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HomeMy WebLinkAboutSWG2021-00342 - SWG As-Built - 3/12/2024 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT! PERMIT INFORMATION Permit Number SWG 2021-00342 Parcel# 12330-53-00037 Applicant Name Costello Pacific LLC Subdivision (Name/Div/Block/Lot) Applicant Address 6223 Mount Tacoma Dr SW BEARDS COVE DIV 6 LOT: 37 City, State, Zip Lakewood,WA 98499 Installer Name South Shore Costruction Site Address 971 NE Larson Lake Rd, Belfair Designer Name Arrow Septic De•••_ s INSTALLATION CHECKLIST 16 • Full System Installation ❑Tank(s)Only 0 Drainfield Only ❑ Repair ® Other 500 g rtank System Type Shallow Pressure Pretreatment Type R �/ 6'2�2� >5 ft. from foundation? - - 0 N/A ❑■ YES VF.] NO >50 ft.from wells? - - ❑ IN 2 Z >50 ft. from surface water? - - El 0 0 FQ El- Cleanout between building and tank? - - ❑ 0 V Tank baffles present? - - ❑ I ❑ t— 24" access risers over each compartment?- - ❑ I ❑ Q. LU Effluent filter installed?- SOD - 0 ❑ CI Septic tank capacity(working) NuWater BNR gal Manufacturer Infiltrator CI D-box water level and speed levelers used? - - 0 N/A ❑ YES Q NO p0 Manifold/D-box accessible from surface?- - El © 0 u. o0z Check valves installed? - - 0 I 0 0Q 40 2 Transport Line Size 2 inch Schedule/Class Bedrooms installed (check one) ❑ 2 I=1 3 0 4 0 5 0 6 ❑Commercial/Other >10 ft. from foundation?- - ❑ N/A 0 YES ❑ NO in >100 ft. from wells?- -P� 0 � :PI ❑ W >100 ft. from surface water? - E ❑Z >10 ft. from potable water lines? - - A�-1 2_� ❑ > 5 ft. from property lines and easements?-- - 4, : ❑ Q 7t9AffpNCOtIN ..•,.. CZ > 30 ft. from downgradient curtain/foundation drains?- - -- Iy uIRON(V) A ❑ ci Drainfield level and observation ports present - �W ❑ t 11EaLTN 0 • Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ ❑■ 0 Pump tank setbacks consistent with septic tank?- - 0 N/A I YES 0 NO Pump tank capacity (flood) 1,287 gal Manufacturer Infiltrator Z 0 X 0 < 24" access riser(s) and accessible from surface?- - H n. Alarm or Control Panel Installed? - - El IX E Control Panel equipped with Timer/ETM /Counter- - ❑ UI 0 n- Pump installed in ❑ Bucket or © On Block or 0 Other a Pump Make/Model Liberty 280 IN Floats or 0 Transducer = a Tank draw down 1 in/min Pump capacity 25 gpm Squirt Height 4 ft Pump on time 3 minutes Pump off time 6 hours Daily flow set at 300 gpd �,n;ec 2'2C1E Mason County OSS Installation Report pg. 2 2- Parcel# � ZJ�O �7 0003�_ ' ABANDONMENT RECORD tere existirg septic components abandoned as part of this Project? - , 0 YES '',4 NO If yes, please describe: 0 YES ❑ NO Were all components pumped out and property abandoned per WAC246-272A-0300? RECORD DRAWING _ • . . . . ... . dewbprstetrt Typical Record The to a t nseent raoord and must be accurate and descriptive entasgh to relocate in the need of maintenancec � trvities and end D buildings,be jpCB m otwets. al R . Ohs=Ward Drams&manifold ofer:taaon&layout.Septclpump Dank location.North arrow.reserve dr/erhdd. and nos.var pens! ��art Dons,eieanouts,and other maintenance access prints. nooc p[e;e Record Drawings may=ate additional delays•n tam i 'aP 1 ! lc, MAR 1 2 2024 MASON COUNTY ENVIRONMENTAL HEALTH JBW Record Drawing Attached . ::V. . ' aT�. :.d.ilis .r7<S.r ... 4.. - .. 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 h�s , here have been cleared/approved by both the designer shown here have been cleared/approved by bof 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 f att ed R rowing is a rate. form and attached Record Drawing is accurate. UZIS2124 i Signature of Installer Date •.• lb K\C e\ "4Ov . � p1 ►AeH�.��i 1: Printed Name of Signee ••4 Z-Ati~ MASON COUNTY PUBLIC HEALTH .� ,7UJ3�9 �� The undersigned approves this Installation Report and PAULA JOY JOHNSON ' Record Drawing on behalf of Mason County Public .-- LSGIgfS,P 1� SCGfiVI" Heal' .• 3-S-Z.1/4 m,me Health Specialist Date (stamp,signature and date) signupdated arrlrlata THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE ----t S Sotyck-a. 1.\exv-cet Lv.\.— edie-v- Sca\&: ;,-0 11M r - � , �i ► 96. i CdSke\`Z ' �c i 't c. ir________as_L_.2.:;,,, 1--°. ' Pas/ Ok-te. 30- 3-ocx)31 won . I/ 36.----, ,--.. 1 1 --'. ., -. \ 34-t Store, 1 `z) � . 1 ri . al x S(, ° q G .C. wt'f'A tVC' � e,KcSti� � RO Pvip c p I II 41A ,MAR 12 i.024 1--I ` rYEi____ 0 T , NvrR��,. 0 M0pFNr C C ! 16..?: .. -^ 1. 1 Lavcoen LaY-e., R.6 R O Audio-Visual Alarms - � `.:".".• tti �ft *•:k ). Cleanout ,P .; O500 C- an Pre-Trash tank Yh•' ', -•. Y' ONuWater BNR-500 ATU Tank • �.' StC6349 =16 PAULA JOY JOHNSON "IC �E 'f '.VI'' __ O 1,000 Gallon Pump Chamber 3--3Wr.1 0 Valve Control Box