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HomeMy WebLinkAboutSWG2025-00276 - SWG As-Built - 1/15/2025 I i Mason County CUSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG Z.O2-5 x T16 Parcel #sQiiiroC2 Lf Z-, , 65-000?O1 Applicant Name `�i.a/cc S okA:74//C.._ _ Subdivision (Name/Div/Block/Lot) Applicant Address / t/ A Rc.--- City, State, Zip h sM4J-- M Pg°S9`f✓ Installer Name Royr4-I 'a-/15(-• Site Address / Al Are)S ec-1- Designer Name 4 iZ ( - .1-I CIO I-6: INSTALLATION CHECKLIST , FAIII-Piull System Installation ❑Tank(s)Only ❑ Drainfield Only lgaepair IDOther System Type Pretreatment Type g1'7-te 1/ >5 ft. from foundatio i I-t.L7-•4)-•�t --- - O N/A ❑YES ❑ NO >50 ft.from wells? -+4,14-im—11 �— s;-; ❑ O O . >50 ft. from surface W17 ❑ O O 4 Cleanout between building and.ta ? - --- - -- ❑ O O O Tank baffles present?I-4--- --- - - -- - - ❑ ❑ O P 24"access risers over each compartment?- ❑ ❑ ❑ uu Effluent filter installed?- ❑ O O Cl) Septic tank size-/66O gal Manufacturer .k,F/1-712Pre)/4 )3,J/ ' J7) © D-box water level and speed levelers used? - - ❑ N/A ❑ YES ❑ NO (12 Manifold/D-box accessible from surface?- - ❑ O O e02 Check valves installed? - "VA ❑ O O ct4 m Transport Line Size Ili 5& (f 0 Schedule/Class Bedrooms installed(check one) p,2 O 3 O 4 ❑ 5 O 6 O Commercial/Other >10 ft. from foundation?- - ❑ NIA ❑ YES O No © >100 ft. from wells?- - O O W >100 ft. from surface water? - - - O O L >10 ft. from potable water lines?- -- - O ❑ Z > 5 ft. from property lines and easements?- - ❑ ❑ c2 > 30 ft.from downgradient curtain/foundation drai ? - - O 0 ❑ ® Drainfield level and observation ports present - - ❑ ❑ ❑ Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?- - - O ❑ Pump tank setbacks consistent with septic tank? - - ❑ N/A YES O NO Pump tank size it)GC) gal Manufacturer ZO R ( L T t;-IW17 .rit 24"access riser(s)and accessible from surface?- - O ❑ I-- a. Alarm or Control Panel Installed? - - ❑ 'i O E Control Panel equipped with Timer/ETM/Counter- - ❑ 1=— O Pump installed in ❑ Bucket or ❑ On Block or ❑ Other F/4.-7,A 1 S'i `L' 0 L (r' E Pump Make/Model C7 L'C-00(r-e' -P f w -Pleats or O Transducer r� j Tank draw down CO J r"O 4/min Pump ca R. capacity ty % gpm Squirt Height 4,;"--61--.� ft Pump on time 2.0 c,_,_ Pump off time Daily flow set at gpd Z .-s i)t},. Z Updated 9/2t/2016 JAN 15 3 ,-W MASON COUNTY ENVIRONMENTAL HEALTH JBW I N recyc'c.- Mason County OSS Installation Report pg. 2 ici Parcel# I 417 , C %C�(�'1 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - ES0 NO If yes, please describe: CA-O5 i--r A 1-c'. ,-,,z__ O L.I 1" -i-` Were all components pumped out and properly abandoned per WAC246-272A-0300? - - YES 0 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: Drainfield&manifold orientation&layout.Septic/pump tank location.North arrow,reserve drainfield,existing and proposed buildings,location of wells,waterlines, wells,observation ports.cteanouts.and other maintenance access points. Incomplete Record Drawings may create additional delays in final instatation approval and related permits.pPRO II n t } AsP�� aeSi, 11 A, JAN 15 •,,; AHE MASON COUNTY ENVIRONMENTAL AT-T! LBW Of-Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ENGINEER 1 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 and Mason County Codes. State and Mason County Codes I furthe ify that a/ information contained on this t further certify that all information contained on this form a d tt the cord Drawing is accurate. form and attached Record Drawing is accurate. Signa ure of In taller Date 1' /� / c/7- /�/' •-1,f/ q , zof Zr- Printed Name of Signee s ".'.,,fit'.., ' . ,:-,; , MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and d ••;9:, Record Drawing on behalf of Mason County Public 1,",:"..':2: 5,,,,,,I2 112 '.. gD;,f.t J HUNTER He Jf '•1•.'f'r,i``.i"-lti121'!i''ii'n. . L �lr 5, 7 `t. Sign tur nvironmental H Ith Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE uadated 8/21/2058 x`13 1500(-) 1ccf RECORD DRAWING (continued) j rn�4 SCALE-1'=20'-0- gg•, 8't FAILED O AGE)-ABANDONED )II DECK EXISTING STUBOUT/CLEANOUT _ EXISTING 2 BDRM RES / - -GLASS SEPTIC TANK(ABANDONED PER'ODE) a. NUWII":R BNR600 ATU IN INFILTRATOR 1060 TANK .i ... I 1)1,4'Mr _ i- f\ JL44hi HEAOWORKS(SEE OETA 2) Q- :.; DRIP E Q�Q �`;'� ADAr:i J.HUNTER - 4 .SF. N7.„:. DRIP IPA(050FT2) -,t. _ 90'-1'SCH40 SUPPL D RETURN LINES(CROSS BELOW WATERLINE) i r WATERLINE(S: WITHIN 10FT OF TANKS AND DRAINFIELD) _ PRESSURE TEST COMPLETED BY INSTALLER SQUIRT HT: DRAW DOW N: TIMER SETTINGS- Y ON: 1.4.) oaf• OFF: Z ki, Z WO CJIM HUNTER&ASSOC. CONTRACTOR L.... =CI -1 y P.O.BOX 162,OLY,WA 98507 ROYAL FLUSH < Z z 753-1226 - 1HANDASC(YIATES®HOTMAu.CON1 INSTALL DATE- 9110/25 Z J RECORD DRAWING SITE ADDRESS/LEGAL vS 4:7B1 N.PROSPECT OR OWNER- SHEA SUNDAHL O '7..."° FINAL DATE- 9/11125 ET1Z TPn 42318-50-00109 SITE A SWG2025-00278 --I flill 1— m s