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HomeMy WebLinkAboutSWG2021-00612 - SWG As-Built - 3/9/2023 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2021-00612 Parcel # 32021-59-01003 Applicant Name Accurate Development Inc Subdivision (Name/Div/Block/Lot) Applicant Address PO Box 76 SHORECREST BEACH ESTATES#2 BLK: 1 LOT: 3 City, State, Zip Allyn, WA 98524 Installer Name South Shore Construction Site Address 391 E Parkway Blvd, Shelton Designer Name Arrow Septic Designs, Inc INSTALLATION CHECKLIST El Full System Installation ❑Tank(s) Only ❑ Drainfield Only ❑ Repair ❑Other System Type Shallow Pressure Pretreatment Type >5 ft. from foundation? - 1 E c E[1\\- • N/A El YES ❑ NO >50 ft. from wells? - J - J ❑ ❑ t Z >50 ft.from surface water? - Mai-0 6 20 p ❑ ❑ HCleanout between building and tank? - -- - - ■ - III I ❑ U Tank baffles present? - - - -- ,- -- - - II ❑■ ❑ H 24" access risers over each compartment?- - By - - - r ❑■ ❑ a ❑ 0 ❑ W Effluent filter installed?- - cn Septic tank capacity (working) 1,250 gal Manufacturer Hagerman 0 D-box water level and speed levelers used? - - [:1 NIA El YES ❑ NO J oO Manifold/D-box accessible from surface?- - ❑ I ❑ m2 Check valves installed? - - ❑ II ❑ oa 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 a YES ❑ NO 0 >100 ft. from wells?- - ❑] ❑ ❑ W >100 ft. from surface water? - - ❑I■ ❑ ❑ ti >10 ft. from potable water lines?- - ❑ ❑ ❑ Z > 5 ft. from property lines and easements?- - El • ❑ a ❑ 0 ❑ w > 30 ft. from downgradient curtain/foundation drains? - - 0 Drainfield level and observation ports present ❑ 0 El ® Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ 0 ❑ Pump tank setbacks consistent with septic tank? - - ❑ N/A ❑ YES ❑ NO • Pump tank capacity (flood) 1,250 gal Manufacturer Hagerman < 24" access riser(s) and accessible from surface?- - ❑ ® ❑ H a Alarm or Control Panel Installed? - - El 0 ❑ 2 Control Panel equipped with Timer/ ETM /Counter- - ❑ I. ❑ D 0- Pump installed in ❑ Bucket or ® On Block or ❑ Other d Pump Make/Model Liberty 290 0 Floats or ❑ Transducer a • Tank draw down 2.5 in/min Pump capacity 55 gpm Squirt Height 6 ft Pump on time 1.5 min Pump off time 6 hr Daily flow set at 7 gpd Updated 8/21/2018 Mason County OSS installation Report pg. 2 Parcel# 320 21 - 5ci — 01 003 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - 0 YES • NO If yes,please describe: Were all components pumped out and property abandoned per WAC246-272A-0300? - " 0 YES 0 NO RECORD DRAWING . . 7hla Is a permanent word and must be accurate and descriptive enough to re-locate In the need of maintenance activities and future development. Types fiord Drawings contain: Drainfield&manifold orientation&layout,Septc/pump tank location.North arrow.reserve dra:field.existing and proposed •location dwells,waterfoas, weus•cpsenmtort ports,clematis,and other maintenance sccass points. Incomplete Record Drawings may create additional delays in 5nal instable.=approval and related Permits. r , ', . • • . . . . . . . . . . • 14 Record Drawing Attached - 47;- -.CERTIFICATION OF INSTALLATiON . :i:._ l :..r.. INSTALLER DESIGNER!ENGINEER I certify that I installed the system in accordance with 1 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- !further certify that all information contained on this 1 further certify that all information contained on this fo atta eel R rowing is a curate. form and attached Record Drawing is accurate. Z-$-L3 Signature of Installer Date ;NJ, Printed Name of Signee ��J' 0.. . .„,.....,c,„ MASON COUNTY PUBUC HEALTH •� ~' The undersigned approves this installation Report and f� t�v Record Drawing on behalf of Mason County Public yrGjt tStt10319 •PAULA JOY JOHNSON*•.'' Health: X1cc14 • Signature of Environmental liteatth Specialist Date (stamp,signature and date) _ ' THiS FORM MAY BE SCANNED AND AVAILABLE FOR PUBUC VIEW ON THE MASON COUNTY WEB SiTE Updated 812112018 i„,,, ..-:s.e")...... A -c-p 1 (pi Stop © r ( 2 SN"" _ _ — �� G-SL — ` _ 3' X Soy 0 - � 2 �- , - _ — Km _ `� 9-Q..Sesre' EDAudio-Visual Alarm mow(? h Cleanout 0 125 0 Gallon Septic Tank 14 14 2-Compartment with " Effluent Filter D \` 0 12SO Gallon Pump Chamber ' V J ` N gaio 0 c,....,(*), %)y-e.,x^s io L.),9• \- ,,n, ` off,,"'`— L Q J 111 g CI 1 Lek 3 -- -- �a-4 k' coat '3lv k C . S csL�e. . 1 't 2-CDr A A pp , it MAR Lc� � v - P - ;. ,�. MASON 0 9 2023 .;� �., COUNTYENV1RONM °as-cQ0:"32.0 2.A - 5G1- o f Do 3 ,x, � L�' r\� ENrgl �,.6. REr HEAL rH 9 I tP�- zU...u�.; �. 51;,I' 0349 •.*C�`J ` E- PAULA JOY JOHNSON .."In l'IC�H '1, SfGNiffi ' - ',-Z3