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HomeMy WebLinkAboutSWG2024-00320 - SWG As-Built - 10/16/2024 r Mason County OSS Installation Report pg. 1 MASON COUNTY APPLICANT/ PERMIT INFORMATION D Permit Number SWG 2024-00320 Parcel# 32332-43-00020 g WT2 Applicant Name Greg Bever Subdivision (Name/DivBlock/LOt) Applicant Address 34 Via Las Flores TR 2 OF LOT 4 EX&TAX 1273 By City, State, Zip Rancho Mirage CA 92270 - Installer Name Shumaker Construction Site Address 24321 NE North Shore Rd Tahuya Designer Name Arrow Septic Designs Inc INSTALLATION CHECKLIST��yy ® Full System Installation ❑Tank(s)Only ❑ Drainfield Only Re ❑Other System Type Pressure Trench Pretreatment Type >5ft.from foundation? -- ----- ------ ------- -- --- -- ❑NIA ®YES NO >50ft.from wells? --- - - - --- --- --- - - - - -- - ------- ❑ ® ❑ Z >50ft.from surface water? --- -- - - - --- - -- - - - - - --- -- ❑ ❑ Q< Cleanout between building and tank? ------ - ------------ ❑ ® ❑ V Tank baffles present? . -- --- - --- - -- - - -- - -- - ---- -- ❑ ® ❑ -a 24"access risers over each compartment?- - - -- -- --- -- ---- ❑ ❑� ❑ NEffluent filter installed?----------- - - - - - -- - - - - - ---- ❑ ❑ Septic tank capacity(working) 1.500 gal Manufacturer Hagerman 0 D-box water level and speed levelers used? - - - - -- --- ---- -- ❑ NIA ❑ Yes QNO 00 Manifold/D-box accessible from surface?----- --- --- --- - -- ❑ ® ❑ mZ Check valves installed? - - --- - - - ---- --- - - ❑ © El ec f Transport Line Size 2 inch Schedule/Class 40 Bedrooms installed (check one) ❑ 2 ❑3 ❑4 ® 5 ❑S ❑Commerciat Other >10ft.from foundation?-- -- - - - - - --- - - ---- ----- - -- ❑ WA ® Yes ❑ NO >100 ft.from wells?-- - ----- - - --- --- -- W ❑ ® ❑ >100 ft. from surface water?--- ----- ---- - ❑ ® ❑ M >10ft.from potable water lines?--- --- -------- - ----- -- ❑ ® ❑ ? > Q 5ft. from property lines and easements?-------- ----- - - - ❑ ® ❑ 2: >30 ft.from tlowngradient curtaiNfoundationcrains?----- - --- - ❑ ® ❑ I] Drainfield level and observation ports present - - - --- -- ------ ❑ ❑ ❑ Graveless chambers or 0 Clean gravel used? (check one) Proper cover installed over drainfield?------ ---- ------- -- ❑ ® ❑ Pump tank setbacks consistent with septic tank?-- ❑ NIA ® YES ❑ No X Pump tank capacity(flood) 1,500 gal Manufacturer Hagerman 24"access nser(s)and accessible from surface?-- - ---- -- ---- ❑ ® ❑ ~ Alarm or Control Panel Installed? ----- - - - --- - - - ❑ ❑ a g Control Panel equipped with Timer 1 EfM I Counter-- --- -- -- -- ❑ ® ❑ 7 tl Pump installed in ❑ Bucket or ❑ On Block or E Other Flow Inducer Tube a Pump Make/Model PF2010- 1hp,230v ® Floats or ❑ Transducer 2 Tank draw down 1.5 in/min Pump capacity 39 pm Squirt Height 20 ft IL Pump on time 1.9 min Pump off time 3 hr Daily flow set at B00 gpd Jp] d Q :8 Mason County OSS Installation Report pg. 2 Parcel# 5'Z;32- 49- 00026 ABANDONMENT RECORD WYES NO Wre e existing septic components abandoned as part of Nis proleC.? ' -------D.F a- - - :-�^'^ 1 , K f ;y;enPd OId - If yes, please desaibe'. -J �10 YES �l yE NO Were ail components pumped out and propehy abandoned per WAC246-272A-03001 - -- LN RECORD DRAWING I. n u w naxew m e`.n.ea mslnun .-and Nwre eev.lognent rroiml FaaN Thb'u a w^^.nenl rtcuN.na moat b.acCurtls nld dev,r,,z n m a of once a . 1—mnuin' tl a manifold cnenednn a larwt seperJ , I, or N Inn bue , W'e^—msem LNnAeld.eusbq end popnud by Wmge. D— on"fl lc.veen aM Metes pennM1s. ,yeys,ywxvaeon pats.tleenoW,end omet mumv�enm avess poinu InrompI.RewN Dnmings may aW adeidunai del s Rwlinmla(an ziWT°al \J ' [Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/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 clearsompproved by both the designer shown here have been cleared/approved by both 11l and Mason County Public Health and meet all State myself and Mason County Public Health and meet all 1 and Mason County Codes. State and Mason County Codes 1111 l further certify that all info anon contained on this i further certify that all information contained on this form and a e Drawing is accurate form and attached Record Drawing is accurate. 24 2 Signature of Installer Date Printed Nameof Signse n MASON COUNTY PUBLIC HEALTH The undersigned approves this installation Report and Record Drawing on behalf of Mason County Public PAULA Joy JONNSON .�� 'LTC E i Eq_ U. Health* (01MV1 to- B -vE Signature of Environmental Halth Specialist Date (Stamp, Signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE cewxe nrstrzpm }{0op CANAL <� k � 382 ZS' za3'Pr;mrygI 0.r w;? H }r{,nc1nGS YGier`K' btSidG xm. s OAudio-Visual Alarm p © Cleanout d'"t © 1500 Gallon Septic Tank a i 5 LopE ' 2-Compartment with r EASE , Effluent Filter O1SOO Gallon Pump Chamber Ao OS Valve Control Box — 'LPA., 1/ P eY t/ Il�/ fp�PL l l . W ELL- PPROVED LE =SG' MASON COUNTY ENVIRONMENTALNEALTN T 0 25 so �5 teo GKEG PJEVM`PtrtcFL# 2331 g�-0002-o N Spa PAUU JOYJOMNlpy' t 15m,