HomeMy WebLinkAboutSWG2025-00304 - SWG As-Built - 10/9/2025 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH
APPLICANT! PERMIT INFORMATION
Permit Number SWG 2025 - 00304 Parcel# 221223190080
Applicant Name Wes Barr Subdivision (Name/Div/Block/Lot)
Applicant Address 681 E Island view rd
City, State, Zip Grapeview Wa 98546 Installer Name Aaron Shumaker
Site Address 681 E Island View Rd Designer Name Cindy Waite
INSTALLATION CHECKLIST
® Full System Installation El Tank(s)Only ❑ Drainfield Only ❑Repair ❑Other
System Type Pressure Pretr atment Type
>5 ft.from foundation? - 1 ❑N/A m YES ❑ NO
>50 ft.from wells? - riivo- ❑ El ❑>50 ft.from surface water? _n�� _ t ❑ ® ❑
HCleanout between building and tank? -- S-- - ❑ ® ❑
V Tank baffles present? -
a NI 0
24"access risers over each compartment cj-_-_' ______Ik _- 0Ill ® 0
W Effluent filter installed?- 1.----------
t-- - 0 ® El
Septic tank capacity(working) 1250 gal Manufacturer Hagermens
0 D-box water level and speed levelers used? - - El NIA 0 YES ❑ NO
p0 Manifold/D-box accessible from surface?- - ElEl
mZ Check valves installed? ❑ ® ❑
OQ
2 Transport Line Size 2" Schedule/Class 40
Bedrooms installed (check one) 0 2 0 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other
>10 ft. from foundation?- •- ❑ N/A ® YES ❑ NO
>100 ft.from wells?- - ❑ In 0
W >100 ft.from surface water? - - ElNI 0
ZZ >10 ft.from potable water lines?- - El NI 0
>5 ft.from property lines and easements?- - El ® El
>30 ft.from downgradient curtain/foundation drains?- - ❑ IR ❑
in
Drainfield level and observation ports present - - 0 ® 0
0 Graveless chambers or J Clean gravel used? (check one)
Proper cover installed over drainfield?- - ❑ ® ❑
Pump tank setbacks consistent with septic tank? - - ❑ N/A IN YES ❑ NO
ZPump tank capacity(flood) 1250 gal Manufacturer Hagermens
< 24"access riser(s)and accessible from surface?- - IDIN ID
l1 Alarm or Control Panel Installed? - - El III ❑
2 Control Panel equipped with Timer/ETM/Counter- ❑ 1110
M
d. Pump installed in ❑ Bucket or NI On Block or ❑ Other
a PumpMake/Model Liberty 280
� ® Floats or El Transducer
a.• Tank draw down 2' in/min Pump capacity 50gpm gpm Squirt Height 5' ft
Pump on time cif ,,,,1 Pump off time °9 /f it-,1' Daily flow set at <.2 7,0 gpd
J Updated 8/21/2018
Mason County OSS Installation Report pg. 2 Parcel# 221223190080
ABANDONMENT RECORD
Were existing septic components abandoned as part of this project? - - YES NO
If yes, please describe:
Were all components pumped out and properly abandoned per WAC246-272A-0300? - - Q YES 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,cleanouta,and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and related permits,
c D 5 ?A�/Y ✓l;lave,/
ir 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.
d Zs
igna we of installer Date
-1ze. 1 0-\
Printed Name of Signee 444 , 2t/
MASON COUNTY PUBLIC HEALTH an ?
The undersigned approves this Installation Report and ��� 51004't8: VA
�
Record Drawing on behalf of Mason County Public . .LICENSED DESIGNER c
Health:
V 019, LAN RES 115,10,
Signature of Environme tal Health Specialist Date (stamp, signature and date)
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Updated 8121/2018
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ORIFICE SPACING 5
Lateral# Length Length Orifice # Distance from Distance from end Length#
# (Feet) (Inches) Spacing " Orifices feeder line of end of lateral
1 40 480 60 8 2.5 2.5 40
2 40 480 60 8 2.5 2.5 40
3 40 480 60 8 2.5 2.5 40
4 40 480 60 8 2.5 2.5 40
5 40 480 60 8 2.5 2.5 40
200 40 200
TRANS LENGTH 25
GPM 23.6
K (2" SCHEDULEN 40) 284.5
FRICTION LOSS 0.249905
Squirt 2
Elevation difference 6
TDH 8.249905
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DRAINFIELD LAYOUT
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X1=CLEANOUT/OBS PORTS ' s
X2=D BOX/VALVE BOX:`'f '
X3=Check Valves
X4=Flow Control Valves
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X5=Soil Logs Awe
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APPROVEDs�nnair_ �
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OCT 0 9 2025 n'--= .}`
MASON COUNTY ENVIRONMENTAL HEALTH
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