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HomeMy WebLinkAboutSWG2022-00150 - SWG As-Built - 1/13/2023 (2) sive!:>y Ys1:1��i i l Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2022-00150 Parcel # 222235002026 Applicant Name TBC Enterprises Subdivision (Name/Div/Block/Lot) Applicant Address PO Box 2503 Trails End City, State, Zip Gig Harbor WA 98335 Installer Name Jack Johnson Site Address 850 E Trails End Dr, Belfair Designer Name Jim Zimny INSTALLATION CHECKLIST $ Full System Installation ❑ Tank(s)Only 0 Drainfield Only 0 Repair ❑Other System Type Pressure Distribution Pretreatment Type >5 ft. from foundation? - - ❑ N/A ®YES ❑ NO >50 ft. from wells? - - 0 ® 0 Z >50 ft. from surface water? - - 0 ® 0 1-- Cleanout between building and tank? - - 0 OE U Tank baffles present? - - ❑ ® 0 17: 24" access risers over each compartment?- - 0 ® ❑ a. W Effluent filter installed?- - 0 1 0 fn Septic tank capacity (working) 1200 gal Manufacturer Hagerman 0 D-box water level and speed levelers used? - - ® N/A El YES ❑ NO 00 Manifold/D-box accessible from surface?- - 0 0 ❑ LL a?z Check valves installed? - - ® 0 0 r.O Q Transport Line Size_ 2" Schedule/Class Sch 40 Bedrooms installed (check one) ❑ 2 0 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10 ft. from foundation?- - ❑ N/A ® YES ❑ NO O >100 ft. from wells?- - ❑ © ❑ W >100 ft. from surface water? - - CII ❑ LL. >10 ft. from potable water lines?- - 0 I ❑ Z > 5 ft. from property lines and easements?- - 0 II ❑ Q Q > 30 ft. from downgradient curtain/foundation drains? - - 0 II Drainfield level and observation ports present - - ❑ ® 0 ❑ Graveless chambers or 0 Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ ® El Pump tank setbacks consistent with septic tank? - - 0 N/A II YES ❑ NO Y Pump tank capacity (flood) 1200 gal Manufacturer Hagerman Q24" access riser(s) and accessible from surface?- - El I 0 ~ Alarm or Control Panel Installed? - - --- - ❑ I ❑ 0_ 2 Control Panel equipped with Timer/ ETM I Counter- - 0 I 0 a- Pump installed in 0 Bucket or 111On Block or 0 Other_ a'• Pump Make/Model Liberty 280 ® Floats or 0 Transducer Tank draw down 2" d in/min Pump capacity 40 gpm Squirt Height 5' ft Pump on time 1 rrrrt12 sec(45GPM) Pump off time 4 Daily flow set at 280 gpd updatod 8f2./201 8 Z- ZZ"L 3 coo Zo2 Lo Mason County OSS Installation Report pg. 2 Parcel# ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - - YES 0 NO If yes, please describe _— Were all components pumped out and properly abandoned per WAC246-272A-0300? - - 0 YES (] NO RECORD DRAWING Ibis Is a permanent record and must be accurate and descriptive enough to re-locate in the need or maintenance activities and future development. Typical Record hc/ tank Location,North arrow.restive banhetd,ginseng and 1xo x sed Gnild�ngs,bcaten of WENS.waterlines. Urawirgs contain, DrainfieW b manifold orientation&tayovt.Sep r„n'[t •:elk,obsorvahon ports.r9nancuts,and other mapilenar•ce access points incomplete Record Dra:wigs may create additional(Ways in final installation approval and related permits APPROVE__ JAN 13 2023 MASON COUNTY ENVIRONMENTAL NEALT. Jaw .Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ENGINEER I 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 all State myself and Mason County Public Health and meet a!! and Mason County Codes. State and Mason County Codes !further certify that all information contained on this I further certify that all information contained on this focv/iA,m rid alt1 bed Record Drawing is accurate. form and attached Record Drawing is accurate. Sige of Installer Date Thrilled Name of Signee 10i. / Q / MASON COUNTY PUBLIC HEALTHam The undersigned approves this installation Report and . o's Record Drawing on behalf of Mason County Public o ooi„ry :, Health: tic se !GNER �y/ t• /3 -23 Expirnr .,r2 .. r Sigi we vironmenta!Health Specialist Date (stamp,signature and date) — THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON IRE MASON COUNTY WEB SITE } -4P E N .5 i>'. 8 6 `� ..‘" r1 s ' W m m O b,1 . _ _ _ p m rt -- ' �R0r- a a N I I 0) ' ; _ a v �✓oJ a Cij r1 w 0 0_ N L z o 0 C Q' M p �O �n W NO L.- 8c Q" = O c ^ L.. rti cn ' v) E3 x , E co u •L- m a o w w C z CI fa°. c aV O N _ , � < rv) ` -0 -a a) Q CIO Ln N Cl. m a E I— c0 m N O m = 4. i \ 01 p \\ A4, \ & PPROVE JAN 13 2023 MASON COUNTY ENVIRONMENTAL HEALTH CD JB N CS) L!1 5 N >- v, • + CU Q 0 : co a-� a) Q — L.. o a m `a = Z = a oa Q � a) a o a > • = A. .. y I o1 _ o1 Z \ A IN T 8I m 01 .. CO N Co N M m v — n) E Trails End DR.