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HomeMy WebLinkAboutSWG2022-00377 - SWG As-Built - 11/14/2024 Mason County OSS Installation Report pg. 1 MASON COUNT ,PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION << Permit Number SwG 2022-00377 Parcel# 32104-54-001A4 Applicant Name AS Fine Homes LLC Subdivision (Name/Div/BIo�oL t)" Applicant Address 871 E Beach Dr Union, WA 98592 Alderbrook GIW Div 4/Lot 114\ I c City, State, Zip 71 E Country Club Dr N Installer Name Hanson Excayakn c.. Site Address Union,WA 98592 Designer Name Arrow Septic Designsync INSTALLATION CHECKLIST 0 Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑Repair ❑Other System Type Shallow Pressure Pretreatment Type >5ft.from foundation? -- ------ - ----- --- -- - -- - -- -- E] NIA OYES NO >50ft,from wells? -- --- - - - - - - --- -- - - -- ❑ x ❑ i >50 ft,from surface water? -- - -- ElW El Cleanout between building and tank? - ❑ ❑t♦ ❑ U Tank baffles present? - ❑ ❑t♦ ❑ r- 24'access risers over each compartment?------ - -- - - - - --- ❑ W ❑ a W Effluent filter installed?--- --- - -- -- - - - - - - - - - ❑ ❑t♦ ❑ fN Septic tank capacity(working) 1.200 gal Manufacturer Hagerman ❑ D-box water level and speed levelers used? --------------- ❑ NIA ❑ YES ® No QJ O Man''rfold/D-box accessible from suAace?----------------- ❑ ❑ moQ Check valves installed? - -----— ^=`=s'P-�°=�` -- - - - - - ❑ ® ❑ 2 Transport Line Size 2- Schedule/Class 40 Bedrooms installed (check one) ❑2 ®3 ❑4 ❑ 5 ❑6 ❑CommerciaVOther >10 ft.from foundalion?-- -- -- - ---- - ------- E] NIA ® YES ❑ NO ❑ >100 ft.from wells?--------------------------- -- ❑ 0 ❑ w >100 ft.from surface water?- ------ - ----------- - --- - ❑ ® ❑ M 110ft.from potable water lines?- -- - --- - - - --- - - ❑ ❑ Z Q > 5ft.from property lines and easements?- - - - ---- ----- - - - ❑ ❑ IY >30 h.from tlowngredient curtainRountlation drains? - ❑ ff ❑ Drainfield level and observation ports present - - ---- ❑ © ❑ ❑ Graveless chambers or ® Clean gravel used? (check one) Proper cover installed over drainfield?--- - - ------ - ----- -- ❑ IN ❑ Pump tank setbacks consistent with septic tank?-- --------- -- ❑ NA jj YES ❑ No ZPump tank capacity(flood) 1,000 gal Manufacturer Hagerman F24-access nsens)and accessible from surface? ❑ ® ❑ IL Alan or Control Panel Installed? ----- - -- - --- -- - - - - - - - ❑ 0 ❑ jControl Panel equipped with Timer I ETM/Counter-- - --- -- - - - ❑ ® ❑ o. Pump installed in ❑ Bucket or e On Block or ❑ Other a Pump Make/Model Liberty 280 W Floats or ❑ Transducer =a Tank draw down 2- in/min Pump capacity 38 gpm Squirt Height 4.5 ft Pump on time 2.33 min Pump off time 6 hr Daily flow set at 360 grid _o-*9-�srzi:rz Mason County OSS Installation Report pg. 2 parcelM ABANDONMENTRECORD Were existing septic components abandoned as part of this project? - -- - --- -------- ❑ YES NO If yes, please describe: Were all components pumped out and property abandoned per WAC246-272"300? -------- ❑ YES NO RECORD DRAWING Tllb Is a permanent recall anC must bs a[[unb vq dw[dptive enougfi u,Meub in Ma nxG N meiMananu a[Wltlw ell N[un dwabpmant T'.RaCprO Dnvnngs main: Dminneld&diannW onema0on 8laycut SaptiGpump bask ba4on.Nandi artow,reaerca tlAiMeld,sousing and proposal buildings,Iwsfwn al idle,wtletlinw, walls,abaanadon psna 4unme,and oMa meinbranw deal pair. Inwmall Rsbad Drsnngs may Cause addidenal dews in final Iusa ion approval and re1rtN penna, .$j Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ENGINEER 1 certify that I installed the system in accordance with I certify that the system has been installed in accor- the septic design stamped`APPROVED"by Mason dance with the septic design stamped'APPROVED"by County Public Health and that any deviations shown Mason County Public Health and that any deviations here have been cleamdapproved by both the designer shown here have been cleared/approved by both and Mason County Public Health and meet all State myself and Mason County Public Health and meet all and Mason County Codes. State and Mason County Codes I further certify that all information contained on this 1 further clarify that all information contained on this form and attached Record Drawing is accurate. form and attached Record Drawing is accurate. Qtr,�W.", II-b-7,+ S4&6re of Installer Date Jared Hanson G, Printed Name of Sign" y' a MASON COUNTY PUBLIC HEALTH r ( �'j The undersigned approves this Installation Report and 'PAU A JOYJJOHNSON.. Record Drawing on behalf of Mason County Public IC E 'f En" 'rA Health: REy �Y��YIII Sgnature of Environmental H Ill Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEWON THE MASON COUNTY WEB SITE Wauw drs+rsp+e �}$ f vt HOm-,S PArc{I 8 32t64 5v ooll y I 71 E Covht try (Iu f i Z�� f--*--+—sue i APPROVED Novi 4-2024 MASON COUNTY EWRONMENTAL HEALTH RET Zr OAudio-Visual Alarm _ _ o © Cle out 0 © 1200 Gallon Septic Tank 2-Compartment with \ Effluent Fllter 3 1000 Gallon Pump Chazaber © Valve Control Box 3�MIh { , J 100349 PAULA JOT JOHNSON E%P1164