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HomeMy WebLinkAboutSWG2023-00232 - SWG As-Built - 10/17/2023 n 4 �J . OCT 1 12023 Mason County OSS Installation Report pg. 1 RECEIVED N COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2023-00232 Parcel# 22018-51-00066 Applicant Name Zenith Group NW LLC Subdivision (Name/Div/Block/Lot) Applicant Address P.O.Box 1708 TIMBERLAKE#3 LOT:66 81/21 INT LOT 71 City, State, Zip Rochester,WA 98579 Installer Name Bamford Septic Repair Site Address 31 E Carr PI W,Shelton Designer Name Arrow Septic Designs INSTALLATION CHECKLIST • Full System Installation El Tank(s)Only 0 Drainfield Only ❑ Reps ❑Other System Type Pressure Bed - Pretreatment Type >5 ft.from foundation? - - - - ❑ ern 0 YES ❑ NO >50 ft.from wells? - I El ❑ 2 Y >50 ft. from surface water? --_\-•r -- -- ❑� El ElH• Cleanout between building and tenkp - El IN El • Tank baffles present? - -4. -- -- - . . , ElI3 ❑ O.▪ 24" access risers over each corn* ❑ IN W Effluent filter installed?- El MI El co Septic tank capacity(working) 1,200 gal Manufacturer Sound Placement O D-box water level and speed levelers used? IN N/A ❑ YES ❑ NO DO Manifold/D-box accessible from surface? ElMI El u. m= Check valves installed? - ❑ Q El Oct 2 Transport Line Size 2 inch Schedule/Class 40 Bedrooms installed (check one) D 2 0 3 El 4 El 5 El 6 ❑Commercial/Other >10 ft. from foundation?. El NIA I] YES ❑ NO O >100 ft.from wells? . U ❑ El W >100 ft.from surface water? - IN El t1 >10 ft. from potable water lines?- ❑ NI ❑ z > 5 ft.from property lines and easements? . El I ❑ K > 30 ft. from downgradient curtain/foundation drains? OR 0 ❑ O Drainfield level and observation ports present 0 Q El 0 Graveless chambers or Q Clean gravel used? (check one) Proper cover installed over drainfield? 0 ® El Pump tank setbacks consistent with septic tank? ❑ NIA ® YES ❑ NO `L Pump tank capacity(flood) 1,250 gal Manufacturer Sound Placement < 24" access riser(s) and accessible from surface?- - ❑ © ❑ a Alarm or Control Panel Installed? El M El 2 Control Panel equipped with Timer/ ETM /Counter - 0 . El i. Pump installed in El Bucket or ® On Block or ❑ Other 4• Pump Make/Model Zoeller N152-D El Floats or ❑ Transducer y Tank draw down 2.5 in/min Pump capacity 48 gpm Squirt Height 8 ft Pump on time 1.6 Pump off time 6 hours Daily flow set at 360 qpd dndt¢d es,-ante Mason County OSS Installation Report pg. 2 Parcel# 22 0 �- 9 —WO V" ABANDONMENT RECORD Were existing septic components abandoned as part of this project? Et YES NO If yes, please describe Were all components pumped cut and properly abandoned per WAC246-272A-0300? - ❑ YES 0 NO RECORD DRAWING This permanent a and must be and duscmative enough to relocate in the need of maintenance activitiesand future development 7ypical Record DrawngS contain °cornfield& n doneslatlos&lay t Septcdpumpl k l&location,North arrow.reseme dreinfield.anstng andproposed bulldog lacason o1 wets.watedines. wfN{oasevadon por&ueanouts.arsoner mantenar¢access points. Incomplete Recd. ,avnngsmay create aado.al delays .final nsallaion approval and r d panes. 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 uncap- 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 /further certify that all information contained on this form and attached Record Drawing is accurate. form and attached Record Drawing is accurate. q Signatureof instal/e Date gn \ a &M'$ e& c J. Printed Name of Signee e•ea MASON COUNTY PUBLIC HEALTH /-2,44g The undersigned approves this Installation Report and P slxnoao 9 PP P PAULA JOY JOHNSON Record Drawing on behalf of Mason County Public 'tamp CEsioNE7S:_ Health: Eznriesaril t`� � spni ( 0 ��/23 —00_23 Signature of Environment I Health Specialist Date (stamp. signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE upoa'eoemrzne Cro+xRSl 4yowa.Y < Ike-yrue.l i c.5 3% 14J----i I , ,. ,0 xzz.5. : % 0 ru u7 zO 40 O� ocAraevcts OhpoY'f$ Zt`.Airk,/�YI J / 1�IV�N(M a" i I® oGIC>N6 N'CS �. 111 a 0 0 0 Ru,z.,-QZZc 10-51- oCOa e?--cPcisE rke‘g-CLite-," , Wfr 98589 4-1 VII 2`T X 56 APPROVED OCT 17 2023 10' z�o ' II MASON COUNT ENJIROHM ENT ALHEALTH c at.K 'I i RET Tj2 ' 'pr0?° k -52. 'I cJw�evye Drc Ce . i avi: . (z) 1r x2L S liwtar � Io r eta,eu+L'^* p.F Beds ccitA E Cam,- l? 1 \,v (.Z) Lo' XZZ.S' Rssev'J-ie gef,R 5 OAudio-Visual Alarm !A Cleasout r c -4,- 400. \\ O3 1200 GallonGallonSealac Tan K ja .i .. 2-Conapennent with n�u n Qj T Emile=Filter ✓�J y O..1 GAULA JOY JOHNSON _Y 3 I150 on Pump Cnzmher /lecr LifCtiS-tl(`M.010 to- ro-tS