HomeMy WebLinkAboutSWG2024-00158 - SWG As-Built - 6/6/2024 Mason County OSS Installation Report pg. 'I MASON COUNTY PUBLIC HEALTH
APPLICANTI PERMIT INFORMATION
Permit Number SWG -295224-00158 Parcel # 22206-75-00010
Applies.,! Name ',Fl"=co_�, n4ART'.N _ Subdivision (Nsme/Div/Block/Lct) 111
Applicant Address 30 Hv E TAHU`."A\%F.LLEr'_R
City State, Zip TAHJYA WA. 98588 - - Installer Name SCHOEING EXCAVATION LLC
Site Address SAME - Designer Name CINDY WAITE
5 ' fiLLATION CHECKLIST
uo 51 r_m m pkr_; poly ❑ Drainfield Oniy ❑ Repair ❑ Other
_;stem Tyr _ PRESSURE DIST Prer=_atment Type
- - - - - - UNIA I7 YES ❑ NO 4k�
❑ q ❑y a s.e - - - - - ❑ gl
Clea ,,neand and ,,, _ I' '9-� fl d f ❑ ❑
U _ . _ _ __-. \_ I- ❑ ❑
el
speed levelers used? - _ - . _ _ - - _ _ K NIA YES IU_ NO
d0 Mat c n'Qle rom surfaes iJ
tCQ urea .c ai _. - _ _ _ _ _ _ _ _ _ _ _ _ .
nldule/Class 5- L" ' ! yy
' ?7 or a, 2 W 3 114 ❑ 5 ❑6 I l CommerciaLGiher
> - _ _ _ _ - - _ _ _ _ _ i NIA YES L NO I
�.
- - - - - - - - - - - - - - - - ❑ ❑
> ,.. sasec:ents7- ___. _ ----_ _ _ _ _ el ❑
- -.11 cu rr irofoundadon draine% ---
D eary ion ports present - - - - - - - n h
r rJ '.ean gravel user-) (check one)
Phi e nr Plr. - - - _ - - _ .
_ A
Pi ..._a t li sep'G an0 - -"d�L, �.� _ ��..: Na, YES ❑ NO
R wo ---gal Manufacturer `-✓uq is H.J,• 6.
2, = �r pie, brim surface?- - - n
AL « r e]^ ❑,
FFF i•
k or 40, Block or ❑ Othe•_
�- - ;? �'3r_ ❑ rats or ,.Transducer
" Taprr - - - P F=•-itY .5 19Pm SPuirt Height_ it
Pr r- �= Pump off brae All
Daily flow set at goo
uIlisasI 10 8
Masan c;;- _. -_--: cation Repci pg. 2 Parcel# 22206-75-00010
ABANDONNIENT RECORD
here ex - -inandoncd as part of this project? - - - - - - - YES NO
Ifyes, pIE,.:. .__.._..
\t re III,. _.. _,_ - r „pa;,y :,u d. r.;tl cer`P✓AC246-272A-03u0? - _ U YES NO
RECORD DRAWING -
Th'I _ a a ra antl d—r prl e en.,h In re-ra,inve,need c,maintenance activities ntl la—development. Typical
era,,, t k ce=n. wreservec '..I
_ ^i £c,
-- -- - 9 Y ml.o ai sa, h s vor eFV ; o rend Pem,cs '
Record Drawing Attached
CERTIFICATION OF INSTALLATION
iNSTA �I DESIGNER/ ENGINEER
I cerh y , „ n accu,Jance with I certify that the system m in peen sraded accor-
the serr,- �tPPROVc,n, by Mason ' dance with the sentic design stamoed "APPROVED'by
Count/ _. - atanr ;,._oians r,,Ar. M=sW' 231 -,/P,;c,:c Health and that any deviations
here h- y�. ,ad Sy both the designer shown here !lave been cleared/approved by both
and Maso _ , , -;-alth and meet all State myself and Mason County Pub Lc Health and meet all
and r' State and Anson County c—,E
urr ail euu" ,Es, on tail
Moe, anc,.,- ';eo Record vrd is accu,ate.
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