HomeMy WebLinkAboutSWG2022-00036 - SWG As-Built - 1/18/2024 Amm
CLEAR FORM o
Mason County OSS Installation Re rt pg. 1 MASON COUNTY PUBLIC HEALTH
APPLICANT/ PERMIT INFORMATION
Permit Number SWG 2022-00036 Parcel # 120185000006
Applicant Name Ton Helblin Subdivision (Name/Div/Block/Lot)
Applicant Address 30842 S Need Rd ISLAND SHORES TR 6
City, State, Zip Canb ORE 97013 Installer Name Tate Choate
Site Address 182 Leaf Ln, Shelton W Designer Name Jim Zimny
IIFsiSTALLATION CHECKLIST
® Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑ Repair ❑Other
I System Type Oscar II Pretreatment Type Enviro-flo BNR 500
>5 ft. from foundation? ❑ N/A ® YES ❑ NO
>50 ft. from wells? - - ❑ ® 0
4 .TL >50 ft. from surface water? - - ❑ ® ❑
,ei5 Cleanout between building and tank? - - ❑ ® ❑
c. Tank baffles present? - - ❑ ® ❑
24" access risers over each compartment?- - ❑ ® 0
Effluent fitter installed?- - ❑ ® ❑
Septic tank capacity (working) 500 gal Manufacturer Hagerman
0 D-box water level and speed levelers used? - - - - -- - ❑ N/A ❑ YES ❑ No
J
oO Manifold/D-box accessible from surface?- - ❑ El
m z Check valves installed? - - - 0 ® ❑
OQ
2 Transport Line Size 1" Schedule/Class Schedule 40
r'—
Bedrooms installed (check one) 0 2 El 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other
>10 ft. from foundation?- - ❑ N/A ® YES ❑ NO
O >100 ft. from wells?- - ❑ El 111
W >100 ft. from surface water? - - 0 ® El
LL >10 ft. from potable water lines?- - 0 ® 0
Z > 5 ft. from property lines and easements?- - ❑ ® ❑
Q PI CI
> 30 ft. from downgradient curtain/fou ation drains? - - El
• Drainfteld level and observation ports resent - - El ® ❑
❑ Graveless chambers or ❑ Cle n gravel used? (check one)
Proper cover installed over drainfield? - ❑ ® ❑
Pump tank setbacks consistent with septic tank? - - ❑ N/A ® YES El NO
• Pump tank capacity (flood) 1200 _gal Manufacturer Hagerman
< 24" access riser(s) and accessible from surface? - - ❑ • El
~ Alarm or Control Panel Installed? - - -- - ❑ RI 0
a.
• Control Panel equipped with Timer/ ETM /Counter- - ❑ I] ❑
n- Pump installed in ® Bucket or C On Block or ❑ Other
n.• Pump Make/Model 1/2 hp 30 GPM t_oweridge Pump IN Floats or ❑ Transducer
d Tank draw down .35 Inches in/min Pump capacity 2 8 gpm Squirt Height N/A ft
Pump on time 32 Secs Pump off time 3 Min 30 sec Daily flow set at 270 gpd
1 Upd.I.d 8121/2018
rillaIllm".""aum.".NIIII..nui"limm"."'"mmllnmunm"..." """"1"u"..m"akMason County OSS Installation Roport pg. 2
ABANDONMENT RECORD
JrIC Jt C,- . ' "t- - ).ES
RECORD DRAWING
• , .roilpiest Lie so..„tr.fte anti jobtrivir.t , ' filo -04,1 irms-,Pr.ana•)(Thetells.:11K1 1d.w.lawnelflt !/71n,
CERTIFICATION OF INSTALLATION
INSTALLER DESIGNER, ENGINEER
. • ..,• ••
,:•es:gr,SQ.".;:t . 7t
!•.,: • Coorty ary 7.-
," :y.• t", :MQW0 110.I5"' ,1,7.11,arq,(nVehl bi
A.4.1'S5e)Cot/ i-iea ^C'nen-f? rrTisve OrKi met:P.1.
.3!..)fr,and Mus;.- C:./004
Cvlq'y!Pc'e 3,,.7, rar.nr -.,7 • • .• a. r.h. ii:fon conti.m.try to.:;
qc:N.:041 icrac-Pe.:Rei J'a'rev is atxurato
"ritit Chotd-c_
111( "st
MASON COUNTY PUBUC HEALTH P
,
".'",,7.••:Jr:dem:Irv-1 ?.<
'r2A.
t 't.;ar ne: ' MASA:" " At../
; •41,ny V
. • • •vER
.i8r )4()NC6r1 I 1(5(-21 2Se"
- .
o -
cLA
- N
N
N
l_ O D OSCdlr�
= o Reserve
a�
_ El
or
.y1- "'
`�� ♦„....................4 ....5..._ _
•
•
/ / x' I
• •
/ram ��� / / \ 1 •
•
r �, O
r I / H /le \\
I A I1 / �_� j ` l
-70
5/ i 3 bedroom; / i
�\ / . Home-. i i I ► /'.�. i. 1 /
2.
t //
Va
\\ ``\ '' \\\♦ 1 to • • / `\\` %
\ \� � Z v/ \ / '
•
\\ Vt Ci*,./iO \\` /,i//
fD
vi
D "- P P R O V E D -' �t\� - ------
et. MASON COUNTY •
ENVIRONMENTAL HEALTH u,=
RET
___- Bank ' il
•
vo 0 w '' � _ 0 I C •
p i cII r-r N O .7 0 " x C77 N• n_ C
rD lD
Vila O A 0 n O
W O i5 t
o P