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HomeMy WebLinkAboutSWG2021-00478 - SWG As-Built - 8/30/2023 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 202100478 Parcel # 32122-50-(mil 00 2,0 -? Applicant Name JDR CONSTRUCTION Subdivision (Name/Div/Block/Lot) Applicant Address 51 E CARDIGAN CT City, State, Zip SHELTON, WA 98584 Installer Name BAYVIEW CONTRACTORS Site Address 51 E CARDIGAN CT Designer Name LAWRENCE PURDUM INSTALLATION CHECKLIST Q Full System Installation ❑ Tank(s) Only ❑ Drainfield Only ❑ Repair ❑ Other System Type PRESSURE DISTRIBUTION Pretreatment Type ATU >5 ft. from foundation? - - ❑ N/A ® YES ❑ NO >50 ft. from wells? - - ❑ II El Z• >50 ft. from surface water? - - ❑ I ❑ H• Cleanout between building and tank? - - ❑ El U Tank baffles present? - - ❑ M ❑ d24" access risers over each compartment?- - El ❑ W Effluent filter installed?- - ❑ MI ❑ u) Septic tank size 500 gal Manufacturer NUWATER BNR 500 0 D-box water level and speed levelers used? - - III N/A ❑ YES ❑ NO ><O Manifold/D-box accessible from surface?- - ❑ NI ❑ ca 2 Check valves installed? - - ❑ ® El 0< 2 Transport Line Size 2" Schedule/Class 40 Bedrooms installed (check one) III 2 ❑ 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10 ft. from foundation?- - ❑ N/A ® YES ❑ NO CI >100 ft. from wells?- - ❑ ® ❑ WCI>100 ft. from surface water? - - ❑ IS L >10 ft. from potable water lines?- - El IN ❑ Z > 5 ft. from property lines and easements?- - ❑ . ❑ L > 30 ft. from downgradient curtain/foundation drains? - - ❑ NI ❑ o Drainfield level and observation ports present - - ❑ I. ❑ pi Graveless chambers or El Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ I ❑ Pump tank setbacks consistant with septic tank? - - ❑ N/A I YES ❑ NO • Pump tank size 1,000 gal Manufacturer HAGERMAN PRECAST Q 24" access riser(s) and accessible from surface?- - El I El ~ Alarm or Control Panel Installed? - - ❑ WI El a 2 Control Panel equipped with Timer/ ETM /Counter- - El • ❑ D d Pump installed in ❑ Bucket or in On Block or ❑ Other a• Pump Make/Model HYDROMATIC SHEF ® Floats or El Transducer CL a Tank draw down 2 in/min Pump capacity 40 gpm Squirt Height 5 ft Pump on time 60 SECONDS Pump off time 4 HOURS Daily flow set at 239.4 gpd Updated 8/21/2018 Mason County OSS Installation Report pg. 2 Parcel# 32122-50-0207 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - _ YES El NO If yes, please describe. Were all components pumped out and properly abandoned per WAC246-272A-0300" - - © YES NO RECORD DRAWING This is a permanent record and must be accurate and descnptive enough to re-locate in the need of maintenance activities and future development. -,s:_a' .r'.'.J o'�Br'd':C^,6 A*a. 4zG'' _'^p:ar4 �3': 3m;i� nf. y •?sf":E drd� end,Mang and araevse:tw�ld�rgs.;c^.a:;;r clues :•f3tEr:^Ef. ssrts :ea- ,.'s n:7 C"E••tea,�Ic"-J"ce 3G^.Etc r:^r'S r-av:'ea:e aCG,rona'sways f na''installat::n aio'cya aria+2la e:_e'^. PROVE AUG 3 0 2023 MASON COUNTY ENVIRONMENTAL HEALTH Jew 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 1 further certify that all information contained on this I further certify that all information contained on this form and attacl ed Record Drawing is accurate. form and attached Record Drawing is accurate. 8/23/2023 Signature of Installer Date Mike Skinner 10/". Printed Name of Signee .4. • MASON COUNTY PUBLIC HEALTH ;' t . The undersigned approves this Installation Report and ,= :• ' • s4 Record Drawing on behalf of Mason County Public :°�LawrenceM.Purdum';�',, -It ; LICENSED DES`GNER\`,„\„;tip EXPIRES 2/25/2025 with Sig at i!Environmental Health Specialist Date (stamp. signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE 14 b U ,010°' ,^. r 4ii i No ow ;. �Z-5'\r�� J b /11j111' ill-t11=iyi O S 0 FFy� _ i ON Ih`11'Alt;�1�y • • c €111) P. W O w Z a W W iz O m Z vn Q CO• _ o ..1., a_1- , U J 0 W o a r O O M Ux O IO O Q W U d p 40 M 7 0 Q W\ W e g CV IN/1 Q - ,5 W pt N d' O Et U U I a� . ~ Z .. 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