Loading...
HomeMy WebLinkAboutSWG2025-00243 - SWG As-Built - 8/26/2025 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2025-00243 Parcel# 32122-50-00124 Applicant Name Fred & Nancy Kreienkamp Subdivision (Name/Div/Block/Lot) Applicant Address 61 E Weymouth PI LAKE LIMERICK#3 , Lot 124 City. State, Zip Shelton, WA 98584 Installer Name Maples Excavating Site Address same Designer Name Arrow Septic Designs INSTALLATION CHECKLIST S Full System Installation ❑Tankis)Only ❑ Drainfield Only ® Repair ® Other 560 gallon pre-trash tank System Type Pressure Bed Pretreatment Type NuWater BNR-500 >5 ft.from foundation? - w N/A 0 YES ❑ NO >50 ft. from wells? _ P-PR-Q- J- El ' xiEl Y >50 ft. from surface water? - - I ❑ Z Q Cleanout between building and tank? -- -- AUG-2 6-�5 - I;; . 0 ❑ U Tank baffles present? P ra,SOt r DPT Y ENUIROr MENTAL a LTI- El ❑ a24" access risers over each compartment?- - ■ 0 CI W Effluent filter installed?- 5 DD El CI (AHa erman Septic tank capacity(working) NuWater BNR gal Manufacturer 9 O D-box water level and speed levelers used? - - ❑ N/A ❑ YES Cl ►0 , �-I �O Manifold/D-box accessible from surface?- - CI Lr m= Check valves installed? - AT Pt)r-&P Ntt ❑ ® q1 g Q 2 inch Schedule/Class 40 i • Transport Line Size i I v1 Bedrooms installed (check one) 0 2 ❑■ 3 ❑4 ❑ 5 ❑ 6 El Commercial/Other t „) 4 c � 7 ❑ N/A 0 YES NO r � >10 ft. from foundation? c» 0 >100 ft. from wells?- p , - ❑ 0 W >100 ft. from surface water? - `"` ❑ LT.. it >10 ft. from potable water lines?- - ❑ 0 ❑ Z- > 5 ft. from property lines and easements?- - CI 0 ❑ (X > 30 ft. from downgradient curtain/foundation drains?- - ❑ © ❑ cl Drainfield level and observation ports present - - ❑ Ol ❑ Graveless chambers or pi Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ I ❑ Pump tank setbacks consistent with septic tank?- - ❑ N/A 0 YES ❑ NO • Pump tank capacity (flood) 1,000 gal Manufacturer Hagerman < 24" access riser(s) and accessible from surface?- - ❑ I. ❑ 1-- 0. Alarm or Control Panel Installed? - - ❑ 0 CI E Control Panel equipped with Timer/ ETM /Counter- ❑ 0 ❑ - D a. Pump installed in 0 Bucket or 0 On Block or ❑ Other Q.• Pump Make/Model Zoeller N161-F 0 Floats or ❑ Transducer a Tank draw down 4 in/min Pump capacity 76 gpm Squirt Height 8 ft Pump on time 1.2 minutes Pump off time 6 hours Daily flow set at 360 gpd ..pOated 8,21.2e'.e Mason County OSS Installation Report pg. 2 Parcels RI 22-50-0012A ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - al YES NO If yes, please describe: Were all components pumped out and properly abandoned per WAC246-272A-0300? - - ti YES p 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: Draindeid&manifold orientation&layout.Septic/pump tank location,North arrow,reserve drain`eld,existing and proposed buildings,location of wells,waterlines, wells.observation Dors.deanouts,and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and related permits. ?N_C • ; cPPRO VE AUG 2 6 2025 ��.' " 3. iviASON COUNTY '`' EIt VIRONfdENTA1'•"EALTH Jaw Ci6 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'nstalled 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 1 further certify that all information contained on this form and attached Record Drawing is accurate. form and attached Record Drawing is accurate. , �' `G -- D Bva 3/ Zs `''• 'Signature of Installer Date �M � r, Printed Name of Signee moo. . 041)..?�, MASON COUNTY PUBLIC HEALTH 1 The undersigned approves this Installation Report and /`�_ 5100149 :c st) Record Drawing on behalf of Mason County Public �` PAULA JOY JOHNSON r•r(;1 'LVC`{-cA:D'Eel-.. `f He � �EXPIR S Da/1 "Cn �� ,101 , L(e `-2S $-I` -2.3" Sign tur�•3,�vironmental Health Specialist Date e (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WE3 SITE updated erzt2ota `, c-A�.6 : ; o = 30 S ' ASBOtL-T skU o C t.ED + NAts9 ARE t E NI Kltt-a P 1 4 pro p fcrte GEL a 321Z2—5-0- 001'24 , t W R '� .�° \ �C}`tic tt'� PRo�SFd 14 1 eW E5 r-1 v'114 p c/4e_E •6a \ \j � Sew a ��� �. )0 • U Audio-Visual Ala-n / .�0 ( 500 Galion?re-Trash tank ` !4 r \< y / `C C NuWater 3NR-500 A T li Tank v 2 ` O' ' ib'' O 1,000 "on?ufl Cha.hber `Y plc. re taceA w14+^ 6 / P \a - • ? . i /\ 5CO ga11o,, ,i re-44-4yt, O i O -r/ ` et, �av`� \ . (��` • o° ,/� g/ �,% •� cold eilea." f ze Id \r'Do ( q*e�/<,, 1- cos FBI g� \D /.f h NI ! z4 h ,I... L . . 4, .." - t v iPPROV e .1:: AUG 2 6 2025 \ 1ASON COUNTY ENVIRONMENTAL HEALTH JBW \` • 1 \ ) si b 4. r=, ' ,.4"'kb, y,,,,: 5,06349 • k y'i2• PAULA JOY JOHNSON ao ••UUC 7 S •b'EgiaN1=ft•' 3 h��1Q S 4 I