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Home My WebLink AboutSWG2024-00092 - SWG As-Built - 11/8/2024 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/PERMIT INFORMATION Permit Number SwG 2024-00092 Parcel# 31904-14-90010 Applicant Name Caleb Chakos Subdivision (Name/Div/Block/Lot) Applicant Address 81 BE Sister Meadows Lane City, State, Zip Shelton,We 98584 Installer Name Pioneer Di ging Inc �L Site Address Same Designer Name Bob Paysse INSTALLATION CHECKLIST Full System Installation ElTank(s)Only ❑ Grainfield Only ❑Repair ❑Other System Type Standard Pressure Pretreatment Type >5 ft.from foundation? ----------- --,- ❑WA yes ❑ NO >50ft.from wells? -______ _________________ - ❑ ® ❑ Z >50ft.from surface water? - _______________________ ❑ ❑ Cleanout between building and tank? ------------------ - ❑ ® El Tank baffles present? -- - -- ---- - ----------------- ❑ . ❑ a24"access dears over each compartment?---------------- ❑ ■ ❑ % Effluent filter installed?- ___________ ______________ El ■ ElSeptic tank capacity(working) 1500 ael Manufacturer Sound Placement �o D-box water level and speed levelers used? -______________ WA ❑yE8 ❑ No 10O Manffold/D-box accessible from surface?-_______________ . ❑ ElC= Check valves Installed? --------------------------- ❑ . ❑ Transport Line Size 2" SehedulttlClass 40 Bedrooms installed(check one) ❑2 ❑3 04 ❑5 ❑s ❑CommerciallOther >10 ft.from foundation?-------------------------.. ❑ WA YES No >100 ft.from wells?-___________________________. ❑ ■ ❑ W >100 ft.from surface water?-______________________- ❑ ❑ >10ft.from potable water lines?---------------------- ❑ a >5ft.from property lines and easements?•______________ _ ❑ ❑ d >30 ft,from downgradient curtain/foundation drains?---------- ❑ ■ ❑ Drainfield level and observation ports present -- -- - ❑ ® ❑ ❑ Greveless chambers or N Clean gravel used? (check one) Proper cover installed over drainfield?-_________________ _ ❑ ❑ Pump tank setbacks consistent with septic tank?------------- ❑ NIA dyes El NO ZY Pump tank capacity(flood) 1500 eal Manufacturer F 24'access riser(s)and accessible from surface?------ ❑ ❑ IL Alarm or Control Panel Installed? --------------------- ❑ ■ ❑ Control Panel equipped with Timer I ETM/Counter----------- ❑ e ❑ O. Pump installed in a Bucket or ❑ On Block or ❑ Other IL Pump Make/Model Liberty 290 ❑ Floats or Transducer d Tank draw down 1.5" in/min Pum ca aci 45 P P ty apm Squirt Haight 3'+ fl Pump on time 1.75 min. Pump off time 4 hrs Daily flow set at 480 apd ura,raenaora Mason County OSS Installation Report pg.2 Parcel4 31904-14-90010 ABANDONMENTRECORD Were existing septic components abandoned as part of this project? ----- - ❑ YES ® NO If yes, please describe: Were all components pumped out and property abandoned per WAC246-272A-0300? ------- - ❑ YES ❑ NO RECORD DRAWING Tied is.sunniness nmN and must as aocurads and daadrplN..nnual,m ry acda In au mass M maminanw acunta s and tuture awNoym.nL Typi®I Fawro DBxegs Pusaln: Dr infieN d nu nrod aMMation 6leynP,aapWpurnpLM bcvkn,N.M..--tlnlnnid.mdsln,..I y,nn nut,Inr ,bcatan wells,xaten.s. xels.Meamrian poRa.Geenoub,eM olM1xmsnrenenu eaead paNb. Imm�pMle RxoN DrawYgs mryoeAe additional delays in final inxtollation eoamwl aM rela�stl yimb. ® Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ENGINEER I certify that I installed the system in accordance with I certfy that the system has been installed/n 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 here have been cleared/approved by both and Mason County Public Health and meet all State myself and Masan County Public Health and meet all and Mason County Codes. State and Mason County Codes I further cerify that all/ntiormation contained on this I further cattily,that all information contained on this form and atAched Re (co orrd Drawing is accurate. form and attached Record Drawing is accurate. Z-DdV� 1116/24 Signature of Installer u Date Robert H.Payees Printed Name of Signee MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and Record Drawing on behalf of Mason County Publk "FVR¢ Health: Signature of Environmental Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE updeNdvetrzpte ` ACCESS/UTILITY �T EASEMENT I � I 3 o II APPROVER \\\ NOV 13 2024 I MASON COUNTY ENVIRONMENTAL JEALTH I i WELL \\ �1� \� RET I 1 I II I I j I I I I NEW HOME I SEPTIC TANK PVM}P TANK 61' PRIMARY: (4) 050' _ 10'OC WITH RV DROP RESERVE BETWEEN I 1 1 27'± REMRD DRAVM(G "'S`O"° `"" = S E2 T 3 4o GB ml amGPIONEER DIGGINNC. PARCFL t 31904-4010 3z4 3MT01. SEI'TICDESIGNS ADDRFSS %JOCSEFllJSROAD noon®3o noors®3z MEM NBEMSON GRAPEVMWA9m% DESIGNER ROBEAT H PAYSSE OFAGE-360i2 W3 FM-3fi V-) SHEET: ASBUILT SCALE P.50 �wsr