HomeMy WebLinkAboutSWG2024-00099 - SWG As-Built Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH
APPLICANT/PERMIT INFORMATION' -
Permit Number SWG 2024-00099 Parcel# 22103-51-00020
Applicant Name Diane&Jeffery Martinson Subdivision (Name/Div/Block/Lot)
Applicant Address 21436 4th PI. S. Benson Lake Div. 2 Lot 20
City, State, Zip Des Moines, WA 98198 Installer Name Menke Excavating LLC
Site Address 1640 E. Benson Lake Dr. Designer Name Dale L. Tahja
INSTALLATION CHECKLIST
II Full System Installation 0 Tank(s)Only 0 Drainfield Only ❑Repair 0 Other
System Type Pressure Trenches Pretreatment Type N/A
>5 ft.from foundation? - - 0 NtA ■YES 0 NO
>50 ft. from wells? - - ❑ e ❑
2- >50 ft.from surface water? - 0 ill
F. Cleanout between building and tank? - - 0 PM 0
✓ Tank baffles present? - - ❑ II ❑
1- 24"access risers over each compartment?- ❑ I ❑
W' Effluent filter installed? - ❑ 5 0
Septic tank capacity(working) 1,200 gal Manufacturer Sound Tanks
fl D-box water level and speed levelers used? ® N/A 0 YEs 0 NO
Qom! Manifold/D-box accessible from surface?- 0 ® 0
dZg Check valves installed? - ❑ III
F Transport Line Size 2 inch Schedule/Class Sch.40
Bedrooms installed (check one) ❑ 2 III 3 ❑4 0 5 0 6 ❑Commercial/Other
>10 ft.from foundation?- ❑ N/A • YES 0 NO
O >100 ft. from wells? ❑ M ❑
-2 >100 ft.from surface water?- - 0 5 0
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it >10 ft.from potable water lines?- ❑ ® ❑
Z.. >5ft.from property lines and easements?- - 0 e 0
K:: > 30 ft.from downgradient curtain/foundation drains? - ❑ II 0
Drainfield level and observation ports present - - ❑ 0 0
0 Graveless chambers or 5 Clean gravel used? (check one)
= Proper cover installed over drainfield?- - 0 S 0
Pump tank setbacks consistent with septic tank?- ❑ N/A ■ YES ❑ NO
Y Pump tank capacity(flood) 1.000 gal Manufacturer Sound Tanks
< 24"access riser(s)and accessible from surface?- - 0 ® 0
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a Alarm or Control Panel Installed? - - 0 ll 0
_: Control Panel equipped with Timer/ETM/Counter - 0 5 0
0- Pump installed in ❑ Bucket or a On Block or ❑ Other
E Pump Make/Model LE51 M Liberty in Floats or ❑ Transducer
7
a . Tank draw down 1.5 in/min Pump capacity 30 qpm Squirt Height 6 ft
Pump on time 3 min. Pump off time 5 hrs. 57 min. Daily flow set at 270 qpd
Updated 8/21/2018
Mason County OSS Installation Report pg. 2 Parcel# 22 1 03-51-00020
ABANDONMENT`RECORD
Were meeting septiccomponents abandoned es part of this peelecl? 0 YES ® MO
If yes,please describe: ___ _
Were as components pumped out and property abandoned per WAC246-272A-03007 0 yrs Q No
:. RECORD:DRAWING
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balk iaamwlim wr.wwn;mote.aeaaernonosesrot+. Mope*.Rand oa+aq•May aaeta addl velar n kW iroblas4444 emeaasl/SASwnitlk
■Record Drevnng Macho]
C ICATION t!INSTALLATION
MSTA4.ER DESIGNER/ENGINEER
I codify Met:fintagedthe system In eccademx with I ce.t' i that the system hashee.'installed taactor-
the aepoe Osage ste ed:"APPROVED"by Masen dance twIb the septic design stamped "by
Com*kale Heath and that anydeNttons shame Mason County Public Health and tat any deviates ..
hare hate been deamd/aHpinved by both the designer shown here have been tharedtappo ed by both
and Mown-County Pub&death and meet at State myself and Mason County Public Healer and meat at
and Mason County Cotes: State and Meson Comgy Cates
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for.',and Wtatwd Record D>exmmg is accurate form and attached Rsmrd m , Is acasst►.
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