HomeMy WebLinkAboutSWG2024-00467 - SWG As-Built - 7/16/2025 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH
APPLICANT/ PERMIT INFORMATION
Permit Number SWG 4 01 Y^ p/,y67 Parcel# 2 26 17-S2—C0O[.)Sz
Applicant Name 44,4_ C,„,_„ ,,„` Subdivision (Name/Div/Block/Lot)
Applicant Address 77 7 5 _Gag.q .1 DK
City, State, Zip 51 el/. G✓, 9pcpr Installer Name Joshua Gunia �p
Site Address 9 �.L Designer Name (.1�('1 Wa l Q_
INSTALLATION CHECKLIST
J Full System Installation 0 Tank(s)Only ❑ Drainfield Only ❑Repair 0 Other
System Type Oscar ; i��+'i:tment Type N/A
>5 ft.from foundation? - - fIS `J 1-., i 0 N/A II YES 0 NO
>50 ft.from wells? - �C , ❑ 0
>50 ft.from surface water? - - tT i t-26 -- W ❑ ■ ❑
Cleanout between building and tank? - - 0 III
C.) Tank baffles present? - N `-- -- -- -. ❑ . ❑
d24"access risers over each compartmen, .y- - - -- -. ❑ II
tW Effluent filter installed?- . ElEl
Septic tank capacity(working) _ .1'27: -gal Manufacturer 12,50 Infiltrator
9 D-box water level and speed levelers used? - - It N/A ❑YES ❑ NO
RO Manifold/D-box accessible from surface?- - 0 IN
u.
CZ Check valves installed? - 0 II El
2 Transport Line Size 1 inch Schedule/Class 40
&city,44 t rLt444.4,)
Bedrooms installed (check one) J 2 MI 3 ❑4 ❑ 5 ❑6 0 Commercial/Other
>10 ft.from foundation?- ❑ N/A U Yes 0 NO
0 >100 ft.from wells?- ❑ ® ❑
11.1 >100 ft.from surface water? - - 0 Ill
LL >10 ft.from potable water lines?- - ❑ I ❑
12 Z >5 ft.from property lines and easements?- - 0 II
>30 ft.from downgradient curtain/foundation drains?- ® Q ❑
13
Drainfield level and observation ports present - - ❑ ® 0
0 Graveless chambers or ❑ Clean gravel used? (check one)
Proper cover installed over drainfield? - 0 ® 0
Pump tank setbacks consistent with septic tank?- - 0 N/A II YES ❑ NO
Z• Pump tank capacity(flood)_ S[ 37 _gal Manufacturer /.?gyp Infiltrator
Q 24"access riser(s)and accessible from surface?- - 0 ® 0
1—
et. Alarm or Control Panel Installed? - - 0 0 0 `
• Control Panel equipped with Timer/ETM/Counter- ❑ II 0
i It
d Pump installed in 0 Bucket or ® On Block or 0 Other
0 Pump Make/Model Orenco PF200511 ® Floats or� 0 Transducer
R. Tank draw down- in/min Pump capacity 75 gpm Squirt Height ft
Pump on time Pump off time' Daily flow set atk gpd
Updated 8/21/2018
4 Go A4714447 L41 — pGte
/,scar. cut -27D C-pP
Mason County OSS Installation Report pg. 2 Parcel#
ABANDONMENT RECORD
Were existing septic components abandoned as part of this project? - - El YES 0 NO
If yes, please describe: Old septic tank decommissioned and filled with gravel
Were all components pumped out and properly abandoned per WAC246-272A-0300? - - ® YES 0 NO
RECORD DRAWING
This le a immanent record and must be accurate and descriptive enough to re-locate In the need of maintenance activities and future development Typical Record
Drawings contain: Drainfleld&manifold orientation&layout,Septic/pump tank location,North arrow,reserve dralnfield,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.
IN 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.
Ali
A• • •
41" ature o_tiller Date ... E4.
A, •A•
i40 Joshua G u n i a ��P „v•s.,. . ,+1+�V'Printed Name of Signee
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MASON COUNTY PUBLIC HEALTH . �``' �' • v\:4•` Q
y st•r•to t 4 a
The undersigned approves this Installation Report an !d • e : E WAI E
LICENSED DESIGNER .• ��k
Record Drawing on behalf of Mason County Public t . „_ N" .."`�.
Heal ``14S�N RUC t5 Lxi'JRts ls,o 1V4
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Q/ ll �o�,rry�A Y o?
Signature of Environmental Health Specialist Dilly,,i FM; (stamp, signature and date)
HEa,r./
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Updated entnote
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cindyewaite@msn.com
From: Gary Stratton <gstratton@envirotechnw.com>
Sent: Friday, July 11, 2025 9:11 AM
To: CINDY WAITE
Subject: Re:Corona Septic Check list
Hello Cindy,
The drain field does have 8 coils for the Oscar System.The previous drawing was to just show the
Ao..
location of placement. I had sent it back to you due to we needed a new As-Built made up for that system
to be completed.
Thank you,
Garrison Stratton
From: Gary Stratton<gstratton@envirotechnw.com>
Sent:Tuesday,June 10, 2025 7:51 AM
To:CINDY WAITE<cindyewaite@msn.com> 4- ,,
Subject: Re: Corona Septic Check list Fr1
Mgs0iv r, Jut 6 20?5
04
From: CINDY WAITE<cindyewaite@msn.com> DJA �ENTAt Hr.
Sent:Wednesday, May 28, 2025 12:59 PM
To: Gary Stratton <gstratton@envirotechnw.com>
Subject: Re: Corona Septic Check list
Corona record drawing. Please sign and e mail it back to me and I will submit it to the health department or
you can submit it directly to the health department. Cindy
From: Gary Stratton<gstratton@envirotechnw.com>
Sent:Thursday, May 22, 2025 3:57 PM
To: CINDY WAITE<cindyewaite@msn.com>
Subject: Re: Corona Septic Check list
I've t ried calling a few times , both your lines just ring and ring.
But yes two new tanks were installed septic is a 1260 and pump is a 1560.
Ith noted on the sheet I filled out and sent over.
As well as the as built sent noted tank orientation and sleeve under waterline location
On May 22, 2025 9:53 AM, CINDY WAITE<cindyewaite@msn.com>wrote:
Would you call me please. 360-426-2113.
From:Gary Stratton<gstratton@envirotechnw.com>
Sent:Wednesday, May 21, 2025 7:45 AM
1