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HomeMy WebLinkAboutSWG2023-00043 - SWG As-Built - 1/4/2024 County OSS Installation Report pg. 1 MASON COUNTY ' BL4�M ALTH Mason Cou y p �� APPLICANT/ PERMIT INFORMATION R 202, Permit Number SWG 2023-00043 Parcel # 32021-59-01012 Applicant Name Patrick Moran Subdivision (Name/Div/Block/Lot) Applicant Address 310 E Libby Rd W SHORECREST BEACH ESTATES#2 BLK: 1 LOT: 12 City, State. Zip Shelton, WA 98584 Installer Name Spear Construction, LLC Site Address 200 E Soundview Dr, Shelton Designer Name Arrow Septic Designs INSTALLATION CHECKLIST © Full System Installation ❑ Tank(s)Only ❑ Drainfield Only ❑ Repair ❑ Other System Type Pressure Trench Pretreatment Type NuWater BNR-500 >5 ft. from foundation? - - ❑ N/A ❑■ YES ❑ NO >50 ft. from wells? - - ❑ 0 ❑ Z >50 ft. from surface water? - - ❑ 0 ❑ FQ- Cleanout between building and tank? - - ❑ a ❑ U Tank baffles present? - - ❑ D ❑ d 24" access risers over each compartment?- - ❑ CI ❑ W Effluent filter installed?- - ❑ ❑ 0 Septic tank capacity (working) NuWater BNR gal Manufacturer Sound Placement ❑ D-box water level and speed levelers used? - - E] N/A Ell YES Q NO J 00 Manifold/D-box accessible from surface?- - ❑ ❑I ❑ OOZ Check valves installed? - - ❑ ■❑ ❑ ❑< Transport Line Size 2 inch Schedule/Class 40 Bedrooms installed (check one) 0 2 ❑ 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10 ft. from foundation?- - ❑ N/A ❑■ YES ❑ NO ❑ >100 ft. from wells?- - ❑ X ❑ W >100 ft. from surface water? - (,.� -- - - ❑ ❑■ ❑ it >10 ft. from potable water lines?- ll 41-11- F - Li ❑ Z > 5 ft. from property lines and easements?- - - - - 11 Li El £ > 30 ft. from downgradient curtain/foundation drain&" - -E7-29-a-23 Ill ® ❑ ❑ __ Drainfield level and observation ports present - r © ❑ © Graveless chambers or ❑ Clean gravel used? .( t cL one) ��, Proper cover installed over drainfield?- �--L1 I ❑ Pump tank setbacks consistent with septic tank?- - ❑ NIA ® YES ❑ NO • Pump tank capacity (flood) 1,250 gal Manufacturer Sound Placement < 24" access riser(s) and accessible from surface?- - ❑ . ❑ H a Alarm or Control Panel Installed? - - ❑ U ❑ 2 Control Panel equipped with Timer/ETM /Counter- - ❑ • ❑ o n- Pump installed in ❑ Bucket or ❑■ On Block or ❑ Other a• Pump Make/Model Liberty 280 ■❑ Floats or ❑ Transducer a Tank draw down 1.75 in/min Pump capacity 38 gpm Squirt Height 6 ft Pump on time 1.5 min Pump off time 6 hr Daily flow set at 240 gpd „�9a'.,"F.:<'r?ri8 Mason County OSS Installation Report pg. 2 Parcel # 3 2 o 2 '- 69 —01012 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - — YES NO tf yes, please describe: T` Were all components pumped cut and properly abandoned per WAC246-272A-0300? - - YES i NO RECORD DRAWING This is a permanent record and must be accurate and descriptive enough to re4ocate in the need of maintenance activities and future development Typical Recant Dravangs contain: Drrtfteid&manifold orientation&layout.Sep:^:pmp Irani(location,North arrow,reserve a-airfield,exisUng and proposed buildings.;ocation of wets.waterlines. wells,Nose-va-dn ports,deanous,and otner maintenance access points. Incomplete Record Drawings may create additional delays in final insatatio!t approval and aerated perms. 4.1,21 Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ENGINEER I certify that I installed the system in accordance with 1 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 1 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. r� t1 OCV IV 23 gn .ure of.ns Ilt� er 1 Date H L c_ aril Weer fretz' ' Q 1 PrintecNama of Signed �r Z�h MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and hfn\• •►:. !-I, 1 Record Drawing on behalf of Mason County Public / 51 COJA9 PAULA JOY JOHNSON Health: LICE/488b1588IGNVt/Ap_tykOrkp\Oil] Li/V_,( exPtf:es�� 1T� Signature of Environmental ealth Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEE SITE updated er2t2o15 L . c "" --\ '.\\:‘ 1 ... C , \WO 5F \ d 3 ��, l Drop ` 2D ` @ 2 B rz \ resent t , ' = vse w s i i �O \1siLa [ ° -0001 \ - flsra AlLCk Marokh /k 4i3zni- 5q- OtO12. • • ; 2.� Sovndview Dr APPROVED Skr,(fon . wA g85ezi JAN 0 Li 2023 5ca to l t 20' MASON COUNTY ENVIRONMENTAL HEALTH t i s RET o to 20 3a 40 Key: Ol Audio-Visual Alarm 02 Cleanout 03 NuWater BNR-500 ATU Tank 41k • 4 1,200 Gallon Pump Chamber ? y iJ, OValve Control Box •ya E S,G.149 49 6s PAULA JOY LECr1ki r) :ION)Vt XPEW1,;? ' (2-Z8-Z