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HomeMy WebLinkAboutSWG2023-00512 - SWG As-Built - 6/20/2024 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2023-00512 Parcel# 41903-34-50031 Applicant Name Tyler&Amelia WaldrOup Subdivision (Name/Div/Block/Lot) Applicant Address 121 W Wivell Rd City, State, Zip Shelton,WA 96584 Installer Name County Line Development LLC Site Address same Designer Name Arrow Septic Designs Inc INSTALLATION CHECKLIST © Full System Installation ❑Tenk(s)Only ❑ Orainfleld Only ❑ Repair ❑Other System Type Shallow Pressure Pretreatment Type >5 ft. from foundation? -- -- - - - - - - - - - " -" - - - - - - - -- ❑ NIA AYES NO 150ft. from wells? - - - - - - - - - - - - " - - - - -- - - - - - - - - - - ❑ ❑ Y >5o ft. from surface water? - - - - -- - - - - - - - - - - - - - " - ' - ❑ Z F Cleanout between building and tank? - - - - - - - - - - - - - - - - - - - ❑ ❑x Tank baffles present? - - - - - - - - - - - - - - - - " - - " - - - - -. - - ❑ � ❑ F 24" access risers over each compartment?- - - - -- - - -- - - - - - - ❑ ❑ WEffluent filter installed?- - - - - - - - - - - - - - - - -- " - - " - - - - - ❑ El w Miles Septic lank capacity(working) 1 200 gal Manufacturer ❑ D-box water level and speed levelers used? - - - -- - - - - - - - - - ❑ NIA ❑ YES K NO 3;i J ❑ ElO Manifold/D-box accessible from surfacep? - - - - --- - - - - - - - - - - 67Z Check valves installed? - - - Q - y - � - - - - - ❑ ❑ o°t Transport Line Size 2inch Schedule/Class 40 _ Bedrooms installed (check one) ❑ 2 X 3 ❑4 ❑ 5 ❑6 ❑Commercel/Other >10ft.from foundation?- - - - - - - - - - - - - - - - - - - - - - - - - - ❑ NIA AYES NO >100 ft. from wells?- - - - - - - - - -- - - - - - - - - - - ❑ ❑ J >100 ft, from surface water? - - - - - - - - - - - - - - - - - - - - - - - - ❑ ❑ W LL >10 ft from potable water lines?- - - - - - - - - - - - - - - ❑ ❑ Z > 5ft. from property lines and easements?- - - - - - - - - - - - - -- - - ❑ ❑ W > 30 ft. from downgradient curtain/foundation drains? - - - - - - - - - ❑ ® ❑ Drainfield level and observation ports present - - -- - - - - - - - - - - ❑ ❑ ❑ Graveless chambers or W Olean gravel used? (check one) Proper cover installed over drainfield?- - - - - - - - - - - -- - - - - - ❑ 11111 L7 Pump lank setbacks consistent with septic tank?------ --- - --- [:1 NIA AYES El NO Y Pump tank capacity (flood) 1,200 gal Manufacturer Miles q24" access risers) and accessible from surface? - - - - - - - - - -- - - ❑ W ❑ ~ Alarm or Control Panel Installed? - - -- - - - - - - - - - - - - - - - - - ❑ ❑ a E Control Panel equipped with Timer/ETM /Gaunter- - - - - - - - - - - ❑ _a Pump ini in ❑ Bucket or X On Block or ❑ Other- s- Pump Make,'Model Zoeller N152 0 Floats or ❑ Transducer � Tank draw down 1-6/8 in/min Pump capacity 36 gpm Squirt Height 7 ft a Pump on time 2.5 Pump off time 6 hours Daily flow set at 360 gpd 1pm-ueairzu+e Parcel# Mason County OSS Installation Re AB- RECORD Wale exlsbng s,ot.FFmponen4 abandoned as Part of Mm Pmlech -_ __ __ __ _ __ _ _ ❑ YF� � NO If yes. Please desalbe: 27 ❑ YES ❑ NO Wag sit P Poneftw WmPad�':and PmPeM ap owed Per W AC24fr2A-0300? RECORD DRAIMNG ,renl ane mu.a.�..w er notl...^.'os .m..meMa ,aea.®.ec•m oa.s'a edrny',wutim mrea.a:a.:m.. TM..a�^t m�+eouan Nmr: „e a.ra c.+�u•. dar:inPm'vn: PanfiBA'6meMda wimlCum 6Nfat5e0oW ^V Perva da+.q.'w'oeavea.n�fireiimulWm aPPwy' w.c.����'P m.tlYnab,as mr m•u.e':au saE vlmrm. inmpe® /A 4 Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNERI ENGINEER I ,,W that I installed the system in accordance with I cerbly 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 cleamd/appmvad by both the designer shown here have been deared/appmved by both and Mason County Public Health and meet ail State myself and Mason County Public Health and meet at; and Mason County Codes. State and Mason County Codes I for"" that all information contained on this 1 further certify that all information contained on this fo attached Recrord Drawing is accurate. form and attached Record Drawing is accurate. U 2-1 Signean,of Installer D e MICHAEL LOVELY s' < r2!). Pdnmd Name of Sgrree � � � �(1 MASON COUNTY PUBLIC HEALTH The undersyned appmvas this Incfa/ration Repnn ann v>pp Ul A IGV Y�' NSON ftecPrtl Drawing on behalf of Mason County Public t O'LKi 1GNEft" Heath. r L � �uwns 04 �, 'S �,�/�✓TSII�1 X� J[I_J�� 6 - Lr7- Z-`f Sg amre W Em;mnmental He Data (stamp,signature and date) SITE THIS FORM MAYBE SCANNEO AND AVAI'.ABLE FOR PUa,IG VIEW ON THE MASON COUNT. WEB wv°i0 finvm ° 1 4PPROVEo O 2024 Audio- SLE .iiarL x lUN 2 1 4FSC,CS�tiN:SAAC44:N'AL iiEAUN � C1ez-:out �8 2-00 Galion Septic Ta*.1c T 2-Co^parmient :¢uent ter wE L (� '000 Cation P_;np Cha ber Dave Control Box / OR yC"''4IriY - , / z �e4yos6, / • �gr�K� q• �,, Wlresewe / � �n be-tw�r• \' 3a5.�e A se s C. TRIG +AtrO•�' co s„ eauu or JON,saN 3'1� 111 V.V �n��ULlI *'� LiCKNSC(5 DE iGNF77 _�}b eui��9ii3 \ � _ � ) ; Mm � } IT\\ ' � \ °F \ \ r . \ ^ ^ \ \ m - QUI wu TRAIL 2 \ j 7 \ \ � c . ° \ \ \ § ) ) ! - § ƒ