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Home My WebLink AboutSWG2025-00349 - SWG As-Built - 10/13/2025 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ P ERMIT INFORMATION Permit Number SWG 20Z --'c 5 3(1 n/ Parcel # 12 to - 7B `'oS Applicant Name Ju Pe 'l '114rn Subdivision (Name/Div/Block/Lot) Applicant Address Y6 X Sc:_: C nil S W/I► 1€9/1' Installer Name �`� S` `( 1 cQ/� City, State. Zip � Site Address 211 E \Melovci_GrS fit Designer Name INSTALLATION CHECKLIST ❑ Full Syster Instellati�o STank(s)Only El Drainfield Only ❑ Repair ❑Other System Type t7ie k'‘ Pretreatment Type G(> '1 _ >5 ft. from foundation? - - - - - ❑ N/A gl YES ❑ NO >50 ft. from welts? �- � - - - ❑ ❑ • >50 it. from surface water? - rrx 1� ❑ ❑ Z Q Cleanout between building and tank? - - - LLr `-- ❑ UTank baffles present? - iya - - - ��5_ _'ti ❑ a24" access risers over each compartment'?): t, ❑ W Effluent filter installed?- - - - ❑ cn Septic tank capacity (working) 4 1 Z5U \ gam nufacturer n lifehy I —IZS U 0 D-box water level and speed levelers used'? - - atom- ❑ YES ❑ NO J oO Manifold/D-box accessible from surface?- • ❑ ❑ CC Check valves installed'? - - ❑ ❑ ❑ clQ Schedule/Class 2 Transport Line Size • Bedrooms installed (check one) ❑ 2 ❑3 ❑4 ❑ 5 ❑6 El Commercial/Other >10 ft. from foundation?- - ❑ N/A El YES ❑ NO CI >100 ft. from wells?- ❑ ❑ J >100 ft. from surface water? - - ❑ ❑ , ❑ W Li >10 ft.from potable water lines?- - ❑ ❑ Z > 5 ft. from property lines and ents?- - ❑ ❑ ❑ a - ❑ ❑ CIcc >30 ft. from downgrad' curtain/foundation drains? - Drainfield level and observation ports present - - ❑ ❑ ❑ ❑ Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ . ❑ 0 Pump tank setbacks consistent with septic tank? - - ❑ N/A ❑ YES ❑ NO Pump tank capacity (flood) gal Manufacturer < 24" access riser(s) and accessible from surface?- - ❑ ❑ H O. Alarm or Control Panel Installed? - - - ❑ CI 2 Control Panel equipped with Timer/ ETM/ r- - ❑ ❑ ❑ D a Pump installed in ❑ Buck r ❑ On Block or ❑ Other 2 Pump Make/Model El Floats or El Transducer a.a Tank draw down in/min Pump capacity gpm Squirt Height ft Pump on time Pump off time Daily flow set at gpd Updated 821/20'B 12iug - " 8- ciLeC. S Mason County OSS Installation Report pg. 2 Parcel # ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - YES EiNO If yes, please desdribe: - NO Were all components pumped out and properly abandoned per WAC246-272A-0300? YES Ei 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 dra:nfield.existing and proposed buildings,location of wells,waterlines, wells.observation ports,cle/ttouts,and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and related permits. L. ,c,1 Q v ykr ed arc(-e-✓ 'T�/�_i- P r .1*fttc-C't-�p./..A'N'ti,44 i.v1.�Ll,fre'.. -64+. t,��t. -�'`- 15 Record Drawing Attached CERTIFICATION OF INSTALLATION - INSTALLER DESIGNER/ ENGINEER 1 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 beer, cleared/approved by both ,. and Mason County Public Health and meet all State myself and Mason County Public Health and meet all I 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 eccrd Drawing is accurate. :form. and,attached Record Drawing is accurate. I 0 13 **2_,5 Signature of Installer ii 4.*,c%-E-41) Printed Name of Signee t MASON COUNTY PUBLIC HEALTH The undersigned approves this installation Report and Record Drawing on behalf of Mason County Public H the r(61471 03t.51.z 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 Updat.'.d 8,2'.1201E t V 6 CA..j.„.1°. g,- .f. .)1 .4 A pp . MASON rbUN 3 ��?5 , 3y+� T1'fN1iRON,MENTAL HFA[TN • 60'to bank R�r Copt(j %),a t)• ( Xt,` 4 \ 1 Stormwaur . 0' 28' 0 " 2 !"; rsdenoe . , - It ii s —,.•. run-off• _ Proposed - _ Home S1te NorthII* • 3Y o „ 1.0 III At" / 11 12006d s tank• C, i . t i 4(! ...3 • ' 10000 moo lank � c:34 1 i .- /• 100' .': Shared Wdl 4,4 • Pc Well : . \ICC( :y s c � + • t = s i I ... +- --•..... ................. ..s......16. "\S 4 A. . . ROVE sD .