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Home My WebLink AboutSWG2022-00224 - SWG As-Built - 10/7/2025 Mason County OSS Ins - nation Report pg. 1 MASON COUNTY PUBLIC HEALTH 1 APPLICANT/ PERMIT INFORMATION Permit Number SWG 2022 -00224 Parcel # t 2. 20 578 0p0i 0 I Applicant Name ((E N M o RS E Subdivision (Name/Div/Block/Lot) Applicant li nt Address Pt) 6ui 1771 1 City, State, Zip 01 y w►l 1-0. W a 9 S5.07 Installer Name J an.I Q. W urIt fnan Site Address 7,3o E• Arto. Dr. Designer Name Kt^ M OYS C INSTALLATION CHECKLIST 1111 Full System Installation ❑ Tank(s)Only ❑ Drainfield Only ElRepair ❑ Othe PbSystem Type r Pretreatment Type >5 ft. from foundation? -- ❑ N/A YES ❑ NO >50 ft. from wells? ri rn�• ❑ Z >50 ft. from surface water? t -t-t -`' - p ❑ ❑ < Cleanout between building and tank? N 2 2023 e1l ❑ O Tank baffles present? t -1u- - 1 ❑ cr.; 24" access risers over each compartment? - - - - - - - - - - ❑ W Effluent filter installed?- $y am El tank capacity (working) D gal Manufacturer �Cl D-box water level and speed levelers used? - - N/A ❑ YES ❑ NO �O Manifold/D-box accessible from surface?- - ❑ ❑ mZ Check valves installed? - -- ❑ ❑ OQ 2 Transport Line Size Schedule/Class Bedrooms installed (check one) ❑ 2 ❑ 3 ❑4 545 ❑6 ❑Commercial/Other >10 ft. from foundation? - -- ❑ N/A YES ❑ NO u >100 ft. from wells?- - El0 ❑ W >100 ft. from surface water? - - ❑ 4/ ❑ ti >10 ft. from potable water lines?- - ❑ * ❑ F-cr > 5 ft. from property lines and easements?- - ❑ `? ❑ d > 30 ft. from downgradient curtain/foundation drains? - - ❑ fig ❑ in Drainfield level and observation ports present - - ❑ g Li ❑ Graveless chambers or x Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ ❑ Pump tank setbacks consistent with septic tank? - N/A S ❑ NO Y_ Pump tank capacity (flood) I5-me gal Manufacturer youiih PLA4 < 24" access riser(s)and accessible from surface?- - ❑ ID a Alarm or Control Panel Installed? - - ❑ A ❑ 2 Control Panel equipped with Timer/ ETM /Counter- - ❑ ❑ ❑ D - Pump installed in ❑ Bucket or 'On Blocks or ❑ Other a.• Pump Make/Model �1/1J4 \k 1014- N , Floats or ❑ Transducer 0_a Tank draw down in/min Pump capacity gpm Squirt Height ft Pump on time Pump off time Daily flow set at gpd Updated 8/21/201B Mason County OSS Installation Report pg. 2 Parcel # r� 12.20572000I0 ABANDONMENT RECORD I 4,, r Were existing septic components aban oned-as part of t is project? - %YES El NO • If yes, please describe: • Were all components pumped out and properly abandoned per WAC246-272A-0300?,- - r A- - - YES El NO RECORD DRAWING This is a permanent record and must be accurate and descriptive enough to re-locate in the need of maintenance activities and future development. Typical Record Drawings contain: Drainfield&manifold orientation&layout,Septic/pump tank 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. ((Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ ENGINEER I certify that I 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 that all information contained on this I further certify that all information contained on this form and attached Record Drawing is accurate. form and attached Record Drawing is accurate. 1 v U---._ .)u iw_ ,1' Is.., Si cre of Installer Date i '•.i ! n /a`r 1 Printed Nam of Signee • /.r W r, •/• r, MASON COUNTY PUBLIC HEALTH • Av�' • It' .ci1 / ,:NNETH G to nc:F 1 The undersigned approves this Installation Report and /�4:l.irtislItintS'l Nt'I'i ' 1I Record Drawing on behalf of Mason County Public �" . fit L' �� Health: r �11 t 0 Ic 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 8/21/2018 0, . E 2. RECORD DRAWING / 4 TP#122b5-78-00010 SWG2022-00224 Trench Cross Section Juan Carlos Estaban 730 E.Alta Dr. n.t.s. C`e,,, Qh'firt Belfair, WA 98528 Abbrev Legal: TRACT 1 OF SURV 12/129 & S 12/134 Oh seryafitioo Filter Fabric Installed: June 2, 2023 �, Designer: Ken Morse 0/S Designer 5100201 12 �r Orifice shield . •�0 Net Septic VQra�'e PO Box 1771 / ' / / / / / ,/ / / •, `� . / Olympia, WA 98507 / Fi11 cap/ / / �;/2 i� ' , Installer: Jamie Workman / / ' / ' • Workman Constracting LLC roLa,L„ F4, v• '6 �• / / ,' / / If O (? t) ° ° r. ° ° Q ' \ 121 E. Timberlake Dr. / �. � \;- boa o � c�o°o lo�� ;0 00�°oo� `'��►F � �� /� Shelton WA 98584 \ \\\.;°04"° ' 4°' °�oo°•o°°o°°o°c/\ i\ \ % ii. 9u �° 0�°^°0000 o°0 o��o°°op00 o /y -\ \ it / /\ /\ / . // \ \-../• t Nt /\ //c //\. / / :r: 7 4.1; wn.q .v. ,e .'a Lot Overview ,. "•`'' ' tom Scale I"=100' :.i'fe;rrtSV;i 1.StNel if.7(''' 659.39' 0 5o ioo I Fs H 71 + + + + ++ + + + + ++ ++ + Edge of Trafficed Area + + + + + + + + RE( RSDRWINGI' + + + + 1�_:mt: + + + + + t + + 1 M•l]M",II i•Irr Kw or<tY�lbup¢r SIIOSt,I un r'rkH 1� ]WI'• Ih Pk1 tiA'1K - + t + + + t + + 2. ,,„y,. LIQrt, .1'. . I LML'III, s1:14 IMTIpp.WAir,7 �•7 • I•adkr /+nm Wmkmm•• + + + + + + + n In il, + ,,,,, w,.,kmm cn,l.,ad[•y4� ••••'•� + t + t + t + + 10 + + + + + + + + + + + + + + + • E[� - :• � •... :,rT;;,m„.:,7.- ..i • + + + + + + + + + + + + ' + + + + APPRov �I . _ • + + + t + + + + + + + + + + t LI•. a' ,k,•w..nk•'.k.n<rmw + + + + + + + + C+ + + + +•n7 + + ` w Irk cA.�•,sl I `'-' I / /r.r..ac'.,.,�..I.`— -.. .. ' .'.,Is.I.w.,+.w.,w. t + + + + Forest d Area+ + N ENVIRONMENTAL HEALTH At.: .I..�.. r. + + + + + + + + + + + + + en ,AASON COUNTY �• • +1 tso + + + + + + + + + + RET ,.•• ,' :. � I + + •, 40 + + + + + + + + + +'' - ":• / r' + + + 1�es+ + + + + + + + + JI•L ••• •••,,,��'�x+'� • 1 I y + t + + t + + -t- I t 9 t + c:K.•a -',�:•� `r•W ..... 1 •/ r+.s I + + + + + + + + + + + + �I y \ + + + + + + + + + + + + •••• �p� Nwme I Sy Yarn, ••. I 11�- + + + + t + + + t + + \ J / 659.17' kn1c Schematic •-- — ... ...... Operating Settings SJ shun. &us Pum Specs. n.t.s. Panel: I fN al W11 9 H b A8A e1 OE 17J or equiv. &o idS - i 012 U On Time 6,7 5 min. ys stur.a) (or equivalent effluent pump)' • 1.Controls & Alarm F-r-- • — on separate circuits Off Time (o hr. i 5 0 G.P.D. �j Dose Vol. ? t-j gal. _ �o Doses/day TDH (feet) 3 -1 Pump shut-off switch Draw Down _ a /a inches Must include: Dose Counter & Elapsed Time Meter GPM 6 2 ta1'id Pot‘-- • clean-out OSI Biotube Effluent J-Box Union Filter.PSC-W-0_ ;a{11$ MC —7 Vacuum Relief' atv n.serk4 1441t Float Tree ,\j\/) ,-\\:;( -) 1- \-,V%�,-x. i.\ ;.:,..;.: % ..i .,, ),5\xv -, -.\\A \.•. \\ — \ ,,.�y� ' WEI ASTM D-3034 4" Sewer Pipe .:;t+� — — — _Fr— -r. ` Minimum 1/4" I., `�`' r drop per41 ',.; `— _ ;. horizontal foot -- — 'o �; i '' ..".r"" .- — = — -•— — ' -- Compact _ o .:soil under �;:r U ;,= l >3 pipe! a 1/ Gloat, ' Removal `<. , Gal. 2-compartment Septic u • Cord °.' ;' •Tank Monolithic bottom-sides •.., i - with cast in riser adapters. ')`y.01yk gal. Pump Tank(typical) - ..... ,'"...;.vr. L`•.. ..l':; -'. .. .. . >,..: '(1000 gal. minimum) Copyright 02021 Ken Morse Tank2020.TCW • • • • • • h O J • N z • �• _ O / 14.2 Cr•• o L � � i 4 • • v • — Law plea • i . — — — — — — — — — -- • Oh •a,1 ' • CU O O a .4"-a- .. . .:4 ' , , - ‘-'t, ., , •• •...::0- : •••..rfp = / '‘‘4%‘1‘11%.*%%46‘ ... -........ fi cte ] • o C`' �°, o / • I U :• • O = ? o cn o ....;'•� Q �r- Nay a — Q .00 c trl • • c- a) a) MI Lp•......... o\ cd � oo o O ' L. a. •............\ s— CT O Oi • - osin cy •i'".• 3 ct H v 0 (,i a) o aa) 5W o ' .. ___ U 1I.:; ... #. rr ��,•...••• ; .O >,ti Uaap „OC•Jrnpuo3 ui--o — O - % . . . t 1�' N \ �••• Ct c- > co tn. C 't; 11 O .., O - — C' • • %a r ; • 44 = / ')0 ... E-' s•-• .. • CI -~ Nsa. \ •2 cce• NC) \/N ; �O.e.‘.1, .-" k - cts......:, _______ ___ .i > uoce, ..., <,--.6 _______ - •_. .. 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