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HomeMy WebLinkAboutSWG2023-00538 - SWG As-Built - 2/6/2024 r __ Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2023-00538 Parcel# 22015-75-90073 Applicant Name Leo Echaniz Subdivision (Name/Div/Block/Lot) Applicant Address 91 E Heron Cove LOT:4 OF SP#775(R) PTN TR 7-C S 4/11 City. State, Zip Shelton, WA 98584 Installer Name Maples Excavating Site Address same Designer Name Arrow Septic Designs INSTALLATION CHECKLIST ❑ Full System Installation ®Tank(s)Only E Drainfield Only ❑ Repair ❑ Other System Type Existing Pressure Pretreatment Type NuWater BNR-500 >5 ft.from foundation? - - ❑ N/A 0 YES ❑ NO >50 ft. from wells? - L.- - ❑ IN ❑ Z• >50ft. from surface water? FEB-01-7 4- - - - ❑ CI ❑ < Cleanout between building and tank? - - ❑ ❑� El Tank baffles present? - t.<-' - ❑ L4 ❑ a24" access risers over each compartment?- - ❑ ® ❑ W Effluent filter installed?- - ❑ ❑ ❑■ SOD Septic tank capacity(working) NuWater BNR gal Manufacturer Hagerman 0 D-box water level and speed levelers used? - - ❑ N/A ❑ YES ❑■ NO ><OJ Manifold/D-box accessible from surface?- - ❑ ❑ 0 00- Check valves installed? - ' �`-`"""` �O`"" - ❑ III ❑ ❑Q 5 Transport Line Size 2 inch Schedule/Class 40 Bedrooms installed(check one) 1=1 2 ❑ 3 ❑4 ❑ 5 ❑ 6 ❑Commercial/Other >10 ft. from foundation?- - ❑ N/A ❑ YES ❑ NO 0 >100 ft. from wells?- - ❑ 0 ❑ W >100 ft. from surface water? - ❑ EC. >10 ft. from potable water lines?- ` A- n- > 5 ft. from property line d easements?- - ❑-� Q 0 El Q > 30 ft. from downgradient curtain/foundation drains?- ❑ ❑ 0 Drainfield level and observation ports present - - ❑ ❑ ❑ ❑ Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ ❑ ❑ Pump tank setbacks consistent with septic tank?- - ❑ N/A ® YES ❑ NO Pump tank capacity (flood) 1,000 gal Manufacturer Hagerman Z < 24" access riser(s) and accessible from surface?- - ❑ . ❑ I-- a Alarm or Control Panel Installed? - - ❑ El ❑ 2 Control Panel equipped with Timer/ ETM /Counter- - ❑ IN ❑ d Pump installed in 0 Bucket or © On Block or ❑ Other 2 Pump Make/Model Zoeller N152 ❑■ Floats or ❑ Transducer a Tank draw down 1.5 in/min Pump capacity 38 gpm Squirt Height -- ft Pump on time 1.5 minutes Pump off time 6 hours Daily flow set at 240 gpd Uptlated 8+212018 Mason County OSS Installation Report pg. 2 Parcel n 2 2 D tS--is-41001 3 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - lg YES EiNO If yes, please describe: Sfi--^Ci "c".t %-• er W Q-S ct e c ev+uNA't ss i o vvedl Were all components pumped out and properly abandoned per WAC246-272A-0300? - YES E NO 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&manifold orientation&layout.Septic/pump tank location,North arrow.reserve drainfield,existing and proposed buildings,location of wells,waterlines, wells,observation ports,deanouts,and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and related permits. r Record Drawing Attached CERTIFICATION OF INSTALLATION 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 4 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 Drat✓✓ing is accurate. ��� —721 -`-- 02— 0 —2i Signature of Installer Date ,. ' Printed Name of Si nee w 3Y'rF 9 P a, MASON COUNTY PUBLIC HEALTH 1 • " !.,� The undersigned approves this installation Report and . s����0. �'. 1 Record Drawing on behalf of Mason County Public P•AULA JCY JOHNSON' Health: L'iCtS�iiriCSiGi•4i'tt` 2:41. 1 G;(7-1 EXPIRES �/���J(-� e 2 ` (o — Signature of Environmentalir✓ _ Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE updated 8)2120r8 IIMIIIr A • /L // ; SGALe - it' = A© v f t> 0 20 4a 60 80 _ - E \ A53U t _T W ' LE0 EC. —ctVlz- r A • i 90 220 -15-°c0Z3 d' '1 f 'Yarce S -9 / 1 v 1 E We-. O N Go vt. 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