HomeMy WebLinkAboutSWG2024-00213 - SWG As-Built - 7/31/2024 Meson County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH
APPLICANT/PERMIT INFORMATION
PermifNumber SWO 2024-00213 Parcel 12330-51-00014
Applicant Name HELEN GRADY Subdivision (Name/Div/Block/Lod)
Applicant Address PO BOX 1446 _
City. Mate;Zip BLLFAIR,WA 9e520 Installer Name ABBA EXCAVATING LLC
Site Address 70 N€GALLEY WAY Designer Nome CINDY WAITE
INSTALLATION CHECKLIST
® Full syafam Installaibh L_]Tank(s)Only ❑ De,rif eld Only Repair ❑Other
Syatem type. X02 TO OSCAR DR _ Protroatmant Type
�e fl.from foundadunp - .- - - - - - . - - - - ply. - - - - - ❑ wA ®Yea No
Twill"1187
le>50 It. twill sulfate weler, _ _ 2, �a ❑
Claanout between building and lank? ` ;` tom`- - - - - - --n- • ❑ ❑
Tana 6afFlea ptaaenl, - tl ���3 0.7 - - -- ❑ N ❑
;24 access naers nvar eatF tompanment. ❑ N ❑
€fnuent filter Installed?- - - - - - - ❑ Cl r
Sephe tahk uapatfty(wotking) 1150 €XXII Manufacturer
D box water level and spend levelers used, -V - E NIA ❑ YES ❑ NO
Manifold/D box occeselble from surfdce'� ❑ ❑ ❑
P,hedk valvaa installed`? ❑ ❑ ❑
s y1«�� . ,
Transport Line Sloe ��� Sc,hedula/t,lass dll
Redwoma Installed(check one) 02 ❑3 ❑4 ❑ 5 [IS ❑Ci0malamial/other
110 R flow fbundation'7 - - - - - - - - - - - - - - - - - - - - - - - - -_ ❑ NIA YES NO
>100 it from Walla, , - - - - - - - - - - - - - - - - ._ - - .- - - - - - - - . ❑ ❑
>100 H, from surfiaca water, - - - - -- - -- - - -- - - - - - - - - - ❑ ® ❑
>10 It. from potable water llna0- - -- - - - -- - - - - - -- - - - - - - - ❑ ® ❑
> 5n from property lines and easements?- - - - - - - - - - - - - --- - ❑ ® ❑
> 30 tl.from downgradiem ourtenJfoundation draln0 - - - - -- - - - - ❑ a ❑
W91hrield level and observation pone present - - - - - - - - - - - - - ❑ ® ❑
Lj Graveleos chambers or ® Clean gravel used? (check one)
Proper cover Installed over drefnlield'±- - - - - - - - - - - - - - - - - -- ❑ ® ❑
Pump tank aethacka cdnalstent with septic lank? - - _ - - - - - - -- - - L] NIA ■ yes ❑ NO
irr Pump tank capacity(Sand) QQ__gal manufacturer _ NAGERMAN PRECAST
arj 24"access riearta)and accessible from Surrd,00- - ❑ ® ❑
Alarm of Control Panel Installed? - - - - - - - - - - - - - - - ❑ ® ❑
control Panel equipped with Timor I ETM I counter- - - - ❑ ❑
Pump Installed In ❑ Bucket or 0 On Block or ❑ Other. _
Pump MakeiMadel _.W/OSCAR SYSTEM . Floats or ❑ Transducer
Tank draw Hawn _. __. inlmin pump depacily -- __ gpm Squid Height It
pump tin time Pump tiff tur o DAily now set at gpd
Mason County OSS Installation Report pg. 2 Parcel a 12330-51-00014
ABANDONMENTRECORD
Wire rdinino Septic companenna abandoned as part of this project? • - - - -- - - - - - - - ® YES NO
It vax. please describe.ORAINFIEEO ONLY. RESUSED EXISTING SEPTIC TANK
Were All 10MPUrarls pumped out And properly abandoned Der WAC246-212A-03UOP - - - - - ❑ YES NO
RECORD DRAWING
this Is a pefmaren[leedd end must W atcUNN And deaNnAl"enbu9n to mJatela In its nasal N solnlsnense 9nrirnlse and IUiore aleveNlmbnt T,M R.caW
G`3Wirgs Mra1rt Q-dinfielaB Nanlfvla orknlalond ayour,$ep1,191.1 rank lula lon.M,dh.. nos—a,.sd. ...,and pp--d n ullatlg6 .,11.1,wffiM619s
.wna oMmrwrin^ran...men+./,e'nn orFs,mei�rn�zncc a.vea.ee't.. m ommch: Alan^,6ne1 In Mdsdn Mnnne.
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® Record Drawing Attached
CERTIFICATION OF INSTALLATION
INSTALLER DESIGNER/ENGINEER
i¢edify that I Installed the System In aocoManca with I certify that the system has been installed in Scene-
the sephe design stamped WPM)VE"D`by Meson dance with the Sulam design slammed-APPROVED-by
County Public Health and that any deviations Shawn Mason County Public Health and that any deviations
here have been cleered/approved by both the designer shown here have been cleared/approved by both
and Mason County Public Health and meet ail State myself and Mason County Public Health and meet all
and Mason County codes. State and Modest County Codes
t further eattif that all Information contained on this I htdher certify that all information contained on this
and attached Record Drawing is accurate, form and a f pig Is to
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MASON COUNTY PUBLIC HEALTH
The undersigned approvals this Installation Report and
Record Drawing on behalt of Macron County Public
Hea1ltnth' q K
5rpaalum of EnWroamental Heaah Spaaialist Date (stamp. signature and date)
THIN raaM MAY PE SOANNEDAND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEe SITE unds.i ume
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