and requirements noted in Section H and III. 0 Denied Local Health Offici���� Date: MASON COUNTY DEPARTMENT'OF HEALTH SERVICES - Environmental Health Water Quality 4ersoalth gum LOC AL(360)427-9670 Application for Waiver/Appeal BELTOLFAIR(3 ) 1-800-7 2 5628 TOLL E 1-800-562-5628 ' �,\ (360)427-7798 Amount Paid: Receipt Number. Instructions 1 ezp.1 ter sxt ottl2 3*loaistctmuiatt It canl>e1R dottatlithesepa are ttl�rcamPte<e6 2 ��sma} �fltr�TtctY�vluwers�ad $�, $�sedllhtirs�n+t9rotit»eufali�atthiretEte � � �ttiinttra lete�:"� ltcatla[t;•�tthater'liinieatt���l�lteaitltda. arcmctlt£tirrc PART 1: Applicant/Parcel Identification Name of Applicant rna,lers Date Mailing Address Telephone —4p -t�4 Assessor's Parcel Number Subdivision Name and Lot PART 2: Nature of Waiver/Appeal ❑ On-Site Sewage Requirements ❑ Food Sanitation Requiremen o Building permit review policies ❑ Solid Waste Requirements a Location, WAC 246-272-09501 ❑ Group B Water System Reqt irements ❑ Holding tank WAC 246-272-12501 ❑ Water Adequacy Requireme is On-Site Standards ❑ Enforcement Timelines Certification contractor(pumper, ❑ Departmental Determination designer, installer, O&Mspec)requirements ❑ Other Description of Waiver/Appeal(include justification,additional material may be attached): �N Applicant Signature. Gam` 11 t ` " rS Date: H.IWDATAURCH/VEIWAIVER WP Update:April 25. 1997 PART 3: Health Department Evaluation(Staff Use Only) IA. Type of Determination Required: I B. Type of On-Site Waiver(if appl cable): ❑ Appeal Waiver ❑None required ❑ Class A /Class B ❑ Iass C 2. Identifrcaton of Specific Code/Standard/Determination(include date of determination or latest codetstandard revision): 3. Nature of Appeal: 4. Hearing Official: ❑ Board of Health ❑ Health Officer ❑ Pollution Control Hearing Board Health Services Director ❑ Certified Contractor Review Board ❑ Environmental Health Manager 5 Mitigating Factors: 6. 1 have reviewed this waiver/variance request. it is complete, and mitigation required by state nd local policy has been submitted. Staff _� l)"� Date: l PART 4: Determination of the Hearing Official The hearing official has determined that approval of this request will not adversely affect public health and is hereby grunted. This decision is based on the following findings and conditions: ❑ The hearing official has determined that approval of this request could potentially have an adversely affect public health and is hereby denied. This decision is based on the following findings: Hearing Official Date: N:IWDArAURCntVEIWAIVE2 WP Update:April 25, 1997 APPENDIX A CLASS B WAIVER OF ON-SITE SEWAGE REGULATIONS WAC 246-272 AND WORKSHEET FOR DETERMINING A REDUCTION IN VERTICAL SEPARATIO This worktsheet is used to determine if a site qualifies for a reduction in vertical separation under the Class B Waiver. Please fill out the worksheet in its entirety. Incomplete worksheets are returned to you and will cause delays in your permit api lication. Part 1:Applicant Information Name of Applicant:�' mG��PV S Date L2 Site Address: Mailing Ad Tess: n Cgy State:�ir7 Zip: Assessor's Parcel#L—' J �� Swcr# Part 2: Checklist 1) Soll Series 3) Cheek the soil structure. 'oO.Y,�c:.iY..y�;:E2:\: .i M.�}�lilFrtiUlQy���(r�Ai1NIG.M::e' 'vSL:'4< Q :.;R.y'gyiY..:vs:.��:n.:) is e& Single Grained or Weak ................ . . :::. Well structured ........................ ....... oar« ❑ Akkrwood Gravelly Sand Loam ................. ❑ r !, Hmsdw Gravelly Send Loam 4) Cheek pereeat dope of the primary/ rve dn[atield liar Loam.................. ❑ area. Hoodspat 0[aveUy ❑ Shelton Gravelly Sod Loam .................... Sinclair Gravelly Sand Loem .................... (3 Other ........ ❑ 2) Cheek the soil type: Less than 3% ................. ...... (3 ...... .;. Greater than 30% ..................... ....... ❑ 5) Check the up—slope up-slope vertical separation. Loam ...................................... ❑ Loamy Sand ................................. SandyLem ................................. Percent Gravel by Volume Less tlrm a.equd to 60% s�x a Less than I2' ........................ ....... ❑ q to Greater 1han60%......................... ❑ ' Greater than Is. ..................... . Determined by: ' Depth to Hardpan ................. ....... Depth to Motteling ................ ....... ❑ Both ............................ ....... 0 6) Cheek the drainage of the soil. toa) Check Horizontal Attenuation ne. y � l Is there less than 50 fat between the d wn gradient side of Well Drained ............................ ❑ ❑ the proposed primary and reserve drai I d areas and the Moderately Well Drained . 14 Property boundary? ...................... Other ......... ❑ © Yes ............................... ......... ❑ ❑ No................................ ......... 7a)Check water table level If yes,the applicant will need to provid c a recorded covenant or easement prior to final aco Vance of the on- site sewage application. 10b) Record 50 foot zone on deed. Z Is the water table: ` o Above36" .................................. ❑ r O Above244 .................................. ❑ Above 12" .................................. ❑ Sieiritifi tiie of 7b) Is a curtain drain proposed up slope of the primary drainfreld area? Is the owner aware and in went wi th these terms? Yes ........... ❑ (home owner initial ) ............................. e�. No............................ Yes ........................................ ............. b `. 8) Is the roperty,on marine shoreline a 9 b . . Is the 50 zone recorded on the deed? d ..�rM Yes ........................................ ❑ . z A 8 No......................................... ❑ Yes ........................................ ❑ 11) Check proximity to welb. NO......................................... if yes,Indiate the distance from the shoreline to primary drain5eld urns feet 9) Are there any fivsh water bodies within,or adjacent to, Indicate the smallest distance from o proposed wells to the the ro boundaries? �g P Pow primary or reserve drainfield urns feet Yes ........................................ No......................................... ❑ If indicate distance from shoreline to Yes. l�Y� reserve eras: fat Designer Comments:toe S� Gy)wJ alra�c� pot 5 SS>F'P Part 3: Certification and Approval Applicant Certification: I certify,to the best of my knowledge,that the above information is We and correct. 1 acknowledge that I am solely responsible for maintaining the integrity of the primary and reserve drainfield areas;and that destruction or damage to the drainfield area may result in immediate rescinding of the o smite sewage permit. Date Q� ' Applicant U Date Health Department Review: Preliminary Review For Design Submission: ❑Approved ❑Denied Environmental Health Sanitarian Date Waiver is 0 Approved ❑Denied Environmental Health Sanitarian Date Comments: MASON COUNTY DEPARTMENT OF HEALTH SERVICES November 13, 2001 PO BOX 1666 SHELTON, WA 8584 SHELTON (360)42 -9670 FAX (360)42 -7798 Mason County Septic ELMA (360)48 -5269 BELFAIR (360) 27 -4467 PO Box 1341 SEATTLE (206)46 -6968 Shelton WA 98584 RE: Design for MASTERS Case No: SWG2001-00384 Parcel No: 321347500040 Your design for the above referenced parcel has been reviewed and is NOT APPROVED. It does not meet the requirements or needs additional information. Please see the comments section of this letter for more information. Please call me at (360) 427-9670, ext. 353 if you have any questions. Sincerely, Cindy Waite Environmental Health Mason County Health Services