The URL can be used to link to this page

Home My WebLink AboutSWG2019-00326 - SWG As-Built - 2/22/2024 r 10"; Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 20( CI — &O 3).(4 Parcel# 51901-50-01069 Applicant Name Vicki Youngs _ Subdivision (Name/Div/Block/Lot) Applicant Address 26926 Avon Ct Lost Lake Block 1 Lot 69 City, State, Zip Kent, WA 98032 Installer Name Tom Weaver/ Allied Design Site Address I >o i-J (tA. l 'i,[ , Dr Designer Name Tom Weaver INSTALLATION CHECKLIST ® Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑ Repair ❑Other System Type Gravity Pretreatment Type >5 ft. from foundation? - - ❑ N/A ]YES ❑ NO >50 ft.from wells? - - ❑ KI ❑ z >50 ft. from surface water? - - ❑ n ❑ 1-- Cleanout between building and tank? -_`S- E-I; - ❑ In ❑ U Tank baffles present? - . ❑ El ❑ a24"access risers over each compartment?.- - - __ . ❑ n ❑ N Effluent filter installed?- - 0 El EJ Septic tank size 1,250 gal Manufacturer Hagerman 0 D-box water level and speed levelers used? - - ❑ N/A RI YES ❑ NO gO Manifold/D-box accessible from surface?- - ❑ ❑ GCheck valves installed? - - ® ❑ ❑ 2 Transport Line Size Ott Schedule/Class 3034 Bedrooms installed (check one) ❑ 2 RD 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10 ft.from foundation? - - ❑ N/A ® YES 0 NO 0 >100 ft.from wells?- - ❑ PI ❑ W >100 ft. from surface water? - - ❑ K1 ❑ u. >10 ft. from potable water lines?- - 0 ® ❑ Z > 5 ft.from property lines and easements?- - ❑ ® 0 d > 30 ft. from downgradient curtain/foundation drains?- - ® ❑ ❑ CI Drainfield level and observation ports present - - ❑ ® ❑ J Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ ® ❑ Pump tank setbacks consistant with septic tank?- - ❑ N/A ❑ YES IX NO • Pump tank size gal Manufacturer <• 24" access riser(s) and accessible from surface?- - ❑ ❑ ❑ O. Alarm or Control Panel Installed? - - ❑ ❑ ❑ • Control Panel equipped with Timer/ETM/Counter- - ❑ ❑ ❑ O. Pump installed in ❑ Bucket or ❑ On Block or ❑ Other n'• Pump Make/Model ❑ Floats or ❑ Transducer a Tank draw down in/min Pump capacity gpm Squirt Height ft Pump on time Pump off time Daily flow set at qpd Updated 8/21/2018 I ( Mason County OSS Installation Report pg. 2 Parcel# 51901-50-01069 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - ❑ YES 50 NO If yes, please describe: Were all components pumped out and properly abandoned per WAC246-272A-0300? - - 1=3 YES Ei 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,Septidpump tank location,North arrow,reserve drainfield,existing and proposed buildings location of wells,waterlines, wells.observation ports,deanouls,and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and related permits. See Attached [X 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 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. i��/t"- 10/15/2019 Signature of Installer Date i/1 Tom Weaver r• • ?� 4:9'— Printed Name of Signee 0. i •9�A MASON COUNTY PUBLIC HEALTH " 41...,...c to h The undersigned approves this Installation Report and 5100333 '.,�!� o� THOMAS E.WEAVER'. 1+ Recort) r wing on behalf of Mason County Public C • „""tom """= Health: EXPIRE 01125/ • t,, ,0 j . ,/,r IV_ __---?,2- '— Signatu a of n mental Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Updated 8212018 1" = 30' % Lost Lake 51 901=50-01 069 o'el aa' SL#1 0-16" Old fill o'el 16-60" Sand Loam SL#2 0-16" Old fill 16-60" Sand Loam SL#3 0-16" Old fill 16-60" Sand Loam Sewage connection for RV Important-do not put chemicals Concrete in RV holding tanks as they are Pad for RV detrimental to a septic system. Before connecting to this syste ```�_ dump RV at an appropriate +30'el location. 5 16'X32 Garage No 200' plumbin 256' ' c jlit /1 80 •9 /(/// l./ v / FMAT N� 10096 se' Reserve D/W p�(THOM E�WEAVER 3 IGENSED.; N R -fir-^.; : .._.. _ S EXPIRss -,!5 x o 6 77 P o ID-Bo. I ° 4 - 50' Legs ' —�• %p 22'el n ' — ~Z___ Water Meter Meter should be moved East /// / 86'' to property corner,out of 22'e( driveway, Do not move the meter West! W. Lakeside Dr P P R O Y E �t. .k. FEB 2 2 2024 MASON COUNTY ENVIRONMENTAL HEALTH JBW