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HomeMy WebLinkAboutSWG2025-00002 - SWG As-Built - 6/6/2025 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2025-00002 Parcel # 32021-50-03005 Applicant Name Charles Swenson Subdivision (Name/Div/Block/Lot) Applicant Address 2224 SE Walker Park Rd. City, State, Zip Shelton, WA 98584 Installer Name T.J. Goos Site Address 2224 SE Walker Park Rd. Designer Name Dale L.Tahja INSTALLATION CHECKLIST ® Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑ Repair ❑Other System Type Pressure Trench Pretreatment Type >5 ft.from foundation? - ❑ N/A ®YES ❑ NO >50 ft. from wells? - VOI IsI❑ ® ❑ • >50 ft.from surface water? �t� ® ❑ HCleanout between building and tank? - - - - - t1 - L1 ® LiV Tank baffles present? - - - - - -p- - - - ■ © ❑ r24"access risers over each compartment? -- \ Ai.-. ii ® 0 W Effluent filter installed?- 8.1 e' - - - -•- 0 ® 0 co Septic tank capacity (working) 1,250 gal Manufacturer Hagerman (traffic rated) Ci D-box water level and speed levelers used? - - ® N/A ❑ YES ❑ NO OO Manifold/D-box accessible from surface?- - ❑ e 0 u. DOz Check valves installed? - - 0 ® 0 0< 2 Transport Line Size 2 inch Schedule/Class Sch.40 Bedrooms installed (check one) ❑ 2 EI 3 0 4 ❑ 5 ❑6 ['Commercial/Other 4 >10 ft. from foundation?- - ❑ N/A ® YES ❑ NO C] >100 ft. from wells?- - ® ❑ ❑ W >100 ft. from surface water? - - ❑ If u„ >10 ft.from potable water lines?- - ❑ a 0 Z >5 it.from property lines and easements?- - ❑ a ❑ Q O > 30 ft.from downgradient curtain/foundation drains? - - 0 II 0 • Drainfield level and observation ports present - - ❑ I 0 IN Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ ® ❑ Pump tank setbacks consistent with septic tank? - - 0 N/A ❑ YES ❑ NO Pump tank capacity (flood) 1,000 gal Manufacturer Hagerman (traffic rated) < 24"access riser(s)and accessible from surface?- - ❑ NO 0 ~ Alarm or Control Panel Installed? - - El UI CI 2 Control Panel equipped with Timer/ETM /Counter- - 0 0 0 M - Pump installed in ❑ Bucket or ® On Block or ❑ Other Pump Make/Model Liberty 280 0 Floats or 1! Transducer EL Tank draw down 2 in/min Pump capacity 44 gpm Squirt Height 6 ft Pump on time 2.7 min. Pump off time 5 hrs. 57.3 min. Daily flow set at 270 gpd Updated 8/21/2018 Mason County OSS Installation Report pg. 2 Parcel#3.am \' 6."C 15:)5 ABANDONMENT RECORD Were existing septic components abandoned as part of this �- - Yes ❑ No it yes, please describe: <. -\`t\r-� ti15 \\11 � �ki.)\\ 1� Nt-N--)\ Cam.._ Were all components pumped out androperly abandoned per'WAC246-272A-0300? - - gil YES ❑ NO RECORD DRAWING This Is a permanent record and must be accurate and descriptive enough 10 re-locate In the need of maintenance activities end future development Typical Record Drawings contain: Drainfleld&manifold orientation&layout,Sepliclpump tank bosion,North arrow,reserve drainfiekl,westing and proposed buildings,location of wets,waterlines, wells,observation pore,deanouts,and other malmlenence access points. Incomplete Record Drawings may create additional delays in final isdallation approval and related permits. -T.‘t\ c,\\e"C; VY- 1-__Z\ • .-1LS'\\e4Art7SINcEyk_..k).C.V\ _i&Ck\I- e.\- \•:%34C.:%. .,)-\.\\'")(1, --\ V\-SCr e _c-).S-ke(1 - \-..\ All-\( ),4_r\- .'-1\- __I ROtc6 T?\-N\ \). \-\\C" CN 2_ '*)*a sCA,Cr Or\ . 7.•a\NInt,1 \-/:3(.. C,3\ --\--M- NS _Y-.13_r \Z4". C.‘ d r co�� o�' 3 \r\. mart ® 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 co to ed on this I further certify that all information contained on this form n Signatureis of Installer Date I, PakAi-ovv Goo s -_:_y• dr.fr41:,.. •‘,./,44, . Printed Verne of Signee y,�,m'd�""*y •�g MASON COUNTY.PUBLIC HEALTH /� i� �� 4 Y . �' The undersigned approves this Installation Report and off 4'wipe1, ..- 5100214 ',�`:41 Record Drawing on behalf of Mason County Public ,+ 4' DALE L. TAHJA 'J I, -.-- ,e' Health:a..iviii,, 7- .-1 :�:��UNSED D SIGNER 1� .4 / /aç Exr . -' , �I Signature of Environmental Health Specialist Date J (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Updated 8r21rzo18 •t ..,. a, 4vdc%e 1.4 .4r...„,e., 4-- In • ," i., ''. "1-• C8 ---- 5:k..-2... ..oci t , • --1-- . , . A . :. .. ----, 1 , .e) r ,:)____.,-•-,cf-- No , ‘ r. (. 0) . 0 , ,,. ., • ,_ ,, , ,,• , Ipr .... .. • --„, • . .....„ _...... , ,,...._,_ • GI to A. .7"cie4.'/... 1 .. . tilo.• z, ,..•7 , Sur Iookr, a ".. • 1 ‘. • . , a . . , 0 • .1-• - d • Aci u (Ili 0 ., I 0 0 / • 111-.1211101. . ) -14--. . 41 / ...1 i --\•,.., / APPROVED / JUN 0 6 2025 /". jj / ti 16 L • 1 i MASON COUNTY ENVRONMENTAL HEALTH /.-. .,-(::: .11 i I, cli RET •-,........ i ,41 i • ./ • , •••'-' 1: , GliLj. , , ' • /06.. / : .... .g6th . i. . „L'Awl _...• t lk' i. ......,„.. .v. .._ .... . 1_........., 4111 . i;r14 -Ate , 8,1 / 1 5100214 Sit . I C 00 0 Oaks L.Tahis 0., LICENSED DESIGNER . • •, . .. . No•wkwelik...womowkwt