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HomeMy WebLinkAboutSWG2022-00351 - SWG As-Built - 3/11/2024 uo - ` U- Mason County OSS Installation Report pg. 1 MASON COUNTY PU: HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2022-00351 Parcel# 32104-54-00070 FF�Z Applicant Name AB Fine Homes Subdivision (Name/Div/Block/Lot) R `�ZQ Applicant Address 871 E Beach Dr ALDERBROOK G &Y#4 LOT:70&PTN 69 �CF'VFQ City. State, Zip Union, WA 98592 Installer Name Hanson Excavating Site Address 341 E Jack Pine Ln, Union Designer Name Arrow Septic Designs INSTALLATION CHECKLIST © Full System Installation ❑Tank(s) Only ❑ Drainfield Only ❑ Repair ® Other 500 gallon pre-trash tank System Type Shallow Pressure Pretreatment Type NuWater BNR-500 >5 ft.from foundation? - - 0 N/A D YES ❑ NO >50 ft. from wells? - - ❑ ® ❑ Y >50 ft. from surface water? - lc--... -�-`t 3—.'-r?f'1 ❑ 0 ❑ Z ! !! ■ ❑ a Cleanout between building and tank? - - ElV Tank baffles present? - 7r= '2-`1. T; - - I ❑ ❑■ ❑ I— 24" access risers over each compartment?- ., ❑ III ❑ a ❑ W Effluent filter installed?- ❑ 0cn 5� M Septic tank capacity(working) NuWater BNR^gal anufacturer Hagerman ❑ D-box water level and speed levelers used? - - ❑ N/A ❑ YES ❑■ NO .- DO Manifold/D-box accessible from surface?- - ❑ ❑ mZ Check valves installed? - - ❑ NO ❑ ❑Q E Transport Line Size 2 inch Schedule/Class 40 Bedrooms installed (check one) ❑ 2 El 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10 ft. from foundation?- - ❑ NIA 1 YES ❑ NO 0 >100 ft. from wells?- - ❑ • ❑ W >100 ft. from surface water?- - 0 L-1■- ❑ L >10 ft. from potable water lines?- - ❑ ❑■ ❑ Z > 5 ft. from property lines and easements?- - ❑ X ❑ Q - 0 MI ❑ ce > 30 ft. from downgradient curtain/foundation drains?- O ❑ Drainfield level and observation ports present ❑ II ❑ Graveless chambers or • Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ 0 ❑ Pump tank setbacks consistent with septic tank?- - ❑ N/A Q YES ❑ NO Pump tank capacity (flood) 1,000 gal Manufacturer Hagerman Z ❑ < 24" access riser(s) and accessible from surface?- ❑ • t•- Alarm or Control Panel Installed? - - ❑ © ❑ 2 Control Panel equipped with Timer/ ETM /Counter- - ❑ n a- Pump installed in ❑ Bucket or pi On Block or 0 Other a Pump Make/Model Liberty 280 ❑■ Floats or 0 Transducer a E 6 ft Tank draw down 2.5 in/min Pump capacity 48 gpm Squirt Height Pump on time 1.8 M;Yt- Pump off time 6 hour Daily flow set at 360 gpd ..ncatec S.-.•-0':E r■muli Mason County OSS Installation Report pg. 2 Parcel# - 2-1 Ci"5- + - 0CX)70 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - ❑ YES NO If yes, please describe: ❑ NO Were all components pumped out and properly abandoned per WAC246-272A-0300? - - 0 YES 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.Septicipump 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 final insta:lation approval and related permits. 1 r (Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER! ENGINEER 1 certify that 1 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 1 further certify that all information contained on this 1 further certify that all information contained on this form and attached Record Drawing is accurate. form and attached Record Drawing is accurate. 7Va;-4-811.- 10/ 2/23 Sig ure of Installer k Dare Jared Hanson 4-4 4. ) Printed Name of Signee , .�� wAe. 1st MASON COUNTY PUBLIC HEALTH y• % ' /t tA� r The undersigned approves this installation Report and s+r.c3as : \� j `' PAULA JOY JOHNSON%.1.\ Record Drawing on behalf of Mason County Public 4: .. "- -.. �Eti UI:$IGNKfi" He / ��EXPIRES 3- t(-2 • y (� 2 - Z - Z�Sig2.46 iironmental Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE .pcatee a/21'2°18