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Home My WebLink AboutSWG2022-00129 - SWG As-Built - 4/22/2024 Mason County OSS Installation Report pg- 1 APPLICANT/PERMR INFORMATION MASON COUNTY PUBLIC HEALTH rApplicantAddress er :�70 ?V2_ 2_d&!( Parcel# 42035-14-90070 egot&Zachary Connole Subdivision (Name/Div/Block/Lot) resoxlgg5 ppia,WA 95507Installer Name Bo Russell iffs Terrace Designer Name Cindy Waite INSTALLATION CHECKLIST rFullStystemm Installation ❑Tank(s)Orxy ❑Drainfield Only ❑Re air Type Pressure trench P ❑Other _ PretreatmentType_NIA- undation? ❑NIA yeswells? . _____ . ® ❑ No urface water? ___ _ _____ ❑El ween building and tank? .--_______________- ❑ ❑ U Tank bales present? -- --- -- ----- --------------- Ela 24'access risers over each compartment?---___ ® El NEffluent filter installed?-______________ ___ El IN Septic tank capacity(working) to cal Manufacturer- Infiltrator technolOgleS 0 O-box water level and speed levelers used? ---_ --` ---------- - ❑ ❑ No DO Manifold/D-box accessible from surface?-_______________ - ®wrA yeg MZZ Check valves installed? ❑ ❑ DO g Transport Line Size _ 2' Schedule/Class Sch. 40 Bedrooms installed (check one) JM 2 ❑3 ❑4 ❑5 ❑6 >10 R.from foundation?--_____ ____________ ❑Commercial/Other ❑ N/A ® ❑ NO G >700 R.from wells?--________________ _ _ ❑ >100 ft.from surface water? ---- - ��_ -I __ ® ❑ G. >10 ft.from potable water lines?--w- a ______ _ ❑ ® ❑ ? >5 ft.from properly lines and sr1r�?- _ .. tj >30 R.from dawngredient cu ndart�'�rt�ihs pC�� _. ❑ ® ❑ Dreinfield level and observatio sg El Ut pre ..n.ttv - BAN ❑ ® ❑ ❑ Graveless chambers or �,r��N�— u check one) Proper cover installed over drain! IA -_ _ _ _ _____ ❑ ® ❑ Pump tank setbacks consistent with septic tank?---_________. ❑ NIA ® Ze bf Pump tank capacity(flood) .lOrrO cal Manufacturer ❑ No Z Infiltrator Technologies H 24`access risers)and accessible from surface?-__-_ ______-- ❑ ® ❑ 1 Alarm or Control Panel Installed? ----- ----------- ---- , ❑ ® ❑ Control Panel equipped with Timer/ETM/Counter--- -- -- ___. ❑ ® ❑ a Pump installed in ❑ Bucket or © On Block or ❑ Other IL Zoeller N152 Pump Make/Model 2 ' ®Floats or ❑Transducer a, Tank draw down --in/min Pump capacity 54 Pm Squirt Height 8.5 ft Pump on time 35 see Pump off time 4 hours Daily flow set at 180 c d P uoana.aura 122;' Mason County OSS Installation Report pg. 2 Parcel# Y26Js% rw qoi 7o ABANDONMENTRECORD Were existing septic components abandoned as part of this project? ---- -- ------- -- ❑ YES ® NO It yes, please describe: Were all components pumped out and properly abandoned per WAC246-272A-0300? ---- -- -- ❑ YES NO RECORD DRAWING That is.p.mlwml mwad and must a.secures and a..otly,M.nnuae ra rv'lmeta In am nave of ma sum ana ecuwk.am'rum.eaust"naa s. Typal a.roN OsuLps[msln Drssmisma menbd Msualbn 6layout.£eglNµmp Is.pinata,N.a,a—manna,unnumun eaefrg and pupmpl buimmus.W.L.reaam waled. 'vaCh w'eervellm y,s,Uam%u�n,xW pnmummandnw a®s mW. Inmmpas ama WaMrp mm,vnNn emuonm dUan In dnn ImmalYWn gpmval and named pemus. �J FZGyarl�re11 ,Nf/u'�iTc� q S P7 l dc+a I? Ghf PN46D us ✓ „6 S-I;iutItk. 44,L� � f 4t APR 2 2 2024 COUNTY�BWM ENT ALHEALTH MASON ❑ Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ENGINEER I certify that 1 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 cleared/apon ved by both the designer Shawn 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 Record Drawing is accurate. t�� 60/23 - Signatureut/lnJstaller Date Iffi Panted Name of Signee MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and stuolia l Record Drawing on behalf of Mason County Public ucCINDY E wA a mp SEp DESIGNER ^ ',r I Heg/(It. eavines p,nw rL rl// 11 G az-aY Sig a f E60ronnigntal Health Specialist Date (stamp,signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Upmmmeavam, I � ,,.,yR IILE DESI(iNEp IL_-/ 1� I EIO WL, p5na AP PROVE i. RESIDENCE 4; 2. GARBAGE }} APR ZS 2024 I 8. 10601NFILITRATOR SEPTIC TANK 4. 1060 INFILTRATOR PUMPE TANK it i MASON COUNTY E 6. EXISTING WELL N�IRONMENTAL HEALTfy 6. WATERLINE Jaw 7. TANSPORT LINE I i 8. CLEANOUTS(2) d 9. ATTENUATIONZONE 51.31 10. AUDIOASUAL ALARM t 11. VALVE BOX " ( 12. PRIMARY, 13 1? �•r�f✓� c I t Ix I �— St,ix 0 -.1'0 " LS `70 O"- 14- 900 70 - 7 'r.