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Home My WebLink About1976 AS-BUILT ABANDONMENT - SWG As-Built - 9/6/2024 �3ttr�Uon/M�T Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANTI PERMIT INFORMATION Permit Number SWG P-7(a l^-Wi 14- Parcel # 420181400030 Applicant Name Lund Machine Rental LLC Subdivision (Name/Div/Block/Lot) Applicant Address 110 W Metzler Mill Rd City, State, Zip Shelton We 98584 Installer Name Schoening Excavating LLC Site Address 7431 W Shelton Matlock Rd Designer Name INSTALLATION CHECKLIST ❑ Full System Installation ❑Tank(s)Only ❑ DrainfWd Only ❑Repair ®Other AhaMonmere System Type Gravity Pretreatment Type >5ft. from foundation? ------ -------- --------- -- -- ❑ NIA ❑YES ❑ No >50ft.from wells? ----- ---------- ------------- - ❑ ❑ ❑ Z >50ft.from surface water? -- - --------- -- -------- -- ❑ El ❑ FCleanout between building and tank? - --- --------------- ❑ ❑ ❑ U Tank baffles present? - - -- - - ------ - ------------ - - ❑ ❑ ❑ 6~ 24"access risers over each compartment?-- ---- ------- -- - ❑ ❑ ❑ W Effluent filter installed?-- -- - - -- -- -- - - - -- -- - ❑ ❑ ❑ W Septic tank capacity(working) 1200 gal Manufacturer 11 D-box water level and speed levelers used? - - -- - - -- --- -- - - ❑ wA ❑ YES ❑ NO C0 Manifold/0-box accessible from surface?----- -- -- ------- - ❑ ❑ El mZ Check valves installed? - - - - - - - - --------- ----- -- ❑ ❑ ❑ O 2 Transport Line Size SchedulaVees Bedrooms Installed (check one) ❑ 2 ❑3 ❑4 ❑5 ❑6 ❑Commercial/Other >10ft.from foundation?-- - ------------------ -- --- ❑ NIA ❑ YES ❑ No G >100 ft.from wells?-- - - - -- ---------------------- ❑ ❑ ❑ W >100 ft.from surface water? - - --------------------- - ❑ El ❑ LL >10ft.from potable water lines?-- ------------------- - ❑ ❑ ❑ a= >5ft.from property lines and easements?---- --------- --- ❑ ❑ ❑ R� >30ft.from downgradient curtain/foundation drains?--- - ------ ❑ ❑ ❑ Drainfield level and observation ports present - - - - - - - - - - - - -- ❑ ❑ ❑ ❑ Greveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?--- --- ------ -- - - - -- ❑ ❑ ❑ Pump tank setbacks consistent with septic tank?-- -- --- - - - - - - ❑ WA ❑ YES ❑ No Y Pump tank capacity(flood) at Manufacturer Q24"access riser(s)and accessible from surface?- ---- -- - - - - -- ❑ ❑ ❑ F a Alarm or Control Panel Installed? - -- - -- - - - - - - - - - - - - - - - ❑ ❑ ❑ Control Panel equipped with Timer/ETM/Counter- - - - - - - -- - - ❑ ❑ ❑ IL Pump installed in ❑ Bucket or ❑ On Block or ❑ Other IL Pump Make/Model ❑ Floats or ❑ Transducer d Tank drew down in/min Pump capacity gpm Squirt Height ft Pump on time Pump off time Daily low set at gpd urae,w aa�noia Mason County OSS Installation Report pg. 2 Parcel# 420181400030 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? --- -- -- - - -- - - -- Q YES NO If yes, please describe:Decommission septic tank on the old unused gravity system Were all components pumped out and property abandoned per WAC246-272A-0300? -- --- --• ® YES No RECORD DRAWING lri4 4.a.rrm�rid scare and mart a.ccurm aM d adpeva anau h W M. In tlm mae a m.Innnanca.tlNMYa.rm nrox.a..w.ya.m. TIW I Rx mmmh. ). MM S m.nWd nMMatlon n IeW t Seod,M bn4I.Mn.WO ermw,menre d.Mn d...I.61 W walla,—di— wN..ohmrv.Em oarb,Weiane..M oNm malnNn.nn.cnaa adna. Inw 1W Remd Di.xirya my m..m addil ddry In M.I iruVMtim 11m .M ml.led Gm ft ® Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNERI ENGINEER I certify that 1 installed the system in accordance with 1 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 clearedlapproved 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 Drawing is accurate. A/5 CIA•14 Signature of Installer Date Brayden Schoeninq Primed Name of Signee MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and Record Drawing on behalf of Mason County Public Health: o►/61z-f Signature of Environment l Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE uyd.lee W.... RECORD DRAWING continued W NA\u,4. Q� tx:vr;*) Vf%AL syaF�•�"• py, S�\+ Nw1 i� ofai alle \. A\,m a.nea Qe teaa, cm, bwUi �• •F;uka wl ?4a V.l. • 4s�a c..Ga, 25' Ib. So Is' Here are some pictures before and after.There was no need for pumping considering it hasn't been used since it was last pumped and inspected.The septic tank lid was pulled off and disposed of before pea gravel was put in.