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HomeMy WebLinkAboutSWG2023-00219 - SWG As-Built - 1/4/2024 Mason County OSS Installation Report pg. 1 MASON COUNTY P BLICffr gyTt1 APPLICANT/ PERMIT INFORMATION itCF��FO(( Permit Number SWG 2023-00219 Parcel # 32232-52-10001 Applicant Name Railroad Avenue LLC Subdivision (Name/Div/Block/Lot) Applicant Address 301 E Wallace Kneeland Blvd, 224 Union-Grays Harbor& UCRR Block: 10 Lot: 1-6 City, State, Zip Shelton, WA 98584 Installer Name Andrew Spear Construction Site Address 151 E Stairs Way, Union Designer Name Arrow Septic Designs, Inc INSTALLATION CHECKLIST ® Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑ Repair ❑ Other System Type Shallow Pressure Pretreatment Type NuWater BNR-500 >5 ft. from foundation? - C❑ N/A Q YES ElNO >50 ft. from wells? - l! 4 1❑ ❑■ ❑ z >50 ft. from surface water? - it - ❑ U] ❑ --< Cleanout between building and tank? - - - - - - - t 9 Zfl2 i ■o Tank baffles present? - - - - - - ❑ 0 ❑ a24" access risers over each compartment?- - U] ❑ W Effluent filter installed?- - By- - - - -- 0 ❑ ❑■ U) Septic tank capacity (working) NuWater gal Manufacturer Sound Placement 0 D-box water level and speed levelers used? - - ❑ N/A ❑ YES ■❑ NO XOO Manifold/D-box accessible from surface?- - ❑ ■❑ CI LL in Check valves installed? - - ❑ ❑■ ❑ 0< E Transport Line Size 2" Schedule/Class 40 Bedrooms installed (check one) ❑ 2 ❑■ 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10 ft. from foundation?- - ❑ N/A Q YES ❑ NO O >100 ft. from wells?- - ❑ ■❑ ❑ W >100 ft. from surface water? - - ❑ 0 ❑ >10 ft. from potable water lines?- - ❑ 0 ❑ Z > 5 ft. from property lines and easements?- - ❑ 0 ❑ Q W > 30 ft. from downgradient curtain/foundation drains? - - ❑ ® ❑ o Drainfield level and observation ports present - - ❑ © ❑ 0 Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ 0 ❑ Pump tank setbacks consistent with septic tank?- - ❑ N/A ® YES ❑ NO Pump tank capacity (flood) 1,250 gal Manufacturer Sound Placement < 24" access riser(s) and accessible from surface?- - ❑ IN ❑ ~ Alarm or Control Panel Installed? - - ❑ © ❑ a E Control Panel equipped with Timer/ETM /Counter- - ❑ El ❑ 0 a Pump installed in ❑ Bucket or ® On Block or ❑ Other a• Pump Make/Model Liberty 280 El Floats or ❑ Transducer a. n. Tank draw down 2.25 in/min Pump capacity 50 gpm Squirt Height 5 ft Pump on time 1.8 Minutes Pump off time 6 Hours Daily flow set at 360 gpd Updated 8/2 1120 1 8 d Mason County OSS Installation Report pg. 2 Para! 3 22 32- S Z, - (°°O t ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - ❑ YES II NO If yes, please describe: Were all components pumped cut and properly abandoned per WAC246-272A-0300? - - L YES El 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 Tpica1 REw c: Drawings contain: Drarrdield&manifold oriemador S.layout,Septiopump tank location.North arrow.r'serve aainFeld,existing and proposed huilorngs.location of wets,waterlines. wefts,obsenvadon ports,dean-ads,and other maintenwrsce wi.. points. IncompIe:e Record Drawings may curate additional relays in Tina;instatadan approval and reared aerials. ® 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 l further certify that all information contained on this I further certify that all information contained on this form and attached Record Drawing is accurate. form and attached Record Drawing is accurate. 1,1 :Li" � ( 2-(2.-2-3gn ure of Ins der Dare t 7r{an Spar PrintecrNeme of Signee C `A"...4))) - �, ,. MASON COUNTY PUBLIC HEALTH L { The undersigned approves this Installation Report and Record Drawing on behalf of Mason County Public 444`...1 ( v ':U'J r. PAULA JOY3A9 -, •,I.•. Health: L•� JOHNSON • �%W k Ul Zij ( 2--L —v�T Signature of EnvironmentaHealth Specialist Date (stamp, signatu> anG date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEE SITE 04. d 1'7318 4 ISm 21 ..,, ..._\fteg)...... -- - _ . d cc Kee 4,-cn..G..c-e S G G 'G.C _ � , , .4. I J • 2:Z.: T 5 1.4:13.<- -Bill—lz ii • ‹._—_cur+-,A,,, aymn . ... 7 / ,' , vcr-K 38R. Garao)e 10 e o v,SE Key: ( Ol Audio-Visual Alarm p _ C.G — ` 02 Cleanout K Xi 0 NuWater BNR-500 ATU Ta i_Eot'24. 0 1,000 Gallon Pump Chamk + ; p 9...wc.w ! ty O Valve Control Box i ii eQ /,,q 9,_.> J Ail 0.4,00 5c.Qtt , `` = o a b. , ..,-...,/,� i so,,, 0 . 4,,,: , ),, G !S L cf c Soo 4/jt., O sr L ! It t �V,), AS�ut rrO/y • 510.349 V get 'FNI4 ,.0. PAULA JOY JOHNSON . IZG„` Jt G.� * Y -L l LLC /y am C� t U�i.ONLtt" e-c.e-, 32232-52- I ooal l Z,--t.g-t3 ( Sl E. 5- -a.Nrs Wc,-A. L 'an