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HomeMy WebLinkAboutSWG2020-00464 - SWG As-Built - 10/2/2024 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2020-00464 Parcel# 22224-75-90042 Applicant Name Gr�e Basch Subdivision (Name/Div/Block/Lot) Applicant Address 7 g0 WX llbzb �'l' 4C w q 0 meDi S r't 3 City, State, Zip Sumner,WA 96390 Installer Name Ian Midgefte Site Address 100 E coon Or North Designer Name Lawrence Purdum INSTALLATION CHECKLIST ® Full System Installation ❑Tank(s)Only ❑Drainfield Only ❑Repair ❑Other System Type Pump to gravity Pretreatment Type >5 ft.from foundation? --------------------------- El WA ©YES NO >50ft.from wells? ------------- - -- - --------- --- ❑ ® ❑ Z >50ft.from surface water? ----------- -- ------- -- -- El ® ❑ FQ- Cleanout between building and tank? ------------------- ❑ ® ❑ U Tank baffles present? --- ----- ------------------- ❑ ® ❑ 1- 24"access risers over each compartment?---------------- ❑ ® ❑ W Effluent filter installed?--------------- ------ ------ ❑ ❑x ❑ N Septic tank size 2 x 1,000 gal Manufacturer Infiltrator IM4060's ° D-box water level and speed levelers used? --------------- ❑ NIA ®YES NO J Gu ManifolN El accessible from surface?----------------- x❑ ❑ Q1= Check valves installed? -------------------------- ❑ ❑x ❑ ° Transport Line Size 2' Schedule/Class 40 Bedrooms installed(check one) ❑ 2 ®3 ❑4 ❑5 ❑5 ❑CommerciaVOmer >10 ft.from foundation?--- ------- ---- -- -- ------- - ❑ NIA ❑x YES ❑ NO ° >100 ft.from wells?------------- ---------------- ❑ ❑x ❑ Wewater?>100ft.from surfac ------- ------- ❑ ❑x ❑ iZ >10 ft.from potable water lines?---------- --- - - ------ ❑ ® ❑ ZZ >5ft.from property lines and easements?---- -- ---------- ❑ ® ❑ K >30 ft.from downgradient curtain/foundation drains?---------- 0 ❑ ❑ ° Drainfield level and observation ports present --- -- --------- ❑ ❑x ❑ x❑ Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfeld?------------------- ❑ ® ❑ Pump tank setbacks consistanl with septic tank?------------- ❑ NIA ® YES ❑ NO Y Pump tank size 1,000 at Manufacturer Infiltrator IM-1060 Z 2C access user(s)and accessible from surface?------------- ❑ ❑x ❑ H ❑ C Alarm or Control Panel lnstalletl? ---------- - ---------- ❑ ❑x `t Control Panel equipped with Timer I ETM/Counter---- ----- -- ❑ ❑ Il Pump installed in ❑ Bucket or 0 On Block or ❑ Other 0- Pump Make/Model Liberty LEH2O0 2hp 230v ®Floats or ❑Transducer 2 a Tank draw down 1 ?5 in/min Pump capacity 35 gpm Squirt Height N/A ft 102 Seconds Pump off time 4 Hours Daily flow set at 358.79 Opd Pump on time p aroma nirzoie Masan County OSS Installation Report pg. 2 Parcei u 22224-75-90042 ABANDONMENTRECORD v— assmg eeot¢ <am.Ponants abandoned as Part of(h'! Prcla't' YES ® NO sryes elesse deecnbe. " `Mere aii compmama Pumped out end Propafiy abandoned Per IVAC200Q72A.03007 -------- C3Ro RECORD DRAWING rnis.a.oermonem score end min e.eccume ew enmgln awaee w Moew w nN row ar m,w,arce enrvroee ew rmm,enwiwmm. +..: �. . x: -, c. n•+ece ax•-a. . sa ^.-e• r.:m e- .y:-..,..- 'r o.r;e--r .vtto^.. � ':ar . as -e: .. 'z-: untie vacu*cna.'.u � -a+a+ary pen0. : '•.x +giaad]•n.•n-b<'n'q avre aeounb-aa a ^..cr:.ap...�+r s 1 ® RaeoM Drawing FnacheC R_y_—y, — CERTIFICATION OF INSTALLATION INSTALLER : DESIGNER/ENGINEER 1 dainty Mal!instalfeU the system in accordance%M 108nity that tlta System ties been installed in acco.' the Septic design stamped"APPROVED'by Mason - dance with the seMic design starnpetlAFPROVF.D"by County Public He811h and that any deviations shorrn Mason County Public Health and mat any devtatinns hero new been uikr W ppmved by both me doeigner shown here have been oloaralkepprowd 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 1 further cer6ty that all information Contained on this : I Nether comfy that all information containrw. on t+ie j bum and a U Reconi Drawin{N ra arc meta. ,.-� to/tin and ettacned.Record Or'ewing is accr,'ate. r sryn,mreamar uer era E �� ('Lit � M fry•N� � .tic..... of f.I od+od Norris o S,gr.^-c--ae MASON COUNT PUBLIC HEALTH m t[[q} (• The undertlgned approves this hisMilaton Report and a t;a •• Record Dre4ing out behalf of Mason County Pubac ewrence,M p4,dym Heath E UC .49EP 5+ NER EXPIRES y26� e Signature o'Env+mnnenfM Heaf!h Spa:9alral Del. 4 (stamp signature and da!;, _ TH,a EOaM!egY BE SC4NrJECanOgY31i4B1E'O4 WBUC VI?'.YOX TXE rdCEON CJUfR1'tP_a b^E ' ' ) gill ! | j ® | k � K � � �( � I k / / $` • # , � & ® & y o �Op . 0��� �3 i /) mo ! ; zo �\ / « i . APPROVED OCT 22 ;)\ MASONc a EWRON4iSlAL"` • � k § � kk ■ a !�§Jig m |$$ (B