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HomeMy WebLinkAboutSWG2021-00688 - SWG As-Built - 2/24/2023 DocuSign Envelope ID: DA79A4B4-C825-4721-8DFO-B1EE0A5A4242 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2021-00688 Parcel # 22029-21-90013 Applicant Name Bert Shinke Subdivision (Name/Div/Block/Lot) Applicant Address 1721 MCCORKLE RD SE City, State, Zip OLYMPIA WA 98501 Installer Name Manke Excavating LLC Site Address 70 SE CANNERY POINT DR Designer Name Micah Halverson INSTALLATION CHECKLIST 0 Full System Installation ❑ Tank(s) Only ❑ Drainfield Only ❑ Repair ❑ Other System Type Pressure Trenchs Pretreatment Type Septic Tank >5 ft. from foundation? - _ - ❑ N/A EYES ❑ NO >50 ft. from wells? - -i -LI-L-1}-\J-Et- '1 ❑ © ❑ Z >50 ft. from surface water? - ❑ 0 El H Cleanout between building and tank? - - - - -t- I- _F�_4 1 Zfl23_ - _ ❑ E ❑ --/U Tank baffles present? - - - - - ❑ 0 ❑ a24" access risers over each compartment?- - By - -=_=_ -- - -- ID ® ❑ Ll1 Effluent filter installed?- - ❑ [ ❑ Septic tank size 1 20n gal Manufacturer Sound Placement CI D-box water level and speed levelers used? - - ElN/A ❑ YES ElNO 0O Manifold/D-box accessible from surface?- - El E ❑ co Check valves installed? - - ❑ E ❑ ci)Q 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 x❑ YES ❑ NO >100 ft. from wells? - - ❑ x❑ ❑ W >100 ft. from surface water? - - El © ❑ E >10 ft. from potable water lines?- - ❑ ❑ ❑ z > 5 ft. from property lines and easements?- - ❑ ❑ El Q Q > 30 ft. from downgradient curtain/foundation drains? - - ❑ El Drainfield level and observation ports present - - ❑ ® ❑ ❑ Graveless chambers or In Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ El ❑ Pump tank setbacks consistant with septic tank? - - ❑ N/A X❑ YES ❑ NO Pump tank size 1975 gal Manufacturer Sound Placement < 24" access riser(s) and accessible from surface?- - ❑ ® ❑ I— a. Alarm or Control Panel Installed? - - ❑ El E Control Panel equipped with Timer/ ETM / Counter- - ❑ ® ❑ D n- Pump installed in ❑ Bucket or ❑ On Block or ® Other Orenco EasyPak EPump Make/Model Orenco 3005 x❑ Floats or ❑ Transducer a Tank draw down 2 in/min Pump capacity 45 gpm Squirt Height 5 ft Pump on time 1 min Pump off time 4hrs Daily flow set at 270 gpd Updated 8t21/2018 1 DocuSign Envelope ID: DA79A4B4-C825-4721-8DFO-B1EE0A5A4242 Mason County OSS Installation Report pg. 2 Parcel# 22029-21-90013 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - El YES X❑ NO If yes, please describe: Were all components pumped out and properly abandoned per WAC246-272A-0300? - - I=1 YES 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,cleanouts,and other maintenance access points. Incomplete Record Drawings may create additional delays in final instal ation approval and related permits. • .1)I \1 L{ e best%V t-Lk IN-e (j 1_0 2.0 Z - ZZ6 prz_r k 2kc 4-0 Icy J Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ ENGINEER 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 I further certify that all information contained on this foragygAttoched Record Drawing is accurate. form and attached Record Drawing is accurate. 2-15-23 t`Jl,`Jt LJJLJl.N40N Signature of Installer Date 'LI '? �IQ A '� ,14 I awrence MankP Printed Name of Signee /L .% MASON COUNTY PUBLIC HEALTH ` .✓ �' • s ',1 The undersigned approves this Installation Report and V : t000.00 �! Record Drawingon behalf of Mason County Public � TNAMILNALVERIKIN el. MONO DES Health: MIRES:arty' Signature of Environment Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Updated 8/21/2018 w..w — — — — � - tom. 3S— — — — — — 7 a( ^ if ale V.,v)dsV»n, c—r __----.. 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