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HomeMy WebLinkAboutSWG2021-00685 - SWG As-Built - 9/12/2025 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2021-00685 Parcel# 32021-41-00060 Applicant Name Mitch Shirazi Subdivision (Name/Div/Block/Lot) Applicant Address 571715th St. Ct. NE City, State, Zip Tacoma,Wa 98422 Installer Name Spear Const. Site Address5i5 rc.Parkway Blvd. Designer Name Bob Paysse INSTALLATION CHECKLIST • Full System Installation ❑Tank(s)Only LI Drainfield Only ❑Repair ❑Other System Type Flout to pressure treatment Type >5 ft.from foundation? - i -� � •- ❑ N/A �YES ❑ NO >50 ft.from wells? - �r"'� �i 0 e ❑ Z >50 ft.from surface water? - - - - - Vkt, ---$c$`3--`• ----\ ❑ ® ❑ HCleanout between building and tank? - ---03- - ® ❑ V Tank baffles present? - 1 --- - -/` El IN ❑ a 24"access risers over each compartmen '-` ----- El 1. 0 W Effluent filter installed?- 414- - ❑ ® ❑ N Septic tank capacity(working) 1200 gal Manufacturer Sound Placement 0 D-box water level and speed levelers used? - - ® N/A ❑YES ❑ NO 00 Manifold/D-box accessible from surface?- - El a ❑ IVE Check valves installed? - IN ❑ ❑ G 2 Transport Line Size 4" Schedule/Class SDR 35 Bedrooms installed (check one) © 2 ❑3 ❑4 0 5 116 ❑CommerciaUOther >10 ft.from foundation?- ❑ N/A • YES 0 NO G >100 ft.from wells?- - 0 U . 0 W >100 ft.from surface water? - - 0 El +P O/ e 1i. >10 ft.from potable water lines?- - ❑ •�*\'1PoJ.0 0 Z >5 ft.from property lines and easements?- - ID ® pP El 12 >30 ft.from downgradient curtain/foundation drains?- - ❑ IN ❑ Drainfield level and observation ports present - - ❑ I 0 ❑ Graveless chambers or 0 Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ ® ❑ Pump tank setbacks consistent with septic tank?- - ❑ N/A il YES ❑ NO ZPump tank capacity(flood) 60 gal Manufacturer < 24"access riser(s)and accessible from surface?- - 0 ® 0 a Alarm or Control Panel Installed? - - ® ❑ ❑ 2 Control Panel equipped with Timer/ETM/Counter- - ® 0 0 n a. Pump installed in ❑ Bucket or ❑ On Block or 0 Other d Pump Make/Model N/A ❑ Floats or ❑ Transducer d Tank draw down in/min Pump capacity gpm Squirt Height ft Pump on time Pump off time Daily flow set at qpd Updated 8/21/2018 Mason County OSS Installation Report pg. 2 Parcel it 32021-41-00060 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - If yes, please describe: - ❑ YES 0 NO Were all components pumped out and properly abandoned per WAC246-272A-0300? -------- ElYES 0 NO RECORD DRAWING Me Is a permanent record end must be accurate and deualptIve enough to re4ocate In the need of maintenance activities and future development Drawings contain. Dreinfiekl&manifold orientation&layout Septic/pump tank location,North arrow,reserve drainfield,exLnung and proposed buildings,location of we l,Typical wells,observation ports,cleano its,end other maintenances accene points. Incomplet Record Drawings may create additional delays In final installation approval and related permits. Ill Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ENGINEER I certify that I installed the system in accordance with 1 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 hem 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 ecord Drawing is accurate. form and attached Record Drawing is accurate. OV Siggna of Install Dbte Logan Spear , 1 hS►�1/ 9 I _ AsPrinted Name of Sfgnee r 1 MASON COUNTY PUBLIC HEALTH ' ' The undersigned approves this Installation Report and t1. ,, wl Record Drawing on behalf of Mason CountyPublic tt •"�"' Health: '�'*:.PIRES:.:.::i.. EXPIRES • '1 \Nikwniks)` CC(Iz,(XX Signature of Envlronmentell Health Specialist Date (stamp,signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Updated dr21/2018 52___________-.--\ G C6 EX\S)�N P � To' DE ol I __ \\___ SEPTIC TANK& FLOUT PROPOSED HOME I /, I DOSING TANK BUILDING SETBACKS ..- ''7 FROM SEPTIC ii%ice, EXISTING WALL COMPONENTS �� �� ��7 '%,iiii7 %7 l%%,%-'.'. "' EXISTING TANK `i%` ii.%%�%,' '5� ii%i FOR LOT 70 �� ,. i r� ' 3 ` ii� C�i , _0 EXISTING 3 BEDROOM �" '� I o < % I z g 13 DRAINFIELD FOR LOT 70 II li II II INSTALLED _ �I 11 II II 2 BEDROOM m N 0 ! I1 II PRAINFIELD -' z N II III !! II 1 m ,IAA ��1 II II L► II I _ D rn __ �I r a I� r_rnn r 2 I I - RECORD DRAWING 1 1 ,,t 1 0 • I O I y �S'•`�4 N. PP - I APPROX. OHWM tee` WSW '. HAMMERSLY INLET I\t_ -.._ j ��� I I EXPIkES PIONEER DIGGING, INC. CUSTOMER: ai oI 00 I ESHOLE I: TEST HOLE 1 i I SEPTIC DESIGNS ADDRESS: XXX E PARKWAY BLVD oHo GS-- L}38 GIs 40+DESIGNER ROBERT H.PAYSSE ROOTS S MASO N RD. GRAPEVIEW,WA 98546 ROOTSTS ROOTS 40 -38 OFFICE-360-4261803 FAX-360-427-2353 DESIGN PAGE ASBUILT