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HomeMy WebLinkAboutSWG2024-00448 - SWG As-Built - 6/6/2025 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION • Permit Number SWG 2024-00448 Parcel # 32011-24-00000 Applicant Name Joseph & Ellie Wilfong Subdivision (Name/Div/Block/Lot) Applicant Address 3200 Galvin Rd N1/2 N1/2 SE NW �9� City. State, Zip Centralia, WA 98531 Installer Name Maples Excavating < O Site Address 700 E Daniels Rd, Shelton Designer Name Arrow Septic Designs /G� �, INSTALLATION CHECKLIST • Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑ Repair 0 Other 500 gallon pre-trash tan' System Type Pressure Trench Pretreatment Type NuWater BNR-500 >5 ft. from foundation? - - El N/A A YES ❑ NO >50 ft. from wells? - - ❑ II ❑ Z >50 ft. from surface water? - - E] 0 ❑ H Cleanout between building and tank? - - ❑ El U Tank baffles present? - - ❑ . ❑ a 24" access risers over each compartment?- - El ❑ * W Effluent filter installed?- - ❑ ❑ D N Septic tank capacity (working) NuWater BNR gal Manufacturer Hagerman O D-box water level and speed levelers used? - - ❑ N/A Ll YES ❑ NO DO Manifold/D-box accessible from surface?- - ❑ El ❑ co 2 Check valves installed? - se - ❑ El ❑ 6Q n Transport Line Size 2 inch Schedule/Class 40 Bedrooms installed (check one) El 2 ■❑3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10 ft. from foundation?- - ❑ N/A El YES iii NO c=) O >100 ft. from wells?- - ❑ • t W >100 ft. from surface water? - - 0 El . t Li >10 ft. from potable water lines?- - ❑ D rvZsii • > 5 ft. from property lines and easements?- - ❑ E b re > 30 ft. from downgradient curtain/foundation drains? - - ❑ © r . 4 Drainfield level and observation ports present - - ❑ ® 14] 1. ❑ Graveless chambers or ® Clean gravel used? (check one) 1 C=== Proper cover installed over drainfield?- - ❑ 0 ❑ Pump tank setbacks consistent with septic tank? - - El N/A ❑■ YES ❑ NO • Pump tank capacity (flood) 1,000 gal Manufacturer Hagerman Q24' access riser(s) and accessible from surface?- - - - - - ❑ I ❑ ~ a Alarm or Control Panel Installed? - - El • ❑ 2 Control Panel equipped with Timer/ ETM/Counter- - ❑ • ❑ D - Pump installed in El Bucket or On Block or ❑ Other a• Pump Make/Model Zoeller N152 El Floats or ❑ Transducer a_ a Tank draw down 1.75 in/min Pump capacity 33 gpm Squirt Height 7 ft Pump on time 2.7 min Pump off time 6 hours Daily flow set at 360 gpd ,;pctated E:212C113 immir Mason County OSS Installation Report pg. 2 Parcel l 2� �'� � ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - ❑ YES 71 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: Drainfieid&manifold orientation&layout.Septic/pump tank location,North arrow.reserve drainfield,existing and proposed buildings,location of wells,waterlines. wells,observation ports,cleanouts,and other maintenance access points. Incomplete Record Drawings may ceate additional delays in final installation approval and related permits. n � 'Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ENGINEER I 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 and attached Record Drawing is accurate. form and attached Record Drawing is accurate. (NI/15/25 Signature of installer{ Date Printed Name of Signee �c of 'Mt F� MASON COUNTY PUBLIC HEALTH a 3' ' The undersigned approves this Installation Report and r • 5160349 ••• kV) Record Drawing on behalf of Mason County Public '" AULA JOY JOHNSON Health: Lit tattiESIGNrtt p Re / 5--2 0-ZS Signature of Environmental Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE updated 8212018 w Cg%2 X 2 7 •'i i W ia.Ery . ..='Ccre�ac..,te5 SV»cxre. Gc L 25 5 o a *-:, = ;,e.LS 'R. ----I- tfr } ,,z$S I _ _ _ _ _ -- J _ ' i / �__ / cr/ ' / —Ir _ r eljAvt 0 f'$19 .-., ...-- \',.. /".. ,o0-4- 5'•y' v,` i . vArea s r• ry 1 jsp'j = i` t i ,e, zOt/i� [ r ti 5ieQ-' . L•.3ca2Ytivi.2 i-rr u c`{ cn iC' 0"FC-14y 5 "i--;C Govnto a4.16.41 S CPrL-E . -'•CC3 e Sd eno 1SG %Aro 0 Audio-Visual.Alarm A,c-9),Lt -1 a Or y; O500 Ge!lon Pre-Trash tank R-f2iCE1 32iOk OJf` O ti�����ater BNR-500 ATE a-n ,, : v _,000 Gallon P-m- o Chamber " '4, • S}k i_`�J ' {z , L O Valve Control Box Li li APPROVED N` pAULA JOY JOHNSON` t rutaiso b>=srGN�a- JUN 0 6 2025 i�` 5cb MASON COUNTY ENVIRONMENTAL HEALTH 5-2.0-t2s • RET