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SWG2022-00279 - SWG As-Built - 2/21/2023
:f VIS �MasonCounty OSS Installation Re 1 Q 9 1 021 MASON COUNTY PUBLIC HEALTH APPLI\ T/ PERMIT INF• : •' •TION Permit Number SWG 2022 00279 �arcel # 12206-31-90082 Applicant Name Woo Shin Subdivision (Name/Div/Block/Lot) Applicant Address 34731 21 st Ave SW City, State, Zip Federal Way, WA 98023 Installer Name Final Vision Inc. Site Address 200 East Cove View Dr, Belfair, WA Designer Name Rod Left INSTALLATION CHECKLIST Q Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑ Repair ❑Other System Type lPP,ESSURE Pretreatment Type >5 ft. from foundation? - - ❑ N/A ❑■ YES ❑ NO >50 ft. from wells? - - ❑ II 0 Y >50 ft. from surface water? - - ❑ El ❑ Z • Cleanout between building and tank? - - ❑ 0 ❑ U Tank baffles present? - - ❑ ❑■ ❑ a24"access risers over each compartment?- - ElEl ❑ W Effluent filter installed?- - ❑ ® 0 cn Septic tank size 1500 gal Manufacturer INN 11-tiN O4% o D-box water level and speed levelers used? - - ■ N/A ❑ YES ❑ NO ><O Manifold/D-box accessible from surface?- - It El El co Check valves installed? - - ❑ III ❑ 0< 2 Transport Line Size _ 2" Schedule/Class 40 Bedrooms installed (check one) ❑ 2 ❑3 El4 ❑ 5 ❑6 ❑Commercial/Other >10 ft. from foundation?- - ❑ N/A 0 YES ❑ NO >100 ft. from wells?- - ❑ ❑■ ❑ o w >100 ft. from surface water? - - El ❑■ El LL >10 ft. from potable water lines?- - ❑ El ❑ Z > 5 ft. from property lines and easements?- - ❑ ❑■ ❑ Q re > 30 ft. from downgradient curtain/foundation drains? - - ❑ IN ❑ o Drainfield level and observation ports present - - ❑ ® ❑ ® Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ ❑ ❑ Pump tank setbacks consistant with septic tank? - - ❑ N/A ® YES ❑ NO Y Pump tank size ISO° gal Manufacturer 1,14VM \ Oe% < 24"access riser(s)and accessible from surface?- - ❑ El ❑ n. Alarm or Control Panel Installed? - - ❑ ® ❑ 2 Control Panel equipped with Timer/ETM/Counter- - ❑ El ❑ d Pump installed in ❑ Bucket or • On Block or ❑ Other Q. At Pump Make/Model LAt›E ' 2.0k0 El Floats or ❑ Transducer a Tank draw down 1.5 in/min Pump capacity 48 gpm Squirt Height 6' ft Pump on time 1 min 15 sec Pump off time 3 hours Daily flow set at 480 gpd Updated 8/212018 I Mason County OSS Installation Report pg. 2 Parcel# 1220fo -31-ci00b2- ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - ❑ YES Or NO If yes, please describe: Were all components pumped out and properly abandoned per WAC246-272A-0300? - - ❑ YES �/� ❑ 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: Drainfleld&manifold orientation&layout,Septic/pump tank location,North arrow,reserve drainfield,existing and proposed buildings,location of wells,waterlines, wells,observation ports,cleenouts,and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and related permits. APPROVE FEB 2 1 2023 MASON COUNTY ENVIRONMENTAL HEALTH JBW 0 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 fon, nd attached Record Drawing is accurate. form and attached Record Drawing is accurate. LQ/Ob0,2) - Si ature of Installer Date GS art Jr/114u, Cf--- f Printed Name of Signee �0)10 �/ r MASON COUNTY PUBLIC HEALTH lj' m:—` The undersigned approves this Installation Report and 11~•;•.ems : " ` Record Drawing on behalf of Mason County Public ,�I� R;�;yT& v Healt . .• •. 411 J t =, ►iiiiii�, (.„.„, LI ���'1....„I 2'21-Z3 ET.„s rL_ L S try Signature .f n . mental Health� Specialist l IL P Date (stamp, signature and date) J THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Updated ar2112o18 c > p O Z > > C O r-rrr mm m m -1mO cn czo my 0 > DzC rpc m= m UI0 O r m D :U X z(n o m23 m O O K LJ(!) m m z m m m -4 cn g' zzi Z oo _ z o (7)1 cn �O O �, OD D O �� o cn cn --i mm —I(f) m m7) -_I �7 DyC 13 z z M > WZZZ m< 7:3 � � 0 m m 2 " I Orn o)m 71 v, O o � _ mD = O zN om Z r- Nrn Z —I --I- C -0 7- m � CoDD Z M O C3 m 2 m (n •2s2.o5 i o z m r m � --I m � � CO m z D O `- • V‘ ,� -<Hv,70 z � n cn A m W y C \\\\\\ I- t m Sao^� = m0 cn m � � c m � )3 m O �m $) v Li)(n m m y� O � C * �m z N Q N m N 9' g o 00000 0�© ,4 u u u u a .. 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