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HomeMy WebLinkAboutSWG2022-00625 - SWG As-Built - 4/27/2023 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2022-00625 Parcel # 12205-34-00040 Applicant Name Juan M Esteban Subdivision (Name/Div/Block/Lot) Applicant Address PO Box 2691 City, State, Zip Belfair Wa 98528 Installer Name Jamie Workman Site Address 851 E Alta Dr Designer Name Micah Halverson INSTALLATION CHECKLIST iii Full System Installation ❑Tank(s) Only ❑ Drainfield Only ❑ Repair ❑ Other System Type ATU -Pressure Trench's Pretreatment Type NuWater BNR-500 >5 ft. from foundation? - - ❑ N/A i YES ❑ NO >50 ft. from wells? - -� C. ❑ El ❑ >50 ft. from surface water? - ` !.f- 1Li •A-TI ❑ El Z ' FQ- Cleanout between building and tank? �'fl- -,+�-1-�' ;iy - _�;❑ ❑ Tank baffles present? - ❑ ❑ U a 24" access risers over each compartment?- - - Fii. ❑ 0 ❑ ❑ WN Effluent filter installed?- 0 ❑Septic tank capacity (working) 500+ Nuwater gal Manufacturer Sound Placement C3 D-box water level and speed levelers used? - - 0 N/A ❑ YES ❑ NO J ❑ �O Manifold/D-box accessible from surface?- - ❑ a ❑ ME Check valves installed? - ❑ 0Q 2" Schedule/Class 40 2 Transport Line Size Bedrooms installed (check one) ❑ 2 ■❑ 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10 ft. from foundation? - - ❑ N/A ❑■ YES ❑ NO CD >100 ft. from wells?- ❑ 0 ❑ W >100 ft. from surface water? ❑ 0 ❑ u., >10 ft. from potable water lines?- ❑ Z > 5 ft. from property lines and easements?- - ❑ 0 ❑ ct CC > 30 ft. from downgradient curtain/foundation drains? - - ❑ 0 Cl 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 iii YES ❑ NO Sound Placement Pump tank capacity (flood) 1233 gal Manufacturer Ell < 24" access riser(s) and accessible from surface?- - ❑ II0 El a. Alarm or Control Panel Installed? ❑ 2 Control Panel equipped with Timer/ ETM / Counter ❑ I Cl D Cl- Pump installed in 0 Bucket or ❑ On Block or ❑ Other ■ Pump Make/Model Liberty 290 Floats or ❑ Transducer a Tank draw down 2 in/min Pump capacity 45 gpm Squirt Height 4 ft Pump on time 1 min Pump off time 4hrs Daily flow set at 270 gpd Updated 8/21/2018 Mason County OSS Installation Report pg. 2 Parcel# 1 L Z C�J —3L-1-_ce0 4-1 0 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - YES E] NO If yes, please describe: c' �c rlc... 5c tA5 -�k 4-c ifi c..) T,,,,. 5, ©1C� SCE 1.-c- i- k Le c.4.k YES , 5�c • EL NO Were all components pumped out and properly abandoned per WAC246 272A 0300? -St- k 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 relat`ed_permits. gII \ 1 wi 4 `( {; r) 4 Sc•oy(6`, �4-w,,,,r;20A-- . MF9L ® 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 for and\... \24.#4,attached Record Drawing is accurate. form and attached Record Drawing is accurate. ' t \A,,._-- 3- 1 U- 202301, Si nature 04/%4of Installer Date owl "I or 11, 0 1 Printed Name of Signee �� 1, 16 MASON COUNTY PUBLIC HEALTH 1s'S + _ .g 01 The undersigned approves this Installation Report and %ewcAm Twv �i" Spy s� wALv+�s43ter 4 Record Drawing on behalf of Mason County Public 0 UCENSED DESIGNER it Health: :������ �•��.����•�.�it EXPIRES:09f18/1� g3Ir\t)/V\IOWP\ ( i l 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 fr&BU ILT: 51/162022-00625 ESTEBAN, JUAN M -- 851 E ALTA DR - BELFAIR WA 98528 PARCEL#12205-34-00040 / / / ---660' +! Existing Driveways/P-r�'ng i i \ R=100' / I'r Well Lowland Area / I \ See:5WGWell 4 / -.. \ \Qei0�t / o \ \ 1 �^ Or sty d o Well \\ II �� 1I I rn R=50 I I I K'(' c 1 O 4 \ y' .4. a S 45, 1 \ / N I 5tppt.. ��y 1 AF1T14�N1@' ALVP.RSOH y / _ _ _ ��^�, LICENSED a SIGt4ER �► / CV 'O CC) • / / -- Existing Driveways/Parking Iprit. • i Fk• /Sti W h9 Shop ... n N D0 GALLOUTS Z e S n 1)SEWER GLEANOUT DESIGN=Low Sao GPO r �* CO 113 2)SOUND PLACEMENT TRASH 0 TANK OPERATING GAPAGfTY 1106PD SOUNDPLACEMENT TRASH/PUMPTANK 4TRENCHES®3wx5'L v 4)WATERLINE WASHED GRAVEL TRENGH'S 5)NUWATER CONTROLLER&DISCONNECT �9 /b. m b)2"EFFLUENT TRANSPORT PIPE T)SWEEP ACCESS(EA.TRENCH) - P� O 8)4"INSPECTION PORT(EA.TRENCH) O 9)MANIFOLD ACCESS y N..,PROPERTY LINE ?GrNCR ; O I ESTABLISHED BY OTHER 5+ eaN rOR CR E BR ZR ME Wells Located within 100'of 55A5 Y V r This is not a surveil: Tn,s Asti /Draunng is intended for the purpose of 0' 25' 50' 100' 150' locating end maintaining the septic system on this parcel. Measurements and distances ere approximate_ It is advised by septic designer Micah Halverson to use a licensed surveyor to determine lot lines, — elevalons,topogrepNy and to provide a legal see plan. Our,er Is responsive for establishing as property lines, easements and/or nghtof...6o SGale:1"=50' Ir,xrinn Date-5/24/2023 Trash/Pn C.nmbo Tanks r wx 7 y ;Y� a �� x _N ..art _ .S, • ' 7 -/ + �� 'Sr . 4,7.1‘..'S'i's.,7-va*'. .'1,V.F--"'.'.1 . . —• ...., . 4 �, I ./.., ,.. ............,„:._,.....i.,_. . ,...:-.- . ,., , r f `� W \ !.i s 3 • f* r 4 K. ', _ VA,` T ---N).L_ - ,..s,_ �3SI 4 �y� ICJ .. , N 4 .. r } r • � 1 1 l ,���ia Cyr Jol Tr I'1Gh.S Images taken 3/11/2023 ; K a. 3''� ' "ram tiffi, ig..,•,, .. .. wi y� , .. .. . ,,,,a,. A'rJt"' i, i Loh 1 �t4� ' ,. •' l� l is ` t'3iiti: - mi R N.,x •, y . . t. , . .- . . '' • ' i. IAA. ' . ' Iii 4- . ,. si" . It') ' • • • • Y • a ii. 'r r