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HomeMy WebLinkAboutSWG2022-00376 - SWG As-Built - 8/21/2025 • Mason County OSS Installation Report pg. 1 C .C, MASON COUNTY PUBLIC HEALTH - APPLICANT/PERMIT INFORMATION Permit Number SWG 2022-00376 Parcel* 22212-59-00013 Applicant Name Donald&Caron Denotta Subdivision (Name/Div/Block/Lot) Applicant Address PO Box 2366 City, State, Zip Belfair,WA 98528 Installer Name South Shore Construction Site Address 17352 E State Route 106 Designer Name Arrow Septic Designs,Inc INSTALLATION CHECKLIST .Full System Installation 0 Tankls)Only ❑ Drainfield Only 0 Repair ❑Other System Type Sand Lined Pressure Bed Pretreatment Type >5 ft.from foundation? - '-1 ❑NIA a vas 0 NO >50 ft.from wells? i -w: ❑ e ❑ IJ II ® 0 0 Y >so ft.from surface water? - pitch 31 7p?a Cleanout between building and tank? r L, ❑ III O E. Tank baffles present? • 0 24°access risers over each compartment .- 0 M 0CI Li Effluent filter installed? 0 0 Hagerman Septic tank capacity(working) (2 each) 1,250 gal Manufacturer La D-box water level and speed levelers used? . NIA 0 Yes 0 NO Manifold/D-box accessible from surface? ❑ ®II ❑❑ ,� Check valves installed? ❑ ITransport Line Size 2" Schedule/Class 40 Bedrooms installed(check one) 0 2 0 3 ❑4 0 5 ®6 ❑Commercial/Other >10 ft.from foundation? ❑ WA .YES 0 NO >100 ft.from wells? ❑ El 0 `- >100 ft.from surface water'?- - II 0 t. >10 ft.from potable water lines? ❑ El ❑❑ -.- >5 ft. from property lines and easements? ❑ III CI>30 ft. from d II curtaintfoundation drains?- II El Drainfield level and observation ports present - ❑ ❑ Graveless chambers or • Clean gravel used? (check one) 0 Proper cover installed over drainfield? ❑ IIII Pump tank setbacks consistent with septic tank?- 0 WA ill YES 0 NO X Pump tank capacity(flood) 1$00 qal Manufacturer Sound Placement 4 24"access nser(s)and accessible from surface? ❑ U 0 Alarm or Control Panel Installed? - ID ❑ 0 Control Panel equipped with Timer/ETM/Counters. ❑ nTube Pump installed in ❑ Bucket or 0 On Block or IN Other Pump Make/Model OrencO PF5010 ® Floats or 0 Transducer y Tank draw down 1.5 in/min Pump capacity 50 qpm Squirt Height 5 ft Pump on time 1.8 min Pump off time 3 hr Daily flow set at 720 ggad tromedereece Mason County OSS Installation Report pg.2 Pare lu 2 2 21 2-59-00 0 13 ABANDONMENT RECORD were amp wee mm¢onema.a bandoned as part of tlds proiedr Et YES ❑ 10 Ifyea,pins*desama Et yes CIthe an par cn rue pumped out and property abandoned per WAC 4e 272A-070m .RECORD ppAYYINNN TSIs a eewnae rowed r sue r mania a'Malay ron rawly S Ms NW a ernn.n Beiwryod WwyderslB -OW* po st.weaSic oar aB.rr~NI=a Yw.as.Bwnreea4wa.n. ONNY 011.160 yeatriea WM WnaX b Os made rye am NM.M owdys awed ewe svwiMraaidew YMa yeatl O dean+ Set Atia ( k021 • B Record DiawlnDArid r 1,-.I; 5:'% .-y-.. CBRTIFIGTIONtOE.NISTALI:AioN ..-A- .:-LAs9_+;T} `.-;' '.. INSTALLER DESIONfl ENGINEER 1 certify that 16Mfelled the system In.covalence v.W I amity Mat the system has been Walked m s000n the septic design stamped"APPROVED'by Mason dance w*A the septic design stamped'APPROVED-by Coto*Pubic Health aid that any deviations shove) Meson County Pudic Health and that any devtaaan hen have been a atecVapprovedby both the designer shown hers have been dewSWpcved by both end Meson Comb Public Healdt and meet es State myself and Mason Canty Pubtc Health end meet al. and Mason County Cain. State and Mason County Codes. I fuithercw6ry that e9 Worms/Jon cantai ed on this I father ter Mat at namaa n contained on VYa ,a yp form and attached Record Clawhnpaccurate. 6ErdZ3-2-22 Signature dpateser Date R•Cti Moon t a `. Printed NsmedSpw MASON COUNTY PUBLIC HEALTH iI • L .A'{- Bl The undeuepnelaAo eS th b,st aadnn Report and ea uB �B Record Drawing co behalf dMason County PublicJOY JOHNSON y. fad p�M0�6�✓� °��7i(!t� L j- L-t -2S demearasl�{pag,Spade& Dery (stamp,signature anddete) Sgnabee THIS FORM ANY BE SCANNED my MAKABLE FOR PIJSJC V1EWON THE MASON COLINTYMtlSITE LOSS le" -re. T i c\ -- ,\ AAS.5u i ii- I Dor Garda Dfho{}a to 17321 E Siak ?a/ft Ph S(a (t:I = 'GO 4 o 100 ISO 200 ofeS . I II I :Te"Hole I I I #1: 0-36"GO to seml-compact gravel layer, ///Ij 36-76"GMS ! - I #2: 0-54"very slightly compact MS&G, 3d.i3 0 5472"MS,no restrictive 67.74 #3: similar to#2(no ramp) cot* C e #4: 0-30" LMS&G to slightly mottled gravel c w v -b Layer,30-68" MS&G IO -5 #5: 0-68"GMS to compaction < c. n 01 r-1 mg A APPROVED ax AUG 2 1 2025 I I v:; ', T,,,,'. E.,riRC MENTAL HEALTH l� 7E- 1 \ "Mail 1oS.14"I :00.5 i 4 p a�v• M • O HG, en kr,- a�N >, n FAULA JOY JONN6CN t7 / O o 61 4 peg C. Exd5ttrq San9 J do Audio-Visual Alarm `1 - © Cleanout /p:)IZ5°Galion Septic Tank �vf 2-Compartment with Effluent Filter �PPROVED1 4 O i,Boo Gallon Pump Chamber v i;e r.. 4v..1- AUU 2 1 2025 1 �� © eD�` arSi sb MASOLNc IYE41iRCp4CRiALHEAL '© RETING ' e , "" '. 0 4_ SeQl1tT an. F` �9 £x i Sti r1 q a.. -''r`°"'h•r- raw.a.l. ioo.ti' be;a444- RsbG, rt p t.,"-e,4 Cam+. 90314.4a L tie s.s(F- ur t . fa INV tite rv< tri in_ 0 9xta Pr;h.a.yakk Ar _ 1� SD « —1 L_ res Y ijr� { TP . N ', $Ornosy r PALKAJOYNJ9HSaa ,. Ne 3- 2-7-'CS C4it l 30' 130' 0 rt5 3p :,4t H