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SWG2024-00268 - SWG As-Built - 9/23/2024
Mason County OSS Installation Report pg. 1 MASON COUNTY P LIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2024-00268 Parcel# 32136-24-90061 Applicant Name DAVID CASTLE Subdivision (Name/Div/Block/Lo Applicant Address 5811 E STATE ROUTE 3 FCt�/VF City, State, Zip SHELTON, WA. 98584 Installer Name SCHOENING EXCAVATING LL Site Address 5813 E STATE ROUTE 3 Designer Name CINDY WAITE INSTALLATION CHECKLIST ❑ Full System Installation ❑Tank(s)Only ® Drainfeld Only ❑Repair ❑Other System Type PRESSURE Pretreatment Type >5 ft. from foundation? - -- - - - - - - - - - - - - - - ❑ NIA ® YES ❑ NO >50ft. from wells? - _ _ _ _ _ _ _ _ _ _ _ _ _. _._ _ _. _ _ _ _ _ _ _ _ _ _ - ❑ ❑ Z >50ft. from surface water? - - _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ❑ ® ❑ FCleanout between building and tank? --- - - - - - _ _ ._ _ _ _ _ _ __ . n © ❑ tJ Tank baffles present? - _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _. _ _ _ _ _ _ _. _ _ _ ❑ ® ❑ a24"access risers over each compartment?- _ _ _ _ _ _ __ _ _ _ _ _ _ . E] ❑ LLI y Effluent filter installed?- - - - - - - - - - - - - - - - - - - -- - - ❑ ❑ El Septic tank capacity (working) _gal Manufacturer EXISTING gO D-box water level and speed levelers used? - - - - - - - - - - - _ _ _ , m wq ❑ ves ❑ No LLManifold/D-box accessible from surface?- - - - - - - .. _. _ _ _ _ _ _ - - ❑ ® ❑ GQ Check valves installed? - - - - - - - - - - - - - - _. _ _ n ® ❑ f Transport Line Size 2 Schedule/Class SCHEDULE 40 Bedrooms installed (check one) [N 2 KI 3 ❑4 ❑ 5 ❑6 [3Commercial/Other >10 ft. from foundation?— - - - - - - - - ❑ WA ® yes E] NO >100 ft. from wells? - - -- - - - -- - - - - - ❑ ® ❑ W >100 ft. from surface water? - - - - - - -��� - ❑ ® ❑ Z >10ft. ftom potable water lines?- -c� - - - -�� ^ _� _ __ _ . ❑ ® ❑ > 5 ft. from property lines and easemerlte?- -- - -- -- - ❑ ❑ ❑ Q > 30 ft. from downgradient curtain/foundatiotira mins?-/- - - - - ® ❑ ❑ Drainfeld level and observation ports present ❑ ❑ Graveless chambers or M Clean gravel useX(check one) Proper cover installed over drainfield?- - - - - - - - - - - - - - -- - - - - ❑ ® ❑ Pump tank setbacks consistent with septic tank? - - - - -- -- ---- - ❑ WA ❑ Yes ❑ No Z Pump tank capacity(Flood) 1250 gal Manufacturer HAGERMAN 24"access risers)and accessible from surface? - -- - - - ❑ ® ❑ a Alarm or Control Panel Installed? - - ❑ El \V1 Control Panel equipped with Timer/ETM/Counter- - - - - - - - - - - ❑ ® ❑ 4. Pump installed in ❑ Bucket or ® On Block or ❑ Other IL Pump Make/Model LIBERTY 280 ❑ Floats or Transducer d Tank draw down 2 in/min Pump capacity 44 gpm Squirt Height 4 ft Pump on time 1 Pump off time 6 Daily flow set at 180 gpd Mason County OSS Installation Report pg. 2 Parcel s 32136-24-90061 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - - - - YES 0 NO If yes, please describe. Were all components pumped out and properly abandoned per WAC246-272A-0300? - ❑ YES NO RECORD DRAWING This is a wrmanent record and must de accurate and as¢tlism,enough In rclo seen In the nee M mamtandnce activities and none development. Typical RKM Disease cmtein, command st mandold m anlemn Is layout.5ened,an p this Wash. Nmm anow,rea.d alerisa,mdaing and on,.Nilalnec mono,or wells,welerline, wntls,observGlon pone,deanoWe.add other maintenance access polrds IOCompltle Record Drawings may create Idurated alloys in final lnetallapon eppmyel and Indeed deal -T'Nsio-1 io'—) -at "'el 0 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 clearsd/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 ell 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. =�6 QD.?224 Signature of Installer Date 4�r rp Pnnfed Name o/Signed aA'4 �^✓ dk MASON COUNTY PUBLIC HEALTH �yc f O c?� sto is N The undersigned approves this Installation Report arGQ1�. 2� G ucei+sEo bEsl R Record Drawing on behalf of Mason County Public Fy 2p� ut•luts ds.tm - nJ a Health: O,i r7yy�y9 y `�IJ F Signature of Environmental Health Specialist Date 7�1� (stamp, signature and date) THIS FORM MAY BE SCANNED ANDAVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE upamhasmnom 0% F CL 4�a I VSYI� _ G too G�l4N au.� r-� - i 20 sot 12M1 q/a lln APPROVED JUL 31 2024 MASON COUNTY ENVRON MENTAL HEALTH RET s ' I VIA "CEN EC OE3� Residence14 9 qr 2. Audio/visual alarm �QI„ I Clean out �9s 8— 63 G ms 4. 1200 gallon exisrting septic tank yc�Om sFq Q 5. 1200 gallon pump tank G 1 6. Transport line 7. Repair drainfield area Vf yaFy` yo L vr- r 8. Water hookup y o- ta rfi"'/ 7 I/a/✓e