HomeMy WebLinkAboutSWG2021-00428 - SWG As-Built - 3/20/2023 C.0
Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH
APPLICANT/ PERMIT INFORMATION
Permit Number SWG 2021-00428 Parcel # 32003-11-90023
Applicant Name Paul Corbett& Debra McCawley Subdivision (Name/Div/Block/Lot)
Applicant Address 81 E Merioneth Rd
City, State, Zip Shelton, WA 98584 Installer Name Bill McTurnal Enterprises/ �s
Site Address 200 E Mason Lake Rd, Shelton Designer Name Arrow Septic Designs
INSTALLATION CHECKLIST
11 Full System Installation ❑ Tank(s)Only El Drainfield Only ❑ Repair ❑Other
System Type Shallow Pressure Pretreatment Type
>5 ft. from foundation? - O � �, - - ❑ N/A 0YES ❑ NO
>50 ft. from wells? - ❑ DI
• >50 ft. from surface water? tlr
Z -MV t na ❑ ii ID
H Cleanout between building and tank? - - CI0 CI
U Tank baffles present? - {Br' - ❑ * ❑
E- 24' access risers over each compartment?- - ❑ 0 Cl
a
W Effluent filter installed?- - ❑ 0 ❑
U,
Septic tank capacity (working) 1,250 gal Manufacturer Snyder
0 D-box water level and speed levelers used? - - 0 N/A El YES ❑ NO
oO Manifold/D-box accessible from surface?- - CII ❑
mZ Check valves installed? - - ❑ El ❑
ciQ
2 Transport Line Size 2" Schedule/Class 40
Bedrooms installed (check one) ❑ 2 ❑■ 3 ❑4 El 5 ❑6 ❑Commercial/Other
>10 ft. from foundation?- - ❑ N/A 0 YES ❑ NO
In >100 ft. from wells?- - ❑ I ❑
WCI>100 ft. from surface water? - - ❑ I
LT >10 ft. from potable water lines?- - ❑ 0 ❑
Z > 5 ft. from property lines and easements?- - ❑ 0 CI
ii > 30 ft. from downgradient curtain/foundation drains? - - 0 ❑ ❑
Drainfield level and observation ports present - - ❑ I ❑
❑ Graveless chambers or ® Clean gravel used? (check one)
Proper cover installed over drainfield?- - El 0 ❑
Pump tank setbacks consistent with septic tank? - - ❑ N/A ® YES ❑ NO
• Pump tank capacity (flood) 1,287 gal Manufacturer Infiltrator(1,060)
Z
24" access riser(s) and accessible from surface? -
❑ IN El
H
a. Alarm or Control Panel Installed? - - ❑ 0 ❑• Control Panel equipped with Timer/ ETM /Counter- -
CI I CICI- Pump installed in ❑ Bucket or ❑■ On Block or ❑ Other
a• Pump Make/Model Zoeller N152 ■❑ Floats or CI Transducer
0-
a Tank draw down 2.25 in/min Pump capacity 57 gpm Squirt Height 2 ft
Pump on time 1.5 Minutes Pump off time 6 Hours Daily flow set at 360 gpd
Updated 8/21.2018
Mason County OSS Installation Report pg. 2 Parcel# 3100-5'11— ct 00 23
ABANDONMENT RECORD
Were existing septic components abandoned as part of this project? ❑ YES ' NO
If yes, please describe:
Were all components pumped out anc properly abandoned per WAC246-272A-0300? 0 YES 0 NO
RECORD DRAWING
•
This is a permanent record and Met be accurate and descriptive enough to re-locate In the need of maintenance activities and future development Typ'tal Retort
Drawngs costa n oreintield 8 manifold orientat on&layout.Sepoctpunp tank location.North arrow.rese-:e d:ainfield.existing and proposed buidirvis,locebon of wens,svater1nes.
wells observation perts,deenoats,end other maintenance access ports. Incomplete Record Drawings may create additional delays in final inateleton approval and related permits.
See ik-tt-ac,h.ec APPROVED
MAR 2 0 2023
MASON-COUNTY ENVIRONMENTAL HEALTH
JBW
Ill Record Drawing Attached
CERTIFICATION OF INSTALLATION
INSTALLER DESIGNER/ENGINEER
. l 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 1 further certify that all information contained on this
form and attached Record�} Drawing is accurate. form and attached Record Dravrng is accurate.
�t,i _ '1 a 1 -L.0 2,?
S nafum of Installs Date
rS7 ,5'tl
Printed Na The of Signee �� `,,,4stis
Mil MASON COUNTY PUBLIC HEALTH '' y; 11 .? h
1 •.�/..
The undersigned approves this Installation Report and f1 tr.:. � >
Record Drawing on behalf of Mason County Public a-f s,G03.9 c�`'4i
PAULA JOY JOHNSON . ••
r
L1C TDESI EFf t`
•i,\„. 320)- 3, 5- z
3
Signs re cif ronmental Health pecialist Date (stamp, signature and date)
J THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE °P e'2t12p1E
i
r
._.gSvb
. , / ..
. . . ' / PPRO E
et --V:=ftft- -v/J MAR 20202 '
,.i4SON COUNTY ENVIRONMENT AL HEALTH
0....
/cJ
bo / JBW
a
20 jAu
Tr
iyo` / ® r` • 7'
Diltin.
CV 'lint,. ! Cn
ti retk I /
4� f /
sly
7//
h 1 �� �
� i ,, (r.
1 M jj
' �...
---- p
1
/ I
/ I
I/
•
/ 0 Audio-Visual Alarm \ 56'—
r---- 3 Cleanout 1 / 4�J-ELL
0 1200 Gallon Sep'dc Mink
2-Compartment with ".(e)
Effluent Filter -
/ 0 1000 Gallon Pump Chamber Za'
/ O Valve Control Box
/ Sc .= t'- goo-
0 3.0 v o qo 1?SS
(Li) 3'�50' 9rtw�ar�p,5-C'����� d r„,.,ie, , , -r-t-n ckn t-5 /4/4,.si,
0 ('or `{' lC la) 5' d c W t"'(\rt. •*..•y; �r
trt c4 ?�3 11•�00 Z_.__ r�SZr v below + ..4 _ •.0y.
l nn {�/� Q'�� • - &.13184Akt°J
!�' s1e�aas
2,V 0 E ,l t� - PYJOHNS . .�,
SON '�sa°5NR• ) .
PRE
3-3-23