Loading...
HomeMy WebLinkAboutSWG2022-00580 - SWG As-Built - 5/3/2024 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/PERMIT INFORMATION Permit Number SVVG 2022-00580 Parcel# 32025-50-00009 Applicant Name CwH 1�e MES,11�� Subdivision (Name/Div/Block/Lot) Applicant Address fp312 �ibsla yaq "G V City, State, Zip I-At'u NA (a Installer Name MICHAEL LOVELY Site Address 50515E ARCADIA Designer Name INSTALLATION CHECKLIST ❑ Full System Installation ®Tank($)only ❑Drainfield Only ❑Repair ❑Other System Type PRESSURE Pretreatment Type >5 ft.from foundation? --------- -- -------___. ❑ NIA ®yEs ❑ NO >SO ft.from wells? .__________ ____�j ❑ ® ❑ _ >50 ft.from surface water? ------ - ❑F Cleanout between building and tank? - -- APR � ❑ ® ❑V Tank bames present? --------- - - ❑ ® ❑24'access risers over each compartmen - • ❑ ❑� ❑ ° ❑W Effluent filter installed?----------- ---------------- El N SNYDER Septic tank capacity(working) 1250 gal Manufacturer O D-box water level and speed levelers used? --------------- ■ NIA ❑Yes NO J CLL El accessible from surface?----------------- ❑ � s?= Check valves installed? -------------------------- ❑ ❑ ❑ �< T Schedule/Class SCHD40 Transport Line Size Bedrooms installed (check one) ❑ 2 03 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10 ft.from foundation?------------ ❑ NIA AYES NO O >100 ft.from wells?--------------- -------------- ❑ ® ❑ Jon >100 ft.from surface water?-______________________- ❑ ❑ i >10ft.from potable water lines?---------------------- ❑ ® ❑ Z¢ >5ft.from property lines and easements?------- --------- ❑ ® ❑ 0_ >30ft.from downgradient curtaintfoundation drains?---- ------ ❑ ❑ Dminfeld level and observation ports present----------- --- ❑ ® ❑ ❑ Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over dminfield?---- --------------- ❑ ❑ ❑ Pump tank setbacks consistent with septic tank?------------- ❑ NIA NYES NO `L Pump tank capacity(flood) 1250 at Manufacturer SNYDER Z Q 24'access nser(s)and accessible from surface?-- ----------- ❑ ■ r C AWrm or Control Panel Installed? ---------- - ----- - -- - ❑ Control Panel equipped with Timer I ETM/Counter----- ------ ❑ ❑ 4 Pump Installed In ❑ Bucket or E On Block or ❑ Other a Pump Make/Model WLLER 152 Floats or ❑ Transducer � Tank draw down 1.25 in/min Pump capacity 39.06 gpm Squirt Height 81, ft a Pump on time 2MIN17SEC Pump off time 6HRS Daily flow set at 360 gpd vw,.a einao,a A C Mason County OSS Installation Report pg. 2 Parcel tt 32025-50-00009 ABANDONMENTRECORD Were existing septic components abandoned as part of this project? -- ------ - - ----- ❑ YES © NO If yes, please describe: Were all components pumped out and properly abandoned per WAC246-272A-0300? ❑ YES ❑ NO RECORD DRAWING ni w.y.mun.n+meare and roue ee a—.and amandare eneuan to rcJow+a in the need a maintenance achemes and future development. Twei nmvd orewno+mmam: n2lndeldamam+admdnmonna,e,,.SmE umptankworon Nomeanew.rasarvedraindeld,e.ama and ymyosed buildings.madmawa¢,wstemnee. wWs.cEsa—maneple aeamW,arnmiummumnommemocandi incomplete Rented rom,cozy a..rs addtllonel interim dnallnffiau"Famoval and named enmlb. ❑ Record Drawing Attached 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 Health and that any deviations here have been clearadlapproved 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 I further certify that all information Contained on this I further certify that all information contained on this form and attached Record Drawing is accurate form and attached Re"I Drawing is accurate. MuGu3eG Luve(ct t{` oa +' Signatureoflnsfaller Dateroz/zoz4 MICHAEL LOVELY d nsv.A.td Panted Name a/Signee MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and 2 510D's<3 Record Drawingon behalfofMason Countypublic fJf ERiC R;,Fd'1 �J cc p SPnU Iry f, Health: Signature ofEnveronmentalhIsalth Specialist Data (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE uaaw az+rzo+e 3 n o o m 3 N5rmR ryb H � zozly H Cny r., O � � Yzn y � —o � z r z G < w � O� r vil7e Hy y m Y `L o m � c 9 OYw ^2gvi E f° � � w 0 i / H v a sm d O A l7 h 77dd 65 � t4y g � 6 a 1 v, b N, i 3-Ilk \ --- " 1 I ;-tom" `x A trsl3, I m 1 �rve� Nu�m1f'1 �S t° I to a