HomeMy WebLinkAboutSWG2018-00034 - SWG As-Built - 5/25/2022 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEAL1
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APPLICANT/ PERMIT INFORMATION
Permit Number SWG 2t,F3 —a31- -f Parcel # 12217429013k
Applicant Name Batjack Holdings LLC Subdivision (Name/Div/Block/Lot)
Applicant Address P.O. Box 7-2-41 Allynmore Ridge 0 T
• City, State, Zip Gig Harbor, WA 98335 Installer Name J&J development
Site Address 16101-4- E State Route 3#A/B Allyn Designer Name Peninsula Septic Designs
. INSTALLATION CHECKLIST •
0o E '-'• 7 1 Full System Installation ❑Tank(s
)( )Only ❑ Drainfield Only • El Repair 0 Other
D System Type pressure distrubution
Pretreatment Type
w >5 ft. from foundation? - 0 N/A ® YES ❑ NO
>50 ft. from wells? - ❑ IN
❑
>50 ft. from surface water? - -
Cleanout between building and tank? - ❑ It ❑
C` . Tank baffles present? - - ❑
NE 1— 24' access risers over each compartment?- - ❑
CO Effluent filter installed?- _ ❑ ® ❑
Septic tank capacity(working) 1250 L1 )gal Manufacturer Haggerman Precast
0 D-box water level and speed levelers used? - - ® N/A ❑ YES ❑ NO
a0 Manifold/D-box accessible from surface?- - ® ❑ ❑
ICheck valves installed? - • . - NI ❑ ❑
2 Transport Line Size Schedule/Class A
arABedrooms installed
(checkone) ❑ 2 CI ❑4 ID 5 . 0
Commercial/Other
>10 ft. from foundation?- - ❑ N/A ® YES ❑ NO
0 >100 ft. from wells? - - 0 ® ❑
•
W >100 ft. from surface water? 0 ® ❑
LL >10 ft. from potable water lines?- _ ❑ NI ❑
•
---� ft. from property lines and easements?- - ❑ PM El0 ft. from downgradient curtain/foundation drains? ❑ IIElinfield level and observation ports present - - IDII ❑
Efj
El
NO
Graveless chambers or al Clean gravel used? (check one)
-; L er cover installed over drainfield?- - El El
p tank setbacks consistent with septic tank?\\< '-2 -
❑ N/A II YES
-_ p tank capacity (flood) 9000 gal Manufacturer Haggerman Precast
24" access riser(s) and accessible from surface?- - 0 ® 0
D.~ Alarm or Control Panel Installed? El ❑
Control Panel equipped with Timer/ ETM / Counter- - 0 Pi ❑
Q. Pump installed in ❑ Bucket or ® On Block or ❑ Other
C.
Pump Make/Model Liberty IN Floats or ❑ Transdu�^.er
13 Tank draw down .344 in/min Pumpcapacity 45
• a. p y gpm Squirt Height 4.041 ft
Pump on time e5M, Pump off time '- 4hrs. Daily flow set at 2.4& gpd
Updated 8/21/2018
Mason County OSS installation Report pg. 2 Parcel# 122174290131.
- . ASANDONMENT RECORD' • •
rW
Were existing septic components abandoned as part of this project? - - ❑ YES [� NO
If yes, please describe:
Were all components pumped out and properly abandoned per WAC246-272A0300? - - ❑ YES D 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, Drainfleld&manifold orientation&layout.Septidpump tank location.North arrow,reserve drainfield,existing and proposed buildings,location of wells,waterlines,
wells,observation ports,deanouts,and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and related permits
❑ Record Drawing Attached
• CERTIFICATION OF INSTALLATION
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 I further certify that all information contained on this
form an attac Record Drawing is accurate. - form and attached Record Drawing is accurate.
12/5/2021
ignature 4,,,..
Installer Date
Kenneth Jones
�r
Printed Name of Signee — __...
MASON COUNTY PUBLIC HEALTH 3�;� •
°a•v.
The undersigned approves this Installation Report and 2�. {
Record Drawing on behalf of Mason County Public o.• t iw2:
Health: ::�?.',?.br<n t: S'�fI T t,'
l iCFF` :i' . ,t:VR Ott
\iNvVY �5'YY1 C17-c J 2_Z Er�,trc;:v l I z>
Signature of EnvironAenta!Health Specialist Date (stamp, signature and date)
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Updated 8/21/2018
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