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HomeMy WebLinkAboutSWG2024-00099/ASBUILT - SWG As-Built - 10/17/2025 c Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/PERMIT ORMATION l _. ._ 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 Manke Excavating LLC Site Address 1640 E. Benson Lake Dr. Designer Name Dale L.Tahja INSTALLATION CHECKLIST ® Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑ Repair ❑Other System Type Pressure Trenches Pretreatment Type N/A >5 ft.from foundation? - `t u-`__ �'rt -- ❑ N/A E YESk�, 'No > ft. fro -> ft. froe wter? - �f----- ,,►•-' ��- -'� ❑ �W�' ❑ HCleanout between building and tank? - _ - 0-- _ ❑ ® ❑ V Tank baffles present? - - - - - ❑ I ❑ 1— 24" access risers over each compartment?---- - - - - ❑ ® ❑ 1.11 Effluent filter installed?- � � ❑ II ❑ co i Septic tank capacity (working) 1,200 gal Manufacturer Sound Tanks G D-box water level and speed levelers used? - - ® N/A ❑ YES ❑ NO 6OManifold/D-box accessible from surface?- - 0 II ❑ mZ Check valves installed? - - ❑ ® ❑ oa 2 Transport Line Size 2 inch Schedule/Class Sch.40 Bedrooms installed (check one) ❑ 2 0 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10 ft.from foundation?- - ❑ N/A ® YES ❑ NO o >100 ft. from wells?- - ❑ I ❑ W >100 ft. from surface water? - - ❑ ® ❑ ti„ >10 ft.from potable water lines?- - ❑ ® ❑ eec� > 5 it.from property lines and easements?- - 0 ® 0 t1! > 30 ft.from downgradient curtain/foundation drains? - - ❑ 0 El G Drainfield level and observation ports present - - 0 1 0 ❑ Graveless chambers or Q Clean gravel used? (check one) Proper cover installed over drainfield?- - 0 I. ❑ Pump tank setbacks consistent with septic tank? - - ❑ N/A ® YES ❑ NO ZPump tank capacity(flood) 1,000 gal Manufacturer Sound Tanks Q 24" access riser(s) and accessible from surface?- - ❑ It ❑ aAlarm or Control Panel Installed? - - ❑ I ❑ 2 Control Panel equipped with Timer/ETM/Counter- - ❑ Q ❑ M O. Pump installed in ❑ Bucket or • On Block or ❑ Other O. Pump Make/Model LE51M Liberty ■ Floats or ❑ Transducer IT Tank draw down 1.5 in/min Pump capacity 30 gpm Squirt Height 6 ft Pump on time 3 min. Pump off time 5 hrs. 57 min. Daily flow set at 270 gpd Jpdated 8:2112018 Mason Ce . OSs installation Report pg. 2 Parcel# 22103-51-00020 MENT RECORD . , Were existing septic components abandoned as part of this proiect? 0YEs NO if yes,please describe: _ Were all components pumped out and tevpoty abandoned per WAC248-272A-0300? 0 YES 0 NO I ORAWING This is s perituawint*mod old No*blt memo**sad ttotterlottr•toovgh to ttHottoto k,tits Mid of milnt.nsnc.OCtteMelf*NS OBVii0PIPION. T core Deraimis toroisitv Ontiniiid4ONN/Mit nvitildiktrt tayout.Septiceournp tank locators,North&crow,MONO dnorfteld.eyeing end arceeliad boating*,Wagon at‘oeihr;vostoitios, %vets.observalionimits.tionoill1.ended's-millniettanoe 40C1:58 points_ Wont**Record°mono,m*y create acklitionot&goys in tinitinitnlInket inverietirdinialint posnits. - . • . . ' • ' ' . - , • • . . I Record Drawing Attached ; tilit'VIFICATIONiessTALumte . INSTALLER DESIGNER!ENGINEER I certtlythat 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 Pubic Health and that any deviations shown I Mason County Public Health and that any deviations here have been cleared/approved try 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 on County Codes. State and Mason County Codes I further cenity Oat 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 D ng is accurahe. Q 't Signature of installer Date re n Printed Name a Signets 41.)!I MASON COUNTY PUBUC HEALTH .0.4..1:4, 4'4 ft The undersigned approves this Installitfion Report and 5100214 #o Record Drawing on behalf of Mason Olitenty Public --- 0.`0 Dale I_Tahja I Health: LICENrD DESIGNER # " " NiVak (‘111 1 t Signature of Health epecielial Date (stamp,signature and date) ,M11001•1111W TNiS RAM MAY SE SCANNEDANO AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE 1,103•0011":118 , . „ , , • , . .... 4.or • 7.-.), ,,,vccNe.., :-.ZdVIN tilicit‘r\SOY\ - - \C o '.. t c.) X., �r, -1 C-) e__c_..cA'A, or 3,r ....- / . c2)exN- 4)` ?. • ..._, • i13 s �h i Z. a, \-P �� ` r ►'i �f \ • rt , r?,I\ • /�AO t• f S Z A ,/ C / / - ,,;64'c, IA 7 sN • sty s , i 5100214 ��1 = ['fl , /O`er DaeL.Tahja + ` ' " r ,Y- • •$ LUCEN°_-_D DESIGNER 1 ,.:_ 0 � r• 11\ t. : • ../o4"1„ vt SO • t 1 .. ... . . , . . oD• ..._ . — - yv. • TO : r ,ta.,2 • t 2:4, . . . . ! . . _, 140' r Ar„ . . , ., ..•• 1 � 5' . , • . • . . • • • • • . , . I.