HomeMy WebLinkAboutSWG2025-00247 - SWG As-Built - 9/15/2025 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH
APPLICANT! PERMIT INFORMATION
Permit Number SWG 2025-00247 Parcel # 42216-50-00006
Applicant Name Ryan Eager Subdivision (Name/Div/Block/Lot)
Applicant Address 5312 Park Rd. E. Lake Cushman Div.9 Lot 6
City, State, Zip Lake Tapps, WA 98391 Installer Name T.J. Goos
Site Address 150 N. Glenwood Rd. Designer Name Dale L.Tahja
INSTALLATION CHECKLIST
® Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑Repair ❑Other
System Type Sand Lined Pressure Bed Pretreatment Type Sand Augmentation
>5 ft.from foundation? - - - -- ❑ N/A IN YES ❑ NO
>50 ft. from wells? - - - -
• >50ft. from surface water? - - - - - - ST,- -c -- - - ❑�-- II ❑
Z � - -- ❑ ® ❑
• Cleanout between building and tank
V Tank baffles present? - - �-�� -11 - - - ❑ ® ❑
H 24"access risers over each compartmgi A- $ \ - - - - - ❑ ® ❑
W Effluent filter installed?- -; �ia. 'i - ---
❑ ® ❑
cn Septic tank capacity(working) 1, y gal Manufacturer Hagerman
D-box water level and speed levelers used? - - IN N/A ❑ YES ❑ NO
OManifold/D-box accessible from surface?- - ❑ ® ❑
mZ Check valves installed? - - ❑ ® ❑
thQ
2 Transport Line Size 2 inch Schedule/Class Sch. 40
Bedrooms installed (check one) U 2 ❑3 ❑4 ❑ 5 ❑6 ❑Commercial/Other
>10 ft.from foundation?- - ❑ N/A ® YES ❑ NO
O >100 ft. from wells?- - ❑ ® ❑
W >100 ft. from surface water? - - ❑ ® ❑
LT >10 ft. from potable water lines?- - ❑ II ❑
ZQ > 5 ft.from property lines and easements?- - ❑ ® ❑
ti > 30 ft. from downgradient curtain/foundation drains?- - ® ❑ ❑
Drainfield level and observation ports present - - ❑ I] ❑
0 Graveless chambers or mg Clean gravel used? (check one)
Proper cover installed over drainfield?- - ❑ ® ❑
Pump tank setbacks consistent with septic tank? - - ❑ N/A ® YES ❑ NO
• Pump tank capacity (flood) 1,000 gal Manufacturer Hagerman
< 24"access riser(s)and accessible from surface?- - ❑ ® ❑
1—
a Alarm or Control Panel Installed? - - ❑ II ❑
2 Control Panel equipped with Timer/ETM /Counter- - ❑ II ❑
a. Pump installed in ❑ Bucket or II On Block or ❑ Other
a• Pump Make/Model Liberty 280 ❑ Floats or 11 Transducer
a
Tank draw down 1.5 in/min Pump capacity 33 gpm Squirt Height 12 ft
Pump on time 2.25 min. Pump off time 5 hrs. 57.75 min Daily flow set at 180 gpd
Updated 8!21/2018
Mason counter MS Installation Report pip 2 turd* V\ DSO- O6
,y,11,e adding seplic components abandoned as part of Its project? ---------+----- p YES p so
It yea,please deecri Ci
were as componentspumped out and properly abandoned dor yeaNO i
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Deaarria misfit WNW mane alo beta a lap*9.p apose tank lesion.Ned*aeon aaww*WOK rem end mama lailklam Maio alvala,rairillass,
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■ Reooid Drawing Attached
-- CO .'flON OF NOT N.
uasTAU t Del ENGVIEER
I way that I instead the system In accordance with I certify that the system has been bid in scoop.
the septic desn stamped`APPROVED"by Mason ^ dews wan Ow 'n °APPROVED"by
County Public Heath and that any deviations shown Mason County Public Heald►and thatany deviations
hens hew been cieemdlbpprovsd by booth the designer ehown here have been ciesradfappobved by both
and Mason County Public Health and meet ail Stale myself end Mason County Public Huh end meet at
and Mason County Codes Sate and Mason County Codas
I tether oerlI y that at hR nt:Won on fhb I further certify y that all Information contained on this
form and attached Drteb - fom and attached Record • ' ;' ., is eawrate.
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' SA- ►I
MASON COUNTY PUMUC HEALTH -- •. t 11
The understood approsnes this Installation Report and ���_ . 5100214 +l
Record Dimming on behalf of Mason COtlntV Public ' ,;e� Dade 1.Tam
Health: v - LICENSED DESIGNER t, •srrnnature of Environmental taal l 3parateltet Date (stamp, and )
MS FORM M mitt 8E SCANNED AND MAKABLE FOR PtoIJG veI V on THE MASON COIR4TY WE9 WE Owls'mums
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