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HomeMy WebLinkAboutAFTERTHE FACT - SWG As-Built - 4/24/2023 AFTER THE FACT RECORD DRAWING, pg 1 MASON COUNTY PUBLIC HEALTH PARCEL IDENTIFICATIONittE zoz _ t _pyA^y Owner Name f Assessor Parcel# 3z02#7 - se, -04/64591 Mailing Address 137 3x 33S1 _- O/M Specialist Name 39)icedel .Saf17C — City, State, Zip c-tzirlit 044 9$5 0 Installer Name Site Address Mir 41122 $& 404E i Designer Name Please complete this checklist to the best of your knowledge. If items are unknown leave blank. . _ NSTALLAT!ON CHECKLIST i System Type l31,rvily Pretreatment Type 1 Drainfield Ln. Ft. 65 Drainfield Sp. Ft. 135 Drainfield depth I-Z..t f >5 ft. from foundation? - - - - - - - - i`] NIA A YES ❑ ND 1 CCM/ (�1 _ p >50 ft. from wells? E V ❑ se >;,0 ft. from surface water? - - ❑ ❑ Cleanout between building and tank? - -- - - - - _ 0 N ❑ I 0 Tank baffles present? _ _ _ _ _ -_ ._ ❑ Y ❑ a24" access risers over each compartment' -. - -- - - - - E] ❑ a • W Effluent filter installed?- -- - - J ❑ ( rd? Septic tank size i2-47° gal Man..ract:::e: L04-A1. (-4.14 02-1EFTP D D-box water level ands speed used? -- - 1 p_ed levelers - VIVA ❑YES ❑ Na ; OO Manifold/0-box accessible from surface?- _ _ _ _ _ ' 1 ❑ >b- Check valves installed? _ _ ._ _ . .- _ _ _ _ i___) ❑ 3 o d 05�l4°4'' IId r Transport Line Size 2 • Se:�edu!e%Cuss l 1 Bedrooms Installed Of known) 0 2 ❑3 ❑4 D n ❑6 ❑CommercialiOther _- d >10 ft.from :cundation?- - El NIA YES ❑ No 0 >100 ft, from Weis?- - •- - - - - - ❑ [i >100 ft. from surface water? - •• - ❑ ❑ j ;a, >i0 ft.from potable water lines?- -- - - - ❑ Y L; a"+�„ S > 5 ft. from property lines and easements?- - - - - - - rl Cj tE > 30 ft. from downgradient curtain/fourdation drains? - ❑ ❑ © ❑ ❑ Observation ports present? - TIC- ❑ Graveless chambers or X C!ean gravel used? (check one) Prope;cover installed over draintleid?- - - - - .- _ _ _. - - _. - - - ._ - .. - ❑ X ❑ I Purrp tank setbacks consfstan;with septic tank? • •- -- - - - --- - - iLl NIA YES ❑ No • X Pump tank size 550 gal Manufacturer L- N 4,S . 'J Clair? _ Z , < 24" access riser(s) and accessible from surface?. - - - -- - - -- - - - - ;_:1 J r CL Alarm or Control Pane! Installed? ;= l Control Panel equipped with Timer I ETM I Counter- )1/ / - Pump installed in ❑ Bucket or X On Block or ❑ Other "- i 2 Pump Make/Model x-!oats or i j Transducer 0_ Tank draw down_ ___inimin Pump capacity--•--.._ gpm Squirt Height _ft Pump on time _ Purnp off tir"e _ - - Daily flow set at apo Updated 229.::J1E. PI ' . Amok _., AFTER THE FACT RECORD DRAWING, pg 2Assessor Parcel # , 'Lv29 �So -oSf / RECORD DRAWING ❑ Drainfield&manifold 0 orientation&layout wldlmensions for re-locatic n. J Trench'bed dimensions and critical distances within layout ❑ Septic/pump tank Location w/dimen- sions for re-location ❑ Location of buildings existing/proposed ❑ Observation ports, dean-out locations, &manifoldsld-boxes Q Location of wells, surface water,roads. &waterlines. ❑ Reserve area(s) ❑ North Arrow • If needed drawing may be attached on a separate page No. Pages Attached I4ll�� // CERTIFICATION OF INSTALLATION DESIGNER/APPROVED OIM 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. ''22 1/ 24 Signature of Designer or Approved OW Specialist Date MASON COUNTY PUBLIC HEALTH This is an after the fact record drawing, which may or may not include a county inspection. This information is to only document an existing OSS location and components. kk---1\clytAriall 14(z(.41z 3 Signature of Environmental Health Specialist Date THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WE8 SITE Updaurd 2a6V2016 1 I ! j . i I I i 1- : m-i, I - 1-- I . -,I -- I--j i C—1—i — 1 1- "Er 1 ` —I ---1... — t- --r--t---� r 1 r— , — I. —�—� 7-1—;—I--i-1 I---- _1. 1 I.- I Ii _ I.. - ,-- 1 -- 1---1-1-1-1-1 I __ \\, 1 '41 i I I 1-1----I 1 if-I-I- -- 1 -I I- _ Y- --- j- , . \ , I I - i 1 I 1 i i ! fir'- I I r 1 i I 1 4C9 So1e Pu�'�' 1 ' M i \ -I 7 - 1 1 I-114r1....4_ _ II-l'.--—'---4- 1 ___. I _. _ I .1 i I tL 1. -Ai I I.- , 1 , , 1 i- 1 ' I u --- --- 1 i,—, - 4.. ‘ it ,� k, i I _ - -1 zt.,a - ,--- -,---t---, - 1 1----,..., -w ! ---1-F----i-i--- ....... -•i, i i I ! !-- 1----i---1- ' • 0 1 1 j �� l i ' 't--0 -I-i- -1---r- -, ._ i- 1 1 I 1 � ,c ..1. t._- ...t ill- 1 - ' c64A-Ls = 46 e i i r--1 - ,... , , _ _i_____I__ . -r i --j -----4-b-----4------______ I ! i ... i___. ... _, ._ ,_.___ ! 1 4 cilsg _ 1 - . - I r 1-i -I-- l h , ,__ 1 1__I —i 1 I I f 1 i ! , I 1,i li, ,� 1 . - _ I - - - -------- _}-- - ; _.i- 1- -1 i _ BAMFORD SEPTIC-REPAIR,LLC 1 1 I _ . ... ..-__ .___-_-. 301 E-WALLACE KNEELAND BLVD ....''-- I 1 T,,% 1 1 TE 224-332 _..._._. S ..i i--�-I-r-- _,-- -- I 1 , i , _ �. -j. 1 . ' SHELTON,WA 98584-2985 A - . I , -- • � t I I 1 '._ i i 1 I . __I - - I . . t _.. I '- —j--- 1 I ! I I I -i 1_.-_i_ .1--1_1-- t,_...I-!1--.-- 1.-1___I--L--t---:-- -.--,-_; -- .---t- . - ;---1-._-- .- -----1