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HomeMy WebLinkAboutSWG2023-00298 - SWG As-Built - 6/25/2025 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2023-00298 Parcel # 42125-76-90044 Applicant Name Julie Meyer Subdivision (Name/Div/Block/Lot) Applicant Address 97 E Wilson Rd Lot D of SP#2154 AF#539918 City. State, Zip Shelton, WA 98584 Installer Name Joe Fassio Excavating Site Address 30 E Lexington PI, Shelton Designer Name Arrow Septic Designs-as-built only INSTALLATION CHECKLIST Iff Full System Installation ❑ Tank(s) Only ❑ Drainfield Only ❑ Repair ® Other 50'Attenuation Zone System Type Shallow Pressure Trench Pretreatment Type >5 ft. from foundation? - - ❑ N/A 0 YES ❑ NO >50 ft. from wells? - - ❑ 0 ❑ z >50 ft. from surface water? - - ❑ ❑ ❑ H CI El CI between building and tank? - - U Tank baffles present? - - ❑ • ❑ a 24" access risers over each compartment?- - CI CI. LU Effluent filter installed?- - ❑ il ❑ u) Septic tank capacity (working) 1,250 gal Manufacturer Hagerman CI D-box water level and speed levelers used? - - ❑ N/A ❑ YES 0 NO �JO Manifold/D-box accessible from surface?- - CI CI 0?2- Check valves installed? - - El ❑■ ❑ O<t 2 Transport Line Size 2" Schedule/Class 40 Bedrooms installed (check one) ❑ 2 ❑■ 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10 ft.from foundation?- - ❑ N/A 0 YES ❑ NO O >100 ft. from wells?- - ❑ ❑■ ❑ W >100 ft. from surface water? - - CI 0 ❑ it >10 ft. from potable water lines?- - ❑ 0 ❑ � > 5 ft. from property lines and easements?- - ❑ 0 ❑ Q ce > 30 ft. from downgradient curtain/foundation drains? - - ❑ 0 ❑ • Drainfield level and observation ports present - - ❑ 0 ❑ x7 ��--- 0 Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ 0 ❑ C Z Pump tank setbacks consistent with septic tank? - El N/A 0 YES ❑ NO �Y Pump tank capacity (flood) 1,250 gal Manufacturer Hagerman o 24"access riser(s) and accessible from surface?- - El0 ❑ �F— El © ❑, Alarm or Control Panel Installed? - r Control Panel equipped with Timer/ETM /Counter- - ❑ I ❑ d Pump installed in 0 Bucket or El On Block or ❑ Other a• Pump Make/Model Zoeller N152D ❑■ Floats or 0 Transducer a • Tank draw down 2" in/min Pump capacity 44 gpm Squirt Height 10 ft Pump on time 2 min Pump off time 6 hr Daily flow set at 360 gpd Updated e21 20 7 3 Mason County OSS Installation Report pg. 2 Parcel a 4 2 12j— i-— `1 ° `f 4 ABANDONMENT RECORD -s NO Were existing septic components abandoned as Jar of this project% _ _ _ - - - E - - describe:please descr ❑ YES 7-1 Id It yes. a4o-2?2A-0300? - - - --- - Were 211 components pumped out and properly abandoned per WAC2 RECORD DRAWING -yP;w� •Honor the need of maintenance activities and 1 Kara develop• 3i h to re-locate in utd.re de elop location ,roes, North arrow,reserve craeeld.exsting and proposed permanent record and must be accurate end descriptive enough i final irs�nation ap^rro�'al and re4ated Fermis. This is a Fe Seoddpu^?ink location.^'eta&manifold other e ance " d Dravrres may cre2:e additoral delays Drawings ccnin� Drat..,. wells,observa3on po;s.c eanoUtS.and o•.^er maintenance access points. inco:n�.e;e.ear III Record Drawing Attached • CERTIFICATION OF INSTALLATION DESIGNER/ENGINEER INSTALLER I certify that I installed the system in accordance with I bean that the system has been installed in accor- the septic design stamped"APPROVED"by Mason dance Mason ith the septic CountyPublic designeah and stamped at a y deviations'APPROVED" by County Public Health and that any deviations shownroved by both here have been cleared/approved by both the designer shown here have been cleared/approved 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 informationI contained on this i further certify that all information contained on this further certify that all .. form and attached Record Drawing is accurate. 1 form and attached Record Drawing is accurate. J Jae c �/•i ..• S . Si azure o Installer �C\ Printed Name of Signee s• `.�� j�, ; MASON COUNTY PUBLIC HEALTH b , , c7;'.:• The undersigned approves this installation Report erg" I:4 6,r,o qg cyy�,\P: LA JOkii J "•• \Record Drawing on behalf of Masog County Pyblic •��f� .•Heal Spy , ,,,,„, d` `. �ez i .ems , 6 lS 0l5' 0U"jYFti' • ZQ —I(0`2..S ✓/y r „ (stamp, signature and date) Environments;neaii Specialist e� �1� Signature ofupdaet erz,rzc-a THIS FORM MAY BE SCANNED AND AVAILABLE FO 'C VIEW ON THE MASON COUNTY WEB SITE Scale : I`=lo0 1 It 0 to 20 LAD t,,a As-built Tulle MeyeC reel# 97\l -7u-clooyii 30 E Lexin tvn P . Sliel fon,WA CIS5$y `D 4 . ,7-,0- , 9\L1 M SUN 2 5 Z025 9 MASON COIN , ^ m'9 (Li)50' r'ENVIRONFA • @5 0.C. w;tt.‘ Zoo L F DJ EN>q-HEAL Tt 1 \ ° Reserve A bb.,c_ 41,1, ‘,,v4; \ <- - ,,„,\ 4 , \ 4. 'r.f,. . � ti ` �� PAUTA°.; 3J4O9HNSON• 11l 4 :; sG nr...+cr�Va \ CO—(6-ZS S \000vo ,c 0 Audio-Visual Alarm \ 1 \\313, Cleanout 3 12SO Gallon Septic Tangy 2-Compartment with Effluent Filter W tiL\' 0 12SO Gallon Illon Pump Chamber (D' Go C Valve Cont-ol Box pau""m'' \---,,-j iSci b0' 2oaa ev EaSk- Lexing+-on PI^' E"Semenf Tbeil-yrta., OcC",:tsc:ssier04-0 ///G051 2"Su-t.ALL'ocr-6.1,,,,_ P' 9 vvEy, o - . - - . . Q,k 5' O.C. _� 10 x 4; '`�'' t.ZS Lo 5c.,-eQ `-fo 7 J ' ----".17 k T fick ...'tre.v.t4S i .2,S" e.cQ.rG.1-cS� 3�. ^N 4 - 1 .I 51) - .5 'F .4 S t ci_/D /i.:: ` - i �• 4` . 0m •S !o I S 2� ''� Mqs 1 - �tdk, 'Dt.' '1, j.��••• 510034, • �.,•j� so, a tue5 �. U Nd� PAULA JOY JOI NSON••. � FNV 1:M48 b ��c to• /RON�e (Q—1°-L5 TH cApsarvo. fia+ti Utz ' v, � -,-r"- 1.../.:. 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