HomeMy WebLinkAboutSWG2024-00357 - SWG As-Built - 6/6/2025 Mason County OSS Installation Report pg. 1
MASON COUNTY PUBLIC HEALTH
APPLICANT/ PERMIT INFORMATION
Permit Number SNG
2024-00357 Parcel # 32025-50 90544
Subdivision (Name/Div/Block/Lot)
Applicant Name Kraig & Marjorie Scherz Applicant Address 9320 Steven Mill Creek Park Unrecorded Lot 4
s Ct NE Maples Exr avatina
Installer Name
City, State, Zip Lacey,WA 98516 Arrow Septic Designs, Inc
Site Address
XXX SE Snider Rd, Shelton Designer Name
INSTALLATION CHECKLIST
air ®Other 500 gal pre-trash tank
Hi Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑ Rep
System Type Shallow Pressure
Pr- -atment Type NuWater BNR 500
1, _ ❑ NIA A YES ❑ NO
>5 ft. from foundation? - L� ❑ ❑j ❑>50 ft.from wells? - Vit.ftl-\\
❑ ❑
• >50 ft. from surface water? u 6-925 y ❑ il ❑
Z ❑• Cleanout between building and tank? ❑ 0o Tank baffles present? - ❑ n ❑
a24" access risers over each compartme iY - ❑ ❑
ui Effluent filter installed? $rTR- Hagerman
El
cn
Septic tank capacity (working) NuWater 500 gal Manufacturer
N/A DI 0 NO
`0 D-box water level and speed levelers used? - - ElLI
❑
�O Manifold/D-box accessible from su�rf�?�-u�-E�� - ❑❑ � ❑
0?Z Check valves installed? -
OQ 2 Schedule/Class 40
5 Transport Line Size
2 ❑ 3 O 4 ❑ 5 1]6 ❑Commercial/Other
Bedrooms installed (check one) ID _ ❑ NIA (] YES ❑ NO
>10 ft. from foundation? - ❑ � ❑
CI >100 ft. from wells?- ❑ 0 El
>100 ft. from surface water? - - El wi ❑
LT >10 ft. from potable water lines?- 0 El? > 5 ft. from property lines and easements? ❑ 0CI X
Q 0
� > 30 ft. from downgradient curtain/foundation drains? - ❑
o
Drainfield level and observation ports present
❑ Graveless chambers or ] Clean gravel used? (check one) ❑ El CD
cover installed over drainfield?
El tJ YES ❑ NO
Pump tank setbacks consistent with septic tank? -Pump tank capacity (flood) Ha erman
1250 gal Manufacturer
�_< 0 K
24" access riser(s) and accessible from surface?- NI 0
Fa— - El
• Alarm or Control Panel Installed? ❑ ® II! Control Panel equipped with Timer/ ETM /Counter-
n- Pump installed in ❑ Bucket or Q On Block or
Other
0- Pump Make/Model Zoeller N152
0 Floats or ❑ Transducer
D. 66 gpm Squirt Height 7 5 ft
Tank draw down 3" in/min Pump capacity 480 gpd
6 hr
Pump on time
1.8 min Pump off time Daily flow set at uGdated81212018
.- ro SS�k
Mason County OSS Installation ReAB �: 12 rn -ga
Parcel+*
ANDONMENT RECORD
- - - -- - 7YES Ili NO R
6
Were existing septic components abandoned as par: of this project? - - r
I`, yes, please describe: _ . YES L NO
Were all components pumped out and properly abandoned per WAC246-2?2A-03QC? - -- - - -
RECORD DRAWING
ment Typical Record
and proposed future
development
of wets,al waterlines,
This is a permanent record and must be accurate and descriptive enough to re-locate ir,the need of maintenance activities and`uture deve op permits.
a r 9nal!bull i ion 2pProon and ts,ed
Drawings contain: Drts.cI d 8 na.andd trier main&layout.Sess ponts. Incok me to Record Drawings n.aydma a ac itional delays ,
wets,obser Oon porn.deara5.and other maintenance access po ' .
v k—ps) k
j 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 actor-
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
1 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 DDT ling is accurate.
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'Signature of installer Data <�1' �1' gg
;i✓'i�\i•-\•� t' / ��
Printed Name of Signee — a
MASON COUNTY PUBLIC HEALTH .-!°} 510J349 .,^y
�0�'` PAUTA JOY JOHkSON •r `l�
The undersigned approves this installation Report and . FAU HN..---
Record Drawing on behalf of Mason County Public 1,t• - 4j�F �� �Sb
Health: l e �' (p_(.._y,,$'
p7AQXYTY1f)
6
(stamp, signature and date) i
Signature of Environmental Health Specialist Date
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SI T
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3 Audio-Visual Alarms 4 ;I 9/13Cleanout �' 1 :; Is
3 500 Gallon Pre-Trash tank f ! {
3 NuWa:e:B\'R-500 ATU Tank 1 1 4 i
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' 3 1.200 Gallon Pump C'I+omber i
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