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HomeMy WebLinkAboutSWG2022-00510 - SWG As-Built - 12/30/2022 Wu C5b4?C Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APP i PERMIT lAT. Permit Number SWG 2022-00510 Parcel # 32309-55-00018 Applicant Name John & Maria Hilligoss Subdivision (Name/Div/Block/Lot) Applicant Address 5051 NW Taylor Rd. Colony Surf Div. 6 Lot18 City, State, Zip Bremerton, WA 98312 nr Name T.J. Goos Site Address 1430 N. Colony Surf Dr. Designer Name Dale L. Tahja INSTALLATION'CHECKLIST IN Full System Installation ❑ Tank(s)Only ❑ Drainfield Only ❑Repair ❑ Other System Type Sandlined, Pressurized Bed Pretreatment Type >5 ft. from foundation? - - ❑ N/A • YES ❑ NO >50 ft. from wells? - •- El I El 2 >50 ft.from surface water? - - El NI El Q Cleanout between building and tank? - - ❑ © El V Tank baffles present? - - 0 ® 0 a24" access risers over each compartment?- - El ® ❑ tW Effluent filter installed?- - El IN Septic tank capacity (working) 1.250 gal Manufacturer Hagerman 9 D-box water level and speed levelers used? - - ® N/A ❑ YES ❑ NO >O Manifold/D-box accessible from surface?- - 0 til ❑ CO Check valves installed? - - ❑ ® ❑ 0< 2 Transport Line Size 1.5 inch Schedule/Class Sch. 40 Bedrooms installed (check one) ❑■ 2 ❑3 ❑4 ❑ 5 0 6 ❑Commercial/Other >10 ft. from foundation?- - ❑ N/A YES ❑ NO a >100 ft. from wells?- in --1 >100 ft. from surface water? - -UD- -i ® El W u. >10 ft. from potable water lines?- -6�� i -202� 0 ElQZQ > 5 ft. from property lines and easements?- - - - - II El Q II ❑ > 30 ft. from downgradient curtain/foundation dra Bs?- - Drainfield level and observation ports present - - y ❑ 0 ❑ Graveless chambers or IE Clean gravel used? (check one) Proper cover installed over drainfield?- - El ® 0 Pump tank setbacks consistent with septic tank? - - ❑ N/A ® YES 0 NO ZPump tank capacity(flood) 1.000 gal Manufacturer Hagerman < 24" access riser(s) and accessible from surface?- - El 111 El F— a Alarm or Control Panel Installed? - - El U 0 2 Control Panel equipped with Timer/ ETM / Counter- - 0 0 ❑ M a- Pump installed in ❑ Bucket or MI On Block or ❑ Other a.g Pump Make/Model Liberty 280 ❑ Floats or ® Transducer 3 a. Tank draw down 1.75 in/min Pump capacity 38 gpm Squirt Height 5.5 ft Pump on time 2.25 min Pump off time 5 hrs 57.75 min Daily flow set at 180 gpd Updated 8121,2018 Mason County OSS Installation Report pg. 2 Parcel# .`C`l -'53_c\ No ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - --- --- 0 YES El Pio If yes, please describe: Were all components pumped out and property abandoned per WAC246-272A-0300? - - ❑ YES 0 NO RECORD DRAWING This Y a permanent record and must be accurate and descrlptNs enough to re-locate In the need of maintpnance activities and future development Topical Record Drawings contain: Drairfeld it manifold orientation&layout,eaplicipurnp tank Iocagon.NoM atrov{reserve draktetd,existing and proposed buildings,location of wells,waterlines, wells,abstention ports,deanouta,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 1 further certify that all information contained on this I further certify that all information contained on this form and attached Record Drawing is te. form and attached Record Drawing is accurate. ' 1,1-' '''''(-- e----r \‘ \ Signature of tnstaller ; 1 Deft it .Kik,�, , 4. v. Printed Name of Slgnee ,iw� ' 0 "�. 4, MASON COUNTY PUBUC HEALTH k,' "f<11r1 �5100214 •J� � The undersigned approves this Installation Report and �` i1 Record Drawing on behalf of Mason County Public '""O4• DALE L.TAHJA �' • Health. - LIC NSE€) DES►GNER..-qam...o I k v EXPO--S. •`� 1 - .2._,___ AL Air ilv. t2 Slgnatu ; ./! ronmental Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Updased en11"18 3 _., . , r.ior 1 Ykc.x.:V\c&-'4‘7o\t- c•-•, \-\\% ' CX(C.e..\ -t• ;p,( •. (31\\--'.51D , ';‘,(3r. •co\rimLi''`i-..•,,A'k': IcC--'• S\ki.el'4=7.7 MS\C) \._.457 \,,i. ty l• \,_ _Y-,Ae._._ \---• c6/-:.\(--\;- ‘ ,,.. • . 1 , i e_c_.03v c . \Jvckl‘t vcip ......_.a.scicz., . . 0,41I .01, i• 1 li ..• f ,ar * (t:\ 'IV- dr Air ir 4 go?' • ,\ t. A., `.,'.4* A 'VG k ,, .,: ,,,., 1 \ .?c,4,,c•\ ...., (:) DALE L. 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