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HomeMy WebLinkAboutSWG2022-00319 - SWG As-Built - 7/24/2023 1 Mason County OSS Installation Report pg. 1 Q,Q.) MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2022-319 Parcel # 22103-50-00032 Applicant Name Jennifer Forrester Subdivision (Name/Div/Block/Lot) Applicant Address PO Box 1942 City, State, Zip Allyn, Wa 98524 Installer Name Spear Const. Site Address 30 E. Benson Lake Dr. Designer Name Bob Paysse INSTALLATION CHECKLIST • Full System Installation 0 Tank(s)Only ❑ Drainfield Only ❑ Repair 0 Other System Type ATU-Drip Pretreatment Type NuWater BNR(CO >5 ft. from foundation? - - 0 N/A ® YES ❑ NO >50 ft. from wells? - - ❑ ® ❑ Z >50 ft. from surface water? - - ❑ ® ❑ < Cleanout between building and tank? - - RI ❑ ❑ U Tank baffles present? - - ❑ IN ❑ I= 24"access risers over each compartment?- - ❑ ® ❑ a. W Effluent filter installed?- - II ❑ ❑ Septic tank capacity (working) NuWater gal Manufacturer Haggerman 0 D-box water level and speed levelers used? - - IIIN/A ElYES ❑ NO oO Manifold/D-box accessible from surface?- - ❑ II mZ Check valves installed? - - ❑ ® ❑ 0< 2 Transport Line Size 1 1/4" Schedule/Class 40 Bedrooms installed (check one) ❑ 2 ❑3 ❑4 45 ❑6 ❑Commercial/Other >10 ft. from foundation?- - ❑ N/A © YES ❑ NO >100 ft.from wells?- - ® ❑ ❑ CI W >100 ft.from surface water? - - ❑ U ❑ LT. >10 ft. from potable water lines?- - ❑ 0 ❑ Z > 5 ft.from property lines and easements?- - Ell ❑ DE > 30 ft. from downgradient curtain/foundation drains? - - 0 0 0 • Drainfield level and observation ports present - - ❑ I ❑ 0 Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ ® ❑ Pump tank setbacks consistent with septic tank? - - ❑ N/A ® YES ❑ NO • Pump tank capacity (flood) 1500 gal Manufacturer Haqqerman Q 24"access riser(s)and accessible from surface?- - ❑ ® ❑ )-- Alarm or Control Panel Installed? - - ❑ II 0 a 2 Control Panel equipped with Timer/ETM/Counter- - ❑ II ❑ M n- Pump installed in ❑ Bucket or ❑ On Block or ❑ Other Flow Inducer d• Pump Make/Model Turbine ® Floats or ❑ Transducer a. a Tank draw down TBD in/min Pump capacity gpm Squirt Height ft Pump on time Pump off time Daily flow set at gpd Updated 8/212018 Mason County OSS Installation Report pg. 2 Parcel# 22103-50-00032 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: Drainfield&manifold orientation&layout,Septic/pump tank location.North arrow,reserve drainrield,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. 