HomeMy WebLinkAboutSWG2024-00352 - SWG As-Built - 1/22/2025 RECORD DRAWING (ASBUILT) pg. 1 MASON COUNTY PUBLIC HEALTH
PARCEL IDENTIFICATION
Permit Number SING 2024-00352 Assessor Parcel# 41924000=0
Applicant Name Alta Forest Products Subdivision (Name/DivtBlock/Lot)
Applicant Address 810 NW Alta Way
City, State, Zip Chehalis,We 98507 Installer Name Kyle Camus
Site Address 780 W State Route 108 Designer Name Adam Hunter
INSTALLATION CHECKLIST
® Full System Installation ❑ Septic Tank Only ❑ Dreinfeld Only ❑ Repair
System Type Pressure System w/send lined bed Pretreatment Type none
>5ft.from foundation? --------------------------- ❑NIA [{EYES ❑ NO
>50ft.from wells? ----------------------------- ❑ ® ❑
Z >50 ft.from surface water? ------------------------ ❑ 111 ❑
fCleanout between building and tank? ------------------- ❑ 111 ❑
O Tank baffles present? ---- ---------------- ❑ ® ❑
1- 24'access risers over each compartment?---------------- ❑ ❑
W Effluent filter installed?---------------- --- ❑
rn 8100 Sound Placement
Septic tank size gal Manufacturer
Dbox water level and speed levelers used? --------------- ❑ NSA ❑YEs ® NO
OLLManifold/D-box accessible from surface?----------------- ❑ ® ❑
mZ Check valves installed?-------------------------- ❑ ® ❑ i
Transport Line Size 2' Schedule/Clesa 40 Z
r.r
Bedrooms installed(check one) ❑2 ❑3 ❑4 ❑5 ®e b
>10ft.from foundation?-------------------------- ❑ N/A YES NO ,o
13 >100 ft.from wells?----------------------------- ❑ El
r �7 W :>100 ft,from surface water?------------------------ ❑ ❑ r
X >10ft.from potable water fines?---------------------- ❑ ❑
Q_ >5ft.from property lines and easements?---------------- ❑ ❑
R' >30ft.from downgredient wdain/foundation drains?---------- ❑ 0 ❑
Orainfield level and observation ports present ----- ❑ ® ❑
® Graveless chambers or ❑ Clean gravel used? (check one)
Proper cover installed over drainfekl?------------------- ❑ ❑
Pump tank setbacks consistant with septic tank?------------- ❑ N/A ® Yes NO
he Pump tank size 5400 gal Manufacturer Sound Placement
R24'access riser(s)and accessible from surface?------------- ❑ ® ❑
yAla"or Control Panel Installed?--------------------- ❑ ® ❑
7 Control Panel equipped with Timer ETM/Counter----------- ❑ ® ❑
IL Pump installed in ❑ Bucket or [6 On Block or ❑ Other
IL Pump Make/Model Orencon PF5030 ®Fbats or ❑Transducer
a Tank draw down 2 in1min Pump capacity 90 gpm Squirt Height 6 2 ft
Pump on time 57 sec Pump off time 2hr off Daily flow set at 87 gpm
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RECORD DRAWING (ASBUILT) pg. 2 MASON COUNTY PUBLIC HEALTH
RECORD DRAVWJNG
❑ Dralnfeld It
manRdd orientation
&layout
Trenclribed
dimerslons and
crucial distances
within layout
Septirripump tank
pia.meed
Location of
bulMbgs
observation pond&
cleanout locations
Location of wells,
inure.water,&
roads
UndsWrbed native I!i
loll between
bandies
❑ North Arrow
If the designer or installer feel the need for additional informetiontoomments,it may be attached.
Recortl tlrawing may also be on a separate page attached. No.Pages Attached
CERTIFICATION OF INSTALLATION
INSTALLER DESIGNER
1 certify that I installed the system/n accordance with I ceNly that the system has been installed in accor-
Hre 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 clealed/approved by both the designer shown here have been clearadfapproved 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 earthly,that all iMomration contained on this 1 further cedHy that all khormation contained on this
fbim a attached Record Drawing is accurate. form and attached Record Drawing is accurate.
Signalursoflrwteller Date 4 �
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�n Name of Signee ,s:' i
MASON COUNTY PUBL6,Hy,EA"LTH ,,CC���� o
The undersigned approves thrs� alla861i61e a�
ORecoMOmwing on 6eheHofMasrqunty?y,. ,g
Health: ����vvG,yOyL Aoan "rE.JE.R.:.
ZLl
ti u .
Signafu ofEnviranmental Health pede0st Date (designers stamp,signature and date) !
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE
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