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HomeMy WebLinkAboutSWG2021-00310 - SWG As-Built - 2/1/2023 CLEAR FORM Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2( OlJ 7/6 Parcel # 32e)2, ts30 3 ooy Applicant Name /40u1 / -steit(/ Subdivision (Name/Div/Block/Lot) Applicant Address 3y( 7 SL-/tfIUck (S /-4cr City, State, Zip 5 ��G, v- -4 Installer Name I ' / /41Wai / Site Address /30 /Y/!(/) ,/ Designer Name /l-Li-j1/ )j INSTALLATION CHECKLIST ✓[YFull System Installation ❑Tank(s) Only ❑ Drainfield Only ❑ Repair ❑Other System Type Pretreatment Type >5 ft. from foundation? ----- W' pi - ❑ N/A El4ES ❑ NO >50 ft. from wells? - `r - ❑ (]/ ❑ Y - - - - 1 Z >50 ft. from surface water? -FER- 1- : 3- ri 0 [r 0 Cieanout between building and to . -- - - [!. CI V Tank baffles present? - BT- - - - - - 37-- ❑ Br a 24"access risers over each comp rrment?--- - - -JAR, 3 ❑ ❑ W Effluent filter installed?- t - -- - -- - - a EK ❑ co Septic tank capacity (working) /ZS`el gitly anufacturer / L L` d7i/ O D-box water level and speed levelers used? - - ❑ N/A _[ YES ❑ NO oOManifold/D-box accessible from surface?- - ❑ [ ❑ C Check valves installed? - - ❑ ❑ ETransport Line Size " Schedule/Class 33Y Bedrooms installed (check one) El 2 [ h ❑4 ❑ 5 El 6 ❑Commercial/Other >10 ft. from foundation?- - ❑ N/A ErcES ❑ NO CI >100 ft. from wells?- - ❑ Er ❑ W >100 ft. from surface water? - - CI 10 CI u >10 ft. from potable water lines?- - ❑ ❑ Z > 5 ft. from property lines and easements?- - CI 1:1/ CIDE > 30 ft. from downgradient curtain/foundation drains? - - 0 [V ❑ Drainfield level and observation ports present - - ❑ LV ❑ ErGraveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ 0-' ❑ Pump tank setbacks consistent with septic tank? - a - (C - IX N/A ❑ YES ❑ NO • Pump tank capacity (flood) gal Manufacturer Q 24" access riser(s) and accessible from surface?- - ❑ ❑ ❑ t` a Alarm or Control Panel Installed? - - CI CI E Control Panel equipped with Timer/ ETM /Counter- - ❑ ❑ ❑ m n- Pump installed in ❑ Bucket or ❑ On Block or ❑ Other EPump Make/Model ❑ Floats or El Transducer eL a Tank draw down in/min Pump capacity gpm Squirt Height ft Pump on time Pump off time Daily flow set at gpd Updated 8/21/2018 A k ' . . . • • • • t .T. 1 . . ( -.- - .' it---1 - ' .. . \ ._ - Z . . \\ \ 2 \\ \\ \ v \ \ \ ' \ \ Ul ... • 41 ; W , \ . I' . .': . \ \ \ \ \ -7 \. ki 5 N -.Z-- \\\ \\\ \ \ \\?-\ \ \ \ ilx. \ \ \ \ \ \ .,--- . - if\ - - -- ,,,,,,,,,„.-.-&----:'`''''..°'‘td•r` C. ,,.., • . \ n 3,9a, 4 1• Ae : . . -Tv . ,, .."---D § rZ1 Xi r,.. , / , ,.... / • . • ---, 3:- rti i . 1: , . . 1. I . . . . • sy)... 712,77... t •--1.1.1'(':C.1(,)S.P; ii‘ .4,•v1. 1 4? PI '4,R1 `-s: - • • • w wags-40 1 • ,..,.. 4...s. . p, LI 0 . P 3 it 1 • • N •U] 1 Li . . 0 r7131 0 0 X c 8' ' th ,.,. 13 P x o ..'N•;‹ ‘.13 01 93 c; › ' n . ...r ft. 1 --- - 'I • Oz. 8 . -: .. ir- g .c›...... i 1 ....... I . it > • a I u r ... 3 . o o 1:4---1 7) Il F • -.... •-•••-, - . . f4,1Qi=(' cii1 3 - . - . .