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HomeMy WebLinkAboutSWG2024-00406 - SWG As-Built - 10/24/2024 %1Ic Mason County OSS Installation Report pg. 1 MASON COUNTY APPLICANT/ PERMIT INFORMATION Permit Number SWG 2024-00406 Parcel # 423295000068Applicant Name David Bodand Subdivision (Name/Div/Block/Lot)Applicant Address fi702 Douglas Ave SE City, State, Zip Aubum Wa 98092 Installer Name Schoeninq Excav Site Address 161 N Wyncochee Dr Designer Name INSTALLATION CHECKLIST ❑ Full System Installation ®Tank(s)Only ❑ Drainfield Only ❑Repair ❑Other System Type Gravity Pretreatment Type >5 ft. from foundation? ❑ NIA 0 YES ❑ No >50ft.from wells? -- -- -- -- -- -- -- - - -- -- -- - - - --- - ❑ © ❑ Z >50ft. from surface water? El-- - - - - - - - - - - - - - - - - - - - --- ❑ ❑� FCleanout between building and tank? -- -- -- -- - - - - - -- -- -- ❑ 0 ❑ U Tank baffles present? -- - -- -- - -- - -- - - - - - - - - - - - - -- ❑ 0 ❑ a 24" access risers over each compartment?--- - -- - - - - - -- - - - ❑ ❑ W Effluent filter installed?-- -- -- -- -- -- - - -- - - - - - -- -- - - ❑ ❑ N Septic tank rapacity (working) 1094 gal Manufacturer Infiltrator 0 D-box water level and speed levelers used? -- -- -- - - - - - -- - - NIA ❑YES ❑ NO QO Manifold/D-box accessible from surface?- -- -- -- -- -- - - - -- - e ❑ ❑ a0Z Check valves installed? -- - - - - - - - -- - - ---- - - - - - - - -- ® ❑ ❑ OQ f Transport Line Size 4" Schedule/Class 3034 Bedrooms installed (check one) 2 ❑3 ❑4 ❑ 5 ❑6 ❑CommerciallOther >1 Oft.from foundation?-- --- - - -- - - - - -- - ---- - - - -- ❑ WA ❑ YES ❑ No G >100 ft.from wells?--- -- -- -- -- -- -- - - -- -- -- -- - - -- ❑ ❑ ❑ W >100 ft.from surface water? - - - -- - - - - - - - - - - -- - -- --- - ❑ ❑ ❑ ILL >10ft.from potable water lines?- -- -- - - - - -- -- -- - -- --- - ❑ ❑ ❑ Q >5ft.from property lines and easements?-- - - - - - - - - - - ---- ❑ El G >30 ft.from downgradient curtain/foundation drains? -- - - - - - - - - ❑ ❑ ❑ Drainfield level and observation ports present -- - - - - - - - - - - -- ❑ ❑ ❑ ❑ Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?-- - - - - -- -- -- --- -- -- ❑ ❑ ❑ Pump tank setbacks consistent with septictank?---------- -- - ❑ NIA ❑ YES ❑ NO `C Pump tank capacity (flood) at Manufacturer Q24"access riser(s)and accessible from surface?-- - - - - - -- ---- ❑ ❑ ❑ Il Alarm or Control Panel Installed? ----- -- - -- -- -- - - - -- - - ❑ ❑ El M Control Panel equipped with Timer/ETM/Counter-- ---- - - - - - 0 0- Pump installed in ❑ Bucket or ❑ On Block or ❑ Other 0- Pump Make/Model ❑ Floats or ❑ Transducer a Tank draw down in/min Pump capacity gpm Squirt Height ft Pump on time Pump off time Daily flow set at gpd uoe.udemnore Mason County OSS Installation Report pg. 2 Parcel it 423295000068 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - - - - - -- Q YES NO If yes, please describe:Pumped.tank lid removed and filled in _ Were all components pumped out and property abandoned per WAC246-272A-0300? - - - - - - -- YES EJ NO RECORD DRAWING This Is a gmwnanl mceN and must W accuram and Uaecrlppva a oug&b rHowN in the dead of maintanance aavitlas and Mum Eavelopment Typical Re nd Omeirgac Ladd Dralnfleld&mendoNonenblim&layout,Sepddpump Ynk Nxetbn.Nonflanow,reservecnamrald,existing antl prollosW nulWings,kcstlon of xxlls,yumanss, wells,dimmmtimports,deamute,amfinermemtenanceacrossi,drft Incomplete Re=d orawings may create additional delaysmfnal Installatan approval and related permits. Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ENGINEER I certify that I installed the system in accordance with 1 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 cleared/approved by both the designer shown here have been cleared/approved 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 information contained on this form and attached Record Drawing is accurate. form and attached Record Drawing is accurate. Zj 10-19-24 Signature of Installer Date Bravden Schoeninq Printed Name of Signee MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and Record Drawing on behalf of Mason County Public Health: Signature of Environmental Ilealth Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE upaNed arztrzwe t N APPROVED OCT 25 2024 MASONCOUNTYENWRONMENTALHEALTH 9 RET 0 7 L 3 Pr rl"I 11r+. 11�\ N WyYroocl.0 Or 2 5�oct i F\ovse S T ¢� it 7 r �. 46' 1 ' s Yl<Ibv�x, oMCP PruPw}y liw loo' A",.r,ta ptr wAc. ? TNtw IJMWI.o --4v- • 0 tk-\X� \:n< aruw&l<\a, �a-rr+ :a\� iv, vankwwr, \ntwl:ox P� }\.1e ^'t� �c Nokc�' prr",rrEit\a loc..}ier. Sh.w+, lwrt is from o+, o\� usbu�\k. wt a;a era S.�t aru, rc ht t\t o\a ' PPROVED SoNkL. .ProQ.uL� \\rt. Tvalcuvn a.rcuvrCl<U \n�tral Nntx[. J OCT 04 2024 MASON COUNTY ENWRONMENTAL HEALTH RET