Loading...
HomeMy WebLinkAboutSWG2023-00339 - SWG As-Built - 10/17/2023 IC,Mason County OSS Installation Report pg. 1 MASON COUNTY PUL--------- 0 IQ€Alarft1p13 APPLICANT/ PERMIT INFORMATION Rfr6/prp Permit Number SWG 2023-00339 Parcel # 32309-50-03011 Applicant Name Aimee Pierce Subdivision (Name/Div/Block/Lot) Applicant Address 16511 SE 28th Street Colony Surf/Div 1/ Lot 11 & 1/2 of Lot 10 City. State, Zip Bellevue,WA 98008 Installer'Name Maples Excavating Site Address 131 N Colony Surf Dr, Lilliwaup Designer Name Arrow Septic Designs, Inc INSTALLATION CHECKLIST IN Full System Installation ❑Tank(s)Only ❑ Drainfield Only © Repac ❑ Other System Type Pressure Bed Pretreatment Type >5 ft. from foundation? - - D NIA Q YES ❑ NO >50 ft.from wells? - _ . ® ❑ ❑ Z >50 ft.from surface water? MI ❑ ❑ Q Cleanout between building and tank? - - - ❑ El ❑ O Tank baffles present? ❑ ❑ ❑ H 24" access risers over each compartment?- - ❑ ❑■ ❑ W Effluent filter installed?- - ❑ ❑■ ❑ to Infiltrator Septic tank capacity (working) 1,060 gal Manufacturer O D-box water level and speed levelers used? ❑■ N/A ❑ YES ❑ NO 0J O ❑Manifold/D-box accessible from surface'- ❑ mZ Check valves installed? - AAC- -Q�' -t -k " - - - ' ❑ El ❑ OQ 2" Schedule/Class 40 2 Transport Line Size Bedrooms installed (check one) ❑■ 2 ❑ 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10 ft.from foundation? -- - ❑ N/A ❑■ YES ❑ NO O >100 ft.from wells? 0 ❑ ❑ W >100 ft. from surface water? ® ❑ ❑ LT. >10 ft.from potable water lines?- - ❑ ❑ ❑ Z > 5 ft. from property lines and easements?- - ❑ ElD Q re > 30 ft. from downgradient curtain/foundation drains?- it i ❑ ❑ Drainfield level and observation ports present 1y�� ❑ . ❑ ID Graveless chambers or ® Clean gravel used? (chgOgrniei Proper cover installed over drainfield? - "- - ❑ ❑■ ❑ Pump tank setbacks consistent with septic tank? - - - ❑ NIA ❑■ YES ❑ NO Pump tank capacity (flood) 1,287 gal Manufacturer Infiltrator Z Q 24'access risers) and accessible from surface? ❑ H a Alarm or Control Panel Installed? - - ❑ II• Control Panel equipped with Timer!ETM /Counter- ❑ II ❑ ? a Pump installed in ❑ Bucket or El On Block or ❑ Other 2 Pump Make/Model Zoeller N152 ❑■ Floats or ❑ Transducer m Tank draw down 1-3/8 In/m!n Pump capacity 35 gpm Squirt Height 8 ft Pump on time 1.7 min Pump off time 6 hr Daily flow set at 240 gpd Un8te7 S,z¢cn Parcel# 3 23o9 - SO-0So\A Mason County OSS Installation Report pg. 2 ABANDONMENT RECORD ■ YES NO Were existing septic components abandoned as part of this project? .. � � please describe: SW:so-Pk n4 U NO If yes, . YES Were all components pumped out and properly abandoned per WAC2a6-272A-0300? RECORD DRAWING This u a permanent re cord and mug be accurate and descnptve enough to re-locate in the need of maintenance activities and future development Noma!Remora lls Drawings njaaoorar aamana o aonalaneaevawwp tank location.Nag arro reserve orai edennd aim ampna ✓gs,location a ttd; /nit welts observation ports.deanaan.and other maintenance access points. ln-omplee Remora Drrrnnga mayPeam aeadonaL delays in.nal insta88aon apv�al and related pants kCJ^2a\ ® 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 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 ail information contained on this form and attached Record Drawing is accurate. form and attached Record Drawing is accurate. .�Ctei(17C,e�i et-zi- 2.3 Signature of Installer Date Panted Name of Signee NC•o • �P•.r•. MASON COUNTY PUBLIC HEALTH �-,A tf /> .A The undersigned approves this Installation Report and N �. i Record Drawing on behalf of Mason County Public b2 .PAULA510Y,JOHNSON Health � o taws tin -` 'c �l� � � � 1� (-2-3 q_3D-t1 Signature of Envrmnme lel Health Specialist Date (stamp, signature and date) THIS FORM MAY SE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY VVEB SITE upaaenamrzo,e f 3o' r /� ^� o 0 /l M aln $ o x\-\- I �, a © ...0-0�- o ® .;_ 4. cJ O Ex;rt. — z8R J 0 U Z 4 ----- TeS4ilole A x Q � k "' Q o 1 4r 2- 51+��\c.r Audio-Visual Alarm o © _ J P 9 k 2�, G-C 0 Cieanout ti� o 0 1000 Gallon Septic Tank el 2-Compartment vZ-N' M Cr) Effluent Filter -J4T-I-0 t 0 .000 Gallon Pump Chamber-/ns -- APPROV 4 MASONC� oC? 17 2023�� ryt ?'7.0�4ME4T41 NEALIH Al RE? 5caLC : l"= za' • n - ¢. .y�,�r/ o to 2,0 30 ` r, i • t�i SLP� c prS- �v-�l ' ,f, `' �l vnuu./o J<niNSGN ?':� ! Q��i� 32309- 50 - 030110f f) �(:FMS4 DE51Gtittl ' i<.c 1 .5 131 N. Colo".-}, SrC- tre. 1 Lilt;w.`P E%R.'ES�Y/1i/ 4- So- t%