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Home My WebLink AboutSWG2019-00059 - SWG As-Built Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/PERMIT INFORMATION Permit Number SWG2 01 9-000 5 9 Parcel# 12330-52-00066 Applicant Name Taws Crutchflled Subdivision (Name/Div/Block/Lot) Applicant Address 200 NE Larson Lake Ln Beards Cove Div 5 Lot 66 City, State, Zip Belfair,WA 98528 Installer Name Josh Peterson Site Address Same Designer Name Lawrence Purdum INSTALLATION CHECKLIST ❑ Full System Installation ❑Tank(s)Only ❑ Drainfeld Only ® Repair ❑Other System Type Pressure sed Pretreatment Type >5 ft. from foundation? ---- --- --- --- - -- -- - - - -- - --- ❑ NIA EZYES NO >50ft. from wells? - - -- - - -- --- - -- - --- - -- - ® El Z >50ft.from surface water? -- - - - - - - - - - - - - - - - - - - - --- ❑ ® ❑ r Cleanout between building and tank? ----- -- - - - - - ------. ❑ ❑ U Tank baffles present? - - - - - - - - - ----- --- - - - - -- ---- ❑ ® ❑ a 24"access risers over each compartment?- -- - - - -- --- -- --- ❑ ❑ rlu Effluent filter installed?- - -- _-- - _ -- -- ❑ ® ❑ Septic tank size 1,0()0 cal Manufacturer Hagerman Precast D-box water level and speed levelers used? - - - - - - --- - - - -- - NIA ❑ YES ❑ NO OLL Manifold/D-box accessible from surface?- --- - -- - - -- - --- - . ® El El CQCheck valves installed? - --- - - - - -- - - ------ - ® ❑ ❑ Transport Line Size 2" Schedule/Class 40 Bedrooms installed(check one) ❑ 2 03 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10ft. from foundation?- _ _ ___ _ _ ___ _ _ _ _ __ _ ____ _ _ _- ❑ N/A ® YES ❑ No O >100 ft. from wells?- - -- - - - - -- ----- -- -- -- -- -- -- - - ® ❑ ❑ W >100 ft. from surface water? - --- - - - --- - -- -_ -- - _ _ -- - ❑ ® ❑ LL >10ft.from potable water linesT---- - -- - -- -- --- ----- -- El ® ❑ Q >5ft. from property lines and easements?-- - - - - - -- ---- _ _- ❑ ® ❑ K > 30 ft. from downgredient curtainHoundation drains?- - - - - - --- - ❑ ❑ Drainfield level and observation ports present - - - --- ❑ ® ❑ ® Gmveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?-- - - - -__-- - - ❑ 91 ❑ Pump tank setbacks consistant with septic tank?--- - -- - - -_- -- ❑ NIA ® YES ❑ No `1 Pump tank size 1,000 cal Manufacturer Hagerman Precast Z Q 24"access riser(s)and accessible from surface?-- ---- El ® Ela Alarm or Control Panel Installed? - -- - -- - -- - - - -- - -- - -- . ❑ ® ❑ E Control Panel equipped with Timer/ETM/Counter--- - - - - - - - - ❑ ® El a Pump installed in ® Bucket or ❑ On Block or ❑ Other Pump Make/Model Liberty LP-280, 1/2hp, 115v ® Floats or ❑ Transducer a Tank draw down 1.75" in/min Pump capacity 38.5 gpm Squirt Height 5 ft Pump on time 78 Seconds Pump off time 4 Hours Daily flow set at 299.94 gpd uoea wi mie Mason County OSS Installation Report pg. 2 Parcel n ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - -- -- - - ---- -- - . ❑ YES ® NO If yes, please describe EX septic tank was retained Were all components pumped out and properly abandoned per WAC246-272A-0300? -- ---- -- 0 YES 0 NO RECORD DRAWING This Is a Parrmmnt wind and moat N accmata and da criptive anoWh to raAObata M 0u mad al rmiMar,me astivklas am fuwra davab D.n,,Wplam parnrrab AmandO!d man2:ipn aaycN PnlarR TyOCe�Rewrd y SMUflpump[anF Igatpp,NMn irtpw rafaNa dgm4eld 4r91mp 0nd ProppSad belion9a, M ,eon pMRNa,w8tttlrnas werk ovdeMpUpn[Oka.cleanoNa antl dne rm:menance aceu Punta rrp ,lee Record CrSenpt ma,,.ad.ddkonaideiayarn 9nar mMa!raubn ao¢arel and n,sMd perm:§ ® Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ENGINEER I cert/fy 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 cleareclapproved by both the designer shown here have been clearedapproved 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 /further certify that all information contained on this fornyliNd attached Record Drawing is accurate. form and attached Record Drawing is accurate. Sign re of Installer Date Printed Name of Signee m MASON COUNTY PUBLIC HEALTH 9I// The