HomeMy WebLinkAboutSWG2023-00333 - SWG As-Built - 6/7/2024 RECORD DRAWING (ASBUILT) pg. 1 MASON COUNTY PUBLIC HEALTH
PARCEL IDENTIFICATION
Permit Number SWG 2023-00333 Assessor Parcel # 22129-24-50010
Applicant Name KARYLIN &DAVID SHOEMAKER Subdivision (Name/Div/BIocWLot)
Applicant Address 8393 E STATE ROUTE 3 LOT 1 OF LLS #06-06
City, State, Zip SHELTON WA 98584 Installer Name SOUTH SHORE CONSTRUCTION
Site Address SH9ELTON wn ROUTE
Designer Name JIM HUNTER&ASSOCIATES
,--/ INSTALLATION CHECKLIST
y� Full System Installation ❑ Septic Tank Only ❑ Drainfield Only ❑ Repair
System Type PRESSURE Pretreatment Type
15ft.from foundation? --- - -- -- - ----- - - ❑ NIA VYES ❑ NO
>50ft. from wells? .-- --- - - - - -- -- - - - - - -- - -- - - -- - - - ❑ ❑M/
Z >50 ft. from surface water? - - - - -- -- - - -- - -- - - - - --- - - ElUv ❑
FQ- Cleanout between building and tank? - - - -- - - - - --- -- - - - - ❑ / ❑
O Tank baffles present? - - - - - -- - - - - -- --- - - - - - - - --- - - ❑ El�Vv/
IL
24"access risers over each compartment?- -- - - --- --- - - - - - ❑ p� El
U1 Effluent filter installed?-- - - - - - -- -- - - - - - -- - - ---- - - - ❑ ❑
to
Septic tank size 1250 gal Manufacturer HAGERMAN
❑ D-box water level and speed levelers used? VNIA ❑ Yes ❑ No
DO Manifold/D-box accessible from surface?-Ez
❑ ��/ ❑
mZ Check valves installed? - - - -- --- -- - - - - - - - - - -- - - - - El ❑
❑� Transport Line Size 2 IN. Schedule/Class 40
Bedrooms installed (check one) ❑ 2 qp,—/3 ❑4 ❑ 5 [:IS
>10ft. from foundation?- - - - -- - - -- - - - - - - - - - - - - -- -- ❑ NIA �VYES ❑ 71i �EB:
❑ >100 ft.from wells?- ❑ spa/ ❑
W >100 ft.from surface water? - - - - -- -- - - - - -- - - --- - - - - - ❑ �L�/ ❑
LL >10ft. from potable water lines?- --- -- - -- - -- - ---- - -- - - ❑ Lip ❑
Z >5ft, from property lines and easements?- - - - - -- --- --- - - - ❑ ��/ ❑ o
> 30 ft. from downgradient curtain/foundation drains? - - -- - - -- - - ❑ ,p._p/ ❑
O Drainfield level and observation ports present --- - - - --- - - - -- ❑ Lb ❑
VGraveless chambers or ❑ Clean gravel used7 (check one)
Proper cover installed over drainfield?--- - - - - - - -- - - - -- - - - ❑ V ❑
Pump tank setbacks consistent with septic tank?-- ------ -- --- ❑ NIA VYES ❑ NO
Y Pumptanksize 1250 g �-/al Manufacturer HAGERMAN .
Q24"access riser(s)and accessible from surface?- - -- -- - -- - - - - ❑ pp ❑
N a Alarm or Control Panel Installed? -- - --- - - - - - - ---- - - - -- ❑ pa V
El
Control Panel equipped with Timer/ETM/Counter-- - -- - - - - - - ❑ V ❑ ,
a Pump installed in VBuGket or ❑ On Black or ❑ Other �/
(L Pump Make/Model LIBERTY 280 pp Floats or ❑ Transducer
a
Tank draw down 2.5 in/min Pump capacity 6.L,5 gpm Squirt Height 2.5 ft
Pump on time 1.44 min Pump off time 5 MF- G8,.,,N_ Daily flow set at 62.5 gpm
RECORD DRAWING (ASBUILT) pg. 2 MASON COUNTY PUBLIC HEALTH
RECORD DRAWING
Draiafield&
manifold orientation
&layout
Trechroed
dimensions and
oral alarm...
within layout
Sepplacement lank
placement
El Location of
hulldings
Observation parts&
clean-out locations
71 Location of wars,
arm.water,&
roads
Undisturbed native
soil between
trenches
North Arrow
If the designer or installer feel the need for additional informationlcomments,it may be attached.
Record drawing may also be on a separate page attached. No.Pages Attached
CERTIFICATION OF INSTALLATION
INSTALLER DESIGNER
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 cleared/approved by both the designer shown here have been cteared/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 cast ched Re,.ryd�Drawing is accurate. form and attached Record Drawing is accurate.
////ivDyo 5/22/2024 - -
S"=
Signature oflnstaller Data LAC A Sh-0�w
RICHARD MOORE _
Printed Name of Signee nr '",rr
MASON COUNTY PUBLIC HEALTH °!�
The undersigned approves this Installation Report and Y r
Record Drawing on behalf of Mason County Public �'' rZA. j w'i E
Signature of Environmental Health Specialist Date (designers stamp, signature and date)
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE
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