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HomeMy WebLinkAboutSWG2019-00318 - SWG As-Built - 1/31/2022 RYason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2019-00318 Parcel# 22025-77-00040 Applicant Name JOSEPH MITCHELL Subdivision (Name/Div/Block/Lot) Applicant Address 13392 OLYMPIC DR SE City, State, Zip OLALLA, WA. 98359 Installer Name B-LINE CONSTRUCTION INC Site Address JARED ROAD Designer Name TOBY SYRETT INSTALLATION CHECKLIST Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑Repair ❑Other System Type GRAVITY Pretreatment Type >5 ft. from foundation? -- -- - - -- ---- - ------- - - - -- - - ❑ N/A EVES ❑ NO >5o ft from wells? - - ----- - -- - ---- ------ - - ❑,7 r_ e ❑ ❑ >50ft.fromsurfacewater? -- -- -- ---- -� t}-Lt�EIIII❑ ® ❑ Z H Cleanout between building and tank? ---- --- - -------!\ \D IN ❑ U Tank baffles present? - -- -- -- - - -- -- --.IAN-1LLULL - LI ® ❑ 24"access risers over each compartment?-- -- --- ----- ® O W Effluent fitter installed?-- --- - - -- - - - - ar--- — ❑ Septic tank size 1200 gal Manufacturer R'0 en-'c' 4 a D-box water level and speed levelers used? - - - ❑ N'A ®YES ❑ NO 00 Manifold/D-box accessible from surface?-- --- - -- - - --- - - - - ❑ ® ❑ m= Check valves installed? - - -- -- - - - - ❑ ❑ II 06 f Transport Line Size 4" Schedule/Class 3034 Bedrooms installed(check one) ❑ 2 ❑� 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10ft.from foundation?--- - -- -- - - - - - - --- -- --- ---- ® NIA YES ❑ NO >100 ft.from wells?-- - - - - - _ - - - -------- - - -- - ----- — ❑ ❑ W >100ft.from surfacewater? ---- - - - - - - - - --- --------- ❑ ® ❑ M >10 ft,from potable water lines? - - - - - - ❑ ❑ Z >5ft.from property lines and easements?-- - -- - -- -- -- - - -- ❑ ® ❑ > 30 ft.from downgradient curtain/foundation drains?-- - - - --- -- U ❑ ❑ Drainfield level and observation ports present -- - - ❑ 5 ❑ ❑ Graveless chambers or 0 Clean gravel used? (check one) Proper cover installed over drainfield? ❑ II ❑ Pump tank setbacks consistent with septic tank? ❑ NIA ❑ YES ® NO Y Pump tank size gal Manufacturer Z 24"access riser(s)and accessible from surface?- - -- ❑ O ❑ y Alarm or Cont of Panel Installed? -- ---- --- - ❑ ❑ ❑ 2 Control Panel equipped with Timer I ETM/Counter-- -- -- - - -- - ❑ ❑ ❑ Pump installed in ❑ Bucket or ❑ On Block or ❑ Other tl Pump Make/Model ❑ Floats or ❑ Transducer a Tank draw down in/min Pump capacity gpm Squirt Height Pump on time Pump off time Daily flow set at gpd Vpolod 9212010 Mason County OSS Installation Report pg. 2 Parcel# 22025-77-00040 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? -- - -- -- - - - -- --- 0 YES Q NO If yes, please describe: Were all components pumped out and propedy abandoned per WAC246-272A-0300? ❑ YES ❑ NO RECORD DRAWING mb is a permanent record arid most be accurate and descriptive enough to n-locate in the need of maintenance activities and lawn development. Tpkal Record Drawings contain: oramlold a mango o,eme0m d layout,Sepik/pump are Ic esson,North arrow,reserve drBlnlleld,e sting and proposed W Hdngs.Iwshon urwtls,waenines. wells.ohservmen pans,deanouts,anc other maintenance ass points. Nwmgele Remm Drawings may o'aala seasonal delays In anal installation apptova and related peimlls. 5 ee 1 aC/T.dJ etid.cged D- 9 {o opy'ofelP L✓h�x-" i ; Wax cJex/pAJeJ ❑ Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ENGINEER 1 certify that I installed the system in accordance with I 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 I furt r certify that all information contained on this I further certify that all information contained on this form red attached Record cawing is accurate. form and attached Record Drawing is accurate. Sign tore of Installer 1 Date L i Printed a of Signee MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and Record Drawing on behalf of Mason Cpunty Public *signature eglf Pfevt pf5l/ Kftro✓rll7 n/e{Sign to Environmental Health Specialist Date e) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE updalemi&tao1e p � $ ) ! § m \ ` JAREDRD ) } , uJ .. § cr k2 � 2 \ ! S M z� § 2 § k - - 2 W2LU ■ 9 | / \ § ` \ / | k)§ 'C �.0 0- C-) �\! § ( f : ! ) ® @ k z \ / 0 | . ■.,; z !| § §§|| 6 czJJ © 4'FEEDER D-BOX WI LINES SURFACE ACCESS RESERVE LATERALS 3 ' PRIMARY GRAVEL TRENCHES 1. , , 15: / 4"PERFORATED LATERALS / if I/ // r r l 4°LINE IN / /FROM BLDG I / / , , r II , ,C / UPSLOPE CURTAIN DRAIN / y1 , r r 10 . O, TO8Y_I Y I'h SV0.Noi / i1CCN5ff1 n 11071 E%AIRES:U4i071� OBSERVATION PORTS DRAINFIELD LAYOUT DETAIL: FOR: MITCHELL JOB#: CURTAIN DRAIN PARCEL#: 22025-77-00040 DATE: 05 AUGUST 2019 OUTFACE BEYOND 50'ATTENUATION ZONE BY:TJS DESIGN PAGE OF NORTH ARROW: SCALE: 1"= 10' ® B-LINE CONSTRUCTION, INC. N o "p