HomeMy WebLinkAboutSWG2019-00335 - SWG As-Built - 2/16/2024 RECORD DRAWING (ASBUILT) pg. 1 MASON COUNTY PU IC HEALTH
PARCEL IDENTIFICATION
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Permit Number SwG 2 Ize/exeao- 3 r' Assessor Parcel# tzioe-at-gogeo
Applicant Name Bartare Steel Subdivision (Name/Div/BlocklLot) R 9Z�74
Applicant Address 401 E Sim"Island Rd S F�F,
City, State, zip Grzpeview,Washington 96546 Installer Name Jack Johnson
Site Address 399 E Stretch Island Road S,Grapwiew Designer Name Michael Staten(Envimter Engineering)
INSTALLATION CHECKLIST
® Full System Installation ❑Tank(s)Only ❑Grainfield Only ❑Repair ❑Other
System Type onp System Pretreatment Type NuWaler BNR500
>5 ft.from foundation? -- - - - - -- fixl/�FeTSF{�]���1Ip ❑ NIA ®YES ❑ No
- El
ft.from wells? - - - --- - - - - - - -- - -_ - --1J" _- ❑ ®
Z >50 ft.from surface water? --- ----- -}Q{�rli -292A 1-10 El
FCleanout between building and tank? ---- --------------- ❑ ® ❑
U Tank baffles present? - - - - - - - - - - - $X==�-- - - ❑ ® ❑
1- 24"access risers over each compartment?- -- ----- -- ------ ❑ ® ❑
IL
w Effluent filter installed?-- - - - -- - --- --- - - - - -- - -- ---- ❑ ® ❑
N
Septic tank size /zoo gal Manufacturer Na
0 D-box water level and speed levelers used? -- - - - - - - - -- - -- - ® WA ❑YES ❑ NO
0J
0 Manifold/D-box accessible from surface?- - -- - -- ---- - -- --- ❑ ® ❑
a?Z Check valves installed? ---- - - -- --- - - ----- -- - - - - ❑ ❑ ❑
DQ f Transport Line Size 1.5 in Schedule/Class astm 3034
Bedrooms installed(check one) ❑ 2 03 ❑4 ❑ 5 ❑6 ❑Commercial/Other
>10ft.from foundation?- - - - - - -- - - - - - - - - - - - - - - ---- ❑ WA ® YES ❑ NO
0 >100 ft.from wells?- -- - - - -- -- -- -- - -- - - -- - -- -- --- ❑ ® ❑
W >100 ft. from surface water? -- - - - -- -- - - -- -- -- -- - --- El ® El
ME >10ft.from potable water lines?- - - -- -- -- -- - - - -- -- ---- ❑ ® ❑
Qz >5 ft.from property lines and easements?-- - --- - - - ---- -- - ❑ ® ❑
K >30 ft.from downgradient curtain/foundation drains?------ ---- ❑ ❑
0 Drainfield level and observation ports present - - - - - - --- ----- ❑ ® ❑
® Graveless chambers or ❑ Clean gravel used? (check one)
Proper cover installed over drainfield?- --- --- --- -------- - ❑ ® ❑
Pump tank setbacks consistent with septic tank?-------- ----- ❑ WA ® YES ❑ No
W. Pump tank size 10D0 gal Manufacturer Na
Q24"access riser(s)and accessible Thom surface?-- -- ------- -- ❑ ® ❑
~ Alarm or Control Panel Installed? - - ---- - --- - --------- - ® ❑ ❑
a
f Control Panel equipped with Timer/ETM/Counter- - --------- ® ❑ ❑
7
a Pump installed in ® Bucket or ❑ On Block or ❑ Other n/a
d Pump Make/Model Orenco ® Floats or ❑ Transducer
a Tank draw down-- in/min Pump capacity - gpm Squirt Height - ft
Pump on time - Pump off time - Daily flow set at - apd
iIN�1N/2m5
Mason County OSS Installation Report pg. 2 Parcel It 121084100080
ABANDONMENT RECORD
Were existing sapfic components abandoned as part of this project? ---------- - - - - - YES ❑ NO
If yes,please describe: ---
Were all components pumped out and property abandoned per WAC246-272A-0300? ---- --- - rEs ❑ NO
RECORD DRAWING
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Record Drawing Attached
CERTIFICATION OF INSTALLATION
INSTALLER DESIGNER/ENGINEER
1 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 clearadiapproved by both the designer shown here have been clearediapproved 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
fo nd at C ad Record Drawing is accurate. (orm and attached Record Drawing is accurate.
2-22-23
S no mofl taller � Date
pE 9
Printed Memo olSgnee
MASON COUNTY PUBLIC HEALTH
The undarsignsd appmves this Installation Report and
Record Drawing on behalf of Meson County Public
S'rrOAALENO
,l �_�6 -�2 y
e of —mantel Specialist Date (stamp, signature and date)
THIS FORM MAY BE SCANFD AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE uamiea amnare
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