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HomeMy WebLinkAboutSWG2021-00082 - SWG As-Built - 9/13/2023 Lr SEP 1 12O23MA'•ON COUNTY PUBLIC HEALTH Mason County OSS Installation Report pg. APPLICANT/ ' i+ I vi j• ATI0 N I. Permit Number SWG 2021-00082 Parcel # 221 1 4-76-001 50 Applicant Name David & Martha Lindt Subdivision (Name/Div/Block/Lot) Applicant Address 600 E Wilson Way City, State, Zip Grapeview,WA 98546 Installer Name Ron Hemley Septic Site Address Same Designer Name Arrow Septic Designs INSTALLATION CHECKLIST © Full System Installation ❑ Tank(s)Only jib ❑ Drainfield Only ❑ Repair II Other Attenuation Zone System Type Shallow,"2` - Pretreatment Type >5 ft. from foundation? - - ❑ N/A 0 YES ❑ NO >50 ft. from wells? Sep �� - - - - - ❑ I] ❑ Z >50 ft. from surface water? - - - y ,j;;� - 0 ❑ ❑ HCleanout between building and tank? - - -".,` - - - - - ❑ ❑■ ❑ U Tank baffles present? - - ❑ ❑■ ❑ d 24" access risers over each compartment?- - ❑ ❑U ❑ W Effluent filter installed?- - ❑ I ❑ u) Septic tank capacity (working) 1,250 gal Manufacturer Hagerman Ca D-box water level and speed levelers used? - - 0 N/A ❑ YES ❑ NO oO Manifold/D-box accessible from surface?- - ❑ ❑■ CI u. co-2 Check valves installed? - - ❑ I ❑ oa I 2 Transport Line Size 2" Schedule/Class 40 Bedrooms installed (check one) 0 2 ❑ 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10 ft. from foundation?- - ❑ N/A Q YES ❑ NO O >100 ft. from wells?- - ❑ 0 ❑ W >100 ft. from surface water? - - 00 ❑ LL >10 ft. from potable water lines?- - ❑ El ❑ � > 5 ft. from property lines and easements?- - ❑ 0 ❑ Q re > 30 ft. from downgradient curtain/foundation drains? - - © ❑ ❑ Drainfield level and observation ports present - - ❑ © ❑ ❑ Graveless chambers or It Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ ■❑ ❑ Pump tank setbacks consistent with septic tank? - - ❑ N/A 0 YES ❑ NO • Pump tank capacity (flood) 1,000 gal Manufacturer Hagerman < 24" access riser(s) and accessible from surface?- - ❑ II ❑ Ha. Alarm or Control Panel Installed? - ? Control Panel equipped with Timer/ETM /Counter- - ❑ II El a Pump installed in ❑■ Bucket or ❑ On Block or ❑ Other - • a• Pump Make/Model Liberty 290 0 Floats or ❑ Transducer a Tank draw down 2.75 in/min Pump capacity 52 gpm Squirt Height 10 ft Pump on time .66 min Pump off time 4 hr Daily flow set at _ 206 gpd oadated .J2 f2O18 kW Mason County OSS Installation Report pg. 2 Parcel# Z- 2 ` - ? co - 0 0 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - • ❑ YES 1111 NO If yes, please describe: Were all components pumped out and properly abandoned per WAC246-272A-03002 - - ❑ YES Q NO RECORD DRAWING Trite 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: Dranfield&manifold onenlation&layout,Seplicipump lank location,North arrow.reserve dr8infeld.existing and proposed buildings,location of wells,waterlines, wells,observation ports.deenouts.and other maintenance access points. Incomplete Record Drawings may create additionei delays in final instakeGon approval and related permits. II 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 air 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 f nd atta had ecor Drawing is accurate. form and attached Record Drawing is accurate. Signet of Installer� l Date em Printed lme of Signee ..e •.;J MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and ..�J� !f • �1. Record Drawing on behalf of Mason County Public J N4�PAULA JOYJi9HNSON Health: A-s1"�'SEN�SE r iC,VE ^ , EXPAES-667161 PN6L-17 \ed,fI 7IC12_>3 - 23 Signature of Environmental Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Updated 8r2tnot8 i so' • t zone F Gi'iNt, ell sd"'''' 1 0/ • lv, t 0 ?•1 9-. �— 51C0349 •I 1 GM- .• .o- P• LA JOY JOHNSON A. too s)0 • - - _ 1 s APPROVED I N SEP 13 2023 `-c, MASON COUNTY ENV1RONMENTAL HEALTH N- RET • v 0 Audio-Visual Ai 3 C1ea*iout 1200 C-allon Septic Tank 2-Compa-tnent with Effiuevt Filter 0 1000 ilo Pul C-"be wr+hGa arr.a 'Tipp hc't ;() Valve Conol Box �_ ` I �J DIY.---f- 31-15. t2' —L>_ W; \5oh wa(((��, — • Dave 4 Ma>rfl,a L ; - d1 �.-f) 3`x3S Fri rylary D PGrc1.1 # 22 11 44 - 76„ oo(SO(cGG - ehc S �: 5 G, E 1scv,/ v.J c t I / u'`"fit`` r�S-l'ry-C i n t , 41 0 30 60 90 izo ( ....M:=:::ft.