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HomeMy WebLinkAboutSWG2024-00029 - SWG As-Built - 4/15/2025 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANTI PERMIT INFORMATION Permit Number SWG 2024-00029 Parcel# 32104-56-00040 Applicant Name AB FINE HOMES LLC Subdivision (Name/Div/Block/Lot) Applicant Address 871 E BEACH DR Alderbrook i Div 7/Lots 40&72 City, State, Zip UNION WA, 98592 Installer Name Hanson Excavation LLC Site Address 531 E MICHELLE DR, UNION Designer Name Arrow Septic Designs Inc. _ INSTALLATION CHECKLIST Q Full System installation ❑Tani Only ❑ Drainfield ❑Repair ®Other soo PMai rank System Type Shallow Pressure etreatment Type NuWater BNR-500 >5 ft.from foundation? -------- - - --- -' ❑WA ®Yes ❑ No >50 ft.from wells? -- - - - ---- S- - 1-1 ® ❑ '1 >50 ft,from surface water? - - - - - ���� - - " ❑ ® ❑ Cleanout between building and tank? ----- - - - ❑ 0 ❑ ~ Tank baffles present? -- - --- - --- --- --- " "-- El © ❑ U ❑ 24"access risers over each compartmen �-- -- - - --- - ❑ w Effluent filter installed?----------- ---- "-- " - - " -- ❑ ❑ rn pR Hagerman Septic tank capacity (working) NUW2taf 500 dal Manufacturer 0 D-box water level and speed levelers used? --------- - ----- ❑ WA ❑ YES NO J ❑ 000 ManifoldlD-box accessible from surface?-- ------------- - - ® ❑ i Check valves installed. -- - - --- -- - --- --- - "--"--- ❑ o2 Transport Line Size 2" Schedule/Class 40 Bedrooms installed(check one) ❑ 2 0 3 ❑4 ❑ 5 ❑6 ❑Commemial/Other 110ft.from foundation?-------- - -- ----- ----- -- - "- ❑ WA ■ YES ❑ NO >100ft.fromwells?--------------------------""- ❑ ❑ W >100 ft.from surface water?---- - - - ------ ---' - --'- -' El ❑ e FL >loft.from potable water lines?- --- fR ® ❑ Z > 5 ft.from property lines and easeme -� f R ❑ Q13 K > 30 ft.from downgradient curtain/fou n dray152- - Drainfield level and observation pods t - -A-1'I-i-t TJ - ® ❑ W Graveless chambers or ❑ CI fl S6iW'k erv(a q4q HEALTH Proper cover installed over drainfleld?--- - - ---JOW - -- -- LJ ❑ Pump tank setbacks consistent with septic tank?-- ------ --- -- ❑ NIA ® YES ❑ NO Y Pump tank capacity(flood) 1000 cal Manufacturer Hagerman Q24'access risers)and accessible from surface?-- --- ------- ❑ 0 H ❑ a Ala"or Control Panel lnsCalled? - - ----- ------- - - - - - - ❑ � 2 Control Panel equipped with Timer/ETM/Counter---- - - ----- ❑ 0 ❑ 7 n Pump installed in ❑ Bucket or ® On Block or ❑ Other a Pump Make/Model Liberty 280 ® Floats or ❑ Transducer 2 a Tank drew down 2" iNmin Pump capacity 38 pm Squirt Height 3 ft Pump on time 2.3 min. Pump off time 6 hr. Daily flow set at 360 gpd upeweamw+a FMason County OSS Installation Report pg. 2 Parcel# 3210a�" Sb ' Oo�`� ABANDONMENT RECORD are existing septic wmponents abandoned as part of this project? - - - - - - - - _- - - YES NO yes, please descnbe'. YES NO Were all components pumped out and properly abandoned per WAC245-272A-0300? -- - ' -- "' RECORD DRAWING inl+Iz+perm•n+n...... mu:�b+., P.ane a++caVW enev9n rc rNocE+In 1h+nx1 oe malnun+nc+activinea+na hart aw•be�n+'K TIP-,RAN cu DY eb PPnWn pertsnaeanwu^ana oNerhmabintenance.,teas pounu.nccno e�+,4emne omvinyn .r.,.P eddll.nm amava��n�nna s�1w^+a�ro'v�an°r�+'auncennu.. 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'APPRO VED"by County Public Health and that any deviations shown Mason County Public Health and that any deviations here have been cleamalapproved by both the designer shown here have been clearediapproved by both and Mason County Public Health and meet all State myself and Mason County Public HeaRh and meet all and Mason County Codes. State and Mason County Codes l 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 Drawing is accurate. CrM-2biL -S Sig ura of Installer Date . Jared Hanson Printed Name of Signee o+ '•+x f rs MASON COUNTY PUBLIC HEALTH . �l The undersigned approves this installation Report and Record Drawing on behalf of Mason County Public ' PAuu aor upHNsO14'3' Si nat of nvironmentaf Health Specialist are 5 i re and date) THIS FORM MAYBE SCANNED AND AVAILABLE W USUCVIE N E A WEB SITE uan.ac arzirzo,a APR 15 2025 MASON COUNTY ENVIRONMENTAL HEA,T n JBW — E• MRN�k� {TA ��2-�' �cALs : i"-30 p Pa aF32te4'41� 000ho D,F, TQ,Edct�5�1�1 k sir t`z ib&sZ f ..�2Q„\n`C)+•2Q}Q.'DYsvZ �>d Benae-11 m;n 1 .1_L{1110 %_S`uc tv *3➢R-500 Tu lZj ;a /1 _,000 GaLon P-I=p Chember 0 V,:, Con=oi'Box l i i � MM C� [ PPUIR JOY JOHNSON . 3 2b-zr PPROVE APR 15 20,, jy. MASON COUNT jBw MENIAL hEALD,