HomeMy WebLinkAboutSWG2024-00010 - SWG As-Built - 10/23/2024 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH
APPLICANT/ PERMIT INFORMATION
Permit Number SWG 2024-00010 Parcel# 22223-77-90064
Applicant Name Daniel Easley Subdivision(Name/Div/Block/Lot)
Applicant Address 1224WRiverside Ave#3
City, State,Zip Spokane WA 94jKta ame Bill Bumbalough
I
Site Address 31 EClaude Ct. r A96 si ame Kenn Webb
IlMSTALLATION CHECK IST
❑ FUII System Installation ❑Tank(s / y ❑Repair E]Other
System Type Stan ressure Pretreatment Type
>5 ft.from foundation? -- ---- --- --- - ---- ❑t#A AYES ❑ NO
' >50 ft.from wells? ----------------------------- ❑ 0 ❑
z >50 ft.from surface water? ------------------------ ClEl0
F .Cieanout between building and tank? ------------------- ❑ ❑
U Tank baffles present? --------------- ------------ ❑ 0 ❑
E- 24"access risers over each compartment?---------------- ❑ ❑� ❑
a
w Effluent filter installed?-------------------------- ❑ ❑
Septic tank size 1250 gal Manufacturer Hagerman Precast
0 D-box water level and speed levelers used? --------------- ® wA ❑vas ❑ NO
pJ
o. Manifold/D-box accessible from surface?----------------- ElB Ela?Z .Check valves installed? -------------------------- ❑ ® ❑
�Q ',
2 Transport Line Size 2" Schedule/Class SCH40
Bedrooms installed(check one) ❑2 ❑3 *4 ❑ 5 ❑6 ❑Commercial/Other
>10ft.from foundation?-- ------------------------ ❑ WA aYES E] NO
0 >100 ft.from wells?-___________________________- ® ® ❑
w >100 ft.from surface water? -_______________________ ❑ ❑
� . >10ft.from potable water lines?---------------------- ❑ ® ❑
Qz">5ft.from property lines and easements?---------------- ❑ ® ❑
K >30 ft.from downgradient curtain/foundation drains?---------- ❑ ® ❑
� '. Drairfield level and observation ports present-------------- ❑ ❑
".E Graveless chambers or ❑ Clean gravel used? (check one)
Proper cover installed over drainfield?------------------ ❑ ® ❑
Pump tank setbacks consistazygtO=egtia tank?_- \L� NA
YE ❑ No
--1I'I�. 0(d 'Olf I A� su( r 27-51 Hagerman Precast
Y ''-Pump tank size 1000 gal per
z
Q .24'access nser(s)and accessible from surface?------------- ❑ 0 ❑
F
a Alarm or Control Panel Installed? --------------------- ❑
Control Panel equipped with Timer IETM/Counter------ ----- ❑ ❑
a-.Pump installed in ❑ Bucket or ® On Block or ❑ Other
o- Pump Make/Model Orenco/OPF500511 ® Floats or ❑Transducer
a
Tank draw down 2" in/min Pump capacity 52 gpre Squirt Height 6+ ft
-Pump on time 69 sec Pump off lime 3 hr Daily flow set at 478.4 glad
uNW WIM10
idason County OSS installation Report pg. 2 Faroe,4 22223-77-90064
�ABANDONMENTRECORD
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Pac b]endggell es.pat of this pmleC.? - - --- - -- - - - upleaseall components pump`d oul and pmpedy abandoned perWAC24o-272A-r�,?OOn - -- ---- - ❑ YES No
". 'RECORD DRAWING
aia Ll ,a.:ovd'yaa. re: aaaduoidw �m,.a:mi u. ..a of mal �.,mrm�e< al,n e. aoyn..a. rypia anm a..
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Record Drawmg Attachec
f CERTIFICATIONS OF INSTALLATION
INSPALLER t DESIGNER/ENGINEER
I cerfrty that(installed the system in accordance with !certAythaf the systerp has been installed m edcor-
the sopticdesign stampQd"APPROVED`by Mason. danc9491tIi4fta.�ep�cde g63taRtped;�`AP ()YED'by
County Public Health and that any deviations shown' Mason ColintyPublld,k/eaflh Hrad IJ]airaaMy+7e!/eBons
here have,been clearad; pptoved by both the designer shown here have bee7igeal{IappFl9`tt_N'd:d1 bGtja
and Mason County Pubfric Heath aodmeet all State myselfand Mason CDunty'Publi,Health:.And meet all.
and Mason County Codes. State and Mason County Codes
I further certify that ell information contained on this 1 furthercedify that all uiformabon contained on this
form and.attached Record Drawing is accurate. form and attached Record Drawino is accurate.
Apnl I7,2
signat�afler Date _..
i
8i118umbaWph {
MASON DOUNTY PUBLIC HEALTH
The undersigned approves this Installation Report and
Record Drawing on bets T of Mason County Public or
He.gUth: ENMEla LH Zd
1 3lzy
Stgdt ,;kt�,6emieeaRh Speclars(. naie (stamp, signature anddate]
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