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HomeMy WebLinkAboutSWG2023-00443 - SWG As-Built - 12/12/2024 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANTI PERMIT INFORMATION Permit Number SWO Z.0 7-3 —00 Lf LA Parcel# 3 Zz - $0— G2 oo-z— Applicant Name lCt-IF 5w C-y Subdivision(NameIDivtBlocklLot) Applicant Address Z"'I Ld£5-V4-oJT PL.4) City, State, Zip SCJrTTtX—WA, R-20(d Installer Name r�eJ f-r"lt.-Cy Site Address /05340 A)E A)o&Trt5j!gf - ✓�DesignerName �.—T�-1t7u1 -4Z:E-- STALLATION CHECKLIST ❑ Full System Installation LgTank(s)Only ❑ Orair l Only ❑Repair ❑Other System Type Pretreatment Type >5 fL from foundation? •-------------- ------- ----- ❑NIA a NO >50ft.from wells? - - - -- ----------- ---- ---- ----- ❑ Z >50ft,from surface water? --- - - - - -- -- ----- - -- ---- - ❑ [_�/ ❑ Cleanout between building and tank7 - ------------------ ❑ L� ❑ (� Tank baffles present? - - - --- - - - - -- - -- - ------ -- --.- ❑ ❑ C 24"access risers over each compartment?-- - ------------- ❑ ❑ ; N Effluent filter installed?. - -- - - -- - - - - - ------ - - - -- � ❑ Septic tank size /OCx- sal Manufacturer O D-box water level and speed levelers used? - - - - ---------- ❑ NIA ❑YES ❑ No 0J 0 ManifoldlD•box accessible from surface?- - -- - - - - - - - - -- --- ❑ ❑ ❑ 09aZ Check valves Installed? - - - -- --- - - - - - - - --- - - - ---- -- ❑ ❑ ❑ rog Transport Line Size Sc le r'�y 0 Bedrooms installed (cha one) ❑2 "J'" ❑5 ❑5 ❑CommemiaUOtl+ar 75 >10 ft from foundation?------ --�-A1 -- -- -- - - ❑ WA ❑ YEa [,� NO y��J >100 ft.from wells?-- - -- --4----- --- ❑ ❑ d ICI >100 ft.from aurtece wets --• ❑ '❑ (� b a >to ft.from po ble�/,','jyp,",'es?- - -------------------- 2 > 5ft.frump pe Yis and easements? ❑ ❑ d r >30 ft,from ngradient curtain/foundation drains?•--- -----• ❑ ❑ d __`>"' CCC Drainfield level and observation ports present - - - - ---------- ❑ ❑ ❑ -� ❑ Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed Over dralnfield?----------- ------ -- ❑ Cl ❑ Pump tank setbacks consistent with septic tank?--- ---- ------ ❑ WA ig YES ❑ No Y Pump tank size /OOU gal Manufacturer /l 2 F ❑i ❑24"access riser(s)and accessible from surface?•---- -------- ❑ AlarmorControlPanelInstalled? - - -- - - ---- ---- - ------ ❑ Er/ ❑ Control Panel a uipp q tlXithTimerIETMICounter------ ----- ❑ L'J ❑a IL Pump installed in Q) Bucket or- ❑ On Block or ❑ OIMr 7 Pump Make/Model Lzc z Y Z9 b I�Flosts or ❑ Transducer 6 Tank draw down Inlmin Pump capacity opm Squirt Height ft Pump on time Pump off time Daily Flow set at apd >v . Mason County OSS Installation Report pg. 2 parcel 0 ABANDONMENT RECORD Were existing septic components abandoned as part of Inis project? -- - - - - - - - -- - - -- ❑ YES NO If yes, please describe: Were all components pumped out and properly abandoned per WAC245-272A-03004 - - --- --- ❑ YES ❑ NO RECORD DRAWING T11N U r INnroMnl ncoN mtl mun b.pUnb xntl tlYrttlpti-muupp.i -..In IN nM or nxln.n... ia..-mtl NI—YmbgnmL Typlal R. DIwJ gs=10: DnOMb&naNbd(ifMnlebl&I"Il,eplh/pUnp Wx w.t.,Nom emW mOrvp oxnlbk,sienna and pf.~bwon .,IpnIM OI.N ,wpwi.,, wah.00wMlbll poop,MYId4,eM pxNf mYnlgMnn Mon polne. NWnIpW!PKOIA DIfMIIaY nxY oehe atlJIIIGIM MIxH In IY41 hefbtlnl 1pnOrel Uh n1eY4 pvlMe. -P � Z VaCJ . COS I- 0i ❑ Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER) ENGINEER 1 cartury 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 stomped"APPROVED"by County Public Health and that any deviations shown Meson County Public Health and that any deviations here have been clearedrapproved by both the designer shown here have been cleared/epproved by both and Meson County Public Health and meet all State myself and Meson County Public Health and meet at/ and Mason County Codes. State and Mason County Codes I further certify that all information contained on this I further certify that ail information contained on this rm d atfa ad cord D�wing is accurate. form and attached Record wmg is accurate. Sia�naN of lnafall'er/ r Date l �P { L a"I Printed Arms of tignoo MASON COUNTY PUBLIC HEALTH stDome�' ✓` '� The undersigned approves this Installation Re ort and LINDYE waITE '!- pp p tilcausFD oaslcraEa Record Drawing on behalf of Mason County Public E%viPEe osla Health:{� � ? Slgmen ofEnvimmemalHealth Specialist Date (stamp,signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WESSITE upmamrnma Setup info 10890 NE Noth Shore RD (Jeff Sweeney) Drew down 2"44 gallons per minute On time 1 min Off time#zbours 45 gallon dose Z per day Squirt height 6' Cycle counter 11 Timer 13:58 L ` � . �� 0 � G �J i Qp ', �•, No �\ �� ��, 0 �G �[U �� d F� �� G � l�l 1. PROPOSED GARAGE/>Sp;F 2. 1200GALLON CONCRETE TRAFFIC - RATED SEPTIC TANK 3 1200 GALLON CONCRETE TRAFFIC RATED PUMP TANK 4, CONCRETE BLOCK RETAINING WALL 5. DRAINFIELD FOR 32224-50-000082 SWG2011-00129 6. AUDIOIVISUAL ALARM 7. CLEAN OUT 8. TRANSPORT LINE 9. DRAINFIELD FOR 32224-50-00029 SWG95-00395 322? _$�p � y 10. DRAINFIELD FOR 32224-50-00084 SWG96-00011 11. CATCH BASIN 12. 12- CULVERT TIGHT LINED. E �fO i SOS I !ZO -i APPR I s ©� ;II, oQVEQ ab 3 l E E E l o L D ICIER 3azzy-s'o_opeaq Na l04 32?Z�I-SD-OoLi� 1 . Proposed garage 2. 1000 gallon traffic rated septic tank 3. 1000 gallone traffic rated pump - 4. Conrete block retaining wall 5. Drainfield for parcel #32224-50-00082 6. Audio/visual alarm 7. Clean out 8. Transport line 9. Drainfield for 32224-50-00029 10.Drainfield for 32224-50-00084 11 .Catch basin 12. 12" tight line culvert 13.20'x45' reserve area parcel �Jyf/ 32224-50-00084 14.20'x45' reserve area parcel 32224-50-000029 i1 , so.000Z9 t3 �7 fa 3