HomeMy WebLinkAboutSWG2022-00267 - SWG As-Built - 5/3/2024 Mason County OSS Installation Report pg. 1
MASON COUNTYPLIC HEALTH
APPLICANT/ PERMIT INFORMATION
Permit Number SWG 2022-00267 Parcel# 32109-50-00042
Applicant Name AS Fine Homes
Subdivision (Name/DivlBlock/Lot) 4p,9 J
Applicant Address 871E Beach Dr Alderbrook G&Y Divislon:5 Lot:4184 F O
Installer Name Hanson Excavation LL C
City, State, Zip Union WA 98592 0
Site Address 60 E Hemlock Cl Designer Name Arrow Set is Des! his
INSTALLATION CHECKLIST
S Drainfeld Only ❑Repair ❑Other sa i Pre-lMhh,�_—
FullSystemInstallation ❑Tah.l Only [Iyp BNR-5)0 NuWater
System Type Shallow Pressure Pretreatment T e�—
❑ NI/. A YES ❑ NO
>5 ft.from foundation? - -- --- - ❑ ❑
>50 ft.from wells? - - ----- - -- - - -- - - El0 El
'1 >50 ft from surface water? - - --- - - - --- - - - - - - - - - - -
El
FQ- Cleanout between building and tank. / p ® ❑
O Tank baffles
ssris risers
overe ---- ---- - -"" - -- -/ _ ❑
n~. 24"access risers over each compartment?- ---- _--aitJ��L--J✓❑1
W Effluent fitter installed?--- - ------ Hagerman
N SNP.- __ _ —
Septictankcapacity(working) NUWater gal Manufacturer
o 0-box water level and speed levelers used? - --- --- '---"-" - ❑ Nra ❑
YES Q NO
® ❑
00 ManifoldfD-box accessible from surface?-- ___ _ _ _ ___ _ __ _ __ O � ❑
mZ Check valves installed? ------ - - -- -
oQ y Schedule/Class
40
2 Transport Line Size
Bedrooms installed (check one) ❑ 2 ❑3 ff 4 ❑ 5 ❑6 ❑CommerciallOther
❑ NO
>10ft.from foundation?- - - - - ---- - - - -" - ❑ NIA YES ❑
❑ m
>100 ft.from wells?--- - --- - -- - --- - - --
o ❑ (9 ❑
W >100 ft.from surface water?
- - - - - - - -- " -- - ❑ ® ❑
1E >loft.from potable water lines?- --- - --- --"-" -- O ❑
Q
>5ft.from property lines and easements?-- -- - - - - ----"- - - ❑ ❑
IY >30 ft.from downgradient curt
drains?- - --- - ---- ❑ ® ❑
Cl
DreinReld level antl observation ports present - - -- - ----- ----
❑ Graveless chambers or M Clean gravel used? (check one) ❑ ❑
Proper cover installed over drainfield?- -- - -- - -----"-"-" --
? Nip ® YES ❑ NO
Pump tank setbacks consistent with septic tank. -- -- -- ----- -- ❑
Y Pump tank capacity(flood) 1250 qal
Manufacturer Hagerman
z ❑
Q Cl
24'access riser(s) accessible from surface?----- --_ -- --- ❑ O
F- Alarm or Control Panel Installed? ----- -- - - - - " - " - - ❑
(L
M Control Panel equipped with Timer/ETM/Counter-- - - - -- - - - ❑
C Pump installed in ❑ Bucket or
On Block or ❑ Other
o. Pump Make/Model Liberty 280 _ ®Floats or Transducer
Tank draw down 2 in/min Pump capacity
44 gpm Squirt Height 2 ft
a 6 Hours Daily flow set at 480 gpd
Pump on time 2.7 Minutes Pump oft time oemearz�ame
Mason County OSS Installation Repo Parcel# 2.10 -50- 00
ANDONMENT RECORD
_ _ [] YES
NO
Were existing septc components abandoned as part Of this project- - - -- - - -- -
If yes, please describe _ __ YES NO
Were all components pumped out and properly abandoned par WAC246-272A-0300- ' - - -
RECORD DRAWING
re°evelopm nv TYP'ul Reuv°
u h m reaor+b m ma nee°or malmenance acnvreea assa fiwminga.loratio or walla.waanlnes,
This IS a perms ent re=ora ana mua0 Ee eccurere and a.xnpw.ono g am art re rve dralnnNa.emceg ana p�opp antl relate°pnmlb.
anaaa onmiauoa alavm+r.sepuupamP ia�x loaatloa.ry
prewings wn�art D2mfiNa6m sn Inrumple�e RewN Draxinga may verse atltlltianal aelNsin final lnamlla�lan appmv
we119.WxlwUpn pM3.GeanaWs.Yitl oClermaintenance eccass P
See �-�-ached
® Record Dra ing Attached
CERTIFICATION OF INSTALLATION
DESIGNERi ENGINEER
INSTALLER
I certify that I installed the system in accordance with 1 certify that the system has been installs in accor-
the septic design stamped"APPROVED"by Mason dance with the septic design stamped"A ROVED"by
County Public Health and that any deviations shown Mason County Public Health and that any eviations
here have been cleared/approved by both the designer shown here have been clearediapproved y both
and Mason County Public Health and meet all State myself and Mason County State and Mason County oublli Health a d meet all
and Mason County Codes.
I further certify that all information contained on this 1 further certify that all information contain of on this
form and attached Record Drawing is accurate.
form and attached Record Drawing is arc rate.
Cr.J1.d-brL 6f-t'o'Z`�
Sig ure oflnstaller Date
Jared Hanson r
Printed Name of Signee
r.
MASON COUNTY PUBLIC HEALTHti ' .irk
oeav
The undersigned approves this Installation Repoli and Ot PAULA toy JOI NSCN'.
Record Drawing on behalf of Mason County Public ty,Lrl_ppgsiG.Nro"
Healthy:'
(stamp, signature and oat
Signature of Environment Health SpeciaLst Date Occvea uxirzme
BE SCANNED AND AVAILAB'_E FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE
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MAY p 3 2024
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a0h'ME 'iALHEALTH FCa9•
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O1 Audio-Visual Alarm
2 Cleanout
��LHAy
500 Gallon Pre-Trash tank
\ O4 NuWater BNR-500 ATU Tax
55 1,200 Gallon Pump Chamb
\ 6 Valve Control Box
25� ' t7) 3x 10 Pr;rnarN
o �<ofosla fat t�F �?�n CticS
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