HomeMy WebLinkAboutSWG2021-00429 - SWG As-Built - 3/20/2025 Mason County OSS Installation Report pg. 1
MASON COUNTY PUBLIC HEALTH
APPLICANT/PERMIT INFORMATION
Permit Number SWG 2021-00429
Parcel# 22132-11-90300
Applicant Name Kyle&Kelly Casteel
Subdivision (Name/Div/Block/Lot)
Applicant Address 733828th Ave SW
city, State, Zip Seattle,WA 98126 Installer Name Active Underground
Site Address 41 E Pine Tree Point,Shelton Designer Name Arrow Septic Designs Inc.
INSTALLATION CHECKLIST
Q Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑Repair ❑Other arewsh Tank
System Type
Shallow Pressure P eatment Type NuWater BNR-500
_ ❑ NIA m YES ❑ NO
>5 ft. from foundation? - --- - --- --' ❑ ® ❑
>60 ft.from wells? - - - - - - - - - - - - ""- �� - - ❑
'1 >50 ft.from surface water? -__ _ - _ _
Z �4 [] ❑
F Cleanout between building and tank? -_ 4118
118- _ - ® ❑
U Tank baffles present?e -- - - - - " - -
d _-� ❑ � ❑
24" access risers over each compartment?- ❑ ❑
uiEffluent filter installed?- - - - - - - - - - - - - -��( Sound Placement
Septic tank capacity (working) Nu Water 500 Manufacturer
0 . D-box water level and speed levelers used7 -- ------ -- ❑ WA ❑YES NO
❑ ❑
K
00 Manifold/D-box accessible from surface?-- - - -- -- --- ----
DOZ Check valves installed
? -- ---- - - - -- -- - - ❑ ® ❑
OQ y^ Schedule/Class 40
f Transport Line Size
Bedrooms installed(check one) ❑ 2 JM 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other
❑
>10 ft. from foundation?- - - - - - ❑ IN❑ WA ® YES NO
❑
0 >100 it from wells?-- -- - -- - - - - - -- - ❑ O ❑
W >t 00 ft from surface water? -- -- - - - - 0 ❑
a: >10ft.from potable water lines?------- """-- -"-- ❑ l!] El
> 5ft. from property lines and easements?--- -- ----- - "-"- - ❑
> 30 ft.from downgradient curtain/foundation drains?-- -- -- - - ' - ❑ 0 ❑
0 ® ❑
Drainfieltl level and observation ports present - - - -- -- - - - '-"' ❑
❑ Graveless chambers or 0 Clean gravel used? (check one) ❑ ❑
Proper cover installed over drainfield?-- - - - - - - --- - -- -----
Pump tank setbacks consistent with septic tank7 -- -------- -- ❑
WA YES ❑ NO
Y Pump tank capacity (flood) 1150 cal Manufacturer Sound Placement® ❑
Z ❑
Q 24" access riser(s) and accessible from surface?--- - -- --' - ' - - ❑
r 0. Alarm or Control Panel Installed? - - -- - - - -- - - - - - - - ❑
rL Control Panel equipped with Timer/ETM/Counter- - - - - - - - - - - ❑
a -holes at 18"
Pump installed in ❑ Bucket or ❑ On Block or Other 5'Pump Silo
a- Pump Make/Model Liberty 280 ® Floats or ❑ Transducer
2 40 opm Squirt Height 3.5 ft
� Tank draw down 1.75 in/min Pump capacity
Q- 6 hr. Daily flow set at 360 gpd
Pump on time 2.25 min Pump off time
ucaerea erzirzora
Mason County OSS Installation Report pg. 2 Parcel# -
ABANDONMENT RECORD
YES ® NO
Were existing septic components abandoned as part of this project? -- -
If yes, please describe: NO
Were ell components pumped out and Property abandoned per WAC246272A-DSDU? --------
RE �.
CORD DRAWING
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aewaec mamn, Dremneaawraa wanlallmaarRA sepreP.aaeaaaNNr crew.rese..aerem*aa.a,aeeaaartcrewsea wlannad—,a iar.alaw r-na>
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Record Drawing Attached
CERTIFICATION OF INSTALLATION
INSTALLER DESIGNERI ENGINEER
I certify that I installed the system in accordance with 1 certify that the system has been installed in scour-
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 clearedrapproved by both the designer shown hen:have been clearetl/approved by both
and Mason County Public Health and meet all State myseff and Mason County Public Health and meet all
and Mason County Codes. State and Mason County Cod"
I further certify that all ation contained on this I further certiry that all information contatned on this
Porn a t ec
an
urate. form and attached Record Drawing is acwhete.
2_ q, 2,5
,a nstaller Date
`Goa oc Aco1� e
Printed Name of Signee
MASON COUNTY PUBLIC HEALTH a ..u .r
The undersigned approves this installation Report and sad 340
PAULA JOY JOHNSON
Record Drawing on behallorMason Courrty Public ' '(. E ' I Nit
Health: lut'I'�
5 A,., 3- Lo -LS
Signature W F nW Health Spsd5llrst Date (stamp, si9naN/a and date)
1B
THIS FORM MAY SE SCANNED AND AVAILABLE FOR PUSUC VIEW ON THE MASON COUNiI'WEB SITE � 2p
11 k 12 Keu f a572e1
1 j E 3 Jill DarrPi # Z213 11 90300
<7► I L-t I t rl rv. 7rc Po i r7t
I * Ie=i�=50=
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1 20 easrhewi'
APPROVED
1 w l MAR 21 2025
MASON COUNTY ENVIRONMENTAL HEALTH
RET
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