HomeMy WebLinkAboutSWG2024-00304 - SWG As-Built - 8/8/2025 limmommiummimmimismenw 6
Mason County OSS Installation Report pg.
MASON COUNTY PUBLIC HEALTH
APPLICANT/ PERMIT INFORMATION
Permit Number SWG 2024-00304 Parcel # 32021-56-01015
Applicant Name HABITAT FOR HUMANITY
Subdivision (Name/Div/Block/Lot)
Applicant Address PO BOX 1549 Shorecrest Terrace 3rd Add! Blk 1/Lot 15
City, State, Zip Shelton, WA 98584 Installer Name Mason County Excavating
Site Address 200 E PANORAMA Dr, Shelton Designer Name Arrow Septic Designs Inc.
INSTALLATION CHECKLIST
0 Full System Installation ❑ Tank(s)Only ❑
Drainfield Only ❑ Repair ❑Other
System Type Shallow Pressure Bed _ ' eatment Type
❑ N/A ❑■ YES ❑ NO
>5 ft from foundation? � a ❑
>50 ft. from wells? - ❑
>50 ft. from surface water? e riSO- - ❑ 0 ❑
Z - ■ ❑
FQ- Cleanout between building and tank? - - - ���1- - - - - ❑ ❑❑ ❑
U Tank baffles present? U - ■ ❑
I— 24" access risers over each compartment? - - - ' ❑ ❑
a �% ❑■ ❑
W Effluent filter installed?- % ❑
co Hagerman
Septic tank capacity (working) 1,250 gal Manufacturer g
O D-box water level and speed levelers used? - - El N/A 0 NO N/A ❑ ❑
�O Manifold/D-box accessible from surface?- - ❑
mZ Check valves installed? - a t. `� } ❑ L7 ❑
0Q 2" Schedule/Class 40
2 Transport Line Size
Bedrooms installed (check one) ❑ 2 ■❑ 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other
>10 ft. from foundation?- - - -She-_, - 6, - - ❑ N/A ❑ YES ■❑ NO
0
>100 ft. from wells? ❑ 0 ❑
- ❑ [■I ❑
W >100 ft. from surface water? -
LL >10 ft.from potable water lines?- - ❑ • ❑
Z > 5 ft. from property lines and easements?- - ❑ I ❑
Ce > 30 ft. from downgradient curtain/foundation drains? - - ❑ El ❑
❑ II ❑
Drainfield level and observation ports present ❑
❑ Graveless chambers or ® Clean gravel used? (check one)
Proper cover installed over drainfield?- - ❑ UI ❑
Pump tank setbacks consistent with septic tank?- - ❑ N/A 0 YES ❑ NO
• Pump tank capacity (flood) 1000 gal Manufacturer Hagerman
a viisyk Eli
< 24' access riser(s) and accessible from surface?-�; r�� ❑ pSI \
~ Alarm or Control Panel Installed? - -S1 � ❑ '`Pi •
a.
E Control Panel equipped with Timer/ETM /Counter- ❑ k`wit�p �
a Pump installed in ❑ Bucket or Q On Block or ❑ Other
n- Pump Make/Model Liberty 280 0 Floats or ❑ Transducer
E
a
9 ft
Tank draw down 2.5 in/min Pump capacity 47 gpm Squirt Height
Pump on time 1.9 min Pump off time 6 hr Daily flow set at 360 gpd
Updated 8:2?120 1 8
rare:# 3 2
o '(°-- O 'O --
Mason County OSS installation Report pg. 2
ABANDONMENT RECORD 7vEs No
onerts abandcned as part of this protect? -' ---- -- - - -- "r
Were existing septic comp �
please descrbe: ___ _- - - 1 1 YES ❑ NC If yes, or JVAC246-2?2r- 300.
Were all components pumped out and properly abandoned p.
RECORD DRAWING
Typical Recorc
t to relocate in the reed of maintenance activities and buildings,dvolcation of wei water:ines,
This isn a permanent record and mud:be accurate and descriptive enoug• V proposed
irblgs approval and;elated perms•
�ravrngs contain: rJta:.^`.teid 8 manifold aie^:anon 3layw:.SepbcJpurnp tank location.Now arrow.rese^�e d2in5eid.e>csing and p�cp�
4
wells.observation ports.dear.outs,and otter maintenance access wins. Incomplete Record Drawings may create additional delays
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Record Dra�nn 1
CERTIFICATION OF INSTALLATION
INSTALLER DESIGNER!ENGINEER I
1 certify that I installed the system in accordance with l 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 ail
and Mason County Codes. State and Mason County Codes I
1 further certify that all information contained on this I further certify that all information contained on this i
form and attached Record Drawing is accurate. form and attached Record Drawing is accurate.Signature of Installer matePr nted Name of Signee AH
MASON COUNTY PUBLIC HEALTHThe undersigned approves this installation Report and �? stooaaa � 3
yra PAULA JOHNSON
Record Drawing on behalf of Mason County Public ���A JOY HNSON.•• 1
Health: g EXPr�eSTi�3Ti
`�'l, I/kv( s -( 3-zs
Signature of Environmental Healtr. Specialist Date
(stamp, signature and date)
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Upatec 82:2018
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APPROVED
o 0 e . t d
AUG 0 8 2025
MASON COUNT'{ENVIRONMENTAL NEAUTH J G ���
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