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HomeMy WebLinkAboutSWG2021-00358 - SWG As-Built - 9/19/2024 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2021-00358 Parcel # 32122-50 - C 0 53(P Applicant Name RON COONE Subdivision (Name/Div/Block/Lot) Applicant Address PO BOX 624 City, State, Zip BRINNON, WA. 98320 Installer Name TJ'S GOOS EXCAVATI Site Address 31 E SOMMERBY Designer Name CINDY WAITE INSTALLATION CHECKLIST A ® Full System Installation ❑Tank(s)Only ❑ Drainfeld Only ❑Repair ❑Other AFC 10 System Type PRESSURE Pretreatment Type BNR 500 F >5 fL from foundation? - ----- --------------- ------ ❑ WA ®YES ❑ >50ft. from wells? - - - - -- ----------------------- ❑ ® ❑ Z >50ft. from surface water? - - --------- ----- -------- ❑ ❑ Cleanout between building and tank? ------------------- ❑ ❑ U Tank baffles present? - - - - - - - - - --- ----------- ---- ❑ ❑ 6~. 24"access risers over each compartment?---------------- ❑ ❑ W Effluent filter installed?- -- -- -- --------- ------ -- --- ❑ ElSeptic tank capacity(working rV Of) ¢DV_Q!�`aI Manufacturer's O D-box water level and speed levelers used? --- ------- - - -- - ® WA ❑YES ❑ NO 0O Manifold/D-box accessible from surface?- --- ------ ❑ ❑ mZ Check valves installed? ---------- - -- - --- - ❑ ❑ ❑ DQ M Transport Line Size 2" Schedule/Class SCHEDULE 40 Bedrooms installed (check one) ❑ 2 M 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10ft.from foundation?- ----------- - - - ----------- ❑ NIA ® YES ❑ No- G >100 ft. from wells?- -- ------------ - - -- ---------- ❑ ® ❑ W >t 00 ft. from surface water? - -_ __ _ _ _______ --- ❑ ® ❑ IL >10 ft. from potable water lines? ❑ ® ❑ QZ > 5ft. from property lines and easements?- - - - - ---- --- - ❑ ® ❑ C > 30 ft. from downgradient curtain/foundation drains?-- - - - - - --- M ❑ ❑ Drainfield level and observation ports present --- -- ❑ ® ❑ ❑ Graveless chambers or M Clean gravel used? (check one) Proper cover installed over drainfeld?- ---- -- - --- ---- ---- ❑ ® ❑ Pump tank setbacks consistent with septic tank?------------- ❑ WA Q YES ❑ No `1 Pump tank capacity (flood 120z sal Manufacturer Q24" access risers)and accessible from surface?------------- ❑ M ❑ aAlarm or Control Panel Installed? -- - - --- - -- ----------- ❑ M ❑ 7 Control Panel equipped with TimerIETM/Counter- ------- - - - ❑ M ❑ a Pump installed in ❑ Bucket or [&On Block or ❑ Other �YPump Make/Model ® FI ats or ®.Transducer CL Tank draw down ( •ZS in/min Pump capacity 2� apm Squirt Height �� ft Pump on time 21 r•n Pump off lime 6h ✓'7 Daily flow set at 270 opd up�wlmie Mason County OSS Installation Report pg. 2 Parcel n 32122-00336 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? ---- -------- - - - ❑ YES Q NO If yes, pies"describe: Were all components pumped out and property abandoned per WAC246272A-0300? ---- - - - - ❑ YES ❑ NO RECORD DRAWING nla is.permanent record and must a accurate and daapdpuve.dough m sAmirs en me need m memtenanca acdvmaa and ndpra dimmi.mr.m. Typkel Recom orawrma mush-. Dralnpea a mandand anenmum a mywA.S"Wpump tend mrai rum alma,reams i drahfiem exam,,,and propaaed buadhgz woman of wens axmrrnas. "Is aweraadan por,,ckenMs.and other ma demaxe auress pints. Inmmpade Remrd Drawings may maw adeddrall,dishy.In final hamllason approval and related permits. L a � c'f'.vCd.1 NTKe IS T'm Jet If Al 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 here have been cleared/approved by both the designer shown here have been cleared/approved 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 rd Drawing is accurate. form and attached Record Drawing is accurate. ��� Signature of nstaller Date e Panted Name of Signee RJR -tom ' MASON COUNTY PUBLIC HEALTH 3 IN YE WAKE ` The undersigned approves this Installation Report and LICENSED DESIGNER Record Drawing on behalf of Mason County Public E., Ls dSm Health: Signature of Environmental Pealth Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE DpMM ntmta YFN`�O JewNbF,yTA/ Ty oil a - Gel .�. .. Ha A•r.- soy �,1a`�./ �• � Py�go G 9� y� 9. Proposed residence 2• 1200 gallon concrete pump tank 3. BNR5o0 in concrete tank 4. 1000 gallon trash tank 5. Transport line � ' 0 ^ �ld� 6- Audio/Visual alarm antlyv mot" r gPsyc 7• Valve box controls 8. Primary yxsb., 1t F �,T cn3n it 9. Waterline