COMMENTS: Need recorded attenuation zone. 11/13/2001 1 of 1 SWG200 -00384 DESIGN FORM-PAGE ONE ttedrNAxUu., A design will be rrevviieewed wMhsen egg of each of the fooll�yWrig Items tms a subadUGM PCam �WtPW4tnGW4W<Yy+pUubleaRwd aana�onehaof�st C�osssi6fla�aketol���n IWaso�nalnoWld Permit Number sWIMDesigner's Name: Designer's Phone N: Applicant's Name: Assessor's Parcel No.: Mailing Address: Subdivision: ela sure z;p &OA Treatment Device O Glendon Bioauw ❑Sand Filter O Mound O Sand I DrataSeid ❑Aerobic Usk-MakeWodek O Disinfection Unit - Make/Modeb Drainfield Type O Gmvity XTVMeh OOfa Uesve ambers Septic TanWDralnfield Specifications Laterals Number of Bedrooms .� ' Schedule/Class , Daily Flow Dome Septic Tack Capacity Number F L 3 1 Z002 Receiving Soil Type(1-6) Separation Receiving Sell Appl.Rate onelffil Required Square Footage a Oft2 ECCjk Designed Square Footage P Reduction n Taken `11 Total Nua�j"f Odfibcs ' ^ Trmch/Bod wtdrh Diameter F 2002 Trench4led Length ft Spacing �i,•i Elevation Measurements ( OPdManlfold Schedulc/Clasa - Original Drainfield Am slope ( 3 % IWgthNew slope If Altered % Diameter ; D��ExcavationGra from q Preferred Manifold Configuration U ? ®Yes ❑N L in Np-sl ) C in Transpgrt Pipe O (Down slope) ScheduldClass Length Designed Vertical Separation �� G�C ;n �d� Graveliess Chambers Required? ❑Yes ❑No ❑Optional Diameter Pump Required? Ryes ❑No Dosing and Pump Chamber Pump/Siphon Specifications NuctberofDoses/Day Dose Quantity Differencein Elevation Between Pump Shutoff and Uppermost Champ Capacity Orifice: 7,A R Pump Controls: Timer(or)Elapse Ti a Meter(olrcN K requirec if Timer: Pump On p Off Uppermost Orifice is O Higher. ❑Lower than Purr/�',Shu ff Capacity 0 Total Pressure Head: m Check the foLlowiag eompoaeatt If the drain between doses: Calculated Total Pressure Head: ��ll.... ��Xq RRRR ❑ Laterals ❑Manifold ❑ rransport (Attach Pump Curve) DESIGN FORM.PAGE TWO Scaled Plot Plan Scaled Layout Sketch Cross-S otion Sketch 19 Test Property locations m Dralnfteld orientation and la Q Property lines Yet Itekr eneed d pth from original Tlenclt/bed dimensions and critical f Sepik W and dtaiatield co ade A Existing and proposed wells within distances within layout depth 100 It of property lines O 0.Box/"T"P'L"locations P Q Critical and umee measurements to cuts, .� Septic tanWpum chamber location banks,and surface water P t2eCemroace de th from original grade 17 L*cadon and orientation of curtain A Observation port location and resMctiv strata: � Clem-out location drain and all absorption components 0 Manifold placement � � co 21 llector to and bottom Q Location and dimension of primary Q Orifice placement p System and reserve area Sand f{3 Buildings O Lateral Placement,with distances to QF Direction of Slopeedge of bed Other css n detatL- indicator L� ro AudU*4* tW alarm referenced q ObscIvatim O Waterlines rm @r Scale of drawing shown on scale bar P cleanouts .0 ltoads/eatemenWdriveways/ Pig Ir? 6 O Critical resource lands(if applicable) AR' North arrow and scale of drawing shown on scale bar V<x 'A I r •. ��;: tilt Width k" Additional fortnation O Design oat O Operation M+iotmaoce Notice Attached O Waivu(s) .:. :•. • +' .� �. 'i„rye'. 3t R:; The undersigned designeadoes, ❑does not,waive the requirement to be notified by the installer of the hours to perform a final inspection prior to cov and given 48 Signature of Designer Date The undersigned has reviewed this design on behalf of Mason County Department of Health compliance with state and local on-Site regulatio Services and dew mined it to be in Envtronm mul Health Speeialif Date SJJLIItID: DESIGN APPROVAL IS VALID ONLY ONDER THE FOLLOWING CONDITION: The design is stamped Approved"by Mason County Department of Health Servi The On-site Sewage Permit has not expired,the Permit Expiration Oate is: I U 3l U The system is installed by a certified installer,unless prior authorintion IS obtained to Mason Corn Department of Health Services, County Drsinfield site conditions have not been altered to adversely atfeet conditions of des a approval 3 a 13�f �s ��6 ���� I`'�-per- ` �.p i-_� I�_..2-�_� ' / � �� #� ?