Loading...
HomeMy WebLinkAboutSWG2024-00339 - SWG As-Built - 11/1/2024 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2024-00339 Parcel# 42025-33-00020 Applicant Name Jefferev Faubion Subdivision (Name/Div/Block/Lot) Applicant Address 310 W G St TR 2 OF S1/2 SW City, State, Zip Shelton WA 98594 Installer Name Maples Excavating Site Address 1590 W Deegan Rd West Designer Name Arrow Septic Designs Inc. INSTALLATION CHECKLIST ■ Full System Installation ❑Tank(s)Only ❑ Drainfield Only W Repair ❑Other System Type Pressure Bed etreatment Type >5 ft.from foundation? - ------ --- -- -- ❑ NIA ® YES NO >50 ft.from wells? - - - - - - - - - ,,\\AAyy - - ❑ ❑ Z >50 ft.from surface water? ----- oy► -- - �+4® - ❑ ❑ HCleanout between building and tank? - �i-1 ----- - -- - ❑ ❑ U Tank baffles present? - -- - - - -- - --- --- - --- - - - ❑ ® ❑ H 24"access risers over each compartme ❑ ❑ a w Effluent filter installed?--- - - - - - - - N Septic tank capacity(working) 100 gal Manufacturer Hagerman D D-box water level and speed levelers used? ------ --------- ❑ NIA ❑ YES NO �O Manifold/D-box accessible from surface?-- --- ------------ ❑ ❑ g?Z Check valves installed? ------- - ---- - - - ---- - ------ ❑ ® ❑ 0¢ 2 Transport Line Size 2" Schedule/Class 40 Bedrooms installed(check one) ® 2 ❑3 ❑4 ❑ 5 ❑6 ❑CommerciaVOther >10 ft,from foundation?- -- - - - - - - - -- - - - ---- El NIA ® YES NO o >100 ft. from wells?---- - --- - ---- --- - -- - --- ---- -- ❑ 0 ❑ W >100ft.from surface water? - ------- ----- - -- ❑ El a. >10ft.from potable water lines?- ----- - -- ---- - - - --- - -- ❑ ❑� ❑ a > 5ft.from property lines and easements?- - - ---- - ----- - - - ❑ ❑� ❑ W > 30 ft.from downgradient curtain/foundation drains?- -- - - --- - - ❑ ❑ o Drainfield level and observation ports present - --- - - - - - ----- ❑ OF ❑ ❑ Graveless chambers or E Clean gravel used? (check one) Propercover installed overdrainfleld?------ ---------- - - - ❑ ❑ Pump tank setbacks consistent with septic tank?-- ----------- ❑ NIA ® YES ❑ No Y Pump tank capacity(flood) 1,000 gal Manufacturer Hagerman Q24- access nser(a)and accessible from Surface?--- ------ ---- ❑ W ❑ t a Alarm or Control Panel Installed? ---- - ------- ------- - - Cl ® ❑ 2 Control Panel equipped with Timer/ETM/Counter-- --- ---- -- ❑ W ❑ 7 a Pump installed in ❑ Bucket or ® On Block or ❑ Other a Pump Make/Model Zoeller N152 0 Floats or ❑ Transducer g a Tank draw down 1.75" inimin Pump capacity 33 gpm Squirt Height 6 k Pump on time 1.8 min Pump off time 6 hr Daily flow set at 240 gpd uoa.ua an�rzoa Mason County OSS Installation Report pg. 2 parcel a '-I20 2S- 33- BE�noZm ABANDONMENTRECORD Were existing septic components abandoned as pan of ---- ------ E YES ❑ NO If yes, please describe'. inJ- e�4-COv„"`. 6F'Cx^QP�. OLA �Jt'9aw•�.^aAA c�}ea v.aQew.d. Were ail componen5 pumped out and propeby abandoned per WAC246-272A-0300? ------ -- ■ YES ❑ NO RECORD DRAWING Tnlz u a wrmanmt rc=n/a am must Et,.aMe arts e.acnpar..ncuyn m rNnmle m Ne n.w m m.inmwnce.c ni.s and NWrc drvebwnanc Typal Ra om,„nw mvm: ora,rmNa a mmdaa oaemaaon a layoN.s<odownm unxlomdon mm�maw.rcxr+eamm.m.mdmna mm laawaN wlNwaa,lauaon awes.wamainu, waua,roserroan aam,a.anma and omom.imuranm arxs w.an. lmmmdde rt�ae oaranae mayenm aeamonal e.laramaw ln.uu.am momva ana mead w+ma,a. 7 Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ENGINEER l certify that/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 clearadlapproved 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 l furthercertify 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. �ll�l� lexL� 10-(t- 24 �S' naum of Installer Data Printed Name of Signee . MASON COUNTY PUBLIC HEALTH • '1' The undersigned approves this Installation Report and ,.y . JOY srooeaa JOHNSON Record Drawing on behalf of Mason County Public ' '1 'PAULA1 �E D `I NE • Health: �p (o Z S ZEE SignatumofEnvimnmentall4asithSpllllllt Date (Stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE uwsm mrrzoie 0 !b 50 As V JEFFREL, FRugtoN PRRGFi# ¢20�-33-000aa 15c1b w) DEeGAN 0.D W r eXtb t iY> r 5 WEL-Co {J u)k 99584 AND v �\ C074 �<...e. g 15 ) YLPR`i`+ ro.fS -f o EHnRONM 1A�NEA d bank del Oct MPSONCOUNr REZ ' OLd D.F, Psno\ abw+de.d O 10 2 5-5 g is : 91 & 7� f LAN Ecs�n, I A V, O Audio-Visual Alarm " © C1CaT10L•i 9-Qom--'`. ® 1000 Gallon Septic Tank sicv3av r0 IP-A PANLA JOY JOHNSDN 2-COniP,a[�ant wiLk� 9umt Fiker (,O - Z.S- `'F 1000 Gallon Pump chamber !(00 FDA r�-45emet-� FYe.S.S'xYe Y+ec1 © lo'x -60' reserJa- Qre.siu.re Wacl .q 7�p •d�+ Q 0 id -t-o...,,K 4c, be x` IJT�µ 1��� �C'. dece�+uxissioned o�- W L�l-L C 33 t.CcL.'E-i eh� -F-eJ be \ Q--Lt6i+.Q-ci