Loading...
HomeMy WebLinkAboutSWG2022-00063 - SWG As-Built - 5/2/2022 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2022-00063 Parcel# 31909-75-00030 Applicant Name Derek&Alyssa Hanson Subdivision (Name/Div/Block/Lot) Applicant Address 2051 SE Lynch Rd City, State, Zip Shelton, WA 98584 Installer Name Hanson Excavation, LLC Site Address same Designer Name Arrow Septic Designs, Inc INSTALLATION CHECKLIST a --6 zse'/ 5144. $ Full System Installation ❑ Tank(s) Only ❑ Drainfield Only ■❑ Repair ®Other Solids Pump at House System Type Shallow Pressure Pretreatment Type >5 ft. from foundation? - - ❑ N/A 0 YES ❑ NO >50 ft. from wells? - - ❑ 0 ❑ Z >50 ft. from surface water? - - 0 ❑ ❑ N El between building and tank? - - ❑ 0 O Tank baffles present? - - ❑ 0 ❑ 1:: 24" access risers over each compartment?- - ❑ 0 ❑ W Effluent filter installed?- - ❑ 0 ❑ N Septic tank size 1,500 gal Manufacturer Sound Placement © 2 D-box water level and speed levelers used? - - 0 N/A ❑ YES ❑ NO RI 0 Manifold/D-box accessible from surface?- - ❑ 0 ❑ o a0 Check valves installed? ` - ❑ ❑ ❑ C=:1 ci p Transport Line Size 2" Schedule/Class HDPE 1 Bedrooms installed (check one) ❑ 2 ❑ 3 0 4 ❑ 5 ❑6 ❑Commercial/Other E 1 >10 ft. from foundation?- - ❑ N/A 0 YES ❑ NO >100 ft. from wells?- - ❑ 0 ❑ cam . 0� W >100 ft. from surface water? 00 ❑ LT. >10 ft. from potable water lines?- - ❑ ■❑ ❑ Z > 5 ft. from property lines and easements?- - El 00 Q W > 30 ft. from downgradient curtain/foundation drains?- - ® ❑ ❑ ® Drainfield level and observation ports present - - ❑ ® ❑ ❑ Graveless chambers or U] Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ ■❑ ❑ Pump tank setbacks consistant with septic tank?- - ❑ N/A ❑■ YES ❑ NO • Pump tank size 1,500 gal Manufacturer Sound Placement Q24"access riser(s) and accessible from surface?- - ❑ ® ❑ H a Alarm or Control Panel Installed? - - ❑ El 2 Control Panel equipped with Timer/ETM/Counter- - ❑ 0 ❑ m a Pump installed in ❑ Bucket or ■❑ On Block or ❑ Other a'• Pump Make/Model Liberty FL50- 1/2 hp, 115v ❑■ Floats or ❑ Transducer a Tank draw down 1.5 in/min Pump capacity 40 gpm Squirt Height 4 ft Pump on time 1.5 min Pump off time 3 hrs (2 zones) Daily flow set at 480 gpd Updated 8/21/2018 Mason County OSS Installation Report pg. 2 Parcel# 3tc1 Oct- 7J - ©e•O(SO ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - ® YES NO If yes, please describe: — c"61- 0,306 No Were all components pumped out and properly abandoned per WAC246-272A-0300? - YES ❑ 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 related permits. QQ ® Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ENGINEER 1 certify that 1 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 ail 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. G f2¢$nZ2- Sig ure of Installer Date '1 Jared Hanson b�, Printed Name of Signee waeyf' 1‘!-J MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and Record Drawing on behalf of Mason County Public - PAULA JOY JOHNSON .e Health: L'ta iSab' �c cass:. 2 9 2e2? Signature of Environmental Health Specialist Date (stamp, signature and date) Updated 8 21r1018 THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE CS) So' casks @ S`f o.c- 1a-A 2 • t 7771111 .A..r r._-=-`{ Pos. Gto...ae�. ' r C I -r� �f v�f'7Jt' �1�0 _ r e . 0 00 1 • \t"@ Q Fa ?oo 2 So ZOO ‘571 4 �_ f,,_7,sf :' cif zi . 1fv Z.,,, S::„ loa Y roo+I . , \ s,..... m„,t,frc.i fowl NI V' Ave t gem f.�4� E L______1,ezt."-setek- j n Audio-Visua kia I q C= u i C31 as prey- 5i- .u=—s.,- Sa::as:o„mot CV ..1-e,,.kr.4.3:kl- e 4-w-o...*- F=:Iter- i1.5 00 G-elio=S'Ig a Co=pestmter f O \tJvc Cate '-ok.@sic 4 et� } Vstz' / i i, APPROVEL • . ., ,if . pE, / JUN 2 4 2022 5v4e V- / MASON/ COUNTY ENVIRONMENTALRET HEALTH i ik t f \A,V se i . '.."4, ro •,,,, ,,,A *--.,,,,h y 1 / i• _0, i • � . f 51 oo349 . 'ti,-) s 11 3' 1 y *PAULA JOYJOHNSON 'f' t ti ,46 R srt`s"i L�'-sc e `/ APR 2 9 2022