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Home My WebLink AboutESTABLISHING RESERVE AREA - SWG As-Built �,/6' //f2 RP",_eo..de. CTi4,L Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG Parcel # 22406-24-00010 c ET-i_07 Applicant Name JENNIFER BHACHHUBER Subdivision (Name/Div/Block/Lot) 1 G': Applicant Address 12239 12TH AVE NW r— ?I t-'n a City, State, Zip SEATTLE, WA. 981277 Installer Name loll Site Address 381 N WEBSTER LANE Designer Name ` 'cal .1:; N INSTALLATION CHECKLIST : : lo, ❑ Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑ Repair ❑Other System Type Pretreatment Type >5 ft. from foundation? - - ❑ N/A 4 YES ❑ NO >50 ft. from wells? - - 0 ® ❑ >50 ft.from surface water? - 0 0 0 Z < Cleanout between building and tank? - - 0 0 0 V Tank baffles present? - - 0 0 0 a24" access risers over each compartment?- - 0 ■❑ ❑ W Effluent filter installed?- - ❑ 0 0 cn Septic tank capacity(working) t260 gal Manufacturer NOT KNOWN 0 D-box water level and speed levelers used? - - ❑ N/A 0 YES ❑ NO Ow O Manifold/D-box accessible from surface?- - 0 0 CI mZ Check valves installed? - 0 0 0 0Q 2 Transport Line Size NOT KNOWN Schedule/Class Bedrooms installed (check one) ❑ 2 0 3 0 4 0 5 ❑6 ❑Commercial/Other >10 ft. from foundation?- - ❑ N/A ® YES ❑ NO G >100 ft. from wells?- - 0 IN ❑ W >100 ft. from surface water? - . 0 ID ❑ z >10 ft.from potable water lines?- - 0 00 F > 5 ft. from property lines and easements?- - 0 ® 0 > 30 ft.from downgradient curtain/foundation drains? - >- II 0 ❑ ci Drainfield level and observation ports present - 0 ® ❑ ❑ Graveless chambers or U Clean gravel used? (check one) Proper cover installed over drainfield?- - 0 0 0 Pump tank setbacks consistent wit`�septtctanikPal4- - ❑ N/A ® YES ❑ NO Z Pump tank capacity (flood) gal Manufacturer NOT KNOWN < 24"access riser(s)and accessible from surface?- - 0 0 Lk o~. Alarm or Control Panel Installed? - - 0 Control Panel equipped with Timer/ ETM/Counter- - ❑ ❑ 0 a- Pump installed in ❑ Bucket or ❑ On Block or ❑ Other mPump Make/Model Nei" bye 0 Floats or 0 Transducer 1 ) per-, Tank draw down in/min Pump capacity gpm Squirt Height ft Pump on time Pump off time Daily flow set at gpd Updated 8/21/2018 Mason County OSS Installation Report pg. 2 Parcel# 22406-24-00010 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - YES 0 NO If yes, please describe: Were all components pumped out and properly abandoned per WAC246-272A-0300? - - YES Q■ 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,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. 