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HomeMy WebLinkAboutSWG2025-00157 - SWG As-Built - 6/11/2025 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2025-00157 Parcel# 51901-44-00068 Applicant Name Karen Frost-Beard Subdivision (Name/Div/Block/Lot) Applicant Address 1410 Pawprint Ct TR 6-H OF GOUT LOT 10 City. State, Zip Colorado Springs, Colorado,80921 Installer Name Maples Excavating Site Address 35 W Frosty LN North Designer Name Arrow Septic Designs Inc. INSTALLATION CHECKLIST © Full System Installation 0 Tank(s)Only El Drainfield Only Repair Other System Type Pressure Bed Pr- . ent Type >5 ft.from foundation? - Iscs..\\Nri.. ❑ NIA 0 YES ❑ No >50 ft. from wells? - ❑ ® ❑ >50 ft. from surface water? - '� - �J - - - ■ • ID El 0 z30� Cleanout between building and tank? --U Tank baffles present? - - III 0 0 a24"access risers over each compartment?-By - - - - - ■ ii 0 W Effluent filter installed?- ❑ © 0 to Septic tank capacity(working) 1250 gal Manufacturer Infiltrator ❑ D-box water level and speed levelers used? - - ❑ N/A ❑ YES ■ NO J - 0 0 XOManifold/D-box accessible from surface? 0 NI mIR Z Check valves installed? El ❑Q 2^ Schedule/Class 40 E Transport Line Size Bedrooms installed(check one) El 2 0 3 0 4 ❑ 5 ❑6 ❑Commercial/Other >10 ft. from foundation?- - ❑ N/A 0 YES 0 NO ❑ >100 ft. from wells?- - 0 1 ❑W >100 ft. from surface water? - ❑ 0 ❑ u. >10 ft. from potable water lines?- - 0 El 0 Z > 5 ft. from property lines and easements?- - 0 0 0 w > 30 ft.from downgradient curtain/foundation drains?- - 0 0 0 CI Drainfield level and observation ports present - - ❑ 0 0 ❑ Graveless chambers or It Clean gravel used? (check one) Proper cover installed over drainfield?- - 0 C 0 Pump tank setbacks consistent with septic tank?- - ❑ NIA 0 YES ❑ NO Y Pump tank capacity (flood) 1060 gal Manufacturer Infiltrator Z ❑ 0 ❑ < 24" access riser(s) and accessible from surface? - ❑ ~ a Alarm or Control Panel Installed? - - ❑ lil 2 Control Panel equipped with Timer/ETM /Counter- - 0 El El a Pump installed in ❑ Bucket or 0 On Block or ❑ Other d Pump Make/Model Zoeller N152 El Floats or 0 Transducer eL n. Tank draw down 1" in/min Pump capacity 25 gpm Squirt Height 8 ft Pump on time 2.4 min Pump off time 6hr. Daily flew set at 240 gpd � Mason County OSS Installation Report pg. 2 Parcel# S 1901 - 44_ °0a(''8 ABANDONMENT RECORD YES 0 NO Were existing septic components abandoned as part of this project? - e - In If yes, please describe: O `` 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 relocate in the need of maintenance activities and future development. Typical Record Drawings contain: Grainfield&manifold orientation&layout.Septic/pump tank location,North arrow,reserve drair.5eld,existing and proposed build ngs,location of wells,waterlines, wells.observation ports,deanouts,and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and related permits. Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ENGINEER 1 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. j5-RP-.LS cA�� Signature of Installer Date - V} i Printed Name of Signee r • MASON COUNTY PUBLIC HEALTH z '` ''i. The undersigned approves this Installation Report and • A..,"'• `f Record Drawing on behalf of Mason County Public ;-�-f`:3• s t 00349 ..5.34.1) PAULA JOY JOHNSON ' Health: 7 �� • �.IC��v .,Gt�:t:a.. EXPIRfiS /1$ CO—Co Signature of Environnkental Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Updatec 8212018 k.",..,3-• • roov t 1J7- r•• %-, ... 1 1 I . 1 ---E04-- ge S C.- — U-'•-c\*.- 1 1 1 I 1 PrEr-1,1 osT-- erk-Ae 1 t 1 • a r,\-AA— =Coq VIARC. t.,451.6101-44-00t)(0 1 '-'5 '‘' " ,-------------1 1 IP 1 5 \INI 9,067‘ 1" i •,---, cd" - - 1 1-----------1. i• L...) \...t./.... ___ .7-s;, s\ktA:rept4 Kicre.5 1 1 ,,,,..„„....,,,reis ,....-1- Pt-- ...; ' \ t, ---- \ ti_2- " 1 1 1 \l' 't)CC) _____ ' 1 . 1 ' \ 1.....\ --••••••-•-.1 Cv...."...r. 1 1 t 1 ) I I 1 I t 1 p I a , 1 1 i 1 1 i i 1 , i 1 10')30' PR.6sS1) 5 t O Audio-Visual Alarm , i/ 1 'd....-.(2.,;5 e 1 e Cleariout 1 OS c- i /-, i • 1 • 1',2-S-0Gallon Septic. Tank 2-Compartment with 1 i Efauent Filter 1 i .\i ) i. 0 1,000 Gallon Pump Chamber . \ i "1 .--,-- X' 0 0 LiL.,4s .,6C___ \t\-0,-S freS1- 0 c -0,..n>.N..A..-e9•A-• \ :(A-1 ' -, - -.7`-' • --=----- -------t- fej4„,.0.2-e-c - - 0 •A9---- \ : ' 0 A,N Cc „ I...vje-Pek, f„--.-----T- ,. o ,,, ..v.... --- _ APPROVED of 1k 5 0' JUN 1 1 2025 MASON COUNTY ENVIRONMENTAL HEAL Irt. .1 k 1 sti• A 1 V W-'1( L 6 U ). WI - .*„. ..!.,.c -..i.P..,01 • 8%. 5100340 _"11 • PAULA JOY JOHNSON..7, • ' •• •It SK .15.0_,___,:l.C.,l'Zi:i•• .1. WCPIRES 1, fiVVV---7. ' . CO •'(.40'"1.1‘