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Home My WebLink AboutSWG2019-00352 - SWG As-Built - 9/18/2024 LNca OCT 2 72023 Mason County OSS Installation Report pg. 1 MASON COUNT R H APPLICANT/PERMIT INFORMATION Permit Number swG 2019-00352 Parcel If 52008-13-90100 Applicant theme Greg Bogdanovich Subdivision (Name/Div/Block/Lot) Applicant Address 500 W. Marketplace City, State,Zip Aberdeen,We 98520 Installer Name House Brothers Site Address 13310 W.Shelton Matlock Rd Designer Name Bob Payne INSTALLATION CHECKLIST ®Full System Installation ❑Tank(s)Only ❑Drainfield Only ❑Repair ❑Other System Type ATU-Pressure Pretreatment Type N. V ter BNR 500 >5 ft.from foundation? - --------------------------- ❑NIA .YES ❑ NO >50 fL from wells? --- ------------------------- - ❑ e ❑ >50 ft.from surface wateo -----------------------. ❑ ® ❑ F Cleanout between building and tank? ------------------ . ❑ ® ❑ L) Tank baffles present? -- --- -- -------------------- ❑ ® ❑ 24'access Nears over each compartment?---------------. ❑ ® ❑ Lu N Effluent filter installed?----- --------------------- . ❑ ® ❑ Septic tank capacity(working) Nuweter g i Manufacturer Mouse-Dwe. (HK4r'1 �9 D-boxwaterlevelandspeedlevelersused? --------------. ■N/A ❑ves ONO 00 Manifold/D-box accessible from surface?---------------- . ❑ e ❑ GaCheck valves installed? ----- -- ------------------ - ❑ ® ❑ Transport Line Size 2- Schedule/Clan 40 Bedrooms installed (check One) ❑2 E 3 ❑4 ❑5 ❑6 ❑CommerclaVomer >10ft.from foundation?-------------------------.- ❑WA ■y s ❑ NO W >100 R from wells?----------------------------- ❑ 0 ❑ >100 ft.from surface water?-----------------------. 0 ❑ ❑ 6 >10ft.from potable water lines?---------------------- ❑ E ❑ as >5 ft.from property lines and easements?--------------- - ❑ ® ❑ C >30 ft.from downgradient curtain/foundation drains?---------- ! ❑ ❑ CCCC Drainfield level and observation pods present -------------- ❑ ❑ ❑ ❑ Greveless chambers or E Clean gravel used? (check one)Proper cover installed over drainfeld?------------------ - ❑ �\Is `!_J3 Pump tank setbacks consistent with septic tank?------------- ❑ WA a vas ❑ No iPump tank capacity(flood) 1500 at Manufacturer House Bros. r 24'access riser(s)and accessible from surface?------------ - ❑ 0 ❑ y Alarm or Control Panel Installed? --------------------- ❑ ® ❑ ? Control Panel equipped with Timer ETM/Counter- -- - ------- ❑ ! ❑ a Pump Installed in ® Bucket or ® On Block or ❑ Other Pump Make/Model Liberty 280 ® Floats or� ❑Transducer yTank drew down_�, In/min Pump rapacity b O ypm Squirt Height 24- ft Pump on time rh:h Pump otF lime ou., Daily flow set at gpd Mason County OSS Installation Report pg. 2 Parcel# 52008-13-90100 ABANDONMENT RECORD Were existing Septic components abandoned as part of this project? ------------ - - . ❑ YES ❑ NO If yes, please describe: Were all components pumped out and properly abandoned per WAC246-272A-03007 - ------ - ❑ YES ❑ NO RECORD DRAWING Taft ft a Panneftn nunm and man w amNaa w di enough a raaeda In as need a nminana"am aeavxftli and own Laeaii Troia Record pawaN¢ : eniifiae a manand ana adan 6 by"-SnOd Tap aNt ewmaN en—.miens dranikidwwnsand prgwf Wilem,Wuxi 0 wan,a'abnlirw, bee.oaarvedm pwb.Wanoub,ar4 dNrmN,lnariu amaa polnb. Lm'gmpYURamm CesM p may aaab WONnW daayam Nat ImftWdm appmM W mlabd parmib. ❑ Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ENGINEER I certlly that I insisted the system In accordance with I certify that the system has been installed in Seder- the septic design stamped APPROVED'by Meson dance with the septic design stamped'APPROVED"by County Public Health and that any deviations shown Mason County Public Health and that any dandelions here have been cleered/approved by both the designer shown here have been cdeamd/appromd by boo and Meson County Public Health and meet all State myself and Mason County Public Health and meet all anti Masan County Codes. State and Masan Couraly Codes I further certify that all information contained on this I further Identify that all information contained on this form and attached Record Drawing is accurate. form and attached Record Drawing is accurate. CLll. �a✓ P�2lm �Z� Stan a onafa11ll\e\r Dere JI)e Pared Name of S/gnee MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and W. Record Drawing on behalf of Mason County Public Health: FxniREe y vv�`sw� I It f6 27 Signature of EnWronmama/Health Spacladiat Date (Stamp,signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MMON COUNTY WEB SITE UplNdMr Ma EXI5TING BULKHEAD NEW HOME --- \ \ h 10' \ Ei NVWATER& Y 1p PUMPTANK INSTALLE RAI D EXISTING \\SELL DNFIELD \ \ � SHARED WELL APPROVE Sy 1% 2111 Rsa \ ENNRCNMENiALHx\ i N,pSONCOUNVAIL RE1 \ t , \ / BE aiAMEDATnME OF516NOFF/ASlVILT FEE WILL 9E 6 W RGED AT THE OF I N3TA WTION PIONEEP, DIGGING, ING MRC.Ft.ois 1390= A LLrl:tl SEPTIC DESIGNS ADDRU§S: L991pB TONMAliO M 3pM3EMM.`\pE\t�\RR f,RApEVIEN',\\'h 9A5i6 DEJG\ER: ROBMTPAYSSEME I "°" OFFCr W416LA13 F�\ 3Lr112/d353 Mt JGS PAGI= ASBUILT