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HomeMy WebLinkAboutSWG2022-00486 - SWG As-Built - 2/12/2025 rApplicant ounty OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION umber SWG 2022-00486 Parcel # 31904-53-00071 Name Henley I I C Subdivision (Name/Div/Block/Lot) nt Address 1537 NW Woodbine Way FAWN LAKE#4 TRS 71 8 72 DPC#24-06 AF#2211929 te, Zip Seattle,WA 98177 Installer Name South Shore Construction dress 370 SE Alpine Ave Shelton _ Designer Name Arrow Septic Designs Inc INSTA!LLTION CHECKLIST Full System Installation ❑Tank($) Only Dramf,eld Only ❑Repair ®Other soo e•�b^yrstm^�°"" System TypeShallow Pre Pretreatment Type NuWaler BNR-500 >5 ft, from foundation? - - - - - - - - - - - --- - --- ---- - - - - - ❑ NIA ® YES NO >50 ft. from wells? - _ _ __ _ _ _ _ _ _ _ __ _ _ __ _ __ _ _ _ _ . ❑ � ❑ Y >50ft. from surface wittel"? -- - - - - - -- - - - ------ - - -- - - ? '- ❑ ❑ H Cleanout between building and tank ❑ ❑ U Tank baffles present? - - - -- - - - - - - - - - - --- --` - - - - - i- 24" access risers over each compartment?- - - --- ----- -- - -- ❑ ❑ IL N Effluent filter installed?- - - - - - - - -- - - -it ❑ ❑ `� Septic tank capacity (working) NuWatef 00 gal Manufacturer Infiltrator o D-box water level and speed levelers used? --- ----- --- - - ' - ❑ N/A ❑ YES NO CLL Manifold/D-box accessible from surface?- - - -- - - - -- - -- -' - ' ❑ ® ❑ g?Z Check valves installed? - - -- - - ---- - -- - - -- - - - - - - - - - ❑ ® ❑ 0 40 Transport Line Size 2" Schedule/Class Bedrooms installed (check one) ❑ 2 ®3 ❑4 ❑ 5 ❑6 ❑CommerciaVOther >10ft. from foundation?- -- - -- - - -- - - - - -- - -- - - -- - - - ❑ NIA ® YES No G >100 ft. from wells?- -- - - - - --- -- - - -- -- --- - - - - -- - - ❑ ❑ W >100 ft. from surface water?- - --- - -- - - -- - -- -- - - - - - - - ❑ © ❑ a >10 ft. from potable water lines?- - - - - - - - - - - - - - - - - - - - - - ❑ ® ❑ 2 > 5ft. from property lines and easements?- - - -- -- - --- - --- - ❑ ® ❑ > 30 fL from downgradient curtain/oundabon drains?- - - - - - - -- - ❑ ❑ Drainfield level and observation ports present - - - - - -- - - - -- -- ❑ ❑ ® Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?- -- - - - - -- - - - - -- -- - ❑ ❑ Pump tank setbacks consistent with septic tank? - - - - ---- -- - - - ❑ WA © YES ❑ NO 2 Pump tank capacity (flood) 1287 at Manufacturer Infiltrator 24"access riser(s)and accessible from surface?- - - - - - - - - - - -- ❑ W ❑ tL Alarm or Control Panel Installed? -- - - - - - - - - - - -- - - -- - - - ❑ 7 Control Panel equipped with Timer/ETM/Counter- - -- - - - - - - - ❑ ® ❑ fL Pump installed in ❑ Bucket or ® On Block or ❑ Other IL Pump Make/Model Liberty 280 ❑ Floats or ❑ Transducer 7 C Tank draw dawn 1.5 in/min Pump capacity 36 gpm Squirt Heigh[ 5.5 ft Pump on time 2.3 min Pump off time 6 hrs Daily flow set at 360 gpd um"w er+rzme Mason County OSS Installation Report pg.2 Parcel a 'J�c1�4' b3— lR5 — ABANDONNIENTRECORD ❑ YES No Wen, existing septic complxrents.abandoned as Part of this Prolact7 If Yes,please descnbe: TE5 ❑ NO antloned per WAC2AFr272A-03007 Were all components pwlW out and Properly ab W RECORD DRAWING teY Y a vYsuw�Y r.[ad MY WI b KtunY.�Na[�Ge'w.mWe b MeuY Y...wa unY UK�.aMb.YYn.e.d"Y Y. yp� pYy��: OM6ME 6rnallaaaMl�m a YWur sepnw+mv Ynt qu4on.1Y�T Ymx.^awM EmtedE.odyM aY v�v Ouo9nP.buOm M,Y.d tom.tleex W.tld afar mYnlmYre Yvn i�ti I�1YnvYY R.mC PYw+e+nW aMe NCINwI tlelMlneW rotYYtim W�M�JYNVY^Ya Record Drawing Attached -.CERTIFlCATION OF INSTALLATION - INSTALLER ro DESIGNER/ENGINEER 1 certify I certify that l design the system in accordance o rgfy that the system has been installed in accor- the septic design stamped'•4PPROVED'by Mason dance with the septic design stamped'APPROVED'6y County Public Health and that any deviations shown Mason County Public Health and that any deviations hem have been c/eared/8pPv0Ved by both the designer shown here have been cleamd/aPproved by both and Mason County Public Heath and meet all State myself and Mason County Public Health and meet all and Mason County Codes. State and Mason County Codes 1 further cattily that all information contained on this I further certify that all information contained on this tooattayf+ed R ramn is a curate. Porm and attached Record Ordwing is acroumte. /C/i/i! ,/f core e. �3�2 Sig�staller Date yR; cha Mco rer Footed Name SI SIWwl " MASON COUNTY PUBLIC HEALTH roves this roahii-rlcn Repot end vi^:�sno Theunders/gng nb CN,r' rwo�n Record Drawing on DehaHol Meson County Public (tE�^^yr�� r'.0 Q Health: LT signore of Env a/HealM Specialist Date (stamp,signature and date) THI5 FORM MAY aE.—NEDAND AVAILI FOR NSI.JC VIEW ON miE MASON CAUNTY YVEa SITE uabwf Mtvmle lbn � L�vJ P��A 11 i q , 0 O q,fbot I N N. b15 HOME to I yaaa.�rsc(aal�eWw� Sf 'Aa' n o is Se 95 ra m Audio-Vianal Ala= /t' S7iV 1�T n C?eanost U500 Gallon? e'f_ash lank 'p 31 0!:SE C) C NuW&i BNI&500 ATU Ta ,000 Gallon r�=p Chasbr 1A Va=ve Con^_oi Box 0 =CO NF�RN wl CrT� F02 (CES ER`� E 22" (�RPcIYELty LDAM`� ��l�SfiND TO �z e'�a•`� . APPROVED .L `"Ep' s"ud MASONCOUNflENVIkONMENTALHEAIik FEB 12 2025 RET a_ -,,r