HomeMy WebLinkAboutSWG2024-00035 - SWG As-Built - 1/10/2025 RECORD DRAWING (ASBUILT) pg. 1 MASON COUNTY PUBLIC HEALTH
PARCEL IDENTIFICATION
Permit Number SWG a.CTa•(-1 - ac G15 Assessor Parcel # `Z2 3 3 _ 2 l-- Ely()0 -z--
Applicant Name ,t,tiA\c_c_< .J 0(,_N...‘S'_;•J Subdivision (Name/Div/Block/Lot)
Applicant Address 4€ C (-mc-i `0& ( t-'' � 'Z- L_-L-s? '2_ -`O2
Zip t_.-.e,.,,P^ . ,� �:1�c..4Nt A-r��.'C
City, State, �c_ C-/� , 9 3�3w Installer Name An. ;;� C_.c,. ,
Site Address Lekfi S e.. P
�C L-Ls t__. - r Designer Name J t ."n qci►•A—E1ArL
INSTALLATION CHECKLIST
1p Full System Installation ❑ Septic Tank Only ❑ Drainfield Only ❑ Rep�ir
System Type fh� --Or°
�e i Pretreatment Type Kt .1,
>5 ft. from foundation? - - ❑ NIA UrYES ❑ NO
>50 ft. from wells? - - ❑ 0- ❑
• >50 ft. from surface water? - - ❑ ❑
z El at ❑
HCleanout between building and tank? - -
U Tank baffles present? - - ❑ 54 ❑
i- 24" access risers over each compartment? - - ❑ Ili ❑
a �, El
▪ Effluent filter installed?- - ❑
cr' PIZ.t C...-'T
Septic tank size �'LO 0 gal Manufacturer_1.�itv tCfL,�.
5 D-box water level and speed levelers used? - - NIA ❑ YES ❑ NO
�, ❑
OO Manifold/D box accessible from surface? 0
o02 Check valves installed? - -- - - - - ❑ ❑
Q
E Transport Line Size Schedule/Class SCy ` .1
2 y
Bedrooms installed (check one) ❑ 2 3 ❑4 ❑ 5 ❑6
>10 ft. from foundation? - - ❑ NIA KYES ❑ NO
• >100 ft. from wells? - - ❑ Els ❑
W >100 ft. from surface wat ? - -
Der ❑
a: >10 ft. from potable water lines?- - ❑ ❑ 0 r
> 5 ft. from property lines and easements?- ❑ ❑ . D
Ce > 30 ft. from downgradient curtain/foundation drains? - - ❑ ❑
• Drainfield level and observation ports present - - ❑ ❑ al9
C
❑ Graveless chambers or ❑ Clean gravel used? (check one)
Proper cover installed over drainfield?- - ❑ g ❑ r
1 l
Pump tank setbacks consistant with septic tank? - - ❑ N/A YES ❑ No f=-
• Pump tank size i'1-0') gal Manufacturer 1--1 l_L.,k^1-.-A.%41.4
ZEl
Q 24" access risers) and accessible from surface?- - ❑
F-a. Alarm or Control Panel Installed? - - 0 ❑
2 Control Panel equipped with Timer/ ETM /Counter-
CI- Pump installed in Li Bucket or ❑ On Block or ❑ Other
°' Pump Make/Model L l(31_^11. c Z`f ' -V 0 [Moats or ❑ Transducer
2
R. `��- (G ft
Tank draw down 3%1'1� in/min Pump capacity 4,3 gpm Squirt Height
Pump on time I AA ,,J Pump off time 4 k1 CZ.S Daily flow set at 3 Le 0 gpm
RECORD DRAWING (ASBUILT) pg. 2 MASON COUNTY PUBLIC HEALTH
RECORD DRAWING
0 Drainfield&
manifold orientation
&layout
Trench/bed
dimensions and
critical distances
within layout
Septic/pump tank
placement
0 Location of ��-�� A���+rC�� v�
buildings
0 Observation ports&
clean-out locations
Location of wells,
surface water,&
roads
El Undisturbed native
soil between
trenches
0 North Arrow
If the designer or installer feel the need for additional information/comments, it may be attached.
