HomeMy WebLinkAboutSWG2023-00180 - SWG As-Built - 12/12/2024 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH
APPLICANT/PERMIT INFORMATION
Permit Number SWG 2023-00180 Parcel# 32021-58-03001
Applicant Name Accurate Devlopment Inc. Subdivision (Name/Div/Block/Lot)
Applicant Address PO Box 76 SHORECREST BEACH ESTATES#1 BLK:3 LOT: 1
City, State, Zip Allyn WA 98524 Installer Name South Shore Construction
Site Address 11 E Earl Or Sharron WA 98584 Designer Name Arrow Septic Designs Inc
INSTALLATION CHECKLIST
Full System Installation ❑Tank(s)Only ❑ Drainfieid Only ❑Repair ■Other soar Pre u.s
System Type Subsurface OnP Pretreatment Type Nu Water BNR-500
>5 ft.from foundation? ---- - - - - - - - - - --- - - -- -- - - - - - El MIA ■YES ❑ NO
>50ft,from wells? -- - - ---- -- --- - - - -- - - - ---- -- -- ❑ ■ ❑
Z >50ft.from surface water7 - - -- - - -- -- - - -- - --- - --- -- El
■
HCieanout between building and tank? - - - --- - ----- ------- ❑ ■ ❑
p Tank baffles present? - - -- --- - -- -- -- - --- - --- - - - - ❑ ■ ❑
24'access risers over each compartment?--- - --- ---- --- -- ❑ ■ ❑
W Effluent filter installed?-- -- -- -- -
-- -'-- - - -- -- - -- --- ElIS❑
Septic tank capacity(working) Sk.NUWster gal Manufacturer Infiltrator
G O-box water level and speed levelers used? -- -- - ----- - - - -- ❑ NIA ❑ YES ■ NO
J ❑ ® ❑
50 Manifoltl/D-box accessible from surface?- - - -
0Z Check valves installed? -- - - - - - - - - - - - - -- - -- -- -- - -- ❑ ■ ❑
cQ
Transport Line Size 1' Schedule/Class 40
Bedrooms installed(check one) ❑ 2 ■3 ❑4 ❑ 5 ❑6 ❑CommemialrOther
>10ft.from foundation?--- - - -- -- - - - - El WA ■ YES NO
>100 ft. from wells?-- - - -------- - - ❑ ■ ❑
W >100 ft.from surface water?- - - - - --- - ❑ ® ❑
LL -10ft.from potable water lines?- -- ---- ❑ ■ ❑
Q� > 5 ft. Imm property lines and easements?- - - - - - -- - - - - - - - - ❑ ■ ❑
LL > 30 ft. from downgradient curtain/foundation drains?--- - - -- - - - ❑ ® ❑
Drainfieltl level and observation ports present - - --- ❑ ® ❑
Proper cover installed over drainfield?--- - - - - - -- - - -- - - - -- ❑ ■ ❑
Pump tank setbacks consistent with septic lank?- - --- - - - - -- -- ❑ NIA ■ YES ❑ No
Y Pump tank capacity(flood) 1,287 at Manufacturer Infiltrator
i .,l. .....,...t.t. e......ni.a.......n...^ ❑ IIIIII O
~ Alarm or Control Panel Installed? - -- --- - - - - -- -- - - -- - - ❑ ■ ❑
a
Control Panel equipped with Timer/ETM/Counter- - - - - - - - - - -
Pump installed in ❑ Bucket or ❑ On Block or ■ Omer Tuba-flow inducer
0- Pump Make/Model Sta-RfteSTEP20-03 20opm,115y,.5hp ■ Floats or ❑ Transducer
d Tank draw claim, 1' in/min Pump capacity 2.5 pin Squirt Height — ft
Pump on time 12 min Pump off time 1.84hr. Daily flow set at 360 ppd
tlN.N�BRIR018
Mason County OSS Installation Report pg.2 parcel p
ABANDONMENT RECORD
Were exstng septic components.abandoned as part of this pmjed7 --------------- ❑ YES NO
It Yes,please describe:
VYER all components pumped out aW properly abandoned per WAC2G&272A-03007-------' ❑ YES ❑ NO
RECORD DRAWING
iNY b I ybMwe[IYmtl W tisl lb KMb aM MKa1PM�^^W�b MWb In IM nKa or m�InbuK��[NitlK mC NJ�Cn'�bOm�K T1 —
pM'Iy Vim: LtlYYtldC 6naYMG a1MNEPl d IeNa.5C914Ai^W bnY Yr�fYh Naf.ne+'.raKfw NYYfietl.adMO sA PR�WAY.Cebl dxV{.MM1w.
w.mKeumvaa mnbe.N eM mbwMu��. naomobb come 0�mryaweemuaMeYyY b6Y InmoYNen.vo�aW�sewY+b.
Record Drawingfittached
CERTIFICATION OF INSTALLATION i
INSTALLER DESIGNER/ENGINEER
i certify that l installed the system in accordance with I cer*that the system has been insteUetl in addl
the septic design stamped'APPROVED-by Mason dance with the septic design stamped'APPROVED'by
County Public Health and that env deviations shown Mason County Public Health and that any deviafions
hen;have been clearad/approved by both the designer shown here have been cleared/appmved by both
and Mason County Public Health and meet all State 'Mif and Mason County Public Health and meet all
and Mason County Codes. State and Mason County Codes
I funhercerW that all intonation contained on this I further certify that all infonati'on contained on this
to art ad Re rawtng is a orate. form and attached Record Drawing is accurate.
/ 2�
Signature oflnsbller Date
Printed Name of Signee -`
MASON COUNTY PUBLIC HEALTH 0
The undersigned approves this Installation Repair and V�. i
Reco�rd.D aWn'g be
on_ half of Mason County Public
u\ r' " vAU,T�A JOi`Y JONNeON
a t z-n•s�c
Spnahaa ofEnvirohmaatal Health SpeclaW Deft (stamp,signature and date)
THIS FORM MAY 9E SCANN MO AVMLASE FOR RJSI.JC VIEW ON I E MASON COUNTY N'ES SR—c �����
70'
1 �v�cl� : 20 -Feet
25'
� ' 12,c5tra6
Z° 1��P � Il E �a� tl deride
i !ae. LL "1859
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O p o 0
APPROVED
2-7' K 48'
LO
MASONCCIE C 12 2024
RONMEN TAIHE
M � REr
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E E 0 z) --
i
. O Audio-visual Alarm
Ocl a out
O3 500 Ganon Pre-Trash Tank u
O4 NuWater HNR-500 Pteteatmeat Tanis
N ms o.v V
. O 1,000 Gallon Pump Chamber Pa Vtn J(IY JOHNapN
OSubsurface Drip System Headwork,