HomeMy WebLinkAboutSWG2021-00382 - SWG As-Built - 6/24/2025 RECORD DRAWING (ASBUILT) pg. 1 MASON COUNTY PUBLIC HEALTH
PARCEL IDENTIFICATION
Permit Number SWG 2Ci. I -1,0 (, ✓'- Assessor Parcel# 31� U -_3 ' �C!
Applicant Name -Par\ L-civet Subdivision (Name/Div/Block/Lot)
Applicant Address Pe, P j L- "�72 I,,
•
City, State, Zip �M
fit-- U3( 1' Installer Name T-.11,''' S' `uv (0/ j-
Z.Site Address
I 1 5 e 1 () Y -rLDesigner Name ef,-1 j— k 1
r
INSTALLATION CHECKLIST J
tej Full System Installation ❑Tank(s)Only El Drainfield Only Repair El Other
System Type n J l 1. 'f �-e -- r atment Type
>5 ft.from foundation? - ❑ N/A -Fe ❑ NO
>50 ft. from wells? - ❑ ❑
>50 ft. from surface water? - ❑ c'r ❑
Z
HCleanout between building and tank? - ❑ ❑
(.) Tank baffles present? - - El 0
d 24" access risers over each compartment?- - ❑ u ❑
N 0.
Effluent filter installed?- - IDSeptic tank size I }/v�(�L"�L.' gal Manufacturer 1v/is '�(4-ei li V l-h thZ4V- ,
0 Vfie
• D-box water level and speed levelers used? - - ❑ YES ElNO
oO Manifold/D-box accessible from surface?- - E El
0?-2 Check valves installed? - - 0 Is ❑
OQ �i )''
2 Transport Line Size i I i chedule/Class S; \�\ 1..1
Bedrooms installed (check one) ❑ 2 30 4 ❑ 5 ❑6 ❑Commercial/Other
>10 ft. from foundation?- - ❑ N/A [vs ❑ NO
CD >100 ft. from wells?- - El El
ElW >100 ft. from surface water? - - ❑ ❑
�-.Z >10 ft. from potable water lines?- - El �� CI
5 ft. from property lines and easements?- - ❑ 0 CI
li > 30 ft. from downgradient curtain/foundation drains?- - ❑ ❑
0
Drainfield level and observation ports present - - ❑ � 0
DI Graveless chambers or ❑ Clean gravel used? (check one) 0 OS—
Proper Proper cover installed over drainfield?- - 0 El
Pump tank setbacks consistent with septic tank? - 11 NIA Yes ❑ NO
Pump tank size ( 0 to 0 gal Manufacturer 1,( r l� �t
< 24"access riser(s)and accessible from surface?- - ❑ �/ LE
-
a Alarm or Control Panel Installed? - - El Ly' 0
_
Control Panel equipped with Timer/ETM/C ter ElC' ❑
d Pump installed in ❑ Bucket�/ orI On BI ck or ❑ Other
2 Pump Make/Model 1 ��.Q!Lr 3C)C'`pm Floats or ❑ Transducer
V. I, l(1 f
d Tank draw down cfSCCi. in/min Pump capacity O L(A-r gpm Squirt Height 0 LC V ft
Pump on time OSt-k.Y Pump off time Op-et' Daily flow set at 3LO god
Updated 12/720 t 5
MCPH RECORD DRAWING (ASBUILT) pg. 2 Assessor Parcel# . I G 0 �1� ')6) q
RECORD DRAWING
❑ Drainfield&manifold
orientation&layout
w/dimensions for
re-location.
❑ Trench/bed
dimensions and
critical distances
within layout
❑ Septic/pump tank
placement
❑ Location of buildings
existing/proposed
❑ Observation ports,
dean-out locations.
&manifolds/d-boxes
❑ Location of wells,
surface water.roads,
&waterlines.
❑ Reserve area(s)
❑ 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 /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.
liCr 3/I7IZU
Signature of Installer Date
?rak.4 itl\ 1\iw 1,, o f Y ?: .t
Printed Name of Signee ;:` .`f i�'''+.,: :
MASON COUNTY PUBLIC HEALTH ��' - x
The undersigned approves this Installation Report and `! '*; b. : i. *"% ' .4,
Record Drawing on behalf of Mason County Public • 'r af+is•
1)1 Health: �7 '
klir\QA(Y\J C ~ IW2Xt 1 "c
Signature of Environme>itai Health Specialist Date (designer's stamp, signature and date)
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Updated 12n2015
(00)
LOWRIDGE ON SITE TECHNOLOGIES, LLC.
Date: /f 7/1.
Re: OSCAR-LOWeFLOW installation at:
Address: j , G L.
Pressure & Flow:
Pressures on the OSCAR headworks:
Dosing: G1 = `j psi, G2= •-1 psi, G3=iripsi
Dose flow rate= tigpm
Flushing flow rate=2 Zgpm.
Pressures on W G-W headworks:
G1= psi, — psi, G3= psi
Dose flow rate= gpm
Installation:OSCAR: 1j A PPRO
Correct number of coils: ; S ROVED
Correct coil arrangement: JUN 2 4 2025
Inspection ports: • ,{. c MASON COUNTyENV1RONYEN'T
Proper sand depth: `{ �� RET AL HEALTH
Headworks in soil: ^� C
LOWeFLOW:
LOWeFLOW level.
Timer settings corn t:
Splitter correct:
Floats set correctly:
Basal preparation according OSCAR-LOWeFLOW Installation manual: Y
PO Box 1179 Lake Stevens,WA 98258 0 877 476-8823 F(425)335-3622 C(425)750-4922 dave c nwridgetech corn
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