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HomeMy WebLinkAboutSWG2021-00143 - SWG As-Built - 8/16/2023 Mason County OSS Installation Report pg. 1 `, MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2021-00143 Parcel # 32105-51-00008 Applicant Name Paul & Darla Fiedler Subdivision (Name/Div/Block/Lot) Applicant Address 5930 NE 65th Ct HIGHLAND PARK#1 LOT: 8 City, State, Zip Vancouver, WA 98661 Installer Name Joe Fassio Excavating Site Address 220 E Arellem Rd, Union Designer Name Arrow Septic Designs, Inc INSTALLATION CHECKLIST NJ Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑ Repair m Other 500 Gal Pre Trash Tank System Type Shallow Pressure Pretreatment Type NuWater BNR 500 >5 ft. from foundation? - -- - ❑ N/A Q YES ❑ NO >50 ft. from wells? - - ❑ ® ❑ Z >50 ft. from surface water? - - II ❑ H Cleanout between building and tank? - - ❑ 0 [30 Tank baffles present? - - ❑ [3 ❑ F- 24"access risers over each compartment?- - ❑ 0 ❑ G. ■❑ ❑ ❑ W Effluent filter installed?- - 0 Septic tank capacity(working) NuWater gal Manufacturer Hagerman 5 D-box water level and speed levelers used? - - - -. - El N/A 0 YES ❑ NO DO Manifold/D-box accessible from surface?- - ❑ IN act Check valves installed? - - ❑ ■❑ ❑ 0< 40 2 Transport Line Size 2" Schedule/Class Bedrooms installed (check ne) ❑ 2 El 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10 ft. from foundation? ❑ NIA ® YES El NO 0 >100 ft. from wells?- - - - - � - - - - ' ❑ ❑ ❑ W >100 ft. from surface w - - UI ❑ ❑ • AVG a: >10 ft. from potable wa ' s?- - - I. 6 2023 - - ❑ 0 ❑ z > 5 ft. from property lines an cat446I R ANT 11 ❑ IN ❑ a IN ❑ ❑ Q > 30 ft. from downgradient curtainlfoll�ei�dralns. -EAI.T�-1 - Drainfield level and observation ports present ❑ ® ❑ ® Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?- - - ❑ ® ❑ Pump tank setbacks consistent with septic tank?- - ❑ N/A ® YES ❑ NO Y Pump tank capacity(flood) 1,000 gal Manufacturer Hagerman Z < 24" - El 0 El access riser(s) and accessible from surface? t— Alarm or Control Panel Installed? - - ❑ •• ❑ °'• Control Panel equipped with Timer/ETM /Counter- - ❑ El El a Pump installed in ® Bucket or ❑ On Block or ❑ Other la• Pump Make/Model Zoeller N152 ® Floats or ❑ Transducer 0_ a Tank draw down 2.5 in/min Pump capacity 48 gpm Squirt Height 5 ft Pump on time 1.9 min Pump off time 6 hr Daily flow set at 360 gpd Updated 8/210018 oar Mason County OSS Installation Report pg. 2 Parcel## 321a 5- S - 00005 ABANDONMENT RECORD © NO Were existing septic components abandoned as part of this project? If yes. please describe: - ❑ YES El NO Were all components pumped out and properly abandoned per WAC246-272A-0300? - RECORD DRAWING ent. Typical Record in the need and proposed andd future de location wTUsical Re This is a permanent record and must be accurate and descriptive smgoruk9ocation�,North�arcvr.resetveof drairtfi�mance etdst7tg��and future development may ceate additional delays'ofinal bull inon apProva:and related prunepermits. was,o contain: Drts,d d&.outs, foldand other a•jonmain&layout.Septic/pumps Incomplete Record Drawings Y wells,otaseva'on ports,dearou[s,and other maintenance mess points, • See kfrGaud 2 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 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. Sig—re of Installer ` Date ... 7o f F0.S S G -''.r Printed Name of Signee r; v'a Wdar '�j. • • MASON COUNTY PUBLIC HEALTH '; rt•i1 : 1. The undersigned approves this Installation Report and y�-lt: s•.� .,9 • �j, Record Drawing on behalf of Mason County Public ,- pgULA JOY JOHNSON eat • t-.1.:1 ,f4 V b')'t`s:Gjv 1-'�N (it) i\ ..)., ,Saar,- • Sig at of vironmental Health Specialist Date (stamp, signature and date) / �J THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE upd.-ted 8212016 i - $—,` j-1 G(� • ASlouc' It' 'E (��Q11z'� 'RV' PUVvi & :.C. .a -tV 2-2- 2(9" SL4fQ0 62. 55. 5 -}DGi�G?I � #z3G 1(j 'S'�ODUU$ .- r o-Ntl-'i{ p.�� \ 2 to Ara ((t -t-t'2" Z211 SL root! NIAL\� 5ccde : ( "_ 4-10 - O wit/fii! N Zz 2� 14. e/_ u o (O to 3 + `ll v� rao +, Co' \ r 3‹., \ <<,, Ol Audio-Visual Alarm p/ CY O2 Cleanout l� 102 500GallonPre-Trash taz© NuWaterB.NR-500 ATU'I% O 1001 000 1,00Q Craton Pump Char_ W/a.nt-i Si?'+ati'1 0 , O6 Valve Control Box Iss 1 cc / t / z i ii Q SO1 3 \ '$MO\c ,e 272. ! h C kA S (;-) 3X1ppr; mAcy e-ti,„ • @ 9' OL . v‘r\-k-\,\ ctsigvf, Athtkit.0 A .. 51 KJn9 NI PAAULA JOY JOHN iO1r-mr.i:$400.m.cia.......5::_sa.b D(PiRErf`•09!i�/