The URL can be used to link to this page

Home My WebLink AboutSWG2022-00143 - SWG As-Built - 12/10/2024 RECORD DRAWING (ASBUILT) pg. 1 MASON COUNTY PUBLIC HEALTH PARCEL IDENTIFICATION Permit Number SWG 2022-00143 Assessor Parcel # 12030-31-90083 Applicant Name David Duvall Subdivision (Name/Div/Block/Lot) Applicant Address 1470 S Nightfield Circle City, State, Zip Ridgefield, WA 98642 Installer Name Mason County Excavating Site Address 605 E Inspiration Way Designer Name Adam Hunter INSTALLATION CHECKLIST ✓❑ Full System Installation ❑ Septic Tank Only ❑ Drainfield Only ❑ Repair System Type DRIP Pretreatment Type N.ler BNR600 >5 ft.from foundation? -------- - �i 1�7 p`qq) I� - ❑N/A ❑✓ YES ❑ NO >50 ft.from wells? --- -- -- - -- - ++��F��u� 'i - ❑ ❑✓ ❑ Z >50 ft. from surface water? ---- - - ❑✓ El- H ❑ Cleanout between building and tank? - --- - -4 - ❑ ❑ ❑ U Tank baffles present? - - ---- - - - - -R-- -- - ❑ ❑✓ ❑ a24"access risers over each compartme (7Y - ❑ ElrLLl Effluent filter installed?- - -- - 21 ❑ El Septic tank size 1200 gal Manufacturer Hagerman Precast o D-box water level and speed levelers used? - - - -- -- --- ----- E] WA ❑YES ❑ NO 0J 0 Manifold/D-box accessible from surface?-- -------- - - ----- © ❑ ❑ mZ Check valves installed? - - - - -- - - --- - --- -------- --- ❑ ❑ aQ 2 Transport Line Size ill Schedule/Class Bedrooms installed (check one) ❑ 2 ❑✓ 3 ❑4 ❑ 5 ❑6 >10ft.from foundaton?- - -- - - -- - - - -- - -- - - - - - ---- - ❑ WA ❑✓ YES ❑ NO >100 ft.from wells?-- --- - -- - - ❑ ❑✓ ❑ J >100 ft.from surface water? - -- - -- -- -- -- -- ❑ ✓❑ ❑ W ME >10 ft.from potable water lines?--- -- - -- -- ❑ ❑✓ ❑ Z >5 ft.from property lines and easements?- - -- ❑ ❑✓ ❑ 0 > 30 ft.from downgradient curtain/foundation drains?-- - - - - - - -- ❑ ❑✓ ❑ Drainfield level and observation ports present -- - - -- - - - ---- - ❑✓ ❑ ❑ ❑ Graveless chambers or ❑ Clean gravel used? (check one) DRIP Proper cover installed over drainfield?-- --- - ----- ❑ ✓❑ ❑ Pump tank setbacks consistant with septic tank?--- - - - ------- [I N/A ✓❑ YES El NO Y Pump tank size 1200 gal Manufacturer Hagerman Precast Q24" access riser(s)and accessible from surface?- - --- - --- ---- ❑ © ❑ ~ Alarm or Control Panel Installed? -- --- -- --- - ❑ © ❑ a Control Panel equipped with Timer/ETM/Counter- -- -- ---- - - ❑ ❑� ❑ 7 a Pump installed in ❑ Bucket or ❑✓ On Block or ❑ Other a Pump Make/Model STA-RITE STEP20-03 © Floats or ❑ Transducer =a Tank draw down 1 in/min Pump capacity 20 gpm Squirt Height DRIP ft Pump on time 1.5MIN Pump off time 2HRS Daily flow set at 360 apm moved 1=014 RECORD DRAWING (ASBUILT) pg. 2 MASON COUNTY PUBLIC HEALTH RECORD DRAWING Drelnfield& manifold orientation If layout ❑ Trenchlbed dimensions and critical distances within layout Septiodpump lank placement SEE ATTACHED ❑ Location of buildings Observation ports& clean-out locations ❑ Location of wells, surface water,& roads Undisturbed native soil between trenches North Armes If the designer or installer feel the need for additional information/comments,it may be attached. Record drawing may also be on a separate page attached. No.Pages Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER I 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 cleared/approved 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 certify that all information contained on this f n attached Reco Drawing is accurate. form and attached Record Drawing is accurate. 1121f24 S,gnbAYInstai Date ALLAN KIRK Printed Name of Signee 12/4/24 MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and •w; .. Record Drawing on behalf of Mason County Public Health \ yu a WWa` v14.5i:4 C.:. 26 Signature of Environmental Health Specialist Date (designer's stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE revW vurzoi4 @@@a@@se _ - • \ ( § | ] \ ) @ 4 m | ! § & ! § § ; - - - - - - JV - - ) ) i ` m ) j � .) e ®p , \ Ti ' r . . � - on ® - , � I : @ � I ) ; f § ! § \ , ) K ) \ ) ) ~\ m m 2 \ � � \ � 0 \ } � O mgw o m - ) § t | - . / ;