�I J Q - a� ,� �-sC. ��(�- za �� ESL, � - � 6SL Zd '"_ Gpm,GaY�ion1 b MasA-erS n 3a i�� �s Doo�o z z Poor LLIP1l Sits. �wldin9 -t' P l� SO F'fnuni�oN -- 50 ---- R CE o R I � �1 E IE7 b2Q� tinned) t pr(:) Soawlm wL%� _ �_ drbl UISUa� /tAaYrz� 1a00 _ g6rJ .r 108-_�/L orifices plucrd 3G� C•roc ehcca�;� 2mel.oC�ficcs {Obe ends c,; •}�.voc& . �-knd or1er,+&+am 'fobt a+ Ia:co wry nt'iCico- Sh�otds. ' Lakrols4o$,Llou�embur 18 36'r I � �P''"S'0 V��S+C�J'_J recv �� �— I-- _ 1 P? er�t D I I SECURED LID WITH GAS TIGHT SEAL 24'DIAMETER 1 ACCESS RISER FINISH GRADE - - - - .TO PUMP CHAMBER FROM SEWAGE SOURCE FLOATING MAT APPROVED EFFLUENT FILTEER SEDIMENTS SEPTIC TANK (TYPICAL) SECURED LID WITH GAS TIGHT SEAL THREADED U ION;T 24'DIAMETER w.:;PT ACCESS RISER S E FINISH GRADE V ' FROM SEPTIC -► O DRAINFIELD TANK EMERGENCYSTORAGE AN 'I SIPHON ALVE• HIGH WATER ALARM LEVEL - - - - - - - - 41 INDEPE DENT WORKING VOLUME FLOAT ITEM NORMAL TIMER OFF LEVEL _ _ _ _ _ _ FOR FI OAT ENCLOSED PUMP MOUNTING SEDIMENT SHROUD CHECK I ALVE' 18 SEDIMENTS SUBMERSIBLE CENTRIFUGAL PUMP PUMP CHAMBER (TYPICALI •AS NEEDED is ENGINEERING DETAILS . " , f, i Performance Data' 32 Pump Characteristics Pump/Met"Unit Subnalrswe Manual Models All 617 M2 Mb M3 M4 M5 24 Avtomatk Models Al — A2 1 — — — — W 112 HP Automatic AN Bra ABl — — — — — — a 16 Horsepower 1/2 z Full Load Amps 12.015.716.014.113.511.9 1.4 Motor Type Spht•Pbeee I Three-Phase o e R.P.M. 1750 ~ Phase 0 1 3 Voltage 115 200 230 200 230 460 575 00 32 ss :M 128 lee 192 Hertz 60 CAPACITY-U.S.G.P.M. Operation Intermittent Total Hood (feet) 8 12 16 20 24 18 29 Temperature 1401 Ambient NEMADesgn A GPM 1/2His 150 120 95 70 40 7 0 Insulation Class A Disdlmge Size 2"NPT and.(3"opt.) Dlmenstqnal Data.-;,�- Solids Handling Unit Weght 70 6s.(SP50AB1 77 NIL) 5-7//01R 1.AF N sim Power Cad 16/3,S1WA,Is I15V,2eeV,230V-10' Y. dnnNkm may al(20'apeossp 16/4,Slay,30 200Y, JW 1/e Isd 2 NPi 4-6/S DISC RGI r gzala, 230V,460V,a 575V"2W dim. t MC €=E Al .,. adsaoh as Materials of Construction 4 FEB 1 200 , 16*t- e boor Handle Steel 7-6116 qb and dWw Lubricating OB Dielectric 00 C�Gj sand seen Motor Housing Cast knell• 16'MINIMUM SUMP DIA. Pump Casing Cast Iron' Shah Stainless Steel Mechanical Seal Fans:Carbon/Cermnk 14-1/4 Shah Seal _ Seal Body:Brass PUMP Spring'Stainless Steel z 7/16 ON Bet Buna•N DISC��H�EARRGGEE 112-13/16 Impeller, Cast 1fee• �1 Upper Bearing Bronze Sleeve I 5 I7re 5-3/4 Lower Bea* Single Row Ball Bening POFF MP v` Fasteners Stainless Steel C KPSaBI=&m1e 3• k r � Q AYRORA/NYDROMATIG Pumps, Inc. C 1840 Banoy Road,Ashland,Ohio 44805` . (419) 289-3042 u r 8e(?b UcJJ -- 34- u i rnin�m,.m,-of a dour ry -SAP-LOC k �- 4vn rv-L nn 7 i i ri �r 3G `` y SC4\t. MASON COUNTY SEPTIC SYSTEMS Diana Field P.O.B. 1341 Shelton, WA 98584 (360) 426-8642 INSTALLATION/MAINTENANCE Pressure Distribution Systems 1. Install laterals with contour of the ground. 2. Install trench bottoms level. 3. Install locator tape on top of all drainfield laterals. 4. Install observation ports as indicated on the plot plan. (Minimum tw per drainfield with the bottom extending to the drainrock/native soil interface. F 5. Install threaded cleanouts at ends of all laterals with cap exterldingto within 6 inches of finished grade and be marked with locator tapeF E 1 ?Z 6. Install audio/visual high water alarm. = ` 7. Install effluent filter on outlet of septic tank and/or 1/8 inch mesh non- corrosive pump screen. (Minimum 12 sq. ft. surface area, not to interfere with controls or floats. 