HomeMy WebLinkAboutSWG2021-00642 - SWG As-Built - 3/12/2024 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH
APPLICANT! PERMIT INFORMATION
Permit Number SWG 2021-00642 Parcel # 32104-56-00058 E
Applicant Name A&B Fine Homes Subdivision (Name/Div/Block/Lot)
Applicant Address 871 East Beach Dr ALDERBROOK G&Y#7 TRACT 58 DIV 7
City, State, Zip Union,WA 98592 Installer Name Hanson Excavating
Site Address 33 E Michelle Court, Union Designer Name Arrow Septic Designs
INSTALLATION CHECKLIST
III Full System Installation 0 Tank(s)Only ❑ Drainfield Only ❑ Repair IN Other 500 gallon pre-trash tank
System Type Shallow Pressure Pretreatment Type NuWater BNR-500
>5 ft.from foundation? - - ❑ NIA El YES ❑ NO
>50 ft.from wells? 0 IN 0
>50 ft. from surface water? - - ❑ 0 0
Z 0
HCleanout between building and tank? ❑ ❑
U Tank baffles present? ❑ • ❑
d24"access risers over each compartment?- - 0 0 0
W Effluent filter installed?- 0 ❑ UI
co Hagerman
Septic tank capacity(working) NuWater BNR gal Manufacturer 9
Ci D-box water level and speed levelers used? - - ❑ N/A ❑ YES Q NO
J 0 0
XO Manifold/D-box accessible from surface?-
O u_
mZ K - 0 II 0
Z Check valves installed? - - -ev,-..o
thQ 2" Schedule/Class 40
2 Transport Line Size
Bedrooms installed (check one) 0 2 0 3 5 ❑6 ❑Commercial/Otter
>10 ft. from foundation?- 41)-
- -- ❑ N/A ❑■ YES ❑ NO
>100 ft.from wells?- - El ❑
O r 0 0
J >100 ft. from surface water? "6
,,,
>10 ft. from potable water lines?- %-•; „ ❑
Z > 5 ft. from property lines and easements?- _ - --- ' D 10 0
ct > 30 ft.from downgradient curtain/foundation drains?- ❑ II ❑
p ❑
Drainfield level and observation ports present ❑
❑ Graveless chambers or p Clean gravel used? (check one) 0
Proper cover installed over drainfield?- - 0
IN Pump tank setbacks consistent with septic tank?- - ❑ NIA 4 YES
NO
Y Pump tank capacity (flood) 1000 gal Manufacturer Hagerman
Z
< 24" access riser(s) and accessible from surface? ❑ ® El
a Alarm or Control Panel Installed? -2 Control Panel equipped with Timer/ ETM /Counter- - ❑ U ❑
Pump installed in ❑ Bucket or ® On Block or 0 Other
2 Pump Make/Model Liberty 280 0 Floats or ❑ Transducer
a Tank draw down 2" in/min Pump capacity 38 gprn Squirt Height
6 ft
Pump on time 2.3 Minutes Pump off time 6 Hours Daily flow set at 360 gpd
Updated 8.'21 2018
Parcel# 3a10/A — 5(0-000 •
Mason County OSS Installation Report pg. 2
ABANDONMENT RECORD MOM
- D YES ® NO
Were existing septic components abandoned as part of this project?
If yes, please describe: - 0YES ❑ NO
Were all components pumped out and properly abandoned per WAC246-272A-0300? -
RECORD DRAWING MIN
This isn a permanent record and must be Cationaccurate
yd escriptive enough to Septic/pump tank location.(ocate in the need of maintenance activities and North arrow.reserve dra field.existing and proposed futUre buildings,lelopm ocatio of wells,'cal Record
waterlines,
wells,o s contain: Drt afield 8 mauts anldd orientation orlayout.
wells.observation ports,deanouts,and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approv- and related permits.
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li Record Dra ing Attached
CERTIFICATION OF INSTALLATION
INSTALLER DESIGNER/ ENGINEER
I certify that I installed the system in accordance with I certify that the system has been installe in accor-
the septic design stamped"APPROVED"by Mason dance with the septic design stamped"A ROVED"by
County Public Health and that any deviations shown Mason County Public Health and that any eviations
here have been cleared/approved by both the designer shown here have been cleared/approved y both
and Mason County Public Health and meet all State myself and Mason County Public Health a d meet all
and Mason County Codes. State and Mason County Codes i
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.
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�L ,d11i 01 2-3 (21 �y
� Date ��� .
Sig ure of Installer !� A� r
WA �f
Jared HansonF.,, i\ s}.
Printed Name of Signee ' ,, , % !
MASON COUNTY PUBLIC HEALTH 5to 349 �`
Y�' PAULA JOY JOHNSON '.
The undersigned approves this Installation Report and �p-: .. T .
I�H "
'_ UC vcsREI� t -
Rec"ors D -wing on behalf of Mason County Public b-,
Health: `� L . -0),_ (._( 2,—Z�''Z{
d ,.
Sig :Cur:.. - vironmental Healt Specialist Date (stamp, signature and date)
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNT`.'WEB SITE ucdeted 8/21/2018
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