Loading...
HomeMy WebLinkAboutAFTER THE FACT - SWG As-Built - 5/29/2024 AFTER THE FACT RECORD DRAWING, pg 1 MASON COUNTY PUBLIC HEALTH PARCEL IDENTIFICATION Owner Name ERICK KNIESTEDT Assessor Partial 42012-52-00004 Is Mailing Address 6635 LAKE SAINT CLAIR DR SE 01M Specialist Name City, State, Zip OLYMPIA, WA. 98513 Installer Name Site Address 50 E PARK RD, SHELTON Designer Name CINDY WAITE _ Pleose complete this checklist to the best of yourknowlical Ifitems are unknown ilim"I lienk• INSTALLATION CHECKLIST System Type GRAVITY Pretreatment Typo Drainfield Ln. Ft 100 DralnOeld Sq.Ft, 300 Dminflold depth —_ __— >5 ft. from foundation? - __ __ __ __ _ _ _ _ _ ____________: ❑ NIA was NO >50 ft.from wells? - - - - - - - - - - - a 2rr� � ® ❑ Z >50 ft. from surface water? - - - - - - ,�f LS' T H Cleanout between building and tank? U Tank baffles present? - - - - - - - - - rg'f' 29Z4> d 24"access risers over each compart ?- - _ __ _____ ._ ® E®3 NEffluent filter installed?- - --- - - - - - - - - _ . ❑ Septic tank size ZOOL) gel Manuhelurer N, ,E'vo 0 D-box water level and speed levelers used? •___________ _ _.. Q NIA �]yea � N® 0O Manifold/0-box accessible from surface?------------ - - - - -EL ❑ CQCheck valves installed? - - - - - - - - __._-, . - - ❑ f Transport Line Size q " chedule/Class_ Nc'F �+.:• Bedrooms Installed(If known) ❑2 3 Q4 ❑5 ❑0 MCcmmercia901her >10 ft.from foundation?- - --------a---- -- -- ------ - ❑ NIA IN yea ❑ No >100 ft.from wells?-- --------------------------- ❑ 4 ❑ tj >100 ft. from surface water? -- ----- --- ------------ - - ❑ 2 >10ft.from potable water lines?. .... . ...... ......... : ® ❑ > 5 ft.from property lines and easements?•-- --_ - , 13 >30 ft.from downgradient curtain/foundation drains?,---__---- ® g Observation ports present? ._ _ - - -., Q ❑ ❑ Graveless chambers or j.Clean gravel used? (check 00) Proper cover installed over drainfield?-- - -- - --- - --- --- - - - ❑ a ❑ Pump lank setbacks consistent with septic tank?- - - - --- - - - - ., E3 WA yea IsNQ x Pump tank size gal Manufacturer F 24"access riser(a) and accessible from surface?• - .- - -. - -. ---- ❑ 13 fl Alarm or Control Panel Installed? -- -- - - - - -- --- - - - - - - -. ® ❑ j Control Panel equipped with Timor/ETM(Counter- - - - - - - - - -- ® ❑ 13 a Pump Installed in ❑ Bucket or ❑ On Block or ❑ OtherIL 1\3 Pump Make/Model ® Floats of [Q Transduoef jL a Tank draw down In/min Pump capacity apm Squirt Height ft Pump on time Pump off time Q'Illy flow lot at d - VpBMMia94Rta AFTER THE FACT RECORD DRAWING, pg 2 Assessor Parcel tt RECORD DRAWING Drainfleld&manifold orientation&layout w/dlmenalDns for re Iodation. ❑ Trench/bed dimensions and cMical dletancea _3'1 t do ' within layout Sepgcipump tank Location w/dimen- sbns for re-locallon ' Location of buildings existing/proposed ❑ Observmbn pods.chan-oW location.. &manlfotds/rbboxes ❑ Location of Wogs. / suface r water,roads,'(` &walerllnes. r®-r'Reserve ani Ly North Arrow If needed drawing may be attached on a separate page No. Pages AllaeheQ CERTIFICATION OF INSTALLATION DESIGNER/APPROVED O/M SPECIALIST I certify that the information contained in this document/s accurate to sly knowledge. The drawing and mdormahch has /been-pbtainedd thcoough common locating practilces. ( a � urApp 1l2a/ 2a2Y Signature es/grrerwApproved O/M Specialist la MASON COUNTY PUBLIC HEALTH This is an alter the fact record drawing which may or may not include a County inspection.. This ratwmatlpn is to paly document an existing OSS location and oomponti Signature of Environmental Heath Specialist Date THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB BITE urmud ertaao�e J l CL cq. Wx U QC h 3 o o © O 21 F i i F � h A II ---