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Home My WebLink AboutSWG2020-00560 - SWG As-Built - 8/6/2024 Mason County OSS Installation Report pg. I MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2020-00560 Parcel# 22233-52-00017 Applicant Name Jay Hambly Subdivision (Name/Div/Block(Lot) Applicant Address 2191 Mason Lake Dr. E. City, State, Zip Grapeview,We 98646 Installer Name Pioneer Digging Inc Site Address Same Designer Name Bob Paysse INSTALLATION CHECKLIST ❑ Full System Installation ❑Tank(s)Only ❑ Dminfiekl Only E Repair ❑other System Type ATU-Pressure Pretreatment Type NuWater BNR 500 >5ft.from foundation? ---------------------------- ❑N/A EYES E] NO >50ft.from wells? ------- ---------------------- ❑ M ❑ _ >50ft.from surface water? -- ---------------------- ❑ HCleanoul between building and tank? ------------------ . ❑ ❑ U Tank baffles present? -- ---- ----- ❑ ❑ a24"access risers over each compartment?---------------- ❑LIJ ❑ N Effluent filter installed?--- --- ---------- --- ----- -- . ❑ ❑ Septic tank capacity(working) NUWater gal Manufacturer Sound Placement �0 D-box water level and speed levelers used? - -------------- SN/A ❑YES E] NO Ou Manifold/D-box accessible from surface?---------------- - ❑ ® ❑ �Z Check valves installed? ---------------- - --------.. ❑ x ❑ O Transport Line Size 2' Schedule/Class 40 Bedrooms installed (check one) ® 2 ❑3 ❑4 ❑5 ❑6 ❑Commercial/Other >10ft.from foundation?- ------------------------.- E] NIA NYES E] NO G >100 ft.from wells?----------------------------. ❑ ❑ W >100 ft.from surface water?- --- -------------------- ❑ 0 ❑ ILL >10ft.from potable water lines?---------------------. ❑ LN ❑ <_ >5ft.from property lines and easements?--------------- - ❑ ❑ K >30ft.from downgradient curtain/foundation drains?---------- ® ❑ Dralnfield level and observation ports present --- -- ❑ ® ❑ ❑ Graveless chambers or E Clean gravel used? (check one) Proper cover installed over drainfield?------------------ - ❑ . ❑ Pump tank setbacks consistent with septic tank?--- -- ------- - ❑ N/A ® YES ❑ NO ZPump tank capacity(flood) 1200 gal Manufacturer Sound Placement Q 24"access dser(s)and accessible from surface?------------ - El ® El SAlarm or Control Panel Installed? ------ - - - - ---------- - ❑ ® ❑ Control Panel equipped with Timer/ETM/Counter-- -- -- -- --- ❑ ® ❑ IL Pump installed in ® Bucket or ❑ On Black or ❑ Other gPump Make/Model Little Giant ❑ Floats or ® Transducer y Tank draw down 1.5 in/min Pump capacity 35 qpm Squirt Height 24+ ft Pump on time 1 min, Pump off time 6 him Daily flow set at 225 gpd ucWWWIrzete Mason County OSS Installation Report pg. 2 Parcel u 22233-52-00017 ABANDONMENTRECORD Were existing septic components abandoned as pan of this project? ------------- - - ❑ YES No If yes, please describe: Were all components pumped out and property abandoned per WAC246272A-0300? ------- - ❑ YES ❑ No RECORD DRAWING Tlib b e pe....W end court M e¢u."W Wl .n .Qh le Mount M Ns coed 0..1..MMIbe..d Mun brelopmeM Tygml aamtl e�ew49e wnwn IXelnfieN 8 menHaN mienbfiw 6 byoN,aeplltlWmp bnh bw4on,WM envx,mane BnIMNN,etleWp ant DIDWeaC Wlbvea,Yxalbn orwBpa,webMnee. web.Melrvalpn pyb.tleemub.vM oMrmtlribnerve eaeas DWMe. Inwmpble a®�tl emwVee mY aeaN efifillFnel Eaep In fiM MCWaYT yplwa ant IWM pennXs. 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 Geared/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 that all information contained on this I further certify that all information contained on this Porn and attached Record Drawing is accurate. form and attached Record Drawing is accurate. I-/ ,4 ...,.«- 7/11124 Signature of Installer Date Robert H.Psysse Printed Name of Signee P MASON COUNTY PUBLIC HEALTH ,Sri The undersigned approves this Installation Report and ° R Record Drawing on behalt of Mason County Public Health: signature of Env/ronmenre Hsafth Specieltat Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE uDml.a eaveata MASON LAKE s � i O \ \ RUN TRANSPORT LINE UNDER HOME V ✓�\ SLEEVEIN 4"3034 EXISTS EXISTING � \ TVEWT�AfdS�ORTLINE NUWATER BNR500 // SLEEVE WHEN DV.PIN & PUMP TANK ' // 50FT OF WELLS \ SWG2012-00118 \ i iI \\ / \\ EXIST \ EXISTING FAILED �� WELL DRAINFIELD IST. \ \ \ELL / \\ �� PROPOSED REPAIR \\ // DRAINFIELD . EXIST. WALL EXPIRE bdTABLE-9 REPAIR MEETING / o TL-B W/OUT AND VERTICALDISINFECTION OF SEPARATION PIONEER. DIGGING, NC- CUSTOMER: IAY HM1BLY SCALE:Nia PARCEL t.2M3-52000r7 TEST HOLE t TE4T WOLE 2 SEPTIC DESIGNS DRAWING PLOT PLAN 044GLS 048ab 3083EMAtiON BFTIAJN RD. GRAPE IEW,WA%546 DESIGNER: ROBERTPAYSSE 44+TILL 4� ' OFHCE-3604261803 FAX-36lM7F-2353 ROOTS'44 ROOTS-48 DESIGN PAGE _OF_ OBPORT CLEANOLrr AT FEEr GRADE ORIG. GRADE THREADED CAP IILTEP 'IT j ORIFICES FABRIC I GLVED TEE MER OR VALVE :• OtBALL . [ •• CHECKVALVES CUSIOMR- •NEFR DIGGINQ INC PAPcEL t wm-52-000t7 TESTHOLEI: . . . . . SEPTIC DESICNb DRAWING' PLOT PLAN 44+TILL 48+TILL EDESIGN