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HomeMy WebLinkAboutSWG2022-00307 - SWG As-Built - 1/13/2023 RECORD DRAWING (ASBUILT) pg. 1 MASON COUNTY PUBLIC HEALTH PARCEL IDENTIFICATION • Permit Number SWG 1,9/2 - 0O307 . Assessor Parcel # 31 r)1„A3 Li Do 3 ) Applicant Name -r.,nx„ Les.✓;_ Subdivision (Name/Div/Block/Lot) Applicant Address I S I ti {-/Dj s.q , S . City, State, Zip ;5in�1k4)1( 1,,,)A S"cii8`i Installer Name ' .4.� 5 ��i I Ii nos Site Address Designer Name J i^-t 1-) y INSTALLATION CHECKLIST Full System Installation ❑ Septic Tank Only ❑ Drainfield Only ❑ Repair System Type C 1e__A cloy) Pretreatment Type >5 ft. from foundation? - _ - - - ❑ N/A [I YES ❑ NO >50 ft. from wells? - i ❑ ❑ >50ft. fromsurfacewater? - -- - - - —-— ` - - - ❑ H Cleanout between building and tank?`1 7.(�-23- !' - - ❑ '® ❑ V Tank baffles present? - - BAN ❑ 14 ❑ d24"access risers over each compartm!• : - - - -` - ❑ ❑ `W Effluent filter installed?- - ❑ IISI ❑ BY Septic tank size 1200 gal Manufacturer SP.S D-box water level and speed levelers used? - - ❑ N/A ❑ YES ❑ NO oO Manifold/D-box accessible from surface?- - ❑ CI ' ❑ OOZ Check valves installed? - - ❑ ❑ ❑ oQ 2 Transport Line Size 1 Schedule/Class Li a Bedrooms installed (check one) IN 2 ❑3 ❑4 ❑ 5 ❑6 >10 ft. from foundation?- - ❑ N/A 31 YES ❑ NO In >100 ft. from wells?- - ❑ N ❑ W >100 ft. from surface water? - -- ❑ 2K1 ❑ 1. >10 ft. from potable water lines?- - ❑ Dt1 ❑ —cr. >5 ft.from property lines and easements?- - ❑ LE ❑ IY > 30 ft. from downgradient curtain/foundation drains? - - ❑ TRI ❑ o .Drainfield level and observation ports present - - ❑ EN ❑ ❑ Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ ❑ ❑ Pump tank setbacks consistant with septic tank? - - ❑ NIA N YES ❑ NO Y Pump tank size 1'1,79 gal Manufacturer sPc < 24"access riser(s)and accessible from surface?- - ❑ IK ❑ F- a Alarm or Control Panel Installed? - - ❑ RI El M Control Panel equipped with Timer/ETM/Counter- - ❑ ® ❑ D n- Pump installed in ❑ Bucket or On Block or ❑ Other a � Pump Make/Model 6,00,1 A 10 A F,75'0 ❑ Floats or [Transducer 0. Tank draw down Y in/min Pump capacity .3 gpm Squirt Height ft Pump on time 0: -l.-S M,^ Pump off time 61 - 3 S r;^ Daily flow set at rip gpm rewsed 1/22/2014 RECORD DRAWING (ASBUILT) pg. 2 MASON COUNTY PUBLIC HEALTH RECORD DRAWING • Drainfield& manifold orientation &layout Trench/bed dimensions and critical distances within layout Septic/pump tank A1414 placement Location of buildings 7 `r Observation ports& clean-out locationsItZ11;t sst `� y����� El Location of wells, ) surface water,& c:\ roads Undisturbed native �P soil between trenches North Arrow If the designer or installer feel the need for additional information/comments,it may be attached. Record drawing may also be on a seperate page attached. No. Pages Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER 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 attached Record Drawing is accurate. form and attached Record Drawing is accurate. I IA/ Signature of Installer Date r%•'•. 1/I.1L.. Printed Name of Signee fr .; MASON COUNTY PUBLIC HEALTH •,`�' {� The undersigned approves this Installation Report and er 2230834 Record Drawingon behalf of Mason CountyPublic ......tUSTiNSRUSSfLL • "R Health: x• ' 07,19/Z3 Oix (4)An.../4._ Signatu a o1r£Avironmental Health Specialist Date desi ners stamp, signatureand da te) ' p g , THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE revised 1 22'2314 .f 1Q STUBOU/CLEANOUT • PREMIER PLASTICS 1000-GAL SEPTIC TANK © PREMIER PLASTICS 100-GAL PUMP CHAMBER ® TIGHTLINE 52'+/- 5 VALVE BOX WITH VALVE PER POD 6 DOUBLE SLEEVED AND GROUTED TIGHTLINE © DRAIN FIELD INSTALLED WHERE DESIGNED PUMP CHAMBER DRAW DOWN = 1/8"/ MINUTE — — TIMER SET PER GLENDON DOSE VOLUME PER GLENDON If O DRIVE • • • APPROVED -• + I,�DRAIN CURTAIN A JAN 1 3 2023 0. EXISTING MASON COUNTY ENVIRONMENTAL HEALTH HOME I + z JBW 0 Q o O1 N J WATER LINE TO_7. ' •3 CO,,, O= 171 SE ARCADIA 0 pOp F' • "97. WATER i WAFER METERS I. II i 44 j Ph~. .F fl GAS �~� `/ LINE '' I b~y 22 10834 ��f 3 `'....,.IVi!�N soma j ' P..51 N R If „?llt. SHED onts,Z3 �3 CUT BANK TO• ~� ROADSIDE 0 30, '�,..DI`TCH —mom � ��� '1/pr. s8 x� ~� RECORD DRAWING %9 4)0 JIM HENRY SEPTIC DESIGN LLC. PO BOX 14531 TUMWATER WA 98511-4531 360-956-7242 CUSTOMER: TANYA LEWIS TAX PARCEL#: 32029-21-00130 SITE ADDRESS: 1819 SE HOLMAN ST LEGAL: LOT 6 ASHBURNS SUBDIVISION 2 PERMIT#: DATE INSTALLED: DATE INSPECTED: NOTE: THE PROPERTY OWNER IS RESPONSIBLE FOR KEEPING 2022-00307 1 1/3/22 1 1/5/22 THE FLOW OF SEWAGE AT OR BELOW THE OPERATING CAPACITY INSTALLER: OF 180 GPD AND SEWAGE QUALITY. Villines Excavation, LIc.