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HomeMy WebLinkAboutAFTER THE FACT RECORD DRAWING-SWG2026-00212 - SWG As-Built - 9/4/2026 tea ' AFTER THE FACT RECORD DRAWI34GI pg 1 MASON COUNTY PUBLIC HEALTH PARCEL IDENTIFICATION q Zi(,.7 r Owner Name S' '.Zu N rs ¢G Assessor Parcel it 3t1Z?≤IOb Mailing Address 7 0 htlrK h O/M Specialist Name (.k'li /PS/t4'i City, State, Zip WJ 13 e143rf 22rrrrgq Installer Name C ors ' H - Site Address g, cl. t14P. Designer Name r< r Please complete this checklist to the best of your knowledge, If Items are unknown leave blank. INSTALLATION CHECKLIST .. System Type v o Pretreat/{(ment Type NIA Drainfleld Ln, Ft, N Dralnfied Sq, Ft. PM Dralnfield depth iV1, >6 ft. from foundation? -- - - --- -- - -- -- - om ❑NIA fYES ❑ NO ,� >50ft. from wells? - -- - - - - r ���1A+i T �h ❑ , I� Tank b Li ut between building and tank? 111 11C'1I 4 -- ❑ (((ttt»>St�"""- ❑ V baffles present? - - - - -- - - - - -- - -- 24"access risers over each compartmenf4 - .?-:,i ❑ � ❑ WEffluent filter installed??- -- ---__-_ ' _ - - - -- ❑ Al ❑ Septic tank size j/,SO gal Manufacturer 'P H D-box water level and speed levelers used? - -- - - - ---- --- -- 2N/A ❑ YES No p0- Manifold/D-box accessible from surface?- -- -- - -- ------ - -- ® ❑ 0 mz Check valves Installed? -- - -- -- -- - - -- --- - - -- - -- - -- $] ❑ ❑ OQ Transport Line Size Schedule/Class Bedrooms Installed (If known) ❑2 13 ❑4 El ❑6 ❑Commercial/Other >10 ft. from foundation? - - - - - - - - - ® N/A ❑ YES ❑ NO >100 ft. from wells?- - - - - - - —] ❑ ❑ W >100 ft. from surface water? --- -- -- - -- ---- - -- - ----- - — ❑ ❑ - >1oft. from potable water lines?-- --- - -- - -- -- -- -- - -- -- — ❑ ❑ '.'Z.--, >6ft. from property lines and easements?- - - - - -- - -- -- - - - - tzJ ❑ ❑ > 30 ft. from downgradlent curtain/foundation drains? - - - - ® ❑ ❑ Observation ports present? -- -- - - - -- - - - ® ❑ ❑ ❑ Graveless chambers or ❑ Clean gravel used? (check one) 1 Proper cover installed over drainfeld?--- -- - - -- ---- --- - -- - ❑ ❑ pump tank setbacks consistent with septic tank?---- -- -- -- --- © NIA El YE$ NO � Yr Pump tank size _gal Manufacturer 24"access riser(s)and accessible from surface?-- - - -- ---- --- - ❑ ❑ -n.-: Alarm or Control Panel Installed? - - -- --- -- ----- ----- -- — ❑ El ,7.'. Control Panel equipped with Timer/ ETM/Counter-- --- -- -- -- ®,1iIT ❑ El ❑ /1 Pump Installed In Bucket or ❑ On Block or ❑ Other ..g:. Pump Make/Model fr)fr ❑ Floats or 0 Transducer "a Tank draw down ItJ)A_in/min Pump capacity gpm Squirt Height /1/4_ft Pump on time Pump off time fA Daily flow set at gpd Updated 2Q812018 AFTER THE FACT RECORD DRAWING, pg 2 Assessor parcel# 3 t/t7 / ô 16$ RECORD.DRAWING ❑ Dralnfield&manifold orientation&layout w/dimensions for re-location. ❑ Trench/bed dimensions and critical distances within layout ❑ Septic/pump tank LocoUon w/dlman- lions f dons for re-location ❑ Location of buildings exlstinglproposed A ❑ Observation ports, clean-out location \ &manifolds/d/d-boxes ❑ Location of wells, J surface water,roads, &weterMes. ❑ Reserve area(s) ❑ North Arrow rir llet : e1 Mkt 1� 4 iio°tlfr Svavlie iser og rs ZaL� If needed drawing may be attached o a page No. Pages Attached CERTIFICATION OF INSTALLATION DESIGNER/APPROVED DIM SPECIALIST I certify that the information contained In this document Is accurate to my knowledge. The drawing and information has been filed through common locating practices. 7/I-iu Slgnatu signerorApprovod O/M Specialist Dote MASON COUNTY PUBLIC HEALTH This is an after the fact record drawing, which mayor may not include a county Inspection. This Information is to only document an existing OSS location and components. Signature of Environmental Health pocialist Date THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE updeled 2OQme N O N. i A 0 z 0 \ P n m \ 3 � ® D _ C Z D O Q p N a 9 y \ p � O A O y E ST ANDREWS DR A w C'iz w o I� II m A 3 D bl Vpmi nP � III Cr) III o OIII a DUI > _ I6 = I m c� III j N p nil m Imp III . I � � iii