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HomeMy WebLinkAboutSWG2023-00006 - SWG As-Built - 3/27/2023 Mason County OSS Installation Report pg. 1 a. C MASON COUNTY PUBLIC HEALTH APPLICANVOEFOTINFORMATION Permit Number SWG 2023-00006 Parcel # 22018-50-00105 Applicant Name K&K Proiects LLC Subdivision (Name/Div/Block/Lot) Applicant Address 3333 164th St. AW Apt. 112 Timberlake Div.1 Lot 105 City, State, Zip Lynwood, WA 98087 Installer Name T.J. Goos Site Address 561 E. Timberlake Dr. East Designer Name Dale L.Tahia INSTALLATION CHECKLIST J Full System Installation ❑Tank(s)Only 0 Drainfield Only ❑ Repair ❑Other System Type Pressure Trench Pretreatment Type >5 ft. from foundation? - 4 ❑ N/A YES ❑ NO >50 ft. from wells? - ` 4 / �-VI -. - ❑ © ❑ z >50 ft. from surface water? - - -BAR- - ��3 - ❑ ® 0 aCleanout between building and tank? - - - - - 0 ❑ V Tank baffles present? - -� - - - - �]■ ID - 24" access risers over each compartment?-- B -�- 0 0 a. . N Effluent filter installed?- - El ME Septic tank capacity (working) 1.250 gal Manufacturer Hagerman dO D-box water level and speed levelers used? ® NSA ID YES El NO � Manifold/D box accessible from surface? ❑ ❑ GdCheck valves installed? - - ❑ MI 2 Transport Line Size 2 inch Schedule/Class Sch. 40 Bedrooms installed (check one) ❑ 2 0 3 ❑4 ❑ 5 0 6 ❑Commercial/Other >10 ft. from foundation?- - ❑ NSA ® YES ❑ NO 0 >100 ft. from wells?- - 0 ® 0 W >100 ft. from surface water? - - ❑ ® ❑ Z >10 ft.from potable water lines?- - 0 0 0 ▪ > 5 ft. from property lines and easements?- - 0 0 0 >30 ft. from downgradient curtain/foundation drains? 0 0 0 O Drainfield level and observation ports present - - ❑ © 0 Pi Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?- - 0 0 ❑ Pump tank setbacks consistent with septic tank? - - 0 N/A ill YES ❑ NO • Pump tank capacity(flood) 1,000 gal Manufacturer Hagerman H • 24" access riser(s)and accessible from surface?- - ❑ 0 0 a Alarm or Control Panel Installed? - - ❑ 0 0 • Control Panel equipped with Timer/ ETM/Counter- - 0 0 0 a- Pump installed in ❑ Bucket or 0 On Block or ❑ Other 2 Pump Make/Model Liberty 290 0 Floats or ® Transducer an, • Tank draw down 2.25 in/min Pump capacity 50 gpm Squirt Height 10 ft Pump on time 2.8 min Pump off time 5 hrs 57.2 min Daily flow set at 270 gpd Updated 8/21/2018 Mason CountyOSS Installation Report pg. 2 Parcel# LC '`� ��r��'�`�' ABANDONMENT REbORD Were existing septic components abandoned as part of this project? - - 0 YES if NO If yes, please describe: Were all components pumped out and properly abandoned per WAC246-272A-0300? - - ❑ Ye8 ❑ NO RECORD DRAWING This Is a permanent record and must be accurate and descrrpttve enough to raloah In the need of maintenance activities and future development. T alRecord cord Drat*gs contain: Dratated 8 manIf Wagon,orientation a layout.Septic/pump tank agon,North anew reserve drat� proposedeid,editing and proposedbuildings,locationo and otw wells, rel waterlines, permits. wells,observation ports,deanouts,and other maintenance across points. Incomplete Record Drawings may create additional delays In Anal Installation• ■ 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 end that any deviations here have been cleared/approved by both the designer shown here have been cleared/approved by both end 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 containecion this 1 further certify that all information contained on this form and attached Record Drawing is fate. form and attached Record Drawing is accurate. 6 -1 \ /4t SignatureInstaller40, ! i Ak% ?. tc sli0G% S / I:Nr �? , Printed Name of Signee ',��'� a Ica 4. ti Z .A0 MASON COUNTY PUBLIC HEALTH / r',' .i. . The undersigned approves this Installation Report and o r 5100214 or•. Record Drawing on behalf of Mason County Public r+ O ' DALE L. TAHJA - , • •LIC NEED DESIGNER v Health: liooloa� _:':-i + I.►..����� y4 .\ -_ti\41-VV\e-111 I-2 —/f? —77 Signature of Environmental Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Updefi°812112151e .1 . .Ln9 1 ..=;;;<. „, ,,1 s'Cli3a ' .-I -Fitj,3 J--, 0 ,, • , • ,' 0 i . I \ _ . `i "(1. ...ii ..,,,, to ��� y . 11i 4 \`�. ` "'ta 0,4./ 1, ,+ , 6 t; .. , c)i s, c,0 ti c.,.. i , ..„;:c gp- <3 .....-0 d , -..\. N, \\\I\ \ -.4.. .`" t ''• ' N . . , -,,l'i'l dr. , • \./ v dr P; 1.4., 1 i ar , ,.. '.k, ,,, \ . - - v d ' so .6.: A # f . i \ ,c •• : '\ • . 0 k. -c>s'.9*-- 1KP \ (.• .• 40_ \ P 'ilk -14 44'.. ,">1-cs- COUN�ERNRApp0ON EVN ET \ MAR 2? � al* MASON MAgON 2423 • � •.. r M 0 • � O , RET HEALTH r , w , ' • el ��• ,f 1 �� 1 =7..�"� i.r: iil