HomeMy WebLinkAboutSWG2024-00244 - SWG As-Built - 9/10/2025 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH
APPLICANT/ PERMIT INFORMATION
v�
Permit Number SWG L024' oteLiq Parcel # iZjO T ' y q" 0/O/'
Applicant Name :Jame:, WICI r 21- Subdivision (Name/Div/Block/Lot)
Applicant Address S ( E. Pi +_.4es �r
r
City, State, Zip 6-n e&'i es.d L✓d `1Ys� Installer Name ' /
Ysle
Site Address XX L�aa ) i 5 Designer Name Vt
INSTALLATION CHECKLIST
7Full System Installation ❑Tank(s)Qniy ❑ Drainfield Only 0 Repair ❑Other
System Type A 1 1-1 ).P`iv Jretreatment Type no
>5 ft. from foundation? - N/A ❑ YES ❑ NO
>50 ft.from wells? - � �� `` 0 0
• >50 ft.from surface water? �: i, ,,1� •! ❑ �" 0
Cleanout between building and tank? - \,,, = ,��t� lEr ❑
o Tank baffles present? - -
d24" access risers over each compartment?-\-'\k -- - 0
W Effluent filter installed?- - - - - - D�'' ❑
i ❑
- Septic tank capacity (working) I?_tom �� Manufacturer 5 P'S —
. 5 D-box water level and speed levelers used? - - IA N/A LEI YES 0 NO
❑
;oO Manifold/D-box accessible from surface?- - El Me (
3Z Check valves installed? 0
Z'
2 Transport Line Size Schedule/Class
Bedrooms installed (check one) ❑ 2 Elje ❑4 ❑ 5 ❑6 ❑Commercial/Other
>10 ft.from foundation? - ja{��s; L ❑ NIA ❑ YES 0 NO
JT! Y1L�7�i� ❑
0 >1D0 ft,from wells? - � gy.
-
-� >100 ' from surface water? ❑ 0
LL >10 ft.''from potable water lines? 0 0
0
Z > 5 ft. from property lines and easements?- - ❑ 1 CC > 30 ft.from downgradient curtain/foundation drains? - - 0 0
Drainfield level and observation ports present - - 0 ❑
❑ Graveless chambers or Vc Clean gravel used? (check one) El
cover installed over drainfield?- - 0
Pe Pump tank setbacks consistent with septic tank? - - ❑ WA WYes ❑
NO
Y Pump tank capacity (flood) /81.75 gal Manufacturer UP
Z ❑
a 24" access riser(s)and accessible from surface? t��' ' ❑ 0
~0. Alarm or Control Panel Installed?
2 Control Panel equipped with Timer/ ETM/Coupler- - - - - - - - - - - 0 le ❑ �\
M
a. Pump installed in El Bucket or ((On Block or 0 Other
n' Pump Make/Model /4 ' 152. Zcei0i_--- [gloats or 0 Transducer
d Tank draw down
'' in/min Pump capacity gpm Squirt Height /13 ft
Pump on time • ' Pump off time 9 alZ.5 Daily flow set at 070 gpd
Updated E 2,.2C05
Mason County OSS tnstatiation Report pg. 2 ?arm+n
ABANDONMENT RECORD
Were extsting septic components abancarte� as car: o; nis pr3jee' • - rl YES Off NO
if yes.prease describe:
Wece ail Components pumpe cu:a-.:;..-vice-j'3r2^.coned per WAC240-272A-C3:::? • - 0 YES 16 NO
RECORD DRAWING
Tiu...p.m.im mot and must bs accosts and desonptM impugn to rw4ocate In the need of maintenance act sties end future development. T,Vlcei Rano-a
3-e.ing L...: O a-rf c d-aii>:x:rorar 3,e .d.Se,7oGT i ling)ocat.ss ^i STOW,reseNe ^;ad.ey;crs lino Pr0.'holso Dialdi ga iocawn olree4.wain es.
7 T4. sz.-41;t1 aa. .Deere ts.al r..e,r j"Ers,^..z.f;eV:ads JC::s irate,ex iteGYO:3..`cs a%CIza:e aOd ni GKJ5 in bra+mateeetIon appGc.*Inc:franc pe,^.ais.
a/c(c--.‘ ,...) a 1 e 0 A? clici„lit,.r..j (....
