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HomeMy WebLinkAboutSWG2020-00612 - SWG As-Built - 5/7/2025 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2020-00612 Parcel # 32104-54-00003 Applicant Name James Lanman Subdivision (Name/Div/Block/Lot) Applicant Address PO Box 423 Alderbrook G&Y#4 TR 3 City. State. Zip Shelton, WA 98584 Installer Name Manke Excavating Site Address 20 E Country Club PI, Union Designer Name Arrow Septic Designs, Inc , INSTALLATION CHECKLIST ® Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑ Repair ❑Other System Type Shallow Pressure Pretreatment Type >5 ft. from foundation? - - - - - - ❑ N/A 0 YES ❑ NO >50 ft. from wells? - - ❑ 0 El Z >50 ft. from surface water? - - [1] ElI H Cleanout between building and tank? - - El El El- - - U Tank baffles present? - - El 0 ❑ F- 24" access risers over each compartment?- - ❑ 1 ❑ a W Effluent filter installed?- - El ❑■ El rn Septic tank size 1,200 gal Manufacturer Sound Placement o D-box water level and speed levelers used? - - -- -- - - ❑ NiA ❑ YES Q NO DO Manifold/D-box accessible from surface?- - - - -- - ❑ IUI El u. OOZ Check valves installed? - -- - - -- - ❑ ■❑ ❑ 0< 2 Transport Line Size 2" ScheduleiClass 40 Bedrooms installed (check one) ❑■ 2 El 3 ❑4 El 5 El 6 El Commercial/Other >10 ft. from foundation? - -. - - - - - - - -- - -- - ❑ N/A © YES ❑ NO CI >100 ft. from wells?- - -- -- - ❑ E ❑ W >100 ft. from surface water? - - E] ❑i El LL >10 ft. from potable water lines?- - - - -- -- -- - 51��1/43. --a3L-' - ❑ ❑ U z > 5 ft. from property lines and easements?- - - - - ❑ ® ❑ a ❑ • ❑ � > 30 ft. from downgradient curtain/foundation drains - - - - -- - - - - - • Drainfield level and observation ports present - - El II ❑ ❑ Graveless chambers or • Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ ■❑ ❑ Pump tank setbacks consistant with septic tank? - • - ❑ N/A ® YES ❑ NO • Pump tank size 1,000 gal Manufacturer Sound placement < 24" access riser(s) and accessible from surface? - - - - ❑ © ❑ F- a Alarm or Control Panel Installed? - - ❑ ® ❑ 2 Control Panel equipped with Timer/ ETM /Counter- • - ❑ ® ❑ D a Pump installed in El Bucket or © On Block or ❑ Other a• Pump Make/Model Glouds PE 51M © Floats or ❑ Transducer a Tank draw down 1.9 in/min Pump capacity 40 gpm Squirt Height 8 ft Pump on time 1.5 min Pump off time 6 hr Daily flow set at 240 gpd Updated£+i'.: Mason County OSS Installation Report pg. 2 Parcel# 2.I o S - 00 003 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 drainfield,existing and proposed buildings,location of wells,waterlines, wells,observation ports.cteanouts,and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and related permits. 42,c aid 5f?h-5 IR Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ENGINEER I certify that l 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 and attached Record Drawing is accurate. form and attached Record Drawing is accurate. , 9-7 -21 ig/�ature nstaller Date . Printed Name of ignee s°t , (?I? MASON COUNTY PUBLIC HEALTH • The undersigned approves this Installation Report and , •' 1'n Record Drawing on behalf of Mason County Public ''r PAULA JOY J.51C('319 OHNSON )\ Health: LiC�1lS00D`0.45k" t, Si nature of Environ ental Health Specialist Date g P (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Updated 8212018 11 wlkr({sue DJ ifhdi• ` to` ac ocYl srPf` —\--,r-e ,� 1, • 1-1 ,5� V\• z !slo� w' o .c4)ya ri`f I W i i I . ' ' 23 1 21� sol.S MNA• I APPROVED is. �_=---f MAY07 s 2025 '1• MASON CCUMA —' / ' ---- .- L___ ; ENVIRON,MENTAIq . rli•. 7 i REr %e •• • 1 r ` k_ :::---- <; 'Q \ —iu : •• ( \•II. . .,=/ mim.••• .. ..., (006 5f Drzp restrvt 1 _: _ Lb _ , ! e h 100 r T n.,, c a © ASbUI1t. Effluent Filter • pia c � ___ _ 3 1000 Genoa tZEO�-5y Pc 0 [nnyt. CW _ v`. `l © Valve �.. 1 ,b ,+dam, , 'h 0 10 ZG 3Q r I"IP) . r;_ F !:( . 5100J49 i �V 7`� PAULA JOY JOHNSON