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HomeMy WebLinkAboutSWG2025-00042 - SWG As-Built - 6/25/2025 mow Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/PERMIT:. . ORMATION Permit Number SWG 2025-00042 Parcel # 32122-50-00308 Applicant Name Treena &Tony Dunnington Subdivision (Name/Div/Block/Lot) Applicant Address P.O.Box 655 Lake Limerick Div. 3 Lot 308 City, State, Zip Shelton, WA 98584 Installer Name T.J. Goos Site Address 20 E. Balmoral Way Designer Name Dale L. Tahja INSTAL:X PN CHECKLIST ® Full System Installation ❑Tank(s)Only 0 Drainfield Only 0 Repair 0 Other System Type Oscar OS-100 Pretreatment Type Oscar X02 >5 ft.from foundation? - - ❑ N/A ®YES ❑ NO >50 ft. from wells? - - 0 U 0 Z >50 ft.from surface water? - - El ® 0 Cleanout between building and tank? - - ❑ U 0 V Tank baffles present? - - 0 ® 0 24" access risers over each compartment?- - 0 I ❑ a. W Effluent filter installed?- - 0 ® 0 cn Septic tank capacity (working) 1,000 gal Manufacturer Hagerman 9 D-box water level and speed levelers used? - - ® N/A ❑ YES 0 NO 4 LL Manifold/D-box accessible from surface?- - ❑ El ❑ Ink- Check valves installed? - - ❑ ® ❑ 0< g Transport Line Size 1 inch Schedule/Class Sch.40 • Bedrooms installed (check one) ❑ 2 1113 ❑4 ❑ 5 ❑6 ❑Commercial/Other 4 >10 ft. from foundation?- - ❑ N/A II YES 0 NO 0 >100 ft. from wells?- - ❑ IN ❑ W >100 ft.from surface water? - - 0 ® ❑ ti >10 ft.from potable water lines?- - ❑ 0 0 >5 ft.from property lines and easements?- - ❑ II ❑mr..„, Ce > 30 ft.from downgradient curtain/foundation drains? - - ❑ al ❑" i Drainfield level and observation ports present - - 0 I 01 z • Graveless chambers or 0 Clean gravel used? (check one) i WI ry Proper cover installed over drainfield?- - 0 © 0 ry Pump tank setbacks consistent with septic tank? - - ❑ N/A ® YES ❑i NO `^ I kig ZPump tank capacity (flood) 1,000 gal Manufacturer Hagerman 1 Ct--__-41 FQ- 24" access riser(s)and accessible from surface?- - 0 SI 0 Alarm or Control Panel Installed? - - 0 UI 0 Control Panel equipped with Timer/ETM /Counter - 0 IR 0 CL Pump installed in 0 Bucket or IN On Block or ❑ Other a. 2 Pump Make/Model McDonald E.30 GPM ❑ Floats or 0 Transducer e Q. Tank draw down 0.1 in/min Pump capacity 30 gpm Squirt Height Drip ft Pump on time 0.36 min. Pump off time 3.64 min. Daily flow set at 360 gpd Updated 8/21/2018 Masson County OW Installation Report pg.2 Parcel# -'� 5�T C ::)10- +CORO Were eeedng alaendongl z= s ,� . --- -- .\- al 128 C No If Yeti, I daubs: 01 ` \�_ \C 1 _ ��C' 1\7' t Were all components pumped out properly abandoned per WAC246-272A-030O1 Cl YES Q NO CORD DR AV1 Thb la a pannowat noord led mot be armaiao Ind dealptithr growth b rolocab In the mod of ariasnance acdvidaa attd ttrmn&d,MNPmsnt. Vicd Pawl orthlords oenlda Drama/ii epaeil rkt atritafon a*oat,8apldpw "rank bastion.Nate arm%rams dalydlek4 adding and mooed toradInso,Madan or web,wnwbrea Nola a6eerw/at pats,dse OIea and other mdelmaooa aooetm paints. incoroDMa Rsoed Oradepa may arse&addllOMI Maid to lea}MteralNon Mimi and rotated Vw+a& 1 ® Record Drawing Attached CERTIFidAT#ON OF MISTAU,AI ON. _ . INSTALLER DESIGNER!ENGINEER 1 certify that I walled the system in accordance with I cerbly that the system has been installed in ac coor- the septic design stamped APPROVED"by Mason dance with U a septic design stamped"APPROVED"by County Public Health and that any deviations shown Mason County Public Hull and that any deviations hete have been cleared/approved by both the designer shown here have been clewed/approved by both end Meson 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 ceriby that all Information contained on this I Anther certify y that all information contained on this ' form and attached ftecord Dray.**is . :i i� tote!and attached Record -• • is accurate. -1 ,11:4----e—C.—_ • i I: ).\ 5 , • Signatu ;at'Installer • ,. . .,(ate t . rti "t-%L s Alai• , 4 Printed Name of Signee ": v t R li r MASON COUNTY PUBLIC HEALTH _tees .4 g 0 .1i The undersigned this installation Report and : •, 5100214 ,r Record Drawing oan behalf lfof Mason County Public : UCENSED L. TAD DESIGNER it t • Health: �4.ioN,. ..�...wi��»�.4. Cf7A-kc ---r4s E Signature ofEnvironmental Specialist Data (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON C CANTlY WEB SITE UP*"MOM � i AMIIIIMINIMINIIIM -f-i-D ) gi 64 , c7K, C = lS j � d s�' m C9 �� to (.14 a���1Sb l%^ram o z ' �� 1; �-n i 'Ll fir,v ,- L)j „ ,t c_-‘0 r,) . If. Ste/ 6'� �\ di., J J %`‘\\% (-5 c't i-j >-- . P n ,y (f) s,- , =-5 0 . i---- — _ ,c)— 5-- . ! b — , ►" flab-,S© 01: -. . . Mai , __19 ,i o - -- \ - 4 " alia,46 1 , is • 0 Ull, �rl '1D C I ir Cr) / • -M a - i -1-- , '41 L,d 6g3ci J L _kl: (---- - g I , t s el / ZQ / A i �Lib J' ' $:.1 j / mz N N< 2.7 \j - I • / P. a YZV 0 b