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HomeMy WebLinkAboutSWG2022-00045 - SWG As-Built - 4/10/2023 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2022-00045 Parcel# 22302-41-00200 Applicant Name Ron Carter Subdivision (Name/Div/Block/Lot) Applicant Address 1394 Marlin Dr SE TR 20 OF SE City, State, Zip Port Orchard,WA 98366 Installer Name Shumaker Construction Site Address 170 NE Toonerville Dr Designer Name Arrow Septic Designs COUArkit- INSTALLATION CHECKLIST IN Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑ Repair ❑ Other System Type Pressure Bed Pretreatment Type >5 ft.from foundation? - - ❑ N/A ®YES ❑ NO >50 ft. from wells? - - ❑ II ❑ Z >50 ft. from surface water? - - ❑� ❑ ❑ H Cleanout between building and tank? ^ 1?- ', [] © ❑ ✓ Tank baffles present? - -E4-u---- ❑ IN ❑ F- 24" access risers over each compartment?-- - - ❑ ® ❑ W Effluent filter installed?- -MAR_ 2_-[LL ' 0 In ❑ co Septic tank capacity(working) 1,200 qqal Man%ct firer Hagerman In D-box water level and speed levelers used? ----- N/A ❑ YES ❑ NO p0 Manifold/D-box accessible from surface? - ❑ NI ❑ m= Check valves installed? - .Q}- *-y'="J(L - ❑ II ❑ GQ 2 Transport Line Size 2 inch Schedule/Class 40 Bedrooms installed (check one) ❑ 2 ❑ 3 0 4 ❑ 5 ❑6 ❑Commercial/Other >10 ft. from foundation?- - ❑ N/A ® YES ❑ NO 0 >100 ft. from wells?- - ❑ II ❑ W >100 ft.from surface water? - - 0 ❑ ❑ u. >10 ft. from potable water lines?- - ❑ 0 ❑ z > 5 ft. from property lines and easements?- - ❑ I] ❑ Q cc > 30 ft. from downgradient curtain/foundation drains?- U ❑ ❑ Ci Drainfield level and observation ports present - - ❑ ® ❑ ❑ Graveless chambers or U] Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ 0 ❑ Pump tank setbacks consistent with septic tank?- - ❑ N/A Ul YES ❑ NO • Pump tank capacity (flood) 1,200 gal Manufacturer Hagerman < 24"access riser(s) and accessible from surface?- - ❑ 0 ❑ d Alarm or Control Panel Installed? - - ❑ Q ❑ 2 Control Panel equipped with Timer/ETM /Counter- - ❑ ® ❑ n- Pump installed in ® Bucket or ❑ On Block or ❑ Other a• Pump Make/Model Liberty 280 0 Floats or ❑ Transducer aTank draw down 2 in/min Pump capacity APPRrrOSViEpt 7 ft Pump on time 2.14 minutes Pump off time 6 hours Daily flow set at 360 qpd APRI 0 2023 Updated 8.2112018 MASON COUNTY ENVIRONMENTAL HE.ALTl DJ A Mason County OSS Installation Report pg. 2 Parcel# 22302-41-00200 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 properly abandoned per WAC246-272A-0300? - - Q YES El NO RECORD DRAWING Thls 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: DranneId&manifold orientation 6 layout,Septicipump tank location,Noah arrow,reserve drainfield,existing and proposed buildings,location of wells,waterlines, wells.observation ports,deanouts,and other maintenance access points. Incomplete Record Drawings may create additional celays inhnai installation approval and related permits. 0 II Record Drawing Attached CERTIFICATION OF INSTALLATION 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 I further certify that all information contained on this I further certify that all information contained on this form and eel Record Drawing is accurate. form and attached Record Drawing is accurate. Signature of Installer Date A a.if 5 U, 4% Printed Name of Signee �•�., !'t MASON COUNTY PUBLIC HEALTH •',1 t I\ 421/1.4 The undersigned approves this Installation Report and W1 �_ I Record D - '•g on behalf of Mason County Public ,l`� Sl%,349 ' _•,fl _ �-r� PAULA JOY JOf iNSpN '�\� Health A P P O 1 L e:NMIti'fii•SiGi4rn•• ',I /e/17- Sly--tore of Environmental Health Speci 1 41: (stamp, signature and date) THIS FORM mIttASelsCa EQ AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Updated 8/21/2018 liks CID Audio-Visual Alarm a a — — _ /a S 1 n 3 Cleanout 50' % S , 3 1200 Gallon Septic Tank lit 8 0 �,2-Compartment withco s o © 0, v, Effluent Filter k _Y 6, 11 3 1200'Grallon Pump Chamber 10 t �G�Scab 1' = 4a1 • ° $° APPROVED R,,, CiL. APR 1 0 2023 WA '1 65 zi MASON COUNTY ENVIRONMENT. HEAL' D J A NI) 12�, .Q Z2.3oZ-4t-00200 cr) i 3 Old Se? +i c for exG s-i n4 Cabin deCoYmb SScoh{d J ah d fit ci info IwAi SeefiC • ,o \ .0-.. \\ 6 \\ \\ A� C.rye, E i- \o`xbD PYIv^o-,'y 'BedD.F• a . t w;- Reser e-*-v-.e-,..,.aAey ,' ' L (4) 3` x5O, Al. . ,4.'.k'ela'=.%," , ;-, " y*a -AULA JOY JOHNSON ...A UCt,*'-c 't 'tStGN I cc /b-7-2--2` tN E —roc,in ey-v ,`e ."1r•