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Home My WebLink AboutSWG2022-00438 - SWG As-Built - 10/11/2022 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ Pew INFORMATION Permit Number SWG 2022-00438 Parcel# 42209-50-00077 Applicant Name Karen White Subdivision (Name/Div/Block/Lot) Applicant Address 3611 Strattford Ct LAKE CUSHMAN#7 TR 77 City, State, Zip Kent,WA 98032 Installer Name Maples Excavating Site Address 341 N Mt Christie Dr, Hoodsport Designer Name Arrow Septic Designs INSTALLATION CHECKLIST III Full System Installation ❑Tank(s)Only ❑ Drainfield Only 0 Repair 0 Other System Type Pressure Bed Pretreatment Type >5 ft.from foundation? - - 0 N/A ®YES 0 NO >50 ft. from wells? - -_ - - - - Ill ❑ ❑ _ Z >50 ft. from surface water? IN ri ID Q Cleanout between building and tank? - - CI 0 ❑ "�'- .„-` i— ❑ U Tank baffles present? - - - - I— 24".access risers over each compartment?- ❑ 0 - a W Effluent filter installed?• 0 NI • Septic tank capacity (working) 1,250 gal Manufacturer Sn dery ' D-box water level and speed levelers used? ® N/A ❑YES NO N-= hi-'W, 0� Manifold/D-box accessible from surface?- - -• -- ® 0 ^. , c0Z Check valves installed? - - ❑ ® ` thA • Transport Line Size 2 inch Schedule/Class 40 Bedrooms installed(check one) 0 2 ® 3 0 4 0 5 0 6 0 Commercial/Othcr >10 ft, from foundation?- - ❑ N/A 0 YES ❑ NO 0 >100 ft.from wells?- - 0 ❑ ❑ -1 >100 ft.from surface water? - " 0 ❑ ❑ W II >10 ft.from potable water lines?- ❑ ❑ ❑ 2 >5 ft.from property lines and easements?- - ❑ III 0 m >30 ft.from downgradient curtain/foundation drains'?- - © ❑ ❑ Q El level and observation ports present - ❑ 0 ❑ Graveless chambers or IM Clean gravel used? (check one) Proper cover installed over drainfield?- ❑ ® . ❑ Pump tank setbacks consistent with septic tank?- - ❑ NIA ® YES ❑ NO Y Pump tank capacity(flood) 1,287 gal Manufacturer Infiltrator z < 24" access riser(s)and accessible from surface? ❑ II 0 a Alarm or Control Panel Installed? - - ❑ PI a S Control Panel equipped with Timer I ETM ;Counter- - 0 ❑ n a Pump installed in 0 Bucket or It On Block or ❑ Other n'• Pump Make/Model Zoeller N152 ® Floats or ❑ Transducer a. a Tank draw down 2,5 in/min Pump capacity 63 gpm Squirt Height 6 ft Pump on time 1.5 minutes Pump off time 6 hours Daily flow set at 360 qpd updated 812v201t Mason County OSS Installation Report pg. 2 Parcel# �22 -5o--ovo-ri ABANDONMENT RECORD YES No If yes, please describe: Were existing septic components abandonec as part of this project? - `e t ov�� (d a v►e ' O a► YES ❑ NO � Were all components pumped out and properly abandoned per WAC246-272A-0300. .---- -- RECORD DRAWING -locate in the need of maintenance activities and future development TypiCol Record This is a permanent record and Must ne tad0 to andu descriptive enough to re approval and related permits. Drawings contain: Drainfield&manifold orientation&Iayout.�SeRPSc'P �cemk°p e e Record Oravings may ceate on,North arrow,reserve additional delays in final proposed buildings, a pion of watls,waterlines, weal,observation ports,dearouts,and other maintenance a points. CLe.k...;..______ ilk Drawing Attached CERTIFICATION OF INSTALLATION DESIGNER/ENGINEER INSTALLER 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 myself and Mason County Public Health and meet all and Mason County Public Health and meet all State State and Mason County Codes and Mason County Codes. I further certify that all information contained on this I further d ertachhatd all infd Drawing rig contained a fined on this te. form and attached Record Drawing is accurate. .-4/1?°-<---4/k.- --------- . 09/2-17_2_1 ''.'' .'' t "Signature of Installer v., ;(3/1 �SAD - Iv- • •.,, `t Printed Name of Signee .. �, MASON COUNTY PUBLIC HEALTH �� j ;ca.' 5700349 The undersigned approves this Installation Report and PAULA JOY°° JOHNSON Record Drawing on behalf of Mason County Public gzcV4S ire 1 Health: ( % j \ 12Z c — -2z.- (stamp, signature nature and date) Signature of Environmental Health Specialist Date upaacsearztrzo,a THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WE5 SITE OMINON.M.I-cifiii .:V:ZZIOIN r`` 5c4kc: l t = 30 f \ . 0 i5 30 S 60 '� Se_tp--- c- AS-`2 ,`J✓` -k-- K are.11 W - y. flu-cat# 4 2.2.01 -50 00077 sio i4? AAj. .1J , --,-t.,—Vilbb:: .4.. , j 4a it �'t .j ers Q , OAl ti) ;z:. -1, . Shad! ®Il ,. 1Nt, �q.,. .. srooaag . ', , a PA.IEIW.,101'JOHNSON'•. APPROVED `Q Q P� 1� a 5 .,�./` rev; OCT 1 1 2022 t " o(• :', ` k` Y Audio Visual Alarm L_! .4 �` T 1tAcn(� rr�.t}}�,rr�',v!RC�!r�?.E'r A!HEALTH r ;_ �i E 7 a _. . 3 Cleanou: 1 0 1200 Gallon Septic Tank * 2-Compartment with J� -kn..L - Effluent Filter k s� t N` 04 1000 Gallon Pump Chamber "c I"