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HomeMy WebLinkAboutSWG2021-00690 - SWG As-Built - 8/5/2024 RECORD DRAWING (ASBUILT) pg. 1 MASON COUNTY PUL3LIC HEALTH PARCEL IDENTIFICATION Permit Number SWG2021-00690 Assessor Parcel# 320105001030 Applicant Name Shelly Brander Subdivision (Name/Div/Block/Lot) 0102 Applicant Address 5456n,Avenue East RECfIV City, State, Zip Kalispell, MT 59901 Installer Name Workman Construction Site Address 1401 E Beaver Ave, Shelton Designer Name Becky Rieder INSTALLATION CHECKLIST ❑ Full System Installation ®Tari Only ❑ Drainfied Only ❑ Repair ❑Other System Type Lift Station - Pretreatment Type >5ft. from foundation? - - - - -- - - - - - - - - - - - - - - - - - - - - - ❑ NIA ® YES ❑ NO >50ft. from wells? -- -- - - - - - - - - - - - - - - - - - - - - - - - - - ❑ 0 ❑ Y >50ft. from surface water? - - - - - - - - - - - - - - - - - - - - - - - ❑ ❑ Z HCleanout between building and tank? - - - - - - - - - - - - - - - - - - - ❑ ❑x ❑ U Tank baffles present? - - - - - - - - - - - - - - - - - - - - - - - - - - - ❑ x❑ ❑ E- 24"access risers over each compartment?- - - - - - - - - - - - - - - - ❑ x❑ El W Effluent filter installed?- - - - - - - - - - - - - - - - - - - - - - - - - - - ❑ ❑s ❑ N Septic tank size 1500 gal Manufacturer Sound Placement D-box water level and speed levelers used? © NIA ❑ YES ❑ No J 00 Manifold/D-box accessible from surface?- - - - - - - - - - - - - - - - - © ❑ ❑ mz Check valves installed? - - - - - - - - - - - - -- - - - - - - - - - - - - ❑ 0 ❑ oa 2 Transport Line Size 2" Schedule/Class SCHD 40 Bedrooms installed (check one) ❑ 2 ❑3 ❑4 ❑ 5 ❑6 ❑Commerci /Other >10ft. fromfoundation?- - - - - - - - - - - - - - - - - - - - - - -- - - ❑ NIA ❑ YES El NO 0 >100 ft from wells?- - -- - - - - - - - - - - - - - - - - - - - - - - - - - ❑ ❑ ❑ W >100 ft from surface water? — - - - -- - - - - - - - - - - - - - - - - - El El ❑ M >10ft.from potable water lines?- - - - - - - - - - - - - - - - - - - - - - ❑ ❑ ❑ Z > 5ft. from property lines and easements?- - - - - - - - - - - - - - - - ❑ ❑ ❑ K > 30 ft,from downgradient curtain/foundation drains?- - - - - - - - - - ❑ ❑ ❑ C3 Drainfield level and observation ports present - - - - - - - - - - - - - - ❑ ❑ ❑ ❑ Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?- - - - - - - - -- - - -- - - - - - ❑ ❑ ❑ Pump lank setbacks consistant with septic tank? ❑ NIA ❑ YES ❑ NO Y Pump tank size gal Manufacturer Q24"access Inserts)and accessible from surface?- - - - - - - - - -- - - ❑ El ❑ IL IL Alarm or Control Panel Installed ❑ ❑ ❑ Control Panel equipped with Timer/ETM /Counter- - - - - - - - - - - ❑ ❑ ❑ 7 a Pump installed in ❑ Bucket or ® On Block or ❑ Other 1L Pump Make/Model Zoeller Ejector x❑ Floats or ❑ Transducer 2 =) Tank draw down in/min Pump capacity gpm Squirt Height ft a Pump on time On Demand Pump off time Daily Flow set at gpd Vp0a1¢tl 11/]/P➢15 MCPH RECORD DRAWING (ASBUILT) pg. 2 Assessor Parcel#320105001030 RECORD DRAWING ❑X Dramfield&manifold orientation&layout wldimensions for re location O Trench/bed dimensions and critical distances within layout ® SeptiUpump tank placement Q Location of buildings exlstlnlypropn5ed 0 Observation pods, clean-out locations, &mandolded-boxes Q Location of well, surface water,roads, &waterlines. ❑x Reserve area(s) QX Noah Arrow If the designer or installer feel the need for additional information/comments, it may be attached. Record drawing may also be on a separate page attached. No. Pages Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER 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 1 further certify that all information contained on this I further certify that all information contained on this form and attached Record Drawing is accurate form and attached Record Drawing is accurate. 6sami 7&z6o a f 07.26.2024 Date Jamie Workman Printed Name Of Signee MASON COUNTY PUBLIC HEALTH - ,q The undersigned approves this Installation Report and h !� Record Drawingon behalf of Mason Count Public eacq Rieder '3 Y '1 G R Healft (. yn g (S' [� 6 ,�iQ�o 07.26.2024 Signature of Environmental keelar Specialist Date 1 (designer's stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB 8ITE rx ieu 1L 1Q 15 J c Z o c3o=- CmV� -za aNF3 ono x's s - O LL g o' uj wz 0 00 _ b O _ \W w \h O 0 O " ;CS OD 9 �b O)S aJy / 1 2F \ Q4P�y ?j Q. \ /5 d� a �