,ee t-?4,7-e, ? -1-And If)
< (1-; •( icilke.er a7.1,2 ,
1 . .A.,„
d/k.-06' dr. 712,e„,/yc
•
// •
Second pr2wha N:tachec
CERTIFICATION OF INSTALLATION -_ If
r d
t
tNSTAt;E.ER ' DESIGNSPI chiGNEER
t cert4'tflat I installed the system In aocoroarce .i:r f ►cattily tea.`:ne system has been.installed in accor-
` the septic design stamped APPROVED'by Mason i dance with ne septic design stamped`APPROVED"by
I County Public health and:net an/deviations shown 1 Mauy Co::.1'%-:tic health and that any deviations
s here have seen cleared app%cc s; oc:: :. st a des,;.:er i mom: e here /e tear aearad/approved by both..
and Maott County Patric Heatn a~:c 11ea. Sra: ; n,yse.fe?.1'Mason. County Public Health and meet all ..
s and Msb-on County Codes. 1 Ste:e aid r::sson County Codes
I furtfer}calif/Lyra:a ::c:.r_:...n_:;7:a- . .ri, i : ..terre.^ti ens all info, ation contained on this
fa. Bracher' `:.Z.ra.:. 3_ s '" .ern*. a ld 8::a:.rlee tern vE -wing is accurate.
t . 0 io i-2-c .!, ..-..
. iird
�� s Y �1
Printed!game cf S:�,r
i 41
tmlIMMMIIIMININIMMININIMINIIMINIMIMMIIMMININWIMS•wr.......... ..q) !� . 51 r; p� C
K MASON Counn �-..'SUC i:GA.-T:': 44'.k .•..1 A:... Crr4rbK.Ts.. /
LICENgI �NER
The un,a'ersigned app ova:th.s :n,s:el;at.�., dY.._.. .. -. �..........�.‘,.... �- r
.' -,, EXPIRES owes
Reccro Drawing on deratf v Ws:A Cc t/fs4r:;,: -C'N ` ,.
'-':r. V / (...(_,.......4
4)
{ Heater G'ym' . /o `
Ves. eye'/ 4<5
Sigma:l e r= /:rc^,-±enre: HaanSpec+a;is: Ja:e 4 4 % (s:arm,signatb:re and date)
r ::;.. s.wi=s=S^.'tn.SL _=C=:P..E._.:y,F,* ..:,' . .;-.c .•tS:.t;O;aTY vh. :rz:ac a .
3 SITE : _•. _'e
1 . Residence
2. 1200 gallon septic tank L e/n i 4-4> 2�'
3. 1200 gallon pump tank
,
4. Audio/visual alarm _____ I c0- 4-1- __ _.__...
5. Clean out
�D � tvd,
6. Transport line SL3,-
7. Water line
8. Valve box
9. Primary drainfield % '� `J�
10 Reserve drainfield --.� ��' /�
•
1
co
i35.4. ‘1, 0 13ffr
aI
\ .—"----7
I\ I
0 rz- i -ityA �s2
its
523 -o—70" R1✓``ttrrrs.c
S +E % EE
•.„. , i�� aArr �A
4 4411)
�� Y+As ��91EE �Poa. ..ti�F9`l41. 1/
PifisAVA g \
®lkii a-7-wq— ,,ai:y`` a, s�41 ,f ooa, �� �'1
/h,48 Sep / 0= 5100418 4 . • CI DYE.WAITE !E1�� (
ONCO(/ 0?0 , LICENSED D SIIGNER i' LICENSED DESIGNER 9' ,/"
NryFNL / �r►a:k..•16���ib�•. \ vex\\I,
�i \\� �\ \\ EXPIRES 05n0,
Rp LX4 NLS J5 tU,
O✓A N�FNTAZ lip,
"4149
. ,
D tea'Ai let/ 4-,._fr
[ -
r
—
i ..
5.19/".C. Citioeisp
I
.. ..........
3
••, __ • ---- r
-771
(11/ -d ' --I --------
/1./2...__ ____
..1/
I ...-..--771 4.-
II
.1
L.,
---
/ ( lea'
)5"
.....
VI' .
I za, t 1,0, , i
1/1:40;' '
ods
, •
0 i
G O 6s pit/ 4-4-4N 0,-,J-(171) , ..., i
.• ,A.
CV Va be ( a Z. Li) '23- ; .
1 ..,q I..
"40 4:)*4 'lb 41 0
.:I IP : 4 i ' .,.4, ,V)11
if Gi
,. ..Pli
of 18 6 0 1,,hIA
,ct y .wAITE
„,, LICENSED DESIGNER
r...................... .. .......,,,,,, 1
EXPIRES 051101
7 11
-
a.'I
0
.11: #1
04.3.
Tin. .
. 0 V/11
i 4 -
Ala SC0 (e
-rifil V ettl /.4.41 2q* APp
11 ROVED
1 %rep elf_c144. 1 SEP 1 0 2025
IVAsav
CotiN
•'i.C,1,-,,,-, -,
•
RECORD DRAWING (continued)
94
11:=15.)
APPROV Law -' 1
SEP 10 2025
MASONCOUNTYE
NVIRON MN HEALTH
DJA