undersigned approves this Installation Report and Record Drawing on behalf of Mason County Public ::!:qW.:47MM,Ry. um-. Health LICENSEDDES f7z yl�Signature of EnVirOnmental He Rh Specialist Date (stamp, signature and date) THIS FORM MAYBE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE U0.i,1Y21'x+5 Rhonda Thompson From: Dennis Nichols-Apex Septic Design <dennis@apexseptic.com> Sent: Friday,July 12,2024 3:36 PM To: Rhonda Thompson Cc Larry Purdum-Apex Septic Design Subject: Record Drawing Site 200 NE Larson Lake Ln Attachments: Crutchfield AsBuilt.pdf Caution: External Email Warning!This email has originated from outside of the Mason County Network. Do not click links or open attachments unless you recognize the sender, are expecting the email, and know the content is safe. If a link sends you to a website where you are asked to validate using your Account and Password, DO NOT DO SO! Instead, report the incident. Hello Rhonda, Here is the Record Drawing(AsBuilt)for 200 NE Larson Lake Ln, PN: 12330-52-00066. 1 have also attached an email to it that shows that we asked Alex if we could make it a 12x40 pressure bed instead of the original10x40. Larry and myself could not find any emails from him about it so we are assumingthat it was approved via a phone call. If you have any questions feel free to give us a call. Thank You. Dennis Nichols Apex Septic Design (253)509-9922 t From: Shaun Freeman-Apex Septic Design shaun@apexseptic.com af Sublaet Feel:200 NE Larson Lake LN/12330-52-00055 Date: May 8,2019 at 11.36 AM To: Wendy Jonas monas@co.mason.wa.us Cc: Josh Peterson KATTRAXJOSH®(iMAILCOM Begin forwarded message: From: Shaun Freeman - Apex Septic Design<sha n apexse tig c.com> Subject:200 NE Larson Lake LN/12330-52-00066 Date:May 8,2019 at 10:05:07 AM PDT To:Alex Paysse<ale apc...... n wa e> Cc:Josh Peterson <KATTRAXJOSH@GMAIL COM>, "Apex Septic Design, LLCn <Jesnnerda xs ' .com> Hi Alex, Good morning,I just left you a voicemail but wanted to followup with an email as well.I'm attaching the approved septic design in question.When the installer cosh with Kat Trax) measures from the existing septic tank,he is finding that the 45' long pressure bed with not fit and stay within the property boundary. Larry is proposing that a solution could be a 12' x 40' pressure bed instead,but we know that typically pressure beds are not to exceed 10' in width. We're hoping to get your input on this as soon as possible since this is a repair, they've got tanks coming today and want to get this instilled quickly.If you agree with Larry's solution what would you like to see from us to address the non-conforming 12'wide bed ?Were happy to complete a waiver justification letter and email it over to you if you'd like—would they be able to continue with installation before that paperwork is officially reviewed and approved by MCPH ?Just let us know and we'll get whatever you want to see turned around ASAP Thanks so much,Alex! Talk soon. 12330-52-0006 6 CRU...LD.pdf Sincerely, Shaun Freeman Technical Documentation OSS Design Apprentice Apex Septic Design,LLC (253) 509-9922 - Main Apex septic Decigo LLC makes no.—nry of ary kind,expressed er implied.e ich mspecc ro the amched file(s)or information contained In the email.The weninp/use of dre avazhal file(c)or ime,mation contained In this email commmoss an agreement by the receiver ch indemnify.delend and hold harmless Apex sSeepon De er eign u umessII Ia oRcea.end employees from and against any and all daima.sum,losses,damages or cos¢Incurred hem using the amched file(s). The nsk and lability for any losses,darnMeaclams or expense,resulting from the use or possession of arty files)received by Apex septic Design LLC The oRcal comma documents andlor desipisand associated documents of raoN an,those paper,"Ian orwilum documents produced by Apex Seem Design,LLC which bear the oche r seal and w 4nk licensed designer seal and signatures. 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