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HomeMy WebLinkAboutSWG2021-00078 - SWG As-Built - 5/30/2023 • Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2021-00078 Parcel # 22007-50-00056 Applicant Name Shoene Enterprises LLC Subdivision (Name/Div/Block/Lot) Applicant Address 1315 Rockcress Drive SE Timberlake Division: 7 Lot: 56 City, State, Zip Olympia, WA 98513 Installer Name Weather Tight Construction Site Address 121 E Aspen Place, Shelton Designer Name Arrow Septic Designs INSTALLATION CHECKLIST © Full System Installation ❑Tank(s) Only ❑ Drainfield Only ❑ Repair ® Other Soo Trash System Type Subsurface Drip Pretreatment Type NuWater BNR-500 >5 ft. from foundation? - - ❑ N/A 0 YES ❑ NO >50 ft. from wells? - - CI '❑ ❑ z >50 ft. from surface water? - - El ❑ ❑ Q Cleanout between building and tank? • - ❑ 0 ❑ 1— U Tank baffles present? - - ❑ 0 ❑ 17- 24" access risers over each compartment? - - ❑ El ❑ a 0 ❑ ❑ W Effluent filter installed?- - rn $N R-soo Septic tank capacity (working) NuWater gal Manufacturer Hagerman o D-box water level and speed levelers used? - - 0 NIA ❑ YES ❑ NO DJ ❑ ❑ O Manifold/D-box accessible from surface?- - ❑ 032 Check valves installed? - - ❑ ❑■ ❑ oa 2 Transport Line Size 1" Schedule/Class 40 Bedrooms installed (check one) ❑ 2 0 3 ❑4 ❑ 5 ❑6 ❑Commerc;aliOther >10 ft. from foundation?- -- ❑ N/A 0 YES ❑ NO CD >100 ft. from wells?- - ❑� ❑ ❑ -1 >100 ft. from surface water? - - ❑ ❑ w lL >10 ft. from potable water lines?- - ❑ I ❑ Z > 5 ft. from property lines and easements?- - - - - ❑ I ❑ Q re > 30 ft. from downgradient curtain/foundation drains? - - 0 ❑ ❑ o Drainfield level and observation ports present - - ❑ © ❑ 1 Proper cover installed over drainfleld?- - ❑ I ❑ Pump tank setbacks consistent with septic tank? - - ❑ N/A 0 YES ❑ NO • Pump tank capacity (flood) 1,000 gal Manufacturer Hagerman Z < 24' access riser(s) and accessible from surface?- -- - -- - - n © ❑ F- a Alarm or Control Panel Installed? - - ❑ • ❑ E Control Panel equipped with Timer/ETM ;Counter• - ❑ I ❑ 0 f1 Pump installed in ❑ Bucket or ❑ On Block or 0 Other Flow Inducer n'• Pump Make/Model Little Giant WE2OGO5P4- 1/2 hp 0 FA FTh ED D.a Tank draw down 2 in/min Pump capacity 3.8 gpm Squirt Height -- ft Pump on time 8 min Pump off time 1.84 hr Dtj,A'400r Flenf23 360 gpd UpCated E.n1 201a MASON COUNTY ENVIRONMENTAL HEALTF DJA Mason County OSS Installation Report pg. 2 Parcel # Z100-1-50-0005to 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 and must be accurate and descriptive enough to re-locate in the need of maintenance activities and future development. Typical Record Drawings contain: Drainlield&manifold orientation S layout.Septic/pump tank location.North arrow,reserve drainfield.existing and proposed buildings.location of wells.waterlines wells.observation ports,cloanouts.and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and related permits. 3 Adi II 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 attached Rec " Drawing is accurate. form and attached Record Drawing is accurate. �� .Z -` 2 87Z3 Signature of Install " Date A P P,R`O V E rsI� Sctt J o Jo Inman ix Printed Name of Signee MAY 3 20 , 3h yot Cyr? MASON COUNTY ENVIRO -'-`�N MASON COUNTY PUBLIC HEALTH v, The undersigned approves this Installation Report and . . '.�1},r Record Drawingon behalf of Mason CountyPublic 'es'if,ULA� S1Ce,,<9 �.�. f, .nor�� ���OHNSONJS� S bSI GN'ifi 5130(16V i nature 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 Undated 8r210018 01114 .minor Aef- -. t A S pt n Fl — & oe - .- t Fart{1 22002-50o056 n \ Luis' sleeve. l 2 I E RS p-c 1 P(aw�- — / ;,' ' l L� u - / 4 v SCCOt1 ,." ZO ) g�-�e 0 !0 20 3o y0 ,/ ‘\/ - I _ . Wi. ' i di II r t (c` a ti t1)4.. I1/ l s'... / bR-Q---747 1 37, NI j MRNuFA(1tL ZED /5,,, ..._ ,. `� \ / HOME�`�s , . , ...._, 6.1' z8.s,c\ Zo' �' O 1\ gem \ /6- V � Ol Z l Audio-Visual Alarm on Post O 22 Cleanout /3 S y *0 OD O 0 © O 0 500 Gallon.Pre-Trash Tank 0 NuWater BNR-500 Pretreatment Tank 0 1,000 Gallon Pump Chamber W:-(4%-• Ck *i-S'Pti' "- 0 Subsurface Drip System Headworks APPRO Erg' MAY 3 n 2023 yt� r� MASON COUNTY ENVIRONMENTAL HEALP 6 ), ri4` ft- �. PAULA.;o r J -"J o��Nsek '• ,. ‘, • S - (C)- 2-3