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Home My WebLink AboutSWG2023-00237 - SWG As-Built - 7/5/2024 Mason County OSS Installation Report pg. t MASON COUNTY PUBLIC HEALTH APPLICANT/PERMIT INFORMATION Permit Number SWG 2023-00237 Parcel# 12118-50-00008 Applicant Name Tim Perry Subdivision (Name/Div/Block/Lot) Applicant Address 1415 6th Ave N#507 City, State, Zip Seattle,WA 98109 Installer Name B-Line Construction Inc Site Address 611 E Rauschert Rd.Shelton Wa Designer Name INSTALLATION CHECKLIST ❑ Full System Installation E Tank(s)Only ❑ Drainfield Only ❑ Repair ❑Other System Type Pump Basin replace Pretreatment Type >5 fL from foundation? ---------------------------- ❑ N/A ❑YES NO >50ft.from wells? - - ---- -- - -------- ------ ----— ❑ ❑ ❑ 110 Z >50ft.from surface water? - - - ----------- ------ ❑ ❑ ❑ F Cleanout between building and tank? --- x�S'itr� ----- ❑ ❑ ❑ V Tank baffles present? - - - - - --- -- - - ---------- - -- -- ❑ ❑ ❑ IL 24"access risers over each compartment?---- - - - -- - - - - - -- ❑ ❑ ❑ W Effluent fitter installed?- - - --- - - - - -- - - - - - - - - - - - - - -- ❑ ❑ ❑ rn Septic tank rapacity(working) gal Manufacturer o D-box water level and speed levelers used? - - - - --- - ------- ❑ wA ❑YES ❑ NO 00 Manifold/D-box accessible from surface?-- ❑ ❑ ❑ oQCheck valves installed? - - - - -- - - -- - d�'-PJ- - - - -- ❑ ❑ ❑ 2 Transport Line Size Schedule/Class Bedrooms installed(check one) ❑ 2 ❑3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10ft.from foundation?-- - - - ---- --------- - ----- -- ❑ N/A ❑ YEs NO >100 ft.from wells? ------- ------------- ❑ ❑ ❑ W >100 ft.from surface water? - - - - - - - -- F�F-to)+-� - -- - ❑ El M >10ft.from potable water lines?- - - - ------- - - _-- ❑ ❑ ❑ QZ >5 ft. from property lines and easements?- - - - ------ ------ ❑ ❑ ❑ N >30 ft.from downgradient curtain/foundation drains?--- - ----- - ❑ ❑ ❑ Drainfiekl level and observation ports present --- - - ❑ ❑ ❑ ❑ Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?- --- ---------------- ❑ ❑ ❑ Pump tank setbacks consistent with septic tank?---- -------- - ❑ N/A`� ApYES ❑ No 2 Pump tank capacity(flood) at Manufacturer_ LVVXG6 \—f PW'n H24"access riser(s)and accessible from surface?------------ - ❑ ❑ IL Alarm or Control Panel Installed? - - - - ------- - ---- ----- ❑ ❑ Control Panel equipped with Timer/ETM/Counter- - - --- - - - - - ❑ ❑ [,(� p- Pump installed in ❑ Bucket or ❑ On Block or ❑ Other 0. Pump Make/Model Orenco ❑ Floats or ❑ Transducer f a Tank draw down in/min Pump capacity gpm Squirt Height ft Pump on time Pump off time Daily flow set at gpd e U�t= mrm18 FMason County OSS Installation Report pg. 2 Parcel# 12118-50-00008 ABANDONMENT RECORD e existing septic components abandoned as part of this project? --- -- --- ----- - - ❑ YES No s, please describe: Were all components pumped out and property abandoned per WAC246-272A-0300? - -- N k ❑ YES ❑ No RECORD DRAWING This U a p ..t rKpW end must O .aunts snd dpcd n-..w h b ro-locak In uw rrtM d m Ih n.nc..dl NWea and fntu.d.lo .m. T,V I aeGwd p.M,w cadaYr. onMMba,reNbn arenl.don 8layan,Seppepumo isnYpation,Hwm.mmv.mmrve ennfiele,evsh�g.na goposed duidvgs,bu4on arweYs.wabdire., weN.uhMmlin nam,d.wwnis,ad mn.r mainte,wa..�®om,m. inanpl.te aw.,»eonwh�s.marwl..ddmwmiaaaysr ew i,.sraisaad a.aov.i.m rwma w.nn. Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNERI ENGINEER I certify that I installed the system in accordance with I certify that the system has been installed In accor- 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 all and Mason County Codes. State and Mason County Codes I further certify that all information contained on this l further certify that all information contained on this form and attached Record Drawing is accurate. form and attached Record Drawing is accurate. 1 7 it-z q SI a re o Instal Date *il 1 Ony Pnntefd Name of Signs MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and Record Drawing on behalf of Mason County Public Health: Izy Signature of EnvironmentA Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE updaed arztrzote RECORD DRAWING continued s APPROVED 111N 23 2023 MASON COUNTY EN41RONMENTALHEALTH RET pec q6Y 1 1 s 2ui � ytd� � 6• I L9"kt-i o is LIT I? `t 1 ; �-f— !, We 4u 6d d �rV PC Pu+n,, •r�G ylN APPROVED V R�rf �e i JUL 15 2024 MASON COUNTY ENVRONMENTAL HEALTH RET ! :1 r—yo— 6,0 oo p SC64 2d oef - S hace /,,, APPROVED .11IN 2 3 2023 MASON COUNTY ENVIRONMENTAL HEALTH R F T renCO Technical Data Sheet j PVC Pump Basins Applications Standard Models Orenco PVC Pump Basins am designed to house effluent pumps, P61854,PB2454 sewage pumps,or grinder pumps in wastewater pumping applications. (Custom basins are available for specific configura8ons.) They are not IAPMO listed. General Materials of Construction Orenco PVC Pump Basins came in 18 and 24in(450 and 60Dmm) Rated pipe PVC nominal diameters.Bases are fiberglass-reinforced polymer(PBP), Bare FpP — attached with epoxy.EPDM grommets seal all piping penetrations.A Gramm EPOM 4in 000mm)inlet elbow and holes to accommodate splice boxes and -- -- discharge piping are located and sized to spec'dic need,Fiberglass access lids and stainless steel fasteners are sold separately. Specifications Optional equipment is available. Model O.D.,including rib I.O. Liquid capacity in(mind In(man) gallin(Umm) PBieXX 19.44(494) 17.50(446) 1,06(0.16) - f PB24XX 25.63(651) 23.50 W 1.88 P.m Product Code Diagram babKeusq'aov®amem IO vgl.erlblGl]5 1OP .AIYYbMMIIe 10 - 9np.9npypbtl 1! 1"W+e1pMM IS = 1Xpplpp®e1 A .albllyWl Vod1 3 I��arRb�11�MIM L - 9111 pTYy,uuf YMitl 51 - 91 YYM sz - epeerbe 9 9111 , 4 � BMiW L5 BEeYaFe ® l6 BMOYM DI = MIa41bYYRmY(bN' 1 x5 = Ct4mgmrdsdY•pa m - EgmenpmllpmWW�Fplq�' Ilr = fWb,PmlWeatrgWpbp' UUY1eem4e �% OVED eY. I. ers JUL 15 2024 Z,=�MASON COUNTY ENVIRONMENTAL HEALTH 72 rn a`aW RET 1e. lenwmm