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Home My WebLink AboutSWG2023-00511 - SWG As-Built - 5/3/2024 MASON COUNTY PUBLIC HEAL Mason County OSS Installation P LICANTI Pport Pg. 1 ERMIT INFORMATION c B Permit Number SWG 2023 00511 Parcel# 32010-31-50160 it Emil Davis Subdivision (Name/Div/Block/Lot) Applicant Name � 297 NE Kissln Tree Ln Swindler's Cove Eslatesl Lot 6 Applicant Address City, State, Zip Tahu a WA 98588 Installer Name Shumaker Construction Designer Name Artow Sap tic s Inc Site Address E Swindlers Cove Rd,Shelton INSTALLATION CHECKLIST ® Full System Installation ❑Tank(s)Only ❑ Grainfield Only ❑ Repair ❑Others Gravity Trench Pretreatment Type--�❑— System Type No NIA �YES >5 ft.from foundation? ------ "" ❑ o11 >50 ft.from wells? --- - -- -"""--- __ _ _ _ _ _ _ ❑ ® ❑ Z >50 ft.from surface water? -- - -- "-- " - ® ❑ r Cleanout between building and tank? - --- - t s-� F4 ❑ ❑ O Tank baffles present? --- - - --- - " - -- -" -- - ❑ ❑ a 24"access risers over each compartment?- ---- -- _- _ 4 ❑ -_ _ _ __ _ ____ _ _______ LJ N Effluent filter installed? He erman (working) 1 Septic tank capacity ( 9)�250 gal Manufacturer--- No G D-box water level and speed levelers used? - -- ----"- - MIA ®yas J ---------- ---- - El❑ QO Man"rfold/D-box accessible from surface? ❑ mZ Check valves installed? -- -- pp .4 SchedulelClass 40 q• M Transport Line Size 4' ❑6 ❑CommerciallOther Bedrooms installed (check one) ❑ 2 ❑3 ®4 ❑ 5 ❑ NIA ® YEs ❑ No >10 ft.from Clfoundation?--------'"- - -_ ____ _______ ___ _ ❑ _ __ _ ___ _ O >100ft.from wells? _ _ _- ® ❑ W >100 ft.from surface water? - - - ----- "--- - -- ---- -- - - - ❑ ® ❑ LL >10ft.from potable water lines?- - ---- - --" - -- ❑ ® ❑ Z' > 5ft.from property lines and easements?--- ---- -"- ® ❑ Q ® ❑ K > 30 ft.from downgradient curtaintlountlation drains?-- - - --- - -- ❑ Drainfield level and observation ports present - ---- ---"- _ -- - ❑ Graveless chambers or M Clean gravel used? (check one) ❑ ® ❑ Proper cover installed over drainfield?--- - -- ' No ? ❑ NIA ❑ VEs tank setbacks consistent with septic tank. -- - --- - '-' "-- P flood) gal Manufacturer ❑`1 24 tank ce 111 Q24"access rise f(s)and a ble from su-ace?-- --^-'--" ❑ ❑ ❑ ~ Alarm or Control Panel Installed? --- -- ' - - " --- ❑ ❑ ❑ n' with Timer/ETM/Cou - `G Control Panel equipped M k or ❑ a_ PUMP installed in ❑ Bucket or oc ❑ Flo r ❑Transducer a- Pump MakelModel ft � Tank dra iNmin Pump capacity gpm Squirt Height a Daily flow set at ump on time Pump off time u�,,.aemrzoe Mason County OSS Installation Rep Parcel# 3201031,50160 ABANDONMENT RECORD [3 YES ® NO Were existing septic components abandoned as Part Of this project tt yes.Please describe: YES NO Were at ems compon Puri out and Property abandoned Per WAC24fr272A-u300? '--'- - RECORD DRAWING ,.:aal..naa.:mv�P eee wPx•�wr+a�rss..'ovm�w.nos,ow PxMRMN 11ds le a prmanMt rtcoltl C.J mast be a'eWep eM tleaenptive enaugM1 to a{ocets�n iM nsaE ar maiManence ac11Vi4ea �rWun EeuebPmaM Try"UI Raco pp.Frya mrJan'. fkehfie4i8 ranibvl oienleiin fllryout SeWc'peR�,��Bamrtlemiga maY aeaL aMiEaM1J°MlemTfintl ins9tlY'ua epwMeM eebbtl . vreYa,apservaLon pmS.cbapa5.antl alM1er manttranLa ucess Wma ® Record Drawing Attached CERTIFICATION OF INSTALLATION DESIGNER]ENGINEER INSTALLER I certify that I installed the system in acorordanos 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 shown Mason County Public Health and that any deviations County Public Health and that any deviations here have been clsared/sppmved 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 on County Codes. State and Mason County Codes and Mas !further 0h Cothy that all In afion contained on this i further certify that all information contained on this °� form and attached Record Drawing is accurate. form and attached cord Drawing is accurate. fit— 9% faze t Sgnatt, pf Installer Data P' tad Name ofSignee `�'. ,� "� MASON COUNTY PUBLIC HEALTHi... The undersigned approves this Installation Report and M1'`""s %+- <e PAULA JOY JOHNSON Y /� ty t''I:Im 4o DeStGNrR Record Drawing on behalf of Mason COun Public \- .1 Health: (stamp, signature and date) Sgnature olEnvimnmenral eatth Specialist Date cws==erz :otl THIS FORM.MAY BE SCANNED PND AVAILABLE POB PUBLIC VIEW ON THE MASON COUNTY WEB SITE 2ZI Bay er= �Mt � bA� 15 �L�32A10_3\- SO lCoO E S�.tiNDLERS Gov Ra ��ToN Wfk gg584 VEG �lniti � 1 o- 3DN too � 5a^1 Qe rao,\S t e�raly inea 50%4� s(c d 41-: 0-62° \oa A roots,)52--75, cg pt mod, c�ancP s�9s0N� ti/4y �(�F ges ��ryF; �31p1 5O AefA t cleanout l A,� '�=<... 4 SNoRf1,1t3E $uFfEF •�'• J I 2 1,250 Gallone?P�th Efrluent Filte O 2-Compartm - M V\ OD-gox with speed-levelers and Over m surface GA 0. FcS"�re' a Slao1U j t PAOLR J!)Y JONNSOu }5i "� 1 lk.�l±jJ�rhy�l NEYi" Lb/13 � fOVLLtK, 'S cav 4-f'�-z�Y Pwe / gW F RD 60 C✓ road ea.,{ y