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HomeMy WebLinkAboutSWG2024-00321 - SWG As-Built - 2/25/2025 Mason County OSS Installation Report pg. 7 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2024-00321 Parcel# 32122-50-00213 Applicant Name TAYLOR WOOD Subdivision (Name/Div/Block/Lot) Applicant Address 41 E STIRLING CT City, State, Zip SHELTON,WA. 98584 Installer Name SCHOENING EXCAVATION LLC Site Address 52 E STIRLING CT Designer Name CINDY WRITE INSTALLATION CHECKLIST ❑ Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑Repair ®Other USING EXISING SEPTIC TRNN System Type PRESSURE Pretreatment Type >5 ft. from foundation? ----- >50ft. fromwells? -- ----- -_ __ __ �51(rTIIT11fl f� 'InJI1 N/A AYES E] NO Z >50 ft. from surface water? - - -- -- __ - �irj��[C �f.�C jii{�I��IIIII;j1++»JJIJIII1 ❑ 0 El x ❑ F Cleanout between building and tank? --- _FEB._ 2520- 111��1 ❑ 0 0 U Tank baffles present? - - - - - - - - - -- -- -- -��"//-pp(('{{J„-»((�n"..,,e_- ❑ O ❑ d 24'access risers over each compartment? By __- ❑ ® ❑ H Effluent filter installed?- - - -- -- ---- ---- ----- ------ ❑ O ❑ Septic tank capacity (working) 1_ 0_ 0 nal Manufacturer EXISTING �O D-box water level and speed levelers used? -__ __ _ _ _____ __- WA ❑ ves ❑ NO �O Manifold/D-box accessible from surface?-_______________- ❑ © ❑ CQ Check valves installed? -- - - - -- - - - _ _ ___ ________ -- - ❑ ❑ 2 Transport Line Size 2' Schedule/Cfass SCHEDULE 40 Bedrooms installed (check one) 02 ❑3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >1Oft.from foundation?------------- ------ ------- ❑ WA ® ves NO >100 ft. from wells?. - -------------------- -------- ❑ © ❑ W >100 ft from surface water? ---------- ----------- ❑ ❑ >10ft. from potable water lines?-__ _____________ _____- ❑ ❑ Q >5 ft.from property lines and easements?-__ _ _ __ ______ _ - ❑ ® ❑ Q > 30 ft. from downgradient curtain/foundation drain?---- -----. ❑ ❑ Drainfield level and observation ports present - - - --------- -- El Graveless chambers or ® Clean gravel used? (check one) Proper cover installed over drainfield?- -- - -- --- ---------- ❑ ® ❑ Pump tank setbacks consistent with septic tank?-- - - - --- - ---- ❑ WA ® YES ❑ No Z Pump tank capacity(flood) 1250 cal Manufacturer HAGERMAN 24"access riser(s)and accessible from surface?--_ ___-____ _ - ❑ ® ❑ y Alarm or Control Panel lnstalleV - __ __ __ _________ __ _ __ ❑ ® ❑ Control Panel equipped with Timer/ETM/Counter-- - - - - - - - - - ❑ ® ❑ a Pump installed in ❑ Bucket or M On Block or ❑ Other Pump Make/Model LIBERTY 260 ❑ Floats or ® Transducer a Tank draw down 1.25 inlmin Pump capacity 27.50 apm Squirt Height-----Z_ft Pump on time 1.6 Pump off time 6 Daily flow set at 180 apd UP4eN.f PM/2010 Mason County OSS Installation Report pg. 2 Parcel n 32122-50-00213 ABANDONMENTRECORD Were existing septic components abandoned as part of this project? •-------- -r- --. YES Q NO It yes, please describe: Were all components pumped out and property abandoned per WAC246272A.0300? -- - - - - - - ❑ YES NO RECORD DRAWING TN'Is a Pnmment Nl dnl and.uet W A.u.%end d...HAbe enough tP.40na.In 0¢need nl mAinbnanne A¢tivdiw end WW%dawle .ant 0—hgeOYneY'. D.In "8menftm.d utin81a pU P P P TyP. Rem. youl, A ri um Ynk MPMen.Norm D,.,,woved. .n d,e¢%IiideMpvpwM,wiiwNpa, I. .1.1d l',ed penks W¢Ils,OEapVtlial pOM,tlaenWls.Nd OMNrtKllnmyiu etcwe pwda. InwmpMa Remold OteWlnpe may C.ele atldpgnal tl¢leys n Ilnel Nablltlim ePPwal entl relaletl pamlMs. 7'4,rll� �Uea�T e u ehd al,"J Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNERI 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 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 attached Record Drawing is accurate. form and attached Record Drawing is accurate. �J a222�- Signatureo11finstaller Date a d J�'Ow - �4' , Printed Nkm ofSignee ec MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report a m; I le ArTel �iNpY Record Drawing on behalf of Mason�qlounty Pu�i� 3 a I - LICENSED SIGNER Heath. :'0 HO' EPNES U510 N"ryN � s F�/F Signature of Environmental Health Specialist Dattt.14 FN i (Stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PURL&VIEW ON THE MASON COUNTY WEB SITE UNI-An s 1=1e Y C Y � s C O, f.3 E v ° a w O W O C O C �p O ' y ,= t k ' V R TO `` `� � fV f''1R10 f0 ICED �.. n N s . M O U W � �(p� D15n SlN41M3 Q '`T 113N01 036N 31 aNl 1 r'