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HomeMy WebLinkAboutSWG2024-00169 - SWG As-Built - 11/1/2024 ♦_r wl Mason County OSS Installation Report pg. 1 S� MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWGSWG2024- Ob16c1 Parcel # 3Z33 ( -?N-SOCT Applicant Name Hoop BEN 'A[ c I I Q. Subdivision (Name/Div/Slock/Lot) Applicant Address gp5 HARRINGTON AVE NE N405 City, State, Zip RENTON WA 98056 Installer Name LOGAN SPEAR Site Address 27051 N US HIGHWAY 101 Designer Name MIC H HALVERSON INSTALLATION CHECKLIST ® Full System Installation ❑Tank($)only ❑ Drainfield Only ❑Repair ❑Other System Type ATU IQ Dressure Trench. Pretreatment Type NuWajg[BNR-tnnn >5 ft. from foundation? ------------- -p-------pp-n--p---- ❑ NIA AYES El No >50 ft.from wells? -- ----------- f:r 1l LY ❑ ® ❑ Y >50 ft. from surface wait.(! •----- -- 4��a 4C lL ❑ Q ❑ FCleanout between building and tank? _—i Hr-QCi-2 5 2024__ , ❑ © ❑ tl Tank baffles present? - -- - - - --- U� '- -- ❑ ® ❑ a24" access risers over each compartmen -�-----------'• ❑ ® ❑ W Effluent filter installed?-- - - - -- - --- ❑ ❑ ❑ to 2383 gal Manufacturer R^ ^"R s^"^'"' Septic tank size � D-box water level and speed levelers used? --------------- ❑ NIA [] YES % NO DO Manifold/0-box accessible from surface?-- - ------- ❑ 0 ❑ mZ Check valves installed? - - - - -- -- - - - --------------- ass ❑ ❑ Transport Line Size 2 in Schedule/Cl 40 Bedrooms installed (check one) ❑ 2 ❑3 ❑4 ❑ 5 ❑6 ®CommemiaVOther ❑ I >tOR from foundatlon?•--- ------- ---- '-" ❑ NIA ID YES NO--- - --- ❑ >100 ft.from wells?------- -------------------- -- ❑ >100 ft. from surface water? -- ❑ ® Cl LL >10 ft from potable water lines?------- --------.------- El El > 5 ft.from property lines and easements?-- --- ----- ❑ El El 30 R from downgradient curtain/foundation drains?---------• ❑ ® ❑ G ----- - - - Drainfield level and observation ports present ---- -- ❑ ❑ Graveless chambers or ® Clean gravel used? (check one) ❑ . ---- - --- ' Proper covennstalletl over ❑ X Pump tank setbacks wnsistant with septic tank?------------- ❑ wA ❑ YES NO ZPump tank size 97Ar.+zg1 gal Manufacturer Q 24-access riser(s)and accessible from surface?- --- ---- - -- - - ❑ ® a IL Alarm or Control Panel Installed? - - --- -- -- -- - --- - - --- - ❑ 2 Control Panel equipped with Timer I ETM I Counter- - - - - --- --- ❑ ® ❑ a Pump installed in ❑ Bucket or ❑ On Block or ® Other Orenco Rviian_9d95 S Pump Make/Model -^^ pC7510 © Floats or ❑ Transducer d Tank draw down 2 inlmin Pump capacity 67 5 opm Squirt Height_ : ft Pump on time t45 min Pump off time z i,x Daily flow set at MM apd uaa�erzrrsore Mason County OSS Installation Report pg. 2 Parcel• 3Z33 I- zN --1 to ABANDONMENT RECORD Were existing septic components abandoned as pan of this project! • --- ----------• ® YES ❑ NO If yes, please describe: Were all components pumped out and property abandoned per WAC249-272A-03007 - ------- ® YES ❑ NO RECORD DRAWING TNe b a assIAW,re aM Mwr W a Ma aM daacnpdw~W RIW In tM n M MajM .me aMNWa eM town dWWM SM. rffl l Recall OmHnye ex : Ore W A aafM abnWMtn 3 leya SeeWNs,ark reserve drehdeM,Ws4M aM PmW Wdd"O bcetbnMwel4,wMMines, weXa,oyyietlon OoiN,deandMs,and oNemaXXenanoe axw pWN. Inwmp4le Racdd IXrxings maY aea2 WdNMral delays M Mel Melellelbn eppreYal aM rebut peemXa. 'Installed Per Design jyS) tl�l ,13 „ 2�� Stlts 0 Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNERI ENGINEER 1 certify that I installed the system in accordance with I certify,that the system has been installed in ac or- 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 1 further certify that all information contained on this ;,attached Ram Drawing is accurate. form and attached Record Drawing is accurate. l V e �r-- 10121194 Signature Ef Installer Date Printed Spear P dnted Name of Signee N OI MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and \ � Record Drawing on behalf of Mason County Public N Rvumom Health: _ ucommoael0ll� ! V1 l 0h(>WL-A t i�LH Signature of Environmental H647 Specialist Data (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE udaaua erztrzmn �sspt i �R aka A , = I T s I I O / 6� o y i i D J J a` .I.w - m I y m - - - - - - - - - - - o m 7. I I y I I � I I ^ w.. N I m _ I a s I I � I � o Q� N I I I I m Q c Q S I I 1 / / }I �6 Q I $I m IIIIIi 3 I gl m I gl O �>-3 m i �^\ .M� V OI ETA V N z 2 v \ iK�� x_a o � E NNm NOm o N o 0 g m y c I o 3 Aaommm vc� m wd 'z° ` GS i iv o �H F3£ 33 3. 38 01 C m 3 a E i� N m m n 0 u o m 0 71 A m a0 O ¢ O O � m m � AnnllrantlOwnpr SXEET NUMPFv M.Halverson Design LLC Hood Rentals LLC sR 32331-23-90108 y 27041 N MY 101 32331-23-90109 PO BOX 1519 Shelton Wa 98584 15914 148th Ave NE , „ 32331-24-90010 Halversondesi nllc outlook.com Woodinville, Wa 98072 System 'B REVISION p:1