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HomeMy WebLinkAboutSWG2023-00294 - SWG As-Built - 9/27/2023isimar 1 • Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG " �� Ll L " --� �� �-�i Parcel # 7 � t��— � � Q Applicant Name rrerf-y C) <i;mil_ Subdivision (Name/Div/Block/Lot) ,Z Applicant Address _QO �i J;', lC fC /GPh �i+l S&J 2©�?/ City, State, Zip „ b-i- ) ggsu`-f Installer Name (7-yo,rry (2 • ,-,, ` cPJ Site Address 1177 JCS I mo« ,j'1nr/k Designer Name Fp INSTALLATION CHECKLIST ❑ Full System Installation J,Tank(s)Only ❑ Drainfield Only ❑ Repair ❑ Other System Type j r,e1(c �rrc, (1 i.fr)r/Q 0 Pretreatment Type >5 ft. from foundation? - - ❑ N/A e`[a,YES El NO >50 ft. from wells? - - 1=14 ❑ Z >50 ft. from surface water? - - ❑ - ❑ • Cleanout between building and tank? - - ^9) al ❑ U Tank baffles present? - A ' N 0. 7 ❑ a 24" access risers over each compartment?- �;■ ►o� coW Effluent filter installed?- \ L•\ a W. i ❑ Septic tank capacity (working) gal Manufacturer . I 0 D-box water level and speed levelers used? - - R � , ❑ YES ❑ NO oO Manifold/D-box accessible from surface?- ❑ ❑ mZ Check valves installed? - - N ❑ ❑ oQ 2 Transport Line Size Schedule/Class Bedrooms installed (check one) )L. ❑ 3 ❑4 ❑ 5 El6 ❑Commercial/Other >10 ft. from foundation?- - N/A ❑ YES ❑ NO >100 ft. from wells?- - ❑ ❑ a W >100 ft. from surface water? - - ❑ ❑ u. >10 ft. from potable water lines?- - ❑ ❑ Z > 5 ft. from property lines and easements?- - ❑ ❑ a Q > 30 ft. from downgradient curtain/foundation drains? - - ❑ ❑ 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 ❑ YES ❑ NO • Pump tank capacity (flood) gal Manufacturer < 24" access riser(s) and accessible from surface?- - ❑ ❑ ~ a Alarm or Control Panel Installed? - - ❑ Cl 2 Control Panel equipped with Timer/ ETM /Counter- - ❑ ❑ 0 a Pump installed in ❑ Bucket or ❑ On Block or ❑ Other a• Pump Make/Model ❑ Floats or ❑ Transducer 0. a Tank draw down in/min Pump capacity gpm Squirt Height ft Pump on time Pump off time Daily flow set at gpd Updated 8/21/2018 Mason County OSS Installation Report pg. 2 Parcel# ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - YES ❑ NO If yes, please describe: 1Ctrl k (4/c el''2 f? R ro(tl? A. (P.,1 - 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 descriptive enough to re-locate in the need of maintenance activities and future development. Typical Record Drawings contain: Drainfield&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 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. /l iignatur• o Installe Date Ze)trL_A Ofc Printed Name of See MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and Record Drawing on behalf of Mason County Public Health: (6A(Y) fl7)Z-� Signature of Environ ental Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Updated 8/21/2018 r - • - MA$O.N, COUNTY HEALTH DEPARTMENT 428 WEST BIRCH STREET •_ SHELTON, WASHINGTON 98584 PHONE (206) 426-5561 RECORD OF FINAL INSPECTION OF YOUR SEWAGE DISPOSAL SYSTEM i OWN ADDRESS ' T S RECORDIS NOT A GUARANTEE OF PERFORMANCE. LEGAL _ w�. A SEPTIC SYSTEM IS NOT A MUNICIPAL SEWER. HOWEVER DESCRIPTIO J l��/ 17' WITH PROPER MAINTENANCE AND CAREFUL USE OF /� � WATER IT CAN GIVE MANY YEARS OF TROUBLE FREE SER- ���j VICE. MANY PROBLEMS WITH SEPTIC TANKS ARE CAUSED. SOIL I� n