8. Tee to tee construction between laterals and manifold with orifices oriented to the 12:00 position. Orifice shields are required. (Unless design specifies 6:00 orientation.) 9. Geotextile (filter fabric) required over drainrock prior to backfilling. If the drainrock extends above natural grade, run the filter fabric at least 2 inches down the trench wall. 10. Install drainfield during dry weather and soil conditions. Any soil smearing must be eliminated by hand raking. 11. Divert all storm water run-off away from on-site sewage system. 12. No curtain drains allowed within 10 feet of the up-slope edge of drainfield and reserve area. 13.No curtain drains allowed within 20 feet of the down-slope edge of drainfield and reserve area, 14.A cover of between 6 and 24 inches of mineral soil containing no grea ter than 10°,6 organic content shall be placed over the entire drainfield area md shall be graded in such a manner as to preclude accumulation of water over the drainfield. Backfill and grade the site to prevent surface water accumulation over any component of the on-site septic system. 16. Installation of drainfield on a sloped area should have check v�yes installed in the manifold to prevent hydraulic overload of the lowest elevation lateral and also to enhance rapid pressurization of the syst"'' 16. This system has been designed in accordance with all current state d county Health Department regulations and this designer assumes no responsibility for its use or longevity. The owner therefore agrees to maintain and make all necessary repairs to the system at no cost to MASON COUNTY SEPTIC SYSTEMS and Diana E9eld. 17. All materials and workmanship must meet County and State regulaions. 19.Deviation ficms this design without prior approval from the designer and Mason County Heath Department will make this de ign null and void. The On-site Septic System owner is responsible for properly operating and maintaining the OSS and shams a.) Determine the level of solids and scion in the septic tank on m every three years. b.) Eo*loy an approved pumper to remove the septage from tank when the level of solids and scum indicates that removal is necessary. - a) Protect the Oss area and the reserve area from 1. Cover by structures or impervious material 2. Surface drainage 3. Soil compaction by vehicular traffic or livestock 4. Damage by soil removal and grade alteration (L) Seep the flow of sewage to the Oss at or below the approved. design both in quanity and waste strength -e.) Direct drains,such as footing or roof drains away from the area where the Oss is located f.) Inspect and clean pump screen every 6 . 12 months g.) Inspect floats and test high water alarm every 6 to 12 montl is High strength waste will increase the depth of the biomat in drainfie(l,causing a decreased flow through the bicmat and posailu ponding or flooding of the draindeld. High strength waste in 6�,_ residence is usually related to the'lifestyle"or habits of the , generally resulting from one or more of the followings - 1. Excessive use of a garbage disposal 2. Consecutive bads of laundry done an on one dad+ 3. Excessive bleach or detergents with added whiteners 4. Dishwashing,showering,and laundering all at the same tinx 6. Medications • antibiotics can kill or impair the biological process in the septic tank 6. Leahy plumbing ftdraulic over1Mdfng) AS-BUILT FORM ta,tssa Now Applicant � �Q Y S Assessor's Parcel# 3 a l 3 4 - Q S - CEO 4 0 Permit Number 1354� - d O 3 8 LI ftwatvo-0t¢n nmbay InstallerL )l N �tP�o� � � ametolvisio lookAmt) Uni Designer \ lIQv10. geld T ?CO`� �Y 41^i .: Yes P or to Completion 1. SEPTICTANK A) >5 S.From foundation?.............................. . . . ...... X— B) >50 ft from wells and surface water? .... _) Bldg stub-omrt to septic tank clean-out if not 1-2"/o? ........ ......... — D) Baffies intact and clean? `Y— E) Dividing wall intact?... .... . ..... ............ ... . . ... . F). Risers installed for access? ..... ............ ....... .. . .. G) Tank Size: 2- gal.;Manufacture )L �� _ 11. D-BOX A) Leveled with water? ... .. ... .... .. . . ..... . .. .. . . . . . .. . . . . ... . . -- B) Speed leveler used? .. ... .. . . ... .. .. . . . . . .. . .. . . . . . . . . . . . . . . . . — I11. DRAINFIELD X A) >10 ft from foundation and>5 ft from property lines? —_ B) >100 it from wells and surface water? .... .. ... ... . . . . . . . . . . ... . .. X C) >to ft from potable water lines? ... ..... ........ . . .. . . . . . ... . . . . — D) Laterals level to±I inch&end caps present if not looped? . . . . ..... .. X - 1� Graveness chambers utilized? ..... ............. ...... . ...... . .. _— F) System dimensions the same as shown on the design?......... . ...... �— G) Gravel clean,properly sized,and proper depth? �— K) PRESSURE SYSTEMS 1) Sand quality ASTM G33? ................................. 2) Head height uniform and:24 inches? Actual head height X 3) Clean-outs and observation ports present? ..................... 4) Monad: Side Slope 3:1? .................................. � 5) Owner informed electrical connections must be made by — owner or licensed electrician and inspected by L&I? . . . . . . . ... . . . IV. PUMP/PUMP AMBER 1 Pumpmodoi S P� �- A) Pump make a! k e B) Chambersize '100 gal; Manufacturep�Z C) Height of pump off bottom of pump chamber inches D) Pump chamber draw-down gallons per inch 13) pump capacity 4n 1 L gallons per minute F) Pump controls:Tuner(or)Elapsed 11me Meter (circle if installed) — If timer is used:Pum On Pump Off' x Screen bask neat filter irok one)instilled? ................ H) Miser instenod for access? ................. 1) Alarm installed? ..... l`),A..................... . ..... ........ 4 w 2 Nun- 0 Dndafieid&manifold orientation &layout 0 Tmnch/bed dimensions and critical distances within layout ❑ Septic/pump tank placement. ❑ Location of buildings. Cl Observation port&clean- n out location. ❑ Location of wells& G( C roads. ❑ Undisturbed native soil between trenches. ❑ North arrow CAUTION:Minor adjustments to septic tank IoWion and&'aiaeld mient don made in the teld b the kutalla ate and aye dai ma.but ooWd In certain eaus compromise the viabili oCthe r le to both the department 4ulat depanmeat or the daigna before h' hem• It Is the installer's trsponsibility,to obtain prior oppmval from either the siawa abova Ong any deviations from the daign Uut alfed the system viability. Any devMom from approved design must be Y: e. �-'' �, :�•�i-������ r r��s�t2TlF1CA bJ��Fe(tlfi3' f3?J> InstallerY Check a box from Row"A"and"13",sign and date the certification A. ❑ I certify that I installed the system without any I certify that all deviations from the des7bcoa.u deviation from the design stamped"APPROVED"by "APPROVED"by MCDHS are shown a MCDHS 8. ❑ I certify that I contacted the designer and left the �/I did not contact the desttggnner prior to e system open for inspection up to 48 hrs prior to / designer waived the notification regti cover.I further certify that all information contained on this form is accurate. I understand that if th�informa'o aaccurate,there will be just cause Cor immediate suspension of my installer certifi a io . er The undersigned approves this installation on behalf of Mason County en of H 3a k3)V �s 06410 z z ® . ��,tblr sty r i I oc�4:nr1 Pico 50 F� nua horo I so, f R I I �� g �ETe-be�l�n :�ad� 30