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Home My WebLink AboutSWG2022-00010 - SWG As-Built - 9/16/2024 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SwG 2022-00010 Parcel # 32104-57-00043 Applicant Name Jeremy Ritchie Subdivision (Name/Div/Block/ t) �CpD$10p Applicant Address 6815 Rosedale St NW ALDERBROOK G&Y#8 LOT:43 RFCc City, State, Zip Gig Harbor, WA 98335 Installer Name Maplewood Construction Site Address 200 E Vine Maple Ln, Union Designer Name Arrow Septic Designs, Inc INSTALLATION CHECKLIST ® Full System installation ❑ Tank(s) Only ❑ Drainfield Only ❑ Repair ®Other sto;-Wn pre-wch Wnk System Type shallow pressure trench Pretreatment Type NuWaler BNR-500 >5 ft, from foundation? -- - -- - - -- - -- -- - - ❑ N/A AYES NO >50ft. from wells? -- - - - - - - - - - - - - - - --- - - - - - - - -- - ❑ ® ❑ Z >50 ft. from surface water? ❑ ❑ F Cleanout between building and tank? - - ❑ x ❑ U Tank baffles present? - ❑ 0 ❑ a24"access risers over each compartment? ❑ 0 ❑ w Effluent filter installetl?- ❑ ❑ N Septic tank capacity (working) Nu Water BNR gal Manufacturer Hagerman _0 D-box water level and speed levelers used? -- -- - ❑ NIA ❑ YES Q NO XO Manifold/D-box accessible from surface?- - - - - - - - - - - - - - - El IN ❑ QZCheck valves installetl? -- - - naf- - cet-`�- - - - -- - - El ® ❑ 2 Transport Line Size 2 inch Schedule/Class 40 Bedrooms installed (check one) [:] 2 ®3 4 ❑ 5 ❑6 ❑Commercial/Other >10ft. from foundation?- - - - - - -- -- - - - - - ❑ N/A ® YES ❑ NO >100 ft. from wells?- - - - - -- --- -- - - - - - o __ ❑ ❑� ❑ W >100 ft.from surface water? -- - -- --- - - - - - -S - - �- - - ❑ 0 ❑ lL >10 ft. from potable water lines?- - - - - - - -e . �p{F ❑ QZ > 5 ft. from property lines and easements?- - - y - - - �1 �J////J{D� El K > 30 IL from downgradient curtain/foundation drains?�•�- - - ��y- C! ❑ ❑ ❑ Drainfield level and observation ports present -- - - - - ��>�- - - - ❑ ® ❑ I] Graveless chambers or ❑ Clean gravel used? (check on91 Proper cover installed over drainfield?-- - - ----- - --- -- - -- - ❑ ME ❑ Pump tank setbacks consistent with septic tank? ---- - - -- - - -- - ❑ WA ® YES ❑ No ZPump tank capacity (flood) 1,000 oal Manufacturer Hagerman Q 24" access riser(s)and accessible from surface?- - -- -- - -- - - -- ❑ ❑ aAlarm or Control Panel installetl? - - - - -- - - - - - - ❑ ❑ Control Panel equipped with Timer/ETM I Counter ❑ ® ❑ _d Pump installed in 0 Bucket or ❑ On Block or ❑ Other IL Pump Make/Model Liberty 280 N Floats or ❑ Transducer 2 a Tank draw down 2.25 in/min Pump capacity 43 gpm Squirt Height 3 ft Pump on time 2 min Pump off time 6 hr Daily flow set at 360 opd U>dLedscoOl6 Mason County OSS Installation Report pg. 2 Parcel# 521 o4 -51 - 00 0`{!) ABANDONMENTRECORD Were exiling septic oomponen[s abandoned as part of this project' - ---- --- YES NO If yes, please describe: Were all :,mponents pumped out and v -- --- - -- YES NO p p properly abandoned per WAC24S272A-0300. ❑ ❑ RECORD DRAWING Tula is a ow,r.,nam r=dm and Mau be a..n.aw and eaar,;aa..a a oo r .cw,i,m., d s,—ii,un.nea a vrd.e,and wsr eaaW—srL Tarai aarwd 0101AA. 6.,: Dissli d a rM1ViWd.ii nvNm a IaY..1.S.go'p.me tanl,I.-,Wnh an3.V,reSErvp&d dd .addr,p Mp pCtg56e btXlGnp6.aGI6n cluvl5.add,Mes. wells,oMe nassa.tlsarcub,srd dw maaaandmes¢ss spots. I—,di R%:N 0.1 mat.aldai—I .,.In Invl'inwWtim app2vel and rested esorib. Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ENGINEER I certify th 7t 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 Pr blic Health and that any deviations shown Mason County Public Health and that any deviations here have been cloared/approved by both the designer shown here have beer,cleared/approved by both and Maso n County Public Health and meet all State myself and Mason County Public Health and meet all and Maso r County Codes. State and Mason County Codes 1 further ce rtffy that all information contained on this I further certify that all infomtation contained on this form and a JYached Record Drawing is accurate. form and attached Record Drawing is accurate. A— 01 �0 24 Signature c Installer Date . r Printed Nave of Stgnee d y F. MASON C JUNTY PUBLIC HEALTH The under igned approves this Installation�{�°on ant , ' ae Rocord DA,Wing on behalfofA ;11untyH�Gb0Ira� O PAULA JOY JOHNSON Health: o�(7,yry O 1oZy L Sign um rn Environmental Heath Speci fist Date ( (T (Stamp, signature and dale) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE owaLe erzvv::e Strrmy R4Ch e °` Rirr.rt 4F�2104 57-Gnny3 200 A V:n.. Mp� Ln `,�s Scalt : ! "'= 2 , e o ie ao 30 50 ®4�` 1 G 1N0 F. � 5 0 Q 00 \h T O 9j -sue •q ppR 3x35' pT;vhar o✓q°y�EyTky�cn DF -rrehc4uS o� 5" O.C . wig h 900 Sp dr p �i Audio-VlaualAlarm reservf as Showvs O2 Cleanout . ® 500 Gallon Pre-'-r-sah O4 NuWater BNR-500 ATU Tank f OS 1,000 Gallon Pump Chamber a O6 Valve Control Box - tr ID JY f PAOIA JOY JOHNSON .