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HomeMy WebLinkAboutSWG2023-00225 - SWG As-Built - 8/22/2023 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2023-00225 Parcel # 22331-53-00061 Applicant Name Phil Freund Subdivision (Name/Div/Block/Lot) Applicant Address PO Box 1825 Collins Lake Div 4 Lot 61 City, State, Zip Belfair, WA 98528-1825 Installer Name Allied Septic Design Excav/Marcii Site Address 201 NE Sundown Dr, Tahuya Designer Name Frank Marcinko INSTALLATION CHECKLIST © Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑ Repair ❑ Other System Type Sand Mound/Lowridge Tech/Oscar X02 Pretreatment Type Areation prior to sand filter >5 ft.from foundation? - - ❑ N/A ®YES ❑ NO >50 ft.from wells? - - 111 ❑ ❑ Z >50 ft.from surface water? - - ❑ ® El HCleanout between building and tank? - - El ® ❑ V Tank baffles present? - - ❑ ® ❑ a24"access risers over each compartment?- - El I ❑ co Effluent filter installed?- - ❑ ❑ 1. Septic tank capacity(working) 1000 gal Manufacturer Hagerman Pre Cast 5 D-box water level and speed levelers used? - - ® N/A ❑ YES ❑ NO OO Manifold/D-box accessible from surface?- - ❑ El El 032 Check valves installed? - - ® ❑ ❑ ❑Q E Transport Line Size 1" PVC Schedule/Class Sch 40 Bedrooms installed (check one) ❑ 2 ❑� 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10 ft.from foundation?- - ❑ N/A IN YES ❑ NO G >100 ft. from wells?- - In ❑ ❑ W >100 ft. from surface water? - - ❑ ❑ EC >10 ft.from potable water lines?- - ❑ MN ❑ Q Z > 5 ft.from property lines and easements?- - ❑ [PI ❑ re > 30 ft. from downgradient curtain/foundation drains? - - ❑ NI ❑ 0 Drainfield level and observation ports present - - ❑ ® ❑ ❑ Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?- - ® ❑ ❑ Pump tank setbacks consistent with septic tank? - - ❑ N/A It YES 0 NO `-r Pump tank capacity(flood) 1166 gal Manufacturer Hagerman Pre Cast Q 24"access riser(s)and accessible from surface?- - ❑ ® ❑ aAlarm or Control Panel Installed? - - ❑ 0 ❑ 2 Control Panel equipped with Timer/ETM/Counter- - ❑ IN ❑ n Pump installed in ® Bucket or ❑ On Block or ❑ Other a ti , ake/Model Franklin Electric 30 GPM Floats or ❑ Transducer M A?7 C Ta,9k draw down. NA in/min Pump capacity 30 gpm Squirt Height NA ft SON,-, Pur time 30 sec Pump off time 3 min 30 sec Daily flow set at 360 gpd NVIRO Updated 8/21/2018 uJA NMENTA(86-, Mason County OSS Installation Report pg. 2 Parcel# 22331-53-00061 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - �■ YES [] NO If yes, please describe:Fiberglass septic tank was pumped and abandoned by filling with soil Were all components pumped out and properly abandoned per WAC246-272A-0300? - - E■ YES NO RECORD DRAWING This is a permanent record and must be accurate and descriptive enough to re-locate in the need of maintenance activities end future development Typical Record Drawings contain: Dralnfield&manifold orientation&layout,Septic/pump tank location,North arrow,reserve drainfield,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. 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 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 ecord Drawing is accurate. form and attached Record Drawing is accurate. 08/18/2023 e•i Signature of Installer Date if f Frank Marcinko i' ,tt Printed Name of Signee j , / MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and 201006 �I Record Drawing on behalf of Mason County Public Frank A.Marcinko 14 Healt • - LICENSED DESIGNER I V 44_Z0OZjt •• •r ire. 0•,% 7 Signature of Environrwa?taQHAaltp,//Sfecialist Date (stamp, signature and date) MASON ��,RM MAY BE ESCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Updated arztnota UN I Y ENVIRONMENTAL HEALTH DJA Record Of Construction . 2p6.54 ;-� N <1). Seasonal Ponding Drainage / r SL#1 0"-22"Sand Loam .� 23"Compact layer O_ DrivewaySL#2 0"-22"Sand Loam 9 23"Compact layer SL#3 0"-25"Sand Loam 26"Compact layer 6s vikpYI Driveway \a - I� APPROVED 3 Bedroom 2tn ut o`b AUG 1 2 2023 26'8"X 70' M Home tro'siw'm con 1 -...........'" % o A P"24�f'A COUNTY ENVIRONMENTAL HEALTH 4' 11 Pc* r ) -�:,5 DJA a ce co _ ems•...._._,_ j twil�, Z. rY e c e Q� �' O 0° P`O45�a� c''<6 0- i VB Q,, 9 a Q(P. S • X 00* (� / a'�o G� / PS Pam/ c' Pa /// OXS' SO'l'ore/.rya O / atP'. ',t r , / Ik.,, 1I Drainage Culvert ,t / tt Seasonal Ponding • j'' _ di tt •�8i- 20100609 +t+ 0 Frank A.Mardnko 0' LICENSED DESIGNER t 0 ..........N...wmgoo..w...k..00,1/ -fret t96 Septic System ROC Name:Freund Tax Parcel: 22331-53-00001 99.36'r p<<IEQ Scale= 1" = 50' Address: 201 NE Sundown Dr,Tahuya 4.',It go This is not a survey ell property lines/boundaries have been demonstrated by the Owners)and/or their Agent(s). On-Site Septic Design i Allied Septic Design and Excavating