HomeMy WebLinkAboutSWG2023-00176 - SWG As-Built - 6/10/2024 J CORD DRAWING (ASBUILT) pg. 1 MASON COUNTY PUBLIC HEALTH
PARCEL IDENTIFICATION
Permit Number SWG �:.} _ -I i Assessor Parcel# 2,x I
Applicant Name YXCe--L Subdivision (Name/Div/Block/Lot)
Applicant Address in C' �I v�h / .cz. R- -
City, State, Zip 3v Installer Name *"
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Site Address • Designer Name N— 0, -C (—
INSTALLATION CHECKLIST
Full System Installation ❑ Septic Tank Only ❑ Drainfield Only ❑ Repair
System Type SK-Aou �s4,r Pretreatment Type
>5 ft.from foundation? - - - - -- ❑ NIA 0 YES ❑ NO
>50ft. from wells? - - - - - - - - --- 51e. - - - - - - - - - - - ® ❑ ❑
Y >50ft. from surface water? - - - - - - - - - - - - - - - - - - - - - - - - ❑ ® ❑
Z
FCleanout between building and tank? - - - - - - - - - - - - -- - - - -- ❑ ❑
U Tank baffles present? ❑ ® ❑
a24"access risers over each compartment?- - - - - - - - - - - - - - - - ❑ ® ❑
W Effluent filter installed?- - - - - - - - - - - - - - - - - - - - - - - - - - - ❑ ❑
N
Septic tank size lam gal Manufacturer Juo
O D-box water level and speed levelers Used? - - - - - - - - - - - - - - - a NIA ❑ YES ❑ NO
DJ
O Manifold/D-box accessible from surface?- - - - - - - - - - - - - - - - - ❑ ❑
'PZ Check valves installed? ❑ ❑
CQ v
2 Transport Line Size d Schedule/Class Sd 't' 40
Bedrooms installed (check one) ❑ 2 03 .W4 ❑ 5 ❑6
>10 ft.from foundation? - - - - - - - - - - - - -- ❑ NIA ® YES El No
l] >100 ft. from wells? ❑ ❑
W >100 ft. from surface water? - - - - - - - ❑ ® ❑
a >10 ft.from potable water lines?- - - - - ❑ ® ❑
Z > 5 ft. from property lines and easements?- - - - - ❑ ❑
� > 30 ft.from downgradient curtain/foundation drains? - - - - - - - - - - ® ❑ ❑
Drainfield level and observation ports present - - - - - - - - - - - - - ❑ ® ❑
NJ Graveless chambers or ❑ Clean gravel used? (check one)
Proper cover installed over drainfeld?- - - - - - ❑ IN ❑
�., Pump tank setbacks consistant with septic tank? - - - - - - - -- -- - - ❑ N/A ■ YES
Z mp tank size law gal Manufacturer .S.'a Sv"UA
C-J-'
N I
yy ccess riser(s) and accessible from surface?- - - - - - - - - - - -- ❑
e'�• A`` Control Panel Installed? - - - - - - - - - - - - - - - - - - - - -
❑ �'
i
Co net equipped with Timer/ ETM/Counter- - - - - - - - - - - ❑
e
' e-p d in ❑ Bucket or 6 On Block or ❑ Other
1
P ke/Model "A 0 l `1 Floats or ❑ Transducer o r
-
T draw down �'S � v mini /min Pump capacity 4 36 h<,A
gpm Squirt Height S ft
Pump on time 1 2(j ro Pump off time ut A„ Daily flow set at gpm
RECORD DRAWING (ASSUILT)Pp. 2 MASON COUNTY PUBLIC HEALTH
RECORD DRAWING
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CERTIFICATION OF INSTALLATION
INSTALLER DESIGNER
I cw*am I Installed the system in accedawe wah I prtlly Mat are system has bean msfaaed In ecoor-
the septic deapn stamped APPROVED-by Mesta dance wah as Septic design stamped'APPROVED'by
County Pu66c Health and that any dewations shown Meson CwnyRUSS;H"M and UW a"deYlabom
here have been deare&oppoved by both Me dennoyre shown hen have been cbaredrap wd by both
and Mason County Pubhc Health and meet ad State myseaand Mean Count Publk HOO M and moat ad
and Merin CcImly,Codes. State snd Mellon County Codes
I FcYt/wr rsmy that all lnfomarion=Ioined w this I haaar tardy that all Inf rmalkn ooWakad on ads
A-aryl eaeawd Record Drawing Is aw"ta. Foam and attached Record Drawkg/se Mfe.
FMMed Name al mg „ '•.�,
MASON COUNTY PUBLIC HEALTH
The wderalgned Boomwa this Instatfaaon Repel and
Ra ld Draw wbehaa of MOW Cou Pub0c * Aw'r'I^ NUWE
kg INY 'La!!�'N,^h'(�ilai�:NIN.�.
3lgnnruro rdPsvemmw HOWth Spocloeet DOW (des4mr's stamp,slgmatun and dale)
THIS FORM MAY BEBCANNEO MO AVAIUBLE FOR PUBLIC VIEW ON THE"OS COUM WEB SITE
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