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HomeMy WebLinkAboutSWG2018-00034 - SWG As-Built - 5/25/2022 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALT APPLICANT/ PERMIT INFORMATION Permit Number SWG O I`� =-(5vc1-pC4 Parcel # 12217-42-90134 Applicant Name Batiack Holdings Subdivision (Name/Div/Block/Lot) Applicant Address PO Box 2269 Allynmore Ridge lot 4 City, State, Zip Gig Harbor WA 98335 Installer Name J&J development Site Address 19013 E SR 3 0-A-1 i� Designer Name Peninsula Septic Designs INSTALLATION CHECKLIST ® Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑ Repair ❑ Other System Type pressure distrubution Pretreatment Type m €o_ca'7 >5 ft. from foundation? - -- ❑ N/A ® YES ❑ NO 54� >50 ft. from wells? - -- - ❑ © ❑ (^ >50 ft. from surface water? - - ❑ 0 ❑ Cleanout between building and tank? - - ❑ 0 ❑ ,=, Tank baffles present? - - ❑ o ❑ ,t; 24"access risers over each compartment? - - - - ❑ II El EtitEffluent filter installed?- ❑ 0 ❑ C� ry.n Septic tank capacity(working) 1250 lti") gal Manufacturer Haggerman Precast `CI D-box water level and speed levelers used? - - IN N/A ❑ YES El NO DO Manifold/D-box accessible from surface?- - ❑ 0 ❑ mz Check valves installed? - - ❑ IN ❑ 0Q 2 Transport Line Size 2" Schedule/Class :.„, 40 Bedrooms installed (check one) ❑ 2 ❑3 ❑4 ❑ 5 9Z.' i'; Commercial/Other >10 ft. from foundation?- - ❑ NIA 0 YES ❑ NO CI >100 ft. from wells? -- - ❑ 0 ❑ W >100 ft. from surface water? - - ❑ II 6L >10 ft. from potable water lines?- - ❑ ® ❑ Z > 5 ft. from property lines and easements?- ❑ 0 ❑ Q rt > 30 ft. from downgradient curtain/foundation drains? - - ❑ II ❑ Drainfield level and observation ports present - - ❑ ® ❑ ❑ Graveless chambers or $ Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ ❑ ❑ [nnPump tank setbacks consistent with septic tank? ❑ NIA ® YES ❑ NO Pump tank capacity (flood) 9000 gal Manufacturer evergreen precast 11 „ access riser(s) and accessible from surface?- - ❑ ® ❑ larm or Control Panel Installed? - - ❑ MI CI ontrol Panel equipped with Timer/ ETM/Counter- - �_ rmp installed in ❑ Bucket or 0 On Block or ❑ Other 2 Pump Make/Model liberty it Floats or ❑ Transducer a. Tank draw down .375 in/min Pump capacity 45 gpm Squirt Height 4.042 ft Pump on time 8!t'4*7 Pump off time 4hrs Daily flow set at ZAP gpd Updated 8/21/2018 Mason County OSS Installation Report pg. 2 Parcel it 12217-42-90134 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - ❑ YES 0 NO If yes, please describe: Were all components pumped out and properly abandoned per WAC246-272A-0300? - - ❑ YES ❑ NO RECORD DRAWING This is a permanent record and must be accurate and descriptive enough to re-locate in the need of maintenance activities and future development. Typical Record Drawings contain. Drainfield&manifold orientation&layout,Septic/pump tank location.North arrow,reserve drainfield,existing and proposed buildings,location of wells,waterlines, wells,observation ports,cleanouts,and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and relbted permits. • ❑ Record Drawing Attached CERTIFICATION OF INSTALLATION • INSTALLER DESIGNER/ ENGINEER l 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 I further certify that all information contained on this form and att he Rec rawing is accurate. form and attached Record Drawing is accurate. 12/5/21 Si nature of Installer Date Kenneth Jones Punted Name of Signec rk�y MASON COUNTY PUBLIC HEALTH t:* a'�� The undersigned approves this Installation Report and .f�e -r • Record Drawing on behalf of Mason County Public Health: �n� S ) ,. Z Signature of nvironme,ttal Health Specialist Date stain signature and (stamp, date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Updated 8121!2018 /. 106' , 86' I ' ' N ` :6c m D _ m 5 9S c•,:,3 mO � m Pg� nOa Y�v:`p,�.� a:gT.�• �,4. v Z rn p S rn. c D r S lN1 (;),{gym - Z m G1 Z Z A iJ;n G' Nor.' ,' 4. ` v vm Di •M rmn m 72 Z < * * n i j!`^,•• .ice' CO E DUPLEX 1,rn Gzi ,3 0 , � z -I c,`T o (6) TOTAL BEDROOM(S) z o Po < D x \ ( a D Z Z Z .1. 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