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HomeMy WebLinkAboutSWG2024-00430 - SWG As-Built - 7/14/2025 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2024-00430 Parcel # 41903-33-00040 Applicant Name Michael & Lori Walker Subdivision (Name/Div/Block/Lot) Applicant Address P.O. Box 1096 TR 4 of SW SW S 55/203 City, State. Zip Shelton, WA 98584 Installer Name Maples Excavating Site Address 170 W Wivell Rd, Shelton Designer Name Arrow Septic Designs, Inc INSTALLATION CHECKLIST ® Full System Installation ❑ Tank(s)Only ❑ Drainfield Only El Repair ❑ Other System Type Shallow Pressure Pretreatment Type NuWater BNR-500 >5 ft. from foundation? - - ❑ N/A 0 YES ❑ NO >50 ft. from wells? - - - - 1 C- EHWIE-? nri ❑ ❑■ Z >50 ft. from surface water? - - ❑ ❑■ El H Cleanout between building and tank? - - - - -JUN 2-4-2-025 - -1,ij El Q ❑ U Tank baffles present? - - r ❑ X ❑ a 24" access risers over each compartment?-By - - - I❑ 0 CI W Effluent filter installed?- - ❑ ❑ 0 SNAR- Septic tank capacity (working) NuWater 500 gal Manufacturer Hagerman 0 D-box water level and speed levelers used? - - ❑ N/A E] YES Ell NO O Manifold/D-box accessible from surface?- - ❑ 0 ❑ oQ Check valves installed? - - ❑ 0 ❑ E Transport Line Size 2 inch Schedule/Class 40 Bedrooms installed (check one) 0 2 ❑ 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10 ft. from foundation?- - ❑ N/A 0 YES ❑ NO Cl >100 ft. from wells?- ❑ ❑ El W >100ft. from surface water? - - El 111 CI Li >10 ft. from potable water lines?- - ❑ I ❑ Z- > 5 ft. from property lines and easements?- ❑ [1] ❑ Q w > 30 ft. from downgradient curtain/foundation drains?- - ❑ LM ❑ ci Drainfield level and observation ports present - - ❑ © ❑ ❑ Graveless chambers or ® Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ X ❑ Pump tank setbacks consistent with septic tank?- - ❑ N/A 0 YES ❑ NO Pump tank capacity (flood) __ 1,000 gal Manufacturer Hagerman Z Q 24" access riser(s) and accessible from surface?- - - ❑ Q El aAlarm or Control Panel Installed? - - ❑ © ❑ E Control Panel equipped with Timer/ ETM/Counter- - ❑ El ❑ n n- Pump installed in ❑ Bucket or ❑■ On Block or ❑ Other a Pump Make/Model Zoeller N152 ■❑ Floats or ❑ Transducer a Tank draw down 2.5 in/min Pump capacity 48 gpm Squirt Height 10 ft Pump on time 1.25 min Pump off time 6 hr Daily flow set at 240 gpd Up.:a 8;7'.12O'.3 o1111111111rr Z 1 Mason County OSS Installation Report pg. 2 Parcel# l 5J ��d d ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - YES D NO If yes, please describe: Qld\ kO�4t. `n^� t OId ? 'F of ki scLev ,re-►�A,eV . Old A.F. ak..des-ted- 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 relocate in the need of maintenance activities and future development Typical Record Drawings contain: Drainfield 8 manifold orientation&layout.Septic/pump tank location,North arrow,reserve drairfield,existing and proposed bLild.ngs,location of wells,waterlines, wells,observation ports,deanouts,and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and related permits. P, '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. z.` --_,74� Z,Li O 3--'-1 —2c; Signature of Installer Date . _ . �. t. Printed Name of Signee k ref ‘, MASON COUNTY PUBLIC HEALTH i , y The undersigned approves this lnstallReport aid k • 7P ?• Record Drawing on behalf of Mason Count�icP blic r� Nw . s t cosaa •.t. .i. Health: (NlT� >f •• PAU LA JOY JOH^SUN \ .� 1Ct1'i 3 tSY1i ;i,NE'�(' ( �.41 o��r Co-1_4F—ZS Signet re of Environmental Health Specialist Date �T,qe�qq�� (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC( W ON THE MASON COUNTY WES SITE updxca 8rz,2a18 , .^v; B SQL 5'x 2 , N 'k oR1 YJI, _ Tom% `/a/: i f I I%i Ao $c t Key: Cn ,- O Audio-Visual Alarm f 0 Cleanout 0 NuWater BNR-500 ATU Tank S 01,000 Gallon Pump Chamber APPROv-aVE. . 0 Valve Control Box(.2 c_9-) 5 �`o Cc:, 0\A -cave k 6.4,d w� J U L 1 4 2025 j• ` M l i vi der� � resmo‘t ea MASON COUNTY EtiViKNMENTAL H- LTf; \ . i \ O 01A olnewciein eci D.F. • • .. .DJA ( 0 Fu."1' Gly,tiAer -t-iect ‘` `. ' tei, (26`f- -Fro►•r, v.)Q10 ' >- l , AviN), act- . 4-._-_-.. \\_,A7-/\ ,., . : ,c\, ;\\ ,... fteis..24.•,,-.. .41....; ,stk \ .1. I if 1 .-—41. . o? ., x.^v y'!�: PAULA JOY JOHNSON v \;41 4;, y:, LIC A1:13L1 SIGtiE'il • `+` (, CeF ...,' c,..Cs417.--""'"N., G v-E-tom _;.-