HomeMy WebLinkAboutSWG2022-00587 - SWG As-Built - 6/3/2024 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH
APPLICANT/PERMIT INFORMATION
Permit Number SWG 2022-00567 Parcel# 4221653-00035
Applicant Name Alan Olson Subdivision (Name/Div/Block/Lot)
Applicant Address 11928 53rd Ave. SE Lake Cushman Div. 16 Lot 35
City, State, Zip Everett,WA 98208 Installer Name T.J. Goos
Site Address 1p Designer Name Dale L.Tehia
INSTALLATION CHECKLIST
® Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑Repair ❑Other
System Type Sand Lined Drip(Oscar OS-50 Pretreatment Type
>5ft.from foundation? ---------------- --- -------- ❑ WA EYES E-] NO
>50 ft.from wells? - -----------
Y >50 ft.from surface water? --____ _ ���¢�� - ❑ E ❑
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F. . Cleanout between building and tank? - - ---- ----- - - - ❑ E ❑
V Tank baffles present? - -- --- ---- - -231O2d- - ❑ E Cl
d.- 24"access deers over each oompartme ?------- ---- --- - ❑ E ❑
_W Effluent filter installed?------ ---- - - ----------- - ❑ E ❑
Septic tank capacity(working) 1.250 ml Manufacturer Hagerman
0 D-box water level and speed levelers used? -------------- - E WA ❑YES ❑ NO
QOManifold/D-box accessible from surface?---------------- - ❑ E ❑
CQ Check valves installed? -- --- --- -- -- --------------
❑ E ❑
2 Transport Line Size 1 inch ScheduldClass Sch.40
Bedrooms installed (check one) E 2 ❑3 ❑4 ❑5 ❑6 ❑Commercial/Otter
>10 ft.from foundation?-------------------------- ❑ WA EYES ❑ NO
� - >100 ft.from wells?----------------------------- ❑ E ❑
W' >100 ft.from surface water?----------------------- - ❑ E ❑
Z >10ft.from potable water lines?--------------------- - ❑ E El
>5it.from property lines and easements?- --- ------------ ❑ E ❑
> 30ft.from downgradient curtainlfoundation drains?--------- - ❑ E ❑
0 Draindeld level and observation ports present -----
❑ Graveless chambers or ❑ Clean gravel used? (check one)
Proper cover installed over dreiMeld?- ---- --------- ----- ❑ E ❑
Pump tank setbacks consistent with septic tank?------------ - ❑ WA EYES ❑ NO
ZPump tank capacity(flood) 1.200 cal Manufacturer Haaamlan
Q 24"access riser(s)and accessible from surface?------------- ❑ E ❑
a Alarm or Control Panel Installed? --- ---------- - ❑ E ❑
� . Control Panel equipped with Timer I ETM ICounter----------- ❑ E ❑
a- Pump installed in ❑ Bucket or E On Block or ❑ Other
a Pump Make/Model McDonald E-3o GPM ❑ Floats or� E Transducer
0=. Tank draw down 0.1 in/min Pump capacity 30 apm Squirt Height Drip ft
Pump on time 0.32 min. Pump off time 3.68 min. Daily flow set at 240 apd
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CERTIFfCAT1014 OF MIBT TION
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and Mason County Pudic HeeMf and MW ON Stab mraeft and Meson Count'Public HaaMI and meet an
and Mason County Codes SMts and Meson County Codes
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MASON CINMTV PUBLIC HEALTH
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