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HomeMy WebLinkAboutSWG2022-00290 - SWG As-Built - 9/16/2022 ' Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALT!- APPLICANT/ PERMIT INFORMATION Permit Number SWG 2022-0290 Parcel# 32032-44-50010 Applicant Name PATRICK WHEELER Subdivision (Name/Div/Block/Lot) Applicant Address 1172 SE COLE RD City, State, Zip SHELTON, WA. 98584 Installer Name SCHOENING EXCAVATING LLC Site Address 1170 SE COLE RD Designer Name CINDY WAITE INSTALLATION CHECKLIST LE Full System Installation ❑Tank(s)Only 0 Drainfield Only El Repair 0 Other System Type OSCAR Pretreatment Type NUWATER >5 ft.from foundation? - >50 ft.from wells? - ❑ N/A ® YES El NO >50 ft. from surface water? - 1; ri MI El 0 II 0 1-1 Cleanout between building and tank? - --_if ( ILi j_ ; El V Tank baffles present? - �1]_ '' p ® ❑ a. P 24"access risers over each compartment?L 4�' '_4 0 ® 0 Effluent filter installed?- }C. _ Mil El cn Septic tank size 1000 +1060 gal Manufacturer- "-.- ;` EXISTING+INFILITRATOR 0 D-box water level and speed levelers used? - mManifold/D-box O accessible from surface?- N/A ❑ YES ❑ NO L]z Check valves installed? - - ® 0 0 g. Transport Line Size 1" 0 ❑ Schedule/Class SCHEDULE 40 Bedrooms installed (check one) 0 2 ❑3 0 4 ❑ 5 ❑6 ❑Commercial/Other >10 ft. from foundation?- - C1 >100 ft. from wells? El N/A ® YES ❑ NO -1 >100 ft.from surface water? - -- El ® 0 Zw ❑ XI >10 ft. from potable water lines?. - 0 3 > 5 ft. from property lines and easements?- © 0 C > 30 ft. from downgradient curtain/foundation drains?- - Drainfield level and observation ports present - - I El ❑ Graveless chambers or ❑ Clean gravel used? (check one) ❑ 0 Proper cover installed over drainfield?- ❑ it ID Pump tank setbacks consistent with septic tank? Z Pumptank size 1060 0 WA ® YES ❑ NO gal Manufacturer INFILITRATOR < 24"access riser(s) and accessible from surface? H El IN Elp. Alarm or Control Panel Installed? - - 0 N Control Panel equipped with Timer/ETM/Counter 0 ❑ 0 II a• Pump installed in ❑ Bucket or IN On Block or 0 Other a x Pump Make/Model AS PER OSCAR SPECS ❑ Floats or El Transducer EL Tank draw down in/min Pump capacity gpm Squirt Height_ ft Pump on time Pump off time Daily flow set at —9pd Mason County OSS Installation Report pg. 2 Parcel# 32032-44-50010 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - If yes, please describe: - ❑ YES NI NO Were all components pumped out and properly abandoned per WAC246-272A-0300? - - El yes 0 NO RECORD DRAWING This Is a permanent record and must be accurate and descriptive enough to re.locato in the need of maintenance activities and future development. Typical Record orawinga contain: OraInfeld&manifold orientation&layout,septic/pump tank location,North on-ow,reserve drelniletd,existing and proposed buildings,location of wells,waterlines, wells,observation ports,deanouls,end other maintenance access points. Incomplete Record Drawings may create additional delays fn final installation approval and related permits. Ure d r;,e f s iirif S-Efil c- 4 a-x 41-1 e el...Lei 4 it I.Se K,rf 2-'re,l Lk. Ogalc l 048 t J G G SC qti. 014,1 i u 61v 1 Ail r 1 fix ilk*, /a.la t,x /.a(/�..p :,zn.4- C J j bu of ace ,eff 6.9;/4 co A,c .P . Gl4v4aro,1i di Ofca4 C141J Pet '1.)2-14-, 0 Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ ENGINEER I certify that I installed the system In accordance ivlth 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 tt ched Record Drawing Is accurate. form and attached Record Drawing is accurate. 9-15-22 Sign ure of Installer Date Brayden Schoening , Printed Name of Slgnee 11�', Q / MASON COUNTY PUBLIC HEALTH 1+ ' 8 The undersigned approves this installation Report and •J' ti +.1• 1?pL7/ Record Drawing on behalf of Mason County Public '� F‘ti III �11, Health: y 1 di' DYE AITE `, r L ENSED ESi13NER I 1 c'-1 1 . r t.xl'nit3 usrtor 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 8121/201a