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HomeMy WebLinkAboutSWG2020-00434 - SWG As-Built - 5/13/2022 tcaltg, a Mgrr� tt Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIAlt# APPLICANT/ PERMIT INFORMATION or:I•...` .,,i,. `"`'` Permit Number SwG 2020-00434 Parcel # 12107-32-50040 Applicant Name HATCH C/O B-LINE CONST. Subdivision (Name/Div/Block/Lot) Applicant Address 2971 E PHILLIPS LK LP RD City, State, Zip SHELTON, WA 98584 Installer Name B-LINE CONST. Site Address 280 E McLANE COVE DR Designer Name TOBY TAHJA-SYRETT INSTALLATION CHECKLIST 0 Full System Installation ❑Tank(s) Only ❑ Drainfield Only ❑ Repair ❑Other System Type PRESSURE Pretreatment Type N/A >5 ft. from foundation? - - ❑ N/A 0 YES ❑ NO >50 ft. from wells? - - ❑ 0 ❑ Z >50 ft. from surface water? - - ❑ 0 ❑ FCleanout between building and tank? - - ❑ 0 ❑ U Tank baffles present? - - ❑ ■❑ ❑ d24" access risers over each compartment?- - ❑ 00 W Effluent filter installed?- - ❑ 0 ❑ cn Septic tank size 1500 gal Manufacturer SOUND PLACEMENT E3 D-box water level and speed levelers used? - - 0 N/A ❑ YES ❑ NO oO Manifold/D-box accessible from surface?- - ❑ 0 ❑ co Check valves installed? - - ❑ El ❑ ciQ 2 Transport Line Size 2" Schedule/Class SCH 40 Bedrooms installed (check one) ❑ 2 ❑ 3 ❑4 ■❑ 5 ❑6 ❑Commercial/Other >10 ft. from foundation?- - ❑ N/A El YES ❑ NO 0 >100 ft. from wells?- - ❑ ❑� ❑ W >100 ft. from surface water? - - ❑ ❑■ ❑ ti >10 ft. from potable water lines?- - ❑ El ❑ Z Q > 5 ft. from property lines and easements?- - ❑ X ❑ • > 30 ft. from downgradient curtain/foundation drains? - - ❑ ❑ ❑ • Drainfield level and observation ports present - - ❑ NI ❑ ❑ Graveless chambers or • Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ ❑ ❑ Pump tank setbacks consistant with septic tank? - - ❑ N/A ❑■ YES ❑ NO • Pump tank size 1500 gal Manufacturer SOUND PLACEMENT Q 24" access riser(s) and accessible from surface?- - ❑ ❑ ❑ H a Alarm or Control Panel Installed? - - ❑ © ❑ 2 Control Panel equipped with Timer/ ETM /Counter- - ❑ I ❑ n E- Pump installed in ❑ Bucket or ❑ On Block or ® Other PUMP VAULT a'• Pump Make/Model LIBERTY FL-61 0 Floats or ❑ Transducer EL a Tank draw down in/min Pump capacity gpm Squirt Height ft Pump on time Pump off time Daily flow set at u� gpd PVkYAQ SC�r''n v 1 \`\ b� SC� �* N� M, D Go� . e \C L CO0.S3I'acvr/C1V:186� Mason County OSS Installation Report pg. 2 Parcel# \Z 10 7- 3 Z"SOO`i O ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - ❑ YES II 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, welts,observation ports,cleanouts,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 wear- 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 attached Record Drawing is accurate. form and attached Record Drawing is accurate. Si ature of Ins ller Date f' • j1 -fir �,�� N '� . .r Ay Printed Name of Signee • MASON COUNTY PUBLIC HEALTH • • i Q- ) The undersigned approves this Installation Report and ' = ` Record Drawing on behalf of Mason County Public ft 712Y i.�`�`� `` -• tt' tl�lSEt. Health: APPREa: 06ro7/ 12-q 17- z Signature of Envintai Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE updated 8/21l2015 i 77.1 W x x D Cn r D 11 D 10°. D -1 m p o a. 0 rev = fn m MCCLANE COVE DRIV =�vpi p m m E xi �r 6 m tv m n C.) 6 D C z OPP'. ct m 0 po r_ r 0 _ <w G � -1 W D Z <ca Zm m ma -ice z . D Fr C!) 0 D \ 0 m 70 o CI m = ` ` ` N1 o � �, � m o 'i N ` ` / ;-‹(r;.V.' ' ' 4.4k \ ( + =• Os r't/ , r\ ,- 4 Aiii,IS 2, t o ' TF`� C �rfrr A: n Ro CD. ! ` R \ / ,.. �I • • v�'y,� ' 0 '� ,`y � ` Z // - o \` C ,3S�y • . 40 'J''' 4 O s I p \/N I cn m v It s"9S -I CD A P RQ V E JU# 4 2022 MASON CO NVIRONY ENT ALHEALTH RET I gas' •� z n (