HomeMy WebLinkAboutSWG2022-00271 - SWG As-Built - 3/24/2025 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH
APPLICANT/ PERMIT INFORMATION
Permit Number SWG 2022-00271 Parcel# 32109-50-00099
Applicant Name AS Fine Homes LLC Subdivision (Name/Div/Block/Lot)
Applicant Address 871 E Beach Dr Alderbrook G&Y/Div 5/Lot 99
City, State, Zip Union,WA 98592 Installer Name Hanson Excavating
Site Address 70 E Rhododendron Ln Union Designer Name Am=Septic Designs Inc
INSTALLATION CHECKLIST
Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑Repair ®Other Wa PreT—Tank
System Type Subsurtace Ddp Pretreatment Type NuWater BNR-500
>5 ft,from foundation? -- --- ---M
❑ NIA ®YES ❑ NO
>50 ft.from wells? ---------- - ❑ ® ❑
Z >50 ft.from surface water? ---- - ❑ ❑
Cleanout between building and tank? - ❑ ❑Tank baffles present? - - - - - --- ❑F- 24"access risers over each compart ❑ul Effluent fitter installed?--- - - - -- ❑ ❑rnSeptic tank capacity(working) NuWufacturer Hagemran
O D-box water level and speed levelers used? -- ----- ----- --- ❑ NIA ❑YES ® NO
QJ
O Manifold/D-box accessible from surface?---- ------ - - - ----
I?�Z Check valves installed? -- - - --- -- - - - ----- - -- -- -- ❑ ❑
OQ 1" Schedule/Class 40
Transport Line Size
Bedrooms installed (check one) ❑ 2 ®3 ❑4 ❑ 5 ❑6 ❑CommerciaVOther
>10ft,from foundation?-------- -- - - - - - - ----- --- -- E] NIA ® YES NO
>100 ft.from wells?------ ---------- - ----------- ❑ ❑
W >100 ft.from surface water?- - -Af-MAR
-p� -- ❑ 0 ❑
M >10 ft.from potable water lines?Z >5 ft.from property lines and ea _a2025
> 30 ft.from tlowngretlient curtai COD ....... ❑ ® ❑
O Drainfield level and observation ports preselPE IRG'' 11TALAEq�;�, ❑ ® ❑
Proper cover installed over drainfield?--- - - --- -- -- -- --- -- ❑ ® ❑
Pump tank setbacks consistent with septic tank?-- --------- -- ❑ NIA YES ❑ NO
`l Pump tank capacity(flood) 1000 at Manufacturer Hagerman
2
24"access riser(s)and accessible from surface?------------- ❑
9
0. Alarm or Control Panel Installed? - ---- - ------ -- ❑ El
M Control Panel equipped with Timer/ETM/Counter-- -- - --- - -- ❑ ® ❑
7
o_ Pump installed in E] Bucket or ❑ On Block or E Other Flow Inducer Tube
a Pump Make/Model Orenco PF200511 ® Floats or ❑ Transducer
a
Tank drew down 2"in 10 min in/min Pump capacity 3.8 bpm Squirt Height - ft
Pump on time 8 min Pump off time 1.84 hr. Daily flow,set at 360 upd
llWabO&11R0,8
Mason County OSS Installation Report pg. 2
Parcel#
ABANDONMENT RECORD
■
Were exlstlng septic components abandoned as part of this projectp ❑ YES NO
If yes, please describe:
Were all components pumped out and properly abandoned per WAC246-272A-0300? ------"
❑ YES ❑ NO
RECORD DRAWING
Tnb is a In...ramN and man,ne aecunra and dacono%M enough on nwoute in the need W ma oundanae a[Mxln and Moro dovehopmanL 1 .1 se.
D.I.uMein: OMn&4d&mnnend onama l0h B lrydut,SQPWPump rink bcaticn.Nord an'M maerve dninfield.eadbop and prt}and Euldvage Idaho a"I.,nateRnu,
wNb,cO..n,..daenwn,and order manMn-..00m.palns, Incamphad Rennet Dminga on,naaae add2mal dalayain Pealinemnlion 8,—W and Naled pennlu.
APPROVE
MAR 2 4 2025
MASON COUNTY ENVIRONMENTAL HEALTH
JBW
M Record Drawing Attached
CERTIFICATION OF INSTALLATION
INSTALLER DESIGNER/ENGINEER
I certify that I installed the system in accordance with I cerbly 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 clearad/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
/further certify that all information contained on this I further car*that all information contained on this
form
and attached Record Drawing is accurate, form and attached Record Drawing is accurate.
l_IQiW.GG Wao-a61L 3-Stz-
Sig re of Installer Date
Jared Hanson
Printed Name of Signse tie
MASON COUNTY PUBLIC HEALTH ¢ 1�
The undersigned approves this Installation Report and `}
Record Drawing on behalf of Mason County Public PAUu JOY JOHNSON'.
h: I 1 ..
S' n.AIV Enwronmema/Health Specialist Date (stamp, signature and date)
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE °primed en+nom
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