HomeMy WebLinkAboutSWG2023-00332 - SWG As-Built - 6/25/2025 RECORD DRAWING (ASBUILT) pg. 1 MASON COUNTY PUBLIC HEALTH
PARCEL IDENTIFICATION
Permit Number SWG 200_3— On- i L— Assessor Parcel # 3 zoo w 3-7 60 G 1
Applicant Name c_Kz., s .i171 no, 5,::h-,(71,h Subdivision (Name/Div/Block/Lot)
Applicant Address 23o/ C.Ap..254_ e,rsv s t r 3
City, State, Zip CL y 4.04- Ys-t) I Installer Name rc., A e -rc S
Site Address 30 7 E £itpt7v% p.c4;p..,/resigner Name /4 y4Ttrr
INSTALLATION CHECKLIST
[Full System Installation [1] Septic Tank Only ❑ Drainfield Only ❑ Repair
System Type a,e�s ` i.-,e Pretreatment Type 1-()i-:
>5 ft. from foundation? - - ❑ N/A [ lEs ❑ NO
>50 ft. from wells? - li ❑• >50 ft. from surface water? - {� (� ir V/ ❑Z �C l`GEm,• � ❑
HCleanout between building and tank? - - - ❑
U Tank baffles present? - SUN-r 7- 2025 - - ❑
a24" access risers over each compartment?- - IL1 ❑
W Effluent filter installed?- - II L�
to B; - -__---
Septic tank size 12 5r� gal : -• - • - _.L J. " ' iaLf r
5 D-box water level and speed levelers used? - - N/A DI YES NO
oO Manifold/D-box accessible from surface?- ❑ [ ❑
CO2 Check valves installed? - ❑
0 Q ,1 Schedule/Class yC�
E Transport Line Size 2.
Bedrooms installed (check one) ❑ 2 ❑3 231 ❑ 5 ❑6
>10 ft. from foundation? - - ❑ N/A [Zprtas ❑ NO
>100 ft. from wells? ❑ Zk- ❑
w >100 ft. from surface water? - Elg/ ❑
it >10 ft. from potable water lines? ❑ ❑
� > 5 ft. from property lines and easements?- - ❑
w > 30 ft. from downgradient curtain/foundation drains? - - ❑ Ea . ❑
o - R' ❑
Drai field level and observation ports present - ❑
'Graveless chambers or ❑ Clean gravel used? (check one) Tr p ❑
Proper cover installed over drainfield?- - ❑
Pump tank setbacks consistant with septic tank? - - ❑ N/A l❑
❑ NO
• Pump tank size ' 7 So gal Manufacturer ,S 0 ilk/ bPL,oLO.1c r
Z ❑
< 24" access riser(s) and accessible from surface?- - ❑ 0 .
❑
~ Alarm or Control Panel Installed? - - Ela 2 Control Panel equipped with Timer/ ETM /Counter - ❑ ED-- ❑
M
CI- Pump installed in ❑ Bucket or On Block or ❑ Other
a.
❑ Floats or ['Transducer
Pump Make/Model Li dtct Ty fG 4B L/"t 2 3 _
a Tank draw down � �/Z_ in/min Pump capacity q a gpm Squirt Height Y ft
Pump on time
�2 ,sec• Pump off time V )/. Daily flow set at gpm
revised 1/22I2014
RECORD DRAWING (ASBUILT) pg. 2 MASON COUNTY PUBLIC HEALTH
RECORD DRAWING
0 Drainfield&
manifold orientation
&layout
Trench/bed
dimensions and
critical distances
within layout
El Septic/pump tank
placement
Location of
buildings
El Observation ports&
clean-out locations
El Location of wells,
surface water,&
roads
El 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
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
1 further certify that all information contained on this I further certify that all information contained on this
form and attached rowing is accurate. form and attached Record Dra . is accurate
l6 f.(7
Sign of Installer Da(C CtJ - --1—S
Printed Na of Signee �P :` f.% I 4.;,
� s
MASON COUNTY PUBLIC HEALTH L
The undersigned approves this Installation Repo a <>_ 0, IAMES L HUNTER g pp LICENSEb of SIGNER
Record Drawing on behalf of Masoil County Pup c : �• ExFrrtEs: o3/z2/-LG
Healt 04,00UN ✓ 4/2 <'
(?5(Z ?c '�F�`,R 4°,
n ure of Environmental Health Specialist DQ F,q7. (designer's stamp, signature and date)
THIS FORM MAY BE SCANNED AND AVAILABLE FOR P t4C VIEW ON THE MASON COUNTY WEB SITE
revised 1/22/2014
.334/.e i I
1,1
-t.:
' ci•A -g-,,,
____-;_.-
,,-
— I
1 ..,
/ - - ---\ ,4 1_ os -7 \
. •h
• ,0
. ; -..•\ 1
;2s 0
, .
. ; - -— • .. . \ ---1,
i• ''l • _..__. _____. ____
, cc'
V
-- — — --; -- —
. ,
,• - ::.--___.—____ : = —-
7 ,
. . . • . <C: . 'CT- ,
1 .
.e..*
c•I
o
-k.
c... . ..
•
..„,
. .. .
•
• t .
• h .
. 0 gv‘‘‘
I -s/•
,--. •/tc‘
• , ;e-i, 11.1 S‘‘
. ,„--. A4--r. '5:1" % . •
. $Ir4 r, ' •,‘Ip,
• c.AZ X -:.'t;"i'`,.; sw--46._
• ;-- ",-.^. 't - ,.,,,,, ....,;"'-...101bili.....4,.... .
!--:::•,,"'N -'''' A‘ '•
- s.<' Wirakk,
. ...
X'- C I 1
i I 11 • c• '-,F!„,4, . 4,,-..„,„,
1 I t • ' 1 • 4.....4"
) WI 1 vl
.1 . iiii 11
) 111 .
) I 4 1
,1 ti, / 11 •
: ? I ; 1 • '
IR
I I I r,
1
SI C7
Pt CI \IQ C '< il ; li 1 .
Z ': 0 -‘
-I . t i 1 ! i • i a ,
--Zi
N.I• ,:< e ,: 1 1 I i
' • ' I ' -,, .
T . 01 P : '; ° , • .
' H i birA• ,
tf) (f) .; !, ) i ) 1 lk ,..
•
. !
161 ..,. • tH ..•. i ; • ,
7,•;:s; 0 0 : . : i ., i
ik•
n • 1, : 1 ' , , , •
E. ., ! _ .i : I
: ] i . lir! ??4,-• 1 .
: , . .. ! , ; 1.,ta, ,• r,.
us 1 ')u•s H 11 . *. : • • 44* t,..—,,.
1 ' 2 -'1 i o ,, , .„, , , ,. ; - • . _
, • :, -. 111 '.„1 ir, .
rn > rri IP
. f I( • I ; $ i ‘ .
3 < , . ! , . , ,
; `<, '. j i ,. 1 f; 1 1 p
, •, 1 , , , ,__. •
nl
CIA -6
p.s. „, • ; :. I t: ii I
Ch i i 1 ! ! i I' •
. 1 ' • ). ‘,