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Home My WebLink AboutSWG2023-00351 - SWG As-Built - 3/26/2024 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH =AddressPO PPLICANT/PERMfi INFORMATION er SWG 2023-00351 Parcel# 3192143-90030 me Rick Manning Subdivision (Name/Div/BlocWLot) dress PO Box 67p Shelton,Wa 98584 Installer Name SPear Const.440 Bloomfield Rd. Designer Name t3oh Paysse INSTALLATION CHECKLIST ®Full System Installation ❑Tank(s)Only ❑Orwrifield Only ❑Repair ❑Other System Type Gravity PraVmlment Type >5ft.from foundation? ._________________________.- ®WA ❑YES NO >50 ft from wells? - ❑ 0 ❑ 2 >50R from surface water? -______________________- ❑ 8 ❑ Fa, Cleanout between building and tank? ------------------ - ❑ ❑ V Tank baffles present? --_- -- ❑ ® ❑ A. 24'access risers over each compartment?.______________- ❑ ❑ W Effluent filter Installed?---_________- ❑ ® ❑ Septic tank capacity(working) 1200 gal Manufacturer Sound Placement �0 -box water level and speed levelers used? --------------. ❑WA ❑ No OLL Manifold/D-box accessible from sur/ate?----------------- ❑ ® ❑ oaCheck valves installed? - ------__- ❑ ❑ f Transport Line Sae 4"PVC ScheduslClass SDR 3513034 Bedrooms installed(check one) ®2 ❑3 ❑4 ❑5 ❑B ❑Commercial/Omer >10ft.from foundation?--------------------------- wA ❑YES ❑ NO O 1100 ft.from wells?----------------------------- ❑ ® ❑ W >100 ft.from surface water)- ❑ ❑ Z >10ft.from potable water fines?--------- ❑ i >5ft from property lines and easements?--------------- . ❑ ® ❑ a >30 ft.from downgradiem curtain?foundabon drains?---- ❑ ❑ Grainfield level and observation ❑ ❑pans present----- ----- _. ❑ Graveless chambers or F Clean gravel used? (check one) Proper cover installed over dminfield?------------------ - ❑ ® ❑ Pump tank setbacks consistent with septic tank?------------------ ® WA ❑ We ❑ NO hd Pump tank capacity(flood) gal Manufacturer F24"access riser(s)and accessible from Surface?------------ - ❑ ❑ ❑ a Alarm or Control Panel Installed? --------------------- ❑ ❑ ❑ Control Panel equipped with Timer I ETM?Counter- ---------- ❑ ❑ ❑ 1 Pump installed in ❑ Bucket or ❑ On Block or ❑ Other IL Pump Make/Model ❑ Floats or ❑Transducer IL a Tank draw down in/min Pump capacity Opm Squirt Height ft Pump on time Pump off time Daily flow set at gpd U...1.1e Mason County OSS Installation Report pg. 2 Parcel a 31921-43-90030 ABANDONMENT RECORD Ware existing Who components abandoned as part or this project? --------- ----- - Ej YES ® NO It yes,please describe: Were all components pumped out and property abandoned per WAC24W72A-00007 ——--—— ❑ YES[] O RECORD DRAWING TMe le a pimelxM rm-W bat summit ma gpLLIIM Ltl dYOIp1M.a Is rib In I mM d me1--a 1 11bs asp Nlun deebl—y i) ,li[oN IXabrye edMun: pelnmew a room,a,,,mepa ,p ,ft momapump is,bulbs,tMM ertgv,leune drmieeld.e-tv ed plo d WUIlnts,lowlbn o/vppe,xxblWro, xaYq obeemlm moss,cbanoue,uticTb rstlsynsn ccesepaiMe, bmmpNb Ramrd LFMIge may veele aeditlpnel delay In final Intlplbtion epprpval eN relebd pvml6. MAR ..,;NtY ENVIRONMENTALHEALTH JBW ® Retard Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ENGINEER I car*that I Installed the system in accordance with I certify that the system has been Installed In accor- the septic design stamped"APPROVED-by Masan 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 clearedlapprved by both the designer shown here have been clearedlepproved 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 Masan County Codes I further certify that all information contained on this I further certify that all information contained on this tam and attached Record Drawing is accurate. form and attached Record Drawing Is accurate. 217124 re ollnat er Date Logan Spear Printed Name of Signee MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and Rec Drawing on behalf of Mason County Public pip"yae H Ith: -3 UPIRES -Z Slpna mental Health Specialist Date (stamp, signature and date) THIS FORM MAYBE SCANNEDANDAVAIIABLE FOR PUBLIC VIEW ON THE MASON COUNTY WE9 SITE e~mmaladle i i / i i `CY i PRIMARY& \ RE5ERVEAREA \\ \ ♦ ` — \ WELL \\ i/ �/ SEPTIC TANK \ \ pp p � v MAR 16 's ` -gONCOUNTY ENVIRON�gENTAIH " AT UILiF_3 1�` AN ASBGILE INSTALL OFN ST FEE WILL BE LNARGEO AT THE OF INSTALLATNIN PIONEER. DIGGING, INC cuscTZr3I pucx n4AN m c FTEXE I: TF HA E zPRCEL k31921i39W30 \ s5.ca w SEPTIC DESIGNS ADDRES4 440 KiDO.amn RD n ROOTS % IM!IEMASJ MB )NRD. CAMEVIEW,WA91t DESIGNER: ROBER.T N PAYSSE OEACE-WN 4]6w.G3 M-3WT VM53 SHEET: SITERM SCALE P.IBO o®cv w„ xaa,em u,w h All o"CM TMUR wno�N OBSERVATION PORT(X2) z � l as h0 D-BOX C o ,o OBSERVATION PORT FINISHED GRADE ORIGINAL GRADE FILTER D-BOXOEQU USE SPEED FABRIC LEVELERS TO ALIZE FLOW pri BRING ACCESS TO WASHED ROCK E z � e .. �nx c b •toza `,,.,'''�',� , rr ENVIRONMENTALHEALT' iOW a' REST. LAYER PIONEM DIGGIN INC QL<ri MM; R"AWYtRJ: 11�I MixL lL';li1Luz P:\Ri_Q µ.31Y}I Tl9Q{TJQ Jig U.` R56 LL5 SFPIk. D)F l(Nsti wuRl:>> i40BUXW )RI3 n&V," Ra 45s A�51L LkWT1paS)A RR CRNti\1LN'.)\:\:95N. 17IAf,�R: RWIAI'ILI'AY�i r'l�rwra:as r. a IRFM:C 34Ji:d Nlry M\ 3M4r_i5i at[D'. DI71%: v . . .0