HomeMy WebLinkAboutSWG2023-00395 - SWG As-Built - 12/1/2023 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH
APPLICANT/ PERMIT INFORMATION
Permit Number SWG 2023-00395 Parcel # 12229-24-00080
Applicant Name JUNE BROWN Subdivision (Name/Div/Block/Lot)
Applicant Address PO BOX 290
City, State, Zip ALLYN, WA. 98524 Installer Name BAMFORD SEPTIC REPAIR LLC
Site Address 231 E WILLIAM PLACE Designer Name CINDY WAITE
INSTALLATION CHECKLIST
® Full System Installation ❑ Tank(s) Only ❑ Drainfield Only ❑ Repair ❑ Other
System Type OSCAR COILS Pretreatment Type XO2
>5 ft. from foundation? - - - ❑ N/A ❑] YES ❑ NO
>50 ft. from wells? - �._ - -_ - _ _c _Iz _ ❑ ❑
gi
>50 ft. from surface water? - ❑ ❑■ ❑
Z
H Cleanout between building and tank? - Elo Tank baffles present? - _. _ - - _ NOV ��� - milU] ❑
LJ
d24" access risers over each compartment?- t _ ❑ El El`W Effluent filter installed?- Fk, _ - - _ — --
-- _ ID ❑ ❑
Septic tank size 1250 gal Manufacturer ROTH _
,0 D-box water level and speed levelers used? - - -. - ❑ N/A ❑ YES ❑ No
XO Manifold/n-box aCae sihle tram f. re?- - - - -14e 2.��Lei-r-L3c f- - ❑ ❑ ❑
u.
QQ Check valves installed? - -- 4 ccest,,1�/e- _ _ _ -. - ❑ ❑ ❑
E Transport Line Size 1 Schedule/Class SCHEDULE 40
Bedrooms installed (check one) ■❑ 2 ❑ 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other
>10 ft. from foundation? - - ❑ N/A 0 YES ❑ NO
CI >100 ft. from wells? - - ❑ ❑ 0
J >100 ft. from surface water? - ❑ ❑
W
ii >10 ft. from potable water lines?- - _ ❑ O ❑
z > 5 ft. from property lines and easements?
cc > 30 ft. from downgradient curtain/foundation drains? 0 ❑ ❑
c
Drainfield level and observation ports present - - ❑ El ❑
IS or e) eAre4 z. Cc,+ is
0 Proper cover installed over drainfield?- - - - - - - -
i Pump tank setbacks consistant with septic tank? - - - -- - ❑ N/A RI YES ❑ NO
Pump tank size 1250 .gal Manufacturer ROTH
Z
24" access riser(s) and accessible from surface?- - ❑ 0 0
IZ Alarm or Control Panel Installed? - ❑ ❑ ❑
2 Control Panel equipped with Timer/ ETM / Counter ❑ ❑ ❑ `\4
n
a. Pump installed in ❑ Bucket or ❑ On Block or ❑ Other-
d Pump Make/Model X02 KIT, INSTALLED PER X02 SPEC:
❑ Floats or ❑ Transducer
Q. Tank draw down
Q. in/min Pump capacity gpm Squirt Height ft
Pump on time Pump off time Daily flow set at gpd
Upcateo 81 ,r2or:
`
A '
Were existill
"'Yes,Please descdbe:
-71
This Is;,
ijerman
11 Wells,obserJatiDn ports.cleancuts,and other Maintenar1cp -PticIPunij,laniumaijun, -11'1`1 uVataintenunce ,it.
access points. d,misfinp and Ypical Roca
rie,...rd')"V'ngs 1-aBY CrOflte additional delays in final 105181lation aPPrOval find .wa ed I
I Ile
Vitached
the septic e 6 With
blic Health and thaj (lance with
here have been any d6viations,Shown 1.
clearedlaPProved bl,both the do-aigi and that any deviations
and Mason County Codes. Effid rkic-ot C;j# been y both
/th&t ali infai-i nation oni-ali7ed f 11 State and Mason (�!Ourft�y Cod&, alth and meet all
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es
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