HomeMy WebLinkAboutSWG2022-00442 - SWG As-Built - 10/22/2024 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH
APPLICANT/PERMIT INFORMATION
Permit Number SWG 2022-00442 Parcel# 320215502021
Applicant Name Glen Butcher Subdivision (Name/Div/Block/Lot)
Applicant Address LLC, PO 13OX 1273 SHORECREST TERRACE 2NO ADD, Lot 21 Block
City, State, Zip BOTHELL WA98041 Installer Name Jim Zmny
Site Address 221 E WOOD LANE.Shelton Designer Name Max Walker
INSTALLATION CHECKLIST
Full System Installation ❑Tank(s)Only ❑D onfield Only ❑Repair ❑Other
System Type Pressure Distribution Pretreatment Type
>5 ft.from foundation? -- --- ---- ------ ---- -------- ❑NIA Eyes NO
>50ft.from wells? - -_ __ _ __ _ _ _ ___ _______ _____ _ _. ❑ ❑
Z >50 ft.from surface water? - ---- ---- ---- ----------. ❑ ❑
F Cleanout between building and tank? -- -----------------
❑ ❑
O Tank baffles present? -- ---- - --- --- --- ---- -------
❑ ® ❑
a24'access users over each compartment?-------- -- ------ ❑ ❑
rW Effluent fitter installetl?--------------------------- ❑ El
Septic tank capacity(working) 1200 gal Manufacturer Hagerman
D-box water level and speed levelers used? --------- ------ . N/A ❑YES NO
�O Manifold/D-box accessible from surface?----------------- ❑ ❑
m= Check valves installetl? -- ---- - ----------- -- ---- - -
❑ ❑
OQ
f Transport Line Size 2" Schedule/Class Sch 40
Bedrooms installed (check one) ❑ 2 ®3 ❑4 ❑5 ❑6 ❑Commercial/Other
>10ft. from foundation?----- -- -- ----- ------ ------ ❑ NIA . yes NO
>100 ft.from wells?-- - -------------------------- ❑ Cl
W >100 ft.from surface water? ------------------------ ❑ E ❑
LL. >10 ft. from potable water lines?----- --------- -------- ❑ 0 ❑
aZ >5ft.from property lines and easements?- --- ----- - ---- ❑ 0 ❑
¢ > 30 ft.from downgradient curtain/foundation drains?---- ----- - ❑ ® ❑
Drainfiekt level and observation pods present - -- -- ❑ e ❑
❑ Graveless chambers or E Clean gravel used? (check one)
Proper cover installed over drainfield?-- --- - ------- - --- -- ❑ ❑
Pump tank setbacks consistent with septictank?------------- ❑ NIA dyes NO
ZPump tank capacity(flood) 1000 gal Manufacturer Hagerman
H 24'access riser(s)and accessible from surface?------------ - ❑ . ❑
a. Alarm or Control Panel Installed? --------------------- ❑ ❑
Control Panel equipped with Timer I ETM/Counter- ----------
❑ ❑
d Pump Installed in M Bucket or ❑ On Block or ❑ Other
gPump Make/Model Liberty 280 ®Floats or ❑Transducer
y Tank draw down 2 in/min Pump capacity 40 npm Squirt Height 7- ft
Pump on time 1Min /0 secs Pump off time 4 Hrs Daily flow set al 270 npd
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Mason County OSS Installation ReABANDONM
RECORD DRAWING
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CERTIFICATION O7=1elsnhs
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r teddy ma:I rnsta,iec the sistsc a :.- � - - - the septic design stamped-APPROVED oythe septic Design stamped APPROV G by Masc unty Public Health antl the[any dedalrons
County Public Health and that any deoatlgoa snc:-"here pare been cleamckapolo.ed by both me das:gre: tl Maso be^ounry.public�40eth 6 dmleat al
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APPROVED
OCT 2 2 2024
MASON COUNTY ENVIRONMENTAL HEALTH
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