HomeMy WebLinkAboutSWG2024-00160 - SWG As-Built - 10/15/2024 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC WEALTH
APPLICANT/ PERMIT INFORMATION
Permit Number SWG 0 0 1 6 (7 Parcel# V-LZ/ (v - S 3- Ooo z El
Applicant Name W eg-Ka CFI N L121 Subdivision (Name/Div/Block/Lot)
Applicant Address 1'7 (& 1 S 2 `l d- ST il,1r 49
City, State, Zip � at a 41f L Installer Name /?6 r a o .L
Site Address L Designer Name 410A 1
INSTALLATION CHECKLIST
Full System Inatallatlon ❑Tank(&)Only ❑Drainfield Only ❑Repair ❑Other
System Type C1Y0Ay' 7(01- Pretrbatment Type .4eYk:kJcT
>5 fL from foundation? --------------------------- [I WA OYES QNO
>50 ft.from wells? ----------------------------- ❑._. 9 ❑
_ >50ft.from surface water? ------------------------ ❑
Cleanout between building and tank? --.----------------- Q ', ❑
O Tank baffles present? -- -- -- -- - ------------------ ❑ ', ❑
F 24"access risers over each compartment?---------------- ❑ (]
WEffluent filter installed?---- -- --------------------- Q
N
Septic tank size gal Manufacturer NIAd,e�r,.sN
D-box water level and speed levelers used? -- ---• ❑ WA ❑YES ' Q No
OLL ManifoidlD-box accessible from surface? ---- -- -
a?Z Check valves installed? -- ---.-- .---- .'-!0---- ❑ ❑
Gg Transport Line Size. . Scheduls/Class
Bedrooms Installed(check one) --t�2 ❑3 ❑4 ❑5 06 ❑Commercial/Other 'I.
>10 ft.from foundation?-------------------------------- ❑ NIA Yes I-] No
>100 ft.from wells?- --- ------------------ ----- ❑ El
J >100 ft.from surface water?-------- // ❑ El
LL >10 ft.from potable water lines?------ - t - ❑ �, �]
aZ > (55
5 it from property lines and easements?--- ❑ �. El
K >30 ft.from downgradlent curtalntfoundation drains?---------- ❑ []
O Drelnfield level and observation ports present ----------- ❑
❑ Graveless chambers or ❑ Clean gravel used? (one(*one) N-4 4rB 3;
Proper cover installed over dreinfield?------------------- ❑
Pump tank setbacks consistent with septic tank?------------- ❑ WA 4vaa d3 No
Y Pump tank size gel Manufacturer_JJAG0R Non t
24'access riser(s)and accessible from surface?--- --- - Q 0
yAlarm or Control Panel installed? •-- --- --- _ ❑- -
f Control Panel equipped with Timer I ETivt/Counter.•. - 13
D
3 Pump installed in Q.Bucket 11 or [IOn Block or- C] Other Z32riS IN 0 it
o. Pump MakelModel tbw✓'\f/AA (-n T- 3 0 0•Eloats or ❑Transducer
p, Tank draw down L . Inlmin Pump capacity 'Z ' Qapm Squirt Height N—4rS AA ft
Pump on time O Pump off time r; Daily flow set at (8`/ opd
wawam+nmx
Mason County OSS Installation Report pg. 2 Parcel f 0 ZZ 1 -5 3-60B7,G
ABANDONMENTRECORD
Were existing septic components abandoned as part of this project? --- ------------ YES NO
If yes, please describe:
Were all components pumped out and properly abandoned per WAC246i272A-0300? -------- ❑ YES r .y� ❑ NO
RECORD DRAWING
ms a a pemanat rtcmE and must se accurN and dastNpWa enwplr m mi..in a.need ur nunsn. acdvidas and Nmrz davWopmmt Ty nol Rav d
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Q�Iecord Drawing Attached
CERTIFICATION OF INSTALLATION
INSTALLER DESIGNER/ENGINEER
1 certily,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 Healh and that any deviations
here have been cleared/approved by both the designer shown hem have been clearedfapproved 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
I further certify that all information contained on this I further certify,that all infamrah'on contained on this
form=Drawing is accurate. form and attached Record DmWng is accurate.
Sign tefa�br/y',�� �//I//Day
�hlrr✓ C•( cf (SQYe.�nLfd 4
PrmteCNameot r
MASON COUNTY PUBLIC HEALTH y�°~ .Ff^
The undersigned approves this Installation Report and
Record Drawing on behalfofMason County Public
Health ApAM I.HUNTER
SbWaed Health Specialist Date (stamp, signature and date)
THIS FORM MAY BE 5CANIMED MDAVAI Ge F FOR PUBLIC VIEW INl THE MASON COUNTY WEB SITE WmeeemrIDte
OSCAR•XOz Check Llst
Date: co — -
Re: OSCAR-XOz installation at:
Address: N �935 OL
Tax yz2tG 53 - 00o2rG
This letter is to confirm that the system installed at the above listed address
was installed as per Lowridge Onsite Technologies, Inc.s specifications.
Pressure & Flow:
Pressures on the OSCAR headworks:
Dosing: GI = -�2— psi, G2= Z-L psi, G3=k psi
Dose flow rate= gpm � ,Q ® ✓r Kr ?tip l 2
Treatment tank: vim' Z W 3 `f 5 gG f h yo -3 b
Patrician tee baffle bottom/by-pass hole at 40-60% of liquid depth
I�z 5 ["I 3 4 --9 (2)3z 2� Yes:——, No:
Discharge tank:
Patrician by-pass hole at 18" to 27" above floor Yes: , No: _
Aeration:
Diffusers close to partition wall Yes: Y , No: _
Aerator in dry location Yes:,y-, No: _
Aerator operable Yes: , No:
Current sensor operable Yes: , No:
Installation:
OSCAR:
Correct number of coils: Yes: �, No: _
Correct coil arrangement: Yes: �, No: _
Inspection ports: Yes: No: _
Proper sand depth: Yes: , No: _
Floats set correctly: Yes: _, No:
Timer settings correct: Yes: _, No: _
Basal preparation according OSCAR
Installation manual: Yes: No: _
Certified Installers Signature: __
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