Loading...
HomeMy WebLinkAboutSWG2023-00368 - SWG As-Built - 2/2/2024 r Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2023-00368 Parcel # 42223-50-00081 Applicant Name Barry & Danna Moore Subdivision (Name/Div/Block/Lot) Applicant Address 1225 NW State St Potlatch Beach Tracts Lot: 81 City, State, Zip Pullman, WA 99163 Installer Name Maples Excavating Site Address 150 N Potlatch Rd Designer Name Arrow Septic Designs INSTALLATION CHECKLIST © Full System Installation ❑Tank(s)Only ❑ Drainfield Only II Repair ❑ Other System Type Sand-Lined Pressure Bed Pretreatment Type >5 ft. from foundation? - - ❑ NIA ❑■ YES ❑ No >50 ft. from wells? - - ❑ 0 ❑ Z >50 ft. from surface water? - - - - - It ;j ❑ ❑ < Cleanout between building and tank? -- U r ❑ 0 ❑ U Tank baffles present? - M- f y -)-' 024 - ❑ 0 ❑ a24" access risers over each compartmentb 0 0 0 W Effluent filter installed?- \\ ❑ 0 ❑ cn BY— .-_. Septic tank capacity (working) 1250 -gal Manufacturer Hagerman 0 D-box water level and speed levelers used? - - 0 N/A ❑ YES ❑ NO oOJ Manifold/D-box accessible from surface?- - . ❑ ❑ mZ Check valves installed? - A+-' t' -+AvY- - ❑ 0 ❑ O Q 40 2 Transport Line Size 2" Schedule/Class Bedrooms installed (check one) 0 2 0 3 0 4 0 5 0 6 ❑Commercial/Other >10 ft. from foundation?- - ❑ N/A 0 YES ❑ NO 10 >100 ft. from wells?- - ❑ ❑■ 0 W >100 ft. from surface water? - - ❑ 0 ❑ 1 >10 ft. from potable water lines?- - 0 0 0 Z > 5 ft. from property lines and easements?- - ❑ 0 0 Q Ix > 30 ft. from downgradient curtain/foundation drains? - - ❑ X ❑ Drainfield level and observation ports present - - ❑ 0 0 ❑ Graveless chambers or © Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ 0 0 Pump tank setbacks consistent with septic tank? - - ❑ N/A © YES ❑ NO • Pump tank capacity (flood) 1500+ gal Manufacturer Hagerman z - CI © El 24" access riser(s) and accessible from surface? ~ Alarm or Control Panel Installed? - - 0 0 0 a E Control Panel equipped with Timer/ ETM/Counter- - 0 ® 0 D il- Pump installed in ❑ Bucket or 0 On Block or ❑ Other a-• Pump Make/Model Zoeller E189F ❑■ Floats or ❑ Transducer EL a Tank draw down 3.4 in/min Pump capacity 88 gpm Squirt Height 5 ft Pump on time 1.33 Pump off time 6 Hours Daily flow set at 480 gpd Updated 801/2018 Mason County OSS Installation Report pg. 2 Parcelx 2\22).:)? '50-Qod8 ABANDONMENT RECORD ® YES ❑ NO Were existing septic components abandoned as par of this project? If yes, please describe: Old Were all components pumped out and properly abandoned per WAC246-272A-0300? - Iv YES ❑ RECORD DRAWING This is a permanent record and must be accurate and descriptivetank location,North arrow, ese.ve crai^5eld existing and proposed bnough to re-locate in the need of maintenance activities and uildings,re location of wets,lopment 'cal Record waterli es, Drawings contain: Drairt;teld 8 manifold oren:ation 8 layout.Septic/pump• wets•observaton oors,cleanouts,and other maintenance access points. Incomplete Record Drawings may c-eate additional delays in final installation approval and related permits. Et_ A-i.-TC��1).APPROVED FEB 2 2 2624 MASON COUNTY ENVIRONMENTAL HEALTH J B W I. 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 -LS-1-4 Signature of Installer Date AI • ••�;,, Printed Name of Signee ` ••rAe���' �' Y'c t••p.;4h MASON COUNTY PUBLIC HEALTH it.•' ��c ' '41 The undersigned approves this Installation Report and �aI.:'Y''9 t' I1j` PAUI�.JOY JOHNSON' �� Record Drawing on behalf of Mason County Public z '�jC rq�ly 1 •` , Health: Dc�i:tis-k i T Signatu a •r ranmental Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE updates arz1rz018 1 .11.!' • ^� 1, (2\ to*f•30 0 2a iota (RC o f t f 1 d�o•m 1d `5 t ► s 1 Q ar,d_, •NM. ASBt���-'C s4 l l t l fiCk S V.'`-t F�RRf o 0 �� �J fe.5e�''L' 4 n r Lc.3"5 - d00 o N o— C-2,S`-oea- ;7 0 2GTU�( 9 0 ,j4eact\ ;g:x R. el'`(' ± oc S lee,Je) c -'8 ............4-- -;:20- .b W R k , xev; - Audio-Visual Alarm Pt ,,,,g.,,\CA. Cleanou t 1 0 v4'c \\ e = Le c,. 'c"` �'`w` 1200 Gallon Septic Tank I o ,. s) 2-Compartment with Effluent Filter ©' g� � *DEGorlMlS5loN�p -r L 9i`f- O 1500 Gallon Pump Chamber � - Pcti (Cv-e•xs`a'.k - tz.00 3 1. V.'t") Z8� a APPROVE 1AFEB 2 2 2024 MASON COUNTY ENVIRONMENTAL HEALTH lk �' -cr JBW 4 r, 510�349 ��'�? �O o-D CANAL i_,\_\- 4:\t':;A'8' 7iYufttrA°A.:(\ 7. : t