HomeMy WebLinkAboutAFTER THE FACT - SWG As-Built - 8/24/2023 l
AFTER THE FACT RECORD DRAWING, pg 1 MASON COUNTY PUBLIC HEALTH
PARCEL IDENTIFICATION
Owner Name ROBBIN DUNN Assessor Parcel# 12108 54 00002
Mailing Address 70 E SUND RROAD O/M Specialist Name
City, State, Zip GRAPEVIEW, WA. 98546 Installer Name FRANK DEMIERO
Site Address Designer Name
Please complete this checklist to the best of your knowledge. If items are unknown leave blank.
INSTALLATION CHECKLIST
System Type GRAVITY Pretreatment Type
Drainfield Ln. Ft. 80 Drainfield Sq. Ft. 240 Drainfield depth
>5 ft. from foundation? - - C N/A 13 YES El NO
>50 ft.from wells? - Sil
� LI
Y >50 ft. from surface water \-
? - W �- -1' ' ' ag ❑
Z 1
Cleanout between building and tank? - �, ❑
o Tank baffles present? - _ �� _2 4 2- . CZ ❑
a. 24"access risers over each compartment?- - - - ❑ ❑
IN
W Effluent filter installed?- k_ II] gl
Septic tank size 7So gal By .cturer N 2/c/o,:..""
0 D-box water level and speed levelers used? - - -. ElN/A [1] YES Igl NO
oO Manifold/D-box accessible from surface? ❑ ❑
Q Q Check valves installed? - - - -- - El
.14
2 Transport Line Size " Schedule/Class
0
Bedrooms installed(if known) 012 ❑3 ❑4 ❑5 ❑6 ❑Commercial/Other
>10 ft.from foundation?- ❑ N/A ❑ YES 3 NO
CI >100 ft. from wells?- - ❑ 4 0
-1 >100 ft. from surface water? 0 ❑ .I
W
ti >10 ft. from potable water lines?- ❑ g ❑
Q > 5 ft. from property lines and easements?- - -- _ _ _ _ _ . ❑
XI
cc > 30 ft. from downgradient curtain/foundation drains? - ❑
111
Observation ports present? - ❑ ❑ N
❑ Graveless chambers or k Clean gravel used? (check one)
Proper cover installed over drainfield?- - ❑ g ❑
Pump tank setbacks consistant with septic tank? - - ❑ N/A ❑ YES X NO
Y Pump tank size gal Manufacturer
Z
24"access riser(s) and accessible from surface? - - . ❑ ❑ ❑
a. Alarm or Control Panel Installed? ❑ ❑ ❑
2 Control Panel equipped with Timer/ETM/Counter ❑ ❑ ❑
n- Pump installed in ❑ Bucket or ❑ On Block or ❑ Other
2 Pump Make/Model ❑ Floats or ❑ Transducer
Tank draw down in/min Pumpcapacity acit P Y gpm Squirt Height ft
Pump on time Pump off time Daily flow set at gpd
Updated 229/2016
AFTER THE FACT RECORD DRAWING, pg 2 Assessor Parcel#
RECORD DRAWING
❑ Drainfield&manifold
orientation&layout
w/dimensions for
re-location.
0 Trench/bed
dimensions and
critical distances
within layout
0 Septic/pump tank
Location w/dimen-
Sions for re-location
❑ Location of buildings
existing/proposed
❑ Observation ports,
clean-out locations,
&manifolds/d-boxes
❑ Location of wells,
surface water,roads,
&waterlines.
❑ Reserve area(s)
❑ North Arrow
THERE IS AN ORIGINAL RECORD DRAWING FOR THIS PARCEL, THIS IS
TO DESIGNATE A RESERVE AREA.
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If needed drawing may be attached on a separate page No. Pages Attached
CERTIFICATION OF INSTALLATION
DESIGNER/APPROVED O/M SPECIALIST
I certify that the information contained in this document is accurate to my knowledge. The drawing and information
has bobtained th ugh common locating practices.
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Signature of e igner or Approved DIM Specialist Date
MASON COUNTY PUBLIC HEALTH
This is an after the fact record drawing, which may or may not include a county inspection. This information is to only
document an existing OSS location and components.
Signature of Environmental Health Specialist Date
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE upealee 2Q9r2U16
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SEWAGE SYSTEM CERTIFICATION
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Property Owner, $//A64.0 I ' Address /V2?J• /2/ A✓f b'E
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Sewage Contractor f, Q eft 1i A • Date S/3773 Par3c1#
1. Scale: 1 Square = 10' 1
2. Draw in physical structures to be on lot.
3. Show location of well or any body of water.
4. Show location of septic system in relationship to structure.
5. Assume an elevation of 100' at one lot, corner & indicate the other lot corner
elevations in relation to it.
6. Use arrows to show direction of slope. Pa•/ 4...4 ✓IF
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Septic Tank Volume 7.1n)
Drainfield Length SSJe4
Cubic Yards gravel used V..7 I/
I certify that this system is installed as shown above, and that all- �Y
requirements and standards of Thurston-Mason Health District hav N
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been satisfied. �y,`
Signat a /v 4=-s>
Contractor's License # 2 L 3 'J L i-a L L
June, ..--1!:7
1970� /� -41'7)