HomeMy WebLinkAboutATF Home System - SWG As-Built - 12/22/2015 AUS'ON COUNTY PUBLIC HEALTH AFTER THE FACT RECORD DRAWING ASBUILT
L' IiCE `IDEYIV TIFICXTION, , ,atet .,.' '. i'
Owner's Name �k0l.fj Assessor's Parcel#
(Twelve-Digit Number) ,
Owner's Address Site Address z I b). i C�IX At 10C !�
City, State,Zip )C�, 6 'e6sq Designer's Name N��
1 .
EI�4 H , LINW— . . -101 FUN,
.r,:,- . �.,
1. TYPEOFSYSTEM P134 -
2. SEPTIC TANK NO YES l
>5 ft. From foundation?............................................................. ❑
>50 ft from wells? ......................................................-........._ ❑
>50 ft surface water? ............................................................... ❑
Building stubout to septic tank: cleanout if not 1-2%? ............ ❑
Risers installed for access?........................................................ ❑
Tank size: gal.
3. DRAINFIELD
>10 ft from foundation?........................................... ❑
>5 ft from property lines and easement lines? ......................... ❑
> 100 ft from wells?............................................................ ❑
> 100 ft from surface water? .............................................. ❑
>10 ft from potable water lines?............................................. ❑
Clean-outs and observation ports resent?......................... ❑
4. PUMP/PUMP CHAMBER ❑
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This attached record drawing was created by Mason County Public Health using information obtained from available records
and a site inspection. All locations are approximate.
Environmental Health Specialist Date
Revised May 2013\
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This site map was created by MCPH by coordimdng mmsurements and infomadon from several sources,induding the Mason County GIS and a field
review. PJI loatims arc appromdmam
Record Drawing
lam`' ON Cot,& re� Pael:
Owner:
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Public
*saferhealthlerHe�th
Date: )Z I zZ I ZC 15
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