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HomeMy WebLinkAboutSWG2025-00044 - SWG As-Built - 6/6/2025 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2025-00044 Parcel # 32127-54-00042 Applicant Name MYER FAMILY TRUST Subdivision (Name/Div/Block/Lot) Applicant Address 236 BAILY ISLAND DR City, State, Zip HENDERSON, NV 89074 Installer Name SCHOENING EXCAVATION Site Address 120 E CLONAKILTY DR Designer Name CINDY WAITE INSTALLATION CHECKLIST 0 Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑ Repair ❑ Other System Type OSCAR X02 Pretreatment Type >5 ft. from foundation? - - ❑ N/A ❑■ YES ❑ NO >50 ft. from wells? - - ❑ IR 0 >50 ft. from surface water? - ❑ ❑ Z - FQ- Cleanout between building and tank? - ElEl Tank baffles present? - - 0 CI 0 d24"access risers over each compartment?- 0 El El Cl)W Effluent filter installed?- - ❑ ® 0 Septic tank capacity (working) 1094 gal Manufacturer INFILITRATOR 1060 --..0 D-box water level and speed levelers used? - - N/A El YES ❑ NO O Manifold/D-box accessible from surface?- 0 0 QQ Check valves installed? - - r-, 0 L..; E Transport Line Size 1 Schedule/Class SCHEDULE 40 j::-15(.91//7) L eigic„,) Bedrooms installed (check one) 0 2 0 3 ❑4 ❑ 5 0 6 ❑Commercial/Other >10 ft. from foundation? - - ❑ N/A 0 YES Wel- >100 ft. from wells?- ❑ 0 ��, CI laK J >100 ft. from surface water? • ❑ 0 3 W - >10 ft. from potable water lines?- - ❑ 0 Q > 5 ft. from property lines and easements?- - ❑ Q > 30 ft. from downgradient curtain/foundation drains? - - ® 0 o b Drainfield level and observation ports present - - CI PO ED "' ❑ Graveless chambers or ❑ Clean gravel used? (check one) 0-5 a>� �,�.-LF,;12 Proper cover installed over drainfield?- - ❑ 0 ❑ ��� Pump tank setbacks consistent with septic tank? - - ❑ N/A 0 YES ❑ NO • Pump tank capacity (flood) 1287 gal Manufacturer INFILITRATOR 1060 Z < 24"access riser(s)and accessible from surface?- - ❑ 0 ❑ a Alarm or Control Panel Installed? - - ❑ ® ❑ Control Panel equipped with Timer/ ETM /Counter- - ❑ © ❑ d Pump installed in ❑■ Bucket or ❑ On Block or ❑ Other 2 Pump Make/Model ❑ Floats or ❑ Transducer a. Tank draw down in/min Pumpcapacity n- p Y gpm Squirt Height ft Pump on time Pump off time Daily flow set at gpd // Co pr/dei SP p Plt— X 0 Updated. 8i212018 Mason County OSS Installation Report pg. 2 Parcel# ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - 01 YES El NO If yes, please describe: Were all components pumped out and properly abandoned per WAC246-272A-0300? - - 41 YES 0 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. Drainfield&manifold orientation&layout,Septicrpump tank location.North arrow,reserve dramfield.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. a Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ ENGINEER 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 qn this I further certify that all information contained on this form and attached Record Drawing is accura form and attached Record�orawing is.accurate. P��• I �� • Get (6 .Z�) i �4 Signature of Installer Date ,;P�� S.0 �S r +t vs Printed Nbme of Signee i''y*• a 3 l0 A.vMASON COUNTY PUBLIC HEALTH '° e p CiNDY WAITE• 1 +'e LICENSED DESIGNER-' ' i� The undersigned approves this Installation Report and gam. l% %%% % %%%%%. Record Drawing on behalf of Mason County Public Exr:i._s us,10. Health: SCrY) a'6 11"-T-- Signature of Environme al Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Updated 8/21/2018 • I. i 4: 41.' • • / COcn �A ?�o . r ...., 71 - • j t a o CD c 0 I -- fires o l x • ♦ • • • •• • r • „ te • COvt c'\ > /N k. 40 • • CO o A Cl) o ♦' la ,' y a c) a r JUN 0 6 2025 dr MASQN COUN11) TY ENVIRONMENTAL HEALT i e� N . 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