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HomeMy WebLinkAboutSWG2020-00519 - SWG As-Built - 6/25/2024 Mason County OSS InsItallation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/PERMIT INFORMATION Permit Number SWG odo -00-S\ON Parcel# 7,11k15v,000\2. Applicant Name b U&Au Sib gg ee Subdivision (Name/Dly/BlocklLot) Applicant Address 0. City, State, Zip -ILOL.C& yhoi,' U31A OjVC106 Installer Name Edda 166W SkeAddress ao k Us-ty` Designer Name 8yer4b rtm INSTALLATION CHECKLIST Full System Installer! nEl Tank(s)Only ❑Dralnfleld Only ❑Repair ❑Other System Type. P &MMptreatment Type >5ft.from foundation? ---------------------------- ❑ tun �yrs El No >50 ft.from wells? -- -------------------------•• ❑ '� ❑ z, >50 ft.from surface er? ------------------------- ❑ ' ❑ F Cleanout between bull Ing and tank? -------------------- ❑ ❑ q Tank befiles present? -- ------ -- ----------------- I ❑ ❑ 24"access risers over ach compartment?---------------- - ❑ ❑ ❑ NEffluent filter installed? - ---- -- ----------- ------- - ca❑^ �� �- J� r1 � �J, ❑ Septic tank capacity( rking) cal Manufacturer WAAI Ott Vkll"UAM _ .! . D-box water level and peed levelers used? -------------- - ❑ WA ❑vas ❑ No O ManifDld/D-box access le from surface?---------------- - ❑ ❑ ❑ L Check valves Installed -- -„---------------------- ❑ •Q ❑ Transport Line Size Schedule/Class 1ADPE Bedrooms Installed (ch ck one) ❑ 2 ❑3 E 4 ❑ 5 ❑S ❑ComnlerclaVOther >10 ft.from foundation --------------------------- ❑ WA WYES ❑ No >100 ft.from wells?-_ __ _________________________ ❑ R ❑ >100 ft.from aurtaoew ter?---------- ------------- - ❑ ❑ W Z. >10 ft.from potable we er lines?---------------------- ❑ Cl z , > 5 ft. from property In sand easements?- --------------•- ❑ ❑ > 30 ft.from downgradi nt ourtain/foundaflon drains?-- - ------ - ❑ ❑ Dralnfield level and obs rvatlon ports present ------ El ❑ Graveless chambe or ❑ Clean gravel used? (oheck one) Proper cover installed oar drainflald?------------------•- ❑ ❑ ❑ Pump tank setbacks cc sistent with septic tank?------------ n ❑ NIA OYES ❑ No Y Pump tank capacity(flo d) 'L D al Manufacturer %Md\ VIAC.rntu4 FZa- ?A`access riser(s)and ccessible from surface?------------ - ❑ ❑ o. Alarm or Control Panel l stalled? ------- ------------- - ❑ ❑ Control Panel equipped Ith Timer/ETM/Counter-------- -- - ❑ ❑ ❑ a. Pump Installed In ❑ B cket or ❑ On Block or ❑ Other IL Pump Make/Model 1 runst I [Moats or ❑ Transducer g C. Tank draw down In/min Pump capacity_/D gpm Squirt Height Nln ft Pump on time 1 • Pump off flme Dally flow set at 9 g C) 9pal upamesmrm+e Mason County OSS In tallation Report pg. 2 Parcel# ABANDONMENT RECORD Were existing septic compo ants abandoned as pert of this project? -------------- - ❑ YES ❑ NO If Yes, please describe: Were all components pumps out and properly abandoned per WAC246-272A-03007 --- - --- - El ;';j 4 ❑ NO ll RECORD DRAWING Thle la a permanent tacord and mus r ccmala and dnctlptive enough to Mood,In me need of malManent.aoas .and future development. Tyl Remd craven,eembA, Dral amen. nlatlon6le'ted aepfipump tank butlon.Noth amw,reaervedralnl adding and proposed boldnga,low4on of Wells,weMArae. .11a..Caervatlm pone,tle6laoR,eM malnlenanceamesapurve In *bRe DnuingsmaycnaleeMigomidele fnflmltn ladonepgovalowmiatedpmmM. El Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER]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 clearedtapproved by both the designer shown here have been cleared/approved by both and Mason County Public 14eell and meet all State myself and Mason County Public Health and meet all and Mason County Codes. State and Mason County Codes 1 further Wily that all information contained on this I further certify that all information contained on this form an ttached Racy Dmwi is accurate. form and attached Reno wing Is accurate. , ature finstallar Date Printed Name of Signee �i. MASON COUNTY PUBLIC,EALTH The undersigned approves t is Installation Report and ADAfd J.XUNTER Record Drawing on behalf of Mason CountPublic t' "fiP.Ftiri@s`ll1N@R"' I eHieCa O::R/ —,f Heett wi_ Signature of EnNmnmen I Heath Specialist Date (stamp, signature and date) THIS FORM MAY 4E SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE �v1i°mueme Request to change Septic Designer Project Name: Seneca Owner Name: Frank and Mary Senecal Project Address: 20 E Rose Point Lane, Belfalr WA 98528 Parcel#22212-56-00012 Drain field Parcel#22212-11-0060 Current Septic Designer: Brent Fox OCS (Onsite Consulting Services PLLC) New Designer:Adam Hunter—Jim Hunter and Associates(360-753-1226) We need to change Designers because Brent Fox has not turned in as-built for above project for over 5 months. The Building Permit and Site Development were Finialed on 5.8.2024 but we can not get the Certificate of Occupancy until the septic as-built is submitted. On a call when he did answer May 911 Brent said he had submitted the as-built, but we found that not to be true and now he will not answer phone calls, emails,or text and repeated attempts by home owner, home designer and builder to reach him. We have not other choice to but change septic designer. The Installer Dodge Excavation and Hunter and Associates will be doing site meeting and inspection and then Adam Hunter will submit the as-built for this project. Signed Owner: (Mary Senecal) Home Desl er Dawn Larson Ahrens—David Hopkins Design Group LLC Builder: Robert Bush it 014wm ! B � ! $ § § ( ! § ; ! | I 2 k § \ / ® 7, ) 6 | \ I ! « % TYPE N ! IN ! © 4 i * § , \ ) , $ \ ( k � � \ )£ , - \ ) ` jo2 ) / / - - : ! ! 0 .