13 aem /o2 AI? /w ail 7e is' Q.1r 9 4 dP Ion J �1jt „..s•''a7 0 Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER! ENGINEER I certify that I installed the system in accordance with l 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. • Signature of Installer Date Printed Name of Signee �P E SAS �t" MASON COUNTY PUBLIC HEALTH �V i if The undersigned approves this Installation Report and q stooa `� Record Drawingon behalf of Mason CountyPublic '�E � LICENSED DESIGNER � Health: {y Ex�'ikES �StO GannT la re. Signature of Environmental 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 O d . Q r o o -� ___ ____ _ r 4. t _ _ - - — — - _ ,,_ ,, .. .____ „......._ , , ,, , .... .,,, _, , ,, t. „. 1 „..... tifr. R ,,,,,„vis FI . . ,. ,„ I ,` f' i ti I i r II. 1 a; - . } s,. # s H ' -„ : j,' , v $ i -4,. J.p �j r fir.L C t00 r '�` � '.S .r�iq +�. 17 .„, .., — 4: , /e a. or, s_ '4 l' lbN! f *4 ... ,,,. _ ,24rt tDao 1-1 Nile MI d0 i ;- m o / r c e , : .,_•• ; _ WO = r o n a 03 '' p `' l, , x 1lifDd " II „ It ,. , , t..i. ft ,L, , " o ii _____....----- 4-:'114 % ! c • i WmCI } / 1 • 1 i t i f f !' C �Oy}D i tit 'i 11, t 1 la La Qo •S. .4.111 A PO.{2 O VI • u 0 I C1 ,` 1_ADO �, ,,, • C` ♦ i /// '•` `t • �� y (�D X N C I (gyp f a IN • , 4'1 iP8„ W. CL 0- — c O CINDv E WAITE -s 1=h 0 LICENSED DESIGNER (D (D 1:7 M 'JII • l MASON DUNTY t�- 13 5 7 • GENERAL S+EIWICES DEPARTMENT - • ENVIRONMENTAL HEALTH SECTION 303 NORTH 4th STREET • SHELTON,WA 98584• PHONE (206)426-5581 RECORD OF FINAL INSPECTION OF YOUR SEWAGE DISPOSAL SYSTEM OWNER `1 ERG l7 y ADDRESS Ai�V� � A t,_ THIS RECORD IS NOT A GUARANTEE OF PERFORMANCE. LEGAL LL4 ys�s� A SEPTIC SYSTEM IS NOT A MUNICIPAL SEWER. HOWEVER DESCRIPTION 7 4.GT j` �,' 3 6,_.2 �i-- WITH PROPER MAINTENANCE AND CAREFUL USE OF / - WATER IT CAN GIVE MANY YEARS OF TROUBLE FREE SER- VICE. MANY PROBLEMS WITH SEPTIC TANKS ARE CAUSED SOIL • BY FLUSHING EXCESSIVE AMOUNTS OF PAPER, CLOTH COMMENTS LOAM cf .,jski/ el-L ud AND PLASTIC MATERIALS DOWN THE DRAIN, OR BY SPE " RELD X LARGE AMOUNTS OF WATER FROM LEAKY FAUCETS OR .NO. SIZE 3 /Zs--' FAULTY FIXTURES. DEPTH TO MONTH THE SEPTIC TANK ITSELF SHOULD BE CLEANED EVERY WATER TABLE- - OF YEAR ---f}— TWO OR THREE YEARS DEPENDING ON THE HABITS OF THE INSTALLER FAMILY, THE NUMBER OF FIXTURES IN THE HOUSE, AND 8 ebiv A THE AMOUNT THAT A GARBAGE DISPOSAL IS USED. CLEAN- SIZE . ING AT THE RIGHT TIME WILL AVOID THE RISK OF INJUR— ING OR DESTROYING THE DRAINFIELD DUE TO SOLIDS DRAINFIELD 3 FEET CARRYING OVER INTO THE DRAINFIELD. CALL THE LENGTH I�.S"' MASON COUNTY HEALTH DEPARTMENT FOR A LIST OF TRENCH AREA ; hs-- SQ. FT. LICENSED SEPTIC TANK CLEANERS IN YOUR AREA. THE ii CLEANER CAN SERVE YOU BEST IF YOU SHOW HIM THIS TILE ❑ CORRUGATED 51 RIGI' 0 CEMENT RECORD WHEN HE COMES. DEPTH of GPT TOTAL HEAVY TRUCKS OR EQUIPMENT SHOULD NEVER BE ROCK BEL DRIVEN OVER THE TANK OR DRAINFIELD. CONSULT THIS CU. YDS.