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HomeMy WebLinkAboutswg2024-00088 - SWG As-Built - 3/17/2025 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWIG 2024-00088 Parcel# 22110-34-90043 Applicant Name Gorst Solid Lane LLC Subdivision (Name/Div/Block/Lot) Applicant Address PO BOX 727 TR 4-C OF S1/4 SW LOT:C-3 OF SP#2892#648196 City, State, Zip Port Orchard WA 98366 Installer Name Final Vision Site Address XXX E Mason Benson Rd Designer Name Arrow Septic Designs Inc INSTALLATION CHECKLIST ® Full System Installation ❑Tank(s)Only ❑ Grainfield Only ❑ Repair ❑Other. System Type Pressure Bed Pretreatment Type >5 ft.from foundation? -_______ ____ �+(13 D NIA ®Yes ❑ No >50 ft.from wells? ---------- --- - ).aC I�r ® ❑ Y >5o ft.from surface water? --------- ® ❑ FEAR 1T z 2025 FCleanout between building and tank? ---- ------- -- ® ❑ U Tank baffles present? - - - ----- - --- --- -- '---' ® ❑ 1- 24'access risers over each compartment?- B� ® ❑ C ❑ ® ❑ w Effluent filter installed?-- --- --- --- - - - - - ---- --'- - ' N Hagerman Septic tank capacity(working) 1200 gal Manufacturer O D-box water level and speed levelers used? ---- ----------- ❑ WA ❑ YES NO QJ 0 Manifold/D-box accessible from surface?-------- --- - ---- ❑ ❑ mZ Check valves installed? -- a�c- - - - ---- -- ❑ ® ❑ GQ 40 f Transport Line Size 2- Schedule/Class Bedrooms installed(check one) ❑ 2 ❑3 ®4 ❑ 5 ❑6 ❑Commercial/Other >10 ft.from foundation?-- -- - - ----- -y�I� ❑ WA ® YES ❑ NO >100 ft.from wells?- ------------ T ��-a ® ❑ W >100 ft.from surface water?- - ----- ---- - -- 0 Eljr >10 ft.from potable water lines?- - 1-y- 15- - ® ❑ 2 > 5 ft.from property lines and easementAT t)N CWNT}'EfN---- - -I- ry © ❑ K >30 ft.from downgredient curtain/foundation drains?-�-I ---- � ® ❑ Drainfield level and observation ports present - - --- --W---- ❑ ❑ ❑ Graveless chambers or ® Clean gravel used? (check one) Proper cover installed over drainfield?--------------- -- -- ❑ 0 ❑ Pump tank setbacks consistent with septic tank?-- --------- -- ❑ WA YES ❑ NO Y Pump tank capacity(flood) 1.200 at Manufacturer Hagerman z 24"access risers)and accessible from surface?-- -- --- ------ ❑ ❑ I.- Alarm or Control Panel Installed? ----- - - --- -- - -- - - --' ❑ El 7 Control Panel equipped with Timer/ETM/Counter-- --- --- - - - ❑ ❑ a Pump installed in ❑ Bucket or a On Block or ❑ Other it Pump Make/Model Liberty 290 ® Floats or ❑ Transducer a Tank draw down 2.5 in/min Pump capacity 55 opm Squirt Height 5 ft Pump on time _min Pump off time 6hr Daily flow set at 480 gpd Vp]BbE e"11RJ18 Parcellt 22116-3 y -gDoN� Mason County OSS Installation Report pg.2 _ .._ENT RECORD �` •i1�' 3. ? ._ _________ _ __ . YES NO Were existing septic components aoandoned AS part of this project yea, Please describes ____ y�q No Were all components pumped out and properly abandoned per WAC?Ab277A-0300? -" - _ . .mDrat++ms.s mpcnnvnanro: Cnrzt.maficWoNB omnae nnirwolaC rw t Na'ion8byoul SvpWPuRmpE raCnkO bcRvtioDn.DRAWING R aA'rmWx.rIcNeMG ewAnt new o Erz„ain�tlA��P �mre a.�dro�m.m .PWe'P d"lmaalwl�rRanazra wells,oEaervaaan P+'r%.tleenaM.antl otlur mauCtiwexx aver Gant. IivFlm01¢re Revd CreulnT n 1�. MAR ® v� N1ASO,y000NIYfNVIRON2(I�$ fN?gIyEAC7ti Q, Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ENGINEER 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 ham have been clearedapproved by both the designer shown here have been dearedapproved by both and Mason County Public Health and meet all State myself and Mason County Public Health and meet ell and Mason County Codes. State and Mason County Codes I further certify that all information contained on this I further certify that all information contained on this form and attached Record Drawing is accurate. form and attached Record cawing is accurate. Sig/nature of Installer Date Prinied Name of Signs MASON COUNTY PUBLIC HEALTH S JO The undersigned approves this installation Report and PAUTA JOYOY JDHNSON'. Record Drawing on behalf of Mason County Public IC 6E 5iGNk7t H Res Envuonmental Health Specialist Date latemp,signature and datel i M FORM MAY BE SCANNEDANOAVARASLE FOR PUBLIC VIEW ON THE MASON COl1N77lwea SUE O R�vGwRy t d IYfyppo 5@n I 4'3R �pOs� �P OAudio-Visusl Alarm _ ® Cleanout } © 1200 Septic Tan k 2-ComParmenwith J � QQ Effiuent Filtlion / ` Qom` t( 04 1100 Callon PumP Chem J- l' M t4 PPRO �E 1 1 `so ' ASONCOU rry RON N7A( V A O _ Bev A 55 ' bwa�i^j K NE p Zo 4o bo 80 R.SIa.it� T?�acF, #22t\a-34- goo43 n G 1,A�¢n�f FiF1J50l1 {ZD E d- . J �VNeev,E\� wa 56s!lk PAULA JOY JOHNSON I 6 "b� 1GN .• bbb