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HomeMy WebLinkAboutSWG2022-00127 - SWG As-Built - 8/9/2022 I. Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANTLPNLIT`INFORMATION Permit Number SWG 2022-00127 Parcel # 32412-11-90071 Applicant Name Kevin Geiger Subdivision (Name/Div/Block/Lot) Applicant Address 2415 2nd Ave. # City, State, Zip Seattle, WA, 98121 Installer Name T.J. Gods Site Address N. Seagul Way Designer Name Dale L. Tahja INSTALLATION CHECKLIST No Full System Installation ❑Tank(s) Only ❑ Drainfield Only ❑ Repair ❑Other System Type Presurized Trenches Pretreatment Type N/A >5 ft. from foundation? - - ❑ N/A ® YES ❑ No >50 ft. from wells? - _ --- ❑ II ❑ >50 ft. from surface water? - 1 'i 4.- ❑ [ ❑ Q Cleanout between building and tank? - - l --- ❑ 0 ❑ [`t- A-cr�-ct2�rt- -- U Tank baffles present? - -- ❑ ❑■ ❑ 1- 24" access risers over each compartmen - ❑ ® ❑ WEffluent filter installed?- By ------- •_ - = ❑ ■❑ ❑ co Septic tank capacity (working) 1,200 gal Manufacturer Hagerman 0 D-box water level and speed levelers used? - - IN N/A ❑ YES ❑ NO 00 Manifold/D-box accessible from surface?- - ❑ IN mZ Check valves installed? - - ❑ ® 0 a -A Transport Line Size 2 inche Schedule/Class Sch.40 Bedrooms installed (check one) ❑ 2 0 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10 ft. from foundation?- - ❑ N/A ® YES ❑ NO Q >100 ft. from wells?- - ❑ 0 ❑ W >100 ft. from surface water? - - ❑ 0 ❑ u. >10 ft. from potable water lines?- - ❑ IN ❑ Zre > 5 ft. from property lines and easements?- - ❑ ® ❑ cE > 30 ft. from downgradient curtain/foundation drains?- - ❑ ® ❑ o Drainfield level and observation ports present - - ❑ 0 ❑ ® Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ WE ❑ Pump tank setbacks consistent with septic tank?- - ❑ N/A ❑ YES ❑ NO ZPump tank capacity (flood) 1,000 gal Manufacturer Hagerman eQ 24"access riser(s) and accessible from surface?- - ❑ I ❑ f- d Alarm or Control Panel Installed? - - El • El. 2 Control Panel equipped with Timer/ ETM /Counter- - ❑ II ❑ D °- Pump installed in ❑ Bucket or is On Block or ❑ Other a' Pump Make/Model Liberty 280 ❑ Floats or 0 Transducer a Tank draw down 1.75 in/min Pump capacity 36 gpm Squirt Height 8 ft 4 Pump on time 2.8 min. Pump off time 5 hrs. 57.2 min. Daily flow set at 270 gpd Updated 8/21/2018 # Mason County OSS Installation Report pg.2 Parcel ��\� 1\ \On ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - 0 YEs ® NO If yes, please describe: Were all components pumped out and properly abandoned per WAC246-272A-0300? - - 0 YES El NO RECORD DRAWING This le a immanent record and must be accurate and descriptive enough to re4ocate in the need of maintenance activities and hitch development TiplaI Record DrpMnya coat In Drelniteld d manifold orientation&layout,Septic/pump tank location,North arrow,reserve dtetrsteld,existing end proposed> ,location of wefts,waterlines, wells,obeerVWlon ports,deanouts,and other maintenance access poInts. Incomplete Record Owings may create additional delays in final installation approval and related permka. • 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 c.onta" ed on this I further certify that all Information contained on this form and attached Record Drawing te. form and attached Record Drawing is accurate. e'7- A I signaturr-41e ot°Inst8ller Date Ct„ , �r t, (1../C (,) S di.--44% V Printed Name of Signee ( r��'F °t yc„ , ., MASON COUNTY PUBUC HEALTH 2 ! + m}.## The undersigned approves this installation Report and t� ;Ail", Record Drawing on behalf of Meson County Public ,;..0�"� DALE L.TAHJA -�, ItI Health. it SEn© SIGNER t b k1�z EXV- _. - —_V* Signature of Environmental ealth Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Updated 8r2112o18 , . . roA C2f r V (01 (f)' i*t r, ' -'0. . • ": .. it • • ".*9 -A-- )--1' r 9': { O IN • I I s :::--. 'A1,1\ .4o,k‘„ c • r. .....- . ,-9 ' R---) 1 ;r-- -- —. . . n • . r. ..› '7 , •o , . rp_ c ,/, , I gp , . . ,. 4 r -„,..... V 1 r,i,,,. . .. „ , • ! „.2 ,.„si 010 . ii 3. . ~ ` ,,,,\ , T , to'l - 11/ i : I %... i *6‘ '_.46N54, f 10 ile I f biz...,,K. • •?:, . ., . • 1 #,-,5:5: 7----S;C--- 4))..t:41'. • r • v i o > c................„.........e.„il, -. c) 10 m O S O 1 :I M xp C.C> r) risIV •..f. rn „,.. *.,. 1\, t1.044