HomeMy WebLinkAboutSWG2021-00100 - SWG As-Built - 10/16/2024 Maibn Cou ty OSS Installation Report pg. t
MASON'COUNTY PUBLIC HEALTH
APPLICANT/PERMIT INFORMATION
Permit Number SYM 2021-0010Q Parcel# 12108.52-00028
Applicant Name TIMOTHY_ZENK _ _ Subdivision (Name/Div/Block/Lot)
Applicant Address 291711TH_WEST
City, State, Zip SEATTLE.Wq 96119 Installer Name SOUTH SHORE CONST
Site Address 238 E TREASURE LANE GRAPEI Designer Name .CINDY WAITE
µ _<INSTALIA'VRt a{aq W1iCRLLIST '
= —7>50ft.fromwelis?
stallation ❑Tank(6)Only ❑Oreirmeld only spas ❑other
ype PRESSURE_. ___ Pretreatment Type BNR800 �(°yi'
- 1
fromdatlon? - ---__ _ - -- ❑ — ve! --
ls? . - .. - _ _ _ _ _ NIA ® ❑ N0
- ----- - ---face water? .__ _F- Cleanout between building and tank: ________ _ '!
ty Tank baffles present? . - _ _ _ -_ _ ___ __ _ ❑
W24"access risers over each compartrlent7 _ _ O E]
Effluent filter installed?- __ . . - --- -- -------- - -- -- -- Cl ® n ,I
11
Septic tank capacity (working) 1094 gal Manufacturer BNR 800 W/10601NFILT_RATOR TANKyl
13 D-box water level and speed levelers used? -- . __.. __ .._ -
O -- ® ua ❑vasuManifold/D-box accessible from sui-" ? ❑ No
EJ
VA
Check valves installed? - --___
=i! Transport Line Size 2- Scledule/Class SCHEOULE 40
Bedrooms installed (check one) 02 ❑3 LJ 4 ❑5 ❑6 ❑CommarciarOther
>10 ft Rolm foundation?- -- --______ _ _
>100 R. mwelis7 - -----__ __ _
JIMA ras ❑ No
W >100 R. from surface water? - - ----____ -- ❑ ® +
❑ ❑
uz >10ft. from potable weterlinea?-- -
L
> 5 ft. from property lines and easements? - '
CL ❑ Liu
>30 ft. from downgradient curtain/foundation drains?-___ _ __ _ 11 ❑ �
Drainfield level and observation ports present - --. __ ____ _- 0
❑ Graveless chambers or ® Clean gravel used? (check one) ❑
` Proper cover installed over drainfield? - - - —.-_______---- ❑ ❑ h
Pump tank setbacks consistent with se tir lank? ______ ____v- - - '—
WA YES No
= Pump lank capacity (flood)_1287 sal Manufacturer 1000 INFILTRATOR
H 24"access riser(s)and accessible from surface?._ . ______ ___ ❑ 0
a Alarm or Control Panel Installed? ------ _ ..- _ ❑
Control Panel equipped with limer/ETM/Counter- -- --- --- -
Pump installed in ❑ Bucket or ❑ On Block or ❑ Other
1116 Pump Make/Model LIBERTY 280 (�
❑ Floats or ❑Transducer
LL Tank draw down _3.5. INmi p Capacity Pump ce act 77 '
-- --�-- ,._gPm 9qurtHeght 55" g
IL— Pump—on 7 - Pump off hme
J
- �, ..,._. _. 6/j,, _. _ Daily flow set at 780 dpd 9
Mason county 033 Installation Report py, s Parael# 12108-52-00028
A NDONMENTRECORD
EWng aaiaM companento abandoned ae Pad of this pmjaat? - --"-__ -_ ___e gaaaibe. -. YES [] NOmpo MW pumPed Out and PmParly abendDr ad --._
Par WAC218 272A-0� ® vEg ❑ NO
nae..oa,.,,,,,q`�„eaa eneW � RECC RD_DRAWIN(i nrealnae nea.n a..uele a "own N"h m nlx.Y m tin n.ea a me..neno ecavxNe.na Nwa r^+I.a..nt iyptal�
e+N..beMlpi iNNloa al.Mlm .ewM pa'il�i. In .mW.aeay.ea9e..exwa.M pm"W holdNq.ryyel aw.,a..nl,,,, :I
aa1.aa.mM..a one m '
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l ^ Kfr��e"or vK O/PP )Pyyy
n 7(o 77 '(`fih _
�s !i Ot�4LJ' Ufa C.lN- O y 6 f
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500cod Drawing Attached !;
h:IHt l".r pu{« rA :. ,T ON ^
rAL
linetalledthey temin DESIGNERIENGINE.ERYs aCcordatrcawary certify that the systa'n has been installed in ecccr-
sgn 8tsmped"APPROVED"by Mason ! dance with the septic design stampedAPPROVED.bylic MRSO a/d that any deviations shown
een dearv&b ro MasonCounty Public Health and mat any deviationsPP Veit by bom the designer shown here have been dOWSORepproved by both
County Public Health and meet as state
and Mason County Cadea. myaen and Maaon Crxnrry Public Hearth and meet 8//
I fudhar cemfy that all Infnmtaaon Contained on mi. State and Mason County Codas
�I I further Demfy mat ell inPo 'on Contained on this
Iurrir fnd a 6d'pJ�ord J)tp Wng is accurate, form and attached R
"� ing is accurate,
l! rw '/ -yaY_ 9/5/24 1
slpneturs oflnstabr Data -- P
RICHARD MOORE
FROCOrd
GUNTY PUBLIC HEALTHuC ED ei NERnned approve$this mgtgllabon Report andawing on behalf of Mason County Public
sWtel"OfEnNmhmerael Health spacreh'st Date--
"'"""^^'-�-�_• - (stamp,signature and date)
T4I8 FORM MAY gE SCANNED ANDAVAILAS E FOR PUBLIC VIEW ON THE MASON COUNTY WEB gR[ �+h
APPROVE
oc I b 2024
MASON COUN EWRONMENTALH LTH
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1. Reside ce
i� 2. BNR: 1 600Nuwater
3. 1200 gi lion pump tank
4 4. AudloA sual alerts
p 5. Tramp rt line
6. Valve E ox'
7. Prima drpinfield envalope(22'x36'x14'x35')
13 I8. Reeery area 4DOef+
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D:Exiatin uilding to be removed
11. Fxia6ng building to be removed
12. Clean o
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