Loading...
HomeMy WebLinkAboutSWG2022-00499 - SWG As-Built - 3/30/2023 Mason County OSS Installation Report pg. 1 C1 • C MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2022-00499 Parcel # 31908-33-00010 Applicant Name C & K RV LLC (St,x. c-e) Subdivision (Name/Div/Block/Lot) Applicant Address 311 E Way To Tipperary TR 1 of SW SW City, State, Zip Shelton, WA 98584 Installer Name Rainier General Development Site Address 120 SE Brewer Rd Designer Name Arrow Septic Designs INSTALLATION CHECKLIST IN Full System Installation El Tank(s)Only El Drainfield Only ® Repair ❑ Other System Type Sand-Lined Pressure Bed Pretreatment Type >5 ft. from foundation? - ❑ N/A ❑■ YES Li NO >50 ft. from wells? - - r -t�-±I- I ❑ 00 z >50 ft. from surface water? - - ❑ 0 CI • Cleanout between building and tank? - - - - MAR 22_202.3--J ❑ U ❑ ✓ Tank baffles present? - ❑ 0 ❑ a24" access risers over each compartment. $y CI 0 CIfW Effluent filter installed?- - CI ❑■ CI Septic tank capacity (working) 1250 gal Manufacturer Evergreen Precast D-box water level and speed levelers used? - - 0 N/A ❑ YES ❑ NO oO Manifold/D-box accessible from surface?- - ❑ 0 ❑ mZ Check valves installed? - v m t - ❑ ❑■ ❑ OQ E Transport Line Size 2" Schedule/Class 40 Bedrooms installed (check one) ❑ 2 ❑ 3 ❑4 El 5 0 6 ❑Commercial/Other >10 ft. from foundation?- - ❑ N/A 0 YES ❑ NO p >100 ft. from wells?- - ❑ ❑■ ❑ W >100 ft. from surface water? - - CI 0 CI it >10 ft. from potable water lines?- - ■❑ ❑ El Z > 5 ft. from property lines and easements?- - El 0 ❑ cc > 30 ft. from downgradient curtain/foundation drains? - - 0 Cl ❑ o Drainfield level and observation ports present - - ❑ © ❑ ❑ Graveless chambers or ® Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ ❑■ ❑ Pump tank setbacks consistent with septic tank? - - ❑ N/A In YES ❑ NO Pump tank capacity (flood) 1900+ gal Manufacturer Evergreen Precast Z < 24" access riser(s) and accessible from surface?- - ❑ I I ❑ I` a Alarm or Control Panel Installed? - - ❑ El ❑ 2 Control Panel equipped with Timer/ ETM/Counter- - ❑ 0 Cl D n- Pump installed in El Bucket or ❑ On Block or 0 Other Tube n' Pump Make/Model Franklin t?F50o5Ii 0 Floats or ❑ Transducer a a Tank draw down 1.5 in/min Pump capacity 50 gpm Squirt Height 9 ft Pump on time 1.8 min Pump off time 3 hr Daily flow set at 720 gpd Updated 8/21/2018 Mason County OSS Installation Report pg. 2 Parcel # 31 ga $' 33'00 0 I 0 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - ® YES D NO If yes, please describe: ..) Q .' ' -, 0 a-- �;";NeL Were all components pumped out and properly abandoned per WAC246-272A-0300? - - El 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: Drainfield&manifold orientation&layout,Septic/pump tank location,North arrow,reserve drainfield,existing and proposed buildings,location of wells,waterlines, wells,observation ports,cieanouts,and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and related permits. See ® 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 form and attached Record Drawing is accurate. form and attached Record Drawing is accurate. 3 - 13_ Z3 Signature of lnst Date Printed Araime of Signee • MASON COUNTY PUBLIC HEALTH ,' r '• The undersigned approves this Installation Report and ` $10649 Record Drawing on behalf of Mason County Public ♦• • PAULA JOY JOOHNSON'••?' Health: L = S 3•'IDrtlicsvm••���� `�� 01. f\u m v 3/30/2 3 - 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 Updated 8/21/2018 r . 3 G o r M i1 © _J `� • y O 0Audio-Visual Alarm NI �� l=. /(J�1 Cleanout \.- . 0 Existing 1,200 Gallon Single-Compartment Tank Use as1 Solids Chamber of Septic Ta ilc 4) New 1,200 Gallon Single-Compartment Tank Use as Liquid/Clear Chamber of Septic Tank 9X D F O New 1,800 Gallon Single-Compartment Pump Tank ® 1 0Zone Distribution Valve 11 9 x To DF 9xSo C.) / ' Ras. . , r I; 0o -NsA-0 `ere- r Cla ( .Q•C,aw\\W'ON"-'41 / a i &42") rew....0 Vel,-- LI) \ cA ( 1 I `4 • ,4\PPROVED ® kMAR 3 0 2023 MASON UNnENVIRONMENTAL HEALTI Serf,/ RE f sti - S\.e.�e,•re co.. eS cA`r.t 3 c.c` 1). 0, 1 ; 1 . .• o (] LS Sp -�S (o o D. .0,*4 itit,A, 215 u I+ .s, iv... ri. :..,, SLR -L c.e. .V.,\1 ()J 0i*'-ktN.� :-;), 51O0349 Pa c ) 3 l/o Q - S 3 COO( o Y�o� PAULA JOY JONNSON 1r L+ • JS brSiGNE t" WO sE 4?)re.w4.c- , sj•e-C 3.3` -Z,3