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SWG2024-00248 - SWG As-Built - 11/14/2024
o NOV i Mason County OSS Installation Report&g, 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2024-00248 Parcel# 32232-50-02002 Applicant Name Shed Saari Subdivision (Name/Div/Block/Lot) Applicant Address 5091 E State Rt 106 City, State, Zip Union WA 98592 Installer Name Joe Fassio Excavating Site Address same Designer Name Arrow Septic Designs Inc INSTALLATION CHECKLIST ❑ Full System Installation ■-rank(s)Only ❑ Grainfield Only ❑ Repair ®Other Wids pump in—n System Type NuWater to existing gEl Pretreatment Type NuWater BNR-500 >5 ft,from foundation? ------ - - - - - - --- - - --- -- - -- -- ❑ NIA AYES No >50 ft.from wells? - - - - - - - ------- - -- - -- - ❑ ® ❑ Z >50ft.from surface water? -- - - -- - - -- - - - - --- - --- - - - El © El HCleanout between building and tank? -- --- -- - --- --- - - - - - ❑ ❑� ❑ U Tank baffles present? -- - - -- - --- - ---- ---- - - - - - - - - ❑ ® ❑ d 24'access risers over each compartment?------ - - - - - - - - -- ❑ Q ❑ W Effluent filter installed?- - - -- - ----- --- - - - - - - - -- El ❑ On5ob Septic tank capacity(working) NuWater BNR gal Manufacturer Hagerman 0 D-box water level and speed levelers used? - - - --------- --- ❑ NIA YES ❑ No 0J 0 Manifold/D-box accessible from surface?-- --- ---------- - - ❑ ❑ °?Z Check valves installed? -- - - - - - - --- - -- - - - ❑ ❑ ❑Q 2 Transport Line Size 2 inch Schedule/Class 40 Bedrooms installed(check one) ❑ 2 H 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10ft.from foundation?- - - - - - - ----- - - - - - --- - - - - - - El NIA ❑ YES ❑ NO >1001t.fromwells?--- - - - - - ---------- -- -- ------ - ❑ ❑ ❑ w >100ft. from surfacewater?- - - - - ---- ---------- - -- - - ❑ ❑ ❑ u. >1011.from potablewater lines?- - - --- - ---------- - --- - ❑ Z > 5 ft.from property lines and easements?---- -- - - -- - ❑ ¢ > 30 ft.from downgradient curtain/foundation drains?--- - - -- - - - ❑ '(/J�\ ❑ Drainfield level and observation ports present --- --- - - - ----- ❑ �/" ❑ ❑ Graveless chambers or M Clean gravel used? (check one) Proper cover installed over drainfield?--- - - - ----- - ------- ❑ ❑ Pump tank setbacks consistent with septic tank?-- ----- -- - --- ❑ NA YES ❑ No Y Pump tank capacity (flood) 1,000 gal Manufacturer Hagerman Q24"access riser(s)and accessible from surface?-- ------ ----- ❑ K ❑ ~ ❑ ® ❑ p. Alarm or Control Panel Installed? -- --- - - - - - - - - - - ------ Control Panel equipped with Timer/ETM/Counter-- - - - -- -- -- ❑ Q ❑ _a Pump installed in M Bucket or ❑ On Block or ❑ Other a Pump Make/Model Zoeller N53- 1/3hp, 115v ® Floats or ❑ Transducer 7 Tank draw down 2 in/min Pump capacity 38 gpm Squirt Height - ft a Pump on time 2.3 min Pump off time 6 hr Daily flow set at 360 gpd U�30.H BR120:8 Mason County OSS Installation Report pg. 2 Parcel# 6 22772-So- o-zo o 2 AB ANDONMENTRECORD rBs ❑ No Were existing septic mmpaneO abandoned as part�ofJ this�p�m7 aJ-' If yes. please describe: YES ❑ NO Were all components pumped out and property abandoned per WAC24B-272A-0300? --"-"' ❑ RECORD DRAWING mo e a w^•^m.era via muses.crow uw a••=nw••mowcs m�+�'+••m n•..w•e m.us«,....acmm..m tuw�d---- Trom R�iO pmnq.mw.= o+wees a mwowa u,•nuem a iewui sscowmrous iauem.nam sm.+. esere oa'vawe,avant as omoeeea www•.wrmm mwa vm«Ines, xas,ms.rwum off.m•,°"e.v'e ansmeimaunu---••rams. �^�•RxwE pmwNgsmrywsN sanesnu a.Wsm fin•I eurauum Nymvsl sM reWetl Mmm= 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 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 deared/approved by both the designer shown here have been cleam"loproved 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 1 further certify that all information contained on this form and attached Record Drawing is accurate.a)ccurate. - form and attached Record Drawing is accurate. S' m of Installer gate o e Fa.5,'I o Printed Name of Signee o f MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and Record Drawing on behalf of Mason County Public c+•erns PANLAJOY JOHNSON Health_,._,, F.1tt� fGNM, 'Ml�itdl�l �1 � �`1 � 31�1�13-2F Signature of Enwronmen&Heath Spedalist Date (stamp, signature and date) THIS FORM MAY BE SCANNEDANDAVARABLE FOR PUBLIC NEW ON THE MASON COUNTY WEB SITE usamserz+rm+e J� SGALE AS BUILT gu�KNEAo -NL C 0o CFt�R\ SAA1� 50gI E. c,-A-TF RT. 1o(� APPROVED NOV 14 2024 ro o s MASON COUNTY ENVIRONMENTA m RET oecK I c e zio �-1 I oEck �BR }•�OUSE Po>C � q � �+ 0 c�ral�•L `E.IC� '�r�Nf�'YF o.C, w rC h � I i � YCSGYV�• II r. I Ol Audio-Viauel Alarm clemout Q J J NEW `��" '• �I © NuWgr-fir$NR-500 AT Tar' e7;15T1N6 i I I O 1,o bo Gallon Pump,Chambe GAsLAOoE P waTEiZvl R ° um .� 1m.SPn calvEweay i - E S'Ya�e lZo��t tClv'- •� � f •�c SLEEv6 WR-CE�'i.tN� tP ,,y ., ENCouNG �D WtTWN t6' OP kNy SI:PZic- Cot- n NC. U eio aaa .PRUIq JOY JOMN$pry' � (-15 Z4