1PpR 0VE �. JUL 242023 I ' - 7NTY ENVIRONMENTAL HEALTH �¢31 ❑ Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ENGINEER I certify that l 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 4 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 Recor Drawing is accurat . form and attached Record Drawing is accurate. X 3�/3 Signatu f Installer Date Logan Spear 1I Printed Name of Signee I. e' .. hh MASON COUNTY PUBLIC HEALTH O ./: The undersigned approves this Installation Report and ,�'�y a;ooa,j Record Drawing on behalf of Mason County Public '�0,,, ROBERT aN`ae Health: EXPIRES Si Icature f Environmental Health Specialist Date 9 (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Updated 821/2018 1 II RESERVE PER DESIGN ► ; I I I I I I I 1 I I 1 \,_\._. _ I I 1 I I I I I I I ! I 1 I 1 I J I I amminmemp Iii I 1 IIII I 1 � DRAINFIELD PER DESIGN I 1 i I 1 I II iii I I` I II II I I I I I I I Iii U 1 1 f I I ..... I I 1 I I ____ ,,_ _ .__ I , _. ...... • ....._ _. , _ AIR/VAC I RELIEF VALVES I IMO HEADWORKS 1 . / N.0 I .o N UWATER& �> . •• o• G ✓G Iri PUMP TANK . '-. N. \ ��, TANKS ROTATED I A. N g.. ' s44P..'y *�� CZ: 90`, OTHERWISE AS ��� ,� �yi �, �, .: \�t9 PER DESIGN 40 ,� �� r '. \�y 110 �1 • / EXPIRES / /4\ I / \ 5G�1LEt:lO I , \ PIONEER DIGGING, INC. P RCEL x:22 03-5 00 2 SEPTIC DESIGNS ADDRESS: 30 E BENSON LAKE DR 3083 E.MAS N BE'S N RD. CRAPEVIE\V,WA 985-I(( DESIGNER: ROBERT H.PAYSSE OFFICE-360-4261803 FAX-36(1-427.2353 DESIGN PAGE ASBUILT 1 :' BFySON •VNCOVEREXISTING1000 •^ /-\ L.-9/Q.D GAL 2-COMP.SEPTIC TANK ( DR/ AT TIME OF INSTALLATION I I AND INSTALL RISERS TO 1 1 ; SEE ALSO ATTACHED FINISHED GRADE. ,MAKE SURE I I WAIVER APPLICATIONS RISERS AND LIPS ARE 1 WATERTIGHT ON BOTH I 1 j I SEPTIC AND PVMPTANKS. 4 O11 / 0 EXISTING t LING I 1�,0 1\ 1 �I \ 1 ! 1 1480 1125.SOFT 5 BED \\ I 1 I ``r RESERVE AREA ` I 1 (20 X 57) I y! 11 750•SOFT S BED I 1 EXISTING GARAGE PRIMARY AREA I I W/LEAN-TO (20 X 38) I I I FUTURE ADU 0-1 o SLOPE i1 I _I 1 _ I PROPOSEDTAN�SS:"J/ J' NVWATER BNRb00 1 `\\ POSSIBLE SEWER 1500*PUMP TANK \ LINE FROM FUTURE ADL/ Ill I a tflvi,INT0IN,50FTTO WELLS EXISTING 111''/i�i VV EE WELL ...\ s_ ` „.t , ��� i 1 ?0?? ,''��'' APPROX.EXISTING T'/LINE I I `Y', TO BE REUSED EXISTING I WELL I 1\ 5......, Wes EXISTING SEPTIC&PUMP TANK TO BE REUSED NEW PUMP Rz ALARM I _. —__ I EXISTING 3 BEDROOM HOME RECENTLY INSTALLED BENSON LAKE 1 ___ �/^ 1 - r APPROX.EDGE OF LAKE I J .-t.-N DLS•C':`>S::\JWT/ASEVI.T FEE MU 6E CHARGE T TIME OF INSTAL LATION.ANY PROPOSED STRUCIVRES ARE SMELT TC' �.". .'� t.E,EiPONSl FOR SETSACJCSUNRE T ',..5.D • 'ED TO StFT1C COMPONENTS CLL-TOMER:JENIFERFORRESTER SCALE I:50 r ' PIONEER.DIGGINGS INC PARCf1.a:2210350-00032 TFST HOLE t HST HOLE 2 TAT MYI AL)DR L\:30 E BENSON LAKL DR (H$`Y O RU. MS C15 037 a_' SEPTIC DESIGN~ w.aa a5 +5.il20 37.1120 ,ivONIeh+JNRD. CR An;EW,WA 98546 DFHC.NrR:ROBERTItPA'ISSE Ai CI i.iS42ok413 15\ 3(0127.2353 DESIGNPA(k.MIL PLAN 4,-114 APPROVE JUL 242023 MASON COUNTY ENVIRONMENTAL HEALTH JBW Printed From Mason County DMS Printed from Mason County DMS