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HomeMy WebLinkAboutSWG2025-00031 - SWG As-Built - 4/19/2025 V Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/-:f RMIT INFORMATION Permit Number SWG 20.25-00031 Parcel # 32010-51-03002 Applicant Name Cori Disimone Subdivision (Name/Div/Block/Lot) Applicant Address 1339 E. Mountain PL. City, State, Zip Tuson, AZ 85719 Installer Name T,J. Goos Site Address IQeO C hAn l-e\S L-c Designer Name Dale L. Tahja • INSTALLATION CHECKLI - NI Full System Installation ❑Tank(s)Only 0 Drainfield Only ❑Repair ❑Other System Type Oscar OX2-0S50 Pretreatment Type Oscar OX2 >5 ft.from foundation? - - ❑ N/A ®YES ❑ NO >50 ft. from wells? - -- 0 ® ❑ Z >50 ft.from surface water? - - ❑ MI Cleanout between building and tank? - 0 I 0 0 Tank baffles present? - - 0 ® 0 • 24" access risers over each compartment?- - 0 I 0 a. LU tit Effluent filter installed?- - ❑ ® 0 Septic tank capacity (working) 1,000 gal Manufacturer Hagerman to l -C 0 D-box water level and speed levelers used? - - RI N/A ❑ YES � I g Do Manifold/D-box accessible from surface?- - 0 0 ENO Zil co Check valves installed? - - ❑ ill D b 2 Transport Line Size 1 inch Schedule/Class Sch.40 ; 4 1 4'+Bedrooms installed (check one) ❑ 2 El ❑■ 4 ❑ 5 ❑6 ❑Commercial/Other i Wil >10 ft. from foundation?- - ❑ N/A ® YES ❑LiiiE a —7 0 • >100 ft. from wells?- - 0 ® 0 W >100 ft. from surface water? - - 0 IN Z >10 ft.from potable water lines?- - 0 II >5 ft.from property lines and easements?- - ❑ ® 0 a > 30 ft.from downgradient curtain/foundation drains?- 0 0 0 © Drainfield level and observation ports present - 0 I 0 ❑ Graveless chambers or IN Clean gravel used? (check one) Proper cover installed over drainfield? - ❑ ® 0 4 Pump tank setbacks consistent with septic tank? - 0 N/A ® YES ❑ NO ZPump tank capacity(flood) 1,000 gal Manufacturer Hagerman < 24" access riser(s)and accessible from surface?- - 0 III 0 a Alarm or Control Panel Installed? - 0 III 0 Control Panel equipped with Timer/ETM /Counter- - 0 U 0 a. Pump installed in 0 Bucket or ® On Block or ❑ Other Q' Pump Make/Model McDonald E-30 GPM 0 Floats or� RI Transducer 0.0 Tank draw down 0.1 in/min Pump capacity 30 gpm Squirt Height Drip ft Pump on time 0.48 min. Pump off time 3.52 min. Daily flow set at 480 gpd Updated 8/21/2018 Mason County 05$ Installation Report pg.2 Parcel tr ,)fit\C -5\_o)c_ ABANDONS READ Were existing septic compcoents abandoned as PM of this project? - i - ❑ YES II No If yes, please Were all comports pumped out and Properly abandoned Per WA I8-2?2A-0300'1' - C3 nosQ No RECORD DRAWING This to a paenMaat word and rant In memo and ds. pdv mop*to mtooalo tit its need or maint.nJJ0a walla and/rAN development Welton of cal R na d Oravaqa coo ler Oti data a t Wreld ,a n e pactpu t t*noaSan.Nast envoi,aa mama dw ndeld adobe and paid weds,obaawtton pate,*Pool%andante'maintenance wpm points. incompose Rowel Onwangs nay an is POonal dahtra In trod Iaatdatbn sprawl and Maud pamBfa. 1 Record Drawing Attached CER VICATION 01111.3TALUMON INSTALLER DESIGNER/ENOWEER I cattilY that I Installed the system In accordance with I certify that the system has been Installed in accor- ths septic design stamped"APPROVED"by Meson : dens with the septic design stamped"APPROVED"by County Public Health and that any deviations shown Mason County Public Health end that-any deviations hem 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 end meet all and Mason County Codes. State and Mason County Codes I further(*Hay that all bnfonnation contained on this 1 further cattily that all Information contained on this form and attached ecpord Dra - long and attached Recordl7ra , is accurate_ ,-.7- 1 t40 , Sigrnabas Dote Q. f 0 A( S — =,... � fN.), Printed Name of Sloe �:. d� t' 'f MASON COUNTY PUBLIC HEALTH J."! :� 1� e's.IVti The u vas this Installation Report and ' 5'100214 Record Drse+iirag ort beftalf of Meson County Public o DESIGNER' ay it Dale L.Talle t f • Health: i r(017) i-iti-zim-s--- . ..... • ,.,,,, ..s Signetutv ofEnvironmental Health Specialist Date (stamp,lure and date) THIS FORM MAYBE SCANNED AND AVAILABLE FOR PUBLIC VIEW. ON THE D MAsol COUNTY WEB SITE uaa"asi $ 1 1� • .s cry LL' ie I( ��-0,,o,off v I() 4. _ LU ,f' � + � N C V `lam � V p.• 7 O C • r it/b %% �Sd -Ilk aZ �� PPROVEQ APR 2 9 2025 SON COUNTY ENVIRONMENTAL HEALTH _ _ — i_ MA RET / i ci ei / • \ // > // -- --� � _ /i �// cT 1.7 ,1-D� // ` / ,f , • � `� i►• 1 i,C/ \ �„ '�•/ . '�J� /cM1c-, -,./ /j Qi / ? '7 0 r d V / _\( � ... 0 ii • '0rN 01) 12) 0` ' C0 vi