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Home My WebLink AboutSWG2024-00235 - SWG As-Built - 8/6/2024 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2024-00235 Parcel # 32127-51-00295 Applicant Name MICHAEL HAYWARD Subdivision (Name/Div/Block/Lot) Applicant Address 60574TH AVE NE City, State, Zip SEATTLE,WA. 98115 Installer Name SHOENING EXCAVATION Site Address 830 E ST ANDREWS DR Designer Name CINDY WAITE INSTALLATION CHECKLIST ® Full System Installation ❑Tank(s)Only ❑ Drainfield Only ('��-'I Repair ❑Other System Type PRESSURE DIST W(reatment Type BNR 500 >5 ft. from foundation? -- W- - ❑ NIA ®YES ❑ NO >50 ft. from wells? - - - - - -- - - _ _ _2 >50 ft. from surface water? - - - - - - - - ❑ ❑HCleanout between building and tank? -- ❑U Tank baffles present? - - - - - - - _ _ _ -a 24"access risers over each compartmen . -. ❑ ❑ Ul Effluent filter installed? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ❑ ❑ ❑ Septic tank capacity (working) 1018 at Manufacturer HAGERMAN BNR 500 O O-box water level and speed levelers used? _ _ _ _ - _ _ - ❑ WA vss ❑ No DO Manifold/D-box accessible from surface?- - - -- - - - - - - - - - - - - - ram- ® ❑ mZ Check valves installed? - - - - - - - - - - - - - - - - - - - -- - - - - - - ❑ 2 Transport Line Size 2 Schedule/Class SCHEDULE 40 Bedrooms installed (check one) 92 ❑3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10ft. from foundation?- - - - -- - - - - - - - - - - - ----- - - - - ❑ N/A ® YES NO >100 ft. from wells?- -- -- -- - -- - - - - - - - - --- - -- - -- - - ❑ ® ❑ W >100 ft. from surface water? - - - - - - - - - - - - -- - - -- - - - - - - ❑ ® ❑ 2 >10ft. from potable water lines?-- - - - - - _ - - - - - - - - - - --- . El IN ❑ > 5ft. from property lines and easements?- - - -- - - - - - - - - - . ❑ ❑ > 30 ft. from downgradient curtain/foundation drains?- - - - - - - - - - ❑ ❑ Drainfield level and observation ports present - - - - - - - - - - - - -- ❑ 0 ❑ ❑ Graveless chambers or N Clean gravel used? (check one) Proper cover installed over drainfield?-- - - - -- - - - - -- - - --- . ❑ ® ❑ Pump tank setbacks consistent with septic tank?- - - - - - ❑ NIA YES ❑ NO Z Pump tank capacity (flood) 1585 at Manufacturer HAGERMAN H24"access riser(s)and accessible from surface?-- - _ . ❑ ® ❑ d Alarm or Control Panel Installed? - - - - -- - - - - - - - - - - - -- -- ❑ 0 ❑ Control Panel equipped with Timer/ETM/Counter- - - - - - - - - - - ❑ ❑ _a Pump installed in ❑ Bucket or M On Block or ❑ Other 4 Pump Make/Model LIBERTY 280 ® Floats or ❑ Transducer a Tank draw down 1.0 in/min Pump capacity 41.25 gpm Squirt Height 5 ft Pump on time 1.1 MIN Pump off time 6 Daily flow,set at 180 opd VOGeIe]P1112018 Mason County OSS Installation Report pg. 2 Parcel x 32127-51-00295 ABANDONMENT RECORD Were existing septic Components abandoned as part of this project? -- - - - - - - - --- - - - m YES ❑ NO If yes, please describe: Were all Components pumped out and properly abandoned per WAC24&272A-0300? - - -- - - - - ❑ YES NO RECORD DRAWING This b a permanent mom and mutt M accurate and descrlpYve enough to ratocete In the need of maintenance activities and future development Typical Recatl IXewings¢mein: Crinkled It mankind aMnitlbn&dinner,SexUW mp lank location,Norm anow roeervs IXaNMN,—sing antl pmpoeed oulldinga.Iorelbn media.w dersedq aellc,conservation pMa,demands,and mMrmeimena xe e¢ess gains mompldta Rmand Craxings may create udditiond delays in Mel inatalle om approval and related pdrom, o Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ENGINEER l 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 cleared/approved by both and Mason County Public Health and meet all State myselfand 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 antl a ached Record Drawing is accurate. form and attached Record Drawing is accurate. 7 ; 74- Signa ere of Installer Date .a1-lF 211t YP f9� Y Panted N me of Signee Jtls tp �� Z W MASON COUNTY PUBLIC HEALTH d The undersigned approves this Installation Report and AA' 's Is- p CINnv E WAtTE Record Drawing on behalf of Mason County Public LICENSED DESIGNER Health: txn,aks 15,td. ��vvvtn �► el� �z� Signature ofEnvironmental Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE upameee r'.mm r C AA,2r, rr( APPROVED AUG Qdi 2024 . S ` MASON COUNTY ENVIRONMENTAL HEALTH ° RET CZ), ..I .p 1. Residence 2. Garage out building 3. Audio visual alarm 4. Clean out 5. BNR 500 Nuwater 6. 1500 gallon pump tank 7. Transport line(to be cased) J 8. Valve Box 9. Drainfield 10. Existing 1000 gallon tank (use as a trash tank) � ) 11. Waterline (transport line ^r to be cased) Large cedar tree to be removed, backfilled with �g /ro ;1v^d C33 sand YE TE LICENSEp DESIGNER EMPIaES 0Y1% 1� S�. ,; so - - 1 A pp UNryEh� v. Ic 06147y �`NN Z Rf? '474q HEa[r I/j(17 9 ti Qabsr,�„K,l,.. per0�ckaas,/�� 1..:•/ e�NFe v*b K Cry \ I � � IJerrh ClND YE WAITE� . ee 'LICENSED GESIGNER ns ;m Y 31,