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HomeMy WebLinkAboutSWG2023-00195 - SWG As-Built - 6/13/2024 RECORD DRAWING (ASBUILT) pg. 1 MASON COUNTY PUBLIC HEALTH PARCEL IDENTIFICATION Permit Number SWG2023-00195 Assessor Parcel# 320215603006 Applicant Name Tom Roth Subdivision (Name/Div/Block/Lot) ✓ - G Applicant Address 1537NWWoel way City, State, Zip Searle,WA 98177 Installer Name DB& R Construction Site Address 81 E Panorama Dr, Shelton Designer Name Becky Rie er INSTALLATION CHECKLIST 41 x❑ Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑Repair ❑Oil 14 System Type Pressure Pretreatment Type FC >5 ft. from foundation? - - - - -- - - -- - - - - - - - - - - - - - -- - - ❑ NIA 0YES NO >50 ft.from wells? ❑ 0 ❑ Y >50 ft.from surface water? - - - - - - - - - - - - - - - - - - - - - - - - ❑ 0 ❑ Z HCleanout between building and tank? - - - - - - - - - - -- - -- - - - - ❑ 0 ❑ U Tank baffles present? - - - - - - - - - - - - - - - - - - - -- - - - - - - ❑ El ❑ F- 24"access risers over each compartment?- - - - - - - - - - - - -- -- ❑ 0 ❑ a W EfNuentfilterinstalled?-- - - - - - - - - - - - - - - - - - - - - - - - - - ❑ 0 ❑ W Septic tank size 1200 gal Manufacturer Sound Placement 0 D-box water level and speed levelers used? © NIA ❑ YES ❑ NO 0J 0 Manifold/D-box accessible from surface?- - - - - - - - - - - - - - - - - ❑ © ❑ a0Z Check valves installed? - - - - - - - - - - - - - - - - - - - - - - - - - - ❑ ® ❑ oa � Transport Line Size 2" Schedule/Class SCHD 40 Bedrooms installed (check one) ❑ 2 ❑x 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10 ft from foundation?- - - - - - - - - - - - ❑ NIA ❑x YES ❑ NO CI >100ft.from wells?- - - - - -- - - - - - - - - - - - - - - - - - - - - - - ❑ ® ❑ —1 >100 ft from surface water? - - - - - - - - - - - - - ❑ ❑x ❑ ME >10 ft.from potable water lines?- -- - - - - - - - - - - - - - - - -- - - ❑ 0 ❑ QZ > 5 ft. from roe lines and easements x ❑ property rty ?- _ _ _ _ _ _ _ _ _ _ _ _ _ _ - ❑ ❑ W > 30 ft from downgradient curtain/foundation drains?- - - - - - - - - - ❑ 0 ❑ Drainfield level and observation ports present - - - - - - - - - - - - - - ❑ ❑x ❑ ❑ Graveless chambers or 0 Clean gravel used? (check one) Proper cover installed over drainfield?- - - - - -- - - - - - - - - - - - - ❑ ❑x ❑ Pump tank setbacks consistant with septic tank? ❑ NIA ❑x YES ❑ No Y Pump tank size 1200 oal Manufacturer Sound Placement Q24° access riser(s)and accessible from surface?- - -- - - - - - - - -- El © El~ a Alarm or Control Panel Installed? - - - ❑ El El L Control Panel equipped with Timer/ETM/Counter ❑ x❑ ❑ a Pump installed in ❑ Bucket or ® On Block or ❑ Other a Pump Make/Model Goulds PE 51 0 Floats or ❑ Transducer a Tank draw down 2 in/min Pump capacity 48 gpm Squirt Height 5 ft Pump on time 1.25 min Pump off time 4 firs Daily flow set at 360 opd UrAe�e41 WIPD15 MCPH RECORD DRAWING (ASBUILT) pg. 2 Assessor Parcel# 320215603006 RECORD DRAWING ❑x Drainfield&manifold orientation&layout wldimensions for re location Q Trenchrbed dimensions and critical distances within layout ® Septidpump tank placement xj Location of buildings existing/proposed ❑K Observation pods, clean-out locations. &manifoldsld-boxes XJ Lacationofwals, surfav,Wdter.real &watmFmi. ❑x Reserve steals) 0 North Arrow If the designer or installer feel the need for additional information/comments, it may be allached Record drawing may also be on a separate page attached. No. Pages Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER 1 certify 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 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 Codes. State and Mason County Codes I further certify that all information contained on this 1 further certify that all information contained on this form and attached Record Drawing is accurate form and attached Record Drawing is accurate. Dave Young 02.05.2024 Signature of Installer Date Dave Young Printed Name o/Signee r MASON COUNTY PUBLIC HEALTH , s The undersigned approves this Installation Report and Record Drawing on behalf of Mason County Public I Health aF3 n] 02.05.2024 Signature of Environmental Health Specialist Date (designers stamp, signature and date) THIS FORM MAYBE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE u031ea121712015 ! ! . § 2 2 f \ d �� a \ • o \ 2 . � g : z < � Q C7 , | § { \ ! < ! § t § � F K " > 0 \ )/ / } \ M \ m7 \ { o z � � � / \ § - \ -7 M_ §° 2\ ! \\ (/ ® _ " ` \{ $\ 7• §E_ 2 § { � / \ 2 _ § \ \ �