Loading...
HomeMy WebLinkAboutAFTER THE FACT - SWG As-Built - 9/18/2025 AFTER THE FACT RECORD DRAWING, pg 1 MASON COUNTY PUBLIC HEALTH PARCEL IDENTIFICATION 2 Owner Name �o c_.� V P.f�` U Assessor Parcel # 2?O QS-CXXOo 3 3 Mailing Address 1(P96 T1otti�.„-- a--;,.,..,_. 0a .rM Specialist Name City: State, Zip T+car\.t,:�ra. , GO r0 f S'S e 4t/iinstaller Name ��t�,r�17uc-.J r\ Site Address I a NE T��� 13V c/f?�9esigner Name l 1 --t•• A J/1�/ Please complete this checklist to the best of your knowledge. If items are unknown leave bla,f/ 040Pit". INSTALLATION CHECKLIST Q 4 .O J System Type Pretreatment Type .N. �1 <" — r ✓. �4' Drainfield Ln. Ft __ I S-__.__,.,._,__„___•.__-, Drainfield Sq. Ft Drainfield depth_ �4 " G >5 ft from foundation? - ._ _ ._ -. .- ... ._ _. ._ _. ._ ._ 0 N/A [6 YES ❑ N >50 ft. from wells? - -- - 0 0 ❑ Z >50 ft from surface water? • 0 Q 0 r Cleanout between building and tank? ❑ al U Tank baffles present? - ❑ ® 0 d24' access risers over each compartment,- - -- - •• - 0 ® 0 LU Effluent filter installed'. - ❑ El [Si 0 Septic tank size:_1 Z.U.) gal Manufacturer LMILnu�+^ o D-box water level and speed levelers used? - - fjr"NIA ❑ YES El NO XO 0 Manifold/D-box accessible from surface'?- - ❑ ❑ ao z Check valves installed" - - - _. _ - E3 0 0 oa 2 Transport Line Size_ / _.,_._._ Schedule/Class 3v 3 L I _ Bedrooms installed(if known) 0 2 Eg.r.3 04 ❑~, El I':',. ❑Commercial/Other >10 ft. from foundation?- -- - ❑ NIA [DYES 0 NO 0 >100 ft from wells?- - ❑ El ❑ w >100 ft. from surface water?-- - -- ❑ al a: >10 ft from potable water lines?• - - ❑ El 0 Z >5 ft. from property lines and easements?- - ❑ Ei 0 Q CC >30 ft from downgradient curtain/foundation drains'? -- - ❑ ER 0 Observation ports present? - - El la 1 ❑ Graveless chambers or D. Clean gravel used? (check one) Proper cover installed over drainfield2- -- -- -- -- - ❑ ❑ Pump tank setbacks consistent with septic tank? - -•- ( -NrA ❑ YEs ❑ NO Y Pump tank size— _ gal Manufacturer _ FZ Q- 24"access riser(s) and accessible from surface'?- - 0 0 0 t1 Alarm or Control Panel Installed? - - - - 0 0 0 Control Panel equipped with Timer /ETM/Counter- - 0 0 0 D Q. Pump installed in 0 Bucket or ❑ On Block or ❑ Other tl PumpMake/ModelFloats or� ___•_` 0 0 Transducer d Tank draw down in/min Pump capacity_ _gpm Squirt Height ft Pump on time Pump off time Daily flow set at god AFTER THE FACT RECORD DRAWING, pg 2 Assessor Parcel# RECORD DRAWING ❑ Drainfield&manifold orientation&layout .1•ndimensions for re-location ❑ Trenchibed . dimensions and critical distances within laycrr ❑ Septic`pump tank Location widirnen- sions for re-location ❑ Location of buildings existing:proposed ❑ 7bservation ports. clean-out locarions• R mando;dsid-bores ❑ Location of wells, surface water,roads, &waterlines. • Reserve arears) 1 North Arrow ;f needed drawing may be attached on a separate page No. Pages Attached 1,,,._. CERTIFICATION OF INSTALLATION DESIGNER/APP VED 0/M SPECIALIS I r i certify that the it rmatron contained in tors document is accurate to my knowledge. The drawing and intorniation has been obtain C through common loc.3hnq practices S,gnature of Des! Ter of A roved D M Specialist Date MASON COUNTY PUBLIC HEALTH does SF ts)S0 This rs an after the fact record drawing. which mosif• ties not include a count nfor;ration is to only cu r • OSS doment •Yistrng location and components � pg/7„ 6, ..,,, SEP 1 �®Signatureo Environmental Health Specialist rate 0JN'r ENV/Rc / THIS FORM MAY BE SCANNED ANCI 4\/Aii ABLE FOR PUBLIC VIEW C ti THE MAE.Ct CO41NTY WEt3'::lT[?