Loading...
HomeMy WebLinkAboutSWG2023-00053 - SWG As-Built - 5/2/2023 ,-,e Mason County OSS Installation Report pg. 1 0___, .C MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2023-00053 Parcel # 52014-11-00010 Applicant Name FRED CRABTREE Subdivision (Name/Div/Block/Lot) Applicant Address 9101 W SHELTON MATLOCK RD City, State. Zip SHELTON, WA. 98584 Installer Name SCHOENING EXCAVATION LLC Site Address SAME Designer Name LLC INSTALLATION CHECKLIST Q Full System Installation ❑ Tank(s)Only ❑ Drainfield Only ❑ Repair ❑Other_ System Type PRESSURE Pretreatment Type >5 ft. from foundation? - - ❑ N/A ❑■ YES ❑ NO >50 ft. from wells? - LI- ❑■ ElZ il>50 ft. from surface water? - -� C ❑■ El H Cleanout between building and tank? - -- - - - "l3 El U Tank baffles present? - - Q-� -L 120 L ❑■ ❑ a24" access risers over each compartment?- - - - - ❑ ❑■ ❑ W Effluent filter installed?- --- ■❑ ❑ u) BY- Septic tank size 12. O gal anufacturer Q ee- 014 iv a D-box water level and speed levelers used? - - 0N/A ❑ YES ❑ NO XO Manifold/D-box accessible from surface?- - ❑ ❑ ❑ co Check valves installed? - - ❑ ❑ ❑ 0< E Transport Line Size 2 Schedule/Class SCHEDULE 40 Bedrooms installed (check one) ❑ 2 ❑■ 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10 ft. from foundation? - - ❑ N/A ❑■ YES ❑ NO 0 >100 ft. from wells'?- - ❑ ❑■ ❑ -.1 >100 ft. from surface water? - - ❑ ❑■ ❑ W L.T. >10 ft. from potable water lines?- - - ❑ ■❑ ❑ Q Z > 5 ft. from property lines and easements?- - ❑ ■❑ ❑ cc > 30 ft. from downgradient curtain/foundation drains? - - 1.1 ❑ ❑ 0 Drainfield level and observation ports present - - ❑ 0 ❑ ❑ Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ ❑■ ❑ Pump tank setbacks consistant with septic tank? - - ❑ NIA I YES ❑ NO Pump tank size /-2SU gal Manufacturer agree. .�,..)-✓ < 24" access riser(s) and accessible from surface?- - ❑ 0 ❑ F- a Alarm or Control Panel Installed? - - ElIN ❑ 2 Control Panel equipped with Timer/ ETM /Counter- - ❑ 0 ❑ D n- Pump installed in ❑ Bucket or ❑ On Block or ❑ Other CL Pump Make/Model LIBERTY 280 ❑ Float T n d r (� a_ Tank draw down 2 in/min Pump capacity_.5-7- gpm i rt H�Ighf��V eft a Pump on time ._ ._ i-✓ Pump off time q fiu Daily,fl�}w U„se[L2023tt P? _gpd �Wff iA1 rr Updated 8/21/2018 ' MASON COUNTY ENVIRONMENTAL HEALTH lit Fo Corn �,C = - fib, �d DJA Mason County OSS Installation Report pg. 2 Parcel # 52014-11-00010 ABANDONMENT RECORD Were existing septic components abandoned as part of this project'? - - El YES 0 NO If yes, please describe: Were all components pumped out and properly abandoned per WAC246-272A-0300? - - 0 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.cleanouts,and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and related permits. 40/2(2.4eld 11v fial/r i G S In ""/?'`/ 7 c),4,5- 5-0iPr° U'<% t^-'/ in ib Crj iAu tik#w Ze"-°P." ik i v"C I. 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 form and attached Record Drawing is accurate. form and attached Record i,wing is accurate. i i�1 A-•i•23 S 1 • Signat e of Installer Date .�� �,pb,o , 1�J1 t a.y Ion 7c_11 a er1 Jln •` S"ti 9� 0i t q'l� Printed Name of Signee i s r MASON COUNTY PUBLIC HEALTH •y� III 18 v` <r $ o CINDY WAITE • The undersigned approves this Installation Report and 0 LICENSED DESIGNER 1, Record Drawing on behalf of Mason County Public A p P • 111V a..:`01`© 4,10 gib"` Health. 