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HomeMy WebLinkAboutSWG2023-00306 - SWG As-Built - 8/2/2024 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2023-00306 Parcel# 32218-75-90111 Applicant Name Geoff Benson&Scott Powell Subdivision (Name/Div/Block/Lot) Applicant Address 453 E Via Escuela#524 City.. State.. Zip Palm Springs CA 92262 Installer Name Shumaker Construction Site Address 931 NE Aquila Ridge Rd Tahuya Designer Name Arrow Be.tic Designs Inc INSTALLATION CHECKLIST W Full system mstana0on ❑Tankls>only ❑ Drameela only ❑ Repair Otnar 600 Gil GR-Tr35G Tit- System Type Shallow Pressure Pretreatment Type NuWater BNR-500 >5 ft. from foundation - - - - - - - MIA vas ❑ NO >50 ft. from wells? - - - - - - - - - - - - - - - - - - - - - - - - - - - - ❑ IN El Y >50ft.from surface water? - - - - - - - - - - - - - - - - - - - - - - - ❑ x ❑ Z ❑ ❑� ❑ Cleznoui between building andtank? - - - - - - - - - - - - - - - - - - - U Tank baffles present? - - - - - - - - - - - - - - - - - - - - - - - - - ' ❑ ❑ F- 24" access risers over each compartment?- - - - - - - - - - - - - - - - ❑ ❑� ❑ d ❑ ❑ W Effluent filter installed?- - - - - - - - - - - - - " - - - " - rn - /xIv,WA*�r Septic tank capacity (working) BNR-500 at Manufacturer Hagerman O D-box water level and speed levelers used? - - - - - - - - - - - - - - ❑ N/A ❑ YES NO DJ O Manifold/D-box accessible from surface?- - - - - - - - - - - - - - - - ❑ QQ Check valves installed? - - - - �' - '=� - '- - - - - - - - ❑ 2 Transport Line Size 2" Schedule/Clasa� ',� 40 Bedrooms installed (check one) ❑ 6 ❑Commerc,al/Othe+ >10 ft. from foundation?- h { -0-�-�� - - ❑ WA Q YES ❑ NO El>100ft. fromwells?- - -- - - - - - - - U - - - - - - - - - - - ' © ❑ J 1100 ft. from surface water? - - - - - -LI - JUL -1-Q 2024 - - - ❑ ❑ W - - - - ❑- - ❑ a >1 Oft. from potable water lines?- - - - - QZ > 5 ft. from property lines and Sesame 159 - - - - - - - - - [I El K > 30 ft from downgradient cunaim,'fcumdanon blame.I - - - - - - - - - ❑ i7J ❑ Drainfield level and observation ports present - - - - - - - - - - - - - ❑ � ❑ Graceless chambers or © Clean gravel used? (check one; Proper cover installed over dramfield?- -- - - - - - - - - - - - - - - - - Pump tank setbacks consistent with septic:ank? - - - - - - - - - - - - - ❑ MIA YES ❑ NO Y Pump lank capacity (flood) 1,000 gal Manufacture, Hagerman Q 24' access user(s)and accessible from surface7 - --- ---- -- -- ❑ K d Ala" or Control Panel Installed - -- ❑ fl Control Panel equipped with Timer/ETM i Counter --- - ---- -- ❑ © ❑ d Pump installed in Q Bucket or ❑ On Block or ❑ Other n' Pump Make/Model Liberty 280 P Floats or ❑ Transducer � Tank draw down 1 76 in/min Pump capacity 33 gpm Squirt Height 7 ft a Pump on k.Te 2.7 min Pump off time 6 hr Daily flow set at 360 gird { Mason County OSS Installation Report pg. 2 ?arcel8 32218-75-90111 ABANDONMENT RECORD Were existing septic components abandoned as part of thls prciect? - - - - - - - - - - - - - - - ❑ YES NO If yes, please absoribe'. --- - --- '" Were all components pumped out and p opedy abandoned per WAC246-272A-03e0? _ - ' - - " ❑ YES NO RECORD DRAWING r.I.•p.,m,,,..o �a a a o Ana en r m m �n:: a m I a,• o�s v�wma,2o mesa •�nou o:en.ro ar, .s ono �.I�.. ,_ .��,. a apc t o ....... - I . ..�...oar� a .,ors.•e om« =w=�ssa n ..mok,sa,. a. �._:.. .... r. .• W Record Drawing,Agazred 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 accot- the septic design stamped'APPROVED by Mason dance with the septic design stamped APPROVED-by County Public Health and that any deviations shown Mlason County Public Heoltn and that any dev a -os mere have been cleared/approved by both the designer srjupr,here re,r,ocen cle eh000roved b, nh and Mason County Public Health and meet all State rnyseff and Mason County Public Health ago r,;eet wn and Mason County Codes. State and Mason County Codas I redber certify that all,chor, a ion contained on th;'s r u bar cam y[ at e11 lnFor na Icn contairea "f.his ;Torn,and attached Record Drawing is accurate- ro n and a r c I d Record a wng !s acc +dry. Slgnatn'sof IrsbIh" Date Printed Name of Slgnee ti• P. MASON COUNTY PUBLIC HEALTH Lae undersigned approves this Installation Rsport "P momaa Record Drawing on behalf of Maso�ounty Public Yo-' PAULA SOY JOHNSON ' Heal . r q ; LiCENsr b -fGNEtl_ o t , a �- 24 Signature o(Envimrmenlel Health gp=,te/lsr �t1�� (Sfanrp. SignaNre and date) TF.:SFORMNAY BE SCANN_eAN—NMILABI.FI'OR. JBJG'AE.,ON THE MASON COUNTY O'Etf A7E I Ugvn }-o t' XAG ?r rna y D.F. Pi�`�rve Tre,.•�-yes beside. Ln m �P�- oOO n r� ZC ba, �.dlhq sei buck �Fe tiyh� � L1y RID�,E RD �o-�- Q�a.oh+ �vcu �K l.�c�vr I i ✓,e �k \ �„`"Y �m u2� 7221�-75 -4011 be ee ect G1Ty! NPA(xUtLA �(DGc' RD { ir ' o-j 2-fw+v 5 �'{ 1�9 Q,,, SsO1-; e �a ¢ll, Shcer2u� ,�.'JT] -I?-l5� -} t �"i J+,, Y1¢i h�v✓ �ccvcss s�� New. OAudio-V:Sual Alzrm - •+. ,., { 500 Gallon Pre-Trash=-k , 9�G V atiW er B--vR-500 ATU T=a k 0 �5 1,000 Gallon Pump Chamber Y p��..ti� �6 Valve Con=ol Box ✓"t. s,JOY imilS .- y. •-/ anuu gar l Ne r�c�trSCQn>•9