The URL can be used to link to this page

Home My WebLink AboutSWG2023-00480 - SWG As-Built - 1/27/2025 J _- ' Manion County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2023-00y,,�D Parcel# 41902-21-90021 Applicant Name JOHN SHARP Subdivision (Name/Div/Block/Lot) Applicant Address 3531 W SHELTON VALLEY RD City, State,Zip SHELTON,WA 98584 Installer Name SKINNER CONSTRUCTION Site Address SAME AS ABOVE Designer Name CWDYWAITE INSTALLATION CHECKLIST Q Full System Installation ❑Tank(s)Only ❑orainfietd Only ❑Repair ❑Omer System Type GRAVITY Pr IType >5 ft.from foundation? ------_-- B ❑ ■,E NO >50 ft.from wells? _ >50 ft.from surface water? -______ _�Aa fg_ ❑ ® ❑ Cleanout between building and UrdCl - ____ _____ - ❑ ® ❑ V Tank baffles present? - -----____ By_ T ❑ S ❑ IL 24'access risers over each comps -______________ - ❑ ❑ yW Effluent filter installed?------------ �_/________ __ ___ .. ❑ . ❑ Septic tank capacity(working) 1200 X�aal Manufricprml. EVERGREEN PRECAST 1D-box water level and speed levelers used? -_____________ - ❑ YES NO 0 Manifold/D-box accessible from surface?-_______________ _ ❑ ® ❑ = Check valves installed? -------------------------- ■ ❑ ❑ i Transport Line Size 41N Scheyge/Class 3034 Bedrooms installed(cheq%,,on ❑2 3 ❑4 05 ❑6 ❑commercagOther >10 ft.from foundedon 4 ---_ ___ El WA yea ❑ No Q >t00Rfrom wells?- 3or - a.--�------- -- ❑ ® ❑ W >100 ft.from suda,fi -�M y ® ❑ irZ >10 ft.fmm Potable terli 9-- - 1z ® ❑ >5 ft.from pro�prly and se __ a ❑ >30 ft.trkxnL�°� '. I ,ALT ,�y�p 10T5-- �"� 9mdlan4cu. "ONIrFNVIRO ❑ Drainfield Ie4elSrtSobseotalkaf - ---- �EOI AW EALTU 0 ❑ ❑ Greveless chambers or .� Clean gravel us 'e-tm�gc aria) Proper cover installed over tlrainfield?------------------. ❑ ■ ❑ Pump tank setbacks consistent with septic tank?------------ - a ❑ YeS No = Pump tank capacity(Bootl) gal Manufepurer Q 24"access riser(s)and accessible from surface?-- --- --______ ❑ ❑ ❑ 6 Alarm or Control Panel Installed? ------------ -------- _ ❑ ❑ ❑ Control Panel equipped with Timor/ETM/Counter----------- ❑ ❑ ❑ I Pump installed In ❑ Bucket or ❑ On Block or ❑ Omer kv IL Pump Make/Model ❑ Floats or ❑Transducer aTank draw down in1min Pump capacity apm Squirt Height ft Pump on time Pump oft time Daily flow set at apd W .esa,ro+e Mason County OSS Installation Report pg. 2 Parcel a 41902-21-90021 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? --- - - - - - - -- - --. YES ® NO If yes, please describe_ Were all components pumped out and Properly abandoned per WAC246-272A-0300? -------- YES ® NO RECORD DRAWING naa b a Pamaanna.awn and Iwr W Omni and de.iA eie anwsn m n+awb n in.now m w aaaaaw aaal sea and Aden awxayn.n, T p ,Rave Drawings cmbin'. UainM1elO 6 meraloq pbnlbpn 6 byoul.Seglr/pumptank Ipw:ipn,NMb anw,neaerve MavifialE,eueOnA anE Dipap]buiNinpq 1'xalon dvNls,v9brines. we115,o%ervtlipn pws,cleanwb,end oMer merNewme acaw pants. InwmOlele RmN Omtiryr Tay ogle aldliwl Aaleys m Ma:iMetlalim appmaal anb relnleJ pails. A PPROVE JAN 2 7 M25 MASON COUNTY ENVIRONMENTAL HEALTH JBW 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 accoi- 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 dea2tl/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 infomtation contained on this I further certify that ail information contained on this fo and attached Record Drawing is accurate. form and attached Record Drawing is accurate. �- A' 12/1612024 Signature of Installer Date A SAMUEL SKINNERPdnted Name of Sign.MASON COUNTY PUBLIC HEALTHThe undersigned approves this Installation Report and Record Drawing on behalf of Mason County Public LWftS pSlb �1 S" Envaorm+antal Health Specialist Date (stamp,signature and date) TBIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE upnblanVenO 1200GAL 2COMP SEPTIC TANK r- 1200GAL-2COMP ISEPTIC TANK i D-BOX r r 9' 19'1f97M5>319'3/ 37'718' r \ HOME. SEDDES] A P P R O V E JAN 21 202.5 MASON COUNTY ENVIRONMENTAj -j JBv, 3ls i �^ 1200 CAL-2COMP !5KT0 VK2COMP ¢f,�{ TANK 67' 9 HOME D HOM# g ZA a � � NAIT[ m¢ ut.EY�ED JESIGNpq tltMfS �, y PPRO VE JAN ; 7 Tt115 D MASON COUNTY ENVIRONMENTAL HEALTH JBW ��s 7- G�LICE'� (. [SIGNER 9111116" 19, 11116" i9'35/16- )`-9'73/4" 37'718" A PPROVED JAN 2 I M.-) MASON COUNTY ENVIRONMENTAL HEALTH JBw SIl