HomeMy WebLinkAboutSWG2023-00465 - SWG As-Built - 9/19/2024 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH
APPLICANT/ PERMIT INFORMATION
Permit Number SWG 2023-00465 Parcel # 32021-56-02028
Applicant Name ROBERT STEWART Subdivision (Name/Div/Block/Lot)
Applicant Address 550 E WOOD LANE
City, State, Zip SHELTON,WA 98584 Installer Name SCHOENING EXCAVATING LLC
Site Address 560 E WOOD LANE Designer Name CINDY WAITE
INSTALLATION CHECKLIST
0 Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑ Repair ❑Other
System Type PRESSURE DIST Pretreatment Type
>5 ft. from foundation? Q NIA ❑YES NO
>50 ft. from wells? - - - - - - ir===fit' Q ❑ ❑
Z >50ft. from surface water? - - - - - - - - - - -- - - - - - - - - - - - - ❑ x El
FCleanout between building and tank? -- - - -- - -- - - 0 ❑ ❑
O Tank baffles present? - - - - - - - - - - - - - - - - - ❑ ❑ ❑
a 24" access risers over each compartment?- - - - - - - -- - - -- -- - El ❑
W Effluent filter installed?- - - - - -- - ® ❑ ❑
Septic tank size 1250 gal Manufacturer HAGERMAN
0 D-box water level and speed levelers used? - - - - - - - - - - - - - - - M NIA ❑YES ❑ NO
J
00 Manifold/D-box accessible from surface?- - -- - -- ❑ ❑
LL
m2 Check valves installed? - - - - - - - - - - - - - - - ❑ ® ❑
QQ
E Transport Line Size 2 Schedule/Class SCHEDULE 40
Bedrooms installed (check one) ❑ 2 0 3 ❑4 ❑'5 ❑6 ❑CommerciallOther
>10 ft. from foundation?-- -,ZyY,y 1!__ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ Q NIA ❑ YES ❑ NO
>100 ft. from wells?- -- -Q-'A-AO, _*x --- - - -- - - ❑ ❑
W >100 ft. from surface water? -- -- - - -- -- - - ❑ M El
LL >10ft. from potable water lines?---- -- -- -- - - ❑ ❑ ❑
2 > 5 ft from property lines and easements?- - - - ❑ 0 ❑
K > 30 ft. from downgradient curtain/foundation drains?- - - - - - - - - - ® ❑ ❑
Drainfield level and observation ports present ❑ ❑
❑ Graveless chambers or Q Clean gravel used? (check one)
Proper cover installed over drainfield?- - -- - -- - - - -- - - - - - - - ❑ ❑ ❑
Pump tank setbacks consistant with septic tank?--- - - -- - -- - - - ❑ NIA Q YES [:1 No
`1 Pump tank size 1250 gal Manufacturer HAGERMAN
Q24" access riser(s)and accessible from surface?- - - - - - - - --- - -
IL ❑ ® -�,,,,rf11 ,�pyf ❑
IL Alarm or Control Panel Installed? - - - - - - - --- - - - - -- --- --
Timer
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❑
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2 Control Panel equipped with mer/ETM/Counter- - - - - - - - - - - ❑ uv \q
_a Pump installed in E] Bucket or E On Block or ❑ Other A\ t\
IL Pump Make/Model LIBERTY 250 ❑ Floats or ® Transducer
2
M Tank draw down 1.5 in/min Pump capacity 34 gpro Squirt Height 4 ft
Pump on time 2 Pump off time 4 Daily Flow set at 270 gpd
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Mason County OSS Installation Report pg. 2 Parcel u 32021-56-02028
ABANDONMENT RECORD
Were existing septic components abandoned as part of this project? - - - - - - - - - - - - - - - ❑ YES Q NO
If yes, please describe'.
Were all components pumped out and properly abandoned per WAC246-272A-0300? - - -- - - - - ❑ YES ❑ NO
RECORD DRAWING
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closings oxaa'rr Oramald s manifold orientation a iayaM1 sepau;fi a p fork loratb4 Norm arrow,rexne mail examine and prcppsM Iwddangs.bunion of walls,andommes,
wall,oMenmkn pans,dismal and di er mamenunce soma qmu. IMomplme Rai Drawings may mate addnplvl fill an final Installation appravm and reamed somas.
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0 Record Drawing Attached
CERTIFICATION OF INSTALLATION
INSTALLER DESIGNEW ENGINEER
I certify that I installed the system in accordance with 1 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 hen;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.
Signature of Installer Date
/J G { AEXPIRES�'10,
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MASON COUNTY PUBLIC HEALTHThe undersigned approves this Installation Report and Record Drawing on behalf of Mason County PublicHealth: ^`
Signature of Environmental Pealth Specialist Date (stamp, signature and date)
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE updated enlrzwe
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