571IZ0 Z3 MAY 0 2 2023 Signature o Environmental Health Specialist Date MA iON COUNTY ENVIRO ? L at re and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW B4AIHE MASON COUNTY WEB SITE Updated 8ml23-a i A J } , �iP i'i, �h� �J eG i i i 2J I ,/ JUG _ O I I • 1°‘,0" 9°•t 3 �yi s/.,�.y -7;4 4, { . 0 . , ;i -, 114, 4, A P E " O V E D- =" '' ��� •E AITE /6� �,se LICENSED DESIGNE �/ LIV1 :—1 .1,../ O Ky MAY 0 2 2023 ix,,Ais u5,,o, // . MASON COUN E'VIRONMENTAL HEALTH (�"/ T�G.LS (we • DJ 1 �QfcL Tam I ApR28 ,023 RECEIV 1 D 0 Ift,t q ,0 , Z7 Is E r ! l , . vaI bA, j cc ,e u ZU/(..0 pier met �xW� 'n,'` 09 Oar j C ie ►iau 1. Pu .s I N I ,< 1°l% „ No 1 , s, 1-2 -act 2iv / 51.3 l W----1-1------T-- -_.C1:_____--_________-___________0. . 4 -80'12... i i1 30 [e"et.uc - - W T�� Cc 011Prir ° -'----7 i '-') .. la a ...4, 3,-- -- - -- - - w• . .• ii, il,•' , • A. .... _ ..„ „ sr • • _,Ars• . •k "S*0 •4044 9.. oitaKtioto. .1:if* ... 0, • • -"' 2'___r, il, ....•,4,,,,,.,. Mk., 30,4* mak ' •96 480.411.40 P'li . ..v A. , ,4 _ 4,. sk 4. ••Woo* sfr ...* -• P... pA r- Ir. ''...4ie•40 °Cr'.1"..- Afkil! 1. a .• )1Lsr .., irk. 4:46--.4- IP••=0. ......•440. ,0,.. jiklion.11,# Ok# 00 • „It, ,...1.10 - -,,,- , 0 A, f pi&. .ir. ott. .....oz. g 00,P • ' -7141• ....A. rili ligt.._ • •-•..1119;0 0"1 r....--v.' lit .....0. • ir. ilk—. 4p,fr., _olvei?'„,`,.14. • --* .. ..".4.4,- ,„,,, ..,**" - ------ • •-•0 is.,_..i. - 0 er;6•03 ,,. * io ,70`,4P1-0 #" ' - •e, 01, f...• t I` 1 r‘iviper;1440 . /It**, 0 jk., .,r4 41.4.4010194' •' ' 0 .- i • f . • Allf , 1"1.4.414.. ..2"' toir•ink Ahr....i.ribt .,...:19 li _ . ,,. , Id 1 1411001.. arao- .. . _ _.•,,g- ,),4 --, itio Noolo . lo .. ...„4.), , ,. „„,..,,c. 0 a - 411r• 4%. . ,,.., • .P. 0 4.,(4 vo ,, .0. „, . „ ,,, s. as. •.. . - .i 1' k, - • ....% thii.„ . "'Aar AP 4 i....., ..... r 51 — li '14 . • i r.,4'.4i,,,' of ct CIN E 1. if tiL LICENSED DESI E• Aitt' • ‘41 Jil 4 1054;:!‘ ilk p , ilp _ 46_ . lib 4114 A - -'' Amax aomiw...... la .......00.4, EXPIRES 05,10, le , gr•OC o• .•. I,- 1 .tui:ei .11111111 40,,ti • `-• , -'. ' -'.:1 / -"Ir ..6 1,00•4 ' . . ,r '-**,•aq'llif, . 0411 4" .431110111. . , 1 . ... .•,- - - • .7 ."'' i ' 044,:t n' •410. k PJ-e cue , - - ..i11- -• 14-• '." , . 'A t lialtio,!... c, ft' '-'s tr. e ° 41.e 0; • ... .....7.....____c. . 4, •N ,4.4. sl• •* jit ‘ 4i • 2 - , ...>-. ... ,. 4 ._ . • • a' : 4 ak .-/#' • • 4, =-•- oierk g MOW =- • '0,-.1.10, 4. „, .• 4 . * II OA 4., 1 0 •# I i it E --- . 4$ , . :1..e - ,, ,F,—... = III A: . ' .., ',011. 1 4. ••• •' .7.4 "It l'ile ill Lc 0 204/,.. .?c;t7,. ell' .114, dir-'* 4•-s..w lig . -....0 , . ,•. ,„:_ii, .:.s. ,,:., / " - 4r. . 4,, Z"*...v - * -.;°:,..... . .... /oo/ 4111° . 'W-4...' • . - ' al • `„ 66 .,, 1-17 rave , , ,41140,0,• . ** -**- , • - . ? 2 Ei •it ' • e• Itaith444 • - smolt -110 11 #.4W-JOI ''''" • 40.•,•• k.^ At. _, - __ •..... - _ _ ....„.----___,...... ,,....... __. -v, . ..4.- . 0 .04 . .......•••••-••• •........_4.4..__.4.........--A....7:444444.4„.. _"--------------------:- 0 1 °.40° .,,,AlF _--,, - ,- ' r / , *•... , . ,, . ' . - • '.5trilw at - /',IL / ., `sit 4. :9:1,r , .... .A, ..•.,••' ,...,, -,,og„ e131.4 Ptifit i ea --NOt Ai e 1 1 -le ...., _ .....,, vot . .... (/ ' ' )elovii, - ..., .. _ illr• , ' • Alls. ,- - tiMiiiifeeti__,,,,,,,4...4 At I, `•,,, `5".2e)lete—ii- 6el7°4, l. - 9/ -1-i5C- ee/ir , IOVED 12/ / 4; 6 /1 ,444_ * ..- It.. _ . Re) - ' —V „„„ .I.ire,.4. • ' len: 2 2023 - . ....- i...P.1 . • — - ' -,,,, .. 11,4 ...L.. , - . ... , •,•••• lit ' . Ifiktaw"• ,4„pc„, - • '''' • - -• --— ° or •.. _ _