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HomeMy WebLinkAboutSWG2021-00062 - SWG As-Built - 4/21/2022 Pere Ili tPlt0 R? 12i7., /;./ Mason County OSS Installation Report pg. 1 MASON COUNTY PUI I&.HEALTH �-' APPLICANT! PERMIT INFORMATION Permit Number SWG jam car)6a Parcel# 32212-75-00060 Applicant Name Bob Nordnes Subdivision (Name/Div/Block/Lot) Applicant Address PO Box 37 City, State, Zip Seebeck, WA 98380 Installer Name Fast Track/Bret Schwartz Site Address 721 Tahuya River Rd Designer Name Tom Weaver INSTALLATION CHECKLIST 3 Full System Installation 0 Tank(s)Only ❑ Drainfield Only ❑Repair ►A Other RV site System Type Gravity Pretreatment Type >5 ft.from foundation? - - ❑N/A ®YES ❑ No >50 ft.from wells? -- - - ❑ ® ❑ Z >50 ft.from surface water? - - ❑ Ea El cc Cleanout between building and tank? - - 0 ® ❑ V Tank baffles present? - - 0 E3 El a24"access risers over each compartment?- - 0 Ej 0 W Effluent filter installed?- - ❑ KI ❑ 07 Hagerman Septic tank size 1,500 gal Manufacturer O D-box water level and speed levelers used? - - ❑ N/A ®YES 0 NO o© Manifold/D-box accessible from surface?- - ElXi El m z Check valves installed? - - ® 0 0 Ct a 4" 3034 2 Transport Line Size Schedule/Class Bedrooms installed(check one) X] 2 ❑3 0 4 0 5 ❑6 ❑Commercial/Other >10 ft.from foundation?- - 0 WA DIVES 0 NO o >100 ft.from wells?- - ❑ 12f ❑ W >100 ft.from surface water? CIt] 0 >10 ft.from potable water lines?- - - - ❑ ] ❑ Z >5 ft.from property lines and easements?- - 0 It El o2 > 30 ft. from downgradient curtain/foundation drains?- - ❑ (t ❑ © Drainfield level and observation ports present - - 0 ] ❑ ;f Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ ►;( ❑ Pump tank setbacks consistent with septic tank?- - ) N/A 0 YES 0 NO • Pump tank size gal Manufacturer < 24" access riser(s)and accessible from surface?- - ® El 0 a. Alarm or Control Panel Installed? - - - - t4 0 2 Control Panel equipped with Timer/ETM/Counter- - GI 0 m C1~ Pump installed in 0 Bucket or ❑ On Block or 0 Other ---- a. • Pump Make/Model 0 Floats or 0 Transducer 4. • Tank draw down in/min Pump capacity gpm Squirt Height ft Pump on time Pump off time Daily flow set at gpd updated 8.n1ne1e 1 Mason County OSS Installation Report pg.2 Parcel 32212-75-00060 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - D YES ® No If yes,please describe: Were aN components pumped out and properly abandoned per WAC246-272A-030O? - ; ❑YES ❑ NO RECORD DRAWING This is a permanent word and must be acctrnta and descriptive onou5A to re.iasate in the mud et mainbnancs aetiebtNO find tutors development Typical Retort Orav imps Contain: tkaiedelo a msndoid orientation d layout,Septic/pump tank location,North anew,reserve Waerdtekd.adding and proposed buildings,location or tots,rraterenes, wells.observation ports,citations.and otter maenenance access points.incomplete Record tksMnps may create adekonal delays In Mat installation approval and netted ponies. See Attached Ca 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 and to rd Drawing is accurate. form and attached Record Drawing is accurate. 04/20/2022 Signature of installer ,. Date Bret Schwarz 5e.1,tk:tNRz 4 Printed Name of Signee MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and sig app o P �" Record Drawing on behalf of Mason County Public ` ' e . '""?•-� Health: rys Signature of :nvironmt t Health Specialist Dale (stamp,signature and date) 9 THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Updated W211 e r411111111F rstltll1111.11b +19'el 70't Tahuya River Rd SL# 1 0-32" Sand Loam - 32" COMPACT 145't g. SL#2 0-32" Sand Loam +15'ei 100'Well Circle ' . 32"Compact E SL#3 0-32" Sand Loam ' 32"Compact 50'Well Circle ii/ The goal of rlc °frnping. is project is t have '`„-°� a Proposed It is important that any RV's be dumped n We1l •- at an approved RV dump site before ?` ✓ r connecting to this system. `'.,, rf° ' Chemicals used in RV's to control { 2-----:Si yr ic- ,,, tit F oder are detrimental to septic systems. e kti Ye' 1 I. Box -�, C . ��St; 2 f , : APPROVED Xsun Q°°�°Rase MAY 05 2022 50'Attenuation MASON COUNTY ENVIRONMENTAL HEALTh z—° '.----- RET C %\4:lf----- ::;,`A, A +3'ell I s " 0'el 14i0t �VsR 'r t«�N ,.- , tip 1" = 60' )32212-75-00060 721 NE Tahuya River Rd