HomeMy WebLinkAboutSWG2019-00436 - SWG As-Built - 11/8/2024 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH
APPLICANT/ PERMIT INFORMATION
Permit Number SWG 2019-00436 Parcel # 32226-76-00100
Applicant Name Nathan Oakes Subdivision (Name/Div/Block/Lot)
Applicant Address 771 NE Southridoe Dr TRS 10-11 OF SURVEY 5/101 S 34/246
City, State, Zip Belfair,WA 98528 Installer Name Homeowner
Site Address Same As Above Designer Name Arrow Se tic Deal s Inc
INSTALLATION CHECKLIST
Q Full System Installation ❑Tank(s)Only ❑ Drainfeld Only ❑ Repair ❑Other
System Type Shallow Pressure Pretreatment Type 50'Attention
>5 ft. from foundation? - - - -- - -- - - - - - - ❑ N/A rE7 Yes
>50 ft, from wells? -- - -- -- - - - -- - - - - - - - - li>50
ft.from surface water? - ---- - - -- --- - - -ZFCleanout between building antl tank? - - _V01 IAOK - ❑ ❑
U Tank baffles present? - - - - - - - --- ��!I17A�t� rC�� ❑ ❑� ❑
24"access risers over each compartme PJ"lllT�� N ❑ ❑� ❑
4 ❑ 0 ❑W Effluent filter installed?- - - - -- - - - -
U)
Septic tank capacity (working) 1200 cal Manufacturer Sound Placement
o D-box water level and speed levelers used? - - - - -- - ❑ WA ❑ YES NO
BOLL Manifold/D-box accessible from surface? --- - ❑ ❑
a?Z Check valves installed? --- - -- -- - - - - - - -- - - ❑ ❑
OQ
2 Transport Line Size 2" Schedule/Class 40
Bedrooms installed (check one) ❑ 2 K 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other
>10ft, from foundation?-- -- - - --- - - - - - - -- - - - --- - -- ❑ NIA ® YES NO
❑ >100 ft.from wells?- -- -- -- ----- - - -- -- - -- ❑ ❑ ❑
W >100 ft.from surface water7 -------__ __ _ __ _- - ❑ ❑
LL >10ft.from potable water lines?-------- ---- - - --- -- -- - ❑ 0 ❑
?QQ > 5ft. from property lines and easements?- ----- - -- --- --- - ❑ ❑ ❑
C. > 30ft. from downgradient curtain/foundation drains?------ -- -- ❑ 0 ❑
Drainfield level and observation ports present -- - - - - - - --- - -- ❑ ❑
❑ Graveless chambers or ® Clean gravel used? (check one)
Proper cover installed over drainfield?--- -- - -- --- - --- - --- ❑ ® ❑
Pump tank setbacks consistent with septic tank?- - -- -- - - - - -- - ❑ NIA ® YES ❑ NO
Y Pump tank capacity (flood) 1200 at Manufacturer Sound Placement
Q24" access risers)and accessible from surface?-- ---- --- - - -- ❑ ❑
t— Alarm or Control Panel Installed? - - -- - - - - - - - - - - - -- -- -- ❑ ❑
Control Panel equipped with Timer/ ETM I Counter- - - - - - - - - - - ❑ ❑
7
a Pump installed in M Bucket or E On Block or ❑ Other
IL Pump Make/Model Liberty 290 ® Floats or ❑ Transducer
a
Tank draw down 2" in/min Pump capacity 44 apm Squirt Height 4 ft
Pump on time 2min. Pump off time 6hr. Daily flow set at 360 gpd
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Mason County OSS Installation Report pg. 2 Parcel# 3 2226-71a -001 00
ABANDONMENT RECORD
Were existing septic components abandoned as part of this project? ❑ YES ,� NO
If yes, please describe'.
Were all components pumped out and properly abandoned per WAC246-272A-0300? -- -- -- - - ❑ YES ❑ NO
RECORD DRAWING
Thls Is a ho—on,nature and moo he acaTe and de n-pt a enough,o re.mcare In 0e need o,mam[enEnae activities and Mum d.velnpm.n,. TYPlral n—,d
oixwloan-a— oremeNd ainan.J...reon al a a seprkranip lank location Nunn erred,reavve dr-reld,ananng and prnpuaed Luildinta,Lotion M work waohnes,
wNl..eba—aa-Pons.ae.aw,and over Teen a lance acceaa purrs. mamplere Revd Drams mar creme eddnlonel delara m nnm Insmnmmn app—ad and reared cermlu.
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 Scour-
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 a a ad Rec D ing is accurate. form and attached Record Drawing is accurate.
(o Z8 Ly
Signature of Installer born ~
rVa-than OCJl '5 (✓havh�ow�, )
Printed Name of Signee
MASON COUNTY PUBLIC HEALTH
The undersigned approves this Installation Report and s,ag
r�r
Record Drawing on behalf of Mason County Public PAULA JOY JOHNSONt JSr N r`(ONEY "
Health. IDURREy
I -S-Z'4
Signature of Environmental qealth Specialist Dale (stamp, signature and date)
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE updated aav:ms
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1200 Gallon Septic Tank
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.Effluent Filter 1
O4 1D00 Gallon Pump Chamber U
OValve Control Box