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Home My WebLink AboutSWG2024-00218 - SWG As-Built - 10/11/2024 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2024-00218 Parcel# 22023-75-00060 Applicant Name Richard Kessler Subdivision (Name/Div/Block/Lot) Applicant Address 1120213th St. E. City, State,Zip Edgewood We 98372 Installer Name Spear Construction Site Address 663 Woodland Beach Lane Designer Name Bob Paysse INSTALLATION CHECKLIST Full System Installation ❑TanIg8)ONy ❑ Drainfield Only ❑Repair ❑Other System Type ATU-pressure Pretreatment Typo Nuwater BNR 500 >5 ft.from foundation? -------------------------- - ❑WA AYES El No >50ft.from wells? ---------------------------- - ❑ ® ❑ >50ft.from surface water? ------------------------ ❑ ® ❑ F Cleanout between building and tank? ------------------ - ❑ ❑ V Tank baffles present? ---- - - --------------------. ❑ � ❑ a24'access risers over each compartment?---------------- ❑ ❑ W Effluent filter installed?------------ -- ----- --- ---- - 0 ❑ ❑ to Septic tank capacity(working) NUWater pal Manufacturer Sound Placement L, D-box water level and Speed levelers used? --------------- 0WA El YES NO �LL Manifold/D-box accessible from surface?---------------- - ❑ ® ❑ Check valves installed? ---- ----------------------- ❑ ® ❑ 2 Transport Line Slze 2' Schedule/Class 40 Bedrooms installed(check one) 0 2 ❑3 ❑4 ❑5 ❑6 ❑CommerciaYOther >10 ft.from foundation?-------------------------.- ❑ WA ®YES ❑ No C >100 ft.from wells?----------------------------- ❑ ❑ W >100 ft.from surface water? ------------------------ ❑ A El M >10ft.from potable water fines?.--------------------- ❑ ,OWE ® ❑ aZ >5ft.from property lines and easements?--------------- - ��' .0 ❑ El K >30ft.from downgradient curtaindfoundafion drains?---------- ® (^ ❑ ❑ Drainfield level and observation ports present -------------- ❑ ® ❑ ❑ Graveless chambers or 0 Clean gravel used? (check anal Proper cover installed over drainfeld?------------------ - ❑ ® ❑ Pump tank setbacks consistent with septic tank?------------- ❑ NIA ® Yes ❑ No Ye Pump tank capacity(flood) 1500 of Manufacturer Sound Placement Q 24"access dser(s)and accessible from surface?------------ - ❑ ❑ IL Alarm or Control Panel Installed? --------------------- ❑ ❑ ? Control Panel equipped with Timor/ETM I Counter----------- ❑ ❑ a Pump Installed in ❑ Bucket or N On Block or ❑ Other g Pump Make/Modal Liberty FL100 Floats or ❑Transducer a Tank drew down 2.5 inlmin Pump capacity 75 gpro Squirt Height 7' ft Pump on fime 1 min. Pump off time 8 hrs. Daily flow set at 225 gpit upltlW wlmla Mason County OSS Installation Report pg. 2 Parcel ft 22023-75-00060 ABANDONMENTRECORD Were existing septic components abandoned as part of this project? -------------- - 0 YES No If yes, please describe; Were all components pumped out and properly abandoned per WAC246-272A-0300? -- ---- - - YES NO RECORD DRAWING till is a yandinmt Tord.m an.e a adauua and ea.dddw.manian m n-Ndam in fine need m mamananaa aanmewe and mein danatopment Typiwi Ramm undinpawNn: Aral x maniwN arlvads.a Yfaad Sdo aim,iank bwddn,noon m,ow.ni—maraw exi and pi musing:..bcaean mai watedm, w.Iw,ou..nuon Dons,awwata.ane odwrnir,wn.nre away pane. axyri Rana d oawmaa may Qaea addnwnai delays in final inaauendn appnrm and radad pemM'ia. ® Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ENGINEER 1 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/appawed by both the designer shown here have been cleared/appreved by both and Mason County Public Health and meet all State mysetl 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 1 further certify that all information contained on thus form an@ attached Drawing is accurate. form and attached Record Crewing is accurate. �i 10/11/24 Signature of frtatNier late Loqan Spear e Printed Name of Signet MASON COUNTY PUBLIC HEALTH -.. The undersigned approves this Installation Report and mask mHaneE Record Drawing on behalf of Mason County Public Exvwss Health: Signature of Environmental eadh Specialist Date (stamp,signature and date) THIS FORM MAY BE SCANNEOANO AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SRE uvdewd unadta EXISTING , WELL �� 1 I j 000 — — \ EXISTING `\ 1 WELL ksol / � I EXISTING \ WELL VALVE BOX �1 EXISTING DRIVEWAY NUWATER 8t ill Iu i PUMP TANK Q REPAIR DRAINFIELD AS PER DESIGN. EXIST. SHOP APPROVED ' EXIST. OCT 112024 \ CABINS MASONCOUNTYENV.INMENTALHULTH RET APPROXIMATE SHORELINE ,tics: 2� F EOORD IIDRAVENG CUSTOMER: RICHARD ICESSUR TEST FIJLEt TEST HJEE2 PIONEER DICiGIl�ICi, WG PARCELa swz3-7s000eo 2W Illy+`I WAM 23«Ivll. SEPTIC DESIGNS ADDRESS. 663WCODLANO BCH IN RWIS" ROJIS®z3 3ME�BHd KD. CA W]E WA985 DESIGNER: KOBEFLT H.PAYSSE OF 36U426iB03 FAX-3G 4VD53 SHEET: ASBIIB.T WALE. P=50 �uww.=..