HomeMy WebLinkAboutSWG2023-00513 - SWG As-Built - 4/29/2025 4
.
RECORD DRAWING (ASBUILT) pg. 1 MASON COUNTY PUBLIC HEALTH
0' PARCEL IDENTIFICATION
Permit Number SWG 2023-00513 Assessor Parcel # 221332150004
Applicant Name ANDY GRUHN Subdivision (Name/Div/Block/Lot)
Applicant Address 2318 65TH LN NW LLS22-02 LOT 4
City, State, Zip OLYMPIA, WA 98502 Installer Name MASON COUNTY EXCAVATING
Site Address 1487 E PICKERING RD Designer Name ADAM HUNTER
INSTALLATION CHECKLIST
0 Full System Installation ❑ Septic Tank Only ❑ Drainfield Only ❑ Repair
System Type SIMPLE PRESSURE Pretreatment Type N/A
1 >5 ft. from foundation? - - - - - - ❑ N/A 0 YES ❑ NO
>50 ft.from wells? - - - - ❑ 0 ❑
4 >50 ft. from surface water? -Z 1%:\o-- - - CI 00
Q Cleanout between building and tank? - %%.- - - - - - - - ❑ 0 0
F-
ti= ❑ 0 0
V r Tank baffles present? - ‘t - - - �- - -
a ! 24" access risers over each compart ' - - �Q� - - - - - - ❑ 0 ❑
W Effluent filter installed?- -
N 4 . 1200 HAGERMAN❑ PRECAST❑(H20 RATED❑)
•., Septic tank size gal • acturer
foi
D-box water level and speed levelers used? - - 0 N/A El YES ❑ NO
)<O Manifold/D-box accessible from surface?- - ❑ 0 0
o02 Check valves installed? - - ❑ 0 ❑
ciQ
2 Transport Line Size 2 Schedule/Class 4
Bedrooms installed (check one) ❑ 2 0 3 ❑4 ❑ 5 ❑6
>10 ft. from foundation? - El N/A 0 YES El NO
0 >100 ft. from wells? 0 0 ❑
W >100 ft. from surface water? - - CI0 0
tL >10 ft. from potable water lines?- - ❑ 0 ❑
z 5> ft. from property lines and easements?- - 0 00
a
( > 30 ft. from downgradient curtain/foundation drains? - - ❑ ❑✓ ❑
rn
Drainfield level and observation ports present - - 0 CI 0
0 Graveless chambers or ❑ Clean gravel used? (check one)
Proper cover installed over drainfield?- - 0 ❑✓ ❑
Pump tank setbacks consistant with septic tank? ❑ N/A ❑✓ YES ❑ NO
Pump tank size 1200 gal Manufacturer HAGERMAN PRECAST (H20 RATED)
24" access riser(s)and accessible from surface?- - ❑ ❑✓ ❑
Alarm or Control Panel Installed? ❑ ❑✓ ❑
Control Panel equipped with Timer/ ETM /Counter-
1 - ❑ 0 ❑
n- Pump installed in ❑ Bucket or 0 On Block or El Other
a• Pump Make/Model LIBERTY 280 0 Floats or ❑ Transducer
a Tank draw down 3.3 in/min Pump capacity 79 gpm Squirt Height 4 ft
Pump on time 0.76 MIN Pump off time 4 HRS Daily flow set at 360 gpm
revised 1/22/2014
moureamor
RECORD DRAWING (ASBUILT) pg. 2 MASON COUNTY PUBLIC HEALTH
T
RECORD DRAWING •
❑ Drainfield&
manifold orientation
&layout
❑ Trench/bed
dimensions and
critical distances
within layout
❑ Septic/pump tank
placement SEE ATTACHED
0 ❑ Location of
buildings
❑ Observation ports&
clean-out locations
❑ Location of wells,
surface water,&
roads
❑ Undisturbed native
soil between
trenches
0 North Arrow
If the designer or installer feel the need for additional information/comments, it may be attached.
Record drawing may also be on a seperate page attached. No. Pages Attached
CERTIFICATION OF INSTALLATION
INSTALLER DESIGNER
1 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 an l•attached Record D awing is accurate. form and attached Record Drawing is accurate.
II4/22/25
Signs ure of Installer Date
ALAN KIRK
4/22/25
Printed Name of Signee ill - rV
MASON COUNTY PUBLIC HEALTH •.�7• s..►e 't
The undersigned approves this Installation Report and ""''',: �•
.•r•- �Z
Record Drawing on behalf of Mason County Public .ti 4 r •.�,#
Health. .:-.- ADAU J.HUNTER •• I
Tirr�i:,r Is IWA... l,.
kTINUIY\ ,YYJ q q/7-S _ ,,,,.F 5 �. ., 26
Signature of Environ!ental Health Specialist Date (designer's stamp, signature and date)
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE
revised 1/22/2014
to
03
0
XI
7J
m
cn
toco
Otte
O
C
_74,
0
r v
i C
K
O n cn
1 = m
v
K n n
D
' Z r
m m
n
17
Zii
r
m OOZ p o o
u u) O
o r
D
7-1 co
O 0 iv
r m
)0" m Z V
N X Co 0
z m 1
> to
G7CD D_
co
Z V Z �• - 1ij
, co
\ so 0
cm
z cr x \ \\ ` '�J i1 m
r \ \� D 0 I w
--1 / \ <-
= m ,u
K
/ / m to
ilig
/ 4 / ni
0
Z
c
r
O
13
m
T.
i m
Z / %
p 1� D i
Z c�
m - i
241.80'
i
X
z n ►-,
0 n O• �' _I 0 (n 71
N D D �in) , O m O m
8 c Z _, ry m m 03 O = X z:'ter,
p = N r�y o -i m f.,s.
x t
J Z C +� �r1 Rom., Cn • f.. #..,,c::i
ot O N A. s; ' •
v O ) A b�
ll m
0
03
Crl
m D - Z
I— D D M —i —I
0 0 r D
x cn 0 D
cn m x m D z 0 r
O , m (A m 0 X m
o a -0 to O X
91 Co x r A Z
m
o x O a.'cn m
w
2 r X 0
X D
O D
O
z