HomeMy WebLinkAboutSWG2024-00314 - SWG As-Built - 9/18/2024 Mason County OSS Installation Report P9 1
APP
Penult Number SING 2024-0031gLICANT/PERMIT INFORMA IO MASON COUNTY PUBLIC H LTH
APPlicant Name Suzanne Parcel# 12233-
gpplicantA Smith 50-00004
Address 70 E.Roc l Point Lane Subdivision (Name/Div/BIocWLot
City, State, Zip Belfair, ) C
Site Address we 88528
Same Installer Name Pioneer Di
Name Desi ner N ing Inc 2
9 Bab Pays t
❑Full System Insta INSTALLgTION CHECKLIST
llation []Tenk(s)On
system Type b �grainfield Only
> ATU-Dd ❑RePalr ❑Other
5ft.arm fountlatlon7 ._________________ Pretreatment/A BN��R Soo
Y from wells? ._____________________ __
>50 R.frO ___.. ❑Nu Z m sudace water? - ❑ res ❑No
ta, Clean out between building and tank? _--------- e F -----
ILLTank present7 ---- - - ---------------------- ❑ ❑
24 accea users over each ❑ ❑
to Effluent filter installed? �mPanmant?-----___- _ ❑ ❑
Septic tank capaciN(working) 12 ________________ - ❑ ❑
9 D-box —�� Bel ❑ O
water level and speed levelers u Manufactuler
pLL Manifold/D�x accessible setl? - -----_____ Sound Placement
heck
a ranspoalves installetl7 ._imm surface?, WA ce?- ❑?Ea
Transport Line Size � . ❑ S ❑ NO
—�� ❑ ❑
Bedrooms installed(check one) ❑2 08 ❑
>70 ft.from fountla6on?-_____ -•3- �4- 06
p "oo ft.from wells?-__ _-- - �8 ❑CPmmencull/Other
>100 ft. from sudaca Water? --- ❑WA YES
LL >10 ft.from ter?._____------------
a ■ ❑ No
Z Potable wter lines?----- - ❑ ❑ ❑
Q >5ft.from ___-_______-
K >30 k pmpa lines and ease marrd?----___ - ❑ ❑
C .from tlowngretlI nt curtain ------
DreGravefield level antl N°untlaaon tlralns. - ❑ ■ ❑
observation v.�-------. ❑
❑ Graveless cham Ports present -_ ____ - ❑
bars °r ❑ Clean gravel usetl. ❑ ❑
Proper cover installed over tlreinfiaW?-_____- (c�eCk one) ® ❑
PumP tank setbacks consistent with se -_-___- -_- - ❑Y PumP tank Ptic tank?-___________ - ❑
FZ capacity and(fl a 1$00 ❑ NIA
24-amass riser(s)and acco_-�9a1 Manufacturer ■ YES
ssible from Surface? Sound Place ❑ NO
a Alarm or Control Panel Installed? --___-_- cement
daceT.________
4 Control Panel equiPPed with Timer/ETM/Counter--_________- - ❑ a
Pump installed in ❑ ® ❑
IL ❑ Bucket or ❑ On Bock ❑ ❑
PumP Make/Mmel Orenm 112 h or ❑ Omer ❑
P turbine Flow Inducer
4 Tank draw down 1 ❑Floats Or
Pump -- in.m Pump 9 TMnsdu on time 6 min. Pacify-9Pm cer
—�-- Pump off time Squill Height WA
2�� —�_ft
Daley now set at_360
Pd
�caweerzvm�e
Mason County OSS Installation Report pg-2
Parcel 7! 12233-50-00004
ABANDONMENT RECORD ❑ YES ® NO
Were existing septic compo
nents abandoned as part of this project? ---
If yes, p lease describW 24&277h030D7
__ YES NO
Were all components pumped out and properly abandoned per WAC
RECORD DRAWING _
M J••cnlww••n°eaM1 m nJmeb m m.nKa N on"'r-na.NmD•••n,arumemsa,locxw NwYOa WBYRTea
TY b.P•mwwe^mN eM mut M ecwnY• eePridM'PlenklaMYn.NCM aimw.reserve eminfin .exetlnN ens P° dens ielePoa Pumib.
Dm/ny mmMn D�eInMm6menlxe4 oM�MYn6 YY° wapainb. Inoonn, Pemre OteMnps nnY beau a00Nonel Ee•He in xnY imYlWon aPPno"
Deus,Pwenaxan pam,manwb,ere amar n,ehiYrenu
® Record Drawing Attached
CERTIFICATION OF INSTALLATION
DESIGNERI ENGINEER
INSTALLER I certify that the system has been installed In accor-
I certify that I installed the system in accOrdance with dance with Me septic design stamped°APPROVED°by
the septic design stamped"APPROVED"by Mason
Mason County Public Health and that rend by both deviation'
County Public Health and that any deviations shown shown here have been cleared/,pp
th the designer myself and Mason County Public Health and meet all
here have been cleered/appmved by bo
Slate and Mason County Codas
and Mason County Public Health end meet all State I t. ancertity that all information contained on this
and Mason County Codes.
rtn d Rwrd
I further certifycertifythat all information contained on this /o an attached e Drawing is accurate.
form and attached Record Drawing is accurate.
SI1/2024
Dale
Signature of Installer
P
Robert H.PBVSa6 a"'
Ptlntad Name of Sign" n
MASON COUNTY PUBLIC HEALTH 9("till+ ro„eM,a�.
The undersigned approves this Installation Report an
Record Drawing on behalf Of Mason County Pubic EXPIRES
Health: 'cm R k 6 (/-I` '-
I (stamp, signature and date) m x
signs Nre of Environmenfel Health SPecieiisf Dare
N ODONT'WEB SITE
THIS FORM MAy BE SCANNED MO AVAILABLE FOR PUBLIC VIEW ON THE MASO
25- �
\ (L ---� I 15�14
\\ 'F------------- __-_1;7
A14AC I ------------------Y
RELIEF VALVES ------ ------------
(ASNEEDED� -------' --------
�\ I ----4----------=� 1 000
odo I -------/----
----------
PROPOSED PRIMARY: I - ---T /
1200 SOFT- 600 LNFT I �L I -----_--_-_- /
24 LINES ®25FT -�--r---- _
--- - /
24"ON CENTER. --�_ _______ __ ____ / i , �o
6 -150FT LATERALS ---z----------------
---L--'-------------- 2
I ---/ L--------------- / _ '\��
--4--�'-------------- ^' o
EXISTING -------------
HEADWORKS I �-t------I---------
(RE-USE) _ ---------- / \
EXISTING TANKS
(NO CHANGES) I CURRENTLY g
�I INSTALLED
DRAINFIELD AREA
SEE NOTES
I
I
PIONEER. DIGGIlV WG PU M: Z E&MM Xuza:a
373E SEPTIC DESIGNS ADDRES4 H � TFSTHOUt TgTHOLE2
IF]ViJN RD GRMEVR'1{,N'.19N RDL3CYPOIJfW P22L5{gip 0'2 'D.xHa 3G}q�W3 FM 3M1gn�23sI � DBIGNER: RJONXTPAIM 22M5\IL 2F34 MJif.
DESIGN PAGL DFMAI. LS{VD
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