��I G�,yY� pat / . aft DEPTH RECORD IN CASE OF ANY BUILDINGS, DRIVEWAYS, SPACE RESERVED FOR REPLACEMENT DISTRIBUTION FIELD: SQ. FT. SWIMMING POOLS, OR EXTENSIVE GRADING OR FILLING , ARE LATER CONTEMPLATED. +L NORTH ■■■■■■aaa■a ■aaaa■aaa■a■■mu■a■ ■aa THEHRUBS OR TREES SHOULD THEY NOT BED NTERDfE CLOSE OE E TOO 11111111 ■ UIIIIhIUIINHIi CLEANING OF THE TANK. THEY CAN BE PLANTED IN THE ■■�ia■'a■■■a aa■■■ a■a■■a!■■■■ p■a■■■■■■'■■ ' DRAINFIELD AREA PROVIDING WILLOWS ARE NOT USED. ■ ■■a■ ■�■a■■■■■ a■■■a■■aa�■ ■a.a ice'^i. '-S4r'�I"1■■� ■■■■■■�■■■■ THE YARD GRADE IN THE DISPOSAL AREA SHOULD BE ■m fl il� i li �..r or ■e■■■asamu ■ SUCH THAT SURFACE WATER IS NOT POCKETED ON THE ��VIF AMSS".41—1 a I il.> •' a ■aa■■a■a■aa■ DRAINFIELD. ANY SETTLING OF THE GROUND OVER THE ■a ► '4_1 �'" _ 111111111111 ■■■■■■a • , G a 'a- ' a�■a■■■aa■■a■ TRENCHES SHOULD BE FILLED IN WITH SOIL. DO NOT EX- ■■a■■■■■ =fa a ■■■■■a■!■Aaw CESSIVELY WATER THE LAWN IN THE DRAINFIELD AREA. a■■■■■■■ a■"- 1 = mom . p ■a■■■a■■■■a■ Ii - r. WATER EVAPORATION FROM THE DRAINFIELD IS ABOUT 11/11111111ai1i=111 f1 1111111111111 ' ■■■■MOMMEM■ aa■a►■■!• a■■■a! a■!■■■ EQUAL TO ONE HALF INCH OF RAIN PER DAY. ■■■■a/a■a R;✓" 0100110►1■0114 10100011,11111001111 FOOTING DRAINAGE, DOWNSPOUTS AND WATER 1C11aj t i ■M■■■aaaa■ I ■■alalaa■! 111 SOFTENER RECHARGE WATER SHOULD NOT BE CON- ■!!■■!� w■■a■■■�a ■■■■a■■■■■ .■■■aa6. ;2�111/1111/1 ' 111111■1111 NECTED TO THE SEPTIC SYSTEM OR DISCHARGED INTO THE !a■■■0��■■■■I1�I■%aaa■I�g a !■■!a■■■a!a■ DRAINFIELD AREA. 111111111�i1111■i1111111Jy 111111111111 ■ IMM ■!■a■■■a�tli �■aa■aa■■■�a THE TYPES OF BACTERIA NEEDED IN A SEPTIC TANK ARE LIMI■>rtiia■11NNNa■Nsa,L , ■■■■■■■aa■ ALWAYS FOUND IN SEWAGE. THERE IS NO NEED TO ADD lN1f11U11'1i/USN/11IU11 t a■C� *11 YEAST OR OTHER STARTERS TO A SYSTEM. THE USE OF RE- ■■a■■a■■■a■■■aa■aa■a■aa IIIN•UuIIaauI ■a■ ■■■■aaa■■■a■■a■■■■■■■■■ c ■/ ■aa■! INN JUVENATORS OR CHEMICALS TO CLEAN A SEPTIC TANK a■aa■■a■■■■1a■a■a■aaa■ t a 0 man a■a HAVE NOT BEEN PROVEN TO BE BENEFICIAL AND MAY BE a■■aa■■■■■■■a■■■■■a■■ 1�.1$ ■� a■a■aa a■ ■■■■�■■■■a■■■■If■■■■■ ■ ■■■■■�■ ■■ HARMFUL BY FLUSHING SOLIDS OUT OF THE TANK OR BY ■NIIMN■■■a■■■a■■■■■a■ ■ ® ■r ■■a■■a■ ■ ■■a■■a■aa■■■■a■■■■ �■■ ill ■■a _■aa ■■■ CHANGING THE CHARACTERISTICS OF THE SOIL. THE - NORMAL USE OF BOWL CLEANERS OR CLEANING COM- POUNDS WILL NOT KILL THE BACTERIAL ACTION OR SLOW ,� "� sAuTN 'fir DOWN THE OPERATION OF THE SEPTIC TANK. , O _gr N /f,v-,�[ THIS IS AN IMPORTANT DOCUMENT _ DATE 'T '�'3.rf Y Prin{IeG EFrP IT WITH DEED OR OTHER E.n}y ! ifiV0 D/ d r 4:344 4 • % i.� p ;rESSENTIAL!OlkQunty DULLS MA • RTIHED BY N