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HomeMy WebLinkAboutswg2022-00246 - SWG As-Built - 9/13/2022 C.1 AUG 2 6 2022 RECORD DRAWING (ASBUILT) pg. 1 RYt MASON COUNTY PUBLIC HEALTH PARCEL IDENTIFICATION Permit Number SWG Z.O `t-Z- O iJ L-(L • Assessor Parcel # k1 L2.V 9.51 000c,c Applicant Name 11;11 A- C .4;i Mc.I /41 Subdivision (Name/Div/Block/Lot) Applicant Address t323 L (1-} -I-- City, State, Zip CS C--Q t� oNe.. q 'Not Installer Name - V t it l' Site Address CA\ {J IkANfY(A pt.., Designer Name A d,- EL/4,,,- INSTALLATION CHECKLIST yr Full System Installation ❑ Septic Tank Only ❑ Drainfield Only ❑ Repair System Type —Sc..ct 1 n.LZ ( .a Pretreatment Type >5 ft. from foundation? - - ❑ NIA 0 YES ❑ NO >50 ft. from wells? - - ❑ El ❑ ? >50 ft. from surface water? - - ❑ © ❑ < Cleanout between building and tank? - - ❑ Ei El ✓ Tank baffles present? - • 0 gl ❑ a24"access risers over each compartment?- - 0 El ❑ W Effluent filter installed?- - 0 ® ❑ u) Septic tank size /0S0 gal Manufacturer cSE'•S El D-box water level and speed levelers used? - - ® NIA ❑ YES ❑ NO DO Manifold/D-box accessible from surface?• - .0 0 . 0 QQCheck valves installed? - 0 0 2 Transport Line Size 2 rr Schedule/Class Sc.& YO Bedrooms installed (check one) 2 0 3 ❑4 ❑ 5 0 6 >10 ft. from foundation?- - 0 NIA 0 YES ❑ NO O >100 ft. from wells?- - El (g ❑ W >100 ft. from surface water? • - ❑ 0 ❑ IL >10 ft. from potable water lines?- • 0 0 0 de.Z > 5 ft. from property lines and easements?- • 0 [ 0 iti >30 ft. from downgradient curtain/foundation drains? - - ❑ VI El fp . Drainfield level and observation ports present • . ❑ X 0 ❑ Graveless chambers or N Clean gravel used? (check one) Proper cover installed over drainfield?- - 0 Z 0 Pump tank setbacks consistent with septic tank?- - ❑ N/A (4 YES ❑ NO • Pump tank size MOO gal Manufacturer S R5 Z Q 24"access riser(s)and accessible from surface?- • ❑ El Cl ~ Alarm or Control Panel Installed? - - 0 IN 0 Jj a 11 E_ Control Panel equipped with Timer/ETM/Counter- - ❑ Xi ❑ n. Pump installed in ❑ Bucket or INOn Block or ❑ Other O. Pump Make/Model L-\ rw Z`bQ 121Floats or ❑ Transducer 2 R. Tank draw down 1 'IA in/min Pump capacity gpm Squirt Height 5 ft u Pump on time : S5 .Sec. Pump off time ("/=CY) gr Daily flow set at Z.40 gpm revise°1122/2014 RECORD DRAWING (ASBUILT) pg. 2 MASON COUNTY PUBLIC HEALTH RECORD DRAWING • • Drainfetd& . manifold orientation &layout Li Trench/bed dimensions and critical distances within layout • Septic/pump tank placement El Location of // -14 1b buildings � • Observation ports& clean-out locations • Location of wells, surface water,& roads Undisturbed native soil between trenches El 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 fi 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 fut e jltity7»t all infoiffiation contained on this form and attached Record Drawing is accurate. fog:thiifkelled Reco _ 3uwrng is a �:te. Wt7- a ,.... `` Signature of installer Date It f `• • 1 fztvfS J7 ,,Z. - I Printed Name of Signee MASON COUNTY PUBLIC HEALTH r � The undersigned approves this Installation Report and 1'� Record Drawing on behalf of Mason County Public • 510154.12 -. 4ti� Health: HUNT ;AD•AM H Signature of Environmental alth Specialist Date 7p'esigners stamp, signature and detect' THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE revised 1/22/2014 • . • :*. /7 1-------- 0 . cn 0 0 > r- M 8 --, - 2 IN3...% / ,. -,, --, co c? •-.., m •---. -----. ' ----., o 9- -1 C , -•„, „...„c, o c = / s••• . x co •k c, --1 c• >z c-, c• -0 .., z• • .....Q rn 0 fik 0 q INIF-4 Z 4.4 I•2 rn 0 73 z 0 -I M / ) 73 - A r- 0 r- 2 cn co < —s m m -4 0 C 03 1- O C 8 i s\! I E 8 -o -I - o I x P i m xi \ , ‘,\ , \. , \, • s . . ...._ .. - .. - - la CINI°1(334‘4" .C..,/ .,,•e, r• ....-•• •'.?Z.... ..i • ?_•. 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