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Home My WebLink AboutSWG2020-00179 - SWG As-Built - 7/6/2023• 1 ' PI Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2020-00179 Parcel # 32106-75-90161 Applicant Name Jensen & Isabelle Ergler Subdivision (Name/Div/Block/Lot) Applicant Address 181 E Union Ridge Rd City, State, Zip Union, WA 98592 Installer Name Joe Fassio Excavating Site Address same Designer Name Arrow Septic Designs INSTALLATION CHECKLIST ® Full System Installation ❑Tank(s) Only ❑ Drainfield Only ❑ Repair ❑ Other System Type Shallow Pressure Pretreatment Type >5 ft. from foundation? ❑ N/A i YES ❑ NO >50 ft. from wells? - ��'�.��, � � � Y >50 ft. from surface water? - ' tf Z �` ❑ ❑ Cleanout between building and tank? -- P - jUN-2-1, if��- o Tank baffles present? - i T - - - - ❑ ❑� Ela 24" access risers over each compartment? _— - ❑ # ❑ W Effluent filter installed?- --�= ' '' ' " ❑ 0 ❑ N Hagerman Septic tank capacity (working) 1,250 gal Manufacturer 9 0 D-box water level and speed levelers used? - - 0 N/A ❑ YES ❑ NO OO Manifold/D-box accessible from surface?- - El ® El m-Z Check valves installed? - Al- 'PUMP 1j4k. - ❑ 0 ❑ � CIQ 2" Schedule/Class 40 2 Transport Line Size Bedrooms installed (check one) ❑ 2 ❑ 3 0 4 ❑ 5 ❑6 ❑Commercial/Other >10 ft. from foundation?- - ❑ N/A El YES ❑ NO CI >100 ft. from wells?- 0 0 ❑ W >100 ft. from surface water? - - ❑ El ❑ u. >10 ft. from potable water lines?- ❑ 0 ❑ z > 5 ft. from property lines and easements?- - ❑ C ❑ Q cc > 30 ft. from downgradient curtain/foundation drains? 0 © El • Drainfield level and observation ports present la Graveless chambers or ❑ Clean gravel used? (check one) ❑ ❑ Proper cover installed over drainfield?- - El Pump tank setbacks consistent with septic tank? - - ❑ N/A 0 YES ❑ NO 1,250 gal Manufacturer Hagerman • Pump tank capacity (flood)Z < 24" access riser(s) and accessible from surface? HoUSE Alarm or Control Panel Installed? - ❑ ❑ I— ❑ ❑ • p. ❑ 0 ❑ E Control Panel equipped with Timer/ ETM /Counter- m a- Pump installed in 0 Bucket or ❑ On Block or ❑ Other & Pump Make/Model Zoeller N152 0 Floats or ❑ Transducer Squirt Height 2.5 ft a. 44 Tank draw down 2 in/min Pump capacity gpm a Pump on time 2.7 minutes Pump off time 6 hours Daily flow set at 480C erz gpd Mason County OSS Installation Report pg. 2 Parcel# 32.10(0^15^ I 01 " ABANDONMENT RECORD - 0 YES 1p NO Were existing septic components abandoned as part of this project? \ If yes, please describe: 0 NO Were all components pumped out and properly abandoned per WAC246-272A-0300? - 0 YES 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- Typiasl Record Drawings contain Drainfieid&manifold orientation&layout.Sepec/pump tank location.Norm arrow.reserve drainfieid,existing and proposed bulk:ngs,location of wells,waterlines, wells,observation ports.deanouts,and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and related permits. OLLbt../C)7V-14) qRecord Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ENGINEER I certify that 1 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 Drawing is accurate. frre 7d / 05 25/25 Sagler to /14 tl Joe -SS'Io T .y.A,r U Printed Name of Signee It.:, ... � trAa, ;.•�.2f,. MASON COUNTY PUBLIC HEALTH J .%,., •. rP The undersigned approves this Installation Report and ,`Z PAULA JOY�o+Nsor: �'. Record Drawing on behalf of Mason County Public O,•. L;c STDYI,O air'.. N. Health: a RES `� ern vh 1 -6 13.'r3 (0-2 $-Z'S Signature of Environmental Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC ViEW ON THE MASON COUNTY WEB SITE updated 6212°18 I } . I State: I :-5ti v r 1 * t = \ �f j s°'Q • • Ls• ; Of :s • °lid 4, r. w- Y * area iI -. • I �l\L1Q 4 r it E `Y .v }' JthSt r1 l 1 Ic* Y, tatc— — I . / %AV' / . . tj -'R'Tr • . tr. ••14. . -,•*;ioriffr/A. `. 510:3a9 .��fi�\ - 1-1-ite-r---: /. (/ • .' PAULA JOY JOHNSON •'t 9 L'fCrhfS� E4fO vE"f1' n+) `_ f • fxviaEs • t,i� •— • APPROVED - CM e JUL 0 6 2023 / / o Li: � xc MASON COUNTY ENVIRONMENTAL HEALTH • RET O Audio-Visual Alarm I (3 Cleanout P op Ms ord• 3 P O3 1250 Gallon Septic Tank 4 . 8R J Q 2-Compartment with • /® , Effluent Filter /� �• O 12-SO Gallon Pump Chamber • / 0Valve Control Box p{:veW 4_ / . .. 3 'i 3' x 1.S.5' • . % iI ice) � x 3z .� 'i � (,1 3 u --.4'`.5' r • (t) 3 z. x 0.7 PR\MPoz )` ` . • � — DQA1 NVII:E-9 �eEivUHES • ea ® off� or". w( R �S .v E f3Z �y7.7 op IN 3E�W BEN oq. ).