Loading...
HomeMy WebLinkAboutSWG2020-00557 - SWG As-Built - 8/5/2025 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION - Permit Number SWG 2020-00557 Parcel # 32116-75-90023 ,_. n Applicant Name John Reese Subdivision (Name/Div/Block/Lot) " NI Applicant Address PO Box 571 c City. State, Zip Union, WA 98592 Installer Name Bamford Septic Repair `r; 1 Site Address 1521 E Shetland Rd, Shelton Designer Name Arrow Septic Designs, Inc t rc===2 j INSTALLATION CHECKLIST ® Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑ Repair ❑ Other System Type Sand-Lined Pressure Bed Pretreatment Type >5 ft. from foundation? - - ❑ N/A ❑■ YES ❑ NO >50 ft. from wells? - - ❑ 0 ❑ Z >50 ft. from surface water? - - ❑ 0 ❑ H Cleanout between building and tank? - - CICI0 U Tank baffles present? - - ❑ ❑■ ❑ d CI 0 CI access risers over each compartment?- - W Effluent filter installed?- - ❑ 0 ❑ Septic tank capacity (working) 1,200 gal Manufacturer Sound Placement 0 D-box water level and speed levelers used? - - ❑ N/A ❑ YES NO DOManifold/D-box accessible from surface?- - El ❑ CI co Check valves installed? - - ❑ 0 ❑ 0< 5 Transport Line Size 2" Schedule/Class 40 Bedrooms installed (check one) ❑ 2 0 3 Cl 4 El 5 El 6 El Commercial/Other >10 ft. from foundation?- - ❑ N/A 0 YES ❑ NO O >100 ft. from wells?- - ❑ ❑■ ❑ W >100 ft. from surface water? - - CI ❑I ❑ Er_ >10 ft. from potable water lines?- - ❑ ❑■ ❑ Z > 5 ft. from property lines and easements?- - CI0 ❑ a x > 30 ft. from downgradient curtain/foundation drains? - - ❑ ® ❑ en Drainfield level and observation ports present - - ❑ 0 ❑ El Graveless chambers or ® Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ ■❑ Cl Pump tank setbacks consistent with septic tank? - - ❑ NIA ❑■ YES ❑ NO • Pump tank capacity (flood) 1,275 gal Manufacturer Sound Placement < 24' access riser(s) and accessible from surface?- - ❑ II ❑ ~ Alarm or Control Panel Installed? - - ❑ • ❑ n. 2 Control Panel equipped with Timer/ ETM /Counter- - ❑ © ❑ o d Pump installed in ❑ Bucket or 0 On Block or ❑ Other a'• Pump Make/Model Zoeller N152 ❑ Floats or ❑ Transducer a • Tank draw down 2" in/min Pump capacity 44 gpm Squirt Height 5 ft Pump on time 2 Min Pump off time 6 Hr Daily flow set at 360 gpd Mason County OSS Installation Report pg. 2 Parcel# SLOG, — z S— `I O C Z3 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - ❑ YES ® NO If yes, please describe: Were all components pumped out and properly abandoned per WAC246-272A-0300? - - E 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: Drainfield&manifold orientation&layout.Septic/pump tank location,North arrow.reserve drainfield,casting and proposed build rigs,location of wells,waterlines, wells,observattOn ports,deanouts,and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and related permits. te- 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 l 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. Q iS Signature of Installe Date Printed Name of Signee r' 1r o4 • 1� A r. MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and Record Drawing on behalf of Mason County Public i � PAUI A,;oY JOHNSON Health: LitS.E ork.. IGNE1t•• ' 1 Q Imo/ Signature of Environmental Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY VJEB SITE Updatec 821/23'8 , T AS13u0LI Sohn g-eeSe -( Parcel 44.3zf(6-75- gCOZ3 • • 1st! Slut-land Rd 0 . h �1 Sca( . l"-Lco` �� t • i r,�o . h Cn. N a Z0 ' 0 60 80 ' .. . 51.Uri349 •c r )'4 `P<, • !",' PAULA JOY JOHNSON :yti- APPROVED Q co5 A AUG :0 5 2025 -23-Lis- , MASON COUNTY ENYIRONMENTALHEAITH wc`\ l' 1 too *^�.PY`yF"5 pg. so 35 1,4 ' j f, i! el la iS -.1'. 1 4 / i / / t--4---) AT 1,r f _; kJ., r1 1 f ' r / eN I \* a t to / 1.r> •-. /I . / r _X 1 1111 - o-. 6Wa 0 Sri • i I S - /cr. .___--. _________ / ive , cz ( I CDAudio-Visual Alarm j 3 Cleanout 1200 Gallon Septic Tank 7 � . 2 Compartment with Effluent Filter 0 12.00 Gallon Pump Chamber I k-44\. ok. c- S`oneti. I 3v- 30•--4 ?r va+c {cad e as-v u h-t. 1 easiticti-., _ l-7?'