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HomeMy WebLinkAboutSWG2024-00417 - SWG As-Built - 6/11/2025 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2024-00417 Parcel# 32021-53-02036 Applicant Name Tracey& Michael McGlothlin Subdivision (Name/Div/Block/Lot) Applicant Address PO Box 1867 SHORECREST ADD REPEAT BLK: 2 LOT: 36 City, State, Zip Shelton, WA 98584 Installer Name Bamford Septic Repair Site Address 191 E Midway Ln Shelton Designer Name Arrow Septic Designs, nc. INSTALLATION CHECKLIST 111 Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑■ Repair ❑Other System Type Shallow Pressure Pretreatment Type ❑ NIA Q YES El NO >5 ft. from foundation? ❑ a ❑ >50 ft. from wells? ECEVE1 I ❑ >50 ft. from surface water? ❑ ❑ Z Cleanout between building and tank? - - ju�1-� 2 - - ❑❑ I ❑ U Tank baffles present? - ❑ . ❑ a24" access risers over each compartme tay ❑ I ❑ W Effluent filter installed? Septic tank capacity (working) 1 250 gal Manufacturer Sound Placement El NIA El YES ❑/ NO D-box water level and speed levelers used? - - El U CI mOJ Manifold/D-box accessible from surface?- ❑ � ❑ Z Check valves installed? 0< 2 Schedule/Class 40 2 Transport Line Size Bedrooms installed (check one) 0 2 ❑ 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other - El NIA Q YES El NO >10 ft. from foundation?- Q ❑ >100 ft. from wells? - ❑ a - ❑ NI ❑ Wit >100 ft. from surface water? - ❑ a it >10 ft. from potable water lines?- - -5 " 1 �� ❑ Z > 5 ft. from property lines and easements?- - ❑ • ❑ ce > 30 ft. from downgradient curtain/foundation drains?- - ❑ U ❑ CI Drainfield level and observation ports present - - ❑ 0 ❑ ® Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?- Pump tank setbacks consistent with septic tank? - - ❑ N/A El YES El NO Sound Placement • Pump tank capacity (flood) 1,250 gal Manufacturer ® El ❑ • 24' access riser(s) and accessible from surface? ❑ d Alarm or Control Panel Installed? - _ ❑ ® ❑ 2 Control Panel equipped with Timer/ ETM /Counter d Pump installed in ❑ Bucket or • On Block or ❑ Other a-• Pump Make/Model Zoeller N152 0 Floats or ❑ Transducer 33 gpm Squirt Height 4.5 ft Tank draw down 1.5 in/min Pump capacity a 6hr Daily flow set at 240 _9Pd Pump on time 1.8 min Pump off time updated&21.2G78 3 Mason County OSS Installation RaAB Parcel# 2021 2o3�o ANDONMENT RECORD YES 0 NO Were existing septic components abandoned as part of:his project? - NO If yes. please describe: • WAC24E 2.2A D300? III YES Were all components pumped out and properly abandoned per RECORD DRAWING ical Record This is a contain: Dr record ma must be accurate laynd out descriptive enough tank o location.Nortn arrcw in he need of maintenance activities and reserve drairield existing and proposed ibcudingsre .liocat on of wells,opment waterlines. Drawings contain: Drainfield&manifold orientate Y create additional delays in final installation approval and related permits. wells,observation ports,deanouts,and other maintenance access coins. Incomplete Record Drawings may 5e_.€-- li Record Drawing Attached CERTIFICATION OF INSTALLATION DESIGNER/ ENGINEER INSTALLER in accor- I certify that!installed the system in accordance with I danceywitht the the septiem hasc design tamped(APPROVED"by the septic design stamped"APPROVED"by Mason 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. 5'Lg-2S Date .�l Signature of lnstallel� � �. } sps Printed Name of Signee O 'r, . `'J' MASON COUNTY PUBLIC HEALTH LI r= w. ., approves this Installation Report and %c s,oesas '��tt The undersigned %"•' ' PAULA JOY JOHNSON••. t Record Drawing on behalf of Mason County Public in? LPAULA JOY J HNSVE1�•• Health: ! I` 1 ' (p-Co -LS- (stamp, signature and date) Signature of Environmental Health Specialist Date Updated 82t12Ct8 THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY'NEB SITE ° i i �4:--°4(.- � St(td? " ;rev I"` ©, ` �iiG110 U1Sl ci = 2--rr3�� ,1 Z - U 7. ��'�a '�J{-.o 4.�e-2 i � [2-CO Gallon Septic Tank rf�—•cam ,.:.� y U 2 Copaa�nent with WATER LINE ,;,< <. �� O. �%=��`- Effluent Filter41/4 riff. Galion Pump Chainbt SLE �� t �� �c -' i 4/3 Valve Control Box �. o P E I -;. n 0EA 2k-�;— c 4.0 , �L f -- ran CX�SA-. S J 1 � � L�1D✓ i 1 C' 1 i o` s i • 1 APPROVED '� 0 1 1 2025 MASON COUNTY ENVIRONMENTAL HEALTH RET SC-cQ Zo ../-4b 7 1; p' /o ' So' 4,c Ark l �i / y-j 'OJ349 ti_�i��, ��LS.�L � � PAULA JOY JOHNSON .•J�f1