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Home My WebLink AboutAFTER THE FACT - SWG As-Built - 4/24/2023 (2) AFTER THE FACT RECORD DRAWING, pg I MASON COUNTY PUBLIC HEALTH ARCEL DEN rICATION Owner Name Assessor Parcel# 302 - So -o`f es69 Mailing Address i 331 O/M Specialist Name 3 Jl�•-,/ . r7C — City. State, Zip 'Et it id A `t$528 Installer Name Site Address /7i j 22. 5 Qr00E Designer Name Please complete this checklist to the best of your knowledge. If items are unknown leave blank. _ NSTALLATION CHECKLIST F. 1 'System Type —LW-twirl Pretreat .ent Type Drainfield Ln. Ft. 15 Drainfetd Sq. Ft. 13 Drainfield depth 'Zt >5 ft. from foundation? - - - - - - �� NIA , YES ❑ NO t >50 ft.from wells? Ct '� - - - ❑ o z .• >50 ft. from surface water? - ❑ CI Cleanout between building and tank? ❑ iX ❑ 0 Tank baffles present? - - - - ❑ X ❑ I d24' access risers over each compartment?- - - E.] f � Effluent filter installed?- - • J ❑ Septic tank size 114° gal Manufacturer L.D At C Lc-2.51 ` 0 D-box water level and speed levelers used? • -- - - -- -- - --- -- - - - 'N/A ❑YES © NO 1 O4 Manifold/D-box accessible from surface?- - - - - - e-, 00 0;' Check valves wnsiaiied? - - - i-'; El '^ i m Transport Line Size 2 • Sc;ladule;•Foss 5`4144 46 ° 'Bedrooms nsta1led (if:mown) 0 2 ❑3 ❑4 ❑S 0 Commercial/Other ; >10 ft. from cundation?- -- - - - - 71 N/A yVES 0 NO a ti >100 ft, from wells?- J0 -1 >100 ft. from surface water? - - D LU0 >10 ft.from potable water lines?- -- - IJ' Ng CI c- > 5 ft. from property lines and easements?- - - -- - - - El ❑ De > 30 ft. from downgradient curtain/foundation drains? - [I p • Observation ports present? - ❑ ❑ ❑ Graveiess chambers or X Veen gravel used? (check one) Proper cover instaaed over drainfieid? - - - - - - - ❑ X Pump tank setbacks consistent with septic tank? - • ---- - -- - •- - - - - ij N/A ' YES ❑ NO `.� Pump tank size 550 gal Manufacturer (?N &J 1 4 24"access riser(s) and accessible from surface?. - - - -• • t❑ __• r Alarm or Control Panel Installed? 1-1t-=� i a. Jam" • Control Panel equipped with Timer I ETM f`Counter- ❑ r 1 1�5 1 _ � Pump installed i.. ❑ Bucket or X On Block or Q Other ��>� • a. • Pump Make/Model Floats or 0 Transducer i m. Tank draw down ini min Pump caoaciy gprn Squirt :--tei ht ft Pump on tine _ Pump off brine— -- yi Daily flow set at apo Lpdated 2.'2 Oi G 50 0(/oa_3 AFTER THE FACT RECORD DRAWING, pg % Assessor Parcel # 12029 --Se) —c)tioeii RECORD DRAWING Q DraiMtteld&manifold orientation&layout wldlmenslons for re-location. El Trench/bed dimensions and critical distances within iayout • Septic/pump tank Location wldimen- sions for re-location 0 Location of buildings existing/proposed ❑ Observation ports, clean-out locations, &manifotds/d-boxes Location of walls, surface water.roads, &waterlines. 0 Reserve area(s) ❑ North Arrow If needed drawing may be attached on a separate page No. Pages Attached /A CERTIFICATION OF INSTALLATION 1 DESIGNER/APPROVED O/M SPECIALIST 1 certify that the information contained in this document is accurate to my knowledge. The drawing and information h en obtai rough common locating practices. a 3 if yvi Signature of Designer or Approved O/M Specialist Date MASON COUNTY PUBLIC HEALTH This is an after the fact record drawing, which may or may nol include a county inspection. This information is to only document an existing OSS location and components. 0(-7Cr►'I 4 L -IJZ 3 Signature of Environmental Health Specialist Date THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Updated 212912016 I i 1 1 - I , r 1-1 1 1 1,-1 1 -rt.-1 i 11 1 1-' 1i- t- I I-- - 1 -r T--• _] r_.[--i , , 7--t---- I-771---1,---riF-1--1-1--1--r-l-i-77' .., a -I ..._.1----- -- .1"---,--1,- .. . • 1 ' i • 1 .(41.. . --1- t--'- --I-1.---rt 1 i i 1-1 i i i i • - Iii I I 1 -. ------ ------- --t---+-L -',‘ 1 11 ', \\\\ - --1 r-1 \ --1 ! i -t -\ i - 1 i 1----r--r---1-- . 1--- ‘------r---\-- ---1 ---- , --- ----1, , 1 ir -I --1 I - ---17--. ---- - - -- r F 1 --t- -----------r-r 11- rt- t---f \ ' ----1--1-1-----T-i-i-r-E-F 1 - 1- _., [-- 1 1 -I 1-- i • 1 , t.- i ---1.- --- -- -! ---i--1---1-1-FT-1-i- 1' -1 - .1---1 I-1 1 i i , 1 , - -t-1 1,- I 1-1 L H --r 1 i ii 1 1 iiir 1 1 ________ 1 • 1 1! i - -----e 1-. 1 I _ I 1 1 illi . 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