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HomeMy WebLinkAboutSWG2021-00411 - SWG As-Built - 8/15/2023 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH IAPPLICANT/ PERMIT INFORMATION P.-,rinit Number SWG 202 --ow I Parcel# 3(ar-7- 22.'' '3IO'f 3 'F' '‘'.'plicant Name „J/�,14 n (e. Subdivision (Name/Div/Block/Lot) \nplicant Address 2j eonkL v. State, Zip b 14 f viiA ( $b 7 Installer Name 'Y 0A Ll1.L Address -70 5£ rik.L'1 gir— Designer Name , I 161 1,-kal INSTALLATION CHECKLIST Full System Installation El Tank(s)Only ❑ Drainfield Only El Repair El Other System Type. & LLAY -f) , Pretreatment Type — ' >5 ft. from foundation? - - 0 N/A EYES 0 NO >50 ft.from wells? . 0 ❑ Z >50 ft.from surface water? - . 0 Ni 0 1--. Cleanout between building and tank? • - . CI I CI 0 Tank baffles present? - - ❑ 1721 ❑ d 24"access risers over each corrirrtment?• - CI t` IDEffluent filter installed?- CI ❑ to Septic tank capacity(working) 1206 c _gal Manufacturer rttD fe1v4[ tlT Siathc , D••box water level and speed levelers used? - - NIA 0 YES ❑ NO 1 ,Th ManifoldiD-box accessible from surface?- - 0 ❑ 1 ,' Check valves installed? - 0 ElTrculsport Line Size 2 it Schedule/Class Bedrooms installed (check one) 0 2 3 ❑4 El 5 ❑6 ❑Commercial/Other >10 ft. from foundation?- ElN/A YES El NO 0 >100 ft.from wells?- ❑ -I >100 ft.from surface water? - �J ❑ rsi ti >10 ft.from potable water lines?•- --44, aUb_/s_ >5 ft.from property lines and easements?- -- -dzy-6../v ❑ tie >30 ft. from downgradient curtain/foundation drains?j17/1? N/t il44 y ❑ ElDrainfield level and observation ports present - ❑ igi Graveless chambers or El Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ A El Pump tank setbacks consistent with septic tank? . - - - ��,,..,, ❑,,II N/A kg YES ID NO `-� Pump tank capacity(flood) (215 __gal Manufacturer ��Lc laicermilar Sr14165 7 -i"access riser(s)and accessible from surface?- -- - .- ❑ ElI Alarm or Control Panel Installed? ❑ ❑ II Control Panel equipped with Timer/ETM/Counter- El Pump installed in ❑ Bucket or On Block or ❑ Other I rump Make/Model N'152, Z48-t1. Z 11Floats or 0 Transducer 090" ,i• Tank draw down A _in/min Pump capacity gpm Squirt Height ft 1 Pump on time 0 GO Pump off time 8 iii. 5 Daily flow set at 9v gpd tlodau,J 8.21/2018 I iron County OSS Installation Report pg. 2 Parcel# 3i 1 22—'7013 ABANDONMENT RECORD ,e existing septic components abandoned as part of this project? - - ❑ YES Dr NO please describe: ___ ----------- — --f Were all components pumped out and properly abandoned per WAC246-272A-0300? • - ❑ YES NO RECORD DRAWING this is a permanent record and must be accurate and descriptive enough to relocate in the need of maintenance activities and future development. Typ cal Record Drawings contain: Drainrield&manifold orientation&layout,Septic/pump lank location,North arrow.reserve drainfieI4,existing and proposed buildings.location of walls,waterlines, wells,observation ports,cleanouts.and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and related permits. APPROVED AUG 15 2023 MASON COUNTY ENVIRONMENTAL HEALTH JBW ❑ 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. cL_Q `� i .;ni iture of Installer Date S r+ t J h12 y a f. -raled Name of Signee L3 r,,�:►► �; �N'" .'.• SON COUNTY PUBLIC HEALTH _ 1 '1•►►► ,a ► 1 he undersigned approves this Installation Report and 4tt0308S4 11► • Record Drawing on behalf of Mason County Public t 1413It►l R.t'N` • '►► He• EXPI•E o?» ZS � , 1' Sign. ure vironmental Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Updated 8r21r201A v 7.5'X 10'RESERVE NN 1111 N11 kl 111 N1 NH 16H NW 1.N4.H.0 ,NH I A Ti o r 1 7.5'X 20 -LATERAL CLEANOUT I2 ° o- LJ LJ \= = = —r! ILATERAL II NSPECTION X © PORT 1x x x x—x x x x x- x-x x-x- Q GATE' II n x D x AUTO n m x REPAIR SHOP 11 4 EMPLOYEES D x I z a x M — war —... I F X CO if a? J m v' X m x R100' `D^ m x Ili m x Z x I. x PARKITc\ x xII x am IN. Iq x x • I( x x GATE 7/2k v .11 V Y Y v Y v v vs, 1, X. YJt 160.06' I Ii\ 0 STUBOUT 1200 GALLON SEPTIC TANK 03 1275 GALLON PUMP CHAMBER TIGHTLINE �, PRESSURE TEST SQUIRT HEIGHT=90" i 1�1 PUMP CHAMBER DRAW DOWN =2"/ MINUTE %. !,>/ 8/I01 -3 TIMER SET FOR 68 SECONDS ON 8 HOURS OFF i . • DOSE VOLUME= 30 GALLONS "�^,'�," ,` It ,,...„„ I2O3O$34 <4.1 4, XI, • • o r19( Z�� P EDI a l RECORD DRAWING AUG 15 2023 ALPHA SEPTIC SOLUTION, LLC. �LTI� PO BOX 14531 TUMWATER WA 98511-4531 360-956-7242 MEgThkil CUSTOMER: ENVIR�N JACK CLOUTIER MR JBw TAX PARCEL#: 3 1 9 1 7-22-9 1 043 SITE ADDRESS: 74 SE LYNCH RD LEGAL: LOT B-3 OF SP#2975 PERMIT#: DATE INSTALLED: DATE INSPECTED: 2021-00411 4/24/23 8/11/23 INSTALLER: BAMFORD SEPTIC REPAIR, LLC.