•,, U')i 2.Q,)r:fj16 _air 03 a v, North p m (� -v o r1 --I O -1 r•-a < i = , j o r -a NJ it 8 8 rn _ 2) rn N N © o = w r- 0 3 0 40• ncu 70 0 I = ( Wo vi f-. r) D N CS 250 C C rll/0m s.T = rUR� rr� O "l.4' 1 s' w OD CD 0 O gerrjrrrl • .'I! .l? I (, \ 00 • ♦ u'Sc, �O ti 40. Ta e co ( UJ 00 9� ti F9 la y 1111/ .11 _.,, pi . .. . 00 _, ,p[. .-) ro „., ....,, !01\3r:..< m C C1 ? N.sit _ ram'kri NN ir 'i 0 Ts NLr' r ::‘,31/... 5.�r. • `�N CA) w: r 1 t?� ` 0 l f y i KURT'S PRE-CAST P.O. Box'99 360 275-1996 Belfair, WA 98528 PROPERTY INFORMATION • Location:1700 NE TAHUYA RIVER DR Tahuya Tax ID:222065000033 Marl To JESSICA FRANCIS PO BOX 3365 Use: SILVERDALE,WA 98383 GENERAL SYSTEM TYPE:Conventional (Non-Pressurized) ON ID:222065000033 County Area: Hood Canal Fold '- ON SITE WASTEWATER TREATMENT SYSTEM INSPECTION REPORT •, Fold Here Here Inspected:10/23/2024 - Inspection Type:ROUTINE - Correction Status:No corrections needed Company: Work Performed By: Submitted 10/23/2024 by: KURT'S PRE-CAST Kurt Olson Kurt Olson COMMENTS&GENERAL INSPECTION NOTES No Deficiencies Noted Dosed DF 15 min working good GENERAL SITE&SYSTEM CONDITIONS The General Site and System Conditions were: Fully Inspected Components accessible for service: YES_ All required service performed(if no-specify omitted inspection items in notes): YES _ Surfacing effluent from any component(including mound seepage): NO Components appear to be watertight-no visual leaks: YES Improper encroachment(structures/impervious surfaces) NO All riser lids securely fastened upon departure: YES Electrical repairs needed. If YES describe in comments: NO - -----—---- Inspected components appear to be in good physical condition: YES Root intrusion on any components. If YES describe in comments: NO Settling problems observed. If YES describe in comments: NO The house/structure was vacant or used infrequently,assessment of the drainfield was not possible. YES ONSITE SEWAGE SYSTEM INSPECTION DETAIL Iistribution:D-Box This component was: Fully Inspected D-Box in good condition: NIA D-Box outlets set to allow e.ual effluent distribution: N/A TANK:Septic Tank-2 Compartment This component was: Fully Inspected Effluent level within operational limits(if NO explain in comments): YES All required baffles in place(N/A=No baffles required): YES Compartment 1 Scum accumulation(Inches,if other specify): 0 Compartment 1 Sludge accumulation(Inches,if other specify): 0 Compartment 2 Scum accumulation(Inches,if other specify): 0 Compartment 2 Sludge accumulation(Inches,if other specify): 0 Pum.in•recommended: NO 'rain field(disposal):Gravity This component was: Fully Inspected Component appears to be functioning as intended: YES Ponding present?If YES explain in comments: NO Drainfield was vacuumed,flushed or hydro-jetted?(If YES,explain in comments) NO MIS report indicates certain characteristics of the onsite sewage system at the time of visit.In no way is this report a guarantee of operation or future performance. ReportlD:1342067 View inspection reports online at www.onlinerme.com Page 1 of 1