HomeMy WebLinkAboutSWG2024-00362 - SWG As-Built - 10/3/2025 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH
APPLICANT/ PERMIT INFORMATION
Permit Number SWG 20 I - 603c . Parcel# 421182400190
Applicant Name Estib Boyzo Subdivision (Name/Div/Block/Lot)
Applicant Address 11925 51st Ave NE
City, State, Zip Marysville,WA 98271 Installer Name Bay Shore Construction
Site Address 7690 W Eells Hill Rd, Shelton Designer Name Cindy Waite
INSTALLATION CHECKLIST
® Full System Installation 0 Tank(s)Only El Drainfield Only 0 Repair ❑Other
System Type Aerobic Unit Pretreatment Type Nu-Water BNR-600
>5 ft. from foundation? • - ❑ N/A ®YES [] NO
>50 ft.from wells? - _ 0 IN
❑
>50 ft.from surface water? - --- 0-1
1"t 0 ® ❑
Z
HCleanout between building " '; ❑ ® ❑U Tank baffles present? - -- 4��___
1� 0 ® 0
a24"access risers over each artrlr�-- • ❑ In 0
W Effluent filter installed?.- - NI 0
N _.1. -
Septic tank capacity(working) 540 gal Manufacturer Evergreen Pre-Cast
0 D-box water level and speed Ievele)rS.ir§ed? - - ® N/A ID YES El NO
OO Manifold/D-box accessible from surface?. - CI It
mZ Check valves installed? -
oQ -- CI OM
2 Transport Line Size 2" Schedule/Class 40
Bedrooms installed (check one) ,�2 0 0 4 0 5 ❑6 0 Commercial/Other
>10 ft. from foundation?- -• ❑ N/A ® YES ❑ NO
0 >100 ft.from wells? 0 ® 0
W >100 ft. from surface water? - . 0 Ng ElLL >10 ft.from potable water lines?- ❑ ® 0
cr-Z >5 ft.from property lines and easements?- 0 HI ❑
12 >30 ft. from downgradient curtain/foundation drains? - - 0 ® 0
ci
Drainfield level and observation ports present - ❑ 0 0
❑ Graveless chambers or 0 Clean gravel used? (check one)
Proper cover installed over drainfield?• . ❑ II 0
Pump tank setbacks consistent with septic tank? - - 0 N/A a YES ❑ NO
• Pump tank capacity(flood) 1250 gal Manufacturer Evergreen Pre-Cast
Z
Q 24"access riser(s)and accessible from surface?- - ❑ ® ❑
aAlarm or Control Panel Installed? - - ElI 0
• Control Panel equipped with Timer/ETM/Counter- - 0 UI 0
0- Pump installed in ❑ Bucket or it On Block or ❑ Other ' 1
O. Pump Make/Model Liberty 250
� I Floats or El Transducer
d Tank draw down 1.5"/ 1 in/min Pump capacity 44 gpm Squirt Height 48" ft
Pump on time 1:15 Pump off time 6 Hrs Daily flow set at 180 qpd
Updated 8121/2018
Mason County OSS Installation Report pg. 2 Parcel# 421182400190
ABANDONMENT RECORD
Were existing septic components abandoned as part of this project? - - 0 YES El NO
If yes, please describe:
Were all components pumped out and properly abandoned per WAC246-272A-0300? - - E] YES 0 NO
RECORD DRAWING
This Is a permanent record and must be accurate and descriptive enough to re-locate in the noed of maintenance activities and future development. Typical Record
Drawings contain Draintield 8 manifold orientation 8layout,Sephdpump'ask location North arrow reserve drainfield existing and proposed buildings location of wells waterlines.
wells,observation ports cleanouts.and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and related permits
TAM S viER. c4ATa,b
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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(he 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 att c ed Record Drawing is accurate. form and attached Record Dp ing is accurate.
8/25/2025 s 1/.,
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Signature of Installer Date j��'_ ti
Brandon Thomason i .< % i` dfli D I
Printed Name of Signee '" ., _4.
Ai
MASON COUNTY PUBLIC HEALTH - - _ '"y `' StQnttB S,
"A � CINDY E WAITE k
i LICENSED DESIGNER 4
The undersigned approves this Installation Report and L:,_ .VM` Sn 4
Record Drawing on behalf of Mason County PublicOCr i_at•.Itt.i, fo-
Healt • f"ASON cooNry 0..f 10�5
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j ?es z� Ufa 416.474Z HP
Si nature of Environmental Hea h Specialist Date AtrH (stamp, signature and date)
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE updated 8/212018
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DUAL PORT AERATOR IN'•
WATERTIGHT DRY,VENTILATED LOC. 1
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1'PVC SLUDGE
RETURN UNE
2-PVC ' DIGESTER CHAMBER
CLARIFIER
TRASH CHAMBER OPERATING CAPACITY:547 GALLONS CHAMBER
FLOOD CAPACITY:631 GALLONS 217 GALLONS
OPERATING CAPACITY:500 GAL. FLOOD:250 GAL.
65' FLOOD CAPACITY:564 GALLONS —) 1
5b' 54.
37' c o 0
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PRECAST REINFORCED) ,•
CONCRETE TANK
' 12'
Q' DIFFUSGR EARS C2)
• PARALLEL TO TANK WALL 4.
3' SLUDGE RETURN
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/ /<* __STONE-FREE NATIVE SOIL
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_ '• - — 61" 1' OR COMPACTED
OVER STONY SOLO
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OCT 0 2025
MASON COUNTY ENV;R 'MENTAL HEALTH
a"ubO'"ar
4.1END SECTION VIEW 4
11\�.
ENVtRO-FLO, INC.
Ac— — Wastewater Treatment Technologies
4' 58" ' ' P.O.BOX 321161,Flowood,MS 39232
1.5"TAPER '/ (877)836-8476 (601)845-4716 fax
www.enviro-fto.net
NuWATER TANK DETAIL FOR i -I
UPDATED:2013 MODEL BNR-600