Record drawing may also be on a seperate page attached. No. Pages Attached
CERTIFICATION OF INSTALLATION
INSTALLER DESIGNER
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 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 Drawing is accurate.
4
LIN — \0-1 /.S ,,, ...;
•
Signature of Installer Date • .
•
..I. At. F .;1
Printed Name of Signee #• 4 mow. w"`"'� 1F o* �\
MASON COUNTY PUBLIC HEALTH Aw. - ''<J
N.• ' 5101,2/3 >F�
The undersigned approves this Installation Report and o' InhtES P..iP gqI
Record Drawing on behalf of Mason County Public icrt•isft)r e 1-..,,N!R -
Health: cyNr...,:. i•oir• `L-G'
C—/1S_
Signature of Environmental Health Specialist Date (designer's stamp, signature and date)
__ r rl n ni,, I nc�ni C M TUG AAA grw rnl INTY WFR SITE
. .
..• ' .
. •
• I
. .4
. i
; !1D. .
-- 1^4...., .._.....;,...... .
CO
...=.
> ..
z 7--• p V
--........,
c et
. 0
rn '•• ------
0..-......:(.0'4
........... --...„ ...0 p
-......,
73 e=3
,
al 7° r ) 0 •, c.., ce,
t —
0 . ......._
9%..) ------------- ........_.----..
.,I I
, D ........, -.............
----..--. 1 1
c-4\
IP
• .
. <.).. ,
-(V+
i .
. 1
•
s\
• \\„ . c4-' •f -I 1 .5z'\ Ic
. \ \
k-t—— sl- -\- --.-
A--
e ti'
.-k
. •••‘.
e;
J
0 1 •
'1 •
• ' 1
. .....
- 1
I ,
'\ •• . .
. ._... ...... .
. ._
. •
I . \ •
t \
....it./ .
. \''• • •
- - Z
... ,\ 0 . 1
1
".-•.... ,
• ( li...
t \ I
.• ' • ‘K 6 t, 1
I
.., --- , ' . •
i • ....,
, .
. Ck , •
• \
AV
6.‘
• ‘ 'ii • A .
c
. • S\4'••.. N)
t>•
' i . i o,\
, , . •, ' 1 ' \ T r•-...._ -37 •
73 U
i i 1
"X 0 0 nrn . 1 •••• ..,i
k 0 , • i 1 , • 1 N
z 70
-r-- 1
N.) m o
7J••• I
• " t-1 Hki 0 TIM • . . i -
143 at G) , r r" ' • , . Ai i ' i
IQ• ....< • , It ,sa 011k .
'-...... III .5 ;•
.•
. - . . ,.. # -% • .., .; -
: >In .
.) • ; to. V)
" )-4 • 1 il, # 0°0%
#r-7..• •l•l(• %% °
j
•
0 EZ'
en P P.- •`1 ,,,‘‘ w( oz,, 0 0 1 ' 1 . 0 ..: . . --, :-'-• ,,.• %
t .10 zc • (e % o (--
. n , . *"..-4 .4. Pr, ,. '13: ••...rn sr, ,
. . c're -i•
-
. n.0(:),A ,„ •f,... • 1, olik
1 • ' t •-;,I CZ, ,::, i c, 4• 1 of 7, • _....".
n 1 ••• (A " n , 1 1 . • i t. • . is-1,-0 A
iv/2,!;73 No0 4 0• '0 iig I
,•0- ire
'1-xi‘,-‘-<? dim i r < ,..,.._- -
\,..
•
t.l . i 11 111 . . , 1 ,1 . - ri•-•/,-,.,
"' .SC540V">- k i.""' PI .
n rp
S I ,
k r 1 4.
I) 0 al 11
% > 3 0 Pq i
0 1
3..7 4 g 1 i g )3 1 1 I • 1
5 ' I
It"' , . ta NI%) _ ---•
CI ii
, .. -I ., 1 1 1 i : •
, .
..,
e Zt: in-I
• v @ % ill . ...--- . _
_ 1 -
) ,..c • ! 1 , 1 . •
•
,
J
. ; i z ; i ' / • •