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HomeMy WebLinkAboutSWG2020-00674 - SWG As-Built - 5/26/2022 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2020-00674 Parcel # 12107-77-00030 Applicant Name Tristan Crites Subdivision (Name/Div/Block/Lot) Applicant Address P.O. Box 793 TRACT 3 OF SURVEY 7/64 S 43/155 City, State, Zip Allyn, WA 98524 Installer Name South Shore Construction Site Address 2991 E Grapeiew Loop Rd Designer Name Arrow Septic Designs, Inc INSTALLATION CHECKLIST 0 Full System Installation ❑Tank(s) Only ❑ Drainfield Only ❑ Repair ❑Other System Type Shallow Pressure Pretreatment Type >5 ft. from foundation? - - ❑ N/A ❑■ YES ❑ NO >50 ft. from wells? - - ❑ 0 ❑ Z >50 ft. from surface water? - - ❑ 00 HCleanout between building and tank? - - ❑ I U Tank baffles present? - - ❑ El ❑ a24" access risers over each compartment?- - ID ❑� ❑ W Effluent filter installed?- - ❑ ❑■ ❑ N Septic tank size 1,287 flood gal Manufacturer Infiltrator 0 D-box water level and speed levelers used? - - 0NIA ❑ YES ❑ NO �O Manifold/D-box accessible from surface?- - ❑ 0 ❑ cat Check valves installed? - - ❑ 0 ❑ 0< 2 Transport Line Size 2" Schedule/Class 40 Bedrooms installed (check one) ❑ 2 ❑■ 3 ❑4 ❑ 5 1116 ❑Commercial/Other >10 ft. from foundation?- - ❑ N/A 0 YES ❑ NO CI >100 ft. from wells?- - ❑ ■❑ ❑ W >100 ft. from surface water? - - ❑ 00 u. >10 ft. from potable water lines?- - ❑ 0 ❑ Z > 5 ft. from property lines and easements?- - ❑ ❑■ ❑ a CL > 30 ft. from downgradient curtain/foundation drains? - - © ❑ ❑ o Drainfield level and observation ports present - - ❑ II ❑ ❑ Graveless chambers or ® Clean gravel used? (check one) Proper cover installed over drainfield?- � - - 0 ❑ n r Pump tank setbacks consistent with septic tank?- /A u I 0 YE ❑ NO • Pump tank size 1,060 gal Manufacturer Infiltrator >n Q 24" access riser(s) and accessible from surface?- - El ❑ 1— a. Alarm or Control Panel Installed? - - 0 ❑ E Control Panel equipped with Timer/ETM/Counter- - RY El — m C- Pump installed in ❑ Bucket or 0 On Block or ❑ Other a'• Pump Make/Model Liberty 290 0 Floats or ❑ Transducer a Tank draw down 1.5 in/min Pump capacity 38 gpm Squirt Height 5.5 ft Pump on time 2.3 min Pump off time 6 hours Daily flow set at 360 gpd • Updated 8/2`.•20'8 1-Z.1 DI_____ 0L:/---- Mason County OSS Installation Report pg. 2 Parcel# —L °° ABANDONMENT RECORD Were existing septic components,abandoned as part of this project? - - 0 YES NO If yes, please describe: Were all components purnperl out and property abandoned per WAC246-272A-03C0? - • - 0 NO 0 YES 2K . , • ' RECORD DRAWING . , • , . . . • . . . r This is a permanent record and must b•accurate and descriptive enough to re-locate In the need of maintenance'cavities and tubas development Tricag Record Drawings=Olen: Onardeld&manifold orientation&layout Sento/pump tank!oczbon.North arrom.reserve tainfieid,eidseng are!proposed P-..tsangs.location of walla weter5nes• weals.citservaaOn;tea,cleanouts,ard other maintenance ao:ess pants. :ncomptete Record Drawings may crogne additional deierys in final instagation eePro,na and reed Permits. . . . . • . • • . . . . . . . . ' • ' . ' . . . t::c Record Drawing Attached • . . INSTALLATION . -.-:."... 'cil..4i:,i ;i:!1"••••:1";:-.-:',-..t!.7....:';' '.... 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'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 further certify that all information contained on this /further certify that all information contained on this fo n art ed R ravingrawingjsjpcurate. form and attached Record Drawing is accurate. .. Li—Zgr7Z Signature of installer Date 7-c) • 1 ollktj, H.I.r,r,Tcd moo 1.- Printed Name of Signee P . '%.7. ..1.-sIst.b•-. ^' . glp 40 MASON COUNTY PUBUC HEALTH The ,1-7,..:,1k • Ath undersigned approves this Installation Report and . .- . ; . Record Drawing on behalf of Mason County Public ,1-1(ta:- PAULA JOY JOHN.:'0:4 .rs,r,sk Health: , i 1:1CMCV.015V>ZNEiti'' ,.). -----c_. ‘‘- `4_ ;Fien4AP2, . / S----S--- 2.--2__ Signature of Environmental Health Specialist Date (stamp,signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SET LIP's"d 8/2140I8 • n cA ril a 0 1 . 9 N 1 1 © f 3 SRC 0 41 if o ,i0 DfivrWgy ►11yo ------� (7ray-e vi ebu booP &d --- AS oui I+ -Tri-s t a h Cr i+-e 5 {=5 r�YN a fi A PCBrC{i 4r(2l07-77-00030 DF -tYenCk,(,c @ . - �1� ZQgI EQ�tv G� �tw Loaf P-d a O.C.0C ifh , wA .��tit SCC& -e-(`,Ms� ihbt-l-w-e-c h . `k� /. Sev_ Hham; •trigs 11 i j t �r,. 5100349 :(C,.'ti'" 0 ZS• SO 75 00 ED Audio-Visual Alarm gyp.: PAULA JOY JOHNSON = 7 f S-i- Ho (e sssa�- �•s"aA ,>-as:cxD 3 Cleanoutp� s �� / ^ SOthe� 5--S -Z2- (� 0- y 10(�Vv1 i Yw 3 1200 Gallon Septic Tank tO CoYYl Ct Cf 0 C fS {roc ' O 2-Compartment with f J Effluent Filter ti �^3�t�?J7 n (�a�Vl ����Sat()cl -1-0 CO vY1 f a 'f o C4+S +hn 4 1000 Gallon Pump Chamber n Valve Control Box