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Home My WebLink AboutSWG2022-00479 - SWG As-Built - 5/6/2023 Mason County OSS Installation Report pg. 1 _,L MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2022-00479 Parcel # 32032-13-00100 Applicant Name Casey Marler Subdivision (Name/Div/Block/Lot) Applicant Address 6208 NE 87th Ave City, State, Zip Vancouver, Wa 98662 Installer Name Spear Construction Site Address Carpenter Rd. Shelton. Wa Designer Name Bob Paysse INSTALLATION CHECKLIST LE Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑ Repair ❑Other System Type Gravity Pretreatment Type >5 ft.from foundation? - - 0 N/A ❑YES ❑ NO >50 ft. from wells? - - ❑ I ❑ Z >50 ft. from surface water? - - ❑ I ❑ HCleanout between building and tank? - - ❑ II o Tank baffles present? - - ❑ ® ❑ H 24" access risers over each compartment?- - ❑ MI ❑ Q. W Effluent filter installed?- - ❑ 1111 El CO Septic tank capacity (working) 1500 gal Manufacturer House Bros 0 D-box water level and speed levelers used? - - ❑ N/A II YES ❑ NO oO Manifold/D-box accessible from surface?- - ❑ IN ❑ u. a?2 Check valves installed? - - ® ❑ ❑ oQ 2 Transport Line Size 4" Schedule/Class 3034 Bedrooms installed (check one) ❑ 2 ❑� 3 ❑4 Li 5 ❑6 ❑Commercial/Other >10 ft. from foundation? - - ® N/A ❑ YES ❑ NO 0 >100 ft. from wells? - - LI ® ❑ W >100 ft. from surface water? - - ❑ I ❑ u., >10 ft. from potable water lines?- - ❑ I ❑ Z > 5 ft. from property lines and easements?- - ❑ ® ❑ ee > 30 ft. from downgradient curtain/foundation drains? - - II ❑ ❑ o Drainfield level and observation ports present - - ❑ ® 0 ❑ Graveless chambers or 0 Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ It ❑ Pump tank setbacks consistent with septic tank? - - ® N/A ❑ YES ❑ NO Pump tank capacity (flood) gal Manufacturer Z - ❑ ❑ ❑ < 24" access riser(s) and accessible from surface? 1— ❑ EL Alarm or Control Panel Installed? ❑ ❑ E Control Panel equipped with Timer/ ETM /Counter- - 0 0 ❑ o CI- Pump installed in ❑ Bucket or ❑ On Block or ❑ Other n- Pump Make/Model ❑ Floats or ❑ Transducer a Tank draw down in/min Pump capacity gpm Squirt Height ft Pump on time Pump off time Daily flow set at gpd UpCaied 8121.2018 r Mason County OSS Installation Report pg. 2 Parcel # 32032-13-00100 ABANDONMENT RECORD Were existing septic components abandoned as part of this project'? - - ❑ YES 0 NO If yes, please describe: -- Were all components pumped out and properly abandoned per WAC246-272A-0300? - ' ❑ YES ❑ 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 Typksl Retold Drawirgs contain. Ors nfe,ld&maratow orienL,ton t.laycut.Sepec t,ml:tenk lucil on.Vorth snow rmu'va drarn`.ek ex sling ant proposed bu•k rigs.location or mills vru:erLnea webs.obse'vntCr ports.rJearc.Lc.and other meintreance access c,oirds. Into'"okIto Reca'C Dran rAs may create aadalonal delays in h'ral ns:atlatior,approval and related pnrmna. li Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ ENGINEER I 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 moot all and Mason County Codes. State and Mason County Codes I further certify that all information containea on this I further certify that all information contained on this form and attach& Record Drawing is accurate. form and attached Record Drawing is accurate. jrt 41`1 i 2/711/z-J naS re of Install r Date 4.4.4., Logan Spear 9 ; y1^ e,i 7 1 ''' r,Printed Name of Signee 1 +< C' MASON COUNTY PUBLIC HEALTH f!'•• slcr� r • The undersigned approves this Installation Report and (.O•; rPO " "6 h Record Drawing on behalf of Mason County Public Exr;7ES Health: Signature of Environme ntal Health Specialist Date (stamp, signature and dale) Up0°1ed f3 2t:2ote THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE — ---- __- / / Ir-,,, _____. _ _. _ I I Y / I / I --1- I / I I I / \ I i 50'ATTENUATION /��` I ZONE (CLASS B) I / \ i S itIn , 0_ III I I \ \ I Q iPld lrrn i \ 1 O ,Ire '',00,.7 1 L__ \ 'dr�rr lr'''',110F 1 I I W of' �r�''r��' �n I p I Z \ jr,,d''of ��, I\ I Q i I \ .0 ,r,ln> I \ / I °C \ °'rrr''� i / V ag ;/ PROPOSED /i orb 3 BEDROOM O,o DRAIN FIELD a \—'— oc /1 I 1 5 4 pp I 1 1 'O `/ I I MgSONco Mqy /0?O? - C/O N rYFN�RONM�3 l I PROPOSED rq I SEPTIC TANK - - ----___ Er `I yE4lrfi r==r --- COLE ROAD l,'1 I I \N / I I i APPROXIMATE sct E a I:"_100' I" L- -- I FVTV R E HOME 't: a %" LOCATION i$,'.' .',1•;. I (tA8 1 WELL 7 I . \\\V�pl SITE AN ASBUILTI INSTALL SIGNOFF FEE WILL �� .. s ' ,��iiii�� BE CHARGED AT TIME OF INSTALLATION E piRES TEST HOLE I: TEST HOLE 2 CUSTOMER CASEY MARLER 0-31 CSL 0-31 GSL PIONEER D I��ING, INC. PARCEL# 32032-13-00100 31+COW SI L 31+COMP SI L SEPTIC DESIGNS ADDRESS: XXX SE COLE RD OtATS OR S VEY. NOT A SURVEY.REfEREC O ARTY GINCLUDE.'MPLJCANTET ROv PROMO 3083E MASON BENSON D. GRAPEVIEW,WA 98546 DESIGNER: ROBERT H.PAYSSE POSER SU N/f M OROPOS ono sE" UE Nwv PRP Ec`T TOE oTM OFFICE-360-4261803 FAX-360-427-2353 SHEET: STTE PLAN SCALE 1"=50' OLPARTMEMIK'ENCT REVIEW OENCRIER NOT RE ROSRRLE FOR SETEACXS UNRELATED SEPTIC COMPONENTS