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HomeMy WebLinkAboutSWG2024-00041 - SWG As-Built - 1/14/2025 RECORD DRAWING (ASBUILT) pg. 1 MASON COUNTY PUBLIC HEALTH PARCEL IDENTIFICATION Permit Number SWG 2,02-4-00041 Assessor Parcel# 22O2o24goOg1 -_ Applicant Name 9a.1a $}okOS Subdivision (NamelDiv/Slock/Lot) Applicant Address 2110 SE U�,% City, State,Zip Qo,�- 0,cam 98IG"I WA Installer Name ';em A^AQ1 Site Address CAScafA Lzy[ Ll\ Designer Name 1A, iilv V� 01 LP ,4 INSTALLATION CHECKLIST Full System installation [:I septic Tank gnly ❑ Drainfield Only ❑ Repair System Type `f i � Pretreatment Type __ >5ft.from foundation? .-------------------------" ❑NIA (✓7YES ❑ NO >50ft.from wells? .---------------------------.- ❑ Z >50ft.from surface water? ------------------------ ❑ u ❑ H Cleanout between building and tank? ----------- ❑ ❑ V Tank baffles present? .----- --------------------. ❑ [� ❑ r 24-access risers over each compartment?---------------- ❑ 'd ❑ a d ❑ W Effluent filter installed7--- --- -------------'-"---'- ❑ N Septic tank size l2$0 gal Manufacturer C✓V re.-a,! " 0 o-box water level and speed levelers used? -------------- - CJ WA rrr❑fff� ❑ NO DO ManfoldlD-box accessible from surface?------ ❑, ❑ 0°Z Check valves installed? - - -- -------------------- ❑ oa 1° $ Transport Line Size Solledulelaass SC4 40 Bedrooms installed (check one) ❑2 0 3 114 ❑5 ❑6 >10ft.from foundation?-- - ----------------------" ❑ NIA YEB ❑ NO LJ >100 ft.from wells?----------------------------- E ❑ W >10o ft.from surface water?---------------------- -" M >10ft.from potable water lines?---------------- ❑ d ❑ ? >5ft.from property lines and easements?- --------------- ❑ © ❑ Q >30 ft.from downgradient curtainlfoundation drains?---------- ❑ IL7:11 ❑ Q ❑ Drainfield level and observation ports present - - - - - --------- ❑ ❑ Graveless chambers or Ej Clean gravel used? (check one) Proper cover installed over drainfield?------------------- ❑ ,�{ FPump nk setbacks consistent with septic tank?-------- NIA i�i y� ❑ nk size \15O gal Manufacturer - �� i rt ❑ t Z r ss dser(s)and accessible from surface?--------Control Penal Installed? ------- -- - - OPanel equipped with TmerIETM ICounter----------• lJ ❑stalled in ❑ Bucket or [�On Block or ❑ Other iake/Model 1 SIrY 290 I:u Floats Or ❑ Transducer 6 Tank draw down I-�-.'inlmin Pump capacity NU gpm Squirt Height Pump on time 2m n. Pump off time H w5. Daily flow set at 4 U Opm RECORD DRAWING (ASBUILT) pg. 2 MASON COUNTY PUBLIC HEALTH RECORD DRAWING Dralni& manifold orientation &layout Trenchlbed dimensions and cull distances wiMin layout SeptlrJWmp tank pl.rranl Location a euikings Obsewallon Pons& clean-out locations Loradon&wells, awtace water,& reads UndisWrl ed native soil between trenches NaMAmV If the designer or installer feel the need for additional irdormetion/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 1 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 Geared/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 car*that all Information contained on this I further certify that all information contained on this form and attached Raw ry-Ofawing is accurate. form and attached Record Drawing is accurate. zS Signa%lue of lof instal efe )- q.A.. II13It_i Punted Name of Sighee 3P IT MASON COUNTY PUBLIC HEALTH ♦aluo ^• •'•sew The undersigned approves this Installation Report and ADAM J.HUNTER 'y Record Drawing on behalf of Mason County Public R•CiCErv5@p I)p51BNE'R"' Health: �M/I ,1� Signature of Heeaalth Specialist Date (designer's stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE �.xa vvrzo�a a«APm£ a - - - � � - ESW - - -0p - - - - - - | ; | ( / a 10 ; ! /, ! . / 0 \ § _ ; � � \ � § k \ ° | § /_ �\ / / ; / | o § § ; ! � § ; � t 0 > § ; ;