HomeMy WebLinkAboutSWG98-0501 - SWG As-Built - 10/15/2001 ENaa4d wey 11.199E
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Applicant
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cant Parcel# livi;:::0103 6f
Permit Number SW4t -- Number
d�� , Cl SG� �� 3 )'�?[f3z
,�' �v Subdivision (NamerowaiodelookLot)
Instaler
• �` L/ '`/A �4 AP f .
Desig11 R / ] i
[ ---- —7—- '-:P'W' '''';'"?;,‘,1t,''s ;,*77.- 7 Sir - - '
NIA Yes Prior to Completion
I. SEPTICTANK
foundation4. ............................ /
A) wells and Burr Water? .. . ............. ------
B tunic dean-oat ffno 11 2'K ............... —
BBldg stub-out to sepdc
Baffles and dean? ...................................... _L —
Divldst>g wall intact?......... ..... —L —
G) Risers�for access?. .. r�S •
U. 0-BOX ..................................... _7c— --J
A) li water?
• Ski er used? ..........................................
III. DA) 10 ft from foundation and>5 ft from property lint ...............
B) >1008 from wells and water?.............................
CI >It4 Laterals from potable p ..n looped? ...........
D Gravelevel ........................F) System dimensions —
ness chambers villized?
property the same as shown on the design?................ -
G) Omni clean,prop sized,and proper depth? ....................
LO Possum SWUM C-33?
.) Head inches?•Actual head height _..—_
3 Clean-ens and observance pods present? .....................
5)5) OwnerMod b ran d epa ticconnections
must be made by _
l icensed electrician and 1 by T.A .............
owner
IV. PUMP/PUMP CHAMBER A) Pomp mike • Pump mods — i
B) Chamber size gal; hes
• Height of pump off bottom of pump chamber gallonsper inches
D) Pump draw-down
8�Per minuteinch .
) Pumpco Timer(or) Time Meter (circle if installed)
O > If cow timer or (ed:Pump On eirde one)installed?alled? ................ IF _
0) Screen
H) Riser installed for access?........ ........•':...............-
1) Alum Installed? ................
.e.ANle..
:my DIMS
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rt of, c •
Caccsassr • -
O Dm/afield&manifold
orientation &layout
O Trench/bed dimensions
and critical distances
within layout 6o1
L' Septic/pump tank
placement.
O Location of buildings.
O Observation port&clean-
ktit,0
out location.
O Location of wells&
roads.
0 Undisturbed native soil
between trenches.
•
North arrow
-- • ..,
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CAUTION:&Omar adjusumenit to sepdc tank bade&eed ocieNtetios sumo&le the field by the inmates ste oo=bis eti the de=itr:
and the desigoc4 but amid Is eon compneebe they iabty eilliesystua.It is da itendiees
hada&mimeo or the designer before leakkg any&wisdom font the desks Ihat dent ibe system viability. Soothe iksiith Rout be
doom above. ,•
Ins or Check a box from Row"A"and"B",sign and date die certification
A. I certify that I installed the system without any 0 I certify that all deviations from the design stamped
deviation from the design stamped"duintovEn"by "APPROVED"by MCDHS are shown above.
MCDHS
B. 0 I certify that I contacted the designer and left the 0 I did not contact the designer.prior thud cover because the
system open for inspection up to 48 bra prior to designer waived the requirement.
COW.
I further certify that all information contained on this form is accurate. I - • . that if.. „ captained herein is not
accurate,there will be just cause for immediate suspension of my initialler -• 1/1 •••
41411) /0111.1.—
I Date
The undersigned approves this installation on behalf of Mason County of
ie4afesZ/C3/
Sanitarian
-am0,4asork County DIVIS •
„rn Mason County DMS
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APPROVED
mc HEALTH DEPT
OCT 1 5 2001
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EK ENGINEERING INC. DATE: 6/23/11 'MK CONSTRUCTION S RE 9AR SCHEDULE FOR MODELS
13
DRAFTED BY: 1250 S, 1250 S-T, m
P_O.BOX 3097 BATTLE GROUND.WA 98604 D.R.N. 1250 P & 1250 P-T
PHONE: (360) 687-7668 FAX: (360) 687-7669 SCALE: CP
NTS HAGERMAN PRE-CAST •
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DATE:
6/23/11
EK ENGINEERING INC. DRAFTED BY: I Aro,.3E7tok..S FOR MODELS "0
1250 S, 1250 S-T 0
m
P.O.BOX 3097 BATTLE GROUND.WA 98604 D.R.N ,
1250 P & 1250 P-T
PHONE: (360) 687-7668 FAX: (360; 687-7669 SCALE: 4N.•
NTS HAGERMAN PRE-CAST
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