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HomeMy WebLinkAboutSWG2024-00117/ASBUILT - SWG As-Built - 10/30/2025 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT! PERMIT INFORMATION Permit Number SWG 2024-00117 Parcel# 12217-24-50033 Applicant Name Nicholas &Courtney Thomas Subdivision (Name/Div/Block/Lot) Applicant Address PO Box 491 LOT: 3 OF LLS#23-02 AF#2201905 City, State, Zip Allyn, WA 98524 Installer Name Shumaker Construction Site Address 51 E Homestead Dr, Allyn Designer Name Arrow Septic Designs, Inc INSTALLATION CHECKLIST Repair II Other 500 Gal Pre-Trash Tank al Full System Installation CI Tank(s) Only CI Drainfield Only 0 y NuWater BNR-600 System Type Shallow Pressure Trench -- ^tetreatment Type t �i t . , NIA Q YES ❑ NO >5 ft. from foundation? - • - ,1 _ ❑ • ❑ >50 le ft.from wells? \-is% El >50 ft.from surface water? - - - - - `L 1-10- - -, - ❑ 0 ❑ Cleanout between building and tank? 1• O� - - - ❑ ❑ Tank baffles present? - - - 0 El ❑ U a 24" access risers over each compartm 19+ - - ❑ UI CI ❑ W Effluent filter installed?- El cn Hagerman Septic tank capacity (working) NuWater 600 gal Manufacturer 0 D-box water level and speed levelers used? - - N/A ❑ CI X ElYES ■ NO CI IN 0 Manifold/D-box accessible from surface?- _ m-2 Check valves installed? - - - -Q/C-V u kC ❑ 0 ❑ 0Q 2^ Schedule/Class 40 2 Transport Line Size Bedrooms installed (check one) ❑ 2 ❑ 3 ❑4 l 5 ❑6 ❑Commercial/Other >10 ft. from foundation?- - ❑ N/A N YES ❑ NO 0 >100 ft. from wells? • CI E] ❑ - CI El ElW >100 ft. from surface water? - u, >10 ft.from potable water lines?- ❑ I El Z > 5 ft. from property lines and easements?- - ❑ El Cl cc > 30 ft.from downgradient curtain/foundation drains?- - ❑ UI ❑ ca Drainfield level and observation ports present - - El • El ❑ Graveless chambers or it 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) 1,500 gal Manufacturer Hagerman z -24" access riser(s) and accessible from surface? ❑ . Li E •- n- Alarm or Control Panel Installed? - - ❑2 Control Panel equipped with Timer/ ETM /Counter- - El It ❑ n 0- Pump installed in © Bucket or El On Block or ❑ Other 2 Pump Make/Model Liberty 280 0 Floats or ❑ Transducer a. Tank draw down 2" in/min Pump capacity 52 gpm Squirt Height 5' ft Pump on time 2.9 min Pump off time 6 hr Daily flow set at 600 gpd Updated 821/2018 ( 221-1 - 2 `�- S�33 Mason County OSS Installation Report pg. 2 Parcel# ABANDONMENT RECORD Were existing septic components abandoned as par: of this project? - YES ® NO If yes, please describe: � NO Were all components pumped out and properly abandoned per WAC246-272A-0300? - - 0 YES , 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 onen:ation&layout.Septic/pump tank location,North arrow,reserve Grainfield.existing and proposed buildings,location of wells.waterlines, weds,observation ports.cleans ts,and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and related permits. c Q Q , 7L\ CJ� ® Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ENGINEER /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 att d Re 'Drawing is accurate. form and attached Record Drawing is accurate. -I -l-1- - Signature of installer Date r .4� Printed Name of Signee N.T.- ` •-`,P, C.-9/1 , %1 MASON COUNTY PUBLIC HEALTH !q�� ` . � , V The undersigned approves this Installation Report and ;' • I vi •'.y •`.�),. Record Drawing on behalf of Mason County Public �f' 5t•;•449 J"-!:' PAULA JOY JOHNSCN s Health: ��(SO(7 `�-. .. �dS�o'bE�Gi�� 1 �� I R b s CP-2 - s- 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 UptlateC 827 2C t 6 it.% ir fa\ t118(o.2i'. $ev ; Y -r1J r. 1 :.W Ol Audio-Visual Ala -.',�;"•'< 1 0 Cieanout _ / I. et)3'xto3'3 e tt 1 f" tee-Trash task ! / -/ 41. rti^rt0.r goo Gallon , store P `� I O NuV�ater BNR-600 ATU Tarim t ® , oc. v.)1reserve j Q i., 00 6aior Pump Charnber IA \Ottv4{.A.A OValve Control Box 56' Oi0oo *ton SePtictwnK v 2-CoMQpr• Nit wIttn -V- ' d sef er3i •;.;aVf.;11,6" .cat led Q rr! , will need Tangy Only� t c' 4184R rYv t J= rtiovse r 1(Sleeve APPROVED waters„� I.. OCT 3 0 1025 to' of f\N� MASON COUNTY ENViRONMENTAC HEALTH omeowEN ri i $ i' cAt_E: 1"= too' RET I ;, zo 1 , T —� ^. 10 30 wo go ILO V. a-1QwII• too'Mirrf, d•F Cow1'heti rN ioNA4_61,o OckS Oz PARcELtr alli-29-50033 C0 '5\ E. •KoMES•CEAT) DR. t---‘ (7 i ;- . 2party • - ,r3,.� Welt ip.., x, G 1. y, , . . CIA eIN' "-ere;1176.r '''. ‘•\) . }1S� ,61 �'' 51O''da9 .•,..e. % /1- ( 6-P W '''�•LL,,PAULA JOY JOHNSON••. (,0--1,64.Ar