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HomeMy WebLinkAboutSWG2023-00186 - SWG As-Built - 8/15/2023 Mason C• . ty OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION 0Pe iVtumb••r SWG 2023-00186 Parcel # 42024-13-00300 P�IGApplic t Nam- Estate of Roland Quinn Subdivision (Name/Div/Block/Lot) *Y.iV. Address PO Box 364 City, State, Zip Shelton, WA 98584 Installer Name Maples Excavating Site Address 2230 W Railroad Ave, Shelton Designer Name Arrow Septic Designs, Inc INSTALLATION CHECKLIST Il Full System Installation ❑ Tank(s)Only ❑ Drainfield Only Q Repair ❑Other System Type Shallow Pressure Pretreatment Type >5 ft. from foundation? - - - - - ❑ N/A 0 YES ❑ NO >50 ft. from wells? - 1ETi- F --- 0 I: ❑ z• >50 ft.from surface water? - - - - - - - 0 ❑ ❑ H Cleanout between building and tank. _-A-0.6-1-0�a1.-J--i,- - -- ❑ ❑■ ❑ ✓ Tank baffles present? - l - ❑ 0 ❑ a24" access risers over each compartment? ❑ 0 ❑ W Effluent filter installed?- = -; - ❑ ■❑ ❑ cn Septic tank capacity (working) 1,060 gal Manufacturer Infiltrator 0 D-box water level and speed levelers used? - - El N/A ElYES El NO DO Manifold/D-box accessible from surface?- - ❑ ❑■ ❑ Cat Check valves installed? - - - -- " e' '`\ - ❑ ❑■ ❑ 0< E Transport Line Size 2" Schedule/Class 40 Bedrooms installed (check one) 0 2 ❑ 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10 ft. from foundation? P P N/A ❑■ YES ❑ NO CI >100 ft. from wells?- w >100 ft. from surface water? - - - - - , - - � -r ,J ® ❑ ❑ 5:- TIA: u. >10 ft. from potable water lines?- - - _ ❑ ❑ ❑ 0 Z SON�bt1NTY ENQ > 5 ft. from property lines and easements? � :El H ❑ 0 ❑ ce > 30 ft. from downgradient curtain/foundation drainsIBW - II ❑ ❑ 0 Drainfield level and observation ports present - - 0 II ❑ ❑ Graveless chambers or 0 Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ ■❑ ❑ Pump tank setbacks consistent with septic tank? - - ❑ N/A II YES ❑ NO • Pump tank capacity (flood) 1,000 gal �Ma�nufacturer Existing Concrete < 24" access riser(s) and accessible from surface?- - - , & - - - - - ❑ 0 LI H a Alarm or Control Panel Installed? - - ❑ II ❑ E Control Panel equipped with Timer/ETM/Counter- - ❑ I. ❑ D Q. Pump installed in ❑ Bucket or 0 On Block or ❑ Other a-• Pump Make/Model Zoeller N152 EU Floats or ❑ Transducer a • Tank draw down 3 in/min Pump capacity 57 gpm Squirt Height 9 ft Pump on time 1 min Pump off time 6 hr Daily flow set at 240 gpd Uo.".aced 5:2'..2018 r , Parcel# 420 Z 1 L( Mason County OSS Installation Report pg. 2 - `�o 0�c ABANDONMENT RECORD - } YES � NO Were existing septic components abandoned as part of this project?. - A. If yes, please describe: 0 D.c. A-0 1U2 a � NO 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 re-locate in the need of maintenance activities and future development elopm of caatRecord Drawings contain: Drainfieid&manifold orentation&layout.Septic/pump tank location,North arrow,reserve drainfield,easting and proposed buildings, and wells,waterlines, erlines, wells,observacon pops,deanouts,and other maintenance access points. Incomplete Record Drawings may create additional delays in final instaiaton approval • mits. AUG 15 2023 t Record Drawing Attached ..: �� �vviRONMENraI.r�Ni r� 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. 'Signature of Installer Date A c1/1 -\tik`e_ i'L'(&-e(t 5 ,,' -..*), Printed Name of Signee y r 'V�, MASON COUNTY PUBLIC HEALTH v' �� The undersigned approves this installation Report and .: � J ,!�' Sto sn9 Rec Drawing on behalf of Mason County Public + � PAULA JOY JOHNSON a1th: " 3:-E ---c\ E'Ft" 1. � �n"S't c -IS ~Z ExPRES g— 1—Z 3 Sig atu 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 8212018 ems;-o�- Parcete 42c72u.t�-OD30Q \--?-11""t 22 3___o w Ra; l rood ve _._. — . — — - - �5� . . t ., _ Zo. —, — 3 % 17 0 Scale: _� — - -___ • � — o \. I -}�re h C tau,5 �a S �•� o to Zo 30 W i-LA feS fv'v.e a S `, 101oSlope 5v owN Q=?tSf ?ole - 4:\ . lA., 34" •ciru foam sai , o� �aica a.�. : y e Ix Oan Audio-Visual Alarm „ loamy Sated - 7© y 3`�-5y fires � � • -- - With Stiq h-t M0 ft, gat 0 Cleanout 'ill V 1 di- 4 Co hip 0 li 10, ' () 1000 Gallon Septic Tank 2-Compartment with C yu, f00f5 ti,ro Ito Q V'�"} . ® j Effluent Filter-p4� G .,Jl rx;Str'n yy 2. iv 5 y" •Fi v�►t, i Gamy o I O 1000 gallon tan , Ltd 5XiSft r1 r:Srrc .rt:dS, use as prime Sand + 3 r01Y e 1 W;th O Valve Control Box cha'"b- 2 BR d.c. t Sony. d tvrlxd soils . -s 1. -1 N * M4Cf i I? -}•o be S ►-e v ed i- e i co v red \ L----- witzr, 10 ' o-F _an Li � St' tiC C o rn po ku iS 7 f4 c QAA cr\ rend • \ i I A • iA P P 3 V E -. i _ .10AUG 5 2023 VIRONMENTAL HEALTH '4' 0 ! i�;iAS:i�COUNTY E JJ. • .*-13' 1 \ SW r 10 34 9 :ii,) 1 �'' ' PAULA JOY JOHNSON ' JJ\ ' \VTiv-e wai 1