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HomeMy WebLinkAboutSWG2025-00220 - SWG As-Built - 9/8/2025 RECORD DRAWING (ASBUILT) pg. 1 MASON COUNTY PUBLIC HEALTH PARCEL IDENTIFICATION Permit Number SWG 2025-00220 Assessor Parcel # 520085100010 Applicant Name 62 West LLC Subdivision (Name/Div/Block/Lot) Applicant Address 15110 Cascadian Way Y City, State, Zip Lynnwood, Wa 98087 Installer Name Bryan's Excavating Site Address 62 W Lake Nahwatzel Dr. Designer Name Adam Hunter INSTALLATION CHECKLIST ❑ Full System Installation 3 Septic Tank Only ,�Drainfield Only 0 Repair System Type Pump Chamber with Solids Pu�•r ``etreatment Type >5 ft.from foundation? - %-1111 ��` -- 0 N/A ®YES ❑ NO >50 ft.from wells? - j:"19--)-- �� ---- - ❑ WI ❑ • >50 ft.from surface water? - �� Z Q 0 ® 0 < Cleanout between building and tank? - . - - - ❑ gEl El U -Tank baffles present? - lE 0 0 P 24" access risers over each compartmen Sy- - ❑ ® ❑ a 0 W Effluent filter installed?- ,- 0 U) Septic tank size gal Manufacturer 13 D-box water level and speed levelers used? - - ® N/A El YES ❑ NO �J ® ❑ O Manifold/D-box accessible from surface?- - m— Check valves installed? - 40 El fn Q 2" Schedule/Class 2 Transport Line Size Bedrooms installed (check one) ❑ 2 ❑ 3 0 4 ❑ 5 ❑6 >10 ft.from foundation?- - SE N/A ❑ YES ❑ NO 0 >100 ft.from wells?- - 0 ❑ 0 W >100 ft. from surface water? - - 0 0 0 ti >10 ft.from potable water lines?- - ® 0 0 Q >5 ft. from property lines and easements?- - RI El l > 30 ft.from downgradient curtain/foundation drains? - 0 ❑ ❑ ca Drainfield level and observation ports present - - WI 0 0 ❑ Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?- - lil ❑ ❑ Pump tank setbacks consistant with septic tank? - - ❑ N/A ® YES ❑ NO 300 Norwesco • Pump tank size gal Manufacturer Q 24"access riser(s)and accessible from surface?- - ❑ lil 0 I lil El — a Alarm or Control Panel Installed? 0 2 Control Panel equipped with Timer/ETM/Counter- - 0 0 iil n n- Pump installed in ❑ Bucket or ❑ On Block or © Other d• Pump Make/Model Zoeller/N267 ® Floats or ❑ Transducer 0_ a Tank draw down in/min Pump capacity gpm Squirt Height ft Pump on time Pump off time Daily flow set at qpm revised 1/22/2014 RECORD DRAWING (ASBUILT) pg. 2 MASON COUNTY PUBLIC HEALTH RECORD DRAWING 0 Drainfield& manifold orientation &layout Trench/bed dimensions and critical distances within layout El Septic/pump tank placement Location of buildings Observation ports& clean-out locations Location of wells, surface water,& roads Undisturbed native soil between trenches 0 North Arrow If the designer or installer feel the need for additional information/comments,it may be attached. Record drawing may also be on a seperate page attached. No. Pages Attached 1 CERTIFICATION OF INSTALLATION INSTALLER DESIGNER 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 I 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. 7�aS�� s Signature of Installerl Date 12>o ,(_ h s 7/30/25 Printed Name of Signee • ru.,.t MASON COUNTY PUBLIC HEALTH A The undersigned approves this Installation Report and Record Drawing on behalf of Mason County Public ti4 Health.` ADArAJ HUNTER Li 4,Th ` Signet re ironmental Health Specialist Date (designer's stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE revised 1/22/2014 :. , // ./ \ / I / 0 \ / I m ( ) q c « m«. $M \ z ›. 00 2 0 —Im0 � � ® / ? \/ I § - § m tn 00 ):. 01— / —I mC cAM0l ik §g 0 0 2 7-5, --i0•I w m kf k o ; a \ 1 4 \ « ± k k 0 5 re/ is , . . \ ' x z u z ��� � � m . • \ �xi � ` 0 • ,S! II X 2 q \ 70 , 2 4 2 R z z . 0 co % % x, q co \ _ b0 iM1U \ x % o m c - Clip • > -§ • Y4�% • -1 1 rn o xi k . 'r\\ • % 0 0 • g i�A� '«{c% m c ~ }�\}/� �� ���% § -I \ /�\y°°' ::\�� c k < ,lƒ� e ee r- (7) 7/ | �0\P . � ' # .- � 2 ® " 2 2 0 I:•' / M ) § / \ \ lb'M 0) ( Cl, m z om k k 0 > 0 m I N.) a j 0 / / ) r / 2 to 0 01 o il