„ '. 1. as 2018 Well MAS08COUNTYE IROHUIENIAL • MI \ t Glendon area. 300+fea�t from bank . { Crest Road Well ••................. 41;;:* 225' to E.VtneYard +110' -3161 2618. 0 11 ONM .N .. ■ +100' QdK.u.L.a4 .11.46. t • a!_ —4-aLi..S 800' I prFrft I:Y Cal Os. id:li• w..l.. n'?J I r `•' Ai ' Printed farm Mason County i MS Bamford septic Repallr,LLC 13607902364 301 E. Wallace Kneeland Blvd STE#224-332 Shelton, WA 98584 PROPERTY INFORMATION Location:211 E VINEYARD CREST RD GRAPEVIEW Tax ID: 121087890065 1.+3i To BOTTOM FAMILY LIVING REVOCABLE TRUST PO BOX 550 Use:Residential,Single Family GRAPEVIEW,WA 98546 GENERAL SYSTEM TYPE:Glendon Biofilter • ON ID: 121087890065 County Area:Totten Little Skookum Watershed F4tl Fdd '- ON-SITE WASTEWATER TREATMENT SYSTEM INSPECTION REPORT Fdo Rare Inspected:10/01/2025 - Inspection Type:ROUTINE- Correction Status:No corrections needed Y Coin an Work Performed By: Submitted 10/03/2025 by: Company: Bamford septic Repair,LLC Thaddeus Bamford Thaddeus Bamford COMMENTS&GENERAL INSPECTION NOTES No Deficiencies Noted Septic tank replacement completed. System is operational and in satisfactory condition. GENERAL SITE&SYSTEM CONDITIONS The General Site and System Conditions were: Fully Inspected YES Components accessible for service: All required service performed(if no-specifyYES omitted inspection items In notes): -------- NO Surfacing effluent from any component(including mound seepage): Components appear to be watertight-no visual leaks: YES Improper encroachment(structures/impervious surfaces) _-_____—.--_—_______—__ NO All riser lids securely fastened upon departure: YES ES Electrical repairs needed. If YES describe in comments: Inspected components appear to be in good physical condition: ____— YES Root intrusion on any components. If YES describe in comments: — _ NO Settling problems observed. If YES describe in comments: _ --- ----- NO The house/structure was vacant or used infrequently.assessment of the drainfield was not possible. NO ONSITE SEWAGE SYSTEM INSPECTION DETAIL ANK:Septic Tank•2 Compartment Filly Inspected This component was' vES Effluent level within operational limits(if NO explain in comments): - YES All required baffles in place(N/A=No baffles required): ' Compartment 1 Scum accumulation(Inches,if other specify): Compartment 1 Sludge accumulation(Inches,if other specify) - Compartment 2 Scum accumulation(Inches,if other specify): Compartment 2 Sludge accumulation(Inches,if other specify) NO Pum•in•recommended TANK:Pump Tank Fully Inspected This component was: Compartment 1 Scum accumulation(Inches,if other specify): Compartment 1 Sludge accumulation(Inches,if other specify): NO Pum.in.recommended: •ump:Effluent Pump Filly Inspected This component was: ES Controls functioning: Glendon YYS Tested.allons•=r minute flow: •edia Filter:Biofuter.Manufacturer-Glendon BioFilter Technologies,Inc.-M-31 Manufacturer.Glendon BioFilter Technologies,Inc. Model:I-31 Fully Inspected This component was: YES Equalized dosing- YES Slope integrity maintained: Sludge accumulation(Inches,if other specify): NO Pumping recommended: — ReportlD: 1453929 View inspection reports online at www.onlinerme.com Page 1 of 2 Panel:Control-1 Pump Manulacturer:Aquaworx FJIy Inspected This component was:Panel functioning(including alarm): pro ary Y YES Pump 1:on minutes(override in parentheses-if present): -Proprietary- Pump 1:off hours(override In parentheses-if present): -Proprietary- Pump 1:gallons per dose(override In parentheses-If present): Pump 1:ETM hours(override In parentheses-if present): Pump 1:Cycle Count(override in parentheses-if present): • • • • • • This report indicates certain chavcleristics or the onsrfe sewage system at fee arm or wsil.in no way is this report a guarani..of operation or future performance ReportlD: 1453929 View inspection reports online at www.onlinerme.com Page 2 of 2