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HomeMy WebLinkAboutSWG2022-00335 - SWG As-Built - 8/14/2023 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2022-00335 Parcel # 42135-50-00053 Applicant Name Bill Yandle Subdivision (Name/Div/Block/Lot) Applicant Address 6215 63rd Ave NE Clear Lake/Lot 18 City. State, Zip Olympia, WA 98516 Installer Name Schoening Excavating Site Address 860 W. Clear Lake Dr., Shelton Designer Name Arrow Septic Designs, Inc INSTALLATION CHECKLIST L'ibert-b-1-E4(N1/4:,. 111 Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑ Repair ® Other 500 ga!tank at shop System Type Shallow Pressure Bed Pretreatment Type >5 ft. from foundation? - - ❑ N/A 0 YES ❑ NO >50 ft. from wells? - - El 0 ❑ >50 ft. from surface water? - - ❑ U] ❑ Z FQ- Cleanout between building and tank? - -. - ❑ El 0 U Tank baffles present? - ❑ 0 ❑ E- 24" access risers over each compartment?- - El 0 ❑ a W Effluent filter installed?- - ❑ ❑ to Hagerman Septic tank capacity (working) 1,250 gal Manufacturer 9 ❑ D-box water level and speed levelers used? - - Q N/A ❑ YES ❑ NO J El�O Manifold/D-box accessible from surface?- El I=1 mZ Check valves installed? - - ❑ 0 El ❑Q 2" Schedule/Class 40 2 Transport Line Size Bedrooms installed (check one) ❑ 2 0 3 El 4 El 5 El 6 El Commercial/Other >10 ft. from foundation?- - El N/A ❑� YES El NO ❑ >100 ft. from wells?- - ❑ ID ❑ W >100 ft. from surface water? - - ❑ I Er_ >10 ft. from potable water lines?- - ❑ 0 El Z Q 5> ft. from property lines and easements?- - ❑ CI El ct .> 30 ft. from downgradient curtain/foundation drains - - ❑ EU CI o Drainfield level and observation ports present - - El IJ El ❑ Graveless chambers or • Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ U ❑ Pump tank setbacks consistent with septic tank? - - El N/A YES El NO Pump tank capacity (flood) 1,000+ gal Manufacturer Hagerman Cr) Z - i < 24" access riser(s) and accessible from surface? ❑ . ❑ ~ Alarm or Control Panel Installed? - - - -� � V-ou�e. - ❑ ❑ U a El © ❑ '' 5 Control Panel equipped with Timer/ ETM /Counter- - o n- Pump installed in ❑ Bucket or ❑■ On Block or ❑ Other v a• Pump Make/Model Liberty FL31 0 Floats or El Transducer rr� CL a Tank draw down 2" in/min Pump capacity 38 gpm Squirt Height 6 ft. tc` Lr Pump on time 2.33 min Pump off time 6 hr Daily flow set at 360 gpd Updated B/21/2018 Parcel# 42( S Mason County OSS Installation Report pg. 2 3 -s°"°D�5—ABANDONMENT RECORD - El YES ® NO Were existing septic components abandoned as part of this project? If yes, please describe: ❑ YES [] No Were all components pumped out and properly abandoned per WAC246-272A-0300? RECORD DRAWING ties and future development. This is a permanent record and must torientation&layout,Septic/pump tank location,descriptive enough to re-locate Norh arrow,reserve drainfield.existing and proposed buildings, ocation of wells.)cal Record waterlines, Drawings contain: Drairfield&ma approval anc related permits. wells,observation ports,deanauts,and other maintecance access points. Incomplete Record Drawings maycreate additional delays in final installation 3e--.e >a , Y !! s AUG 14 2023 4 r MASON COUNTY EN VIRONPRCiti1ENTALHEALTH Jaw ❑ Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER! ENGINEER l certify that/installed the system in accordance with /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 l further certify that all information contained on this form and attached Record Drawing is accurate. form and attached Record Drawing is accurate. Sig ure of Installer C Date �j Brayden Schoening ` o 2{r}. Printed Name of Signee ,c .3.'`,t th MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and % • 51C0349 .':_i�) Record wing on behalf of Mason County Public Yrc PAULA JOY JOHNSON ' Z(1, Health: ( Rrib4^ uuPZ -...___ ilitic.. ......\ <1_1 c(......2:2 . Signat e virpnmental Health Specialist Date (stamp, signature and date) HIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Updated 8212°',3 t _ 1 1 13.1.V. • ,.. t 1 _ ......_ .. i 3 ciesr_out . -t-- ::.__\. • \ ... % ........:,. 0.....1. 1. . . ...-,. , . ;‘,;• \ - ; ;.....; • 3 \ 1 • 12s.m.2..c=00.1C-aripts,F7o.::Seilevtit_v.ic.taTank . u \N i 0 1000 Galion plz_.,p cbatab t: ify, • 0 ' ''\ \ \: s (..-(X-s •,••••-^-e -N I.\ - ® •-/° eP B .....4-, -t•cti—k -•\,.. 5-no 3-6,--0---- II, 1 - cz-z,s6e- ' • ( ci.I x.2-5{ --- t • . , - ,3 ,_...i 1—...1. afain-iv."4`• i cd:kv-cla•se'9" v i _..... 4 Seicw61 . \ 1 ' 1 1 's •3- • - 1 — . . „ 1 4 . .. . . :.6) faN" ?As.i2-4"Ni-sIC 7 \'it.1,•: 11.11 4.0, PrH ° V E 4SON COUNTYN 23 i1IRONMENAL • ALIG - shag --X--- w- til• I ..•)'1.;`, ,-- • i 1 1 %All$0.•3/4N% 1 i 4 Zall eti 'IC'5. 152 i t A .. 0,..:.• • ...,,,,, 4 i - - 1 •r:":\CP:' 51"a cS49 41,6 PAULA JOY JOHNSON 8: 4.gs:zds. gii.. 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