HomeMy WebLinkAboutSWG2024-00403 - SWG As-Built - 7/11/2025 F.
JUL 1 1 2025
RECORD DRAWING (ASBUILT) pg. 1 RECEIVED ASON COUNTY PUBLIC HEALTH
PARCEL IDENTIFICATION
Permit Number SWG 2024-00403 Assessor Parcel # 220175100036
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 1121 e lakeshore Dr w Shelton Designer Name Adam Hunter
A d4
INSTALLATION CHECKLIST
Full System Installation ❑ Septic Tank Only ❑ Drainfield Only ❑ Repair
System Type Trench Pretreatment Type NA
>5 ft. from foundation? - - ❑ N/A [YES ❑ NO
>50 ft. from wells? - - ❑ 13/ ❑
Z >50 ft. from surface water? - - ❑ ❑
<- ❑
Cleanout between building and tank? - - ❑
✓ Tank baffles present? - - ❑ ❑
}-- 24"access risers over each compartment?- - ❑ VEl
W Effluent filter installed?- - ❑ V ❑
Septic tank size 1250 gal Manufacturer hagerman precast
0 D-box water level and speed levelers used? - - El N/A ❑Y .c ❑ NO
O Manifold/D-box accessible from surface?- - ❑ ❑
0?2- Check valves installed? - - L ❑ ❑
o¢ scd 40
E Transport Line Size 2" Schedule/Class
Bedrooms installed (check one) ❑ 2 ❑ 3 ❑4 ❑ 5 ❑6
>10 ft. from foundation?- - ❑ N/A Is rt' ❑ NO
O >100 ft. from wells?- - ❑ ❑
w >100 ft. from surface water'? - - ❑ ❑
u. >10 ft. from potable water lines?- - El [T�/ El
> 5 ft. from property lines and easements?- - ❑ CS ❑
o
12 > 30 ft. from downgradient curtain/foundation drains? - - ❑ (7 El
11 /
Drainfield level and observation ports present - - El ❑
❑ Graveless chambers or Wr Clean gravel used? (check one)
Proper cover installed over drainfield?- - ❑ ❑
Pump tank setbacks consistant with septic tank?- - ❑ N/A tYEs ❑ NO
• Pump tank size 1250 gal Manufacturer hagerman precast
Q 24"access riser(s)and accessible from surface?- - ❑ ❑
H-
a Alarm or Control Panel Installed? - - El O' El
2 Control Panel equipped with Timer/ETM/_Counter- - ❑ ( ❑
a Pump installed in ❑ Bucket or VOn Block or ❑ Other
1 Pump Make/Model liberty 290� [}`Floats or ❑Transducer
a
Tank draw down 7 in/min Pump capacity 80 gpm Squirt Height 4'+ ft
Pump on time 1 ,„;. �n s„cflnis Pump off time 4 HRS Daily flow set at 360 qpm
RECORD DRAWING (ASBUILT) pg. 2 MASON COUNTY PUBLIC HEALTH
RECORD DRAWING
• Drainfield&
manifold orientation
&layout
• Trench/bed
dimensions and
critical distances
within layout
Septic/pump tank
placement
Ei Location of
buildings
• Observation ports&
clean-out locations
• Location of wells,
surface water,&
roads
El Undisturbed native
soil between
trenches
•
El 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 seperate 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 Rec Drawing is a e. form and attached Record Drawing is accurate.
07/08/2025
Signature of installer Date
Scott Johnson / 7/10/25 •
Printed Name of Signee A 111,
;'•t
II
MASON COUNTY PUBLIC HEALTH
The undersigned approves this installation Report and
Record Drawing on behalf of Mason County Public %,4tjt
!�
.rj ,u,H,a ..I
i��• ADAUJ.HUNTER II
Health: ealNailapc0/1 I I 1-zs- rrrN:SSI W8.1
Signature of Environmental 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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