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Home My WebLink AboutSWG2022-00543 - SWG As-Built - 4/16/2025 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2022-00543 Parcel# 22105-50-00034 Applicant Name Laird, Harrison M&Margaret Subdivision(NamalCiv/Block/Lot) Applicant Address 1322 S Sunset Dr Cry,State,Zip Tacoma We 98465 Installer Name Shumaker Construction Site Address 931 E Mason lake rd Designer Name Pioneer digging Inc INSTALLATION CHECKLIST Full System Installation ❑Tank(s)Only ❑Drainfeld Only ❑Repair ❑Other System Type Bio Barnor drip Pretreatment Type Bid Samar >5 ft.from foundation? .-------____ -"' --"-'-- ❑trip .YES NO >50 ft.from wells? ------------- ----- - ❑ ® ❑ _ >50 ft.from surface water? ----___ _ __ Q Cleanout between building and tank? ----- ❑ El B�_____ ❑ V Tank baffles present? ------ Q _ ❑ ❑ 24"access daers over each compartment?---`F/d. S__ ❑ . ❑ Ul Effluent filter installed? _____ �9____ _. ❑ Cl Septic tank capacity(working) 1200 sal M rer Hagerman'. �O D-box water level and speed levelers used? ----- ® trap ❑Yes ❑ No QO Manifald/D-box accessible from surface?----_______ ❑ ❑ GQCheck valves installed? ----------------- ❑ ❑ 2 Transport Line Size 1" SGIN dlee/Cless 40 Bedrooms installed(check orw) ❑2 ❑3 04 ❑5 ❑6 ❑CommemiaUOther >10 fL from foundation?------------------------- - ❑ NIA fires ❑ NO G >100 ft.from wells?---------------------------- ❑ ■ ❑ W >100 ft.from surface watw7------------------------ ❑ . ❑ s >10ft.from Potable water lines?.---------- ❑ ❑ a >5R from property lines and easements?--------------- - ❑ ■ ❑ C >Wft.from dowagradient curt-m/faundaaon drams?---------- ❑ ® ❑ Drainfleld level and observation parts present ----- ❑ ® ❑ ❑ Graveless chambers or ❑ Clean gravel used? (check one) Proper cover Installed over dralnfleld? ----___ . ❑ ® ❑ Pump tank setbacks consistent with septic tank?_____________ ❑ MIA . Yes ❑ NO hdPump tank capacity(flood) 1500 at Manufacturer Hagerman's FQ-- 24"access naer(s)and accessible fromsurface?------------ . ❑ . ❑ (L Alarm or Control Panel Installed?-.................... ❑ ® ❑ Control Panel equipped with Timer/ETM/Counter----------- ❑ ❑ e' Pump installed in ❑ Bucket or ❑ On Block or ! Other flow inducer IL Pump Make/Model earned PF 200511 ❑Poets Of ❑Transducer 4 Tank draw down T 10min in/min Pump capacity 30 dpm S in Height N/A tt Pump on time 10 w.t tom. Pump oB rme .DeDv flow set at _Q o gpd �MVMM1/[O16 MASON COUNTY ENVIRONMENTAL HEALTH JBW Mason County OSS Installation Report pg. 2 Parcel# 22105-50-00034 ABANDONMENT RECORD Were existing Peptic components abandoned as pad of this project? -------------- - ® YES 0 NO It yes,please describe: were all components pumped out anal properly abandoned per WAC246-272A-0300? ------- - X YES 0 NO RECORD DRAWING Tub h.par,ruMnl rKptl are ml.r W.eo..h aM GXt,lpllw..UN.ro rHomta IT It.—d 1.1.1 no.W.Mro.^a Nwr.avNopm.nc Typa'al Rewa ^0.^^^Nlrt p,alrlflW LrnnbWmWanm 61.pq YptidpmpIarX bp!lor.No[M1 err-r—,.ae.A.11..10 -1 pm{ 4,,.uM,,bWWn rr-1o.wr�aeim., wIM.oErombn prole,tlumuX,.M W W nY'rMOrrOtl'4..pqu. Irwny4le IIew4&rewryv nrayw.r.aWllmal Ca:iR'^Ilryl ngallNim epyar.l enp e.k�aa pmN.. Appnovr APR 16 an: t MASON COUNTY EN ;L HEALTH JBW ® Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ENGINEER I certify that I installed the system in accordance with I cerdry that the system has been installed in accor- the septic design stamped'APPROVED'by Mason dance with the septic design stemped'APPROVED"by County Public Health and that any deviations shown Mason County Public Health and that any deviations hens have been cleareclapproved by bath the designer shown here have been clearedyapproved by both and Mason County Public Health and meet all State myself and Meson County Public Health and meet all and Mason County Codos. State and Mason County Codes I further certify that all information Contained on this t further Certify that all information contained on this form and alachad Record Drawing is accurate. form and attached Record Drawing is accurate. Signatum&instiller Dak Pouted Name of Signee a MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and r.sd'.p„„�s� Record Drawing on hehalf of Mason County Public w - .. .-- He exPIPEs (� L1-/c zf S1 atu imnmental Health Specialist Date (stamp,signature and date) THIS FORM MAY BE SCANNED AND AVAII.ABLE FOR PUBLIC VIEW ON THE MASON COUNTY We$SITE upea.a m'ara ` 2 0 c lzSo 7740, PC— y Oft 11 EXPIRES APR 16 2025 MASON COUNTY ENVIRONMENTAL HEALTH JBW