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HomeMy WebLinkAboutSWG2025-00089 - SWG As-Built - 7/11/2025 1 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2025-00089 Parcel # 51914-41-90010 Applicant Name BRENT LOW Subdivision (Name/Div/Block/Lot) Applicant Address 440 W BULB FARM RD City, State, Zip SHELTON, WA. 98584 Installer Name SCHOENING EXCAVATION LLC Site Address 440 W BULB FARM RD Designer Name CINDY WAITE INSTALLATION CHECKLIST II Full System Installation ❑Tank(s)Only ❑ Drainfield Only 0 Repair ❑Other System Type PRESSURE DIST Pretreatment Type >5 ft.from foundation? - - ❑ N/A 0 YES ❑ NO >50 ft.from wells? - - 0 © 0 Z >50 ft.from surface water? - - 0 0 0 HCleanout between building and tank? - - El Al U Tank baffles present? - - 0 111 ❑ a24"access risers over each compartment?- - 0 0 0 W Effluent filter installed?- - 0 0 0 Cl) Septic tank capacity(working) 1250 gal Manufacturer HAGERMAN 1250 0 D-box water level and speed levelers used? - - ® N/A El YES El NO OO Manifold/D-box accessible from surface?- - ❑ [3 ❑ OQ Check valves installed? - - 0 0 ❑ 2 Transport Line Size 2" Schedule/Class SCHEDULE 40 Bedrooms installed (check one) 0 2 0 3 0 4 ❑ 5 ❑6 ❑Commercial/Other >10 ft.from foundation? r ❑ N/A © YES ❑ NO 0 >100 ft. from wells?- - 0 0 0 W >100 ft. from surface water? - - 0 0 0 to " _ z >10 ft.from potable water lines?- - ❑ 0 ❑-� > 5 ft. from property lines and easements? - 0 0 0 , C 4 12 > 30 ft. from downgradient curtain/foundation drains? - - $ 0 0 .t! , Ir, Drainfield level and observation ports present - - GI 0 ❑ > � ` NJ ❑ Graveless chambers or 0 Clean gravel used? (check one) o C Proper cover installed over drainfield?- - 0 0 ❑ "' 1,_ �` Pump tank setbacks consistent with septic tank? - - ❑ N/A El YES ❑ NO Z Pump tank capacity (flood) 1455 gal Manufacturer HAGERMAN 1250 < 24"access riser(s)and accessible from surface?- - 0 0 0 dAlarm or Control Panel Installed? - - ❑ © 0 2 Control Panel equipped with Timer/ETM/Counter- - 0 0 0 \ , n a- Pump installed in ❑ Bucket or 0 On Block or ❑ Other a PumpMake/Model LIBERTY 250 � ❑ Floats or 0 Transducer d Tank draw down 1 in/min Pump capacity 26 gpm Squirt Height 6 ft Pump on time 1.75 MIN Pump off time 6 HRS Daily flow set at 182 qpd Updated 8/21/2018 - - Parcel# 51914-41-9001� OSS Install: 1 pg. 2 Mason County ABANDONMENT RECORD - - _ _ _ 0 YES 0 No abandoned as part of this project? • - Were existing septic components _ _ _ . 0 YES Q NO If yes, please describe: " - - - Were all components pumped out and properly abandoned per WAC246-272A-0300. RECORD DRAWINGTypical Record proposed future nde,development of wells atRecord Thi ent record and must be accurate and descriptive enough t[hon-locate Norttt arrrow,the re reserve dra r f eld,existing and �tubuildingS approval I and re awa permits. Drawings in as penman out,Septidpump tank Iota Incomplete Record Drawings may create additional delays in final installation erlines Drawings contain: Drainfield&man'rfold orientation&lay wells,observation ports,cleanouts,and other maintenance access points. Pk 4,1 p v 2 fi-q.-.1p - �a.-4. . p12.4 port.) tc....a'4.1 1;44071dr.j it ia,i (i tI- C 0 rv5 /44,0t l II 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 dancewith tic designdeviations by County Public Health and that any deviations shown Mason County Public Health and that any 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. i;,1i• i�- .,i , Signature of Installer DateF, yGk c YA O�XI }VP ,-W c , , •• ti,A ,.. • Printed Nafne of Signee i - •' : ' 4'i • MASON COUNTY PUBLIC HEALTH ''o? IN r E w I E �� �, • L��F'ar�':DESIGNER • `' The undersigned approves this Installation Report and `_ zCF+ ,����V Record Drawing on behalf of Mason County Public "= 1,. Health: �J 3`) C)ArY\e(t°17) —1 ( i ( Zs Signature of Environmental Health Specialist Date (stamp, signature and date) THIS Fr1RM MAY RE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Updated en1/2018 `A k r • AP1PRov k ; • •''‘, TA 11 % /4 MASON CQU aTY E!,v1P7,ON MENTAL HEAD 7 . Er11 t., 4, T. ..0 - .. .0 j. , it f 01 • o ` t' ,,,, i (''',),k.. ti((-.) 1 :--- , . r J .1 Z.4.Z:i ,,„.. 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