HomeMy WebLinkAboutSWG2024-00404 - SWG As-Built - 6/24/2025 e 4
JUN 1 1 2025
RECEIVED
RECORD DRAWING (ASBUILT) pg. 1 MASON COUNTY PUBLIC HEALTH
PARCEL IDENTIFICATION
Permit Number sWG 2024-00404 Assessor Parcel 22017-51-00034
Applicant Name Scott Johnson Subdivision (Name/Div/Block/Lot)
Applicant Address 8639 salty dr nw
City, State, Zip olympia wa.98502 • Installer Name Scott Johnson
Site Address 1151 e lakeshore dr w shelton wa Designer Name Adam Hunter
- 98,44 -�
INSTALLATION CHECKLIST
LU Full System Installation El Septic Tank Only ❑ Drainfleld Only -❑ Repair
System Type subsurface drip Pretreatment Type
>5 ft, from foundation? ❑ NIA ❑ NO
>50 ft. from wells? ❑ ❑
s. >50 ft.from surface water? - - ❑ ❑
i-
.rt Cleanout between building and tank? - - ❑ ❑ I
O Tank baffles present? - - - - -- - ❑ ❑
I24"access risers over each compartment?- - CI El
W Effluent filter installed?-. • - ❑ ❑
w 1200 Hagerman precast
Septic tank size gal Manufacturer
3 D-box water level and speed levelers used? --- - [ Ill YES ❑ NO
gOManifold/D-box accessible from surface?- -•- . ❑ ❑
1:92. Check valves Installed? - - R.d ❑ ❑
0
Transport Line Size 1" Schedule/Class4
Bedrooms Installed (check one) 0 2 tla< ❑4 ❑ 5 ❑6
>10 ft.from foundation?- ❑ NIA Ell NO
in >100 ft. from wells?- - ❑ ❑
--I >100 ft. from surface water'? - El El
ElLtl
Ls >10 ft. from potable water lines? - El
Z > 5 ft. from property lines and easements? - -- --- - - - ❑ 01i > 30 ft. from downgradient curtain/foundation drains? - V 0
n Drainfleld level and observation ports present - - -- ❑ ❑
❑ Graveless chambers or ❑ Clean gravel used'? (check one)
Proper cover installed over drainfleld?- -• -- ❑ ❑
•
Pump tank setbacks consistent with septic tank?- ❑ N/A YEs . ❑ NO
SL Pump tank size 1200 gal Manufacturer Hagerman precast
2
24"access risers) and accessible from surface?- - ❑
i—
n. Alarm or Control Panel Installed? - 0 0
* Control Panel equipped with Timer/ET /Counter- - ❑ ❑
a. Pump Installed In {{I� Bucket or On Block or ElOther __ _-- .-•
little giant we g05p4
• Pump Make/Model • Floats or ❑Transducer
a Tank draw down '3 2 In/min Pump capacity 26 gpm Squirt Height drip ft
9.52 min 2 hours 360 gals
• Pump on time Pump off time Daily flow set at gpm
RECORD DRAWING (ASBUILT) pg. 2 MASON COUNTY PUBLIC HEALTH
RECORD DRAWING
O Dralnfieid&
manifold orientation
&layout
Trench/bed
dimensions and
critical distances
within layout
Septic/pump tank
placement
Location of
buildings
Observation ports&
clean-out locations
Location of wells,
surface water,&
roads
• Undisturbed native
soil between
trenches
• North Arrow •
If the designer or Installer feel the need for additional Information/comments,It may be attached.
Record drawing may also be on a separate page attached. No.Pages Attached
CERTIFICATION OF INSTALLATION
INSTALLER DESIGNER
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.
6-6-2025
Signature of Installer Date
Scott Johnson � � ••^�
ti: •..•Y q.tv ••i.,
Printed Name of Slgnee
MASON COUNTY PUBLIC HEALTH �7 NThe undersi ned a roves this Installation Re ort and ao:1&‘.:1;44
a .112 Rg pP plyl i;,,,
Record Drawing on behalf of Mason County Public •;�,�
Health:
Signature of Environmonta Health Specialist Date (designer's stamp, signature and date)
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE
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