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Home My WebLink AboutSWG2024-00202 - SWG As-Built - 10/20/2024 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/PERMIT INFORMATION 1Cg1 Permit Number SWG 2024-00202 Parcel# 422125011003 Applicant Name Fiord Holdings LLC Subdivision (Name/Div/Block/L Applicant Address 2135E Stotbery Rd ra City, State, Zip Shelton,WA 98584 Installer Name Brandon Tho Site Address 24341 N US Highway 101 Hoodspo Designer Name Jim Hunter T INSTALLATION CHECKLIST i Full System Installation �,❑Tfle�nk(s)Only ❑Drainfield On Yr,�1❑Repair ❑Other System Typeh�TlrnCe..SI. 3• p�""-N 'Pfalreatment Type >5 ft.from foundation? ---------------------------- ❑N/A ❑ NO >50&from wells? --- --- ---------- ---------- --- ❑ . ❑ Z >50ft.from surface water? ------------------------ ❑ ❑ Cleanout between building and tank? -------------------- ❑ ❑ U Tank baffles present? --------------------------- ❑ ❑ a24"access risers over each compartment?-__ ____________. ❑LLI . ❑ N Effluent filter installed?- _ _ ____ __ _ _ _ _______________ ❑ ❑ Septic tank capacity(working) 1250 gal Manufacturer Evergreen Precast of D-box water level and speed levelers used? -- - -- -- - ------- M WA ❑YES ❑ NO 00 Manifold/D-box accessible from surface?-_______________. 0 ❑ ❑ oCCheck valves installed? - - - - - - - -- - - ------------ - -- ❑ ❑ f Transport Line Size Schedule/Class Bedrooms installed(check one) ❑2 ❑3 ❑4 ❑ 5 ❑6 ECommercial/Other >10 ft.from foundation?- -- - - - --- ---------- ------- ❑ wA .YES ❑ NO >100 ft.from"Its?------------------------------ ❑ ❑ W >100 ft.from surface water? ------------------- ----- ❑ ■ ❑ LL >10ft.from potable water lines?---------------------- ❑ e ❑ > 5ft.from property lines and easements?---------------. ❑ ❑ >30 ft.from downgradient curtain(foundation drains?--------- - ❑ ® ❑ 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?-----lit�ANIA YES ❑ No toWM nuf2ct°vt G114VL It! Pump tank capacity(flood) b0� al Manufacturer f0(4h`� Evergreen Precast 24•aGoa**riaer(a)and aooeaelble from eurfaga?- - - --------- - ❑ ❑ 0. Alarm or Control Panel Installed? --- - - - - ----------- --. ❑ Cl jControl Panel equipped with Timer/ETM/Counter- --- --- --- - ❑ ❑ d Pump installed in ❑ Bucket or ■ On Block or ❑ Other n' Pump Make/Model Meyers ME45 � P 0 Floats or El Transducer 6 Tank draw down 2 in/min Pump capacity 52 dpm Squirt Height 65 Pump on time 158 sec Pump off time fo hours Daily flow set at 550 gpd 1.&2'.s Mason County OSS Installation Report pg. 2 Parcel n 422126011003 ABANDONMENTRECORD Were existing septc components abandoned as part of this project? -- - - ---------- . ® YES No If yes, please describe:Existing tanks Were all components pumped out and properly abandoned per WAC246-272A-0300? - - - - - - - - ® YES NO RECORD DRAWING This is a permanent record and MUM N acmnb and anvnptma eroupn Iv redouta In Ina Iwea of mam4nence aglmka and I.W.aaewpni Tyowl Ri 0nwmgarmta.n OranMtl6mani...enla'Andlayge $¢pWlpump9nkk^aM^,ryMna'mw,reserve dralMed ealny aIill. ud nuldi, k.1-0 alb aiaTi a. neh,vM,M,M m:cns,tlea^cals.and pier mambranw.aces pints. Inwrpyty Rxaa O.vxYgv miy✓dale aMX:nal dtlels In'nal FslAlaron apa'mel aM reYlad ttrm4. ❑ Record 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 a=r- 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 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 attac R rd ccurate. form and attached Record Drawing is acc te. 10/2/2024 Signatureofinstaller Date z.4- Brandon Thompson Printed Name of Signed ^r T MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and 5' Slda+r3 s' Record Drawing on behalf of Mason County Public Health CANES L NIMIER DESICr- ER Etnarr5. 01,221 Signature of Environmental Hea h Specialist Date (Stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Lmaaa ezi xoe S UN PUBLIC UTILITY DISTRICT NO. 1 130ARD OF COMMISSIONERS OF MASON COUNTYR,MIKE SHEE Commissioner N.21971 Hwy.101 JACK JANDA,Commissioner Shelton,Washington 98584 RON GOI..D,Commissioner March 11, 2024 Fjord Holdings, LLC 213 SE Stotbery Rd Shelton,WA 98584 RE: Sleeved water line at 24311 N US Highway 101, Hoodsport WA Dear Mr. Hansen, Mason County PUD No. 1 (PUD)finds any future needed improvements of a sleeved water line along N Finch Creek Rd to be adequate for the referenced property. Per the conversation with the Water Superintendent TJ on Friday February 2, 2024, at the property with John Hansen. The PUD is okay with a new mainline installed with it being sleeved, since It will be less than 1 O' from the drain field. If a new line needs to be installed, it will be the property owners responsible to install the sleeve and mainline along N Finch Creek Rd, from the intersection of N US Hwy 101 and N Finch I'I Creek Rd to property corner of Hood Canal Community Church and Fjord Holdings. A PUD water tech will need to be there to make sure the work is being done to the PUD standards. Sincerely, Brandy Milroy Water Resource Manager (360)877-52,49 9 (800)544A223•FAX(360)877-9274 www.meson-pudl.org I o _ r w. lid 3 ILA 1 Fes, N � m ,y x O A 2 I i I W f i tni 10 ',fi, � Al a � 8 03 �Ga rIN o! I rl CC v >� > I I f ' G