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HomeMy WebLinkAboutSWG2023-00149 - SWG As-Built - 7/5/2023 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2023-00 f Li C\ Parcel # 31902-31-00060 Applicant Name SANTA SERVICE LLC Subdivision (Name/Div/Block/Lot) Applicant Address 2430 160TH AVE NE City, State, Zip BELLEVUE, WA 98008 Installer Name SCHOENING EXCAVATION Site Address 3571 SE LYNCH RD Designer Name CINDY E WAITE INSTALLATION CHECKLIST © Full System Installation ❑ Tank(s)Only ❑ Drainfield Only ❑ Repair ❑ Other System Type OSCAR Pretreatment Type BNRe00 NUWATER >5 ft. from foundation? - >50 ft. from wells? - - ❑ N/A ❑■ YES ❑ NO Ill Z >50 ft. from surface water? - 11 J1r2 till CI El ll Q Cleanout between building and tank? - - - - 5 _! III [II El U Tank baffles present? - j�N r ���� ID El El a 24"access risers over each compartment?- - El ❑ W Effluent filter installed?- - - - 'Sy .r_ - ------_ Ei El Septic tank size Rives Goa gal Manufacturer HAGERMAN O D-box water level and speed levelers used? - U] N/A ❑ YES ❑ NO �O Manifold/D-box accessible from surface?- ❑ ❑� El m— Check valves installed? - ❑ ❑■ El- 0< 2 Transport Line Size Schedule/Class SCHEDULE 40 Bedrooms installed (check one) ❑ 2 ❑ 3 0 4 X1 5 ❑6 ❑Commercial/Other >10 ft. from foundation?- - - ❑ N/A N YES ❑ NO fn >100 ft. from wells?- - ❑ ❑ --1 >100 ft. from surface water? - Li al III El LL >10 ft. from potable water lines?- - ❑ It ❑ Z- > 5 ft. from property lines and easements?- Q - Ill NI ❑ Q > 30 ft. from downgradient curtain/foundation drains? - - ID El Drainfield level and observation ports present - ❑ © ❑ 0 Graveless chambers or ❑ Clean gravel used'? (check one) Proper cover installed over drainfield?- - ❑ U] ❑ Pump tank setbacks consistant with septic tank? - - - -- - ❑ N/A IN YES ❑ NO Pump tank size(101 1500 gal Manufacturer HAGERMAN Z 1 H24"access riser(s) and accessible from surface?- - ❑ MI CIa Alarm or Control Panel Installed? - - ❑ © ❑ E Control Panel equipped with Timer/ETM /Counter- ❑ U ❑ D a Pump installed in ❑ Bucket or © On Block or ❑ Other Q. Pump Make/Model LA 2 5o in 1Z50 O�� 1 cal 4 V i,, ,.d Floats or 0 transducer Tank draw down EL Tank Pump capacity gpm Squirt Height ft Pump on time Pump off time Daily flow set at gpd Updated 8/21/2018 Mason County OSS Installation Report pg. 2 Parcel# 31902-31-00060 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - Q YES NO If yes. please describe. Were all components pumped out and properly abandoned per WAC246 272A-0300? 1=1YES 0 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 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 related permits. ® 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 1 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 Dr_wing is accurate. ��1 b-15�Z3 1 al Signature of Installer Date dr , A f ,, �<0 Printed Name of Signee :�A.� �"'`' 2 ��,1 n ��J MASON COUNTY PUBLIC HEALTH ' 51ooi 8 `�• I\ti The undersigned approves this Installation Report and i• O LICEN D DESIGNER ,11 Record Drawing on behalf of Mason County Public mum. �������� �„ �/ EXPIRES 05/101 Health: 4i3fr49V1—P \-"Tvn ---7) .3...).2„. Signature of Environme tal 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 , SWG2023-00149 31902-31-00080 3571 SE Lynch Road At existing residence Septic tank Hagerman 1250 gallons Pump Tank Hagerman 1250 gallons(pumps up to 1500 gallon trash tank) Existing barn Trash tank Hagerman 1500 gallons BNR 600 in Hagerman tank Pump tank Hagerman 1500 gallons(set up per Oscar SOP) m PoF�eS 9� nn'' Q � �� 510.0 f`--Nf 0� LICENSEr(,ESIGNEft JUL l ASON COUNTY ENVIRONMENTAL HEALTH RET 311 I F. ,/. — — t i_ 1. 3 BEDROOM RESIDENCE 2. GARAGE t I y.7 3. 1200 SEPTIC TANK 4. 1200 PUMP TANK 5. rSga GALLON TRASH TANK M 6. BNR 600 IN CONCRETE TANK ""; 7. TRANSPORT LINE 2" 8. TRANSPORT LINES 1" _ 9. EXISTING WELL _ \ 10.WATER LINE 11. EXISTING BARN j • 12. PRIMARY DRAINFIELD OSCAR GA 13. RESERVE DRAINFIELD ' 14.AUDIONISUAL ALARM r G 15. CLEAN OUT(2) .\\\ `� " I:16-- '/ \ 1Ali ---dAii 9 \ iQl/ $ nf / f G-Ir" 613 s./E 1oa,y, t, \ , /) O h. �. .. tri V E MAY 0 5 2023 6 ��—�1 / N COUNTY ENVIRONMENTAL HEALTr' Jaw/_......„..„----#-"/ • inif-4-1- s ,• a.Yttsy151#4 , am / r _/ I St v 3 J� 6 IGl `�IZdIA� /e IN E AITE N �1 - � UC . ED DESIGNER\ tt l?•e APPR /12 LI I C9.—I f:1413 1�1lid Gl 2,7 JUL 0 5 2023 MASON COUNTY ENVIR YAEN t HEAT TH ' -..c e,.t_ C e .I� RET 337, .I LL(, / , 14 3/ 762,,?/� 0 0 ��i' I Zoo ' 1 !S"(Ji Printed From iviasu bounty DMS j Printed from Mason County DMS r -_ J !J