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HomeMy WebLinkAboutSWG2023-00276 - SWG As-Built - 12/19/2023 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLIG N7 MLTNNNOHMATJCN . Permit Number SWG 2023-00276 Parcel # 32412-11-90062 Applicant Name Jingfu Sun Subdivision (Name/Div/Block/Lot) Applicant Address 21092 37th Ct. S. City, State, Zip SeaTac, WA 98198 Installer Name T.J.Goos Site Address N. Seagull Way Designer Name Dale L.Tahja I N S TA L LATiON CHE CK L IS T. , ElFull System Installation ❑Tank(s)Only ❑ Drainfield Only ElRepair ❑Other System Type Pressure Trenches (Infiltrators) Pretreatment Type >5 ft. from foundation? - - ❑ N/A ®YES ❑ NO >50 ft. from wells? - .- 0 ® 0 Z >50 ft. from surface water? - - 0 II El H Cleanout between building and tank? - -- - - .DEL-La2Q23_ _ _ _- ❑ NI El U Tank baffles present? - ' - 0 ® ❑ 24" access risers over each compartment? - - - . ❑ ® 0 I Effluent filter installed?- .- El II ❑ Septic tank capacity(working) 1.250 gal Manufacturer Hagerman 9 D-box water level and speed levelers used? - - IN N/A ❑ YES ❑ NO miSManifold/D-box accessible from surface?- - 0 IN ❑ Check valves installed? - ❑ NI Eloa 2 Transport Line Size 1.5 inch Schedule/Class Sch. 40 Bedrooms installed (check one) © 2 ❑3 0 4 ❑ 5 0 6 ❑Commercial/Other >10 ft. from foundation?- - ❑ N/A ® YES ❑ NO 0 >100 ft. from wells?- - ❑ I ❑ W >100 ft. from surface water? - - El Ell IT. >10 ft.from potable water lines?- - ❑ N1 ❑ Z >5 ft.from property sines and easements? ❑ II ❑ Q iz > 30 ft.from downgradient curtain/foundation drains? - - 0 © ❑ o Drainfield level and observation ports present - - il ❑ 0 ® Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ ® ❑ Pump tank setbacks consistent with septic tank? - - 0 N/A ® YES ❑ NO ZPump tank capacity(flood) 1,000 gal Manufacturer Hagerman < 24" access riser(s)and accessible from surface?- - ❑ ® 0 aAlarm or Control Panel Installed? - - 0 UI 0 Control Panel equipped with Timer/ETM/Counter- - ❑ 0 ❑ _I- Pump installed in ❑ Bucket or ® On Block or ElOther a Pump Make/Model Liberty 280 . � 0 Floats or 0 Transducer 0=, Tank draw down 2 in/min Pump capacity 44 gpm Squirt Height 8 ft Pump on time 9 min. Pump off time 23 hrs. 51 min. Daily flow set at 180 gpd Updated 8/21/2018 Mason County OSS Installation Report pg. 2 Parcel# 3 \, k\L \ \s-10061, ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - El YES ® NO if yes, please describe: Were all components pumped out and properly abandoned per WAC246-272A-0300? - - ❑ YES [] NO RECORD DRAWING r This is a permanent record and must be accurate and descriptive enough to re-locale in the nand of maintenance activities and future development Typical Record Drawings contain: Drain-field&manifold orientation&layout,Septic/pump tank location,North arrow,reserve drainfiekl,existing and proposed buildings,bcallon of wells,waterlines, wells,observation ports,cleanouts,and other maintenance access points. Incomplete Record Drawings may create additional delays in final Installation approve[and related permits. ® Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ENGINEER 1 certify that 1 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 1 further certify that all information contained on this I further certify that all infonnation contained on this form an attached Record Drawing is a rate. form and attached Record Drawing is accurate. ...( `� Signature of Installer ate it wi' f)0141 .0t(1. &CO S '..'k 4 e- s P. Printed Name of Signee i/ i ,yo1 •l.;c �� •S 1 � F. c i MASON COUNTY.PUBLIC HEALTH : �! } ,`h�-1� The undersigned approves this Installation Report and '` `,, 51002'14 ‘,`,1�f 1 . Record Drawing on behalf of Mason County Public r "- DALE L. JA t Health: Li_Cf,NSED D Sii'lER St Alike[". "4. .•. .`. . 'fir..,.:+.s•.+.°L . .. 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 updated&/21R018 it ill 0 � -' S A I f"•�,✓( ` ..1' 314 yj',eit / r w �� R i � 9 y +(t , -) f J 1 • 1 O , .. . 0 'i —c7\Y( ('' i'ci \ , v • i I ' i I r� .''' I ,r 6)3:1.t).4.H)3 ,t, I/(—e- 3____c_._)4. / . I 54_0J—iO �• c 0.> ..) , '! = D ► , APPROVED. c, • O a 1 DEC 11 2023 _ • C� O MASON COUNTY ENVIRONMENTAL H O HEALTH RET 0 : tom