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HomeMy WebLinkAboutSWG2022-00342 - SWG As-Built - 7/5/2024 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2022-00342 Parcel# 32104-60-00103 Applicant Name Mike& Rebecca Anderson Subdivision (Name/Div/Block/Lot) Applicant Address 31516 2nd Cf. S Alderbrook G&Y Div: 11 Lot: 103 City, State, Zip Federal Way WA 98003 Installer Name Bamford Septic Repair LLC Site Address 151 E Westwood Ln E Designer Name Arrow Septic Designs Inc INSTALLATION CHECKLIST I] Full System Installation ❑Tank(S)Only ❑ Drainneld Only ❑Repair ❑Other System Type Shallow Pressure Trench Pretreatment Type Nuwater BNR-500 >5 ft.from foundation? --- --- - - - ----- --- -- --- -- --- ❑ NIA ® YES ❑ NO >50 ft.from wells? - - - ---------- - --- -- - - - - -`--- ❑ ❑ Z >50ft.from surface water? -- -- -- -- - --- - - ---- - - - --- ❑ 0 El FCleanoul between building and tank? -------- ------- - -- - ❑ ❑� ❑ U Tank baffles present? -- - - -- - --- - ---- --- ----- --- - ❑ © ❑ 1- 24'access risers over each compartment?---------------- ❑ 0- w Effluent filter installed?- - -- - - - --- ------ - ---- ❑ ❑ ❑� W (Sti r Septic tank capacity(working) BNR-500 gal Manufacturer Sound Placement o D-box water level and speed levelers used? - - - - -- - ----- - - - ❑ NIA ❑ YES ® NO QO Manifold/D-box accessible from surface?-- - - - -- - - - ❑ ® El p?Z Check valves installed? -- -- -- - --- - ---- - - ❑ ® ❑ ❑Q M Transport Line Size 2- Schedule/Class 40 0 Bedrooms installed (check one) ❑ 2 113 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10ft.from foundation?-- -- - - - - ---- - - - -- --------- ❑ NIA AYES NO O >100 ft. from wells?-- --- - -- ----- - -- - - -- ❑ ® ' -u >700 ft. from surface water? - - - - - - - - ----- ----- --- - -- ❑ ® b w LL >10ft.from potable water lines?- ----- - ---- -------- - - - ❑ ® r. Z > 5ft.from property lines and easements?---- - - - - ----- - - - ❑ ® - a K > 30 ft.from tlowngratlient curtain/foundation tlreins?--- -- - -- - - ❑ � Drainfield level and observation ports present --- -- ❑ ❑ ❑ Graveless chambers or F Clean gravel used? (check one) Proper cover installed over drainield?- -- - - - --- --- - -- -- -- ❑ ® ❑ Pump tank setbacks consistent with septic tank?-- - ------ - - -- ❑ MIA ® Yes ❑ No Y Pump tank capacity(flood) 500/1000 gal Manufacturer Sound Placemt-combo pretrash&Dump 2 24'appe55 teens)and accessible from Surface?-- --- ----- --- ElE El ~Q Alan or Control Panel Installed? - - - ❑ 0 ❑ a � Control Panel equipped with Timer/ETM/Counter-- - - -- - ---- ❑ © ❑ p- Pump installed in ❑ Bucket or E On Block or ❑ Other a Pump Make/Model Zoeller N152 IN Floats or ❑ Transducer a Tank draw down 2" in/min Pump capacity 38 gpm Squirt Height 5.6 ft Pump on time 2.33 min Pump off time 6 hr Daily flow set at 360 gpd upoeNa vnrzom Mason County OSS Installation Report pg. 2 Parcel# 32scY—fi0'Q9 (�3 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - --- - - - - - -- - - -- YES NO If yes, please describe: Were all components pumped out and properly abandoned per WAC246-272A-0300? YES No RECORD DRAWING TNa Is a gmynaM nalhed and dead de s vme aM aeaulptlry aneuga b Rb dv in Vie nead or malnWunce=1viYn and M1rture tlavala0mmt Ty,,cal Ra ix, Draai mmam Dramfutl BmanMtl wenhEon d byaN.S aadpump lank btabon.Nunn arrow,reserve nralnFnd, WJNsgs.Iva'.0-nadir adia"nes. code.pawadm pare.a.nwn.and dna ma�MenanaaaaR palnLL. Inmmpl.le aem,d oR«mga m.v uale.ednonal dwvs In rnm Ins6gelion.ppRaldnd Rlaaa wrmlls. Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ENGINEER l certify that I installed the system in accordance with I certify that the system has been installed in actor. 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 ay and Mason County Codes. State and Mason County Codes I further certify that all information contained on this I further certiry that all intbrmatian contained on this form and attached ord Drawing is accurate. form and attached Reccnf Drawing is accurate. �u Z G2� Signetur /nyAn^all Date Print d Name of Signee y p MASON COUNTY PUBLIC HEALTH ). r The undersigned approves this Installation Report and sdo deg ` fA Record Drawing on behalf ofMason County Public PAULA JOY JOHNSON Health: t E51' N"SS'tY}b, Signature of Environmental Health Spsciallst Date (stamp,signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE aaaaae e¢rnmg Plot flan Mic44e14?Vbeoca ArAirson Yarcfl4F32I09-(o0- 00103 y, zp' Gol�•� 15( E Westwood Lh E Coafst c�. S�alf : c"= 20' \ ��• ° 1° I° do tIG v \ \ \ `7 \ \ (3) 3'x(9-7'. �PrlAy-y df. vW itIn 2ooLF reset, o p z T � N 2 1 Z5s � rn DY;vew°y Rem y a�0j9o9e\�\\ �38. 2 O 1 Audio-visual Alarm n�O2 Cleenout © NuWater BNR-500 ATU Tank c \ e.COKg0 5DO PRE-lRASM� '?.. n 1,000 Gallon Pump Chamber p, js; jc 09 9955 Valve Control Box- ��.P 6+00341 PAUTA JOY JOHNSON LN . IS'5 owNes � J `