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HomeMy WebLinkAboutSWG2025-00185 - SWG As-Built - 7/10/2025 4_,% Mason County OSS Installation Report pg. 1 MASON COUNT LIc5 ALT APPLICANT/ PERMIT INFORMATION 9,AN IS Permit Number SWG 2025-00182 Parcel # 32006-50-00013 Applicant Name Nathan Sanchelli Subdivision (Name/Div/Block/Lot) Applicant Address 60 E Alder PI E OAK PARK 1 LOT: 13 City, State; Zip Shelton, WA, 98584 Installer Name Maples Excavating Site Address 60 E Alder PI E Designer Name Arrow Septic Designs Inc. INSTALLATION CHECKLIST Q Full System Installation ❑ Tank(s)Only ❑ Drainfield Only II Repair ❑ Other System Type . ,__,-_.. Sand Lined Pressure Bed Pretreatment Type__ >5 ft. from foundation? - - ❑ N/A 0 YES ❑ NO >50 ft. from wells? - - 0 0 0 Z • >50 ft. from surface water? - 0 0 0 H• Cleanout between building and tank? - - ❑ 0 0 U Tank baffles present? - - ❑ 0 0 a24" access risers over each compartment?- - ❑ I ❑ W Effluent filter installed?- - 0 III 0 N Septic tank capacity(working) 1250 gal Manufacturer Infiltrator 0 D-box water level and speed levelers used? - - ❑ N/A ❑ YES ❑■ NO XO Manifold/D-box accessible from surface?- - 0 0 PE m- Check valves installed? - G -Ngyp itAvoc' 0 II 0 oa 2 Transport Line Size 2" Schedule/Class 40 Bedrooms installed(check one) 0 2 0 3 0 4 0 5 ❑6 ❑Commercial/Other >10 ft. from foundation?- 'il - ❑ N/A ❑ YES ❑■ NO O >100 ft. from wells?- - 0 0 0 W >100 ft. from surface water?- - ❑ 0 0 ti >10 ft. from potable water lines?- - 0 0 ❑ Z > 5 ft. from property lines and easements?- 0 0 0 Q IX > 30 ft. from downgradient curtain/foundation drains?- - 0 © 0 ❑ ❑ NE ❑ Drainfield level and observation ports present - - ❑ Graveless chambers or 0 Clean gravel used? (check one) Proper cover installed over drainfield?- - 0 0 0 Pumptank setbacks consistent with s tic to ?- - ❑ N/A 0 YES 0 NO p 0l2BZ F Pump tank capacity(flood) 1060 gal Manufacturer Infiltrator Z < 24" access riser(s)and accessible from surface?- - 0 0 ❑ a. Alarm or Control Panel Installed? - - ❑ I ❑ 2 Control Panel equipped with Timer/ETM /Counter- - ❑ It 0 D o- Pump installed in ❑ Bucket or 0 On Block or 0 Other a PumpMake/Model Zoeller N153 � ❑■ Floats or 0 Transducer a Tank draw down 2.5 in/min Pump capacity 63 gpm Squirt Height 6 ft Pump on time 1.4 min Pump off time 6 hr Daily flow set at 360 gpd Laaalr�& z::le 1 Mason County OSS Installation Report pg. 2 Parcel# 32500(0 - - 800k3 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - YES NO If yes, please describe: ()L&. V-QltI-OVQ.kv OCk• 'rn C IL 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 re-locate in the need of maintenance activities and future development Typical Record Drawings contain: Drainfieid&manifold orentation&layout.Septiupump tank location,North a-row.reserve drairfield,existing and proposed buildings,location of wells,waterlines, wells,observation ports,cleanouts,and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and related permits. 5-ek. J�\ � 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 1 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. 2,4�Zs Signature Date Printed Name of Signee '" 04 MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and �.510,348 Record Drawing on behalf of Mason County Public PAULA JOY JOHNSON Health: If(: t)2>iri' NEa'• EXPIRES - Co - Lco -Z'S Signature of Environments Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE uaoatec 8212ots n ;2 so 3e 40 A'S-bk► it' N;.P`Ikk vC tt'E.L`i VP c-L�32-604o-•50-oc 13 ( e •e pt-DeaP- E A ,:_______________,_______________ S l-TC,N 9 4 N W, A. t,„:,2, gax APpR0 VEo AA. .an vz2 MAsoN JUL 1015 ..,, ' AC COUN�EN , t,' 4� ��,�1, vs...)� �RONMENTA1 HEAL i1P"� �',� RET . 5 1 G 349 \7(l1 \ N� PAULA JOY JOHNSON 'T • •DdriiSVir%gr N .. .n..N. N.►��-S, .4.5 \C WIRES .' 1 \ /3,<1 / .-..'‘ CO—150-Z;S- ( t 1 ` t` j , GO o\\ \ �/ S oI`rI o zky leey: © \2`• x 0 Audio-visual Alarm o p ©- O — / U Clea-:opt ®- 'Sr / l 1250 Gallon Septic Tank �' �// 2-Comparmient with U• Effluent Filter e,,Ntrt — __— ___.— / s, 4 1000 Gallor_Pump Chamber X x z / OA p P ro lc i�Ma�e t a c ec :ate. a' K —/ a-� end D.s• a 19e a100,--+ cpled ® 0 l c. -f w ci-s Q e w►avid 1/`0 eA&