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HomeMy WebLinkAboutSWG2022-00269 - SWG As-Built - 8/22/2023 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2022-00269 Parcel # 32104-52-00146 Applicant Name AB Fine Homes Subdivision (Name/Div/Block/Lot) Applicant Address 871 E Beach Dr ALDERBROOK G&Y#2 TR 146 City, State, Zip Union, WA 98584 Installer Name Hanson Excavating Site Address 150 E Dogwood Ln, Union, WA Designer Name Arrow Septic Designs INSTALLATION CHECKLIST NE Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑ Repair •Other Soo Gallon Pre-trash Tark System Type Shallow Pressure Pretreatment Type NuWater BNR-500 >5 ft.from foundation? - - ❑ N/A El YES ❑ NO >50 ft. from wells? - - LI ❑ ❑ Z >50 ft. from surface water? E ❑ ❑ HCleanout between building and tank? - - ❑ . ❑ U Tank baffles present? - - ❑ • ❑ a II El access risers over each compartment?- - ❑ W Effluent filter installed?- -SOD - El ❑ ❑ Septic tank capacity (working) NuWater BNR gal Manufacturer Sount Placement 0 D-box water level and speed levelers used? © NSA ❑ YES ❑ NO p0 Manifold/D-box accessible from surface?- ❑ IN �?Z Check valves installed? - 0.+ y� �a`z>` _ _ _ _ _ Elit ❑ ❑Q 2 Transport Line Size 2 inch Schedule/Class 40 Bedrooms installed (check one) ❑ 2 ❑■ 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10 ft.from foundation?- - ❑ N/A ® YES ❑ NO 0 >100 ft. from wells?- -- - - m ❑ ❑ W >100 ft. from surface water? - © ❑ ❑ >10 ft. from potable water lines?- - ❑ 0 El > 5 ft. from property lines and easements?- . ❑ NJ ❑ Q CC > 30 ft.from downgradient curtain/foundation drains? - - © ❑ ❑ Drainfield level and observation ports present - - ❑ UI ❑ ❑ Graveless chambers or K Clean gravel used? (check one) Proper cover installed over drainfield?- ❑ ® ❑ Pump tank setbacks consistent with septic tank? - - ❑ N/A I YES ❑ NO `-r Pump tank capacity (flood) 1,200 gal Manufacturer Sound Placement < 24" access riser(s)and accessible from surface?- - ❑ IN ❑ r- a Alarm or Control Panel Installed? - - ElMI El 2 Control Panel equipped witn Timer/ETM/Counter- - ❑ • ❑ m a Pump installed in ❑ Bucket or UI On Block or ❑ Other n'• Pump Make/Model Liberty 280 ■❑ Floats or ❑ Transducer a Tank draw down 1.5 minutes in/min Pump capacity 33 qpm Squirt Height 4 ft Pump on time 2.7 minutes Pump off time 6 hours Daily flow set at 360 qpd ,,pate❑8.210.0113 Parcel# 32-1 04 - 5z - 00I4(c. Mason County OSS Installation Report pg. 2 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - YES NO If yes, please describe Ell 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. Typical Record Drawings contain: Drainfield E,manifold orientation&layout.Septic/pump tank location.North arrow.reserve drainfeld.existing and proposed buildings.location of wells,waterlines, wells,observation ports.cleanouts.and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and related permits. w CV Lti INN en ® N O n+2 C" w -4 } • C Q 0 U /Mg . 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. Z9'kL oe-IS` Z 3 Sig ure of Installer Date AJared Hanson ,� � Printed Name of Signee a o, +u, '9 P MASON COUNTY PUBLIC HEALTH �4 `'' ` ,IP -J j� The undersigned approves this Installation Report and f, �j(1• Record taws g on behalf of Mason County Public �'<5^ PAULA JOY JOHNSON •�''Z 7 Si`(¢V iGN C: f Health I ' _ 715 - . (40 4 Si ture E i n ental Health Specialist Date (stamp, signature and date) S FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Upaared 8212°16 • KEG . 0Audio-Visual •Alarm . ' • Ab l Vi-- 0 Cleanout A5 Ft S^ . Ho m e O s 500 Craton Pre-Trash tankfarC.( 32I Q 9-'5 2-OG J k, 3NuWater BNR-500 ATU Tank !SO cDarwoco L �'. 05 1,000 Gallon Pump Chamber S CO. Le . 1 20 06 Valve Control Box G s o 20 30 J. O. APPROVE A 11, N . �\ \ J s AUG 12 2023 'MASON COUNTY ENVIRONMENTAL HEALTH JBW 1 L.. O to- 1 \ Pro • J i • 4, / F- . , //z k. ®� L / , /z / / / Ni (3 ) 3 x 5G zs� // e �,; �3`x 3 1 �- x1 �; o ( E ) 3 x Z 0 ' cf �� Pr i cn7 ad y D. F "1-7Y eAA.c./n,eS 5 t p .G. ,.,, -, -t-t,.. re sever e- (,-, IN -/.l ck..b o - / 05; 4Ltb vt, ' 7.4, tc.447 ‘.443.(k, % 51010 4 9 :j PPAUULL�A JOY JOHNSON.�'• . �( exw�.s asri,