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Home My WebLink AboutSWG2020-00341 - SWG As-Built - 11/8/2024 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/PERMIT INFORMATION Permit Number SWc 2020' 0034N Parcel# 22016-50-00194 Applicant Name Kristine Anderson Subdivision (Name/Div/Block/Lot) Applicant Address 400 Union ave BE Timberlake Div 1 Lot 194 City, State, Zip Olymnia. WA 911501 Installer Name Jeff Lovely Site Address 371 E Agate Or Designer Name Tom Weaver INSTALLATION CHECKLIST [& Fue System Insullatlon ❑Tank(s)Only ❑Drsinfiels Only ❑Repair ❑Omer System Type Pressure Pretreatment Type Septic lank >5ft,from foundation? - -- ------------------------ ❑WA K]YES ❑ NO >50ft.from"Its? ----------------------------- ❑ KI ❑ _ >50ft.from surface water? ------------------------ ❑ ❑ ❑ FCleanout between building and tank? ------------------- ❑ KI ❑ O Tank baffles present? - - -- ----------------------- ❑ ❑ ❑ 6 24'access risers over each compartment/---------------- ❑ ❑ WEffluent fitter installed?-- --- ------ ---------------- Septic tank size 1,200 oat Manufacturer Miles 0 D-box water level and speed levelero used? --------- - - ---- �f WA ❑YES ❑ NO OLL Manifold/Dbox accessible from surface?--------------__. ❑ ❑ C112 Check valves installed? -__ ______________________- ❑ ❑ ❑, Oe( M Transport Line Sae 2 Schedule/Cleas SCh 40 Bedrocrru installed(check one) ❑2 W 3 ❑4 ❑5 ❑6 ❑Commercfal/Other >10A.from foundation?------------------------- - ❑WA cam ❑ NO >100%fromwells?----------------- ------------ ❑ IN ❑ W >100R from surfacewater9----- ------------------- ❑ ® ❑ LL >10ft.from potable water lines?------------------ -- - ❑ ® ❑ _ >5 ft.from property lines and easements?----------- ----- ❑ ® ❑ ¢ > 30ft.from downgradient curtaintfountlation drain?---------- ❑ ® ❑ C3 Drainfield level and observation ports present----- X) Graveless chambers or ❑ Clean gravel used? (check"I Proper cover installed over drainfield?---------- --------- ❑ ® [] Pump tank setbacks consistent with septic tank?-- -- -- ------- ❑ WA ] yes ❑ No Y Pump tank Sae 1,200 sal Manufacturer MIIeS F24"access nser(s)antl accessible from surface?---- -- ------ - ❑ ❑ ❑ a Alarm or Control Panel Installed? ---- ----------- - -- -- ❑ ® ❑ Control Panel equipped with Timer I ETM/Counter-- - - - ------ ❑ ® ❑ 4 Pump installed in ❑ Bucket or ® On Block or ❑ Other a. Pump Make/Model Liberty 1280 Qg Floats or ❑Transducer IL Tank draw down 2 in/min Pump capacity 40 apm Squirt Height 5 fl Pump ccrtime 1.5 Min pumpofltime 4Hours Dairy now set at 360 apd uwr aixroie Mason County OSS Installation Report pg. 2 Parcel a 22018-50-00194 ABANDONMENT RECORD Wert etiaNy"Ptic compaMnls aEanaonea as Pan of this PmjedT .-------------. ME NO It yes,pwm OaspEa' rtr Nkn a1 oomponanp pumped pW and PMP"abaMara f par WAC2e 27I 30M-------- ❑ ME QS No RECORD DRAWING TeY Y T awFFYI Feb W FW M Ye�Y W YrtiK�rY/ w nyuY F h M yyer�re�MIllw W YYw inr}�t TwYI MYO G'rFrvr.- pwwaln.Ypaa.ireneMnx+4Mw Wbm.YFn rw star.YYar..eaMFMMaa�.YFswywY.WNF�, ��MxWn Porh6Fan.W eFvmFWN Ym N4.Yo^Mr�NaFwP^w1Fa WYFIaYFI FYW Fr1aIF�W M/rMOwFY Record Drawing Attached CERTIFICATION OF INSTALLATION 71NS�TALLER DESIGNER/ENGINEER I/nsraned the system in accordance ith I certil Mat Me system has been hrsbnsd in acow- sgn stamped'APPROVED-by Mason dance with Me septa design stamped'APPROVED'by c Heath and that any deviations xf" Mason County Public health RW tut any deviatbns hem have bean ceNeNapproved by both the designer shown hale have been Clalm"ppmved by both and Mason County Pudic Health and meef at State mysen aid Mason CWnfy Public Health am,meat w and Mato.County Cafes. State and Mason County Codes I lumber certify mat alt inWamMbn COntainetl on this I further caddy Mat an 0101mr161n contained on this form and ab"d 50tord Orawing is accuse. tam and attached Record Drawing is accurate. Nov. 8, 2024 L ly orl. ow � t Pmtw nNms NsgrMe ; . [ MASON COUNTY PUBLIC HEALTH The undensgoed approves this/nssnarion Rapat SW rwui5mr�hAw q. ,� Recall Orawm9 on DeAanol Mason County Public _.- .. Health SgWtua ofEnvtiW at abh Speytst pare (stamp,signature and dais) TMS FORM NAY SE SC EOAH[)AVAMBLE FOR PUBLIC VIEW ON THE MASON COINiY NEB anE ' "NIrw 1'=20' SL#1 042'Sand Loam 42'Compact 2201&50 00194 SLt2 0-36'Sand Loam 36'Compact 371 E Agate Dr SLf3 042'Sand Loam 42'Compad E.Agate Dr SL#4 0-32: Sand Loam 72' is q n 5t D/W 20'WEINEN NEN6.1 ' � 26'X 60'Three bedroom N home m N G r m y 1 „ s (� / co 160,86' ST X L#1 160.15' J� � �o1Zal2� X SL63 3Z-r�TY 100% Reserve 93.74'