The URL can be used to link to this page

Home My WebLink AboutSWG2021-00427 - SWG As-Built - 8/15/2023 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2021-00427 Parcel # 32104-50-00059 Applicant Name Melinda Rowan Subdivision (Name/Div/Block/Lot) Applicant Address 9303 N Harborview Dr ALDERBROOK GOLF &COUNTRY CLUB/l T.S S City, State, Zip Gig Harbor, WA 98332 Installer Name Bay Shore Construction, Inc Site Address 941 E Manzanita Dr, Union Designer Name Arrow Septic Designs INSTALLATION CHECKLIST II Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑ Repair It Other 500 gallon pre-trash tank System Type Shallow Pressure Pretreatment Type NuWater BNR-500 >5 ft. from foundation? - - ❑ N/A 0 YES ❑ NO >50 ft. from wells? - - 0 ❑ ❑ Z >50 ft. from surface water? - - 0 11 ❑ < Cleanout between building and tank? - - ❑ 0 El U Tank baffles present? - - El 0 ❑ !- 24" access risers over each compartment?- - ❑ 0 El W Effluent filter installed?- - ❑ 0 ❑ co Septic tank capacity (working) NuWater BNR gal Manufacturer Infiltrator 0 D-box water level and speed levelers used? - - 0 N/A ❑ YES ❑ NO oOJ Manifold/D-box accessible from surface?- - ❑ m2 Check valves installed? - - ❑ ❑0 El 0 a 40 2 Transport Line Size 2 inch Schedule/Class Bedrooms installed (check one) ■❑ 2 ❑ 3 El 4 ❑ 5 ❑6 ❑Commercial/Other >10 ft. from foundation?- - ❑ N/A 0 YES ❑ NO 0 >100 ft. from wells?- - 0 ❑ El 111 >100 ft. from surface water? - - 0El0 >10 ft. from potable water lines?- - ❑ 0 o J � > 5 ft. from property lines and easements?- - ❑ 0 f`'r� a - 0 > ›. gi 30 ft. from downgradient curtain/foundation drains.? © ❑ 4 al Drainfield level and observation ports present - El 0 Q ❑ Graveless chambers or • Clean gravel used? (check one) 1 _ a Proper cover installed over drainfield?- - ❑ ❑ ID i w Pump tank setbacks consistent with septic tank? ❑ N/A ❑■ YES NI I] NO�17 Y Pump tank capacity (flood) 1,287 gal Manufacturer Infiltrator < 24" access riser(s) and accessible from surface?- - ❑ w ❑ F- 0. Alarm or Control Panel Installed? - - El • ❑2 Control Panel equipped with Timer/ETM /Counter- - ❑ El 0 a Pump installed in 0 Bucket or ❑ On Block or ❑ Other a Pump Make/Model Liberty 250 0 Floats or ❑ Transducer a Tank draw down 1.2 in/min Pump capacity 30 gpm Squirt Height 4 ft Pump on time 2 min Pump off time 6 hours Daily flow set at 240 gpd Upoateo 8212018 011111111111110116. Parcel# 32 t 04- 50- 0 001 Mason County OSS Installation Report pg. 2 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - 0 YES NO If yes, please describe: Were all components pumped out and properly abandoned per WAC246-272A-0300? - - 0 YES 0 NO r RECORD DRAWING This is a permanent record and must be accurate and descriptive enough to re-locate in the need of maintenance activities and future development Typical Record Drawings contain. Drarnfield&manifold orientation&layout,Septic/pump tank location North arrow,reserve drainfieid.existing and proposed buildings,location of wets.waterlines, wens,observation ports deanouts.and other maintenance access points. incomplete Record Drawings may create additional delays it final installation approval and related permits AP POVE AU615 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 1 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"alttland meet all State myself and Mason County Public Health and meet all and Mason County Code . State and Mason County Codes l further certify that information contained on this i further certify that all information contained on this form ar e Record Drawing is accurate. form and attached Record Drawing is accurate. � l I; 05/ZG(73 Signatuif of/ stalky Date orifkfr :161--ci-1646.0. Ma ,f(.14 ` Printed Name of Signee Wog I' la MASON COUNTY PUBLIC HEALTH . . .. �.`• ti The undersigned approves this installation Report and f ' 510 349 'i Z' PAULA JOY JOHNSO Record Drawing on behalf of Mason County Public G- r , I fc�,.s_�»�. ��lac• -lth: ='CSSXe�" b.3gt� (.. (�A � '5-15-23 % -1-z3 S'. Ilie Environmental Health Specialist Date (stamp, signature and date) / THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE updated 8l212018 j� � r k t �QtAY'S� up` 2 t3R ‘*olds s ro GRCZPCiV poilcH ® — — ___ i G -F------ _— .4 4,1 \, l\ `I (9 ' SCOte... \II r30 0 is 3v Lt5 t, �. I"ANZ f{ tv t T" D2 — A_S SU t LT- (I) > 3 x 51 • r Meer\ ‘-kcsaz _ID ' Pr 0\-7 Mateu 32,10y 50-0005c 0) 3 X 2`� P 0 Audio:Visual Alarm w 11-\r\ Cam) Is 35 , 0 Cleanout r-e.,S e v o Qi\ G W . 0 500 Galion Pre-Trash tank H' 04 NuWater BNR-500 ATU Tank . .4t. •..k)s O1,000 Gallon Pump Chamber !A8tiive Control Box �W.:/ r '�� 0 V O6 Val N : y�,,. 5100349 . thi:. Q ,4V: PAULA JOY JOHNSON 0 51��3NIP� °°-' » '�s9 r�src b MPO it#4 .