HomeMy WebLinkAboutSWG2025-00073 - SWG Application / Design - 9/15/2025 ,
Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH
APPLICANT/ PERMIT INFORMATION
Permit Number SWG 2025-00073 Parcel # 32021-56-02014
Applicant Name Cannell Investments LLC Subdivision (Name/Div/Block/Lot)
Applicant Address PO Box 448 SHORECREST TERRACE 3RD ADD BLK: 2 LOT: 14
City, State, Zip Spanaway, WA, 98387 Installer Name Bill McTurnal
Site Address XX E Panorama Dr Designer Name Arrow Septic Designs Inc.
INSTALLATION CHECKLIST
® Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑ Repair ❑ Other
It System Type Shallow Pressure Pretreatment Type
I'IS--- 1 >5 ft. from foundation? - - 2- -- Je-�- v" A" r - - ❑ NIA Q YES ❑ NO
CO >50 ft.from wells? - K ❑ 0 ❑
>50 ft. from surface water? - "-r��j*C k1N- - - - - ❑ E ❑
z;5_ Cleanout between building and tank? - - 1ep& .- - -,,{�5_ _ _ - ❑■ ❑
U Tank baffles present? - Q�,- _ _ ri..%_ _ _ _ X ❑
a24" access risers over each compartmen -P. ❑ 0 ❑
W Effluent filter installed?- - ❑ ❑■ ❑
cn
Septic tank capacity (working) 1,250 $QaI nufacturer Infiltrator
0 D-box water level and speed levelers used? - - - Li N/A ❑ YES El NO
oO Manifold/D-box accessible from surfac?- - ❑ El CI
m 2 Check valves installed? - - - �''''`f -4319- - - ❑ I ❑
0<
2 Transport Line Size 2" Schedule/Class 40
st .Lute - Bedrooms installed (check one) III 03 ❑4 ❑ 5 ❑6 ❑Commercial/Other
`r� s .\ .--3 >10 ft.from foundation? - 2' Is'-\— 5." �42'N`v - ❑ N/A ❑ YES ❑■ NO
d C a >100 ft. from wells?- - ❑ 0 ❑
W >100 ft. from surface water? - - ❑ ❑■ CI
ti >10 ft. from potable water lines?- - El ❑� ❑
z > 5 ft. from property lines and easements?- - ❑ ❑■ ❑
Q
eL > 30 ft, from downgradient curtain/foundation drains?- - ❑ ® ❑
o
Drainfield level and observation ports present - - ❑ NI ❑
❑ Graveless chambers or 0 Clean gravel used? (check one)
Proper cover installed over drainfield?- - ❑ I ❑
Pump tank setbacks consistent with septic tank? - - ❑ N/A ❑■ YES ❑ NO
Pump tank capacity (flood) 1,060 gal Manufacturer Infiltrator
Q24" access riser(s) and accessible from surface?- - ❑ I] ❑
H
a Alarm or Control Panel Installed? - - ❑ 1] El
• Control Panel equipped with Timer/ETM /Counter- - ❑ I ❑
a Pump installed in ❑ Bucket or El On Block or ❑ Other
a• Pump Make/Model Zoeller N152 ❑■ Floats or ❑ Transducer
a
• Tank draw down 2 in/min Pump capacity 50 gpm Squirt Height 3 ft
Pump on time 1.8 min Pump off time 6 hr Daily flow set at 360 gpd
,late:8:21.2,,•8
Parcel= 2'): 2l- -- °2-53l4-
Mason County OSS Installation Report pg. 2
ABANDONMENT RECORD 0 YES ill NO
Were existing septic components abandoned as part of this project? - - - - - - - - -
If yes, please describe:
YES NO
Were all components pumped out and properly abandoned per WAC246-272A-0300? - - -- - -
- -
RECORD DRAWING
This is a pe No h arrow,reserve drainreld,exis:ng and proposed buildings,location of wells.wated:ne
nr;anent record and must be accurate and descriptive enough to relocate in the need of maintenance activities and future development. Typical Recorc
well .oDrawings contain: Or s. eld n mauts and t e r at or&layout.Se Pomp tank
-r final installatior approval anc related dermas.
wells.observation pores,cteanouis.and other maintenance access poirris. Incomplete Record Draw:ags Tay ueate additional delays:
SeQ
® Record Drawing Attached
•
CERTIFICATION OF INSTALLATION
INSTALLER DESIGNER] ENGINEER
I certify that 1 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 tall informatton contained on this form and a 1 further certify that all information contained on this
h / eco Drawing is accurate. form and attached Record Drawing is accurate.
Signature of Installer Date /;)
,,t At,
G-A.' \\N_ --ctL- • ‘4':) .r'; *1
Printed Name of Signee 414,54 ,S'� `< i '� i 0 " ...Asti,r.
/� C. � .�y�
MASON COUNTY PUBLIC HEALTH C0(/ / � <� r`g` -
approves this Installation Repoilt d V <V2 �� t,
The undersigned %-, ,S ,co9ao r)f\
Record Dr- ng on behalf of Mason County Publi�)/l v�j , y` PAULA JOY JOHNSpN •: �(
Health:/ �1lqy L'M iE 'YiEf�t�E
r/b
7/ 7 5.
Signature of Environmental Health Specialist Date (stamp, signature and date)
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE updated erzt2ota
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