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HomeMy WebLinkAboutSWG2023-00469 - SWG As-Built - 1/29/2024 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION --...._,......_` Permit Number SWG 2023-00469 Parcel# 32026-75-90061 `s<,�/ Applicant Name Rodney Peters Subdivision (Name/Div/Block/Lot) JAN 2 !!! 9 2024 1: Applicant Address 160 W Old Olympic Hwy TR A OF SP#1896 SEE SURV 4/115 R City, State, Zip Olympia, WA 98502 Installer Name Sam Skinner Construction / Site Address 11 SE Jainee Ln Designer Name Arrow Septic Designs INSTALLATION CHECKLIST El Full System Installation ❑Tank(s)Only ❑ Drainfield Only 0 Repair ❑ Other System Type OSCAR X02 Pretreatment Type >5 ft. from foundation? - - ❑ N/A ❑■ YES ❑ NO >50 ft. from wells? - - ❑ ® ❑ Z >50 ft. from surface water? - - El 0 El FQ- Cleanout between building and tank? - - ❑ 00 V Tank baffles present? - - ❑ ® ❑ a24" access risers over each compartment?- - ❑ MI W Effluent filter installed?- - ❑ ❑ 0 N Septic tank capacity(working) 1,200 gal Manufacturer existing 2-compartment concrete �0 D-box water level and speed levelers used? - - 0 N/A I: YES 0 NO ><O Manifold/D-box accessible from surface?- - 0 PI mZ Check valves installed? - - ❑ MI 0 6Q 2 Transport Line Size 1 inch Schedule/Class 40 Bedrooms installed (check one) ❑ 2 0 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10 ft. from foundation?- - ❑ N/A ■❑ YES ❑ NO O >100 ft. from wells? 0 ❑ W >100 ft. from surface water? - AlR-avIn- 0 ❑ u. >10 ft. from potable water lines?- - ❑ ❑■ ❑ co - o z I LU Q 2024 ;� > 5 ft. from property lines and easements?- - - ❑ ■❑ ❑ CC > 30 ft. from downgradient curtain/foundation GOUNT-Y- .aWROAIMElni.HEALTH 0 ❑ ' '' CI �- Drainfield level and observation ports present - JBW- ❑ 0 ❑ t r-- 1 ❑ Graveless chambers or ❑ Clean gravel used? (check one) it N a Proper cover installed over drainfield?- - ❑ 0 ❑ i 4 t Pump tank setbacks consistent with septic tank?- - ❑ N/A 0 YES ❑ Nd �. i • Pump tank capacity (flood) 1,000 gal Manufacturer 2-compartment Evergreen Precast < 24" access riser(s) and accessible from surface?- - ❑ 0 ❑ F- a Alarm or Control Panel Installed? - - II • ❑ 2 Control Panel equipped with Timer/ ETM /Counter- - ❑ ® ❑ n- Pump installed in ❑ Bucket or ❑ On Block or • Other on bottom of tank a'• Pump Make/Model AY McDonald E-30 © Floats or ❑ Transducer a. Tank draw down -- in/min Pump capacity 2.1 gpm Squirt Height — ft Pump on time 30 seconds Pump off time 3 minutes Daily flow set at 360 gpd Updated S2 1,201e Mason County OSS Installation Report pg. 2 Parcel# 52°2 0— 16— q00 6-1 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - YES NO If yes, please describe: Sri 6-eV vOc-5 Gte.coAvm i 55 towed +nY oLutz! D•F. u Qs ako4c "elf Were all components pumped out and properly abandoned per WAC246-272A-0300? - - tti 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 activttles and future development Typical Record Drawings contain: Drairrrxld&manifold orientation&layout,Septictpump tank location.North arrow,reserve dreinfieid,existing and proposed buildings,location of wells,waterlines. wets.observation ports,deanouts,and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and related permits. .P 0 E FED ;t 0 2024 MASON COtiNir EN4"IRON ENTAL HEALTH JBRecord 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. - of/1Qj 2-4N, � Signature of Installer Date )� r\U L SKtl�I.SE Z ^3 �s� Printed Name of Signee MASON COUNTY PUBLIC HEALTH y ned approves this Installation Report and '- r' stOY J N . 4`t' The undersigned p � PAULA JOY OHNSON �'i Reco Drawing on b half of Mason County Public "l:t:✓PNSEtiUESiG1Ji±ft' Health Sig atur vironmental Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE updaled 8n112o18 1't Hey: Audio-Visual Alarm-Upgrade to OSCAR X02 Panel • 1 Cleanout • • O3 Existing 1200 Gallon Septic Tank ' 2-Compartment with s Effluent Filter-Add risers &X02 Kit 6 1 O 4 Existing 400 Gallon Pump Chamber LitW 1 N eL L.Iber4-1 LE 51 M O Existing Primary Mound Drainfield - "o decommissioned m l O Existing 10'x 25'Sand Filter-to be abandoned/decommissioned ti eR I07 New 1,000 Gallon 2-Compartment ri Dose/Pump Tank with Headworks W 5-'6 ' 1 IOg Airbox-Place at higher elevation than tank lids 4.D 5.,,,, ... , . ik:4- .- v.). - t=, et )4P Pc. 1 .k O ,v PAUTA5 JOY JO°349 C HNSON . (�{ �_ •LiC:�S'E ION • , Z�j 0 . l '3\. -q`.-1.r.........../ ,��~ 4‘ Sz / • 1 ,S / SCatf• ,�k Q Qy� a�r� ✓ 2a c CPC t / j.j 1Y9 3.5 1 4b.c TP r � :� 3 Za2k,-zs-Raob! r ,N/1 , . eci -� APPROVE , • • FEB 101024 MASON COUNTY ENVIRONMENTA JR W L HEALTH