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HomeMy WebLinkAboutSWG2025-00143 - SWG As-Built - 6/23/2025 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2025-00143 Parcel # 422045100008 Applicant Name Bette Pierson Subdivision (Name/Div/Block/Lot) Applicant Address C/O Patricia Sahr City, State, Zip Yakima Wa 98908 Installer Name Schoening Excavating LLC Site Address 100 N Duckabush Dr W Designer Name N/A INSTALLATION CHECKLIST ❑ Full System Installation ❑Tank(s)Only 0 Drainfield Only ®Repair ❑Other System Type Gravity Pretreatment Type >5 ft. from foundation? - - 0 N/A 0 YES ❑ NO >50 ft.from wells? - 0- 0 0 0 z >50 ft.from surface water? - - 0 ❑I 0 Cleanout between building and tank? - - ® ❑ 0 V Tank baffles present? - - ❑ II 0 d24"access risers over each compartment?- - ❑ II W Effluent filter installed?- ❑ © 0 Septic tank capacity(working) gal Manufacturer CID-box water level and speed levelers used? - - 0 N/A 0 YES ❑ NO DO Manifold/D-box accessible from surface?- - 0 ® El oil Check valves installed? - - ® 0 0 GQ 2 Transport Line Size 4" Schedule/Class 3034 Bedrooms installed (check one) 0 2 0 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10 ft.from foundation?- - ❑ N/A ® YES 0 NO CI >100 ft. from wells? - - 0 © 0 W >100 ft. from surface water? - - ❑ 0 0 Li >10 ft. from potable water lines?- - ❑ 0 0 Z > 5 ft.from property lines and easements?- - 0 ® ❑ Q Q > 30 ft.from downgradient curtain/foundation drains? - - ❑ 0 0 Drainfield level and observation ports present - - 0 0 0 0 Graveless chambers or 0 Clean gravel used? (check one) Proper cover installed over drainfield?- - 0 ® 0 Pump tank setbacks consistent with septic tank?- - ❑ NIA ❑ YES 0 NO Pump tank capacity (flood) gal Manufacturer < 24"access riser(s)and accessible from surface?- - 0 0 0 I - d Alarm or Control Panel Installed? - - 0 0 0 2 Control Panel equipped with Timer/ ETM/Counter- - 0 0 0 M a- Pump installed in ❑ Bucket or ❑ On Block or 0 Other 2 Pump Make/Model ❑ Floats or 0 Transducer 0. a Tank draw down in/min Pump capacity gpm Squirt Height ft Pump on time Pump off time Daily flow set at gpd Updated 8/21/2018 Mason County OSS Installation Report pg. 2 Parcel# 422045100008 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - ❑ YES Q NO If yes, please describe: Were all components pumped out and properly abandoned per WAC246-272A-0300? - - ❑ YES 0 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,cleanouts,and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and related permits. 0 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. 5/16/2025 Signature of Installer Date Bravden Schoeninq Printed Name of Signee MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and Record Drawing on behalf of Mason County Public Health: f 7 c Signature of Environmental Health Specialist Date (stamp, signature and date) Updated 8/21/2018 THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE r x3 I r "0 --k rj."-§ig 111 o �o� , ... __ _ ,� _ z w 0 `,• i' a o e t oe f o� H t 11i ; '....‘-I. Sh------------- i R-- 4, I 0 I i & R- cf '''' gg`b g 1 ' & 5 . • J -rt 1 Efr- ,e. F X a. a� — # s s m G a ¢- cs s p '? o APPROVED f s s JUN 2 3 2025 I S� o '� - �- = a— MASON COUNTY ENVIRONMENTAL HEALTH °� �• RET