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Home My WebLink AboutSWG2020-00239 - SWG As-Built - 7/11/2024 ! Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SVJG 2020 00239 Parcel# 22233-52-00019 Applicant Name 518 Home Solutions LLC Subdivision (Name/Div/Block/Lot) Applicant Address PO Box 134 City, State, Zip Grapeview We 98546 Installer Name Shumaker Construction Site Address 2221 E Mason Lake dr East Designer Name 7, INSTALLATION CHECKLIST ❑ Full System Installation Tanks)Only Drainlieltl Only ❑Repair ❑Other System Type Pretreatment Type >5 ft.from foundation? -----------------y---------- ❑NIA YES NO >50 ft. from wells? ------------------ --- - -- - -- - - ❑ e ❑ 2 >50 ft.from surface water? .-- ----------------- ---- ❑ ■ ❑ FCleanout between building and tank? ------------------ - ❑ ■ ❑ U Tank baffles present? .- -- - - ---------------- -- --- ❑ . ❑ F 24"access risers over each compartment?------------ - --- ❑ . ID y LU Effluent filter installed?.------------------------- - ❑ . ❑ Septic tank capacity(working) 1250 cal Manufacturer Haoermen's 0 D-box water level and speed levelers used? -------------- . EWA j ❑rise ❑ rvo Man'rfold/D-box accessible from surface?-- ---------- ---- - ❑ ❑ QQ Check valves installed? . - - - - - - - - -- ------------ -- .. . ❑ ❑ 2 Transport Line Size 2- Schedule/Class 40 Bedrooms installed(check one) ❑ 2 ❑3 ❑4 ❑ 5 ❑6 ❑Commercial/other >10ft.from foundation?------- -- ---------------- - 0N/A ❑YES NO G >100 ft.from wells?-- ------------ ------------ - -- ■ ❑ ❑ W >100 ft.from surface water? --- --------------------- ❑ ❑ Z >10ft.from potable water lines?------------------- --- ! ❑ ❑ a > 5ft.from property lines and easements?------------ - - - - ! ❑ ❑ Q > 30 ft.from downgredient curtain/foundation drains?----- - ---- 0 ❑ ❑ Drainfield level and observation ports present -- -- -- ---- -- -. e ❑ ❑ ❑ Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?---- ----- --------- - N ❑ Pump tank setbacks consistent with septic tank?------------ - ❑ NIA E YES ❑ No Y Pump tank capacity(flood) 1000 at Manufacturer Hagermen's Z F 24"access riser(s)and accessible from surface?----- -- ----- - ❑ ® ❑ y Alarm or Control Panel Installed? ----------- - - - - - - - --- ❑ ❑ Control Panel equipped with Timer/ETM/Counter-- - -- - - ---- ❑ ® ❑ IL Pump installed in a Bucket or ❑ On Block or ❑ Other 111. Pump Make/Model Liberty 280 0 Floats or ❑Transducer 1 Tank draw down 2 in/min Pump capacity 50lipm apm Squirt Height N/A ft Pump on time 2min Pump oBtime 6 hr Daily flow set at 328 apd uoesw n,rnne Mason County OSS Installation Report pg. 2 Panel# 22233-52-00019 ABANDONMENTRECORD Were existing septic components abandoned as part of this project? - - Q YES NO If yes, please describe: Were all components pumped out and properly abandoned per WAC246-272A-0300? -- ---- - - m YES No RECORD DRAWING ♦n,.J.a pa—an rewN and mu.r ba.cmnY and dueanW.aneuen m rslaut.In Off--of melmearcna ece.ltle..ad ruwn em.m,n a. T11-1 n—ld Drawmea caddm DrelnfeN a menked oeaN.ennrniaomm.sepfmrpbmp tank l000tan.Nmu as .,eaeN emmnza..anang am mnro bupolpps.lanxIon of w.us.r afaamea. wena.om..xnon pwfe,a.anpuu,em omm malmenanaa acceaa poems. o-complefa ne<pm ore naa mar u.aa aeaiaanal aeura In noel mawwmnappm"m ana elmea pamn.. Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ENGINEER 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 cleareclVapproved 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. 417 11 Signatuurrreee o`f'Installlerr� // Date /'//a.'GYI 4 w.1"1� Prrnted Name o1 Sign" MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and Record Drawing on behalf of Mason County Public Health: -7 Signature of Environmental alth Specialist Date (stamp, signature and date) THIS FORM MAYBE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE upea.eN IMIS I '75� ')CCY 1C YJAkI / \ y�'G" ha„sc � wakr 5 F Lk& Tar vvlH SD aG"I Zp 1✓ S ThtW[�t� i 00nlrn EYJr!;yJ Ili y� +anks 1Ue\1 CI' �_Zp ` '.mil �n t kN x APPROVED nsoN_ UN GO JUL 1 1 2024 EHVROHMENTgLHEq��{ ITOPOGRAPHV PROFILE:_ � i �E Permit number. 2.c�ZJ ' OOZ $ f Direction Brale: 'Ih Za—ITAppmval:woMkauw Building: Owner/Applicant 5/$ /¢,h„ g,j,h4_41C Planning: _— — — Date of -- Parcel Number 22L73-f2 - 600 /9 .application: i Env. Health: