HomeMy WebLinkAboutSWG2022-00390 - SWG As-Built - 5/16/2024 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH
APP ANT/PERMIT INFORMATION
Permit Number SWG 2022-00390 Parcel# 320215502037
Applicant Name TDC Entarptrsas LLC Subdivision (NamelDiv/Block/Lot)
Applicant Address PO Box 2503 SHORECREST TERRACE 2ND ADD BLK:2 LOT.37
City, State,Zip Gig Harbor WA 98335 Installer Name Jack Johnson
Site Address 20 F view PI,3haltoo Designer Nama dim zany
IStALLATION CHECKLIST
® Full System Installation [3-Fanlk(s)Cily ❑Dreinfield Only ❑Repair ❑Other
System Type ATU-Presure Distribution Pretreatment Type Enviroflo-bnr 500
>5 ft.from foundation? -------- ------------------ ❑WA Eyes NO
>50ft.from wells? -___________________________- ❑ e ❑
Z >50 ft.from surface water? -_____ _____ ___________- ❑ E ❑
Cleanout between building and tank? ❑ E ❑
Tank bales present? ------- -- __________ ______. ❑ ❑
M 24"access risers over each compartment?- - - - - - -- - - - - -- - - ❑ ❑
Effluent fitter installed?----- --- ----- ------------- ® ❑
Septic tank capacity(working) al Manufacturer Hagerman
o D-box water level and speed levelers Sct?e --- -- S N/A ❑YES ❑ No
gO Manifokt/D-box accessible from surfs ?----------------- ❑ ❑
mZ Check valves installed? --------r----------------- ❑ ❑
OQ
g Transport Line Size 2" Schedule/Class sch 40
Bedrooms installed (check one) PI2 ❑3 ❑4 ❑5 ❑6 ❑CommemiallOther
>10R.from foundation?--------L----------------- ❑ N/A Eves ❑ No
>100 ft. from wells?- ----------I
p ------------------
W >100 ft. from surface water? -_- --_ ❑ El.._________________- ❑ ® ❑
0. >10 ft.from potable water lines?----- ---------------- ❑ . ❑
z >5ft, from property lines and easements?---------------- ❑ ❑�
Q
K >30ft.from downgradient curtain/fou lydation drain?---------- ❑ ❑
in Drainfiekd level and observation ports present -------------- ❑ ® ❑
0 Graveless chambers or ❑ Clean gravel used? (check one)
Proper cover installed over dminfield?/---- ❑ ❑
Pump tank setbacks consistent with septic tank?------------- ❑ NrA fives NO
NdPump tank rapacity(flood) 17 '. net Manufacturer Hagerman
Q 24"access riser(s)and accessible from surface?------------- ❑ ❑
aAlarm or Control Panel Installed? ---'�----------------- ❑ B ❑
f Control Panel equipped with Timer/ M/Counter----------- ❑ ❑
7
a Pump installed in [] Bucket or On Bbck or ❑ IXher
IL Pump Make/Model Ii 280 0 Floats or ❑Transducer
f
a
Tank draw down 1.5 in/min Pump rapacity 30 apm Squat Height 5' tl
Pump on time I min Pump off time 4nrs Daily flow set at f 60 rpd
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Mason County OSS Installation ' port pg.2 ParcelM 3 20 z 16-So? 3:7-
BANDONMENT RECORD
Were exie4rg Rolm,canRodents aba d as non of this Rioted? -- -- - - -- ------- ❑ YES NO
II Yes.please 0escnbe I _..
VEm all cdnpone-h pumped out and ab"oned per WAc2,16-272 03001--------
RECORD DRAWING
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I&IRecord Drawing Attached
CERTIFICATION OF INSTALLATION
INSTALLER DESIGNER/ENGINEER
I certify that l istalled the system in ante with I certify that the system has been installed in accor-
lhe septic design stamped`APPROVED by Masmr dance with the septic design stamped'APPROVED'by
Cotmly Public Health and that any dendull ons,slI Mason County Pubic health and that ony deviations
here have been cfearedlapproved by but I the designer shown here here been clearediappmved by both
and Mason County Public Health and ME Of all State myself and Masons County Public Health and meet all
and Mason County Codas. Stale and Mason County Codes
1 furtherceddy,that all infounation contabted on this I further cedlfy that all information contained on this
III td if hod Record Drawing Iss WORRIES. form ad affadled Record Drawing is accum(e.
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Si ura of Installer Oafe
�c1� �QknSn�
Printed Name of Sgnee
MASON COUNTY PUBLIC HEALTH e a N
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Tlne mdersgrled appro.This brslallaign Report and a +
Record Drawing an behalf
/off�Mesa?)County Pubic
Heal(f: �NI S—f 1 ' I S- 1—`2 L
Sfgniffure of Envaavnnn i Health Speciefist Dale h damp,signature and date)
THIS FORM MAY BE SCANNED rO AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE o✓+N'^a1me
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MASON COUNTY ENVIRONY E1TAt HEALTH
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