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HomeMy WebLinkAboutSWG2023-00036 - SWG As-Built - 12/12/2023 Mason County OSS Installation Report pg. 1 MASON COUNTY PUB IC HEAtlat APPLICANT/ PERMIT INFORMATION DEC 12/023 Permit Number SWG 2023-00036 Parcel # 12330-51-00010 REC EC Applicant Name RJ Peabody Subdivision (Name/Div/Block/Lot) Applicant Address P.O. Box 565 BEARDS COVE DIV 4 LOT: 10 City, State, Zip Burley, WA 98322 Installer Name Final Vision Site Address 20 NE Galley Way, Belfair Designer Name Arrow Septic Designs INSTALLATION CHECKLIST IN Full System Installation ❑ Tank(s)Only ❑ Drainfield Only ❑ Repair ❑ Other System Type Sand-lined pressure bed Pretreatment Type >5 ft, from foundation? - - ❑ N/A Q YES ❑ NO >50 ft. from wells? - - ❑I• ❑ ❑ Z• >50 ft. from surface water? - - El 0 El H Cleanout between building and tank? - - El 0 El Tank baffles present? - - El ❑■ El a 24" access risers over each compartment?- - ❑ ❑■ ❑ W Effluent filter installed?- - El ❑■ El U) Septic tank capacity (working) 1,200 gal Manufacturer Hagerman 0 D-box water level and speed levelers used? - - - [U N/A ❑ YES ❑ NO OO Manifold/D-box accessible from surface?- - Ill ❑ El co, a Check valves installed? - - - -V9`-"4`� ��`"^ - El El 2 Transport Line Size 2 inch Schedule/Class 40 Bedrooms installed (check one) ❑ 2 El 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10 ft. from foundation?- - ❑ N/A IN YES ❑ NO >100 ft. from wells?- - El Cl ❑ W >100 ft. from surface water? - - ❑ D ❑ c�_`3 ii >10 ft. from potable water lines?- - El 0 El ;-G f� Q > 5 ft. from property lines and easements?- - El ❑■ CI 8; Q > 30 ft. from downgradient curtain/foundation drains? - - © ❑ ❑ c Drainfield level and observation ports present - - ❑ © ❑ �, El Graveless chambers or ® Clean gravel used? (check one) --- Proper cover installed over drainfield?- - El ■❑ El :i t�-�- r Pump tank setbacks consistent with septic tank?- - ❑ N/A I YES ❑ iNo L�--SJ Pump tank capacity (flood) 1,000 gal Manufacturer Hagerman < 24"access riser(s) and accessible from surface?- - ❑ • ❑ H Alarm or Control Panel Installed? - • Control Panel equipped with Timer/ETM /Counter- - El III El d Pump installed in ❑ Bucket or 0 On Block or El Other 2 Pump Make/Model Liberty 290 ❑] Floats or ❑ Transducer Q. Tank draw down 2.5 in/min Pump capacity 55 gpm Squirt Height 5 ft Pump on time 1.6 min Pump off time 6 hours Daily flow set at 360 gpd Updated 8/212018 Mason County OSS Installation Report pg. 2 Parcel 2 330— 51 -0 CO [ O itageogiwitgroopp Were existing septic components abandoned as part of this project? - - YES NO if yes, please describe: Were all components pumped out and properly abandoned per WAC246-272A-0300? - - YES NO This is a permanent record and must be accurale and descriptive enough to re-locate in the need of maintenance activities and future development Typical Record Drawings contain: Dranfeld&manifold crientatan 3 Layout.Sepx/pump ant lomton,^loth arrow,reserve dramield,existing and proposed oaldings,location cf wells,v.eterlirs, wells,e:servatior:pers,dearouts,ard otiner maintenance a -s pants. Incomplete Record drawings tray aeate addih nil delays in final insmliadon appal and reload oermrts. Record Drawing Attached 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 all information contained on this form and attached Record Drawing is accurate. form and attached Record Drawing is accurate. 10l l—1/23 Signature of installer Date Printed Name of Signee e •ot {j r MASON COUNTY PUBLIC HEALTH =&gar o The undersigned approves this Installation Report and h • l 51G^3S9 Record Drawing on behalf of Mason County Public y T. G, PAULA JOY JOHN', Health: EXPIRES 019/it/ tL-k�z3 Signature of Environmental Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE uPdaled 8r21/2D18 44 85 ' SCp\LE: `„_ Z o L I G tv 20 3o a P\Q'Proktvnok2.`v\ Voo' As Bu L_-r- -d-o s-}'rtam . •Pc s `P -c,, V vtx\c--; td by WC- Ia+nd t°ARC t t2530-5 - 000(p biolQ�lS�' NEG ��- y ��1 O r Q ___c---- _ J ' (,4„„)0 ( ,,- ---\ C 1\/ a a J 3 �� ROCK. 143 , ?., 9 \z,-.4.-.. -,A I r I o I A--------t____ / Z' �� • wfii --2® APPROVED /1/ DEC 18 2023 G41-L eY t MASON COUNTY ENVIRONMENTAL HEALTH V Ac RET Key: 4;5 0 Audio-Visua.l.Alarm .'....4% �i A, L0t 5J1v3,J4O9 _ t�a� \'1tt. 6 �oAA ? 3 1200 Gallon Septc Tank 2-Compa went with E n,ert Filter � 3 1000 Gallon Pump Chamber W+r s 3 l }"CK