Loading...
HomeMy WebLinkAboutSWG2024-00456 - SWG As-Built - 2/12/2026 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2024-00456 Parcel # 61902-32-00020 Applicant Name Heather Pierce Subdivision (Name/Div/Block/Lot) Applicant Address 340 Garrard Creek Rd TR 2 OF N1/2 SW S 41/112 City, State, Zip Oakville WA 98568 Installer Name House Brothers Site Address 70 W Salmonberry Dr, Elma Designer Name Arrow Septic Designs Inc. INSTALLATION CHECKLIST 0 Full System Installation ❑ Tank(s)Only ❑ Drainfield Only ❑ Repair . ❑Other System Type Sand-Lined Pressure Bed Pretreatment Type >5 ft. from foundation? - - ❑ N/A 0 YES ❑ NO i >50 ft.from wells? - - El0 ❑ Z >50 ft.from surface water? - - ❑ 0 ❑ FCleanout between building and tank? - ❑ 0 ❑ o Tank baffles present? - ❑ 0 ❑ a24" access risers over each compartment?- - ❑ 0 W Effluent filter installed?- ❑ 0 ❑ cn Septic tank capacity (working) 1,250 gal Manufacturer HB Tanks � D-box water level and speed levelers used? - ❑ N/A ❑ YES 0 NO QO Manifold/D-box accessible from surface?- - - - -. ❑ ❑ 0 mz Check valves installed? - - ❑ 0 ❑ 2 Transport Line Size 2" Schedule/Class 40 Bedrooms installed (check one) ❑ 2 0 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10 ft. from foundation?- - ❑ N/A 0 YES ❑ NO CI >100 ft. from wells?- - ❑ 0 ❑ W >100 ft. from surface water? - • - ❑ 0 ❑ it >10 ft.from potable water lines?- - ❑ 0 ❑ Z > 5 ft. from property lines and easements?- - ❑ 0 ❑ Q X > 30 ft. from downgradient curtain/found + n - ❑ 0 ❑ cm Drainfield level and observation ports p t - - - ■ • ❑ ❑ Graveless chambers or 0 Cle vel s d? (ch`ck :a$' ' • Proper cover installed over drainfield? S -�, - ,, ,.- - -; t] 0 ❑ Pump tank setbacks consistent with septic^ta nk?-}-E-A�1/ gA r-rr---- - ❑ N/A 0 YES ❑ NO `r Pump tank capacity (flood) 1,250 gal `i�tllgnufacturer HB Tanks Z Q 24"access riser(s) and accessible from surface?- - Q MI n H O. Alarm or Control Panel Installed? - - ❑ © El 2 Control Panel equipped with Timer/ETM/Counter- - ❑ 0 ❑ n- Pump installed in ❑ Bucket or ❑■ On Block or ❑ Other a' Pump Make/Model Liberty FL50- 1/2hp ❑■ Floats or ❑ Transducer a. Tank draw down 2 in/min Pump capacity 48 gpm Squirt Height 5 ft Pump on time 1.8 min Pump off time 6»hr Daily flow set at 360 gpd )8 aced ei21/2018 Mason County OSS Installation Report pg. 2 PE,rce! r-lr {c l9c - 3Z_ O6..cD?-1° ABANDONMENT RECORD . C YES ® NO Were existing septic comaanen abandoned as par: of :his protect' - If yes, please describe: ���� YES ❑ NO Were all components pumped cut and property abandoned per WAC24 -2?2.A-3..uC RECORD DRAWING T Rxord This is a permanent record and:rust be accurate and descnpuve enough to relocate in the reed of maintenance activities and future developm en t. yp� Dian:ngs Grttain: pra:nfsM 4 man:loic onertatir..b iayout.Seotlapu�.0 tar✓locaecn.North arrow.reserve c. n`ela.a s:fng and p.mpesea C:.:iciags.io1ation o'wens.war:e:1�^es. welts.oD .a,rr pos.J?arcutl ana over r %ena'.ce access co:ms. Inco^rpte'e Recc:d Ire rras may eate addi.anat delays in final instaldffiten aop ova;and reta:ed partrris. ll Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ENGINEER I certify that I installed the system in accordance with t 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 ali and Mason County Codes. State and Mason County Codes I further certify that ail information container on this ' I further certify that all information contained on this form nd attached Reco�Drawing is accurrraat .. fog and attached Record Drawing is accurate. S afar of Installerlr 1.3=-,z- i r rl.i� jed -41\U't- 1!4t) Printed Name of Signee �,• as y. mA*,- ra cvUNT'r, PUBLIC HEALTH r, r •tr• The undersigned approves this installation Report and s,o�aasr Recor wing on behalf of Mason County Public •::"....yr yea. PAULA JO} JOHNSON :h He (.../\r"yr\.. ),,,........A....___ __ r-TO: ,T Y D(P N.,-- J/15 Signatc>f e o E vi nmental Health Specialist Date ;stamp, signature and date} irly UN iY WEB SITE � '.ec 512'12")16 THIS FORM MAY BE SCANNED AND AVAILABLE FOR FEB 123 MASON COUNTY ENVIRONMENTAL HEALTH JSW . - -d 7\!t, Iii CI:(_i �_ �o a �' i,� r .-)6..C4-r'ci 7 i,..,c_:, ka A ...c.,, _ 4:4x 41\w, , , * , .5. ____,:, c--. )._----7--- ( ,)s,z6 ei\et,141 .4 _�\- _c_ Ns �! cl' S ioo4 -,-,. ca,.... b- i o ..4- CP r —1 0 x rte. r fa -- v. r p ID-it\ - . t. -,c gli O OO , j,- s P F.- 14, r, ,c_.) it-. P.. i Y` _ s G d o `' il, t I i _s� N `-Ca I r' c.J�;, o !� .�Yr' I 1- S4. q y coo tD N (/i p ' (fi,