HomeMy WebLinkAboutSWG2023-00252 - SWG As-Built - 3/12/2024 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH
APPLICANT/ PERMIT INFORMATION
Permit Number SWG 2023-00252 Parcel# 420014090060
Applicant Name Erin and Salem Schankel Subdivision (Name/Div/Block/Lot)
Applicant Address 161 E Frog Acres
City, State, Zip Shelton, WA 98584 Installer Name Hanson Excavation LLC
Site Address 100 E Timber Ridge Designer Name James Medcalf
INSTALLATION CHECKLIST
® Full System Installation ❑ Tank(s) Only ❑ Drainfield Only ❑ Repair ❑Other
System Type 4BD Pressure Sand Lined Bed Pretreatment Type
>5 ft. from foundation? - - El N/A 0 YES ❑ NO
>50 ft. from wells? - - ❑ IN ❑
Z• >50 ft. from surface water? - - ❑ 0 ❑
HCleanout between building and tank? - - ❑ I
U Tank baffles present? - 1- 5 2 b - El Ela 24" access risers over each compartment?- f ?.i - ❑ I
W Effluent filter installed?- ❑ ❑t■ CI
(f) &--- -%/4 - -Septic tank capacity (working) 1200 gal Manufacturer Sound Placement
0 D-box water level and speed levelers used? - - is N/A ❑ YES ❑ NO
DO Manifold/D-box accessible from surface?- - Ill ® ❑
0?2 Check valves installed? - - ❑ ❑ ❑■
OQ
2 Transport Line Size 2" phedule/Class Sch 40
Bedrooms installed (check one) 0 2 3 114V ip 6 ❑Commercial/Other
>10 ft. from foundation?- - - NIA ® YES ❑ NO
>100 ft. from wells?- /Wig, _ qR-1- -- __ i, 0 ❑
o co0,,UT 4 20 is
-1 >100 ft. from surface water? - - ;: ® ❑
WdlR,- _ .' :;
!.-
it >10 ft. from potable water lines?- d -.:;fir/ "'■ ® ❑
Z > 5 ft. from property lines and easements? ❑ 1. Cl
d > 30 ft. from downgradient curtain/foundation drains?- - ❑ ® ❑
• Drainfield level and observation ports present - - El NI ❑
❑ Graveless chambers or IN Clean gravel used? (check one)
Proper cover installed over drainfield?- - ❑ ® ❑
Pump tank setbacks consistent with septic tank? - - LI N/A Q YES ❑ NO
• Pump tank capacity (flood) 1200 gal Manufacturer Sound Placement
< 24" access riser(s) and accessible from surface?- - ❑ ® ❑
~
a Alarm or Control Panel Installed? - - CII CI
2 Control Panel equipped with Timer/ETM /Counter- - ❑ II ❑
D
n- Pump installed in ❑ Bucket or ❑ On Block or • Other Designer Specified Pump Vault
o'• Pump Make/Model Liberty 280 ® Floats or ❑ Transducer
a.
a Tank draw down 1.5 in/min Pump capacity 3 L{ gpm Squirt Height 8 ft
Pump on time .z . J v^1 LA Pump off time w ka-..-r Daily flow set at 34,0 gpd
Updated 8/21/2018
Mason County OSS Installation Report pg. 2 Parcel# 420014090060
ABANDONMENT RECORD
Were existing septic components abandoned as part of this project? - - El YES El NO
If yes, please describe:
Were all components pumped out and properly abandoned per WAC246-272A-0300? - - Ei YES ❑ NO
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 Typical Record
Drawings contain: Drainfield&manifold orientation&layout,Septic/pump tank location,North arrow,reserve drainfiekl,existing and proposed buildings,location of wells,waterlines,
wells,observation ports,cleanouts,and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and related permits.
4PPRO ,L.
Co�NTYE2 2024
mew 4E4/741
• Record Drawing Attached
CERTIFICATION OF INSTALLATION
INSTALLER DESIGNER/ENGINEER
I certify that I 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 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
1 further certify that all information contained on this /further certify that all information contained on this
form and attached Record Drawing is accurate. form and attached Record Drawing is accurate.
L� i?i 2/24/2024 iir
Sign e of Installer Date �!�• f,
Jared Hanson
Printed Name of Signee ;
is ,�1
MASON COUNTY PUBLIC HEALTH �I
The undersigned approves this Installation Report and ir�' ".e
• E CALF
Reco rawing on behalf of Mason County Public ��'/ % IGNn
AhNNV�:im:.vi..wkno k.
H>�alth: '"-7- 04I'st s-
natu f nvi nmenta Health Specialist Date (stamp, signature and date)
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW• THE MASON COUNTY WEB SITE Updated 8/21/2018
L
?arc 4 M 46-SO0600
RECORD DRAWING (continued)
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