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Home My WebLink AboutSWG2021-00643 - SWG As-Built - 11/16/2023 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/PERMIT INFORMATION Permit Number SWG 2021-00643 Parcel# 32104-56-00056 Applicant Name AB Fine Homes Subdivision (Name/Div/Block/Lot) Applicant Address 871 E Beach Dr r,, ALDERBROOK G &Y#7 LOTS: 55&56 City. State, Zip Union,WA 98592 Installer Name Hanson Excavating v' Site Address 40 E Michelle Ct,Union �1' Designer Name Arrow Septic Designs, Inc INSTALLATION CHECKLIST 0 Full System Installation ❑Tank(s) Only ❑ Drainfield Only ❑ Repair ❑Other Soo gallon pre-trasn tank System Type Shallow Pressure Pretreatment Type NuWater BNR-500 >5 ft.from foundation? - - ❑ N/A Q YES ❑ NO >50 ft.from wells? - 10 ❑ ❑ Z >50 ft.from surface water? • ❑ ❑ Q Cleanout between building and tank? - ❑ 0 ❑ H U Tank baffles present? ❑ El El f— 24" access risers over each compartment?- - ❑ ❑� ❑ O. Effluent filter installed?- 0 ❑ ❑ N Hagerman Septic tank capacity (working) BNR-500 gal Manufacturer 9 o D-box water level and speed levelers used? • N/A ❑ YES ❑ NO �O Manifold/D-box accessible from surface?- ❑ ❑ mZ Check valves installed? ❑ • ❑ Oct 2 Transport Line Size 2 inch Schedule/Class 40 Bedrooms installed (check one) ❑ 2 0 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10 ft.from foundation? ❑ NIA ® YES ❑ NO >100 ft.from wells?- 0 ❑ ❑ W >100 ft. from surface water? - MO ❑ ❑ LT >10 ft from potable water lines? - - - ❑ • ❑ Q > 5 ft. from property lines and easements? ❑ IN EL > 30 ft. from downgradient curtain/foundation drains? - ❑ N ❑ Drainfield level and observation ports present - ❑ • ❑ ❑ Graveless chambers or • Clean gravel used? (check one) Proper cover installed over drainfield? - ❑ El ❑ Pump tank setbacks consistent with septic tank? ❑ wA YES ❑ NO Y Pump tank capacity (flood) 1,000 gal Manufacturer Hagerman Q24" access riser(s) and accessible from surface? ❑ MI ❑ H 1 Alarm or Control Panel Installed? - - ❑ IN ❑2 Control Panel equipped with Timer/ ETM /Counter- ❑ El Eln. Pump installed in ❑ Bucket or ® On Block or ❑ Other Q Pump Make/Model Liberty 290 1: Floats or ❑ Transducer EL, Tank draw down 3 in/min Pump capacity 57 gpm Squirt Height 6 ft Pump on time 1.5 min Pump off time 6 hr Daily flow set at 342 qpd .,,aa c saozO'a • Parcel# 521 o4- 5(2- COO Mason County OSS Installation Report pg. 2 ABANDONMENT RECORD YES NO Were existing septic components abandoned as part of this project' If yes, please describe. D YES El NO Were all components pumped out and properly abandoned per WAC246-272A-0300? RECORD DRAWING Thispermanent record and must be accurate and see enough l th need or mamtenance activities et a Ip LTypicala rc Drawings contain D, ' a ♦ndrtm(i' & ayaepGp tankJ l - Noan w reaerie a. la 9 and proposed c'a g .I wets. d,es. wells.Observation ports.CleanoWs,and other maintenance access points. Incomplete Reccr mmwips ay create additionai delays .anattnstalletton a?p cv.3 and related p Cli+_..r. 1 0 Record Dra ingAttached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ENGINEER I certify that I installed the system in accordance with I certify that the system has been insta/e in accor- the septic design stamped 'A PPRC"APPROVED''by Mason dance with the septic design stamped"A ROVED"by County Public Health and that any deviations shown Mason County Public Health and that any eviations here have been cleared/approved by both the designer shown here have been cleared/approved y both and Mason County Public Health and meet all State myself and Mason County Public Health a d 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 contain d on this form and attached Record/'c/ Drawing is accurate. form and attached Re Drawing is ace rate. 9Ycuiaevv lul3oe /G�6'' h Sig .ure of Installer Dee gF�,j<�,- .pi( Jared Hanson r/$��,�1' ai `. Printed Name of Sigree "'" v tr .t h 1 MASON COUNTY PUBLIC HEALTH a �� PAL AJrr HNSON l� The undersigned approves this Installation Report and nnr o LILaI Y)i)f CNnt"_Y Record Drawing on behalf of Mason County Public S`._- Exmv Csr;ei'�� Health: L 01 0 1 ( fi6rz3 1-Z1> Signature of Envircnm ntal Health Specialist Date (stamp. signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE oaea:aaentvci,a 7 % 35'r) ` ?yomary �L-T C� - n 7 IRv41 eS@ OL- k_ �/,l rOiM1tC$ 'O D. - � 5G OOOSb Vet resevRit "4re Parvf #32toH' HOE MrC u4 _la C-1' 5 i• �'. SCGu : t ';3O �0'i• ° /5 30 55 60 k � \\\� APPROVED \\\\ NOV\b` 1 6 2023 wasi40:.:,i. e' ,,,;vu_e' _ HEALTH PET e U) Audio-Visual Alarm (' . U Cleanout <, l' / 1 500 Gallon Pre-Trash tank d to , IrN- --- `3 NuWater BNR-500 ATU Tank_ \ `V ' ii- 1,000 Gallon Pump Chamber Valve Co ffol Box off_c Y iea.O8 °I e Lti r i I. '^'S �•L • - =FS . u? PAULA JO I-JOHNSON 'y1