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HomeMy WebLinkAboutSWG2022-00281 - SWG As-Built - 2/3/2023 7 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2022-00281 Parcel # 22113-23-00000 Applicant Name Travis Harder Subdivision (Name/Div/Block/Lot) Applicant Address PO BOX 94 City, State, Zip Grapeview,WA 98546 Installer Name Shumaker Construction Site Address 1474 E Grapeview Loop RD Designer Name Arrow Septic Designs INSTALLATION CHECKLIST • Full System Installation ❑ Tank(s) Only ❑ Drainfield Only ❑ Repair ® Other 50'Attenuation Zone System Type Shallow Pressure Pretreatment Type >5 ft. from foundation? - - ❑ N/A 0 YES ❑ NO >50 ft. from wells? - - ❑ M ❑ Z >50 ft. from surface water? - I -M-[ ---4 0 ❑ ❑ H Cleanout between building and tank? - - I ❑ ❑■ ❑ U Tank baffles present? - - -FEB _0-3-�23- -- - ❑ ❑I ❑ a24" access risers over each compartment. - - ❑ El W Effluent filter installed?- - ❑ ■❑ ❑ U) Septic tank capacity (working) 1 500 gal Manufacturer Hagerman Cl D-box water level and speed levelers used? - - 0 N/A El YES ❑ NO DO Manifold/D-box accessible from surface?- - ❑ ❑II■ ❑ mZ Check valves installed? - °.c 9 t.` '(e --144)."-s& - ❑ ❑I ❑ OQ 2 Transport Line Size 2" Schedule/Class 40 Bedrooms installed (check one) ❑ 2 ❑ 3 ❑4 ■❑ 5 ❑6 ❑Commercial/Other >10 ft. from foundation? - - ❑ N/A 0 YES ❑ NO 0 >100 ft. from wells? - - LI ❑■ ❑ —! >100 ft. from surface water? - - El ❑ ❑ W EC >10 ft. from potable water lines?- - ❑ ■❑ ❑ Z > 5 ft. from property lines and easements?- - ❑ ❑ ❑ Q a > 30 ft. from downgradient curtain/foundation drains? - - ■❑ ❑ ❑ Drainfield level and observation ports present - - ❑ ® El ❑ Graveless chambers or ® Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ It ❑ Pump tank setbacks consistent with septic tank? - - ❑ N/A ® YES LI NO Pump tank capacity (flood) 1 500 gal Manufacturer Hagerman Q24" access riser(s) and accessible from surface?- - El © El ~ Alarm or Control Panel Installed? - V\M-h Y10 U 5 e - El ❑ ❑ a 2 Control Panel equipped with Timer/ ETM /Counter- - El © ❑ D a Pump installed in ® Bucket or ❑ On Block or ❑ Other a Pump Make/Model Liberty 280 0 Floats or ❑ Transducer n. Tank draw down 1 in/min Pump capacity 26 gpm Squirt Height 5 ft Pump on time 5 min Pump off time 6 hr Daily flow set at 600 gpd Updated 812''20'E Mason County OSS installation Report pg. 2 Parcels 221 i 3- 23-O000 U ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - E YES ® NO If yes, please describe: Were all components pumped out and properly abandoned per WAC246-272A-0300? - - ❑ 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'. Grainfield&manifold orientation 8 layout.Septic/pump tank location,North arrow.reserve drairfield.casting and proposed buildings,location of wells,waterlines, wets,observation ports.cleanouts,and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and related permits. Sle e iitt'G . ( IAA: 12 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 1 further certify that all information contained on this I further certify that all information contained on this form and att e Drawing is accurate. form and attached Record Drawing is accurate. Signature of installer Date ' !l Printed Name of Signee :r.of ^J�f ' MASON COUNTY PUBLIC HEALTH `F z . The undersigned approves this Installation Report and •s`:_l. • Record Drawing on behalf of Mason County Public ct PAULA JOY JOHNSON !'{, LIC SI~lobriZ .ttEr .. ., ; Health: EXPIRES N-,\e.N--) 2-s- 23 Signature nyiron ntal Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Updated 8/2120/8 AShoi- 1t Tjrovis Halt d{ r Furt4iPrzz i3.23-OOo00 i'-174-1 &car nfircy hoof Rd Scott: ('`= co. 1 1 i 7 330.59' 0 30 00 90 120 r T f d Z - l;Sf hDL2 3 Sjs l 27" L5 -r root-S ciy h �� +o Soli-d -I-it► 2 `12" 'L5 +roofs © / , ,; ,\ -y , , ; ;; +o Cor -I-HZO we iI , , \ �(5) xG \\\,... / f f i nulry Dr. ___ 7 \/ IS M th reSVr v 5$R --______),'� . -,yzl.9Di © Mi s fto0s� :�_ - .� �' ® it — o � dOUJ nAn� PP 0 !1E befoul -i. FEB 04 2023 " 4. MASON COUNT' s' ' . _. Key: Audio-Visual Alarm-5a•.-, Q. ,. .., c, Cleanout ie. . �'. 0 15 00 Gallon Septic Tank II ,A...1 iti • 2-Compartment with . d 1.7 Effluent Filter '"?, s1c-s.0 O4 1500 Gallon PumpChamber N PAULA JOY JO �JN'"':ii 1C�H54't�t� �'`: " O Valve Control Box RE-SW� 2- 3-23 /331.03'