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HomeMy WebLinkAboutSWG2021-00298 - SWG As-Built - 8/7/2024 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2021-00298 Parcel # 12309-41-90021 Applicant Name Allan &Lea Carstensen Subdivision (Name/Div/Block/Lot) Applicant Address PO Box 2813 City, State, Zip Belfair, WA 98528 Installer Name Shumaker Construction Site Address 91 NE Bear Creek Dewatto Rd Designer Name Arrow Septic Designs INSTALLATION CHECKLIST 0 Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑ Fend, ❑ Other. System Type Pressure Trench Pretreatment Type >5ft. from foundation? - - - - - - - - - - - - - - - - - - - ❑ NIA yx;I AYES ❑ NO >50ft. from wells? - - - - - - - - - - - - - - - - - - - - - - - - - - - ❑ Z >50 ft.from surface water? - - - - - - - - - - LS:i5a�lturer . ® ❑HCleancut between building and tank? - - - - - _ _ O ❑0Tank baffles present? - - - - - - - - - - - - - - - 4 ❑� ❑a24"access risers over each compartment?- - - - - 0 ❑W Effluent filler installed?- - - - - - - - - - - - - - - - - - -N eySeptic tank capacity(working) 1000 lurer Hagerman 0 D-box water level and speed levelers used? - - - - - - - - - - -- - - - ❑ NrA ❑ YES Q NO 0J 0 Manifold/D-box accessible from surface?- - - - - - - - - - - - - ❑ ❑ o7Z Check valves installed? - - - - - - - - - o.A- Q �-PM'k - - - ❑ ❑LI El 04 2 Transport Line Size 2" Schedule/Class 40 Bedrooms installed (check one) ❑1 2 ❑ 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other 110ft.from foundation?- - - - - - - - -- - - - - - - - - - - - - - - - - ❑ NIA NYES ❑ NO 0 1100 ft from wells?- - - - - - - - - - - - - - -- - -- - - ❑ 0 ❑ W1100 ft from surface water? - - - - - - - - - - - - - - - - - El ❑f El a >10ft. from potable water lines?- - - - - - - - - - - - - - - - - - - - - - ❑ ❑� ❑ Q > 5ft. from property lines and easements?- - - - - - - - - - - - - - - - ❑ W ❑ X > 30 ft. from downgradlent curtain/foundation drains? - - - - - - - - - ❑ ® ❑ 0 Drainfield level and observation ports present - - - - - - - - ❑ © ❑ ❑ Graveless chambers or Q Clean gravel used? (check one) Proper cover installed over drainfield?- - - - - - - - -- - - -- - - - - - ❑ ❑� ❑ Pump tank setbacks consistent with septic tank? - - - - - - - - - - - - - ❑ NIA Q YES ❑ NO Y Pump tank capacity (flood) 1000 gal Manufacturer Haberman F24' access riser(s) and accessible from surface?- - - - - - - - - - - - - ❑ © ❑ d Alarm or Control Panel Installed? - - - - '� y"'�-- - - - - - - ❑ � ❑ Control Panel equipped with Timer/ ETM /Counter- - - - - - - - - - ❑ 0 ❑ a Pump installed in K Bucket or ❑ On Block or ❑ Other E' Pump Make/Model Liberty 280 Floats or ❑ Transducer 2 =) Tank draw down 2 in/min Pump capacity 38 gpm Squirt Height 5 ft IL Pump on time 1.5 Minutes Pump off time 6 Hours Daily flow set at 228 gpd uream�brv�oie e 12'iO4 41- 40021 Mason County OSS Installation Report pg. 2 Parcel# ABANDONMENT RECORD YES ® NO Were existing septic components aberdoneb as part of:his project? If yes, please describe NO Were all components Pimped out and properly abantloned per WAC2C6-2724-G3CC7 ---"-' - " ❑ YES RECORD DRAWING iryu Is a pertnznent rtaore me mmt ee accumee one aascnprive enough m«Jocaa 1n me neae et mamronance acuvluee and future development TV"i R"s Drawn,:mnoln. orvneHe s nanrtoie ofien'ation a lavom.sapucoun'A'anx loravon Ncc^snow.reserve:ramneia etsans one prccese hWeo-.9s.locreu m.+ans.weteNnee, ..ua.oaaereasoo pmu.aa.nn,:m,aid ome.ma�rze=and—1 pm,r5. mwmpma s.=om omw�ss mar Qesa ada:eonai agar= `^e:'^am,la::w+appA•a;a=e rela:m pa mee. ® Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ENGINEER I certify that 1 installed the system m 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 Masan 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 their ail information contained on this I further certify that all information contained on this form and ad a didDrawing is accurate form and affacned Record Drawing is accurate. 24 Signatu.2 r �aD 4 Pi f' Printed Name of Signee MASON COUNTY PUBLIC HEALTH The undersigned approves this Ini6 motion Rob and p Record Drawing on behalf o/Mason`V'o,{INty Pub c(J v / �� _ vnutn Jo H ealth: gl7/T�aYra ), Health Specialist Oct. (stamp, signature and date) THIS FORM MAY BE SCANNED ANC AVAILABLE FOR PCB_IO'VIEN ON THE MASON COUNTY V,B SITE ao=a.m erz.rzas o ?0 0o ao i10 ASP�u�y-c �39 ftllar t Lza ( ar$7LnSCY� Sq � rcel� lz3o9- '-{\-good g; NE er I s vz r0.P � �nktruovs 6 7 wi'�, re52rY2S ad)0.ctn-t r 6 Zkbo- .V Audio-Visual Aiarn' Cleanout �3l 1000 Crallan 3eptle Tank 1 U 2-Conparnnem with Effluent PIlter ,n 1000 Gallon Pump Chanlb \J W�-�{•�, 0....1�' - SCPtrov. 0 Valve Control Box 35-lo. _9 mA Hoy.sa d sea. p,-,vewc j r n +o d� wilt PP PAULA JOY JOHNSON Q UG ? 2024 "r :