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HomeMy WebLinkAboutSWG2020-00355 - SWG As-Built - 1/26/2024 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2020-00355 Parcel # 32024-22-90022 Applicant Name Daniel Orris Subdivision (Name/Div/Block/Lot) Applicant Address 91 E Lighthouse Rd LOT 2 OF SP #694 PTN OF NW NW S 33/92 City, State, Zip Shelton, WA 98584 Installer Name Weather Tight Const-Scott Johnson Site Address 91 E Lighthouse Rd, Shelton Designer Name Arrow Septic Designs, Inc INSTALLATION CHECKLIST ® Full System Installation ❑ Tank(s)Only ❑ Drainfield Only ❑ Repair II Other 500 gallon Pro-trash System Type Shallow Pressure Pretreatment Type NuWater BNR-500 >5 ft. from foundation? - ❑ N/A ❑■ YES ❑ NO >50 ft. from wells? - -- - - - ❑ i ❑ Z >50 ft. from surface water? - - It El H• Cleanout between building and tank? - - - - ❑ Q ❑ O Tank baffles present? - -- - - - -. - ❑ 0 ❑ a24" access risers over each compartment?- - -- - - ❑ ❑■ ❑ W Effluent filter installed?- - - ❑■ ❑ ❑ to Nv w es-- Septic tank size BNR-500 gal Manufacturer Infiltrator 0 D-box water level and speed levelers used? - -- -- - - • N/A ElYES ❑ NO OO Manifold/D-box accessible from surface?- - -. -- - - ❑ ® ❑ co, Z Check valves installed? - - - - -e- --e-4 "" - - ❑ ❑■ ❑ 0Q 2 Transport Line Size 2" Schedule/Class 40 Bedrooms installed (check one) ❑ 2 ❑■ 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10 ft. from foundation?- - ❑ N/A YES ❑ NO 0 >100 ft. from wells? El w >100 ft. from surface water? - - — ---R-0 V i- ❑ ❑ it >10 ft. from potable water lines?- - - - AA1 ❑Q ❑ Z > 5 ft. from property lines and easeme �t�l, 2��4 d 0 ❑ ce > 30 ft. from downgradient curtain/fours(i 0ll>VEN}VIRONMEN-TAL-HEALII ❑ ❑ 0 Drainfield level and observation ports present - - - -JEtw - ❑ 0 ❑ © Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ ❑■ ❑ Pump tank setbacks consistant with septic tank? - - - ❑ N/A © YES ❑ NO • Pump tank size 1,060 gal Manufacturer Infiltrator < 24" access riser(s) and accessible from surface? - ❑ 1. ❑ ~ Alarm or Control Panel Installed? - - ❑ © ❑ a E Control Panel equipped with Timer/ETM /Counter- - ❑ E] ❑ a Pump installed in ❑ Bucket or Q On Block or ❑ Other D.• Pump Make/Model Zoeller N152 0 Floats or ❑ Transducer a Tank draw down 2 in/min Pump capacity 50 gpm Squirt Height 5 ft Pump on time 1.8 min Pump off time 6 hr Daily flow set at 360 gpd Updated 621/20iA Parcel# ° f Mason County OSS Installation Report pg. 2 ;� ~ `oO"7 ABANDONMENT RECORD 0 YES t* NO Were existing septic components abandoned as part of this project? - 777��� If yes, please describe: 0 NO Were all components pumped out and properly abandoned per WAC246-272A-0300? - YES RECORD DRAWING This is a permanent record and must be accurate and descriptive enough to re-locate in the need of maintenance activities and future development Typical Record Drawings contain: Drainfield R.manifold orientation&layout.Septic pump tank location.North arrow.reserve drainfield.existing and proposed buildings,location of wells,waterlines, wells.observation ports,cleanouts.and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and related permits. APPROVE0 JAN 2 6 2024 MASON COUNTY ENVIRONMENTAL HEALTH JBW Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ ENGINEER 1 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 1 further certify that all information contained on this 1 further certify that all information contained on this fo and attached Record D wing is curate. form and attached Record Drawing is accurate. , " L.___,--- -------- Signature }o�f-install Date �0 5C0 1 • •\�S�� blp .' r , �. �� wait •, 11 Iic7 J1 Printed Name of Si nee 's • lr MASON COUNTY PUBLIC HEALTH ,'-.. -• u�kr J;' St:ri3<e -`,`f The undersigned approves this Installation Report and y' PAUt.A JOY JOHNSON .•!y�` Record Drawingon behalf of Mason CountyPublic 's LI�.Nsv-i �E,,1CWptt _ b Health: --,2 --,-,ly I Sign to nvironmental alth Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Updated 821r2018 - r 53 _ • . , . / \o° 3Bg- . c• � © �) 3` x35f r''md`l ---45' Qr {✓e�J�e7 G (�. C. t� l'1 �' gvC�e lyt(Oi�ct • J, /,�/ 1, �i/// a` // /// . L N O Audio-Visual Alarm !7d O Cleanout f3 500 Gallon Pre-Trash tank 0 NuWater BNR-500 ATU Tank 55 1,000 Gallon Pump Chamber W\ . a... -S t.v.,, , UValve Control Box — I Lihfh oo S.€ Kci 30. Z05.it' ' road Ac5\0 \ 1� if eo5r.vnt _tc-ANz-t..),..._ O-Nrs—s . Par Cef 4 3Zo7y-2Z -9 'OZZ 8 .r . 61 f L� hthov5c3-d __ `�vV Qy �`� _ 9�J;)) • 5cafe . - L40` , .. v . t t t 1 f t .� • 57U0349 ..'44- `�' PAULA JOY JOHNSON .% o zG 40 60 80 4:DCr. Eti gcNrpr . exatRE 09.)i b/?:eT 2--1 Z3 '40 a/ A ` eP I V v k 1. m 1 w (7 w$ a Q' • �k "'g �0 1 a ay 6 a6 W 3 i• _ 2EV • = 4 N . 0 Z z a M {Y p � k s /, J= 1t .%' y� Z a it 11 1. 8 W CC J1ch Z44° 1 ti U vg 47 yy'y �� 4 1 a s�t3 s 4 0 " 4 a? VA o`, ao A a uu ud 4 ii 2 n h - +a v at r `v q o A ?• ")I I hd ;1 % 4I 1, n m 1,,"•r. i.i14 pn•£oF i lil s-sa O£ a \\ \ 1 i W � \\\ T _ \ \ \ N i G� i I • i ! V! ti R 4 I z c a M ,.. 71 v O \, Ti . ... , 0 _ u, ,_, •• O , .: _ f:ii ',A°. i a i '. ta/ { • n ` I 11,1) W 4'0 " � � y°��� A IN C . 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