HomeMy WebLinkAboutSWG2023-00323 - SWG As-Built - 5/2/2024 RECORD DRAWING (ASBUILT) pg. 1 MASON COUNTY PUBLIC HEALTH
PARCEL IDENTIFICATION
Permit Number SWG 202.3 -00323 Assessor Parcel# q222L050o0p01
Applicant Name -fak✓1 Steway-(- Subdivision (Name/Div/Block(Lot)
Applicant Address �$ N.Tilhcmtn beach
City, State, Zip Skcj+ew IJO. R`d'564 Installer Name G's $ j'1 rerulte UG
Site Address Sane. Designer Name GN nd 0 i f
INSTALLATION CHECKLIST,
❑ Full System Installation Septic Tank Only ❑ Drainfield Only ❑ Repair
System Type Pretreatment Type
>5R from foundation? •---------------r-�-II tyII� -- ❑NrA ®YES El No
>50 ft from wells? ------------ E-T 6-IT V i5 -- ❑ ® ❑
Z >50 ft from surface water? ------- - ---------- -- ❑ ® ❑
H Cleanout between building and tank? - -APR 2�2f124_ _. ❑ `.® ❑
U Tankaccessspros overe - - ------ - ❑ ® ❑
a 24'access risers over each compartmen ❑ ® ❑
W Effluent filter installed?--- -------- ---------------- ❑ ❑
N
Septic tank size 2%6 gal Manufacturer Re i-h
o D-box water level and speed levelers used? - ----- ❑ WA ❑res ❑ No
00 Manifold/D-box accessible from surface?- --------- ❑ ❑ ❑
CZ Check valves installed? --------- --- - ---- --- ------ ❑ ❑ ❑
Transport Line Size Schedule/Class
Bedrooms installed(check one) 2 ❑3 ❑4 ❑ 5 ❑6
>10 ft.from foundation?------X--------- -------- ❑ wA ❑ YES ❑ NO
>100ftfrom wells?----------------------------- ❑ ❑ ❑
W >100ftfromsurfacewater? -______________________- ❑ ❑ ❑
LL >10R from potable water lines?---------------------- ❑ ❑ ❑
Z > 5ft.from property lines and easements?--- ---- - -------- ❑ ❑ ❑
>30 fit.from downgradient curtain/foundation drains?---------- ❑ ❑ ❑
Drainfield level and observation ports present ----- ❑ ❑ ❑
❑ Graveless chambers or ❑ Clean gravel used? (check one)
Proper cover installed over drainfield?------------- --- --- ❑ ❑ ❑
Pump tank setbacks consistant with septic tank?------------- ❑ N/A ❑ YES ❑ No
Y Pump tank size cal Manufacturer
a24'access riser(s)and accessible from surface?------- ------ ❑ ❑ El
aAlarm or Control Panel Installed? ------------- -------- ❑ ❑ ❑
jControl Panel equipped with Timer/ETM/Counter-- ---- ----- ❑ ❑ ❑
EL Pump installed in ❑ Bucket or ❑ On Block or ❑ Other
a Pump Make/Model ❑ Floats or ❑ Transducer
0
a
Tang draw down infmin „Pump capacity apm Squirt Height ft
Pump on lime Pump off time Daily Flow set at apm
—..w 1l 4
RECORD DRAWING (ASSUILT) pg. 2 MASON COUNTY PUBLIC HEALTH
RECORD DRAWING
7dimnslonsand
8rientation ,L_ 's andancesV'Wthl
SOPffut o
❑ aepamant tank
placement
❑ Location of
buildings
❑ Obsam"on ports&
dear-out locations
❑ Looald-of wello.
surface wale..&
roads
❑ Undisturbetl native
soil betwean
benches
❑ North Arrow
If the designer or installer feel the need for additional infonnatioNcomments,it may be attached.
Record drawing may also be on a separate page attached. No.Pages Attached
CERTIFICATION OF INSTALLATION
INSTALLER DESIGNER
I wrt fy that I installed the system in accordance with 1 certify that the system has been installed in accor.
the septic design stamped'APPROVED'by Mason pence 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 bean cleared/approved by both the designer shown here have been GeaMd(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 earthy that all informegon contained on this /further certify that all information contained on this
form
'and
attached nR�ecJoJrd Drawing/s accurate. form and attached Record Ora wing is accurate.
�igf(atuv of Installer Date
�? �E
Jake-C614U asp Y
Pointed Name ofSignse
MASON COUNTY PUBLIC HEALTH
5 9
The undersigned approves this installation Repoli and � u DNssoE sIIGMNER
Record Drawing on behalf of Mason County Public
Health: crimes osae
Signature of Eavironmentai Han speclaiist Date (designer's stamp, signature and date)
THIS FORM MAY BE SCANNEOANDAVALLABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB aria
nar.svnrmrx
APPROVED
MAY 02 2024
CONLI �� MASON COUN7YEWRQN,MENTALHEALTH
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HEs�,e APPROVED
AUG 3 0 2023
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