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HomeMy WebLinkAboutSWG2022-00466 - SWG As-Built - 5/10/2023 Mason County OSS Installation Report pg. 1 (1 x MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2022-00466 Parcel# 42017-44-00050 Applicant Name JENNIFER WAITERS Subdivision (Name/Div/Block/Lot) Applicant Address 6031 W SHELTOTN MATLOCK RE City, State, Zip SHELTON, WA. 98584 Installer Name SCHOENING EXCAVATING LLC Site Address SAME Designer Name CINDY WAITE INSTALLATION CHECKLIST In Full System Installation El Tank(s)Only ❑ Drainfield Only ®Repair El Other System Type PRESSURE DIST Pretreatment Type >5 ft.from foundation? - - 0 N/A ®YES El NO >50 ft.from wells? ---- ❑ II CI Y >50 ft.from surface water? - ' /--- 1�-� CI CIZ Cleanout between building and tank? -- I� -�l� ❑ II CI • Tank baffles present? - — Q 4-2023- / ❑ ® ❑ d 24"access risers over each compartme try I ❑ IN CIW Effluent filter installed?- �"�-` - ❑ ® ❑ Septic tank size 1060 gal Manufacturer INFILTRATOR 0 D-box water level and speed levelers used? - - • N/A ❑ YES ❑ NO ou.O Manifold/D-box accessible from surface?- - CI ® CI OQCheck valves installed? - - CI Ill 2 Transport Line Size 2 Schedule/Class SCHEDULE 40 Bedrooms installed (check one) IN 2 ❑3 ❑4 El 5 ❑6 ❑Commercial/Other >10 ft.from foundation?- - ❑ N/A Ili YES ❑ NO c >100 ft. from wells?- - ❑ ❑ ❑ W >100 ft.from surface water?- - CI ® CI u. >10 ft. from potable water lines?- - ❑ 0 ❑ Z >5 ft.from property lines and easements?- - ClNI CId >30 ft.from downgradient curtain/foundation drains?- - ® ❑ ❑ Drainfield level and observation ports present - - 0 © 0 • Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ RI ❑ Pump tank setbacks consistant with septic tank?- - El N/A ® YES ❑ NO Z• Pump tank size 1060 gal Manufacturer INFILITRATOR < 24"access riser(s)and accessible from surface?- - 0 ® ❑ a Alarm or Control Panel Installed? - - ❑ ® ❑ • Control Panel equipped with Timer/ETM/Counter- - ❑ MI 0 ``A CI- Pump installed in ❑ Bucket or ® On Block or El Other a• Pump Make/Model LIBERTY 28Q ❑ Floats or ® Transducer per,- Tank draw down 2 in/min Pump capacity 54 gpm Squirt Height 2 ft Pump on time__^_ ),_Z___ Pump off time /2 AK( Daily flow set at 180 gpd Updated 8/21/2018 Mason County OSS Installation Report pg. 2 Parcel# 42017-44-00050 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - ■] YES ❑ 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 end must be accurate and descriptive enough to re-locate in the need of maintenance activities and future development. Typical Record Drawings contain: Drainfield&manifold onentation&layout,Septic/pump tank location,North arrow,reserve draintield,existing and proposed buildings,location of wells,waterlines, wells,observation ports,deanouts,and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and related permits. stet 1-401, // J.t --/a,v k 6,to l!O K' -1—a"l" T/pvck r'r7,e. IN 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 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 attached Record Drawing is accurate. form and attached Record Dt:wing is accurate. 25or5 Signature nstaller Date �� ,A4 f' r J`iayckteN 4SJ+-1/4)CV t 1/4�A{stt 1 9 11 Printed Name of Signee 44 Aki4 i MASON COUNTY PUBLIC HEALTH v h 10,431 :t` The undersigned approves this Installation Report and S� cl Es R ib Record Drawing on behalf of Mason County Public �•�►••�•�•••�� ......�1, � Exr'lNEs O:v10r Health: z3 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 w , /6.--"---i)7 ��1 .. .y . D � AP.PRO 0 Q MAY 10 2023 \ 1\ MASON COUNTY ENVIRONMENTAL H •LTH / RET 1. Existing residence 6'.1-v m �2`SL( a, 3t , s; L 2. Audion/Visual alarm 36 s: L 3. Clean out '� 2 G - 4. 1200 gallon concrete septic tank , 5. 1200 gallon pump tank - ./ 6. Transport line - 7. Valve Box St- 8. Primary Drainfield l 9. Reserve Drainfield 10. Waterline ? I 11. Existing failed drainfield tii 12. Well/pump house 111 I !1 P � I 51,..,e a elP Cl DYE V A LICE •ED a•5 ER �; w jlll ' W"' i► '.;,( % i‘%"'#, [ ,fr �G/ 1A, Lateral# Length Length Orifice # Distance from Distance from end # (Feet) (Inches) Spacing" Orifices feeder line of end of lateral 1 41 492 60 9 0.5 _ — 0.5 2 41 492 30 9 0.5 0.5 3 31 372 30 7 0.5 0.5 4 31 372 30 7 0.5 0.5 5; 31 372 60 7 0.5' 0.5 6 31 372 60 7 0.5 0.5 7 0 0 60 0 0.5 8 0 0 601 020 - 6 �_. 46 TRANS LENGTH 40 — GPM ? 27.14 — - K (2"SCHEDULEN 40) 284.5 —` — FRICTIO 0.517828 N LOSS - Squirt i 2 ---- ----- -- _ Elevation difference 5 —�` TDH 7.517828561 --- Trench Depth Zi/, _ APPROVED MAY- 10 2023 ZIP _ MASON COUNTY ENVIRONMENTAL HEALTH RET - P '- .• il ..4` ' DizetiloirellLw d� ! y T ? C4?.- :fA\ vo i+ 1 tvo 2 ohs-t4,1,..1 id d)ci eci de(Air 80 b5e Iw& ,r 201�S ,, . %P� a�(��i. .sQy:0)04*,,, 1,„„, ,') V�(V� 4P E.WAITE le ni�F;1` (�d.t i LICENSED DESIGNER 111 tr EXPIRES 05.10, II 2 "