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HomeMy WebLinkAboutSWG2018-00081 - SWG As-Built - 2/22/2025 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/PERMIT INFORMATION Permit Number SWG 2018-00081 Parcel# 42201-50-05008 Applicant Name RANDY NEFF r h St�bd.Lvisior)_{Name/Div/Block/Lot) Applicant Address b �Nh` 2_' �SQtr City, State, Zip r Installer Name FINAL VISION INC Site Address 41N MARDEL AVE HOODSPORT Designer Name DALE TAHJA INSTALLATION CHECKLIST ® Fuli System Installation ❑Tank(s)only ❑ Drainfleld Only ❑Repair (]Other System Type Pretreatment Type _ >50 ft.from wells? -----_-______ � - ❑ -Z >50 t.from surface"ter? ._ __ __ __ __ ■ ❑ Fa- 13 Cleanout between building and tank? --- -H-B-}A ❑ ■ ❑ U Tank baffles present? -- -- - -- - -- © ■ ❑ a 24"access users over each compartnent7 - -�__„__.. ❑ . ❑ Effluent filter Installed?--- -------- ------------ - ❑ ■ ❑ Septic tank capacity(working) 1200 dal Manufacturer SOUND PLACEMENT o D-box water level and speed levelers used? ------ ---------- 0ryp ❑yEg ❑ xo 00 Manifold/D-box accessible from surface?-________________ ❑ e ❑ GQ Check valves installed? - --- ----- ----------.______.- ❑ ❑ X Transport Line Size 2 Schedule/Class 40 Badreoms installed(check one) ❑ 2 ®3. ❑4 ❑5 ❑6 ❑Comm clal/Other >10 ft.from foundation?-- -------- w � wA MYES El No Q >100ft.fromwells?__ __ _________ Fe.,lE E El w >100ft from surfacewater? -- ----- -- --_-r---_ ❑ Z >10ft.from potable water lines?---- - -_FEB:Z./1- §_- El > 5 ft.from property lines and easemenf �`1tANNTMENyIRpN,pE7yfAl HEA ® El> 30ft.from downgradient curtainrfoundatlon drains?�W----- ® ❑ Drainfield level and observation ports present --- -- ❑ ❑ ❑ ® Graveless chambers or ❑ Glean gravel used? (check;one) Proper cover installed over drainfield?- ---------------- - - ❑ ® ❑ Pump tank setbacks consistent with septic tank? -- ---------- - ❑ NIA . YES NO Y Pump tank capacity(flood) 1000 at Manufacturer SOUND Q24"access riser(s)and accessible from surface?------------ - ❑ ❑ CAlarm or Control Panel Installed? --- ------- -- ------- - ❑ ® ❑ = Control Panel equipped with Timer IETM/Counter----------- ❑ ❑ a Pump installed In ❑ Bucket or ❑ On Block or ❑ Olfier FLO INDUCER Pump Make/Model ORENCO PF30051 Floats or ❑ Transducer Tank draw down 1.25 in/min Pump capacity a tip 11 Squirt Height 5 ft Pump on time 3 MIN Pump off time 6 HR Daily flow set a! 260 dpd upewe Wlnvis Mason County OSS Installation Report pg. 2 Parcel# 42201-50-05008 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? ------ -------- - YES ® No If yes, please describe; Were all components pumped out and properly abandoned per WAC246-272A-0300? - ---- - - - YES NO RECORD DRAWING Drra la a pvnaaaam wcam aaa wu.r ea xauwn aria aocaarma eaougn m waowr.m aria eem or waneanane.aeei.mn em mepw aa.alapmam. ryplcm aaao,c Orawinga wnlNn: O2inLeltl 8 menNOH oaenbYcn 8 byaN.SeptirJpump rank hUon.NOM anaw,ruerve tlrelnirela,ixiating eM pmpvua puiltlings,bceti0n or wills,we:atllnes, waua,o tda pani,aev,oNe,am mar meimaaawa eaen poem. mo-,aii a pawn Dwa nua may aware sddl l Jahip in rmm l,,,,a is iod ap,a-1 and mla,ed pam,na. �iysCNCCU��FB�y®�� @����������'�G; ® Record Drawing Attached CERTIFICATION OF INSTALLATION ... - INSTALLER DESIGNER] ENGINEER 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 Meson County Codes I furthercerMy that all information contained on this I further certify that all information contained on this fo(m/}jand attached Retold Drawing is accurate. / form and attached Record Drawing is accurate. 1M�`�l ,_7 U/A1 ,, Si ature of Installer Date ? JASON SCHAUER Printed Memo ofSignee MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and a' S1002N Record Crawling on behaff of Mason County Public Dale L.Tahje r" LICENSED DESIGNER Sig atom kWimilmental Health' paaaiisl Date (stamp, signature and date) THIS FORM MAY BE SCANNEDAND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE upaaw ersuzma I � , or_: S�ar��orWh � �wr e c �rr1 �coc — �rcr\ 1A=\ 50 0 R , soma\p 5\4s 4 i 7 i , i i 0 51OW4 VIE Dale L LICENSED DES FES 2 4 ?025 / SON COUNT J131ONMENTgG Jew HEALTH