HomeMy WebLinkAboutSWG2021-00073 - SWG As-Built - 3/27/2024 Mason County OSS Installation Report pg. i
APPLICANT/PERMIT INFORMATION MASON COUNTY PUBLIC HEALTH
Permlt Number SWG 2021-00073
Parcel M 22212-56-00010
Applicant Name John end Brands Leach
Applicant Address 1311 Starlino Street Subdivision (Name/DIv/81Ock/Lot)
City, State,s Steilacoom we.98388 Installer Name Shumacher Construction
Site Address 40 E.Rose Point Lane Belfair,We
Designer Name Bob Pevsse
INSTALLATION CHECKLIST
rCleanout
m Installeson ❑Tenk(s)Only ❑Drainfleld Only
❑Repair ❑Other
m Type PretreatmentPretreatment Type Nuw der BNRBNR 500
oundation? -__________________________-
wells4 .__ _______ �wA ❑YE9 ❑ NO
surface water? -___ _____ ❑ ® ❑
hveen building and tank? - ❑
O Tank bamas present? ._ ___ _ _ ______ ___ ___�-_- - ❑ ® ❑
1 24'access risers over each compartment?.____________ __- ❑
U1 Effluent filter installed?__________________ ❑ ® ❑
Septic tank capacity(working) NBWater_Agl ManuFacturer ❑ ❑
Infiltrator
9 D-box water level and speed levelem used? --______
O� NIA Manifokl/D-box accessible from surface?--_____ ❑ras ❑ No
❑ ® ❑
CZ Check valves installatl7 ❑
g Transport Line Size 1.25' SahedulNCise 40 Cl
Bedreoma installed(check one) 02 ❑2 ❑4 ❑6 ❑8
>1oft on
.from foundati -______________ ❑Commarcel/Orher
® NIA (]YEa ❑ NO
9 >100%.from Wells?-----------------------------
W >10pft.fmm sur(acawateft-_______ El ® ❑
® ❑
Z "Oft-from Potable water lines? El-____________________ �
i >5R.from property lines and easements?--------------- - ® Q
G >30fL from down9redient certainrfoundetbn crane?---------- ® ❑ ❑
Dralnfleld level and observaeun ports present----- _ ❑ ❑
❑ Greveless chambers or ❑ Clean gravel Used? (check one) ® ❑
Proper cover installed over drainfield?----______ ❑
Pump tank setbacks consistent with septic tank?--__________. ® ❑
❑ NIA ® YES ❑ NO
Y PUMP capacity(flootl) 1500 cal Z Menufardtoar Infiltrator
24'access rlser(s)and accessible from surface?- ❑ �
IL Alarm or Control Panel Installed? --------------__----- ❑ ® ❑
Control Panel equipped with Timer I ETM/Counter----------- ❑ ❑
R Pump Installed In ❑❑ Bucket or ❑ On Black or ® ONer
7 Pump Make/Model r' Orenco � 00 S ®FbaLs kr�—r0- ❑Transducer
y Tank draw down TBO / n`k n
in/mm Pump rapacity 2 apm Squirt Helght--&dt� a
Pump on lime Pump off time Daily flow set at 240 oOd
UrEvhCMiors
Mason County Oss Installation Report pg. 2 Parcel# 22212-56-00010
ABANDONMENTRECORD
Were eIIISOng Septic components abandoned as part of this pmjoclg
If yes,please describe: YES NO
Were all components pumped out and properly abandoned per WAC246272M3002•______.
® Y4C � rb
RECORD DRAWING
TN.a•w�mewm nc.,e ens nth ae.amme.ea memw...eowe ro .xrr ro rM...e r msro....w.ewnw.ne ea..s.a.
Onwinp[mpein 0.e1Ng10l mangle wbnYtlm6YYeu1,5epWpiunP JmFbuJpry XOM Yfgv,.BneM1e JRIIRep,eYyym elN Pw•e^l Typblpe[gn
weu..meem.eo.Pm.,a.emm.,[m an.mem.eme.�e.Pain:. mm, aow®e wwsN..ioemon arme.,..mawe,
.sea amm,e o,..,.Ne may vwu.wnma wme m rea m.wsree-pm.nrNJ PeXda.
® Record Drawing Attached
CERTIFICATION OF INSTALLATION
INSTALLER DESIGNER/ENGINEER
I cattily that I installed the system in accordance with I Certify that the system has been installed in accd,-
me septic design stamped"APPROVED'by Mason tlacce with the septic design stamped'APPROVED"by
County Public Health and that any deviations shown Mason County Public Health and that any devietbna
ham have been c/earactappmved by both the designer shown here have been cleered/ppmmd by both
and Mason County Public Health and meet all State myself and Masan County Public Health and meet all..it Mason County Codes. State and Mason County Codes
l lurmer certify that all intermstion contained on this I further cerafy,that all information conlalned on this
form and ads d Record Drawing is eccurete. form and attached Record Drawing u accurate.
ignafure uflnslalier Daly
Aaron Shumacher
Printed Name&Signs&
MASON COUNTY PUBLIC HEALTH u
{
The undersigned approves this Installation Report and
Repord Drewbg on beha/f at Mason County Public "O0'a4rn inrwe
Health: FXN
Slgnetuye alEnvlmnmerslal Hsa Spamall M Data
(stamp,signature and tlateJ
THIS FORM MY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE owmemnma
PO 7UrHoLE 1.•
4-24 COVy CLAY/TOP SOIL
MPACT CLAY SIT DRY WITH R0075
24-213 COMPACT CLAY, NO ROOTS
7ZfTHOLE2.-
M.ee6 0-3 HEAVY CLAY/TOP SOIL
3-21 COMPACT PIT RUN GRAVEL WITH CLAY SILT
PRE6 21-30 COMPACT CLAY SILT WITH ROOTS
/ \ypppGyNyL EXIST. BULKHEAD
@6
EXISTING \
PROPOSED REPAIR �� HOME
DRAINFIELD. "5F EXI5TNG
CARPORT
1500 GAL. PUMP TANK
� voPa �
NVWATER BNR-500 LCFSS
P
KEEP PROPOSED SEPTIC TANKS
50 FT+ FROM BULKHEAD
APPROVED APMIOVED gab
MAR 27 2024 MAR 22 2021 dv0
MASON COUNTY ENWRONMENTALHEALTH
MASON COUNTY E%EOHMEHTALHEALTH P�2
RET �
PIONEER DIGGNQ INCEDEsl(zqEp,
FL
*IN LEM SCALE:
3tr00010
SEPTIC.DESIGNS E ROSE POINT IN
3083E Mw50t`'eFN;gN RD. fdtnFlyII:W.Wn 9d596 BIXTPAtSSE & i
OFFICE-36642"M FAX-3fiDi 2353 _OF_