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HomeMy WebLinkAboutSWG2023-00025 - SWG As-Built - 1/10/2025 RECORD DRAWING (ASBUILT) pg. 1 MASON COUNTY PUBLIC HEALTH PARCEL IDENTIFICATION Permit Number SWG 2023-00025 Assessor Parcel # 222175000010 Applicant Name JIM DONAHUE Subdivision (Name/Div/Block/Lot) Applicant Address PO BOX 1347 City, State, Zip TENINO,WA 98589 Installer Name DB&R- DAVE YOUNG Site Address 91 NE BELAIRE DR, BELFAIR Designer Name ADAM HUNTER INSTALLATION CHECKLIST ❑ Full System Installation ❑ Septic Tank Only ❑ Drainfield Only ❑ Repair System Type GRAVITY Pretreatment Type N/A >5 ft.from foundation? --- --- - --- ❑NIA ❑J YES ❑ No >50 ft.from wells? ---- -- -- - to _- - ❑ ❑ ❑ Z >50 ft.from surface water? -- - - - - - ❑ ❑✓ ❑ FCleanout between building and tan -. ❑ 0 ❑ U Tank baffles present? - - --- - - - -a- 24" access risers over each oompa --- ❑ ❑✓ ❑ uJ Effluent filter installed?---- --- ----- - -- -- ----- ----- ❑❑ ❑� ❑ y 1250 HAGERMAN PRECAST Septic tank size at Manufacturer 0 D-box water level and speed levelers used? -- -- -- - ----- --- ❑✓ run ❑ YES ❑ NO 0J 0 Manifold/D-box accessible from surface?- --- ------ -- ----- Check valves installed? - -- - - - -- - - - - --- -- - -- ---- - - ❑ ❑ OQ 2 Transport Line Size N/A Schedule/Class N/A Bedrooms installed (check one) ❑ 2 913 ❑4 ❑5 ❑6 >10ft.from foundation?- -- - ---- - - ----- --- -- - ---- - © WA ❑ YES ❑ No 0 >100 ft.from wells?--- -- ----- -- - - - --------- ----- El ❑ ❑ J >100 ft.from surface water? -- - - - ------------ 0 ❑ ❑ lLI u- >10ft.from potable water lines?-- -- -- -- - - - - ----- -- --- ❑J ❑ ❑ Z >5ft.from property lines and easements?-- - -- -- -- - - - -- -- ❑� ❑ ❑ >30 ft.from downgradient curtain/foundation drains?----- - ---- 0 ❑ ❑ Drainfield level and observation ports present -- - -- - - ---- --• ❑ ❑ ❑ Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?--- - - --- - ---- - ----- © ❑ ❑ Pump tank setbacks consistant with septic tank?---------- --- ❑✓ WA [I YES ❑ NO Y Pump tank size N/A aat Manufacturer N/A a24"access risers)and accessible from surface?- - ---- - ------ © ❑ ❑ CAlarm or Control Panel Installed? -- - --- - ----- ----- - -- - ❑� ❑ ❑ 2 Control Panel equipped with Timer/ETM/Counter---- - ------ ❑� ❑ ❑ a Pump installed in ❑ Bucket or ❑ On Block or ❑ Other N/A ELPump Make/Model N/A ❑ Floats or ❑ Transducer IL Tank draw down N/A in/min Pump capacity N/A opm Squirt Height N/A ft Pump on time N/A Pump off time N/A Daily flow set at N/A opm rearm 1rzvm14 RECORD DRAWING (ASBUILT) pg. 2 MASON COUNTY PUBLIC HEALTH RECORD DRAWING ❑ Drainfield& manifold onentabon &layout ❑ Trench/bed dimensions and critical distances within layout ❑ Septicfpump tank placement ❑ Location of buildings Observation ports& deamoullocations ❑ Location of wells, sudace water& roads ❑ Undisturbed native soil between trenches ❑ North Arrow 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 clearedtapproved 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 further c ily th t all information contained on this I further certify that all information contained on this to and all h Recond Drawing is accurate. form and attached Record Drawing is accurate. 4/30124 Signature of Installer Date DAVE YOUNG 4/30/24 Printed Name of Signee MASON COUNTY PUBLIC HEALTH 77 "•{ ''r` The undersigned approves this Installation Report and '^ ``d. Record Drawing on behalf of Mason County Public Health: .oa+ra 26 Signature of Environmental Health Specialist Date (designer's stamp, signature and date) THIS FORM MAY BE SCANNEDAND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE —xe irzvzma W s = gym - U O � ys o ¢ $ W a ddON r APPROVEDo ' JAN 10 2025 s ` ' MASON COUNTY ENVIRONMENTAL HEALTH �r 4a I e D O p� me, S .rc i �dg 3 i � 0 � m Rhonda Thompson From: Adam Hunter <adamj.hunter@gmaiLcom> Sent: Thursday,January 9,2025 10:34 PM To: Rhonda Thompson Subject: Re: SWG2023-00025 Caution: External Email Warning!This email has originated from outside of the Mason County Network. Do not click links or open attachments unless you recognize the sender, are expectingthe email,and know the content is safe. If a link sends you to a website where you are asked to validate using your Account and Password, DO NOT DO SO! Instead, reponthe incident. Hi Rhonda, The drainfield was accepting water at the time of the installation. I haven't heard about any problems since then. Adam On Wed,Jan 8,2025 at 9:48 AM Rhonda Thompson<RThompson(cbmasoncountvwa aoy>wrote: Hi Adam, I have the tank only asbuilt here for Jim Donahue at 91 NE Belaire Or(22217-50-00010). 1 wanted to sign off on this asbuilt and mark the system as satisfactory in OnlineRME but the reports seem to indicate the drainfield was notworking. I imagine you did some type of investigation before deciding to only replace the tank?I didn't catch it during my review, but I am hoping you can provide an explanation of the system performance at this time. Thankyou, Rhonda Thompson, RS Senior Environmental Health Specialist Mason County Public Health 415 N 6`h St.Shelton,WA 98584 1