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HomeMy WebLinkAboutSWG2022-00542 - SWG As-Built - 4/3/2023 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2022-00542 Parcel # 22206-52-00039 Applicant Name SALTY GULCH C/O B-LINE CONS Subdivision (Name/Div/Block/Lot) Applicant Address 2971 E PHILLIPS LK LP RD City, State, Zip SHELTON, WA, 98584 Installer Name B-LINE CONST. Site Address 281 NE SNOWCAP DR Designer Name TOBY TAHJA-SYRETT INSTALLATION CHECKLIST i Full System Installation ❑ Tank(s)Only ❑ Drainfield Only ❑ Repair ❑ Other System Type PRESSURE Pretreatment Type N/A >5 ft. from foundation? - - ❑ N/A ® YES ❑ NO >50 ft. from wells? - - - ❑ e ❑ Z >50 ft. from surface water? - ez -- ❑ © ❑ FQ- Cleanout between building and tank? - - 3- - II ❑ ❑ U Tank baffles present? - ` - —z.4 2113 - ❑ 0 ❑ 1, P. 24" access risers over each compartment? -��`-r _- - -- - ❑ 0 ❑ -- W Effluent filter installed?- - - ❑ ® ❑ U) Septic tank capacity (working) 1200 E'.y Manufacturer SOUND PLACEMENT 0 D-box water level and speed levelers used? - - ® N/A ❑ YES ❑ NO �O Manifold/D-box accessible from surface?- - ❑ III ME Check valves installed? - - ❑ I ❑ thQ 2 Transport Line Size 2" Schedule/Class 40 Bedrooms installed (check one) ❑ 2 E 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10 ft. from foundation?- - ❑ N/A ® YES ❑ NO 0 >100 ft. from wells? - - ❑ 0 ❑ Ill >100 ft. from surface water? - - ❑ III >10 ft. from potable water lines?- - ❑ ■❑ ❑ Z > 5 ft. from property lines and easements?- - ❑ MI ❑ Q re > 30 ft. from downgradient curtain/foundation drains? - - ❑ 0 ❑ 0 Drainfield level and observation ports present - - ❑ © ❑ ❑ Graveless chambers or 0 Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ 0 ❑ Pump tank setbacks consistent with septic tank? - - ❑ N/A Q YES ❑ NO • Pump tank capacity (flood) 1475 gal Manufacturer SOUND PLACEMENT < 24" access riser(s)and accessible from surface?- - ❑ 0 ❑ H a Alarm or Control Panel Installed? - - 0 ❑ ❑ 2 Control Panel equipped with Timer/ ETM /Counter- - ❑ 0 ❑ m n- Pump installed in ❑ Bucket or ❑ On Block or 0 Other PUMP VAULT a• Pump Make/Model LIBERTY 280 0 Floats or E] Transducer a Tank draw down in/min Pump capacity gpm Squirt Height ft g6�► (� Pump on time Pump off time r/��A} ` Daily flow sett at�� gpd ` V1vn , -X.�C.4- UW QOXLS C.�C.�G l Uv/ Ir v-t t` ` \L �`M' 'Qk-C. e Updated r ' -1-.wL C. ;hiS� Co+�S��`�t °V\ dolltllllllmb. Mason County OSS Installation Report pg. 2 Parcel# ZZ Z o 6 — 5Z—O QO 3 t ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - YES NO If yes, please describe: Were all components pumped out and properly abandoned per WAC246-272A-0300? - - Ei YES Ei 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,cleanouts,and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and related permits. J I 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 Drawing is accurate. form and attached Record Drawing is accurate. 3-21 - 23 Signature of Installer Date -11:y(Or or•Gy 3\ Printed Name of Signee z MASON COUNTY PUBLIC HEALTH 5100299 '.CL The undersigned approves this Installation Report and O TOBY J.TAHJA-SYREIT F� LICENSED DESIGNER Record Drawing on behalf of Mason County Public Health: EXPIRES: 06/07/2Lf - (S( z5 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 B/21/2018 Za( NE SNOWCAP DR. i i - - WATER LINE L..... ..„, ____ ; a 1200 GAL PUMP TANK I 1200 GAL SEPTIC TANK APROX FUTURE HOME o co lev I RANSPORT LINE I PARKING 0 APROX PROP LINES MANIFOLD i le // ACCESS EASEMENT I �� �� / Oo� , 2 20' ram-- ' ' I ��o PRIMARY&RESERVE DRAINFIELD ±100' SOIL LOGS: SOIL LOGS A 0-42"GMS WITH POCKETS OF CSG APPROVED OVER TILL n, APR 03 2023 [irk l A0-48"GMS �, �t� WITH POCKETS OF CSG MASON COUNTY ENVIRONMENTAL HEALTh �� ':`�`. OVER TILL RET �• SEPTIC SYSTEM SITE PLAN -e ,,'1Y%- l' -•' _> '' p 3Y1•�f:Ji' 4 FOR: SALTY GULCH LLC JOB #: idli,i`E j' � ; PARCEL#: 22206-52-00039 DATE: 03 MARCH 2023 EXPIRES: oct ,I BY: TJS DESIGN PAGE 5 OF NORTH ARROW: SCALE: 1" = 30' 0 0' 30' 60' © B-LINE CONSTRUCTION, INC.