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HomeMy WebLinkAboutSWG2023-00267 - SWG As-Built - 8/15/2023 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Per a. •• mber SWG 2023-00267 Parcel # 42204-50-00092 pplicant ame Lakeview Property Solutions, LLC Subdivision (Name/Div/Block/Lot) G \ em1ltnt • 'dress 3225 McLeod Dr, Suite 100 Lake Cushman#5 TR 92 U, CitaState, 'ip Las Vegas, NV 89121 Installer Name Maples Excavating Ett-G-\\I- - .•ress 521 N Mount Jupiter Dr, Hoodsport Designer Name Arrow Septic Designs, Inc INSTALLATION CHECKLIST z-03 '� U] Full System Installation ❑Tank(s)Only ❑ Drainfield Only gm Repair L j Other System Type Shallow Pressure Bed I_��� >5 ft. from foundation? I. �'�Pretreatment Type i)I' LS-l7�I_ U S ❑ N/A Q YES ❑ NO - >50 ft. from wells? - -I © ❑ ❑ • >50 ft. from surface water? ill AK 1 23_ - � 0 ❑ ❑ HCleanout between building and tank? - - - - -`— ❑ 0 ❑ O Tank baffles present? - - 8 . - - ❑ 0 ❑ P 24" access risers over each compartment?- - ❑ 0 ❑ a W Effluent filter installed?- - ❑ II ❑ co Septic tank capacity (working) 1,250 gal Manufacturer Snyder 0 D-box water level and speed levelers used? - - ❑ N/A ❑ YES ❑ NO oO Manifold/D-box accessible from surface?- - ❑ 0 ❑ mZ Check valves installed? - - ❑ 0 ❑ o Q 40 2 Transport Line Size 2" Schedule/Class Bedrooms installed (check one) ❑ 2. ❑■ 3 ❑4 ❑ 5 ❑6 ❑Commercial//Other >10 ft. from foundation?- - ❑ N/A ❑■ YES ❑ NO O >100 ft. from wells?- - 0 ❑ ❑ W >100 ft. from surface water? - - 0 ❑ ❑ it >10 ft.from potable water lines?- - ❑ ❑ 0 Z > 5 ft. from property lines and easements?- - ❑ IC Q a ❑ ❑ � > 30 ft. from downgradient curtain/foundation drains? - - 0 Drainfield level and observation ports present - - ❑ U] ❑ ❑ Graveless chambers or 0 Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ 0 ❑ Pump tank setbacks consistent with septic tank?- - ❑ N/A 0 YES ❑ NO • Pump tank capacity (flood) 1,287 gal Manufacturer Infiltrator Q 24" access risers) and accessible from surface?- - ❑ I] ❑ F- a Alarm or Control Panel Installed? - - ❑ El ❑ 2 Control Panel equipped with Timer/ ETM/Counter- - ❑ 0 ❑ n a Pump installed in ❑ Bucket or 0 On Block or ❑ Other a' Pump Make/Model Zoeller N152 0 Floats or ❑ Transducer 2 a. a Tank draw down 2 in/min Pump capacity 50 gpm Squirt Height 5 ft Pump on time 1.8 min Pump off time 6 hr Daily flow set at 360 gpd Ur,:.a:ee 8..2`:/2018 4-2,zo`f-- 6-0 - a 0 0 GI. 2 Mason County OSS Installation Report pg. 2 Parcel# ABANDONMENT RECORD Illi YES � NO Were existing septic components a lore+-' •-kasep of this project? tea— k If yes, please describe: vim`�^ NO rewozrmik- Were all components pumped out and properly abandoned per WAC246-272A-0300? - ® YES RECORD DRAWING This is a permanent record and must be accurate and descriptive enough to relocate in the need of maintenance activities and futur'nde'e�tion of wment Tlyp' �rd Drawings contains Drainf eld&manifold orientation&layout.septic/pump tank location,North arrow.reserve drainfield,ensting and proposed g waterlines, wells,observation ports,deanou5,and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and related permits. CJ _ APPROVE M, o�,CouN T� S 2473 `I.°_ i eNviR : Jaw MrNTAL HEALTH ® 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. /n `/G - $- l -23 Signature of Installer Date ,.. g��cvuV� c /( a st / � . . Printed Name of Signee c, tra_34,..At' . MASON COUNTY PUBLIC HEALTH N • • .�` f 4' -•s,� The undersigned approves this Installation Report and : 1 gt:. ;. ,)4 Record Drawing on behalf of Mason County Public PAULA JOY JOHNSON' :` Heat . / , r8l a '., sw-. - (ft;I ^ s g g- 7- z3 �UV� Signatur of i nmental Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE uwatec an 1rzcta ►" 1 — N. Mo .lN-t uP',1•5 o p_,-?" 31 `c. . 2 2 ' S CAL.ig';•-01 O l 0 10 30 40 51 \IG,.,-1.-ks- D-----761 ,E,o , 1 I ►o AS 3 - c Viz, N NJOUN. ul�tY Rp CIE t5l (cs o s\i ' 1 • ‘. •S BR '--- . \ I 1Xc..‹....) 1 Exi sk% oust I 1 I d1 i I i D Ec1c ct al )1i lifik s (a X 2-2-S ..© Art . ti1/43 sd`j"-reU'--k-,,,.,L.A.-1-s I k. leet• S N.Qcoll. i d Lf LS.✓C „ ` Rv eQ�s T'.l1 1 1 .• 510034 �f _ 4. ' ' PAULA JOY JOHNSON..1\ rif (0)4. ZZ S j 6, CSSJE-f RFs r,� N i nn, 4 44 r o e 1 1, o x2.Z-S 0 f ► 4Ls-s. b. I. L ` r y ev: J — — — r 4 8. 3 Audio-Visual Alarm wood St;4 7 l.3 Lc' 3 1200 Galion Septic Tank rJ c w•'`as -5 ti 2-Compartment with — R.E E N 8 LT Efuent Filter al 0 1000 Callon Pump Chamber APPROAUG 15 2023 VE .. : MASON COUNTY ENVIRONMENTAL IEALTN JBW