Loading...
HomeMy WebLinkAboutSWG2022-00492 - SWG As-Built - 2/3/2022 r111r■111• ;""...: Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2022-00492 Parcel # 42329-50-00124 Applicant Name BILL RINEHART Subdivision (Name/Div/Block/Lot) Applicant Address 900 SUNSET WAY City, State, Zip ISSAQUAH, WA. 98027 Installer Name SCHOENING EXCAVATION LLC Site Address 40 N DOW COURT, HOODSPORT Designer Name CINDY WAITE INSTALLATION CHECKLIST ❑ Full System Installation El Tank(s)Only 0 Drainfield Only ❑ Repair El Other System Type GRAVITY Pretreatment Type >5 ft. from foundation? - - ❑ N/A 0 YES ❑ NO >50 ft. from wells? - - _ ❑ El ❑ Z >50 ft. from surface water? - j1-IE-{ LE LL,,�_vi_ ui ) ❑ ❑D ❑ FQ- Cleanout between building and tank? - 0 Tank baffles present? - - -F-E-B- 0 3-2D23- -J. ❑ ID ❑ a24" access risers over each compartment?- - ( ❑ El DI Effluent filter installed?- ❑ El ❑ Septic tank size 1000 gal Manufacturer EXISTING 0 D-box water level and speed levelers used? - - ElN/A 0 YES ❑ NO XO Manifold/D-box accessible from surface?- _ ❑ 0 El 02 Check valves installed? - - ❑■ ❑ El 2 Transport Line Size 4 Schedule/Class 3034 Bedrooms installed (check one) ❑■ 2 ❑ 3 ❑4 ❑ 5 El 6 ❑Commercial/Other >10 ft. from foundation?- - ❑ N/A 0 YES ❑ NO O >100 ft. from wells?- - El El ❑ W >100 ft. from surface water? - - ❑ 0 ❑ LT.Z >10 ft. from potable water lines?- - ❑ ■0 I:: Q > 5 ft. from property lines and easements?- - ❑ © ❑ Ce > 30 ft. from downgradient curtain/foundation drains?- 0 ❑ ❑ 0 Drainfield level and observation ports present - - El ® ❑ gJ Graveless chambers or El Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ ® El Pump tank setbacks consistant with septic tank? - - ❑ N/A ❑ YES ❑■ NO • Pump tank size gal Manufacturer si Z < 24"access riser(s) and accessible from surface?- - ❑ ❑ ❑ a Alarm or Control Panel Installed'? - - ❑ ❑ ❑ Control Panel equipped with Timer/ETM/Counter- - El ❑ ❑ a Pump installed in El Bucket or ❑ On Block or ❑ Other a Pump Make/Model � El Floats or El Transducer Tank draw down a in/min Pump capacity gpm Squirt Height ft Pump on time Pump off time Daily flow set at gpd Updated 8/2 1120 1 8 Mason County OSS Installation Report pg. 2 Parcel# 42329-50-00124 ABANDONMENT RECORD Were existing septic components abandoned as part of this project'? - - Q YES 0 NO If yes, please describe: Were all components pumped out and properly abandoned per WAC246-272A-0300? - - Q YES 0 NO RECORD DRAWING This is a permanent record and must be accurate and descriptive enough to re-locate in the need of maintenance activities and future development. Typical Record Drawings contain Drainfield&manifold orientation&layout,Septic/pump tank location,North arrow,reserve drainfield.existing and proposed buildings,location of wells.waterlines, welts.observation ports.cleanouts,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 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. - / pP i 23.23 0 s i Signatu • of nstaller Date J %, "•S., TA f Printed Name of lgnee i 4�, s ►, \�` MASON COUNTY PUBLIC HEALTH i d. N The undersigned approves this Installation Report and ro 5 E4WAITE '7 1 Record Drawing on behalf of Mason County Public .v LICENSED DESIGNER 1� Health. �������� ��►��v� WPM\ r EXPIRES osrl0r Signature of Environmental Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Updated 8/21/2018 PPROVEA f r FEB 0 9 2023 4111111111 MASON COUNTY ENVIRONMENTAL HEALTH 3 tkik / Q I iv 19- re-4ksiP 3 e�If/,N7 0,d q a2,/Uw Ads #rM� 1.../l7 N Dow 07) 1 0/go .12/u4.74..7 cl<u.+ti L,1,2 33. 9-S0- ooiZ9 C9 €1.,ik rZ Ps'c Gt�c� ZU I yG' Gam' " 2 ' Q W 1' 3C • i ►1 No Q Ps s 'eb d CINDY E.WAITE LICENSED DESIGNER 1 LxPIRLS 05110,