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HomeMy WebLinkAboutSWG2022-00136 - SWG As-Built - 8/15/2023 RECORD DRAVVING (ASBUILT) pg. I MASON COUNTY PUBLIC HEALTH i . PARCEL IDENTIFICATION Permit Number SWG 2022-00136 Assessor Parcel# 32021-55-01016 Applicant Name DAVE DUVALL Subdivision (Name/Div/Block/Lot) i Applicant Address1470 S NIGHTHAWK CIRCLE SHORECREST TERRACE 2ND ADD BLK1 LOT 16 RIDGEFIELD, WA 98642 City, State, Zip Installer Name h9�� =-� C , �� k4 c$r ix Site Address 81 E ASHWOOD LN, SHELTON Designer Name ADAM HUNTER INSTALLATION CHECKLIST 1----- A Full System Installation ❑ Septic Tank Only 0 Drainfield Only ❑ Repair tl System Type Pretreatment Type 1 >5 ft. from foundation? - --� r _ ------ - ,ID NIA [2]YES ❑ t40 6 >50 ft. from wells? -- - - - - .0 ❑ >50 ft. from surface water? - -- - - ❑ © ❑ < Cleanout between building and lank? - Iil1JL tl a iiii.L- - ❑ © ❑ U Tank baffles present? - ❑ 2 ❑ a 24" access risers over each compartment?- icy` - ----;❑ 0 ❑ W Effluent filter installed?- - Z 0 0 1 c.) "t_cc Septic tank size I Z.Q� gal Manufacturer «ffij -( fa.4-41.1_, Q D-box water level and speed levelers used? r»,a ❑ YES ❑ NO x O Manifola/D-box accessible from surace?- - f LI ❑ ❑ a?2 Check valves installed? - - ❑ a ❑ °`� � 0 I- Transport Line S ze `� Schedule/Class Bedrooms installed (check one) ❑ 2 r: A -it, ❑ 5 ❑5 >10 ft. from foundation? • � ❑ N/A YES ❑ NO 11 >100ft. fromwells? ��- - - - - ❑ ❑ —! >100ft. fromsurfacewater? - - ���+ - - - - ❑ ❑ ❑ ,�, b >10 ft. from potable water lines?- ���fr - . -� ❑ ❑ R. - 5 ft. from property lines and easements? NO N?� - - � �� R. I > 30 ft. from downgradient curtam/foundation drat 1(0 4Fi� - - �I ❑ n Drainfield level and observation ports present - rgll ❑ ❑ ❑ ❑ Graveless chambers or ❑ Clean gravel used? ;check one) ti Proper cover installed over drainfield?- ❑ g ❑ Pump tank setbacks consistent with septic tank? - -- --- ❑ N/ [�] YES ❑ No Pump tank size I —" gal Manufacturer i..;'r, --,r 4-+4---'"1- cr 24" access risers) and accessible from surface?- - ❑ -El ❑ t h Alarm or Control Panel Installed? - - ❑ if1 ❑ Control Panel equipped with Timer I ETM/Counter- - 0 .❑ ❑ I 0 Pump installed in ❑ Bucket or IS On Block or ❑ Other 2 Pump Make/Model �' ,�. �'� �U . �'- 6 12""Floats or 0 Transducer ' n Tan draw down OSCAR in(min Pump capacity OSCAR gpm Squirt Height OSCAR _ . Pump on time OSCAR Pump off time OSCAR Daily flow set at 360 gpm ,44 "0.1 ,----r_ reissd 1/122114 fir.. ......... .i RECORD DRAWING (ASBUILT) pg. 2 MASON COUNTY PUBLIC HEALTH — _ • _ RECORD DRAWING n 1 El Drainfiield& manifold orientation &ieyout 0 Trent !bed dimensions and critical distances within layout El Septic/pump tank Pp .ifi, " � V placement (T� 1 It E ‘, Location of AUG I J 2023 �� ' buildings MASON COUNTY ENVIRONMENTAL 0 Observation ports& NE4LTH clean-cut locations Jew El Location of+wells, surface water, & roads Ei Undisturbed native soil between trenchts El North Arow • If the designer or installer feel the need for additional information/comments,it may be attached. 1 Record drawing may also be en a soperate page attached. No.Pages Attached ....... CERTIFICATION OF INSTALLATION • t INSTALLER i DESIGNER I 1 certify that 1 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 at ched ecord Drawing is accurate. form and attached Record Drawing is accurate. Signature of installer - Date /c�,//�.—..� I i,.- d 7/27/23 Printed Name • or Signee ,.•... + +'`j „,: MASON COUNTY PUBLIC HEALTH . �t The undersigned approves this Installation Report and Reco - or-awing on behalf of Mason County Public .; t-, ;'mitt 1 l'e,ith' 4 bloom `` 1 HUNTER `." t t D 4. / • -(3"(2 6" ( 5 % ' ADAGJ.i'fil'rit'filtiKS`iaM: : Sign. ,ure ge ironmental Health Specialist Date (designer's stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE sy ASHWOOD LN 60' 0 A m m iE z D 1 m _ w 0 Z xi in 7J o m o cn D • C 1 D C Z K CD o 0 • D cn a) C m m x v r Y 0•• 0 I z L.____________._._ _.m n O D o m D A A O II X e ir D N D Z T Ti, r m o 0 0 N N -0O m T -I N O 3 13 0 x -i N m O ~ N.) 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