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HomeMy WebLinkAboutSWG2024-00180 - SWG As-Built - 8/20/2024 r Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2024-00180 Parcel# 42204-51-00048 Applicant Name Uchenna Abakporo Subdivision (Name/Div/Block/Lot) Applicant Address 6234 Flora Ave S LAKE CUSHMAN#6 TR 48 City, State, Zip Seattle WA 98108 Installer Name TJ's Excavating Site Address 91 N Duckabush Or W Hoodsport Designer Name Arrow Septic Designs Inc INSTALLATION CHECKLIST Full System Installation ❑Tank(s)Only ❑ Drainfie d Only ❑Repair ❑Other System Type Pressure Bed Pretreatment Type >5 ft. from foundation? - ------- ------ ----- --- - --- ❑IUA OYES ❑ NO >50ft,from wells? -- - - - --- --- ------ ------ ------ ❑ ❑ Z >50ft,from surface water? -- - -- - - - --- ------- - - --- El ❑ r Cleanout between building and tank? - -- - --- ------- -- --- ❑ ❑ L) Tank baffles present? - - - - - -- --- -- - - - -- El ElF- 24'access risers over each compartment?- - - - ------------ Cl ❑ Q. El ® El Effluent filter installed?- - - - - --- - - - - - - - - - - - - ---' N Septic tank capacity(working) 1,200 gal Manufacturer man M D-box water level and speed levelers used? --- - ----------- ❑ NIA Hager❑ YES BNO 00 Manifold/D-box accessible from surface?-- - - - - -- - -- - - - --- ❑ ❑ e mZ Check valves installed? -- - - -- - - - - - - -- - - - - ---- -- ❑ ® ❑ oa 2 Transport Line Size 2 inch Schedule/Class 40 Bedrooms installed(check one) ❑ 2 ®3 ❑4 ❑ 5 ❑6 ❑CommerciallOther >10ft.from foundation?-- - - ----- -- - -- - - - ------ - - - ❑ NIA ® YES ❑ NO >100ft. from wells?----------------- - ----------- ❑ ❑ w >100 ft.from surface water?- ------- ------- ----- -- - ❑ ❑ a >10ft.from potable water lines?- - - --- - --------- - - - - - - ❑ ® ❑ Z > 5ft.from property lines and easements?- ------- ----- - - - ❑ ® ❑ R > 30 ft.from tlowngredient curtain/foundation drains?- -- - - --- - - ❑ ® ❑ Drainfield level and observation ports present - - - --- - - - --- -- ❑ ® ❑ ❑ Graveless chambers or M Clean gravel used? (check one) Proper cover installed over drainfield?- -- - - -- --- - - -- ----- ❑ ® ❑ Pump tank setbacks consistent with septic tank?------ - -- - - -- ❑ NIA ® YES ❑ No Y Pump tank capacity(Flood) 1,000 gal Manufacturer Hagerman Q24-access nser(s)and accessible from surface?-- ------ --- -- ❑ W ❑ ~ Alarm or Control Panel Installed? - -- - - - - - - - - - - - - - - - --- ❑ 0 ❑ a E Control Panel equipped wkh Tmer/ETM/Counter-- - -- --- - - - ❑ ❑ a Pump installed in ❑ Bucket or ® On Block or ❑ Other a Pump Make/Model Liberty 280 ' ❑ Floats or 0 Transducer � Tank draw down 1.25" in/min Pump capacity 24 gpm Squirt Height 7 ft a Pump on time 3.75 min Pump oft time 6 Fir Daily flow set at 360 gpd uemuaamro,e Mason County OSS Installation Report pg. 2 Parcel# �'2204-SI-�x7o4 ABANDONMENT RECORD YES No we, existing septic mmponems abandoned as part of this project? --- ---- -- ❑ ' If yes, please describe. No Were all components pumped out and probeHY abandoned per WAC246.272A-0300? ------ YES RECORD DRAWING YPm Rye m,.s,w�•^e^ .mb,.a mew a.mm.u..a a.+caW+..nws^m,.iw+u m n.cow a m.;,a.,,.nm.mvle.s a.a nwm a...�aw�m• R7TAC-" -,3 pnxv�aamrM'. ORiMd]BrtuNbW cnemaum6 W'wtS<FaJw^amnk lc®am.NN artux.ne.ne ev�W.daWN.M paN�WJaNi% unman a..db.wm6 ea. n IncvmW.a RxcE pmm6s msY wau ealYCar+tl ad l+N firel motWYm aPPT.e vN iYWapY A. veb.ae.>^wua^o�.u.vms..na mno.ur,w.�¢a xmH 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 actor 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 cleanYoVapproved by both the designer shown here have been c/earadlapproved 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 ,rbly that all information contained on this loan and attached Re rd Drawing is acoufate. form and attached Record Drawing is accurate. Signature lIn ller D to ? s ?p Punted Name of Signea d�'• M1 MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and �r 516 kr Record Drawing on behalf of Mason County Public PAULA JOY JCHNSON Health: Ili Cow `d1z�12`i B-cam-z � signature of Environnlentai Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MABON COUNTY VNES SITE pp°e•0 n12p1B � SLEEvE= wR�eYLucvfi WR"CE'R w1TKIN La ' OF SE TIG COMPONENT o to w 3O : o IOY•so. dk L-CA I Ar�N N RBhKF t5lo > a I P erz 422D4-S1-00d04 MlN o3 `e e 9 r' v I R I N Ducutius+4 MW F1ou5E d ` 1� 67.6iope W A F— — s�tolpe \ ! I 1p'M,PI 1 11Y. ' O (V ,),,,• q - pOM� � � I KOuSE � � NO FOUNDATION DRAIN / 30' DOWN GRADIENT OF 1 PRIMARY/RESERVE GRAINFIELD l zQKv o � Bev; OAudio-Visual Alarm 15' © Cleanout © 1200 Gallon Septic Tank 2-Comparffitaot with Effiuent FUter APPROVED O 1000 Gallon Pump Chamber AUG 20 2024 Q "b�l1 Va_\Ues MASON COUNTY ENVIRONMENTAL HEALTH © Sp 9P-h RET h PAIILA JO JOY JONN50 i%Pi 1 g-1`t�L•F