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HomeMy WebLinkAboutSWG2023-00023 - SWG As-Built - 7/26/2023 Mason County OSS Installation Report pg. 1 c-, MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2023-00023 Parcel# 32003-42-00011 Applicant Name Reginald &Michelle Tweed Subdivision (Name/Div/Block/Lot) Applicant Address P.O. Box 371 TR1-A OF GOVT LOT 3 SURVEY6/113&8/55 S52/152 City, State, Zip Carlsborg,WA 98382 Installer Name Maples Excavating Site Address 4000 E State Route 3, Shelton Designer Name Arrow Septic Design INSTALLATION CHECKLIST II Full System Installation ❑ Tank(s) Only ❑ Drainfield Only ❑ Repair ® Other 500 gallon pre-trash tank System Type Pressure Bed Pretreatment Type NuWater BNR-500 >5 ft.from foundation? - - ❑ NIA D YES ❑ NO >50 ft. from wells? - - ❑ IN ❑ >50 ft. from surface water? - - ❑ ❑■ . ❑ Z F Cleanout between building and tank? - - ❑ 0 Cl U Tank baffles present? - - ❑ U ❑ F- 24" access risers over each compartment?- - ❑ Ii ❑ Q. El W Effluent filter installed?- - ® ❑ co Septic tank capacity(working) NuWater BNR gal Manufacturer HagermanCC 0 D-box water level and speed levelers used? - - jil NiA ❑ YES ❑ No ' c_ --1c- XOou_ Manifold/D box accessible from surface? ❑ CI �` m Z Check valves installed? - L� - -1_1'42 - ❑ IN 0 Q 40 E Transport Line Size 2 inch Schedule/Class Bedrooms installed (check one) 0 2 ❑ 3 ❑4 ❑ 5 ❑6 0 Commercial/Other I (.'' i >10 ft. from foundation?- - ❑ N/A ❑■ YES ❑ NO 1 r 0 >100 ft. from wells?- - ❑ ® ❑ W >100 ft. from surface water? - - ❑ II ❑ ti >10 ft. from potable water lines?- - ❑ 0 ❑ Z > 5 ft. from property lines and easements?- - ❑ ® 0 re > 30 ft.from downgradient curtain/foundation drains?- - © ❑ ❑ 0 Drainfield level and observation ports present ❑ 0 111 ❑ Graveless chambers or Q Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ X ❑ Pump tank setbacks consistent with septic tank? ❑ N/A YES ❑ NO Pump tank capacity (flood) 1,200 gal Manufacturer Hagerman < 24" access riser(s) and accessible from surface?- - ❑ • ❑ h IF El — a Alarm or Control Panel Installed? ❑ 2 Control Panel equipped with Timer/ ETM /Counter- - ❑ It ❑ n a_ Pump installed in ❑ Bucket or ® On Block or ❑ Other a Pump Make/Model Zoeller N152 El Floats or 0 Transducer a. a Tank draw down 2.25 in/min Pump capacity 52 gpm Squirt Height 5 ft r' Pump on time 2.3 minutes Pump off time 6 hours Daily flow set at 480 gpd Updated 8;21;2018 Mason County OSS Installation Report pg. 2 Parcel# 32DOJ 42` ABANDONMENT RECORD - ❑ YES \FL NO Were existing septic components abandoned as part of this project? if yes, please describe: ❑ NO Were all components pumped out and properly abandoned per WAC246-272A-0300? ❑ YES RECORD DRAWING This is a permanent record and must tie accurate and descriptive enough to relocate in the need of maintenance activities and future development Typical Record Drawings contain: Drdinfield&manrfold orientation 8 layout.Septic/pump tank locators,North arrow.reserve urainfield.existing and proposed#bta urn sgs approvalocaton f wells, waterlines, permits. wells,observation ports,cleanouts,and other maintenance access points. Incomplete Record Drawings may create additional delays in finalJUL 2 IV , 2023 MASON COUNTY EN Pi`."'- Ord D - ';Attached t-VI'L`ZALT, CERTIFICATION OF INSTALLATION JQ1Al INSTALLER DESIGNER/ENGINEER 1 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 Drawing is accurate. ti 4 f�'�_,/ , o-17o�� z-S �' t 11, Siggnnature of Installer D to Af)' 7 k-\\ vtGI t 5 / �J J L' ,1 MAtgl", r),. Printed Name of Signee • r_-PA� . ^, MASON COUNTY PUBLIC HEALTH r 1'.-' r• tip' 4. S,UO3a9 ::), The undersigned approves this Installation Report and '�Z' PAUI A JOY JOHNSON Re Drawing on behalf of Mason County Public •LICENS> t7ESIGNE'fi ealt Sig at Environmental Health Specialist Gate (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE oplateo 8212018 Ranid & .41 er ..,.=::: —•\.el—„---, - Patcrt l32G03 cjZ-000i l 001 Scale- : -- �a r7 / 1?, , ,i.c3, 1513 ov,„ S011 • c6. Pi (Le-f4 f:/-/ (>-- i . / / .,& „AiN\., . . oc- p--- . „ , -,\0001\ ce--/ i , f ,‘' Iti I \ \ . \ / i / • .o7 *- g_c, I --C-E • . , \ lit, yD FZ°k • -�� � �1G �s 6. S as^ - PctiaR,LtiN 7P l Os 01- 1 V14 W �t t IN1 ' tit .;��' ti:?-1. GQ INA Pd Ni r` 1 % cp s e Catgt / \ ! o a ,,, i S J I OAudio Visual Alarm < �•,. 1aY,G Q� a J,< I^- Al— ' 8' `� S�M+a' !" 2 Cleanout b b ; FQ SS4RE' \ O e'- O500 Galion Pre-Trash tank J-. 0 NuWater BNR-500 ATU Tarr 4.'•Akki)) l-r •O-' P '�csCr 'G� I O1,200 Gallon Pulp Chamber •? ---,............, -, 'i',g� 33.'' D.„. ....,, . „,..., , , , ... ..... . ..v..„., ......\\,,,, ,,.... 0 fic., ''''....T1)} \ !,,,.. <:, y1- 5i00349 :3`r PAULA JOY JOHNSON .?"t^ 1 ow,14s bri s7��