HomeMy WebLinkAboutSWG2025-00061 - SWG As-Built - 10/27/2025 /RECORD DRAWING (ASBUILT) pg. 1 MASON COUNTY PUBLIC HEALTH
PARCEL IDENTIFICATION
Permit Number SWG 2025-00061 Assessor Parcel # 520017690023
Applicant Name BILLY SARNO Subdivision (Name/Div/Block/Lot)
Applicant Address 3803 SE ARCADIA RD TR2C OF SURVEY 3/153
City, State, Zip SHELTON, WA 98584 Installer Name GOLDY EXCAVATION
Site Address 80 W GRIZZLY RIDGE RD Designer Name ADAM HUNTER
INSTALLATION CHECKLIST
0 Full System Installation ❑ Septic Tank Only ❑ Drainfield Only ❑ Repair
System Type SAND LINED PRESSURE BED Pretreatment Type N/A
>5 ft. from foundation? - ❑ N/A Q YES ❑ NO
>50 ft. from wells? ❑ 0 ❑
Y >50 ft. from surface water? - 0 ❑
Z #;31-
HCleanout between building and tank? - - - 14 a',.�- -- 0 ❑
o Tank baffles present? - - - - - - - - - - J--� 0 ❑
a24" access risers over each compartment?- -: '-' - - - - --n 0 ❑
(W Effluent filter installed?- - - - - ❑ 0 ❑
1250 HOUSE BROTHERS
Septic tank size gal anufacturer
_� D-box water level and speed levelers used? - - 0 N/A ID YES ❑ NO
XO Manifold/D-box accessible from surface?- - ❑ 0 ❑
u.
mZ Check valves installed? - - ❑ 0 ❑
pQ
2" 40
2 Transport Line Size Schedule/Class
Bedrooms installed (check one) ❑ 2 ❑ 3 D 4 ❑ 5 ❑6
>10 ft. from foundation?- - ❑ N/A 0 YES ❑ NO
>100 ft. from wells?- - ❑ 0 ❑
W >100 ft. from surface water? - - ❑ 0 ❑
LI >10 ft. from potable water lines?- - ❑ 0 ❑
Z > 5 ft. from property lines and easements?- - ❑ 0 ❑
Ct > 30 ft. from downgradient curtain/foundation drains? - - ❑ 0 ❑
Drainfield level and observation ports present - - ❑ 0 ❑
❑ Graveless chambers or 0 Clean gravel used? (check one)
Proper cover installed over drainfield?- - ❑ 0 ❑
Pump tank setbacks consistant with septic tank? - - ❑ N/A ❑✓ YES ❑ NO
Pump tank size 1250 gal Manufacturer HOUSE BROTHERS
< 24" access riser(s)and accessible from surface?- - ❑ 0 ❑
d Alarm or Control Panel Installed? - - ❑ 0 ❑
2 Control Panel equipped with Timer/ ETM /Counter- - ❑ 0 ❑
m
d Pump installed in ❑ Bucket or 0 On Block or ❑ Other
2 Pump Make/Model ZOELLER N152 0 Floats or ❑ Transducer
a Tank draw down 2.8 in/min Pump capacity 70 gpm Squirt Height 5.8333 ft
Pump on time 1.14min Pump off time 4 hrs Daily flow set at 480 gpm
revised 1/22/2014
RECORD DRAWING (ASBUILT) pg. 2 MASON COUNTY PUBLIC HEALTH
RECORD DRAWING
0 Drainfield&
manifold orientation
&layout
❑� Trench/bed
dimensions and
critical distances
within layout
El Septic/pump tank
placement
SEE ATTACHED
O Location of
buildings
El Observation ports&
clean-out locations
❑� Location of wells,
surface water,&
roads
❑ Undisturbed native
soil between
trenches
❑� North Arrow
If the designer or installer feel the need for additional information/comments, it may be attached.
Record drawing may also be on a seperate page attached. No. Pages Attached 1
CERTIFICATION OF INSTALLATION
INSTALLER DESIGNER
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
.nd Mason County Public Health and meet all State myself and Mason County Public Health and meet all
d ason County Codes. State and Mason County Codes
'. rt certify that all information contained on thisliti
1 further certify that all information contained on this
•
:n. .ttached Record Drawing is accurate. form and attached Record Drawing is accurate.
10/24/25
Signa re of r'rtaller Date
JA GOLD
'Tint:d Name of Signee 1W2442,5,`;.
,4
MASON COUNTY PUBLIC HEALTH " '^"
The undersigned approves this Installation Report and . `t
Record Drawingon behalf of Mason CountyPublic �A
ADAM J.HUNTER
Health: �,r,•,•i,t,st4-.y�:af:a-'
S' s.;-'5 ")")61•
c4:FiNUMI COV\ (7,1
Signature of Environmental Health Specialist Date (designer's stamp, signature and date)
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE
revised 122/2014
331•*
•
T.
r
m
70
0.)o4.
N
o
PROPOSED DRIVE r--) 70
,-
µ ----- m
co
i
Ig µ
r / $
_ _ _ _„6: 1,4.)
IR
J l
331** n
n fen)
y
-0 N z
z cn
A
z
0
coz
m
a 0
x
1
rn
1
13e1
H11d3H 1V1N3WNO llAN3 A11Nf100 NOSVW 0
5zoz l Z 130
a3AOlddtif
0,.. ..„.:411%
o .1t011,.1.' ''''';'W‘4%11111011Ikllp
rz
4j, TA
0
ti p
it 53 0 R
O n2
CP O
0 CN0 Nxz co < R
I- s N m Z
-I 0
tojn N 3 O® m0 � c mcw ° Ro OO p n
T oO mO y � *o
gi', cn 3 ,-a"' cn 7. z m
(n Z N
0 'Q
N r v_i Z n z m
m y m : O Z g m
a o 0 D > 0 5 Z O
0o 5 03
li N D A D -< y -C
N m P Z
N -1
I
N xiOo D
?O , N 1 m
N
cn m Z