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HomeMy WebLinkAboutSWG2025-00119 - SWG As-Built - 8/28/2025 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH R APPLICANT/ PERMIT INFORMATION Permit Number SWG 2025-00119 Parcel # 320304300210 Applicant Name Zhang Ji Subdivision (Name/Div/Block/Lot) Applicant Address 11416 SE 72ND ST City, State, Zip NEWCASTLE, WA 98056 Installer Name Josh Gunia Site Address 182 southeast VIC king rd Designer Name Adam Hunter INSTALLATION CHECKLIST wi Full System Installation ❑Tank(s)Only 0 Drainfield Only 0 Repair 0 Other System Type Pressure trench treatment Type >5 ft.from foundation? - 0 N/A ®YES ❑ NO >50 ft.from wells? - - - - �- - El NI ❑ Z >50 ft.from surface water? - c. �) _ - - - ,a.��' 0 Ni El Q Cleanout between building and tank? - V., ❑ ® ElU ;Tank baffles present? - - • - -- 0 0 0 E- 24"access risers over each compartment?, - - - - - 0 RE a W Effluent filter installed?- Niai - 0 ® 0 N Septic tank capacity(working) 1250 gal Manufacturer Infiltrator .51 D-box water level and speed levelers used? - - IN N/A ❑ YES 0 NO 00 Manifold/D-box accessible from surface?- - El El t9 Check valves installed? - '- 0 0 0 ❑Q 2 • Transport Line Size 2 inch Schedule/Class 40 Bedrooms installed (check one) 0 2 0 3 0 4 ❑ 5 ❑6 0 Commercial/Other >10 ft.from foundation?- '- 0 N/A ® YES 0 NO O >100 ft.from wells?- - 0 is 0 ill >100 ft.from surface water? - - 0 DM ❑ il u. >10 ft.from potable water lines?- - 0 El 0 > 5 ft.from property lines and easements?- - ❑ ® El0 . > 30 ft.from downgradient curtain/foundation drains? - - 0 is 0 o Drainfield level and observation ports present - - 0 is ❑ ❑ Graveless chambers or M Clean gravel used? (check one) Proper cover installed over drainfield?- - 0 ® 0 Pump tank setbacks consistent with septic tank? - - 0 N/A Q YES 0 NO • Pump tank capacity(flood) 1480 gal Manufacturer Infiltrator Z < 24" access riser(s) and accessible from surface?- - 0 ® 0 F- a Alarm or Control Panel Installed? - - 0 0 ❑ 2 Control Panel equipped with Timer/ETM /Counter- - ❑ 0 0 a Pump installed in 0 Bucket or 5 On Block or ❑ Other mPump Make/Model Liberty L280 ® Floats or 0 Transducer a Tank draw down 2.4 in/min Pump capacity 62.4 gpm Squirt Height 4.5 ft Pump on time 1m17s Pump off time 4H Daily flow set at 480 gpd Updated 8/21/2018 Mason County OSS Installation Report pg. 2 Parcel# 320304300210 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - Q YES NO If yes, please describe:old septic tank pumped and filled with gravel Were all components pumped out and properly abandoned per WAC246-272A-0300? El 0 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,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. 0 Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER! ENGINEER I certify that I installed the system in accordance with !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 I further certify that all information contained on this I further certify that all information contained on this for nd attached cord Drawing is accurate. form and attached Record Drawing is accurate. ."------------ 06/18/25 . Signature o Ins Iler Date * —, �/ 'i . Josh Gunia -`'` Printed Name of Signee /,f:: lc• MASON COUNTY PUBLIC HEALTH .-1`" ts• The undersigned approves this Installation Report and ,f,,�_ . 51Uu.1t1 Record Drawing on behalf of Mason County Public • %_;'' ADAl l J.IIUHi l rI Health: 1 1 it,`l•r:,4 •)(..! •.r,.j f I',.,.. Q 1�5:>SS ::r::i:':. .t (61171 kg— Signature of Environmen I Health Specialist Date (stamp, signature and date) Updated 6l21I20t8 THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE RECORD DRAWING (continued) t`, / / N 17 / c0 NNNNN \ NNN\ 7z..... /as , CD \ j ! \ iga ,..0 \-)6,, —11".0 G F� . aa ~ 664e \ . ,.. . , ,, ' ,',/,„'A-e-- 4.,'4:,, / Lk) 0 CI\ `-'1), Ci/719;'t .s; ti 0000000000 o mm c m U) m m m m m � Z m 13 n O m -t 4 = 1 j:, . (� c Z z z Z ' +St O D2 D 1 D 0 o p p cc .y c .,1, . 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