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HomeMy WebLinkAboutSWG2025-0003/ASBUILT - SWG As-Built - 10/21/2025 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH S APPLICANT/ PERMIT INFORMATION 1 Permit Number SWG 20 5-0003z Parcel# 42318-51-00037 Applicant Name ROBERT i3URNS Subdivision (Name/Div/Block/Lot) Applicant Address 13312 197TH ST E _ City, State, Zip GRAHAM, WA. 98338 Installer Name SCHOENING EXCAVATION Site Address 171 N CLALLUM PLACE Designer Name CINDY WAITE i INSTALLATION CHECKLIST_ ® Full System Installation p Tank(s)Only ❑ Dr 'nfield Only ❑ Repair ❑Other System Type reatment Type >5 ft. from foundation? --C � ���- '-\ - - ❑ N/A Q YES ❑ NO >50 ft. from wells? s l:• �' ` '' �' I iM 4 ❑ Z >50 ft. from surface water?!- - j' ❑ ❑■ ❑ 1.5 Cleanout between building and tank? -r �� ❑ 0 /ii ❑ V Tank baffles present? - \ ' - ❑ © ❑ a24" access risers over each compartme t A - - - -- ❑ ♦❑ ❑ W Effluent filter installed?- co oN El ❑� El Septic tank capacity (wor g) 1060 gal Manufacturer INFILTRATOR 0 D-box water level and speed levelers used? - - • N/A ❑ YES ❑ NO XX0 Manifold/D-box accessible from surface?- - Q ❑ ❑ m Z Check valves installed? - - El 1® ❑ 0< 2 Transport Line Size 2 Schedule/Class SCHEDULE 40 AID 41d,-4 h.r2 Bedrooms installed (check one) 0 2 ❑ 3 ❑4 ❑ 5 ❑6 E Commercial/Other >10 ft. from foundation?- - ❑ N/A © YES ❑ NO >100 ft. from wells?- - ❑� 0 ❑ o W >100 ft. from surface water? - - ❑ ❑� 4 ❑ a: >10 ft. from potable water lines?- - ❑ 0 \ ❑ Q > 5 ft. from property lines and easements?- - ❑ ' ❑ Q > 30 ft. from downgradient curtain/foundation drains?- - MI A El Drainfield level and observation ports present - - ❑ 0 ❑ ❑ Graveless chambers or pi Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ ® ❑ Pump tank setbacks consistent with septic tank? - - ❑ N/A Q YES ❑ NO • Pump tank capacity (flood) 12 P1 gal Manufacturer INFILTRATOR < 24" access riser(s) and accessible from surface?- - ❑ 0 ❑ ~ a Alarm or Control Panel Installed? - - Ela ❑ 2 Control Panel equipped with Timer/ETM/Counter- - ❑ 11 El 0 CI- Pump installed in ❑ Bucket or 0 On Block or ❑ Other d Pump Make/Model LIBERTY 250 [' Floats or 91 Transducer 2 d Tank draw down 1.25 in/min Pump capacity 30 gpm Squirt Height 6 ft Pump on time 90 SECONDS Pump off time 6 Daily flow set at 180 gpd Updated 8/2 112 01 8 Mason County OSS Installation Report pg. 2 Parcel# 42318-51-00037 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - 111 YES NO If yes, please describe: Were all components pumped out and properly abandoned per WAC246-272A-0300? - - ❑■ 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,cleanouts,and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and related permits. E Oki/eA ,e .✓ CI•ri NQ eld 0 Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ENGINEER 1 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. Signature of Installer Date Act. of � Ib AO S iVwbGYh yVA �y a"y910 Printed ame of Signee •�, < 4c' �il� d �'MASON COUNTY PUBLIC HEALTH • ; � .18, a• The undersigned approves this Installation Report and DY E. AITE ' LICENSED DESIGNER 4, Record Drawing on behalf of Mason County Public Health: ExPIRb:s 05,10, SR±MAN)(011 (14 11)3 Signature of Environmental Health Specialist Date (stamp, signature and date) Updated 8/21/2018 THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE ogiiiiimmiiimilimir • i -4 iiii " t. i n 1 h a. ,, - In, °ft% i • n . . ( pp s* • •' • • r1 u A'• DYE �. 1 . ; ,: ENBED t3 % ; i r,_ • EXPnit S as,. t Ir i 0 N M 1 f J 0 b ti� r • \ fQ I f i. 4 4 A u j ii °n �4 a ' 'P� 1 c t Cr) PR V le . . o O MASON�p� R !Q o * Xil --I - 0D 0 i 1 m = al N C j ,r ' Ay .{,.�_ C�r �1 �l a cn '� firif su `1I t . _ V ILI P� ed Fror Ma g,�•o t � %' . P ted from Mason ntyDII .