HomeMy WebLinkAboutSWG2024-00236 - SWG As-Built - 9/19/2024 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH
APPLICANT/ PERMIT INFORMATION
Permit Number SWG 2024-00236 Parcel# 31904-53-00023
Applicant Name BRUCE KARR Subdivision (Name/Div/Slock/Lot)
Applicant Address 1770 BE CRESCENT DR
City, State, Zip SHELTON, WA. 98594 Installer Name SCHOENING EXCVATION LLC
Site Address 1770 BE CRESCENT DR Designer Name CINDY WAITE
INSTALLATION CHECKLIST
❑ Full System Installation ❑Tank(s)Only ❑ Dreinfield Only ❑Repair ❑Other
System Type PRESSURE Pretreatment Type
>5 ft.from foundation? - -- - ---- ------ - ---- - ---- - - I-] NIA ®YES NO
>50 ft. from wells? - -- - - -- - - - - - - --- ---- -------- El ® ❑
Z >SO ft. from surface watef? -- - - - - --- - - - - - - ---- -- ❑ ® ❑
HCleanout between building and tank? --- - -- --- - --------- ® ❑ ❑
U Tank baffles present? - - - - - - - - - - --- - - - - - - --- ----- ❑ ® ❑
a24"access risers over each compartment?- - - - - -- --------- ❑ ® ❑
Wy Effluent filter installed?- -- -- - - - --- - - - - - - - - - -- -- --- ® ❑ ❑
Septic tank capacity (working) 1200 gal Manufacturer EXISTING
O D-box water level and speed levelers used? -- --- -- -- - - -- - - ® wA ❑YES ❑ No
aLLManifold/D-box accessible from surface?- -- --- --- -- - - ---- ❑ B ElOQZ Check valves installed? - - - - -- - - - -- - - ---- - - - -- -- - - ❑ ® ❑
Te Transport Line Size 2" Schedule/Class SCHEDULE 40
Bedrooms installed (check one) ❑ 2 ®3 ❑4 ❑ 5 ❑8 ❑Commercial/Other
>10 ft from foundation?- - - - - - - - - - - ---- --- - --- -- -- ❑ wA OYES NO
>100 ft. from wells? - - - -- --- -------- - ---- ❑ ❑
W >100 ft. from surface water? - - - -- -- -- -- - - - ------- --- ❑ ® Cl
Z >10 ft. from potable water lines? --------- --- -- ❑ IN ❑W c
Z >5ft. from property lines and easements?- - - - - -------- - -- ❑ ® ❑..�
>30 ft.from downgradient curtain/foundation drains?- - - - - - -- - - ® ❑ ❑
Dreinfield level and observation ports present - ------ - - -- - -- ❑ ❑ i
E Graveless chambers or ❑ Clean gravel used? (check one) i
Proper cover installed over dreinfield?- - --- - -- - - - - - - -- - -- ❑ ® ❑
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Pump tank setbacks consistent with septic tank?--- - - - -- ----- r
❑ WA ® YES ❑ � I�
Z Pump tank capacity (flood) 1287 gal Manufacturer INFILITRATOR
Q 24"access riser(s)and accessible from surface?- ----- - ---- -- ❑ ® ❑
aAlarm or Control Panel Installed? --- - - - - -- --- ---- ---- - ❑ ❑
Control Panel equipped with Timer/ETM/Counter- - - - - - - - -- - ❑ ❑
o. Pump installed in ❑ Bucket or ❑ On Block or ❑ Other
d Pump Make/Model LIBERTY 280 ❑ Floats or� Transducer
a Tank draw down 1.5 in/min Pump capacity 72 Opm Squirt Height 3 ft
Pump on time 1.4 MIN Pump off time 4 Daily flow set at 277 gpd
Mason County OSS Installation Report pg. 2 Parcel# 31904-53-00023
ABANDONMENT RECORD
Were existing septic Components abandoned as part of this project? -- - - - - - - - --- - - - ❑ YES 0 NO
If yes, please describe:
Were all components pumped out and properly abandoned per WAC246-272A-0300? - ❑ YES ❑ NO
RECORD DRAWING
The he a permmant te,artl nnai must La aCCUMW and dnctlptba though W redocste In the need M Maintenance¢tIVI1M and NW n development Typtal Record
Green,torah: Drawfield a maMNN wlantmion b lapin.SeplwOump lank IpGatbn.NOM anaw.inane,d,ainfied.exhiew and prapnew wi tinge,muhon of wells,an#thee,
wells,Observation xi deaar rats,and other meknenanaa acass paMe. In=nake RewM Draw,ings
smay create addNmal delays in final Insulation approval and related pampa.
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Record Drawing Attached
CERTIFICATION OF INSTALLATION
INSTALLER DESIGNERI ENGINEER
I 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
hem have been cleareaVapproved by both the designer shown here have been cleareelmoproved 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
form and attached Record Drawing is accurate. form and attached Record Drawing is accurate.
cl ct 24
Signthem of Installer Date
Printed Nat
�M�oe-n i,,.rl A3a Yry
eo/Signee � {ys�
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MASON COUNTY PUBLIC HEALTH 5 ooa
The undersigned approves this Installation Report and LICITE
ENSED D SIGNER
Record Drawing on behalf of Mason County Public e.p,es ps,p�
Health:
R lut-v,,tPW t- R ((k zZ
Signature of Environmental Health Specialist Date (Stamp, Signature and date)
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE updeledarzlnals
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