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HomeMy WebLinkAboutSWG2024-00181 - SWG As-Built - 5/23/2027 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number swG 2024-00181 Parcel# 32029-50-03001 Applicant Name 2018 Bowman Properties LLC Subdivision (Name/Div/Block/Lot) Applicant Address P.O.Box 910 FOREST PARK BLK:3 LOTS: 1-2 City, State,Zip Shelton,WA 98584 Installer Name Hanson Excavating Site Address 1711 Ridge Rd,Shelton Designer Name Arrow Septic Designs INSTALLATION CHECKLIST ® Full System Installation ❑Tank(s)Only ❑ Drainfield Only 0 Repair ❑Other System Type sand4ined pressure bad Pretreatment Type >5 ft.from foundation? --------- ----- ---- --------- ❑wA (]YES NO >50 ft.from wells? ---- ------- {2-{l8-(���� -- ❑ © ❑ Z >50 ft.from surface water? ------ IS t12 JS ❑ 0 ❑ F Cleanout between building and tank? - ❑ 0 ❑ O Tank baffles present? --- ----- -----MAY-'-?'-1�- -- ❑ ® ❑ C 24'access risers over each comps Ant?------------- -- ❑ ® ❑ W Effluent filter installed?-------- yam+--�� -- ❑ ® ❑ Septic tank capacity(working) 1 250 gal Manufacturer Hagerman o D-box water level and speed levelers used? --------------- ❑ wA ❑YES NO J 00 Manitold/0.box accessible from surface?-------- ---LL ❑ ❑ mQ Check valves installed? -------- -t-PN-=''1f- o � +--- ❑ ❑ M Transport Line Size 2 inch Schedule/Class 40 Bedrooms installed(check one) ❑ 2 ❑3 ®4 ❑ 5 ❑6 ❑Commercial/Other 110ft,from founda0on?----------------- ❑ wA ®YES ❑ No 0 >100 ft from wells?-- ------------- ❑ X ❑ w >100 ft.from surface water? -------------- ❑ ® ❑ LL >10ft.from potable water lines?- --------------------- ❑ ❑ Z Q > 5ft.from property lines and easements?---------------- ❑ X El K > 30ft.from downgradient curtain/foundation drains?---------- ❑ W ❑ Drainfield level and observation ports present -- ------------ ❑ ® ❑ ❑ Graveless chambers or ® Clean gravel used? (check me) Proper cover installed over drainfeld?------------------- ❑ ❑ Pump tank setbacks consistent with septic tank?------------- ❑ NIA ® YES ❑ NO ZPump tank capacity(flood) 1,250 gal Manufacturer Hagerman Q 24"access nser(s)and accessible from surface?----- ❑ ® ❑ a Ala"or Control Panel Installed?--- ------------------ ❑ 0 ❑ Control Panel equippedwith Timer/ETM/Counter----------- ❑ ❑ a Pump installed in ❑ Bucket or ® On Block or ❑ Other a Pump Make/Model Liberty FL100 Floats or� ❑ Transducer IL M Tank draw down 4 inimin Pump capacity 88 gpm Squirt Height 5 ft Pump on time 1.33 minutes Pump off time 6 hours Daily flow set at 480 gpd opera av,rm�e Mason County OSS Installation Report pg. 2 Parcel# 320so- O DI ABANDONMENT RECORD Were existing septic componen1ts. abandoned as part of this project? - - - - -- -- ---- - - ' YES ❑ NO If yes, please describe: CIA -TPM. decar�nrnisst ovt old L. G.cc,ba-,v6'+ YES ❑ No Were all components pumped out and properly abandoned per WAC246-272A-0300? --- -- --- RECORD DRAWING Thb Is a minamm,rl and must Ge+ccunr.and ee:cnptira enough b mlooM In me metl of mamten.r-activlrea and Imurt devewpm nL Typit l Rmm Drayar,a mnaan: o2mfide s manJeM orientation n izym,L S"a mp ur W k laradan.NAM Sin— re5crw dralnfleld.entire and pmm.euYelnoa,'rc of"'a watenlnes. walb.Msetvatian ports.demnub.ananNer maNaenanm xucs pmnu. Incdmplete Rermeoraangs may n,na addNana dWays In final mfinfiamnapProv —Ma mamha. 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 installea in accor- the septic design stamped"APPROVED"by Mason dance with the septic design stamped"AF OROVED"by County Public Health and that any deviations shown Mason County Public Health and that any Javirations hers have been cleared/approved by both the designer shown here have been cleareNapproved y both and Mason County Public Health and meet all State mysefYand Mason County Public Health a 7d 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 contain of on this morn and attached Record Drawing is accurate. form and attached Record Drawing is acci rate. Qkii2-6ea u Sig ure oflnstaller Date •� Jared Hanson', Printed Name of Signwe L MASON COUNTY PUBLIC HEALTH stomna The undersigned approves this Installation Report and PRnlq JOY JONNapN '. Record Drawing on behalf of Mason County Public 'Ltd to I EN'• Health: rawf YM SIL311-1 S- Z(- 2� Signature of Environmental Health Specialist Date (stamp, signature and date THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE �ea'ed ez'rzafa r uj s � 2 V J 9 I � 0 Lo� ® o �XISTIK(! O a' at.si<t� 3 sa a� -Ma*K �cowwt+is5'.e.d � oR\VFwrtj� d' APPROVED r-. o °© MAY 23 2024 SON COUNP ENVIRON4.ENTAL HEALT PAO AJpy oHNsoH; Yyjp 'L't0 tl i af4 w , RET �VL wY e RDA 20 , t - 21 � 5lecue �u�'-✓l�we.. OAudio-Visual Nara, jzV\tr. W � gSCi — © cleanout a rry zapt ;` K� BOW MRaI 200 Galion septic Tank ''3e,2�E� '32oie1-sG—o3OOL © 2-Comptterartment ' 1�T.11 c�7'•~ (Z\D6E � — wen gt}ECTON W/� 9958`� 0 chamber i,pOoGallonpamp j 52cov�Q c�"P'f�""'h o�'GY-!5'Ff wt i I