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HomeMy WebLinkAboutSWG2021-00221 - SWG As-Built - 3/12/2024 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT! PERMIT INFORMATION Permit Number SWG 2021-00221 Parcel# 22320-50-00051 Applicant Name Costello Pacific LLC Subdivision (Name/Div/Block/Lot) Applicant Address 6223 Mount Tacoma Dr SW LAKE CHRISTINE 1ST ADD LOT: 51 City. State, Zip Lakewood,WA 98499 Installer Name South Shore Construction Site Address 40 NE Rhody Ln,Tahuya Designer Name Arrow Septic Designs INSTALLATION CHECKLIST • Full System Installation ❑ Tank(s)Only ❑ Drainfield Only ❑ Repair ❑ Other System Type Shallow Pressure Pretreatment Type >5 ft.from foundation? - ❑ N/A 0YES ❑ NO >50 ft. from wells? - �-R-0itt ❑ PR ❑ • >50 ft. from surface water? - - - "�r.-"• ❑ ❑ ❑ Z t Cleanout between building and t -- �- } - -- - ❑ ❑■ ❑ Luef ✓ Tank baffles present? � �'ODNTY ENVIR , -`i ❑ ® ❑ a24"access risers over each compartment?-- - ---- .•' SAL- LTr ❑ ® ❑ W Effluent filter installed?- W - ❑ ® ❑ N Septic tank capacity(working) 1,200 gal Manufacturer Hagerman 0 D-box water level and speed levelers used? - - ❑ N/A ❑ YES ❑■ NO D_' ❑ I ❑ O Manifold/D-box accessible from surface?- - m—Z Check valves installed? - 1x " 1awAk - El Al ❑ O a 40 2 Transport Line Size 2 inch Schedule/Class Bedrooms installed(check one) 0 2 ■❑ 3 ❑4 0 5 ❑6 ❑Commercial/Other >10 ft. from foundation?- - ❑ N/A 0 YES 0 NO 0 >100 ft. from wells?- - ❑ ❑l 0 w >100 ft. from surface water? - - ❑ 0 ti >10 ft. from potable water lines?- - ❑ J ❑ Z a > 5 ft. from propert y lines and easements?- - 0 IN 0 cc > 30 ft. from downgradient curtain/foundation drains?- - ❑ I El0 Drainfield level and observation ports present ❑ II 0 ® Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ El ❑ Pump tank setbacks consistent with septic tank?- - ❑ N/A © YES ❑ NO Y Pump tank capacity (flood) 1,000 gal Manufacturer Hagerman Z < 24" access riser(s) and accessible from surface?- - ❑ El 0 F- a Alarm or Control Panel Installed? - - ❑ II ❑ 2 Control Panel equipped with Timer/ ETM /Counter- - ❑ El ❑ d Pump installed in ❑ Bucket or ® On Block or ❑ Other 2 Pump Make/Model Liberty 280 0 Floats or ❑ Transducer d Tank draw down 2.5 in/min Pump capacity 47.5 gpm Squirt Height 4 ft Pump on time 1.9 minutes Pump off time 6 hours Daily flow set at 360 gpd JpCated 3'21:2D 8 Mason County OSS installation Report pg. 2 Parcel# 22�2(�-5D` oDp 5 j ABANDONMENT RECORD No- . : Were existing septic components.abandoned as part of this project? � Yes yl.If yes, please describe __- 0 YES ❑ No Were al components pumped out and property abandoned per WAC246-272A-0300? •---" RECORD DRAWING . .. acNv t}rs and future development TypicalRecord mooed and mu be accurab and descriptive enough to re4oeate in the need of maintenance Dui of weals, ReC d TRW b a North arrow.reserve tiro nANd.existr+9 and D and fatted paw att�4s co : Dra�+fdd&Rsati(o!d odenta4imt b IaY�t•� tank tDta'JOn. ' �eate add ' a'.delays to faun installation aDP� ya.cf servabon pats,eieenouts,aid other maintenance access per. ':ncomp Record Drawing may V40 . PPS 0 V E , Amp ., e. . A/Aso/yrs, 2 2024 -,;! i • I fvVIRONMENTAC h' • j 8 w EACTi ►: Record Drawing Attached It CERTIFICATION OF INSTALLATION r: . - :• ' - DESIGNER/ENGINEER INSTALLER I certify that I installed the system in accordance with I certify that the system has been incited 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 yse and Mason aso County Codes• Health and meet all • and Mason County Codes. State that all information contained on this I further certify that all information contained on this I further certify fo off ed R raving is a rate. form and attached Record Drawing is accurate. I ; • 02422/� Y 01 Signature of Installer Date Printed Name of SigneeIto ?, ,,,, MASON COUNTY PUBUC HEALTH , The undersigned approves this Installation Report and eirl-v'"-.71e.AuLA5jc.°;losiiNso.N.:4'.714ewe . Drawing on behalf of Mason County Public LI StlYMGNE'Ft * R s VI iN Health: 1..... L%""Z4 - Al LA-flt-% d ronmental Health Specialist Date (stamp,signature and date) Sig Sit''' updr.a erttr�a THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE '^ i(i j, ` ti6' rdo, sue- -000 , fir: C. 'RP in 9 / 0‘ 005aik `n ,pQ- 2 t <b"./9/.(7-P & k,.-) . .--:--,.C"-- /T / 1 Ker. •••...........- PPRO V/ t0vis1arn. MAR 12 2024 I )': leanout MASON COUNTY ENV/RONMEN 1200 Grano n Septic Tank jB AL '� ► HZ_Compartment with w Effluent Filter 1 I O 10 00 Gallo i. 1 am Pump . ber !' 11 x 5 - 0 O ; 1 ' O Valve Control Box 39,9- �ahaf cxG1- -N( T ii f 1Ao M e ?T. fib - `tt / i .1,7 ifi:•0,t W- I4' 1 ` . PAULA JOY fZNso .. 5C , i ; EXPIRES i ,,E , 11 Z— z3 -24 AC' j ir\ .f lnl Gl-CCY cvL C,Y1Ga S 4$ -- NE -?oc \