HomeMy WebLinkAboutSWG2024-00372 - SWG As-Built - 9/19/2024 "W-90"
Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH
' `.APPGICAIiT/,PERMIT-INF.,ORMATION
Permit Number SWG 2024-00372 Parcel# 319015100035
Applicant Name Chris Leaman Subdivision (Name/Div/Block/Lot)
oy
Applicant Address 62093rd Ave SE
m yu
City, State, zip Olympia WA.98501 Installer Name Chris Lesmen d
Site Address 50 SE Bluff Loop Rd Designer Name Chris Leaman
0
TR7N4�.AMR
❑ Full System Installation Tank(s)Only ❑ Drainfeld Only ❑ Repair ❑Other
System Type 2 Bedroom Glendon Bloater Pretreatment Type
>5 ft.from foundation? ---------------- ----------- ❑ WA YES ❑ NO
>50ft.from wells? - -- --------------- -- --------- ❑ ® ❑
>50ft.from surface water? -- ---------- --- --------- ❑ ❑
Cleanout between building and tank? ------------------- ❑ ® ❑
Tank baffles present? - -------------------------- ❑ ❑
24"access risers over each compartment?---------------- ❑ ❑
Effluent filter installed?--- ----------------------- ❑ ® ❑
Septic tank capacity(working)
1200 gal Manufacturer Fred Hill
_ D-box water level and speed levelers used? ----- --------- EIUA ❑yEe
NO
ManifoldlD-boz accessible from surface?---- ------------ ❑ ❑
. -- ------- ❑ ❑
, Check valves installed?
Line Size Schedule/Class
Bedrooms installed (check one) W 2 ❑3 ❑4 ❑ 5 ❑B ❑Commercial/Other
>10ft.from foundation?---- -- ------- ------------- 0 WA ❑ YES ❑ NO
>100 ft.from welts?-------------- - ------------- ❑ ® ❑
>100 ft. from surface water? - ------------- ---------- ❑ e ❑
>toft.from potable water lines?-------------- ------ -- ■ ❑ ❑
>5ft. from property lines and easements?- --------------- ® ❑ ❑
> 30ft. from downgradient curtain/foundation drains?---------- ❑ ❑
Drainfield level and observation ports present - ---- - -------- ❑ e ❑
❑ Graveless chambers or ❑ Clean gravel used? (check one)
Proper cover installed over drainfield?------ ----- --- ---- ❑ ❑
Pump tank setbacks consistent with septic tank?---- ------- WA,I INYES ❑ NO
Pump tank capacity (flood) 1200 gal Manufacturer h1111
24"access riser(s)and accessible from surface?------------- ❑
Alarm or Control Panel Installed? ----------- ----- ----- ❑ El
Control Panel equipped with Timer/ETM/Counter--------- -- ❑ . ❑
Pump installed in ❑ Bucket or a On Block or ❑ Other
Pump MakelModel Teal 2P407 ❑ Floats or ®Transducer
Tankdrawdown perglendon in/min Pumpcapacity per 9lendon gprn Squirt Height N/A ft
Pump on time per Glendon Pump oft time per glerdon Daily flow set al 249 9Pd
Mason County OSS Installation Report pg. 2
Parcel# 319015100035
'aA',""A'B/iNDpNMENIT RECORD' ` - c :,�"a .,a«Wit:,.' JMN0
c,r-
were existing septic components abandoned as pan of this project? --- ---- '- ' ----" ❑ YES
If yes, please describe:
Were all.components pumped out and property abandoned per WAC249-272A-0300Y ""--- '- ❑ YES
R
This le a pe..e"sister,end sees,M e xerere else deeenpdve enough is rsloub M Vre nes0 df"disnanw aeMlaw end Mare desslo"N. Tiri RemN
nrawlrr9a eanlevi: DrnMnk 8 mnlMp rcbnlelbn 61aYW.SePW WmP�x helbn.NpM erNW.refYve hYMlak.BXb11nY Md pgmed WgMBa.buss"dwells wvrerllPes,
well esseredon ores,clemous,end eCar meblYuno epav Worse. InmnebM Re srd presents mry crests,eddids"el dWye m Mel sess"wed"pe"aM"eli Permits
Record Drawing Attached
INSTALLER DESIGNERI ENGINEER
I certify that I installed the system in accordance with I car*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 dearadrapproved by both the designer shown here have been deared/approved by both
and Mason Co ty Public Health and meet all State myself and Mason County Public Health and meet all
*nrCnty State and Mason County Codes
mationcontainedon this I further certify Nat all information contained on this
rawing is accurst . form and attached Record Drawing is accurate.
B"
(Inds
Pdn ame of Signee
MASON COUNTY PUBLIC HEALTH
The undersigned approves this Installation Report and
Record Drawing on behalf of Mason County Public
Health:
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 ayessess ndta
uw
V
TOPOFBANK
7 I _
SS a FROM FOUNDATION TO WATER
I s7 � h( ��I✓F"'y�'�'pf"L y� �jr x �L � "I
IR
Fm
li't Sss�ti i Yy"* Rkr•�'�''9�yU�Y
FENCE
ry
� r n
., '"
W ROAO EASEMENT ^
FLOW SPUTTER UNE STAKE
t]9S'ASSOPRTION AREA(COMBINED TOTAL•26M
SURVEY PW
- - - - - - - -- - ------- -- - - - - -- - - - - - - - - ---
APPROVED
SEP 19 2024
MASON COUNTY ENVIRONMENTAL HEALTH
RET