Loading...
HomeMy WebLinkAboutSWG2024-00223 - SWG As-Built - 7/31/2025 p1ECI 7 JUL I ' 2025 , Mason County OSS Installation Report pg. 1 MASON COU\ PUBLIC AI,T APPLICANT/ PERMIT INFORMATION By Permit Number SWG ;ID Z IA -00 273 Parcel# '? . i 3 ? --z_.( coot) I Applicant Name Ll-4c -L 5 J c6-Ittrs'a.i.Subdivision (Name/Div/Block/Lot) Applicant Address 7l cY3 /4a LL Is r (›teJJll Lu t•rli -5 T<C) City, State, Zip p L ,.- ' we, C--i 256 Z Installer Name ./1J(1,.. $/ Site Address Designer Name j!`� (-( ,,,,,,..1-..,./' INSTALLATION CHECKLIST [,i Full System Installation 0 Tank(s)Only ❑ Drainfield Only ❑Repair El Other System Type P eatment Type >5 ft. from foundation? - -- j -- ❑ N/A $'YES ❑ NO >50 ft.from wells? ��� - ❑ WI ❑ Z >50 ft. from surface water? - -JUL- 4 402-5- - i - ❑ CI CI o H Cleanout between building and tank? ❑ 0 ❑ V Tank baffles present? 13 - - - k- El ® ❑ d24"access risers over each compartm - El © CI ltl Effluent filter installed?- - ® ID ID tank capacity(working) l � gal Manufacturer I - -� � -S! O D-box water level and speed levelers used? - - ,Er N/A 0 YES 0 NO �O Manifold/D-box accessible from surface?- - .e( ❑ ❑ u. OOZ Check valves installed? - - ❑ ,0' ❑ clg • Transport Line Size r� 4 p Z. Schedule/Class Bedrooms installed (check one) ❑ 2 ❑ 3 ( I 4 ❑ 5 ❑6 ❑Commercial/Other >10 ft. from foundation? - - ❑ N/A 12r YES 0 NO O >100 ft. from wells? - - l-- ;:1 121 ❑ W >100 ft. from surface water? - -- -- y f, I. CI z >10 ft. from potable water lines?- -- --�UL 3-1-2025-- '..t.'`'■ 8 CI zr > 5 ft. from property lines and easem ?N 6GU t.Y-E VtReMMMEI J rRE�;, D ElT > 30 ft. from downgradient curtain/foundation drainsam ❑ ❑ Drainfield level and observation ports present - - ❑ Ei ❑ tt] Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ e ❑ Pump tank setbacks consistent with septic tank?- - ❑ N/A 0 YES ❑ NO ZPump tank capacity(flood) tr e) gal Manufacturer t-t-gr,r4.4.— - Q 24"access riser(s)and accessible from surface?- 0 ;f 0 F- Q. Alarm or Control Panel installed? - - 0 ❑i ❑ • Control Panel equipped with Timer/ETM/Counter- - b 0 ❑ a Pump installed in 0 Bucket or 41 On Block or ❑ Other Pump Make/Model Ar (; C . 0 -73 IA-a---" 21 Floats or 0 Transducer t a Tank draw down Z.- th _ in/min Pump capacity S� qpm Squirt Height / ' ft Pump on time 1 kiL,IJ Pump off time 11-1 P S Daily flow set at -3 '7 qpd Updated E 212018 Mason County OSS Instaljation Report pg. 2 Parcel# ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - ❑ YES NO If yes, please describe: Were all components pumped out and properly abandoned per WAC246-272A-0300? - - YES (] 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: Orainfield&manifold orientation&layout.Septic/pump tank location.North arrow.reserve drainfield,existing and proposed buildings location of wells.waterlines. wells.observation pods,cleanouts•and other maintenance access palms. Incomplete Record Drawings may create additional delays in final installation approval and related permits. ft..1 APPROVE JUL 3 1 2025 MASON COUNTY ENVIRONMENTAL HEALTH 4 JBW [-Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER!ENGINEER l 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 4 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 :to; ed Record Drawing is accurate. form and attached Rec Drawing - curate. Signature of Installer Date L. Printed Name of Signee Z 1"), MASON COUNTY PUBLIC HEALTH 4" s 1 0Q73 J• The undersigned approves this Installation Report and S'- !A41ES R.FfUNTER '+ Record Drawing on behalf of Mason County Public LiCF,fVSEU t>Esf��bEP wak0 HeaffPP FXtff'cc: 03/22/-2Lr Sig ture ironmental Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Updated8/21/2018 Willi I . girs e .. )7- b co o z ..... o .F-, C • rri 03 \ • , %gm z c.•, till 5-3 --.. 41:10 '1/4 0 * •e-) tie c0° 1...., rn 4.71 \ \ i I z --I iris , , 0 — — c.. t .......... ,-- o rm.. .-'40 ( i 4 \ VI _ •. s , i ) 1 • c it< c \ \ , ., .--- 37 I 1 .. ) \ - ........ ---..... ( \ s sti —........ _,_______,......_ _ ....,,,..... . \ ,. .. . ,... .......s......_ ,....___ .„ . . _ cs ... ,---... ...„....---._ --..., , . • ... ,„. :‘,.. .. ..- 1.--• - %c 44._____ ........ ---.............. ......_ ..........4 ,• ,....., .. \ \ . \. ‘• ...a '‘r .‘,C) . qv •,' i .. • :. - , . ' c_ \... , . St . . • . • \ - (A\ \ G. 1 A a \ \ Jo ., z , ., , \\---........_____L'• . . ci. • _._ t- f-_ - -, 1- - _.".„ . . ..- -,....,, i ... • ------- -.--- - -,-•...__ --- .. •-• - --„. ._.. , ... ,s, - • 1 ., \ . . , „ , •‘ . , P F . . ....,, ! . 4 -IrNb tk i ItP 1 -•?---- 1 -___ — 1• f 1 1 i t i Pi 'to._ • 1 1 i I i'. I 0 t • ; : ; I ' I t i ; • i i . 1 I : i 1.. s iikr t t f i i 1, '1 I I . { St. 414 I% 7:7 I i t Li ) r ; I .1 f ! 1 ..S. 5° P3 71 H 1 I i ' i ; c ", I' 1 i , ! 4 `• 0 P 3 1 i i 11 ; 1 rro •.,•A•:.-% 74 ,..\• 7j 0 \i X C 4 i eH • - . 1 ':,-- _ iv. # 'e r 0 Tr\ i 1 -, '4 # . porn 4 i , 1 , 1 1 ,--, wrP I , •A., ... g to N• .:( 1 . 01 ,, g3 1 , ... i ID ' f . t CC in I , f i r-%.0 . ii.•in J E 0 0 N.i n 1 I k., 1, n . . 1 t , .' d I J .4 • w ul 1 In H r 0 .1 1• IZ al 1 i 1 , 1 1a I ' ) ... lk r CO F i rf-. (I ro 0 . ; 1 1 1 t! i ii 0 ....1 0 t, min-i 0" r • \J1 1 1 ) ! } i , 1 . t 1 ( 1 i