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HomeMy WebLinkAboutSWG2020-00611 - SWG As-Built - 2/21/2023 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION --___._-_- - . Permit Number SWG 2020-00611 Parcel # 51901-41-90020 Applicant Name Terry&Joanne Ochsner Subdivision (Name/Div/Block/Lot) Applicant Address 584 W Lakeside Dr. r..._ City. State; Zip Shelton, WA 98584 Installer Name Manke Excavating ► D Site Address 83 W Lost Lake Park Ct, Shelton Designer Name Arrow Septic Designs nc N in,_j INSTALLATION CHECKLIST © Full System installation ❑Tank(s)Only E Drainfield Only ❑ Repair ❑Other System Type Sand-Lined Pressure Bed Pretreatment Type >5 ft. from foundation? - - ❑ N/A El YES ❑ NO >50 ft. from wells? - - 0 ❑ Cl Z >50 ft.from surface water? - - ❑ El FCleanout between building and tank? - - ❑ 0 Cl 0 Tank baffles present? - - ❑ ❑■ ❑ F— 24' access risers over each compartment?- - ❑ 0 ❑ W Effluent filter installed?- - ❑ 4 ❑ N Septic tank capacity(working) 1,200 gal Manufacturer Sound Placement 0 D-box water level and speed levelers used? - - 4 N/A ❑ YES ❑ NO DJ O Manifold/D-box accessible from surface?- - ii CI CI mZ Check valves installed? - - ❑ 4 ❑ o a 40 2 Transport Line Size 2" Schedule/Class Bedrooms installed (check one) ❑ 2 0 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10 ft.from foundation?- - ❑ N/A El YES ❑ NO 0 >100 ft. from wells?- - ❑ ❑ ❑ W >100 ft. from surface water? - - CI0 CI LL >10 ft. from potable water lines?- - ❑ CI ❑ z > 5 ft. from property lines and easements?- - El0 CIcc fY > 30 ft. from downgradient curtain/foundation drains?- - 0 ❑ ❑ CI Drainfield level and observation ports present - - ❑ ❑ ❑ ❑ Graveless chambers or 0 Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ ■❑ ❑ Pump tank setbacks consistent with septic tank?- - ❑ N/A ❑■ YES El NO Pump tank capacity (flood) 1,000 gal Manufacturer Sound Placement < 24" access riser(s) and accessible from surface?- - ❑ 0 ❑ 0. Alarm or Control Panel Installed? - - ❑ U ❑ 2 Control Panel equipped with Timer/ETM/Counter- - ❑ 0 CI n n- Pump installed in ❑ Bucket or 0 On Block or ❑ Other a Pump Make/Model Liberty 290 0 Floats or CI Transducer a. a Tank draw down 2 in/min Pump capacity 44 gpm Squirt Height 8 ft Pump on time 2 min Pump off time 6 hr Daily flow set at 360 gpd U adated a2'2013 Mason County OSS Installation Report pg. 2 Parcel# S( qo 1 - Li t- I oo w ABANDONMENT RECORD Were existing septic components abandoned as pan of this project? - YES X NO If yes, please describe: NO Were all components pumped out and properly abandoned per WAC246-272A-C300? - - E YES 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, wells,observation ports,deanouts,and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and related permits. S U, .al--/-4,c-he--6L A PPRovE FEB 2 1 ?023 1ASOP4 COUNTY EA, VIR O VMENTAL HEALTH JBw Z Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ ENGINEER 1 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. /11f' ( 1/ /D ZZ fr- ighature Installer Date A!r .� q. Printed Name of`Signee `,' • {J MASON COUNTY PUBLIC HEALTH fir; The undersigned approves this Installation Report and ' • t'e Record Drawing on behalf of Mason County Public yra PAULA eJU Y;G NSON ' He t C `S0.T; iGN�i ' . -�c�Y:S-� � D +w RES OgriT� -Z� 2�j ( .24t-- ZA . Sign to 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 821;2018 . Lfai • • `• 30 6o a o :2.0 • 0 • • I 10`r3(01 Pr;?not y 511 1-41-1Q0 .. tr- --:::::A;„-...._ '240 "D-F. e.ci. u)/ • M' 1 ID`X36 RQS p,T8a4 _i.e ( 4 � ✓ R►•taJ 4 5leeqe wit'' 3o'r3o' l;,nee e,,n , 3�' , - ?,-.'��k -}a.�ks -cvo,,M ,:r, t0 W - a.-41 c o✓ cs$•e c V (X0e01 • }..a.44";c. V a,{'ea! • 5 LGMgOSi)464*' 0 ii p "Len - r % to •• Audio-Visual Alarm 3 r Cleanout , '� - z4 O 5• 1 ' 5 e-�-ba�1G 3 r M �, k•3vt wa cY 0 1200 Gallon Septic Tank n- 2-Compartment with -- i / Effluent Filter w, • 0 1000'Gallon Pump Chamber AC S moo ' eas2 e,w, K,� �- Y ;v1SYesS, I I,V�'µ L�:3 v, u, r e�re55 �;1i 1:e ' in 1. P. -ca.v0- C \o a . ! ‘x ' .5" is �� ' .,., •' / .j - we ",. 4,..1-;,,,. ,,, ,..i : , , i..:.,(,,- , ..-1 -N. - ,:.:: -..v: et..F.,AULA JOY JOHNS.ON ' •. ` �s �.3 4fi ` ' EXPIRES 11 0 t .4', t (-t,- Z2 ' 1o' 0) 160 - II. l