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Home My WebLink AboutSWG2022-00040 - SWG As-Built - 7/12/2024 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/PERMIT INFORMATION Permit Number SWG 2022-00040 Parcel# 32127-51-00259 Applicant Name Walter&Nancy Comehl Subdivision (Name/Div/Block/Lot) Applicant Address 631 E ST Andrews Dr. City, State,Zip Shelton,WA 96584 Installer Name B-Line Construction Inc Site Address 631 E SLAndrews Dr. Designer Name INSTALLATION CHECKLIST ❑ Full System Installation 0 Tari Only ❑ Drainfield Only ❑ Repair ❑Other System Type Pressure Pretreatment Type >5ft.from foundation? ----- ----------------------- ❑ NIA ❑YES E] NO >50ft.from wells? ----- - ----------------------- ❑ ❑ ❑ Z >50 ft.from surface water? --- - - - ----- El ❑ El Cleanout between building and tank? --------- -- ----- ❑ ❑ ❑ U Tank baffles present? - - - ----- - - ---- - - ---- -- - ---- ❑ ❑ ❑ a24"access risers over each compartment?--- -- --- - - ------ ❑ ❑ El IW Effluent fitter installed?---- - - - ---- -- ----- - - -- - - - -- ❑ ❑ ❑ Septic tank capacity(working) gal Manufacturer O D-box water level and speed levelers used? ------ ---- - - --- ❑ WA ❑ YES ❑ NO 00 Manifold/D-box accessible from surface?-- ❑ ❑ ❑ a?a Check valves installed? ---- - - - - - --- - ----- - ------- ❑ ❑ ❑ OQ f Transport Line Size Schedule/Clan Bedrooms installed(check one) ❑ 2 ❑3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10 ft.from foundation?-- - - ------------ -- ❑ WA ❑ YES ❑ No >100 ft.from wells?---------- -- ------------------ ❑ ❑ ❑ W >100 ft.from surface water? - --- - ---- - ❑ ❑ ❑ LL >10ft.from potable water lines?- - - ----/1 ,,,,0W 1� ❑ ❑ ❑ _ >5 ft from property lines and easements?-�uA�um� N-F❑ ❑ ❑ >30 ft.from downgradient curtain/foundation drains? --- - ----- - ❑ ❑ ❑ G Drainfield level and observation ports present --- - - --- - ----- ❑ ❑ ❑ ❑ Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?-------------- ------ ❑ ❑ ❑ Pump tank setbacks consistent with septic tank?--- -------- - - WA YES YES ❑ No !le Pump tank capacity(flood) gal Manufacturer M.,00 Q24'access riser(s)and accessible from surface?------------ - ❑ El F-a Alarm or Control Panel Installed? --- - -- --- - - - - -- - - ---- ❑ El jControl Panel equipped with Timer/ETM I Counter- ---- - - --- - ❑ ❑ �- a. Pump installed in ❑ Bucket or ❑ On Block or ❑ Other �- Pump Make/Model Oranco ❑ Floats or ❑Transducer :3 Tank draw down in/min Pump capacity gpm Squirt Height ft a Pump on time Pump off time Daily flow set at gpd u�vaamrzo,e Mason County OSS Installation Report pg. 2 Parcel n 32127-51-00259 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? --- -- - ---- - -- - - ❑ YES NO If yes, please describe: Were all components pumped out and property abandoned per WAC246-272A-0300? - -- - ElYES NO RECORD DRAWING This Is a permanent record and must he acwrafe aM tlwcrlgNe erougk he rai In the naaJ of malrNnantt ecHHists aM fuNrt development Typical Recom OmvAnpc camain: Oranfiee 8 nurNob cnenletion 6layout SepWpump Wk bra6m,NatM1 arrow,neerve dramfield.esisting end yapose0 hultinpa,brallm M walk.waterllnez, halls,abxmtimn pas tleemuls,and other mandemnce access point. Incomplete Recent n,anings may croak addMnnal dents in fin9 translation approval and related permis. pgRecord 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 cleamdyapproved by both the designer shown here have been cleared/approved by both and Mason County Public Health and meet all State myseN 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. Sign ure oflns(all Date T Pri ten dName ofSignee MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and Record Drawing on behalf of Mason County Public Health: Signature ofEnvironmenta/Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCAN NED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE "WhadeTrzdta RECORD DRAWING continued ! " Zvi CB'07MY�i • QeP�o 4��' C z ..yGO " Pv...r vaalt) i i I �G I 3 3' — 1 I APPROVED FEB 2 3 2022 MSYN COUtiTYElMRoWEWAL NET 1 !!! Lyc SU . aa zs-y Pump Basin with Effluent Pumping Assembly bodW Pnrl cx.nPnl vale PvendYv bbdel Pcwpmeceswemd tawnb uodd_ Mow &ed Bdh _._ WKOWd rIGoe M.M Gdps pletlletyeAssemdy Mudd_ MOdd__ conduit to tonb0l Pmd EIMMt Ma 19e ConbuYSW Pkride Hose blotld MB Wt i Tqe to Fit SaNtnq Tx lend COMB Fin Priory Tan ---- -- FIWAwttcnbIY (Flouts OM be MOWI__ kmrged 10 AND. inW BrOed n Prvnnry Tank ) Rbmtdecs PUMP Beck Fbr eMucer— MOdd— FeM tut <' Pipe 10 Ft boomp^ Box utend B' BMW Bmh Niel N�"m eYlkem FtPtP Pita cnr dv Modd__ MOybtPump Vea! MOW NOW-4.0 (05 21 Rev. 4.0 (OS/2Q 4720Y1. Ordim Syaleme, inc. APPROVED FFB 2 3 2022 "ON COUNT'(EH1TJ.1('C*EN7PUHFA