HomeMy WebLinkAboutSWG2023-00526 - SWG As-Built - 12/11/2024 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH
APPLICANT/PERMIT INFORMATIO;vIBk
Permit Number SWG 2023-00526 Parcel# 22016-5
Applicant Name Brian Reid Subdivision (Nameot)
Applicant Address 847542nd Ave.SW
City, State, Zip Seattle,WA 98136 Installer Name ht Cons onSite Address 60 E. Fmnjo Beach Dr.,Shelton Designer Name aINSTALLATION CHECKLISTF Z�Full System Installation ❑Tank(s)Only ❑Drainfield Only ❑RepaiSystem Type Oscar 0550 PretreatmenOscar X02
>5 ft.from foundation? ---- - ---------------------- ❑wA fives NO
>60ft.from wells? - ---------------------------.- ❑ M ❑
ZY >50ft.from surface wate ? -----------------------. ❑ E ❑
FCleanoutbetweenbuildingandtank? ------------------- ❑ ■ ❑
Tank baffles present? --------------------------- ❑ 0 ❑
O. 24'access risers over each compartment?--------------- - ❑ ❑
WEffluent filter installed?--------------------------.. ❑ ■ ❑
Septic tank capacity(working) 1,060 oat Marw(aclaer Infiltrator
O D-bozwaterlevelandspeedlevelersused? -------------- - TWA ❑Tas ❑ No
ORManlfold/0.bo><accessible from surface?---------------- - ❑ ❑
CQCheck valves installed? ---------------------- --- ❑ ❑
2 Transport Line Size I inch ScnedukdCleas Son.40
Bedrooms installed(check one) 0 2 ❑3 ❑4 ❑5 ❑6 ❑ConmerciaWOlher
>10ft.from foundation?-------------------------. ❑ wa Eves NO
>100 ft.tram wells?----------------------------. ❑ ❑ ■
W >100ft.from sudacawater?-----------------------
- ❑ ❑
ILL >10ft.from potable waterlines?--------------------- . ❑ ❑
a_ >5ft,from property lines and easements?---------------. ❑ . ❑
K >30 ft.from downgradient curtainttoundation drains?------__-. e ❑ ❑
Dralnfield level and observation ports present----- ❑ e ❑
❑ Graveless chambers or, ® Clean gravel ysetl? (check one)
Proper cover installed over drainfield?--"e-'0`-`�1---- -------- ■ ❑ ❑
Pump tank setbacks consistent with septic tank?------------ - ❑ wA ■ res NO
= Pump tank capacity(flood) 1,060 oat Manufacturer Infiltrator
f24'access risers)and accessible from surface?-------------
Alarm or Control Panel Installed? ------------ - ❑ ® ❑
Control Panel equipped with Timer/E7M I Counter---------- -
IL Pump Installed in ❑ Bucket or ❑ On Block or ❑ Other Per Manufacturers Requirement
Pump Make/Model Lowridge TechnologiesN Floats or ❑Transducer
a Tank draw down 0.1 irdndn Pump capacity 30 epm Squirt Height drip fl
Pump on time 0.48 min Pump off fine 3.52 nin Daily flow set at 240 apd
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Mason County OSS Installation Report pg. 2 Parcel# 22016-50-03005
ABANDONMENT RECORD
Were existing septic components abandoned as on of this project? --------------- ❑ YES ® NO
If yes, please describe:
Were all components pumped out an0 proper%abandoned per WAC24e-272A-0000?-------- ❑ YES NO
RECORD DRAWING
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Record Drawing Attached
CERTIFICATION OF INSTALLATION
INSTALLER DESIGNER/ENGINEER
1 certify that 1 installed the system In accordance with 1 certify that the system has been installed in acoor-
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 diumdons
here have been cleareaVapproved by both the designer shown here have been cleareNapprovad 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
corm d a e. k form and attached Record Drawing is accurate.
Sigruaarreoflnda Dab a
Scott Johnson y
Pr#dea Nerve ofsignee
3g tS_ g
MASON COUNTY PUBLIC HEALTH 'PA
`
The undersigned approves this installation Report and 3&}v 5100214
Record Drawing on behalf of Mason County Public (j Dale L.Tahje
Health: LICENSED DESIGNER
Signature of Envlronmenrel Hee#h Specialist Date (stamp.signature arid date)
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