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HomeMy WebLinkAboutSWG2024-00033 - SWG As-Built - 11/1/2024 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number swG 2024-00033 Parcel# 32136-13-00082 Applicant Name Helen Hamlin Subdivision (Name/Div/Block/Lot) Applicant Address 2210862nd Ave City, State, Zip Spanaway,WA 98387 Installer Name House Brothers Site Address W 60 E Deer Creek Rd Shelton Designer Name Arrow Septic Designs Inc INSTALLATION CHECKLIST ® Full system Installation ❑Tank(s)Only ❑ Drainfield Only ❑Repair Other Lass ua tank coon In pump System Type Pump to Gravity Beds Pretreatment Type >5ft.from foundation? -- ------------------------- ❑WA ❑O YES NO >50ft,from wells? - - ----- - - --- ----------------- ❑ 0 ❑ Z >50ft.from surface water? -- - --- - - --- - - -------- --- El ❑ Cleanout between building and tank? ----- - ------------ ❑ ❑ L) Tank baffles present? - - - - - - - ---- ----- -- - - ------- ❑ ® ❑ t- 24'access risers over each compartment?---- - - -- - ------- ❑ ❑� ❑ W Effluent filter installed?-- ---- =-- ----- - ------- ----- ❑ © ❑ W Septic tank capacity(working) 1.500+ 1 250 gal Manufacturer HE Precast O D-box water level and speed levelers used? ------- ❑ NIA © YES ❑ No Cu Manlfold/D-box accessible from sudacev d1 ❑ ® ❑ roZ Check valves installed? -- --a+ - --tC- - -- - - ❑ ff ❑ Transport Line Size 2" Schedule/Class 40 Bedrooms installed(check one) ❑ 2 ❑3 ❑4 ❑Q 5 ❑6 ❑Commercial/Other >10 ft.fromfoundation?-- -- -- -- --------- - -- - --- - - ❑ NIA YES NO >100 ft, from wells?--- -- -------------------- ---- ❑ ❑ W >100 ft. from surface water?- - ---- --------- --- -- -- -- ❑ ❑ M >10ft.from potablewater line*?- - - - --- ------ -- - - --- -- ❑ 0 ❑ Q? > 5ft.from property lines and easements?----- -- - - - - - ---- ❑ 11 ❑ C > 30 ft. from downgradient curtain/roundation drams?-- - - - - -- -- ❑ IN ❑ Drainfield level and observation ports present - - - -- ❑ ® ❑ ❑ Graveless chambers or R Clean gravel used? (check one) Proper cover installed over drainfield? - - - ----- -- ❑ I] ❑ Pump tank setbacks consistent with septic tank?------ - ------ ❑ rap ® YES ❑ No Y Pump tank capacity(flood) 1,250 at Manufacturer HB Precast-2-comp with lift pump Z F 24'acceas riser(*)and accessible from surface?------------- ❑ rl a Alarm or Control Panel Installed? --- ---- ------- - ---- -- ❑ 0 ❑ Control Panel equipped with Timer/ETM/Counter-- - - - ---- -- ❑ ❑ 0 o- Pump installed in ❑ Bucket or ■ On Block or ❑ Other p- Pump Make/Model Lift Pump-Liberty 293 ® Floats or ❑ Transducer a Tank draw down - in/min Pump capacity gpm Squirt Height - ft Pump on time - Pump off time Daily flow set at gpd up>au=pm.ro,. Mason County OSS Installation Report pg. 2 Parcel it 79-O IzJ- zog2 ABANDONMENT RECORD 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 WAC246.272A-0300? ---- —- - ❑ YES ❑ NO RECORD DRAWING This is a prmuwm room ua must he amurro and ancnW.e enough to n ovte In the n.aa or medmaunt.aalvWas and noun a..ewpmant Typical amount Drawings doman: omMfew a manlydp camel It layout,S.gWoumo a nx Imtian.No*anw,...dalnnNtl,m:'vonq sib oroWmed WiBiy.,ImYon dweua.watallrca. well,udeervmbnouN,tleenou6,and Mee maammmmmaaaeepaints. lnwmpl.ls a mj Dnwirea may Peat,addloorul delays.,final ineuRPomn appnuel and rouses Paemib. Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ENGINEER I certify that l installed the system in accordance with l car*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 cleared/approved by both the designer shown here have been c/aamdrapproved by both and Mason County Public Health and meet all State myself and Mason County Public Heatth 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 informat-,conr_.%red On this form and stlacl d Record Drawing is accurate. form and attached Record Drawing is accurate. {. .. ,i��� 10 01 2 Signal ra of lnstaller�// Date a�f Printed Name of Signee � wa MASON COUNTY PUBLIC HEALTH The underaigned approves this Installation Report and F - min vav d Record Drawing on behalf of Masan County Public PAULA.lov IoimsoN'y` Heatth: ads, 5" 0'4�n2q l� fo - 3 /-z� Signature of Environme tal Health Specialist Date (stamp,signature and date) THIS FORM MAYBE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE udealesamrmne SGALE " =1oO' 0 30 0o ao sac � � Ftrr�e= Helen{-lamlin i 3 BR ?p pm,,kA*3nb'w oom g0 E PeERUVM-RC dra'vlf--ald 66 a wowda"y-, b go^y 3&0,�8,otEN�6}�a+� '` � r �� ,p���yy�, : V e �So, C 4EEK suppER H u Me r zr, I GREEK Z `e'r o o D a � z '� Y ��, ' •` �q T S O ZBF' p �Zg.aS PAULq JOY JOHN50N -1 O r �f b IGNEYt" � Ke _ m59 z m at SOQ Cleanout p 1 - 3t-uk Ol �5 4k O 2I artm Gallon Septic Tank c r rier g. mpsnx with EfRuent FYlxer i C $ and c with ssurfacerelers and cover m surface O ��zSo Crs-t'� L-cm-w.5e{•xc-«w