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HomeMy WebLinkAboutSWG2026-00029 - SWG As-Built - 3/4/2026 / . • 1 RECORD DRAWING (ASBUILT) pg. 1 MASON COUNTY PUBLIC HEALTH Mini,Wit _.'. '>:' ..,. IP `RCtIO NT'IFICATIO;N +z'Mat:tkag Permit Number SWG 2-'0 -(9 --©OO1.9f Assessor Parcel# ctZ2O45 XOOO 8 i Applicant Name A A,-n )-I.,.'j-tc Subdivision (Name/Div/Block/Lot) Applicant Address V.O 1 93"t Ave.Sw City, State, Zip Art*,c,,, W A gbSl"t- Installer Name T c.... 3 VI l 1 :v►{r Site Address fill. l/lAri le34 Dr. Designer Name '5'm µ,.„1-c,- h-_Ls-0. -: ;. N INSTALLATIONCHECKLIST " ., - i ' Let Full System Installation ❑ Septic Tank Only 0 Drainfield Only 0 Repair } System Type Pe z... c.re- -Soda)i;.1.-61 Pretreatment Type r-141>5 ft.from foundation? - - 0 N/A ®YES 0 NO :=':s''>50 ft. from wells'? - '4'>50 ft.from surface water? - 0 Z 0 'I,err?Cleanout between building and tank'? - -1P Tank baffles present'? - ' 24".access risers over each com artment?- 101;:4 Effluent filter installed'?- O O Ir:� _ A Septic tank size 125O gal Manufacturer 17/147 I 1-n,1-. . ri:tL{:'�_._.il D-box water level and speed levelers used? - - I.N/A ❑YES 0 NO tol!Manifold/D-box accessible from surface?- - 0 0 1 41-716.Check valves installed? - - 0 0 i; 511*Transport Line Size Z. Schedule/Class -S CA `1 x Bedrooms installed(check one) 0 2 ®3 0 4 0 5 0 6 tEilv 4.0>10 ft from foundation?- ❑,N/A 1i YES 0 NO c i>100 ft.from wells?- =a�,-zi>100 ft.from surface water?- - 0 2 0 -p>10 ft.from potable water lines?- - 0 El 0 'rh >5 ft.from property lines and easements?- - 0 g j 0 '7,,t1>30 ft.from downgradient curtain/foundation drains?- - 0 0 yr , Drall infield level and observation ports present ❑ [� O `�1 0 Graveless chambers or is Clean gravel used? (check one) EtriVA Proper cover installed over drainfield?- 0 reS 0 11.4 Pump tank setbacks consistant with septic tank?- - 0 N/A El YES 0 NO Pump tank size 12.50 gal Manufacturer 7'n i'i I}n,lr� Al ❑ ® 0 fir'��)24"access riser(s) atid accessible from surface?- L' ti Alarm or Control Panel Installed? - - 0 MI 0 ' :' 0 0 r Control Panel equipped with Timer/ETM/Counter- Pump installed in ® Bucket or ❑ On Block or 0 Other ,,'4�''l Pump Make/Model fP 6 4 1 $D r, k 7 ® Floats or 0 Transducer t 'Tank draw down YI in/min Pump capacity S 1 gpm Squirt Height 3 ft iYt4��;� � A3 ..,Se-c_..Lx i Pump on time 70 ..,Se-c_. Pump off time '/ �r3 Daily flow set at 3 be gpm C � revised 1/22/2014 . . RECORD DRAWING (ASBUILT) pg. 2 MASON COUNTY PUBLIC HEALTH Drainfield& manifold orientation &layout El Trench/bed dimensions and critical distances within layout El Septic/pump tank placement /// �� JC` Location of buildings El Observation ports& clean-out locations Location of wells, surface water,& roads El Undisturbed native soil between trenches ID North Arrow If the designer or installer feel the need for additional information/comments,it may be attached. Record drawing may also be on a separate page attached. No.Pages Attached INSTALLER DESIGNER I certify that I installed the system in accordance with i certify that the system has been installed in accor- the septic design stamped"APPROVED"by Mason dance with the septic design stamped"APPROVED"by County Public Health and that any deviations shown Mason County Public Health and that any deviations here have been cleared/approved by both the designer shown here have been cleared/approved by both and Mason County Public Health and meet all State myself and Mason County Public Health and meet all and Mason County Codes. State and Mason County Codes I further certify that all information contained on this 1 further certify that all information contained on this form and attached Record Drawing is accurate. form and attached Record ing is accurate. Signature of installer Date ,� 2 P Girt, 1:e4 fte-g (1 • Printed Name of Signee k ��w�of"'z'yti� MASON COUNTY PUBLIC HEALTH MA The undersigned approves this lnstallatio ,$report and 4 2O �, 51%273 Record Dr • g on behalf of Mason Cou ty`P1�to®� �S I�ttitEs it I INTER . Health: N"ERV/RONMEN T LfC `R 7 ( o -16 AC HEAIL _;. n /22/`L..1e Signature of Environmental Health Specialist Date (designer's stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE • • - revised 1122/2014 I c',.-"' >'a».^- e„,4 i o '3, •t ft E 6t ' p0 QVI ,, » n o _ i •il A r U � H 'fl N . / si • 0 U . U) df •N • . f- a O N 0 • ww• F ID m -•---2 N O a . %A D Z al: tp. I..I n: ILI G _ n n'- 0 0 f ,•-`y',`t, eY r''IEF ly {- iV ,- cr ''a,.;.`r'�' ,,,,,,,,17,,,,-L--, '. Ate.•.;S. St ��q,.sF.'y� e l ( i I J • ���� (,� ,mot) • IL w J N 11.1 a .. „" c... > z o • z a � I fy O y�� w cn `' . ';,, 9. .�'1' . ; 1). t,; lc), O r.) !3 O •, ,,,, . . O. 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