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HomeMy WebLinkAboutSWG2023-00018 - SWG As-Built - 5/9/2027 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT)PERMIT INFORMATION Permit Number swG 2023-00016 Parcel# 22221-52-00014 Applicant Name Alan and Pam Aho Subdivision(Name/Div/Block/Lot) Applicant Address 709 N.N street City, State,Zip Aberdeen,we 98520 Installer Name Shumaker Const. Site Address 151 Tawanah Falls Dr. Designer Name Bob Paysse INSTALLATION CHECKLIST ■Full System installation ❑Tmk(s)Only ❑Dreinfield Only ❑Repair ❑Other System Type ATU-Drip Pretreatment Type NuWeter BNR 500 >5 ft.from foundation? .----------------------------------------- ❑WA ®YES NO >50 ft.from wells? ----------------------------- ❑ � ❑ Z >50 ft.from surface water? ------------------------ ❑ ❑ FQ- Cleanout between building and tank? ------------------ - ❑ 0 ❑ V Tank baffles present? ------- -------------------- ❑ ® ❑ a2Caccess risers over each comparhrrent?-______________- ❑ ® ❑ W Effluent filter installed?-__________________________ ■ ❑ ❑ N Septc tank capacity(worldn9) NUWater sal Manuhohrer_ Haggemnen D-box water level and speed levelers used? -- _____-___. ❑WA vas NO �O Mannold/D-box accessible from surface?------------------ ❑ ■ ❑ G= Check valves installed? -------------------------,- ❑ ® ❑ Transport Line Size 1. Schedule/Class 40 Bedrooms installed(check one) ■2 [3,3 ❑4 ❑5 ❑6 ❑CommerclaVOther >10ft.from foundation?-________________________. (:I WA ■YES NO 9 >100 ft.from wells?----------------------------- ❑ ■ ❑ W >100 ft.from surface water?-_______________________ ❑ ■ ❑ M >10ft.from potable water lines?-------- a_ >5 ft.from property lines and Easements?--------------- - ❑ 0 O >30 a.from downgradient cumin/foundation drains?-------__- ■ ❑ ❑ Dminfiekl level and observation Ports Present -------------- ❑ ® ❑ ❑ Greveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drain6eld?------------------ - ❑ ® ❑ Pump tank setbacks consistent with Septic tank?------------- ❑ WA ® YES ❑ NO = Pump tank capacity(flood) 1500 oal Manufacturer Haggerman F 24"access nsar(s)and accessible from surface?------------ - ❑ ® ❑ IL Alarm or Control Panel Installed? --------------------- ❑ ❑ aControl Panel equipped with Timer/ETM/Counter----------- ❑ ■ El Pump installed in ■ Bucket or ❑ On Block or ❑ O6rar Q. Pump Make/Model Orenco PF 2005 ■Floats or ❑Transducer IL Tank draw down in/min Pumpcapacty opm Squirt Height ft Pump on time 6 min Pump off time 2hr Daily flow set at 240 Opd Mason County OSS Installation Report pg.2 Parcel It 22221-52-00014 ABANDONMENTRECORD were Misting septic components abandoned as part of this prefect? -------------- - OYES NO If yes,please dascribo: Were ell components,pumped out end property abandoned per WAC245-272A-030W•------- © YES No RECORD DRAWING col.Ia a Pam.n.m nmm am me.r eua.nn e.a aeser on.a en..do m.......In cos need of memenaMe eaueNe end tm.,.o..aoem..c TrPwl aaam ma.red&-oadd.--'o.a"o'd, 1.11 w=.uo.,n.ne en-re,,-m.mneia.em..q and o�.ea nmio.:.aa,tr:tion of odds,wmedin- we¢e.m.ewem Pone,oon—ts,am o n r mmmenaoa ems.Poem,. mrommee vewm o'a..mas mar=reere.dsuon.me.ye m s,e mswiawo aoP,—I.nd nomad,z, ® Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNERI ENGINEER I certify that I Installed the system in accordance with /certfy 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/approved 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 Codas. State and Mason County Codes I farther certify that all Information contained on this /further cadAy that all intormalion contained on this form and attached Record Orewing is accurate, farm and attached Record Drawing is accurate. Slgnatum of Installer r Date Aaron Shumaker Printed Name of Signee MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and no.aarei'P..a:� Record Drawing on behalf of Mason County Public Health: ssPiRes S qf/ 7 Sign re of Env/ronmen Hoalrh SpaelellGt Date (Stamp, signature and date) THIS FORM MAY BE SCANNEDANDAVAILABLE FOR PUBLIC VIEWONTHE MASON COUNTYWEB SRE unawdemrmm ��TT rTWANOfi IrALLS DR/W I I EXI5TING I DECK I CARPORT I EXISTING HOME &ADDITION I II NEW TANK5 EXISTING SHED I NVWATERBNR500 11500 PUMP TANK 1 3 APPROXIMATE EXISTING g D ..,, s'S<ope STORM DRAIN 0 (CONCRETE CULVERT INSTALLED DEEP) ;u 23'-10" D 5 O O o_ z : < I I 80' --� RESERVE 18X25 (450 FP) PRIMARY n ' 12X25 (300 FTl) Y:Irne RORD DRAVMG PIONEER DIGGWG, WC. 1 11"OMFR: ALAN&PAMA TESEIkN.EI: 'ME WV j ME7T YJ 3: PARCEL s-Z222M-OM4 i�u,l.M� 036 LM5 K% SEPTIC DESIGNS ADDREck NTWANOHEAIISOIL Rt 3EM1v�NBFT.'RD. CKMINIM,%\A"57 DF-gGNLR: ROBEIRTELPAYSg •'•' te r .'FTICE-3 42Uk4)3 FAN-3en+nn53 wrn: ASKULT SCALE rew �,�•�' ,,..,,