Loading...
HomeMy WebLinkAboutSWG2021-00149 - SWG As-Built - 9/28/2023 soisimmIllimilmillommilir I Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2021-00149 Parcel # 42024-13-90351 Applicant Name JOHN NESSET Subdivision (Name/Div/Block/Lot) Applicant Address PO BOX 214 City, State, Zip PT TOWNSEND, WA 98368 Installer Name LOGAN SPEARS Site Address 2144 W RAILROAD AVE Designer Name ROBERT H. PAYSSE INSTALLATION CHECKLIST ® Full System Installation ❑Tank(s)Only El Drainfield Only ❑ Repair ❑ Other System Type CONVENTIONAL PRESSURE Pretreatment Type >5 ft. from foundation? - - ❑ N/A j YES ❑ No >50 ft. from wells? - - ❑ ❑■ ❑ >50 ft. from surface water? - - ❑ ❑■ ❑ I-- C IC between building and tank? - - ❑ ❑■ ❑ U Tank baffles present? - - ❑ I ❑ a24" access risers over each compartment?- - El I LU Effluent filter installed?- - ❑ ❑■ ❑ cn Septic tank capacity (working) 1500 gal Manufacturer_ HOUSE BROs 0 D-box water level and speed levelers used? - - El N/A ❑ YES ❑ NO J oO Manifold/D-box accessible from surface?- - ❑ El ❑ mZ Check valves installed? - - ❑ ❑■ ❑ 0< 2 Transport Line Size 2" Schedule/Class SCH. 40 Bedrooms installed (check one) ❑ 2 El 3 El 4 El 5 ❑6 ❑■ Commercial/Other >10 ft. from foundation?- - ❑ N/A Q YES ❑ NO O >100 ft. from wells?- r f ,. ❑ I ❑ J >100 ft. from surface water? - - ❑ I ❑ ti >10 ft. from potable water lines? iiftlf--Sill -,-�o-23 I ❑ Z > 5 ft. from property lines and easements?-- -r, ■ Q p p y cvt,7!tNVIRORNTE-N.TA EALT� ❑ ❑ O > 30 ft. from downgradient curtain/foundation drains?- JS - �]- 0 ❑ Drainfield level and observation ports present - - ❑ ® ❑ ❑ Graveless chambers or IM Clean gravel used? (check one) Proper cover installed over drainfield?- - El 0 ❑ Pump tank setbacks consistent with septic tank? - - El N/A ❑■ YES ❑ NO • Pump tank capacity (flood) 1500 gal Manufacturer HOUSE BROs Q24" access riser(s) and accessible from surface?- - ❑ II ❑ ~ Alarm or Control Panel Installed? - - ❑ II El a E Control Panel equipped with Timer/ETM /Counter- - El © ❑ D n- Pump installed in ❑■ Bucket or El On Block or ❑ Other a• Pump Make/Model LIBERTY FL50 1/2 HP El Floats or 0 Transducer 0_ Tank draw down 1 in/min Pump capacity 30 gpm Squirt Height 2 ft a Pump on time 2 MIN Pump off time 4 HRS Daily flow set at 360 gpd Updated 8/21/2J18 Mason County OSS Installation Report pg. 2 Parcel# 42024-13-90351 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - ❑ YES 0 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 descriptive enough to re-locate In the need of maintenance activities and future development. Typical Record Drawings contain: Drainfieid&manifold orientation&layout,Septclpump tank location,North arrow,reserve drainfield.existing and proposed buildings location of wells,waterlines, wells,observation ports.deanouls,and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and related permits. *Q E , .. 11. t :- 4, f\A4_ (4 Ckc j Sty' •1LL%3L3 .A..IH t ONOOUNjy ENVIRpNNIENI etas OM I Record Drawing Attached • CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ ENGINEER 1 certify that l 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 fo and attached Record Drawing is accurate. r . form and attached Record Drawing is accurate. i (..._ 1/257-1 3 ign tire of ins eller Date �� Loeyem c ea✓ S��4', � Printed Name of Signee yti r. \;�""fir, MASON COUNTY PUBLIC HEALTH . The undersigned approves this Installation Report and ,, Record Drawing on behalf of Mason County Public o' .z<",•' - Healt. : -, - _u: z t XiLn' c Exr- -s (z) , - C1_2(6..7 3 Sign tur En ironmental Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE U ii.t"a 21!lu18 RECORD DRAWING INSTALLED /......"-**---- r TANKS ..... / " ---...... LOCATION APPROX. / TRANSPORT LINE --............ .... i I de I 1 1 N / , L i _... _, (LOT 5) / NEW OFFICE BUILDING1 ---- —_ L __ ___ / \ \__ _ _ _ PRIVATE ACCESS 7..... --,........ _ _____ ._ , N z \ ... — ..... i \ / / .........., - ... — — — , — APPROVE ,..5,..„... -7-- ..... . , ., , SEP 2 8 2023 .. • .. lo, / ( / / MASON COUNTY ENVIRONMENTAL HEALTH JBW (LOU) // / .., _ , 4-2Q2,..„ 141R .1 - _ DRAIN Fl ELD AS A F0„7 . ... -,:j--903.5 IC .I'-'--- PER DESIGN / I .-- ,,_,...:' ..•'!.... / ,.c-f VMS.;i"4.• . °C. ........„ _ . _ . ,_ . .. ,. •" ,..„::::- , ;:::.:_--_. / .i,,,,,s, . • it , 0.. - • , . , :. • 51C0317 '.1,41./ • •-,,;""- _ *".,) I 0:: ROna,i, • PAYISSE . ..., 0 ^ '6 at' Int F• It. i.... ---. ,) it, AI ' ' .... -_:- EXPIRES INSTALLED PRIMARY .....%..... & RESERVE TO SERVE ...... .... ":-.3 _/_ EXIST. 42024-13-90355 (LOT 5) STRUCTURE PIONEER DIGGING, INC. CUSTOMER: JOHN NESSE'. PARCEL#:4202+13-90355 SCIALLI:40 I . , i SEP.FIC DESIGNS ADDRESS: 2140 W RAILROAD AVE CESCLAIMER.1NIS IS NOT A SURVEY.REFERENCES INCLUDE APPUCANTCOUNTY PROVIDED 3083 I.MASON RI NSON ItI). CR N1,1 V NAV,\V.‘98546 DESIGNER: ROBER.I.I'AYSSE PLATS OR SuRvEYS.FIELD MEASUREMENTS AND COUNTY GIS.DESIGN INTENDED FOR SEPTIC PURPOSES ONLY PROPOSES DEVELOPMENT MAY BE SMOKY TO OTHER 0 MCI -360-426-1803 I.\\-360-427-2353 DESIGN PACE ASBUILE DEPARTIAENVAGENCY REVIEW DESIGNER NOT RESPONSIBLE FOR SETBACKS UNRELATED TO SEPTIC COmPCNENTS.