HomeMy WebLinkAboutSWG2024-00067 - SWG As-Built - 12/2/2024 Mason County OSS Installation Rapport pp. i MASON COUNTY PUBLIC HEALTH
APPLICANT/PERMIT INFORMATION
Permit Number sm -2024-00067 Parcel# 1233252000D1
Applicant Name pub Moab, Subdivision(Name/Div/Block(Lo0
APPlkant Address 41 EDavbreak Or CLIFrON B)DDE LOT.1
City,Stale,zip B;Irar WA9B524 IrntaAer Narne rcevm Smm
Silo Address I IIE Osybreak Dr Designer Name dim zmnv
INSTALLA71ON CHECKLIST
■Full SM.Imtsiol(on ❑Tank(e)Only ❑DralnfiddOrly ❑Raper ❑01her
System Type Presure Detnnuum Pretreelmem Type
>Sft.from founnation? --------------------------- ❑wA ■vas ❑No
>50ft,from wells? ----------------------------- ❑ ■ ❑
ZY >SOa.homsurfemweleR ------ . ❑ ■ ❑
r Cleenout between halsirN ship tank?------------------- ❑ ■ ❑
tg Tank bases present?___________________________ ❑ ■ ❑
LL24-access risers over each compartment?-______________- ❑ ■ ❑
al E1Mem filler instakedt.-------------------------- ❑ ■ ❑
Septic tank capaciry(workng) 120o sal Manumdum Haoerman
O o-box water lawl shot speed lowlers used? -- ----_---.. ---. ■uu ❑vas NO
Q�LL Manllol0l tpx accesme aom surtece>.---------------- ❑ ■ ❑
Wa Check values installed? -------------------------- ❑ ■ ❑
E Transport Line Size 2' SchedulelDless Sch 40
Bedrooms lnstelled(check one) 02 ■3 ❑4 ❑5 ❑S ❑CommarO.Il loll
>10ft.a0mfouMabon?-------------------------- ❑N/A ■vas ❑ No
O >100 fL from wells?_____________________________ ❑ ■ ❑
W >log It aameudacewetaR------------------------
I[: >10ft.thm potataewater Mes?-------------------- ❑ ■ ❑
>5ft,ftom property fines and Basements?---------------- ❑ ■ ❑
>30ft.from downgredkm cumin/foundskn drain?---------- ❑ ■ ❑
Drainfied level ark observation ❑ ■ El
present --------------
❑ Orawles i Chambers or ■ Clean growl used? (check one)
Proper cover installed over drassfil-_________________- ❑ ■ ❑
Pump tank setbacks consultant with septic tank?------------- ❑ NA ■ vas ❑ Nc
= Pump tank tapacdy(Ilood) 12M sal Manufacturer Hagenman
Q 24-access risers)and accessible from surface?------------- ❑ ■ ❑
yAlarm or Control Panel matatle0?--------------------- ❑ ® ❑
jControl Panel equipped with TimaN UNI l counter----------- ❑ ■ ❑
_d Pump notation in ■ Bucket or ❑On Bk N* or ❑ Omer
1 Pump MakeRAodel libgry 2w
Z ■Floats or ❑Transducer
y Tank drew down 2 IrJmn Pump capacity 50 gpm Squirt Height 10 ft
Pump on time Irrvn t0 Sec Pang ofrtirrw 4 hrs Deity flow Sal at DO dpd
Maven County OSS IneWlMien Report pg.2 PmcMa 12�17 seuml
ABANDONMENTRECORD
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RECORD DRAWING
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CERTIFICATION OF INSTALLATION
MTALLER DEEIONER/ENGINEER
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MASON COUNTY PUBLIC NEA
The urNefapned appmvea tda InsteN&kai Repay and
Record Drawing on behalf of Mown Coolly Public
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