HomeMy WebLinkAboutSWG2022-00175 - SWG As-Built - 7/12/2023 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH
APPLICANT/ PERMIT INFORMATION
Permit Number SWG ZL ZZ - 00I7S Parcel # 12 3307 69005-V
Applicant Name .- ,.! 4 13, 0y 4rr,,,,,.,,/5,t Subdivision (Name/Div/Block/Lot)
Applicant Address 1'• 0. i3ox l/0 7
City, State, Zip 131-L.�A-i` U,?- 98528 Installer Name Z-ol,,,, -7)o1„vcti}
Site Address 5S- We- YhA-sr- Rd. Designer Name DhvEs $k ct,z 4 E5 r,✓c•
INSTALLATION CHECKLIST
IA Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑ Repair ❑ Other
System Type 6i 4v1. / FLe;j SySlLE Pti1 Pretreatment Type O/3-
>5 ft. from foundation? - - ❑ N/A inYES ❑ NO
>50 ft. from wells? - .- 1 VE ❑
Z >50 ft. from surface water? - f' �j , 41 '• �. �jj `j;• ❑
HCleanout between building and tank? - - - - f - � � 2023 • ❑
0 Tank baffles present? - - ,Ri - 20 /g r11 0
a24" access risers over each compartment?- - - - -- - -COUNIY W RONMENTAL H �`'H 0
W Effluent filter installed?- - _ _ �- ;; W ❑
cn
Septic tank capacity (working) 12-CO gal Manufacturer Gv,z. h,0 n qt-;—
0 D-box water level and speed levelers used? - ❑ N/A .d YES ❑ NO
><O Manifold/D-box accessible from surface?- - 0 t5 El
QQ Check valves installed? - X ❑ 0
2 Transport Line Size -_ y Schedule/Class_ P t/%-- 3 03 L/
Bedrooms installed (check one) ❑ 2 3 ❑4 ❑ 5 ❑ 6 ❑Commercial,/Other
>10 ft. from foundation?- - ❑ N/A X1 YES ❑ NO
O >100 ft. from wells? - - 0 ElW >100 ft. from surface water? - - 0 0
L. >10 ft. from potable water lines?- - 0 IS1 0
Z > 5 ft. from property lines and easements?- - 0 5 ❑
ix > 30 ft. from downgradient curtain/foundation drains? - - 0 0
ca
Drainfield level and observation ports present - - 0 al 0
❑ Graveless chambers or 0 Clean gravel used? (check one)
Proper cover installed over drainfield?- - ❑ Tiu ❑
tank setbacks consistent with septic tank? ❑ N/A ❑ YES No
• Pump tank ca . (flood) gal Manufacturer
Q 24" access riser(s)and a ible from surface? 0 0
I`
a Alarm or Control Panel Installed? 0 0
2 Control Panel equipped with Timer/ ETM / Coun - - ❑ ❑ ❑
d Pump installed in 0 Bucket or ock or ❑ O
i n' Pump Make/Model 0 Floa r ❑ Transducer
a
Tank draw in/min Pump capacity gpm Squirt Height ft
mp on time Pump off time Daily flow set at
IUpdated 8/21/2018
Mason County OSS Installation Report pg. 2 Parcel# ) Z 3 3 0 7 100 S'/
ABANDONMENT RECORD
Were existing septic components abandon praect' 0 YES 0 NO
It yes, please describe.
Were aII umped out and properly abandoned per WAC246-272A-03O0; • - - - - - -
RECORD DRAWING
Tha le a peneenere record and must be accurate and deanfpdve enough to meocata In tad need al ma nbnanaa actt WYaa and Mure development. Tpcal gem::
thswnge carman. Cratnlato&manhfd oremtinon d.bycvt Septic/pump tank nce*on HORn a,row.mece e o emten e'osang end CaOpoaad b oasoca.°cadon at eels,waterless.
sees.ebaervab n ports.ctaiecxta inn ether mants,en.s am zss tong. inecentiete f2ect J Uawr•,e•wry wale addQane esters•.ens InatawfAr approval and related cermet
APPROVE
D JUL 12 2023
MASON COUNTY ENVIRONMEVTAL HEALTH
JBW
Record Drawing Attached
CERTIFICATION OF INSTALLATION
INSTALLER DESIGNERJ 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
I further certify that all information contained on this I further certify that all information contained on this
for vind a ed Record Drawing is accurate form and attached Record Drawing iS accurate.
` ', 5 —5 . 2
S .ne ire of► taller Date
ja6k z 3 (I)
Printed Name of Signee
MASON COUNTY PUBLIC HEALTH r
2,
The undersigned approves this Installation Report and
Record Drawing on behalf of Mason County Public = ' t,r.20y w1�
Heat a A.a:-lrav
Sign to nvironmenta!Health Specialise Date (stamp signature and date)
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE •
T n No
�/d /+,b0C,� -0 a
� - ;� \L -
1
c.. r- -t3_, ,._\;.1 o)i)--1 thcz, ,.-;-- m
o
o mOO Z -0.
