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HomeMy WebLinkAboutswg2022-00364 - SWG As-Built - 12/15/2024 41, `, r Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT! PERMIT FORMATION Permit Number SWG 2022-00364 01 # 32328-31-00170 Applicant Name CHRIS POWEL 1.%- Sub ion (Name/Div/Block/Lot) Applicant Address 810 NW DEWA EAC D C. 1-0 City, State, Zip TAHUYA, WA, 985 Instal me KAT TRAX Site Address 810 NW DEWATTO EACH DR signer Name ACME SEPTIC DESIGN IN ALLATION CHECKLIST Q Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑Repair ❑Other System Type PRE-TREATMENT TO PRESSURE Pretreatment Type BNRCO 0 >5 ft.from foundation? - - ❑ NIA U]YES ❑ NO >50 ft.from wells? - - ❑ ® ❑ Z >50 ft.from surface water? - - El ❑� ❑ N Cleanout between building and tank? - - ❑ ❑■ ❑ U Tank baffles present? - - ❑ ❑■ ❑ d 24"access risers over each compartment?- - ❑ ❑� ❑ W Effluent filter installed?- - ❑ ❑ ❑■ N Septic tank size 1250 gal Manufacturer HAGERMAN 9 D-box water level and speed levelers used? - - ■❑ N/A 0 YES ❑ NO DO Manifold/D-box accessible from surface?- - ❑ Ell 0?-2 Check valves installed? - - ❑ ❑ ❑ OQ 2 Transport Line Size 2" Schedule/Class 40 Bedrooms installed (check one) ❑ 2 ■❑3 ❑4 ❑ 5 ❑6 ['Commercial/Other >10 ft. from foundation?- - ❑ N/A ❑■ YES ❑ NO >100 ft. from wells? ❑ ■❑ ❑ W >100 ft. from surface water? - - ❑ ❑� ❑ LT >10 ft.from potable water lines?- - ❑ ❑■ ❑ Z > 5 ft. from property lines and easements?- - ❑ ❑■ ❑ Q tY > 30 ft.from downgradient curtain/foundation drains? - - ❑ MI ❑ Drainfield level and observation ports present - - ❑ II ❑ 0 Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ ■❑ ❑ Pump tank setbacks consistant with septic tank?- - ❑ NIA Q YES ❑ NO • Pump tank size 1500 gal Manufacturer HAGERMAN Q 24" access riser(s)and accessible from surface?- - 0 0 ❑ I- a. Alarm or Control Panel Installed? - ❑ 0 ❑ 2 Control Panel equipped with Timer/ETM/Counter- - 0 I ❑ °- Pump installed in ❑ Bucket or ❑ On Block or 0 Other FLO-INDUSER d• Pump Make/Model ORENCO PF3020 ❑� Floats or ❑ Transducer D • Tank draw down 1.5 in/min Pump capacity 48 gpm Squirt Height 6+ ft Pump on time 56 SEC Pump off time 3 HRS Daily flow set at 358.4 gpd Updated W21/2018 Allimmillimilillalom . Y, sb, 'a ' Mason County OSS Installation Report pg.2 Parcel# 32323100170 ABANDONMENT RECORD YES © NO Were existing septic components abandoned as part of this project? If yes,please describe'. YES NO Were all components pumped out and properly abandoned per WAC246-272A-0300? RECORD DRAWING This Is a permanent record and must be accurate and descriptive enough to re-louts In the need of maintenance activities ef future d elopre+nt t wTNpiced waterlines,Record layeu welts, observation mdaln:Orair,fwld& tS..ndl orlentwatn a nOce,SaU pmntP tank location,North arrow,reserve dralnteld,misting and proposedand rimed arms, welts.observation pots,tleanCnta.and other maintenance access Points.Incomplete Second Drawings may create adoibonal delays in Mal hatta albs approval 1 11Sd11 0 Record Drawi a.ched zoz4 111\11•11111t1 2 V CERTIFICATION OF INSTALLATION MIMI DESIGNER!ENGINEER INSTALLER I certi that the system has been installed in a 47- I certify that!installed the system in accordance with the septic design stamped'APPROVED"by Mason dance with the septic design stamped"APPRO De by deviations shown Mason County Public Health and that any deviations County Public Health and that any roved byboth here have been cleared/approved by both the designer myself n haers have beend Maven County Public Health and meet all and Mason County Public Health and meet all State State and Mason County Codes and MasonCounty Codes. I further certify that all information contained on this I furthhererceertify th. :JJ information contained on this form and attached Record Drawing is accurate. form and atta,Record Drawing is accurate. / , e/2Ati .a. Si. afur Installer Date i IML ... ir4C./Illr vb. P nted Name of Signee iri ".. _ MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and . '117r;� r t Record Drawing on behalf of Mason County Public i 0211r FNSE s DESIGNER Health: /11/1 EN 1'1/11111 U 17 J�2� EXPIRES 1219512t& (stamp signature and date) Signature of Environmental Health SpecialistDate , Opd,tad e<s,rzo,e THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE 0 a 0, D r ffl o m O13IdNIVHd AHVWI2:1d C Z D o 3/\2:3532� w %00l ' m53 C.:› O �40 = No / m cNri ..t rn il'i ••••.,.......,...:, • :-. :,.,....0141.4spit,........ \ 3 00000-1-£-8Z£Z£-1• 0b'd� Xdl 4 .9Z � Icn e?., i. .._ .:.:,..:'...,\.; t ,,,,\‘ --_,.4 . _ -_:_. 0. • \ 0000 �HH� . * * » * * *. 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