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HomeMy WebLinkAboutSWG2022-00498 - SWG As-Built - 6/21/2025 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2022-00498 Parcel # 42124-22-00000 Applicant Name Marshall Clement Subdivision (Name/Div/Block/Lot) Applicant Address 1553 N 38th St City, State, Zip Seattle, WA 98103 Installer Name Maples Excavating Site Address 141 E Enchantment Heights Dr Designer Name Arrow Septic Designs, Inc INSTALLATION CHECKLIST 0 Full System Installation ❑ Tank(s) Only ❑ Drainfield Only ❑ Repair ❑ Other System Type Shallow Pressure Pretreatment Type >5 ft. from foundation? - - ❑ N/A ❑■ YES ❑ NO >50 ft. from wells? - - El ❑■ ❑ z >50 ft. from surface water? - - El • ❑ FQ ❑■ El- Cleanout between building and tank? - - ❑ o Tank baffles present? - - El ❑■ El d24"access risers over each compartment?- - ❑ 0 ❑ cW Effluent filter installed?- - El • ❑ Septic tank capacity (working) 1,500 gal Manufacturer Hagerman o D-box water level and speed levelers used? - - ❑ N/A ❑ YES ❑■ NO X0 Manifold/D-box accessible from surface?- - ❑ [II El ao 2 Check valves installed? - °tom f v-v-00'Yk ❑ [U El oa 2 Transport Line Size 2 inch Schedule/Class 40 Bedrooms installed (check one) El 2 ❑ 3 ❑4 ❑■ 5 ❑6 ❑Commercial/Other >10 ft. from foundation?- - ❑ N/A 0 YES ❑ NO Cl >100 ft. from wells?- - ❑ 0 El J >100 ft. from surface water? - - ❑ El ❑ W u. >10 ft. from potable water lines?- ❑ ■❑ El � > 5 ft. from property lines and easements?- - El ■❑ El Q x > 30 ft. from downgradient curtain/foundation drains? - - El 0 ❑ Drainfield level and observation ports present - - Cl 0 ❑ ❑ Graveless chambers or • Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ 0 El `'Il "` ,1 Pumptank setbacks consistent with septic tank?- _� � p - ❑ N/A ® YES ❑ NO r `E (0,), Pump tank capacity(flood) 1,500 gal Manufacturer Hagerman dZ ligg 24" access riser(s) and accessible from surface?- - ❑ I] ❑ 1 v •—.4. Alarm or Control Panel Installed? ❑ I ❑ j o �� Control Panel equipped with Timer/ ETM /Counter- - ❑ I ❑ "' M' Pump installed in ❑ Bucket or 0 On Block or ❑ Other • i (: Pump Make/Model Zoeller N152 LI Floats or ❑ Transducer d Tank draw down 1.5 in/min Pump capacity 39 gpm Squirt Height 4 ft Pump on time 3.8 min Pump off time 6 hr Daily flow set at 600 gpd Jc . -cc•2 .2) g Mason County OSS Installation Report pg. 2 Parcel# 1-1124 - 22 - coo° ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - ❑ YES iit NO If yes, please describe: Were all components pumped out and properly abandoned per WAC246-272A-0300? - YES 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: Orainfieid&manifold orientation&layout.Septic/pump tank location.North arrow.reserve d airfield.exsting and proposed bu Icings.location of wells,waterlines, wells,observation ports.deanouts,anc other maintenance access points. Incomplete Record Drawings may eeate additional delays in final installation apprcvatf rtand related permits. 1 f I T Record Drawing Attached CERTIFICATION OF INSTALLATION f 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. 7/7�" ``�-= O--l/o 3/ 24 Signature of installer Date ,t.s4:-.41)),. Printed Name of Signee %,, a �� a. hr MASON COUNTY PUBLIC HEATH hi OZ ,�• 't i // +f'�. w t .. . , The undersigned approves this!n�/t,ption RL��nd `s-�, ,A:� yf�: s�•�,� :a'� f, Record Drawing on behalf of Mason Ci TO'dclypubli f u"����PAULA 10y�OHNSON 1''� Health: yFy�/� 0� p148 tiE gGNE�(` , ,_______ l�(7S1 G��J 00, a Iq, y EXPIRES 13. 2:ii CO l 7-2T Signature of Environmental Health Specialist Date F4(Tj (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE updxed 8'212o18 ` n n B t Big -' /^,' i p d= ,{H. 4: 0 �' o��� \ *i: 32` is*-rots-s -6 --'; © *2: 55' 15+roe+5 A'o "' O Audio-Visual Alarm • / / * u ,. s 0 Cleanout / \ /1!y/11'rz-c� 01500 Gallon Septic Tank - • ��e �1 2-Compartment with / S c ca-= Effluent Filter 1\ / O 1500 Gallon Pump Chamber I \ / CcrMr : \ l OValve Control Box / / (S) 3kso �� ' , Osit4a ` O, c _veserk / 3 7„ ‘e e.A„-• 5toto2 \ J isv +.1 t / ,A O r if„,;-4,4 • et:.k,ix 5 9 ,() PAULA JOY JOHNSON ?i� WIRES 7;i / 6.-`7-Zs }As 5 v t L-� 13 'W‘za_A y C -w. J I � A c�� 42 tz4 - 22-'CCCC C S. �j:� G Ekk cl. D.A. 414SON SUN -, f LAi A qg - �°UNry 5�,o2 �'°" (S) 3 X SC' ,D. F. f y`'��, p✓/R�4 H+�F S @ GI ` 0. G- c ts� e 3