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HomeMy WebLinkAboutSWG2020-00530 - SWG As-Built - 11/17/2023 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2020-00530 Parcel # 22132-53-00011 Applicant Name Accurate Development, Inc Subdivision (Name/Div/Block/Lot) Applicant Address P.O. Box 76 SPENCER GLEN LOT: 11 City, State, Zip Allyn,WA 98524 Installer Name South Shore Construction Site Address 150 E Spencer Glen Dr, Shelton Designer Name Arrow Septic Designs INSTALLATION CHECKLIST ® Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑ Repair ❑Other 500 gallon pre-trash rank System Type Shallow Pressure Pretreatment Type NuWater BNR-500 >5 ft. from foundation? (lam -rp(l; i N - ,- ❑ N/A BYES ❑ NO >50 R. from wells? - II U Z >60 fl.from surface water? - 1{II,c-� IAi 2t l 0 ❑ ❑ F Cleanout between building and tank? i1+ -1 ❑ ® ❑ U Tank baffles present? A i ❑ if d 24" access risers over each compartment?I�y------- -'-- __- ❑ I W Effluent filter installed? DM ❑ ❑ N Hagerman Septic tank size NuWater BNR gal Manufacturer 0 D-box water level and speed levelers used? 0 NIA ❑ YES ❑ NO OLLManifold/D-box accessible from surface? ❑ mZ Check valves installed? ❑ 0 ❑ e2 Transport Line Size 2 inch Schedule/Class 40 Bedrooms installed (check one) ❑ 2 03 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10 ft. from foundation? ❑ N/A 0 YES ❑ NO O >100 ft. from wells? I0 ❑ ❑ W >100 ft. from surface water? - ❑� ❑ ❑ m >10 ft.from potable water lines?- ❑ ❑0 ❑ Z > 5 R. from property lines and easements? ❑ IR ❑ Q K > 30 ft.from downgradient curtain/foundation drains? lil ❑ El O Drainfield level and observation ports present ❑ • ❑ ® Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?- ❑ RI ❑ Pump tank setbacks consistent with septic tank?- ❑ N/A NI YES ❑ NO • Pump tank size 1060 gal Manufacturer Hagerman < 24`access riser(s) and accessible from surface? ❑ © ❑ f a Alarm or Control Panel Installed? ❑ El ❑ • Control Panel equipped with Timer/ETM /Counter- ❑ 0 7 6. Pump installed in ❑ Bucket or ® On Block or ❑ Other a D Pump Make/Model Liberty 280 El Floats or ❑ Transducer CI. Tank draw down 1.5 in/min Pump capacity 29 gpm Squirt Height 4 ft Pump on time 3 min Pump off time 6 hours Daily flow set at 348 gpd Onoaaa en•rzoia a • Parcel# 22132-53— C�II— Mason County OSS Installation Report pg.2 . . . ABANDONMENT.RECORD Were e>sarg s ePde comRonems,abandarled as part of this Project? - YES NO If yes,please describe: NO Were all components pumped out and property abandoned per WAC246-272A-03007 • 0 YEs RECORD DRAWING . . TM.Is a PrMM ncc d—met b Ican*M dncd4dIda mYph to name.N the and at null W w4 s W1an and Mtn der/OOplaraaL TWOS Racal Drawings wM:darrdd&meld!dentedon&lyou.sepicOW*Iffird ca n.Nat maw.room bYNkM.swan m4 Yaps PRIMP.WIPP 4Mn."tees. wdm thaw %Dab.*mimic to cilhonaliMarynas®OMB.Inmmiled Rem!Omega nay aria Vdmae dsap.MMtl'mamba*"tWall aN Sated arch. 1 j),_, • • • • • *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 actor- the septic design stamped'APPROVED'by Mason dance with the septic design stamped'APPROVED'by County Public Health and that arty deviations shown Mason County Public Health and that any deviations here have been cleared/approved by both the designer shown here have been clearecVapproved 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 /further certify that all information contained on this I further certify that all information contained on this a ed rawmg is a rate. font and attached Record Drawing is accurate. 12-Z 21 signature of Installer Date f E. �ti. .iChord Moore � : .0- Panted Name ofSignes i' • r ', MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and r Repwd Drawing on behalf of Mason County Public -/r Paut A c .. e Health: v <�:y. d � i h17v3 D „zti signature ofEsvironm Health Specialist Date (stamp,signature and date) THIS FORM MAY BE SOANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Umwe2112016 — E S -cnC-ef (7l4'n DV — ASbui (f 1� A-CC urA+c D{vetopiu 1t wa+cr ?a c< I #22_132-63-0001I 1 150 f srrCe( Glen Dr qSCCPt N e wa .1 I pArkirq / / 0 (0 2a 3o v0 NI1 / / i—ly"" i 27'xtig" Fro 05.ect 33Q- .MF HouSe (3) 3`xQ5 ` Primary 14/ > l)F +Ce @ et •M CLaif bok I , LhC J VOL . w;kk OOT $ 0 rccrvvt lnbetweel 11314 o rim U Ol Audio-Visual Alarm V� I " ,r%� O Cleanout l' NLJ 500 Gallon Pre-Trash tank 1 = wC nit 0 NuWater BNR-500 ATU Tank 2% O 1,o00 Gallon Pump Chamber IS1oPL 0 Valve Control Box lh C., t I I ,s �i `;s ule \ti b 75 " R� , " LtCNSfp FZ Y SA]E lITMR\E�'.tbiidi '.L ".`.-=jf I - ZS- Z2