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HomeMy WebLinkAboutSWG2024-00343 - SWG As-Built - 4/11/2025 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2024-00343 Parcel # 22018-51-00043 Applicant Name Jason Engh Subdivision (Name/Div/Block/Lot) Applicant Address 5229 S STATE ST TIMBERLAKE#3 LOT:43 & 1/21 INT LOT 71 City, State, Zip Tacoma WA, 98409 Installer Name Maples Excavating Site Address 80 E Carr PI East, Shelton 98584 Designer Name Arrow Septic Designs Inc. INSTALLATION CHECKLIST — © Full System Installation ❑ Tank(s)Only ❑ Drainfield Only ❑ Repair ❑ Other System Type Shallow Pressure - - ment Type 1 >5 ft.from foundation? (�� i- - ❑ N/A 0 YES [1] NO >50 ft. from wells? - lJ ❑ ® ❑ Z >50 ft.from surface water? - - oil -1-�02�- • 0 ❑ a Cleanout between building and tank? - - - - - -- - ■ 00 U Tank baffles present? - - - - - - , 0 ❑ F— 24" access risers over each compartment?- 5-Y- - - ❑ 0 ❑ a W Effluent filter installed?- - ❑ 0 ❑ U) Septic tank capacity (working) 1250 gal Manufacturer Hagerman o D-box water level and speed levelers used? - - ❑ N/A ❑ YES ■❑ NO >40 Manifold/D-box accessible from surface?- - ❑ NB mZ Check valves installed? - - ❑ ® ❑ 0< 2 Transport Line Size 2" Schedule/Class 40 Bedrooms installed (check one) E 2 ■❑ 3 ❑4 E 5 ❑ 6 ❑Commercial;Other >10 ft. from foundation?- - ❑ N/A 0 YES ❑ NO >100 ft. from wells?- a ❑ 0 a ❑ W >100 ft. from surface water? -pr IP v MI ❑ ti >10 ft. from potable water lines? - - - - '°` - ':3 ❑l ❑ z > 5 ft. from property lines and easement- ,. - -- 1-t --- - ■ 0 ❑ Q Q > 30 ft. from down gradient curtain/found- • ains? ��E11�A1-hF� Li Drainfield level and observation ports prel J�L4 - BV'�- - -- ❑ iii Li ❑ Graveless chambers or • Clean gravel used? (deck one) Proper cover installed over drainfield?- - ❑ ® ❑ Pump tank setbacks consistent with septic tank? - - ❑ N/A IN YES ❑ NO • Pump tank capacity (flood) 1000 gal Manufacturer Hagerman Q 24" access riser(s) and accessible from surface?- - ❑ I ❑ H a Alarm or Control Panel Installed? - - Elg El 2 Control Panel equipped with Timer/ETM /Counter- - ❑ ® ❑ m - Pump installed in ❑ Bucket or ® On Block or ❑ Other CI- E Pump Make/Model Zoeller N152 EI Floats or ❑ Transducer a Tank draw down 2.5 in/min Pump capacity 48 gpm Squirt Height 6 ft Pump on time 1.9 min Pump off time 6hr Daily flow set at 360 gpd Jodmcd 8/212C 18 Mason County OSS Installation Report pg. 2 Parcel 2200?- S1- 000 3 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 This is a permanent record and must be accurate and descriptive enough to re-locate in the need of maintenance activities and future development Typical Record Drawings contain: Drainfield&manifold orientation&layout.Septic/pump tank location,North arrow.reserve drairfield,essting and proposed builcings,location of wells,waterlines, wets,observation ports,deanous,and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and related permits. APPROVE APR 17 2025 0 MASON COUNTY ENVIRONMEN'Li I \Cord Drawing Attached ram;: CERTIFICATION OF INSTALLATION INSTALLER DESIGNER!ENGINEER I certify that I installed the system in accordance with l 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. �,' ,,,g,-k 2- 13-z5 ,..,` Signature of Installer Date ff<4.��2u\•��� k (4''` � te 5d:i.. Printed Name of Signee r..; :'0 'ri. / MASON COUNTY PUBLIC HEALTH �, �.J • The undersigned approves this Installation Report and y PAULA JOY JOHNSON yrl Record Drawing on behalf of Mason County Public ' f 1. � � �_ �>:ct J_� �ti[�iGN�a:: � alt , a. �'S � �CSJIP EXPIRES /1-5/ 0 /f C) k., L(- (-7, 4 if--(c-Z5- V__ Sig tur �vironmental Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE ua.:acec 8212018 , ( yg' x 2S' ?i l k5� C R Pt y 1 o, Vf Tftvt4c.ffEs @ H.0 • `<S%, ( \ . to Zoo LF oc Resc r D.E A6°Ve • \ 1 ,' t �g i ', I / i / ,/ / / / , , *49 I Dr . \ I \ / i l�I P',rki• \ M 4 © 0 ® s , WATP.L N E 0 AsR `, =5 1 v' �'RGi,A <8, i^ \\ j.f: ` k. Gam?C- . = 3c.) - • B :S -go AS' el. Kev NS - Rctii I t 0 Audio-Visual_Aar, .. __- . 3-5 v vz EV15 ,-, _ _ 3 C?eanout PA C.E.L"`22�is's?-cz0Ys . U. 1200 Gelo_ Septic Tank 2-Co (3a-�R up a,-nent wi P i_ e Effluent.Filter. ice L:D ,t OAr G F-a* O 000 Galion Pump Chamber OValve Control Box A. 11t5 ,, N �� 6NSA` �ANN\1Rp S' Ni,`ofry• �t •' 1 4 ' 5100349 %I) ta' PAULA JOY JOHNSON ',"\ OSpppJ6 ucm b GNER • Lk)_t k-t