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HomeMy WebLinkAboutSWG2023-00500 - SWG As-Built - 2/23/2024 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2023-00500 Parcel # 12330-52-00045 4� Applicant Name BRICK C/C B-LINE CONST. Subdivision (Name/Div/Block/Lot) 4-,6, 2 Applicant Address 2971 E PHILLIPS LK LP RD RFC 4/Ro 24 City, State, Zip SHELTON, WA 98584 Installer Name B-LINE CONST. Site Address 311 NE SCHOONER LOOP Designer Name TOBY TAHJA-SYRETT INSTALLATION CHECKLIST ❑ Full System Installation ❑Tank(s) Only III Drainfield Only ❑ Repair ❑Other System Type GRAVITY Pretreatment Type N/A >5 ft. from foundation? - - ❑ N/A ®YES El NO >50 ft. from wells? - - El II El Z >50 ft. from surface water? - Ft� - CI ® El • Cleanout between building and tank? - 1u1 - ❑ It El U Tank baffles present? - U El IN El 24" access risers over each compartment?- - ❑ in El a W Effluent filter installed?- - ❑ I] ❑ rn Septic tank capacity (working) gal Manufacturer EXISTING 1200 GAL --c3 D-box water level and speed levelers used? - - ❑ N/A ® YES ❑ NO DO Manifold/D-box accessible from surface?- - El II ❑ ii Ca Z Check valves installed? - - ❑■ ❑ ❑ 6Q 2 Transport Line Size 4" Schedule/Class 3034 Bedrooms installed (check one) ❑ 2 ❑� 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10 ft. from foundation? - - El N/A ® YES ❑ NO O >100 ft. from wells?- - El El El W >100 ft. from surface water? - - El MI Er. >10 ft. from potable water lines?- - El I ❑ z > 5 ft. from property lines and easements?- - ❑ 0 ❑ Q CI NE CI > 30 ft. from downgradient curtain/foundation drains? - - ro Drainfield level and observation ports present - - El IN El ❑ Graveless chambers or IN Clean gravel used? (check one) Proper cover installed over drainfield?- - El ® ❑ Pump tank setbacks consistent with septic tank? - - ❑ N/A ❑ YES ❑ No • Pump tank capacity (flood) gal Manufacturer < 24" access riser(s) and accessible from surface?- - El El El CL Alarm or Control Panel Installed? - - El El Ela 2 Control Panel equipped with Timer/ ETM /Counter- - El El El m - Pump installed in El Bucket or ❑ On Block or ❑ Other a• Pump Make/Model ❑ Floats or ❑ Transducer a. a Tank draw down in/min Pump capacity gpm Squirt Height ft Pump on time Pump off time Daily flow set at gpd Updated 8/21/2018 Mason County OSS Installation Report pg. 2 Parcel# 12 3 36 -5 Z - 0OO`t E— ABANDONMENT RECORD . Were existing septic components abandoned as part of this project? - - ❑ YES II NO If yes, please describe: Were all components pumped out and properly abandoned per WAC246-272A-0300? - - ❑ YES El 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,cleanouts,and other maintenance access points. Incomplete Record Drawings may create additional delays in finali installation approval and related permits. [5,t›- I D.c O / .T� 0 ` U,,, 3 der- r(\ob., e- . ce ,Vc 0 0 0 0 Cab �sea°.� ' tto^� p or ‘-.> OeJt o to o N 2�`t VI P , -----/-j t.( u. ❑ Record Drawing Attached I 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 l further certify that all information contained on this II form and attached Re rdawiag is accurate. form and attached Record Drawing is accurate. 2'2Z'ZA S' nature of lnstalle Date i I ' _ . Printed Name of Signee / I :► 4,0 "°,.'F f s< MASON COUNTY PUBLIC HEALTH 5100299 `.F�1 The undersigned approves this Installation Report and `o TOBY j.TAHJA-SYRETT _" i ar LICENSED DESIGNER Record Drawing on behalf of Mason County Public . �.�������� 4�.��.���� Health:-0' EXPIRES: 06/07/211 'L----- -0" C1)111/19 3._/(--2y Sig :tu le nvironmental Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Updated 812 1 12 0 1 8 a ........7 Ho e5 43.1ti' arcel- 3Z10 y s -00070 3u1 >% , lc PJ Lk? u S( l( ( 30' �� l a� D 15 3° 115 C'a ttl C__. ' SD \ .,....------ \ CI 01/4t. G s ( ) I N _ y c' clra+ vn-lie 1d tire NClteS .4► ,k`°��- 0 5 . Dt. WI Df i f # 1,.! ',Q.- 4 •._.... _ ...._ reserve below 6 w ' Key: ;•9 r, S'.c 0Audio-Visual Alarm ( Z$J 0 Cleanout I �• 33 500 Gallon Pre-Trash tank 9005,-f\ • /�114 04 NuWater BNR-500 ATU Tank Ni Q 4'L ` re5prve, 0 1,000 Gallon Pump Chamber / y. 0 Valve Control Box , .4\ lb !/ Yr; • dip Sop g lah 5�° wmc.L�a C� o c*, ... . . : 51003A9 :At- PAULA JOY JOHNSON 4'� 4: UCEUS'Eti tiMaiEll'' '4 xp+Res n " rillialliglifill"" l 0-60"+GLS WATER LINE / lk 0-66"+GLS Q O O \' ADD 5G�•00 / ' 83' / EXISTING 3-BDRM MOBILE HOME / / 4111111110 PORCH / 110' DRIVE/PARKING PROPERTY LINES /' ` 4 0 RESERVE DRAINFIELD ' ® BACKFILL OLD SYSTEM ,' / ® /WITH C-33 �' ,' -/1" IF ENCOUNTERED . � �� ,..07,/ APROX EXISTING � 4001 ;;r`� ��:'_�LF ,�+�,- DRAINFIELD(DASHED) ,ao. D-BOX ' . #elee,A.V ''' , -, `? Nei* 60 411Ft-• t O� SOIL LOGS A �� �f1 't o • e� NEW DRAINFIELD LATERALS � 0299 � �`% TWO.TAHJA-SYRETT -'GI, =���•,_ �ENSED • SIGNER 10110 `1 EXPIRES: 06/07/ •SITE PLAN: APPROVED FOR: BRICK JOB#: DEC 1 1 2023 PARCEL#: 12330-52-00045 DATE: 24 NOVEMBER 2023 BY: TJS DESIGN PAGE S OF 1 Q, MASON COUNTY ENVIRONMENTAL HEALTH NORTH ARROW: SCALE: 1" = 20' DJA 0 0' 20' 40' © B-LINE CONSTRUCTION, INC.