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HomeMy WebLinkAboutSWG2024-00175 - SWG As-Built - 6/6/2024 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/PERMIT INFORMATION Permit Number SWG 2024-00175 Parcel# 32106-33-00160 Applicant Name Peggy Mitchell Subdivision(Name/Div/BiocWLot) Applicant Address 3311 E State Route 106 TR 16 OF N12 LOT 5 City, State, Zip Union WA 98592 Installer Name Union City Enterprises Site Address same Designer Name Anow Sepfic Designs INSTALLATION CHECKLIST ■ Full System Installafion ❑Tank(s)Only ❑ Drainfield Only E Repair ❑Other System Type Send-fined pressure bed Pretreatment Type- IS ft.fromfoundation? --------------------------- ❑WA EYES, ❑ NO >50ft.from wells? ----------------- ---- -------- ❑ E ❑ Y >50 ft.from surface water? ------------- --- -------- ❑ E ❑ 2 H Cleanout between building and tank7 ------------------- ❑ ■ ❑ p Tank baffles present? --- ------ --------- ❑ E ❑ r 24'access risers over each compartment?---------------- ❑ ■ ❑ Q. Effluent filter installetl?----- ---------- ---- - ------- ❑ ■ ❑ N Septic tank capacity(working) 1.200 pal manufacturer Hagerman 0 D-box water level and speed levelers used? --------------- E] WA ❑M ■ NO Vq}UC be [ 00 Manifold D-box accessible from surface?--- - x-�- -- ❑ ■ ❑ mZ Check valves installed? -------A-- 13 04 2 Transport Line Size 2 inch Schedule/Class 40 Bedrooms installed(check one) ❑2 E 3 ❑4 CIS ❑6 ❑CommerciauOther >10ft.from foundation?------------------------ -- ❑ WA ■YES ❑ NO >100 ft.from wells?--------- W f>100ft.from surface water?---r''- --- ~=y--F �e-- ❑ ■ ❑ a >tO ft.from potable water lines?---------------------- ❑ ■ ❑ QZ >5ft.from property lines and easements?--------- ------ ❑ ■ ❑ K >30 ft.from downgradient curtain/foundation drains?---------- ❑ ❑ Drainfield level and observation ports present -- ---------- -- ❑ ❑ ❑ Graveless chambers or a Clean gravel used? (check one) Proper Cover installed over drainfield?-- ----------------- ❑ E ❑ Pump tank setbacks consistent with septic tank?------------- ❑ WA EYES ❑ No 54 Pump tank capacity(flood) 1,000 gal Manufacturer Hagerman Q24"access riser(s)and accessible from surface?------ ------- ❑ E ❑ ~a Alarm or Control Panel Installed? --- - --=- ❑ E ❑ f Control Panel equipped with Timer/ETM /Counter----------- ❑ ■ ❑ 7 o. Pump installed in ❑ Bucket or ■ On Biock or ❑ Other a Pump Make/Model Liberty FL50 ■ Floats or ❑Transducer f a Tank draw down 3.25 in mm Pump capacity 62 gpm Squirt Height 6 ft Pump on time 1.45 minutes Pump off time 6 hours Daily bow set at 360 ppd yw,warz,au,e �� lob-33- aolbo Parcel# i Mason County OSS Installation Report _. . - �W/11 rEs p No Were existing septic o,,ponents abandoned as part of this ptoJ et7 -Old , ,. u J sfn 551By1 J�—B —j{t Ye NO If yes, please desonba: V out W Were all wmponanls Pumped out and properly abandoned per WAC246272A-03007 RECORD DRAWING m tM nptl M m.ImxiMu sWXW ud INun brYWm.�'L T59knl PWE now.pmeMa Melt.M mu.t Ee rcurN aM WKdprrh..oh m mbub Nml deW.'MWIiMf. on.res canww: p,s„MBa me�xaa ax.nnm�swyour.swoaoumo msx uo,an.Nam sim,.wsro aelmra,marewaswsse wm.nol+�Ia,a r.Iwe nm�x.. wpn,oesnNsmn paw.asnnom,ra omer meimmerrs saran Fume. lirompww Remm Dmoya mnrasw.eeimn.I ssw»'^ Record Drawing Attached CERTIFICATION-OF INSTA A.ATiON INSTALLER DESIGNER/ENGINEER I certify that 1 installed the system in accordance with 1 certify that the system has been installed in accoo- 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 clearoo/approved by both the designer shown here have been c/earodlapproved 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 l further cerofy that all information contained on this I further certfy that all information contained on this form and attache Record Drawing is accurate. Corm and attached Record Crowing is accurate. Signature of Installer Cate /�� • Lc. uH.. 5;��. ®ems - .,.; Printed Name of signee f ,t MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and 'ti} RAULA+or+oaasoN`y. Record Drawing on behalf of Mason County Public Hea/th: SlQnatum of Errvinorurent4l Health Spedalist Dote (stamp,signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE UWMaRtrAtt S tE;i =h a ac ,b eo Bo iQCig�U!�T Q as � r1�t helQolbD 9 ar F luo J3- '33i1 E STh'� R'�- 1b6 �/L $koKoJ� J 5 H R Ivff p- ?' Q Audio-Visual Alarm �4 .e f Q Cleanout ; Tu a,00J.v © 1200 Gallon septic Tank T Q, PAUL JOY JOHNSON•'. 2-CompartInaut-ith J E .. Effluent FSliter 1000 Gallon Pump Chamber old kmK APPR VED g +Q JUN 06 2024 MASON COUNTYENVIR NMENTALHEALTH 3BR RET NoGs� : .:le".j 1Jcio�tib°� rpyt a+ ivessi.+� Rv wru„ so, o A _ F ^ QfJ Y S0 Well X � J IOX4S Qr,mar� rf �; - df bed w Yl- c R�4TF /C6 Q�S