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HomeMy WebLinkAboutSWG2023-00365 - SWG As-Built - 9/20/2023 MM SEP 2 0 2023 M • .ON COUNTY PUBLIC HEALTH Mason County OSS Installation Report P9 1 , �N APPLICANT! - - ' • Permit Number SWG 2023-00365 Parcel# 12207-75-00340 Subdivision (Name/Div/Block/Lot) Applicant Name Malissa Fyffe TR 34 OF SURVEY 5194-96 Applicant Address INSereno Circle Dr City, State, Zip Bremerton,WA 98312 Installer Name Bamford Septic Repair Site Address 41 E Razor PI,Belfair Designer Name Arro____W Septic Desions INSTALLATION CHECKLIST El Other 1111 Full System Installation 0 Tank(s)Only 0 Drainfield Only 0 Repair Pretreatment Type System Type Shallow Pressure - El NIA 0 YES ❑ NO >5 ft.from foundation? ❑ ❑ >50 ft.from wells? - 0 0 0 Z >50 ft. from surface water? El 0 0 < Cleanout between building and tank? - ❑ 0 El • Tank baffles present? 0 Si 0 - 1--- 24" access risers over each compartment? ❑ 0 Lill Effluentfilter installed? existing concrete Septic tank capacity (working) 1200 gal Manufacturer 0 N/A ❑ YES ❑ NO ❑ D-box water level and speed levelers used? - 0 ❑ DJ O Manifold/D box accessible from surface?- ❑ II ❑ 0?-2 Check valves installed? - �[ Goa 2 Transport Line Size 2 inch Schedule/Class 40 2 3 0 4 0 5 0 6 ❑Commercial/Other Bedrooms installed (check one) ❑ �>10 ft. from foundation?- - ❑ NIA 0 YES ❑ NO 0 0 0 >100 ft. from wells? 0 W >100 ft. from surface water? - 0 ❑ LL, >10 ft. from potable water lines?- 0 0 ❑ Z > 5 ft. from property lines and easements?- - ❑ cc > 30 ft.from downgradient curtain/foundation drains?- - ❑ © ❑ Drainfield level and observation ports present 0 ill pp Graveless chambers or ❑ Clean gravel used? (check one) 0 Et ❑ Proper cover installed over drainfield?- Pump tank setbacks consistent with septic tank?- - ❑ NIA YES ❑ NO 1,000 gal Manufacturer Hagerman Y Pump tank capacity (flood)Z < 24" access riser(s) and accessible from surface? 0 ❑ 0 11 0 El aAlarm or Control Panel Inatallcd? - - - - - . 0 0I Control Panel equipped with Timer I ETM /Counter- d Pump installed in ❑ Bucket or 0 On Block or 0 Other aZoeller N-152 0 Floats or ❑ Transducer Pump Make/Model 7,5 ft A� 2 in/min Pump capacity 38 gpm Squirt Height !� �' Tank draw down _ Pumpon time 2.3 minutes Pump off time 6 hours Daily flow set at 360 gpd SEP 2 0 2023 Lpaated 8421;2018 MASON COUNTY ENVIRONMENTAL HEALTH DJA • Parcel# k 2 2 01 —15— 00 3 Mason County OSS Installation Report pg. 2 ABANDONMENT RECORD _ r2 YES ❑ NO Were existing septic components abandoned as part of this project? If yes, please describe: iralh-c-ie GL YES ❑ NO Were all components pumped out and properly abandoned per WAC246-272A-0300? - RECORD DRAWING Typical Record ocate In need maintenance activities and This isn a permanent record and must be Lion&a and descriptive stank location,ough to lNorth arrow,eeserve d a field e>asting and proposed buildings location of were development lls,waterlines, DSflpt w ls,observation contain: Draports, cle &uts,anldd orientation&layout,access p ump wells,observation ports,deanouu,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 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. °Cy 14 1 2-3 /4 Signature of IInnstalle ate �� . •�� T""p�. � 4.0� wV Printed Name of Signee �� Z�,,i. MASON COUNTY PUBLIC HEALTH ( •"� 11,, The undersigned approves this Installation Report and rJ a ��' stooa49 ,�,�‘ `, �a:a r PAULA JOY JOHNSON '. (}, Record Drawing on behalf of Mason County Publi Ep 2 0 2023 :L'IC�tSE t SiGNEfI'`S Health: ^! SQ 1 O b$1� 7/70/jet,„viRo,,r�t�IrrA ��� z5 Si nat re of Environmental Health Specialist Date 0JA _NEA(Ty (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE upeated 821/20t8 • ,hetv _fir ____LIL-- NIA 1�SSa 4 �'feV 1 IacCf 1 J 2.201-7 5-0 1-- 1°_ : q LLo.So r PI0.1 f� (*°) 5CaIr: I ": 3o ' goo' / 0 16 3 o 95 &° / '"� E. ' S4-'Ylal drglil• ild d Ctbana0lned. 3 n1 Ex?sTme, e• iz „� .�q`r P (0 0 `� CD _ tio.* "1, :;•?a �c, eas rvur,-Y ���?' s,003ae\ "b PAULA JOY JOMNSON • Exa+aes i i�� eAli-). ----.. \ : i Key; Ss 0 Audio-Visual Alarm \ 0. f F Cleanout ,i Xi S}i Y1 • - P q 4- (( 1200 Gallon Septic Tank ' 2-Compartment add >g08• -6/� o Effluent Filter,f i 5 c 15 +t:d 5 , i '" d 44 1000 Gallon Pump Chamber oC O Valve Control Box \ w 5�• A\ (I) 3 x 2! ' E Ro,Sor L.N (2)3'x41 e Q.tM \ (,o a o,S rNLY\k 2,00 `-- --Vj'-'t3L. SEP 2 0 2023 MASON COUNTY ENVIRONMENTAL HEALTH DJA