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HomeMy WebLinkAboutSWG2024-00179 - SWG As-Built - 5/7/2025 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT! PERMIT INFORMATION Permit Number SWG 2024-00179 Parcel# 32104-50-00086 Applicant Name AB Fine Homes Subdivision (Name/Div/Block/Lot) Applicant Address 871 E Beach Drive ALDERBROOK GOLF&COUNTRY CLUB LOTS: 86&87 City, State, Zip Union, WA 98592 Installer Name Hanson Excavating Site Address 61 E Jack Pine Ln, Union Designer Name Arrow Septic Designs INSTALLATION CHECKLIST ® Full System Installation ❑ Tank(s)Only ❑ Drainfield Only ❑ Repair III Other 500 gallon pre-trash tank System Type Subsurface Drip - -treatment Type NuWater BNR-500 >5 ft.from foundation? - - ❑ N/A 0■ YES ❑ NO >50 ft. from wells? - - - - - ❑ ® ❑ Y >50 ft. from surface water? - _ - ��- - - El Elz -0< Cleanout between building and tank? -tl, - - - �`—1 - li ❑■ ❑ ✓ Tank baffles present? - - -`i�@�- - -- e- - El ❑ I— 24" access risers over each compartment' ‘ �`` `- - - - ❑ A ❑ W Effluent filter installed?- - - - - I - -- - - ❑ ❑ It cn r •I Septic tank capacity(working) NuWater B ':, :I Manufacturer Hagerman D-box water level and speed levelers used? - - ❑ N/A ❑ YES El NO 00 Manifold/D-box accessible from surface?- E'{-EN)t'`'oR-K s - ❑ 111 ❑ co-2 Check valves installed? - - ❑ ® ❑ 6 Q 2 Transport Line Size 1 inch Schedule/Class 40 Bedrooms installed (check one) ❑ 2 ❑■ 3 ❑4 ❑ 5 ❑ 6 0 Commercial/Other >10 ft. from foundation?- - ❑ N/A Q YES ❑ NO O >100 ft. from wells?- - ❑ MI 0 W >100 ft. from surface water? - - ❑ ® ❑ LT >10 ft. from potable water lines?- - ❑ ❑■ El Z > 5 ft. from property lines and easements?- - ❑ I Ela Ce > 30 ft. from downgradient curtain/foundation drains?- - ❑ II 0 O Drainfield level and observation ports present - - ❑ ® ❑ ❑ Crwvciccs chambcro or ❑ Cicon grovel u3cd? (check one} Proper cover installed over drainfield?- - ❑ CI ❑ Pump tank setbacks consistent with septic tank?- - ❑ N/A El YES ❑ NO Pump tank capacity (flood) 1,000 gal Manufacturer Hagerman < 24" access riser(s) and accessible from surface?- - ❑ 0 El E- a Alarm or Control Panel Installed? - - ❑ 0 LI E Control Panel equipped with Timer/ ETM /Counter- - ❑ © ❑ m a Pump installed in ❑ Bucket or El On Block or • Other flow reducer tube a• Pump Make/Model Orenco PF 200511 0 Floats or ❑ Transducer a Tank draw down 2"/10 min in/min Pump capacity 3.8 gpm Squirt Height — ft Pump on time 8 minutes Pump off time 1.84 hours Daily flow set at 360 gpd Update-,'52t2G?e Mason County OSS Installation Report pg. 2 Parcel# 321o4 - Sb - 0008(0 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - [ YES NO If yes, please describe: I Were all components pumped out and properly abandoned per WAC246-272A-0300? - - ❑ YES ❑ NO RECORD DRAWING This is a permanent record and must be accurate and descriptive enough to re-locate in the need of maintenance activities and future development. Typical Record Drawings contain: Drainfielc&manifold orientation&layoct.Septic/pump tank location.North arrow.reserve drainfield.existing and proposed buildings.location of wells,waterlines.. wells,observation ports,cleanouts.and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and related permits. P Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ENGINEER 1 certify that 1 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 ail 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. 7V� 4-d1-L 05/Cj 11/2S Atli VA Sig ure of Installer Da r Jared Hanson rpil , v A'IPrinted Name of Signee � T• MASON COUNTY PUBLIC HEALTH L3..A. YlThe undersigned approves this Installation Report and Af, s,003a9 Vl Record Drawingon behalf of Mason CountyPublic 4' O FAULA JOY JOHNSCN r LiC8ic_iIB<PiRn 8iG l=ft • \). Health: '0 �n s\R- i\VWVCCL(11 Cf7 (LC S.'G-1-5- Signature of Environmental Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE upciatec 8/21,20 8 1 :8 sae yG \4.-, .---------- c �\-7, ? =ESL -50-OJ°S `,��J �RG`G p1N LrJ ,�,S`o4� , 1 y ,..„,- ,,, ,kt°2 \ '5)\ , 77, \\\'\\ .: ., , , , , % \*:‘,„,,,,,, , r \ ,�g�� `ems,;. ‹, ) ,..,, u '1\''''"ItAtiv4 .) 7 ......._ , ... , ,,, i \ . Tr--19., . „ „. , ..., , ,� �- — _.\ ......_ ____ / tiJ rr l_ini.,11 ii 1 rii \ U mat liiik&• • -• ,..r:A,gisim. D R%‘f Ev�A i i I 1 fi f= 1 gli L I j ,f, MAY 0 7 2025 Key: MASON CGUNIY Eh t7RONy4EhTA�H f., U Aa.^_�o-V sua`A az--� RET �LTI N. t , r' U Cleanout i m •• �� 1 { 4 ; NuWat 00 7re-eat,?nen t Tank J•.• \J eF 3�t�'Z Jv l C . ssooi•i9 ••:fi t 5;-, ePAULA JOY JOHNSON .yt' o 1,000 Cron - u---p Cha=ber -Ns-s ti� Z � Subs a_ ace � p Sys�e_ eadworks 5-(I -Z5