HomeMy WebLinkAboutSWG2024-00099/ASBUILT - SWG As-Built - 10/17/2025 c
Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH
APPLICANT/PERMIT ORMATION l _. ._
Permit Number SWG 2024-00099 Parcel # 22103-51-00020
Applicant Name Diane&Jeffery Martinson Subdivision (Name/Div/Block/Lot)
Applicant Address 21436 4th PI. S. Benson Lake Div. 2 Lot 20
City, State, Zip Des Moines, WA 98198 Installer Name Manke Excavating LLC
Site Address 1640 E. Benson Lake Dr. Designer Name Dale L.Tahja
INSTALLATION CHECKLIST
® Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑ Repair ❑Other
System Type Pressure Trenches Pretreatment Type N/A
>5 ft.from foundation? - `t u-`__ �'rt -- ❑ N/A E
YESk�, 'No
> ft. fro -> ft. froe wter? - �f-----
,,►•-' ��- -'� ❑ �W�' ❑
HCleanout between building and tank? - _ - 0-- _ ❑ ® ❑
V Tank baffles present? - - - - - ❑ I ❑
1— 24" access risers over each compartment?---- - - - - ❑ ® ❑
1.11 Effluent filter installed?- � � ❑ II ❑
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i
Septic tank capacity (working) 1,200 gal Manufacturer Sound Tanks
G D-box water level and speed levelers used? - - ® N/A ❑ YES ❑ NO
6OManifold/D-box accessible from surface?- - 0 II ❑
mZ Check valves installed? - - ❑ ® ❑
oa
2 Transport Line Size 2 inch Schedule/Class Sch.40
Bedrooms installed (check one) ❑ 2 0 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other
>10 ft.from foundation?- - ❑ N/A ® YES ❑ NO
o >100 ft. from wells?- - ❑ I ❑
W >100 ft. from surface water? - - ❑ ® ❑
ti„ >10 ft.from potable water lines?- - ❑ ® ❑
eec� > 5 it.from property lines and easements?- - 0 ® 0
t1! > 30 ft.from downgradient curtain/foundation drains? - - ❑ 0 El
G Drainfield level and observation ports present - - 0 1 0
❑ Graveless chambers or Q Clean gravel used? (check one)
Proper cover installed over drainfield?- - 0 I. ❑
Pump tank setbacks consistent with septic tank? - - ❑ N/A ® YES ❑ NO
ZPump tank capacity(flood) 1,000 gal Manufacturer Sound Tanks
Q 24" access riser(s) and accessible from surface?- - ❑ It ❑
aAlarm or Control Panel Installed? - - ❑ I ❑
2 Control Panel equipped with Timer/ETM/Counter- - ❑ Q ❑
M
O. Pump installed in ❑ Bucket or • On Block or ❑ Other
O. Pump Make/Model LE51M Liberty ■ Floats or ❑ Transducer
IT Tank draw down 1.5 in/min Pump capacity 30 gpm Squirt Height 6 ft
Pump on time 3 min. Pump off time 5 hrs. 57 min. Daily flow set at 270 gpd
Jpdated 8:2112018
Mason Ce . OSs installation Report pg. 2 Parcel# 22103-51-00020
MENT RECORD
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Were existing septic components abandoned as part of this proiect? 0YEs NO
if yes,please describe: _
Were all components pumped out and tevpoty abandoned per WAC248-272A-0300? 0 YES 0 NO
I ORAWING
This is s perituawint*mod old No*blt memo**sad ttotterlottr•toovgh to ttHottoto k,tits Mid of milnt.nsnc.OCtteMelf*NS OBVii0PIPION. T core
Deraimis toroisitv Ontiniiid4ONN/Mit nvitildiktrt tayout.Septiceournp tank locators,North&crow,MONO dnorfteld.eyeing end arceeliad boating*,Wagon at‘oeihr;vostoitios,
%vets.observalionimits.tionoill1.ended's-millniettanoe 40C1:58 points_ Wont**Record°mono,m*y create acklitionot&goys in tinitinitnlInket inverietirdinialint posnits.
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I Record Drawing Attached ;
tilit'VIFICATIONiessTALumte .
INSTALLER DESIGNER!ENGINEER
I certtlythat 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 Pubic Health and that any deviations shown I Mason County Public Health and that any deviations
here have been cleared/approved try 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 on County Codes. State and Mason County Codes
I further cenity Oat 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 D ng is accurahe.
Q 't
Signature of installer Date
re n
Printed Name a Signets 41.)!I
MASON COUNTY PUBUC HEALTH .0.4..1:4, 4'4 ft
The undersigned approves this Installitfion Report and 5100214 #o
Record Drawing on behalf of Mason Olitenty Public --- 0.`0 Dale I_Tahja I
Health: LICENrD DESIGNER #
" " NiVak
(‘111 1 t
Signature of Health epecielial Date (stamp,signature and date)
,M11001•1111W
TNiS RAM MAY SE SCANNEDANO AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE 1,103•0011":118
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