The URL can be used to link to this page

Home My WebLink AboutSWG2023-00360 - SWG As-Built - 4/9/2024FA n County OSS Installation Report pg, t MASON COUNTY PUBLIC HEALTH APPLICANT!PERMIT INFORMATION mit Number SING 21z3-cc St- Parcel#_ 3'ZOz-I _580 -DZm4, licant Name 'i p�lu �,. � Subdivision (Name/DIvIBIocklLot) licant Address _3Z1 c ?r F- - -h-y bop , State, Zip cSH-tom,—yr.J WA Installer Name -y Address Designer Name FrTygE INSTALLATION CHECKLIST Full System Installation ❑Tank(s)Only ❑Dminfiekl Only ❑Repair ❑Other System Typo Pretreatment Ty R��h.VLthW N C(� >5 ft.from foundation? .-________ Cl a55assaa >50 R from wells? ._____ ________________ _______ Lid /a ❑ NO >50ft.from surface water ----------------- -- ---- ❑ L_p7/ ❑ H Cleanout between building and tank? -__________ _______- 1 ❑ O F Tank baffles Present? -- --- --- ---------------- ❑ 24"access risers over each compartment?._______________ ❑ NEffluent filter installed?.__ ___ _ O Septic lank size II Septic �D(yrLs� pal Manufacturer C - _- C) D-box water level and speed levelers used? _ ____ _ _ _ _ ___ jaa ❑yE8 ❑ NO QS Manifold/Dbox accessible from surface?-__________ _ ____. ❑ Eir ❑ Oa= Check valves installed? - - ---------------------- - - @- ❑ ❑ S Transport Line Size I " SchedulatCless j O Bedrooms installed(check one) ❑2 V. o ❑4 ❑5 ❑6 ❑CommenciapOther >10 ft.from foundation?-_____ ____________ _____ _ _- O >100 ft,from wells?-_________________________ ❑ wa �� NO W -100 ft.from surface water?-- ---- ------------------ El ❑ iZ >10 ft.from Potable water lines?- --------------------- ❑ ❑ >5ft.from property lines and easements?---------------- ❑ - ❑ f] >30 ft from downgradient curtein/foundation drains?--- --____. I ❑ Drainfeld level and observation Ports present -- - --________. El ❑ ❑ Gravefess chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfiell------ ------- ------ ❑ ❑ Pump tank setbacks consistent with septic tank?-------_____. ❑ tua yFB r�M ❑ x0 ZPump tank sae.L gal Manufacturer h6r6 C-A.Mr- i F 24"access risers)and accessible from surface?_____________ O — ff�' O R Alarm or Control Panel Installed? ------ —_ ___ _________ ❑ Control Panel equipped with Timer/ETM/Counter.--- ---_ _ _. ❑ ❑ Pump Installed in ❑ Bucket or ❑ On Block or Lg OMer 4Xd Pump Make/Model 61"I 2-0 10 17— Pleats or ❑Treneduar IL Tank draw down in/min Pump capacity pprtl Squirt Height R Pump on time Pump off time _ Deily flow set at Om kersawms Mason County OSS Installation Report pg. 2 Parcel a ABANDONMENT RECORD Were existing septic components abandoned as part of this project? -- --- - - - -- ----- YES If yes, please describe'. Were all Components pumped out and properly abandoned per WAC249-272A.03009 -- - - - - -- YES No RECORD DRAWING Tnb b.P.Im.n.nl,.cow me mua w exeM..w I...pure. _o'.o-mo.0 n me e..e or m.Imaun...etlrNl.und mwn a..nopn.nt Typnn nacwe DtexYpe rOnleln' DNnAeNAmened u.ner em,,We per.praudn.re ...n..mwwhu..n.unu.eamroe.w i.v.,uuua+a..«n.wu.Nne...ni..oe..,..noe wn..n...,ove..w.n.r m.xe.e.ere..a..wnn iM.mWm R-dow.ew.m.vo..1..damonan.i.r.x nen wwp....vvwr.iew mi.i.d mmn.. ❑ Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ENGINEER I certify that I installed the system in accordance with I0941HY 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 claarod/epproved by both the designer shown here have bean om.mamppmved by both and Mason County Public Health and meet all Stets myself and Mason County Public Health and meet all and Mason County Codes Stem and Mason County Codes I furthercertify that all information contained on this I furthercenily that am information contained on this to attache Recyd Dra ing is accurate. form and attached Retard Drawing is accumfe. 1;z_1 Signature of teller Date _IW NNWO of Signee MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and Record Drawing on behalf of Meson County Public Health: EXPIRES Signature cf EnWmnmen Haaah SpBd ii t Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SnE ad smm. PARKWAY BLVD --------------- - - - - — - - I I FUTURE WATERLINE 10FT+ FROM ALL 055 COMPONENTS & LINES I I I I APPROX. Nqs PROPOSEDTANKS I FUTURE rpp b 4,Gy O 1j HOE N 500 PUMP TANK I LOCATION I GyryFNh p91pZ4 �O I )TC/O I '�Fl y�Fylq/yeq!py P4 fAvv ►c — - I? o I ri-4 A-t V m-&AMG K I o k-l- {eVCFits¢ 11% 10'BLD 5ETBACK PRIMARY DRIP AREA I Z 6111 SOFT/464 LNFT I I 1 N I I I I 55_ - ' RESERVE AREA 913 SOFT e Ircee�.i<wlwrsee EXPIRES AN ASBUILT/INSTALL SIGNOFF FEE WILL BE CHARGED AT TIME Of INSTALLATION Cl15TOA1FA TRAVIS LARSON TEST FL�LE I: TEST HOLEZ PIONEER DIGGING, WG PARCEL k3=-WO71%l4 Iu 3P3� N SEPTIC DESIGNS ADDRESS )=PARKWAY BLVD RN)IS019 K0015®21 3093 EAVCON BETa.N1R0. cRAPEVIEW wn 9B546 DESIGNER: ROBFILT FL PAYS¢ 1-NONT I. OFFICE 361/426M03 FAX-360427-2353 SHEET: SrrE PLAN SCALE P=71P oF.o...w,.r w,�=.Fw ea�a�cxsuwwrtTO i AN CHARGE INSTALL OFSIGNOFF FEE MALL BE CHARGED AT TIME OF INSTAlLABON NUWATER BNR500 APPROX. 1500 PUMP TANK FUTURE HOME �^JWS O LOCATION f , F 0 I o I C I 1� RELIEFELIEF VALVES o I HEADWORKS I I I I R R I a N I I � I � , I - 5' -� 23=-b„ - - - - - - 31 6 APPROVED MASONCOUAPR 09 2024 Via, FRET NMENTALHEALTH CUSTOMER: TRAV6 LARSON 3 EST FORE I: TEST HOL E 2: PIONEER. DIGCPCG NC. PARCEL«3xav-589w SEPTIC. DESIGNS ADDRESS: XXX PARKWAY BLVD RJJTS 019 lkJ 1 ®» 3(k13 EMM DE\�JNRD. G 3&)EW,WA 9N596 DESIGNER: P OBERT R PAYSSE JFFlCE-3bJ426I&13 FAX-360-02>-2353 $HEFT: DF DETAB. SCALE.' P=1(y