,, `\ Z N m
-?-. •
c1 S \rn n O
/ .. 7 fT7 W • < f "Po...
m O 10'NO iU1LD ZONE `, cc`
-3 0 \i„\\\\,‘
\ .o
... _,,„„pr, \
k .__, -I 03 . \\
.\\N \
'i: ,
•
-err. 1 ‘'k(.-C.I.\):1 \ \ \
•
Cn i �-- 1 0
. ., ., -i --0 r- -,. , .
m O ► ► s.
•
11/A! 1l
--, _ //) -13 ---------74
�-_ R3 C 1
•ii I S 0 Qom\1 ` ` -`-�'-�.` ` Rl ° `-\\\ ;11d 1
xo ,` nm
c, o �T
yn
--I CO c) Z'$)- ... 2 .,
k )4 z r\\
-a -< cn -1
Z
I
1. - Cn �VL ar-'1k' )3 iZ 'ld )3Zoy m0 )] - C ° on O ommo � a• ooz -IHh
Zm rn � Do1 c) � mZZ �-rC o, �� z m
PHI
-;k` H
co
ao
f - F
`�
• * -1 p n
- co r, Z
ni
mTO 6o 3 0' 0 ° m T 0 n ZO
O
"J m � a c, 0 CI
o `�° r`Qo p O
r-
o > X n o -- `0 in a 3 p rn rcn v,
i ^ -'
4 O� rn 6 a o m T C O -i
(0 )0 o ro `� o O 40 r )3 co
z ° m
cc. C V, V, o n n In
ono n _ a a o _I n m m Ith A a
rn
O �_ 2 v,, o ° OZ r Z •
n 00 n : ° 1 1 z
n 2 G .� D o
71 �i c0 0) o '` 3 �' o o v w n
m rn n o v y �' ® ti o T
ch<' (t= n Q • Q 1a N
cn(n 4U) Nm rill 0 ,�...Z G * t" chi A °
N) O N O 11:, 'f-1-'
ca Co oN s
-' o y
l
S
Do not Damage Or Disturb Soils When Clearing
Drainfield Area
1
rINSTALLER TO ENSURE ALL ON-SITE SEWAGE
% / TANKS/COMPONENTS MUST BE WATERTIGHT TO
•
SURFACE_
.I 4' / ' DISCLAIMER
/ f` / This map does not represent a survey
5 / --- nor does it purport to show all easements
e�
or encroachments, if any.
A— t3,
------\\---
' /7 • Additional Drains May Be Required
I 1 / v ' To Divert Surface Or Subsurface Water Problems
/ ELL IS U- LOPE.
I PROPO' O SEWA •
lrv• , ` ` SYSTE
a,I, p�
i
0. L ) r ` STUMP SPLITTING OR STUMP
/ r`' ! / GRINDING IS RECOMMENDED
__ yll
3-BEDROOM • / / FOR TREES GREATER THAN 12"
IN DIAMETER WITHIN DRAINFIELD
AREA. PROTECT SOILS WHEN CLEARING
/ LL ISO SLOPED 'r
/ lI / PROPOSE SEWAG
SYSTEM •p. WM DRAIN LI
/--% 0 -- ---,Oh i
tIrwA I A . _ JIV , / I .i
SMT / --- ,
NO WELLS WITHIN 100'♦
r' 1
\ / ALL COVER TO BE 55 MIN/INCH
) I ;' DIVERT ALL SURFACE WATER AWAY
i
/ ' FROM DRAINFIELD AREA.
PREPARE SITE & INSTALL DRAINFIELD
� l /
II
DURING DRY CONDITIONS
• l Normal usage must meet the followinIg
�' / criteria or be lower
PS.(0Biochemical oxygen demand 130-174 MG/L
//
r c'\ TSS: 47-71 MG/L
FOG: 10-20 MG/L
DO: 0-1.0 MG/L
`/7
PH: 6.5-7.2
.'cy TEMP: 48-70*
*With microscopic life forms present
**Higher waste strengths will result in
premature failure of the septic system.
Al
E= A_A...
0' 100' 200'
OWNER. •,� SCALE:
;' '1 DAVE'S SEPTIC SERVICES INC. 1" = 100'
BRANDY AMUNDSON 1 �;�',, DATE:
> �, P.O. BOX 301 12-23-2021
7 A i', �µ.!,' SEABECK, WA 98380 REVISION
TAX ID: 12330-76-90054 frii. SNY 1N fi+t'! (360) 710 2449• 5-15-2023
"4 'r.• t REVISION
LaVoie ow 6-5-2023