BY FLUSHING EXCESSIVE AMOUNTS OF PAPER, CLOTH COMMENTS Tact, -ij �f A j_ei AND PLASTIC. MATERIALS DOWN, THE DRAIN, OR BY SITE F ELD -T�� LARGE.AMOUNTS OF WATER FROM LEAKY FAUCETS OR NO. // U S✓� / b S ZE >Y FAULTY FIXTURES. DEPTH TO / / MONTH WATER TABLE (O OF YEAR / �0 • THE SEPTIC TANK. ITSELF SHOULD' BE CLEANED EVERY TWO OR THREE YEARS DEPENDING ON THE HABITS OF THE INSTA R .4 �E�`7-+1 - FAMILY, THE NUMBER OF FIXTURES IN THE HOUSE, AND p`L THE AMOUNT THAT A GARBAGE DISPOSAL IS USED. CLEAN- SIZE SEPTIC TANK (S) Joor> • ING AT THE RIGHT TIME WILL AVOID THE RISK OF INJUR DRAINFIELD FEET ING OR DESTROYING THE DRAINFIELD DUE TO SOLIDS �� i LENGTH CARRYING OVER INTO THE DRAINFIELD. CALL THE TRENCH AREA SQ. FT. MASON COUNTY HEALTH DEPARTMENT FOR A LIST OF �` LICENSED SEPTIC TANK CLEANERS IN YOUR AREA. THE TILE �r ''?..J CLEANER CAN SERVE YOU BEST IF YOU SHOW HIM THIS DEPTH �p �m CORRUGATED ❑ RIGID ❑ CEMENT RECORD WHEN HE COMES. • 12 DEPTH HEAVY TRUCKS OR EQUIPMENT SHOULD NEVER BE ROCK �� I II T DOTAL CU. YDS. J� �,, giwDEPTH DRIVEN OVER THE TANK OR DRAINFIELD. CONSULT THIS SPACE RESERVED'OR ' RECORD IN CASE OF ANY BUILDINGS, DRIVEWAYS, REPLACEMENT DISTRIBUTION FIELD: SQ. FT. SWIMMING POOLS, OR EXTENSIVE GRADING OR FILLING _,_a•. '_l_' �_l NORTH. _. •- t-+-- - { .;... . t-1 _- -.. ARE LATER CONTEMPLATED. - 1_.ii.-I _-.-.. .-.r1._I_._ _i._.1_, ..�-.._�_1_�_I.._.- ;._. SHRUBS OR TREES SHOULD NOT BE PLANTED CLOSE TO I-) i-.� •" - ;-• 1 .. . --- L. - 1 ------T- ---'I-i 11 THE SEPTIC TANK AS THEY WOULD INTERFERE WITH I ' .411' 4 -j-;-- - '- CLEANING OF THE TANK. THEY CAN BE PLANTED IN THE - I•-. .. . .. .. • '. "••- •'-- DRAINFIELD AREA PROVIDING WILLOWS ARE NOT USED. 'I- -t-t --.- ... -... . .L. .'+ , ^mil •4. /. THE YARD GRADE IN THE DISPOSAL AREA SHOULD BE )1i : , _.. _. . . _ ' ' ' ;-:-:-.- --. SUCH THAT SURFACE WATER IS NOT POCKETED ON THE I, t •- f • - • - • L ' r- �,p1-,- --•rrO DRAINFIELD. ANY SETTLING OF THE GROUND OVER THE 0.. ' " ' ' ' •' • ' ` -. ' ' • ,--` �r `• 41- L >G • . TRENCHES SHOULD BE FILLED IN WITH SOIL. DO NOT EX- ._, . . . .0 . - . . ..._..:-.' _;__: . .=:� , CESSIVELY WATER THE LAWN IN THE DRAINFIELD AREA. • • ., . i . ' . I�: WATER EVAPORATION FROM THE DRAINFIELD IS ABOUT ��.I - . I �L 1 . - EQUAL TO ONE HALF INCH OF RAIN PER DAY. I`• �.• - . • I. • • . )• - • t • I 1 . FOOTING DRAINAGE, DOWNSPOUTS AND WATER SOFTENER RECHARGE WATER SHOULD NOT BE CON- b I _ . . J' -, NECTED TO THE SEPTIC SYSTEM OR DISCHARGED INTO THE I . , I6 ; DRAINFIELD AREA. • . . • I THE TYPES OF BACTERIA NEEDED IN A SEPTIC TANK ARE J ALWAYS FOUND IN SEWAGE. THERE IS NO NEED TO ADD • I I • YEAST OR OTHER STARTERS TO A SYSTEM. THE USE OF RE- _ ,y q' o- JUVENATORS OR CHEMICALS TO CLEAN A SEPTIC TANK `o, ib ' BE BENEFICIAL AND MAY BE 1 Pvr0 /- a I 1 HAVE NOT BEEN PROVEN TO , HARMFUL BY FLUSHING SOLIDS OUT OF THE TANK OR BY I O-*,zt I C' CHANGING THE CHARACTERISTICS OF THE SOIL. THE I _^t� NORMAL USE OF BOWL CLEANERS OR CLEANING COM- I ,• SOUTH POUNDS WILL NOT KILL THE BACTERIAL ACTION OR SLOW ' 1' DOWN THE OPERATION OF THE SEPTIC TANK. (.1 _ / e-- gn In ACIAL,t-tril -ade �P�STHISIS AN IMPORTANT DOCUMENT TE 4---' VED Y //'J i �.;. Printed Tito . cTH ►o my Di S. / 7-10 / , �J 1 Pin ffT[3 T't.e11.�`i�r(3TtF&Iunty DMSi TE � CERTIFIED BY Ow -1 .