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HomeMy WebLinkAboutSWG2025-00124 - SWG As-Built - 7/10/2025 immiummilommim r Mason County OSS Installation ReportCD --J P pg. 1 MASON COUNTY PligLIC H :11 H APPLICANT/ PERMIT INFORMATION 1 Permit Number SWG 2025-00124 Parcel # 32127-51-00117 = M 4 Applicant Name ANN ROY Subdivision (Name/Div/Block/Lot) N Applicant Address 43 SPRING CREEK CT . In City, State, Zip KALISPELL, MT. 59901 Installer Name SCHOENING EXCAVATION Site Address 211 E PENZANCE RD Designer Name CINDY WAITE INSTALLATION CHECKLIST NO Full System Installation ❑Tank(s)Only ❑ Drainfield Only 0 Repair 0 Other System Type Pretreatment Type >5 ft. from foundation? - - ❑ N/A ®YES ❑ NO >50 ft. from wells? - - ❑ IN 0 Z >50 ft.from surface water? - - El EN ❑ • Cleanout between building and tank? - - ❑ 0 ✓ Tank baffles present? - - 0 © ❑ a 24"access risers over each compartment?- - El 4 El tu Effluent filter installed?- - El 0 Septic tank capacity(working) 1094 gal Manufacturer INFILTRATOR 1060 9 D-box water level and speed levelers used? - - IN N/A El YES ❑ NO OO Manifold/D-box accessible from surface?- - 0 0 El CQCheck valves installed? - - El 2 Transport Line Size 2 0 IN p Schedule/Class SCHDULE 40 Bedrooms installed (check one) 0 2 0 3 ❑4 0 5 ❑6 ❑Commercial/Other >10 ft.from foundation?- - ❑ N/A ® YES ❑ NO 0 >100 ft. from wells?- - 0 IN 0 -I >100 ft. from surface water? - - ❑ IN ❑ W Li. >10 ft.from potable water lines?- ❑ ® ❑ z > 5 ft. from property lines and easements?- - ❑ 11 0 G > 30 ft. from downgradient curtain/foundation drains? - - RE 0 Drainfield level and observation ports present - - 0 4 0 0 Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?- - 0 ❑ 0 Pump tank setbacks consistent with septic tank? - - ❑ N/A 4 YES ❑ NO Z Pump tank capacity(flood) 1287 gal Manufacturer INFILTRATOR 1060 H24"access riser(s)and accessible from surface?- - El ® 0 a. Alarm or Control Panel Installed? - - 0 ® 0 Control Panel equipped with Timer/ ETM/Counter- - 0 © 0 a Pump installed in ❑ Bucket or ® On Block or 0 Other 12' Pump Make/Model LIBERTY 250 � 0 Floats or ® Transducer 0.• Tank draw down 1.25 in/min Pumpcapacity23 gpm Squirt Height 6 ft Pump on time 1.5 Pump off time 3 Daily flow set at 180 qpd Updated 8/21/2018 Mason County OSS Installation Report pg. 2 Parcel# 32127-51-00117 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - 0 YES [] NO If yes, please describe: Were all components pumped out and properly abandoned per WAC246-272A-0300? - - 0 YES 0 NO RECORD DRAWING This is a permanent record and must he accurate and descriptive enough to re-locate In the need of maintenance activities and future development. Typical Record Drawings contain: Drainfield&manifold orientation&layout,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-e4t. 041 ! Hdo al Orr q Ae al 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 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. i. t• ®l Signature of Installer Date .,y p Printed ame of Signee io .)"% ,_ . MASON COUNTY �•�3� �" � y''tli `� PUBLIC HEALTH 4 , The undersigned approves this Installation Report and • — ooa �t CINDY E WAITE• �t1 Record Drawing on behalf of Mason County Public •'. LICENSED DESIGNER t' .,.� lb. %Nam. 4s.�.��, 77(opc- Health: - EXPIRES 05,10, Sig ature of Enviro mental 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 <Z1 1 7 • \ f� 'V ` aillVVV ® Y ,�C C "'AC� A-7,4,Dz^'ad a Kb- � J p �•411La Le IJiliI11 o D, •- c4adifNadtiadav z o13 c _ T �" r \o a N O / T 4 (:::) . .., n S 0 I � Jil 111 09 7 % i i e : „, • ...,,„ t„ ., I 1 4 1 I i iM °be, , i g APPRC ; a D " • .o MQY 19 70Zi a - M SON C��JNTT E'�'WRO;MESS et 1 ..4 s'AL HEALTH Si, 4. V Si `. !, - - - . r , . .. i . __. Prins c �._4 _ :; .. .. .. 4.: . ...-- _ _ ... ��_�_�__ Prime.;)}'iiili Mason L;Zu w `ut�'i: