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HomeMy WebLinkAboutSWG2021-00150 - SWG As-Built - 9/27/2023 LADD SEP 1 12023 Mason County OSS Installation Repo pg• �ECF►V , MASON COUNTY PUBLIC HEALTH APPLICANT/ ' ' • • : i ATION Permit Number SWG 102-k— 0 A\ \� 'arcel # 22309-75-00280 \, S (Name/Div/Block/Lot) Applicant Name NICOLE �9 ' bdivision� Applicant Address 18818 SE 4 City, State, Zip ENUMCLA . . 98022 Iler Name TATE Gl+(3 Arm Site Address 101 NE ANVIL LN, TAHUYA, WA. C. Designer Name ROD LEFT INSTALLATION CHECKLIST 0 Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑ Repair 0 Other System Type STANDARD PRESSURE Pretreatment Type >5 ft. from foundation? - ❑ N/A ® YES ❑ NO >50 ft. from wells? ❑ ® ❑ >50 ft. from surface water? - - ❑ al El Z Q Cleanout between building and tank? ❑ ® ❑ ❑ ❑ U Tank baffles present? - ❑ F- 24" access risers over each compartment? ❑ El ❑ a ❑ Lii Effluent filter installed?- ❑ Septic tank size 1250 gal cn Manufacturer HAGERMAN CI D-box water level and speed levelers used? - - El N/A ❑ YES 0 NO❑ oOJ Manifold/D-box accessible from surface?- - ❑ Ill❑ m Z Check valves installed? ❑ 0 Q 2" Schedule/Class 40 2 Transport Line Size Bedrooms installed (check one) ❑ 2 ❑3 D 4 ❑ 5 0 6 0 Commercial/Other >10 ft. from foundation?- - ❑ N/A 0 YES ❑ NO >100 ft. from wells? ❑ 0 ❑ W - 0 ® ❑ >100 ft. from surface water? - 0 Elu, >10 ft. from potable water lines?- ❑ Z > 5 ft. from property lines and easements?- - 0 El 0 CL > 30 ft. from downgradient curtain/foundation drains? - - ❑ 0 ❑ Drainfield level and observation ports present - - ❑ A ® Graveless chambers or ❑ Clean gravel used? (check one) ❑ El cover installed over drainfield?- - ❑ Pump tank setbacks consistant with septic tank? - - ❑ NIA YES I=1 NO Pump tank size_ 1250 gal Manufacturer HAGERMAN Z ❑ 0 ❑ < 24" access riser(s)and accessible from surface? - El 0 ❑ I- 0_ Alarm or Control Panel Installed? 0 ❑ 2 Control Panel equipped with Timer/ETM/Counter- ❑ n- Pump installed in 0 Bucket or ❑ On Block or ❑ Other -- a Pump Make/Model LIBERTY 280 0 Floats or ❑ Transducer a 45.5 m Squirt Height 5 ft Tank draw down 1.75 in/min Pump capacity 9P Pump on time 1 MIN 19 SEC Pump off time 3 HRS Daily flow set at 479.2 gpd Updated 8/21/2018 s Mason County OSS Installation Report pg.. 2 ���s(��P�at# 22309-75 00280 .-sv �ti :Ic =ABAN-R N ER-r.•'REtA 0 OD Were existing septic components abanooneO e part at PM project? - ❑ ES ® tit7 If yes,please bibo: Ware at components pumcod out and property abandoned Per WAC248-272A-03007 - D YES ❑ MO riu.e a paraeUMnt raced sad meet to ewta.rx+an.a.abode.ionovolar.soara b tl..,ie.J of Nabataean=eels.e and heart I.wYepee.wa. Tri++d Recant a.wYge coNa .'Drawled S~Pat Manna.C await,S.GddbtweP tank Ioalbn Iowa afe2.4.roar=ant rid,.atArra r.e fropa.N WO,"boa.d pia wisdom. tapir ' eM.avd oit r nw.,derr>t.ezc.os Prints, smelYeb Rowed Ora.ina.wA aaa.e edeldenal ietays b Ind ywYwhn hWr led tailed 001,1e- Q Reecx fd Drawing Attached r p AS[•/'� /�' �yr�� �.ry. • CER,fFICA1ION::.0f�• TALa'A 1 L,�• •)- . -• r r _ . INSTALLER DESIGNER!EENGINEER I codify that t instated the syeern in accordaru:e with I tardy ttlet the system has been installed in acme- the septic design stamped'APPROVED"by Mason dance with the septa design stamped'APPROVED"by County Public Health and that any deviations shown Mason County Public Health and that any deviebons here have bean cleated/approved by both the designer shown here have been cceeredfgpproved by both end Mason Ccunfy Public Health and meet all State myself and Meson County Public Health and meet ern and Mason County Codas. State and Mason County Codes t further certify that all into/m9tion contained on this I further certify that all information contained on this form end attach Record Drawing is accurate. iorm and attached(Record Drawing is accurate. Signature of installer Date %i TA C I• Z Printed Name of Sigllitti " ‘' ,,. • MASON COUNTY PUBLIC HEALTH F �• ' . The under nod approves ibis installation Report and Jy 0.% Record[)ra.ew,g on behalf of Mason Comfy PuhUcLICENSE,DESIGNER Heath: EXPIRES 12/151 ak _,�;, , yv of(-7,-7(73 Sgneftir d a1 F-IIVvtvme diftl th SpeG 6I5t ;c (Stamp,signature and date) TheS FORA MAY at scAtiaztamo AVAILABLE FOR PUBLIC VIEW ON THE RIAXN coJNTY WEB STfE "jO"`d °a'a D p p Z D Dr 5j C 0 r r Z 10•••........,_ . • m Z -nj ,.,--1 m DPI I 11 co 1 1 • D I I I I I I I • c Z to rn� I I. I I . I I I DZpcTTh1hHhhhhhhI O 0 0 --1I I 1 I 1 1I 1 1 1 1 1 I I 1 1 1 1 1 1 1 1 • O , z o (n < O� 1 1 1 1 1 I I I I I I I I I I 1 1 1 1 1 1 1 1 � 1 . m e cmm m I I 1 1 1 . 1 11 . 11 I . I . 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