Loading...
HomeMy WebLinkAboutSWG2004-00287 - SWG As-Built - 11/18/2025 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT! PERMIT INFORMATION , Permit Number SWG 2024-00287 Parcel # 22221-52-00031 Applicant Name Exodus Acres LLC Subdivision (Name/Div/Block/Lot) Applicant Address PO Box 76 TWANOH FALLS LOT: 31 S 56/26 City, State, Zip Allyn, WA 98524 Installer Name South Shore Construction Site Address 400 E Twanoh Falls Dr, Belfair Designer Name Arrow Septic Designs, Inc. INSTALLATION CHECKLIST Drainfield Only ❑ Repair ill Other 500-Gal Pre-trash Tank 0 Full System Installation ❑Tank(s)Only ❑ NuWater BNR-500 System Type Shallow Pressure Trench Pretreatment Type >5 ft. from foundation? - -�— - - - ❑ N/A D YES ❑ NO - >50 ft. from wells? - 1-g -(�4 + - ❑❑ 0 Li> 0 ft. from surface water? - - - - Cleanout between building and tank 2�i_ V Tank baffles present? - % -t4� ] 16 - CI ❑ 1:: 24" access risers over each compart% ?- - - - - .By - - ❑ 0 W Effluent filter installed?- B� -: -. ❑ ❑ 0 N •10 gal Manufacturer Infiltrator Septic tank capacity(working) Nu - 0_CI D-box water level and speed levelers used? - - El N/A El YES El NO X0 Manifold/D-box accessible from surface? ❑ ❑� El mZ Check valves installed? - a R".} C ❑ • ❑ 0< 2" Schedule/Class 40 5 Transport Line Size Bedrooms installed (check one) ❑ 2 U 3 ❑4 ❑ 5 ❑6 ❑Commercial;Other >10 ft. from foundation?- - ❑ N/A U] YES ❑ NO >100 ft. from wells? ❑ 0 ❑ W >100 ft. from surface water? - - ❑ 0 0 ti, >10 ft. from potable water lines?- 0 El ❑ Z > 5 ft. from property lines and easements?- - ❑ 0 0 C4 > 30 ft. from downgradient curtain/foundation drains?- - 0 ® ❑ o Drainfield level and observation ports present - - ❑ © ❑ ® Graveless chambers or ❑ Clean gravel used? (check one) ❑ ❑ Proper cover installed over drainfield?- - ❑ Pump tank setbacks consistent with septic tank? - - ❑ N/A 0 YES ❑ NO • Pump tank capacity (flood) 1,060 gal Manufacturer Infiltrator ❑ z - • 24" access riser(s)and accessible from surface? ❑ •0 ❑ 1-- Alarm or Control Panel Installed? - - a. 2 Control Panel equipped with Timer/ ETM/Counter- D M Pump installed in ❑ Bucket or 0 On Block or ❑ Other a• Pump Make/Model Liberty 280 Ii Floats or ❑ Transducer a 38 m Squirt Height 6 ft Tank draw down 1.5 in/min Pump capacity 9p Pump on time 2.3 min Pump off time 6 hr. Daily flow set at 360 gpd Updated 8/212018 22,27�t — SZ�—o 6�� � Mason County OSS Installation Report pg. 2 Parcel# . , ABANDONMENT RECORD - 0 YES � NO Were existing septic components,abandoned as part of this project? - If yes, please describe: 0 YES 0 NO Were all components pumped out and properly abandoned per WAC246-272A-0300? - • RECORD DRAWING • : :.•. . us devetopment Typical Record Than Ls a pennant rapped and must be accurate and descriptive enough to re.tocate to the need of maintenance activities and tutOf We",weer5nel, Drawings contain: Dnsitte0ald;tttMNdd odentatott&layout,Septic/pump tank location.North arrow,reserve dr.>lnfietd.ensting and proposed atbnand reacted Permits'wept,o polls,gMttottts,and other maintenance access points. c Incomplete Re rd Drawings may create additional deiaYs In fatal lnstatta0at approval • • Record Drawing Attached • • =' .CERTIFICATIONSOF INSTALLATION ._' . ..•�ti.•, .,�-: ?:�:.�' . DESIGNER!ENGINEER INSTALLER I certify that I installed the system in accordance with I certify that the system has been installed in atxnr- 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 andnd Mason Mason Gouty unty Public des Health and meet all and Mason County Codes. t further certify that all information contained on this 1 further certify that all information contained on this fo atta ed R cawing is a rate. form and attached Record Drawing is accurate. • Signature of Installer Date r Printed Name of Signet r• o. .m ,..,.. MASON COUNTY PUBUC HEALTH % I approves this Installation Report and I.4.•- . '. The undersigned (�cT stogy.•s .�•,�• Record Drawing on behalf of Mason County Public y'� PAULA JOY.10f.17 N . Q•.` ��•� •}p�I�TIEfE�� Health: t,( ( /�� XP �1.- Specialist Date (stamp,signature and date) Signature of Environmental Health P� uPawd erttrzofa THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBUC VIEW ON THE MASON COUNTY WEB SITE t N ----------:--- 0 0 0 13® 1 o . ® "� I fig' up. SLoP6 5 ®� _ ']Bo x_• d,�D�?-ate 2tY . 3 :� 1 1.... t a i vo),. 31• '�r' S i- • --. 5 5* `: { t \ ' ! !_ CI., 1 v.. . 10,_____\--).,_ ,.( .,, , \ �\ 0, ,AU3 -ko F .1 - t , , 2 \ af. f - �© ` \\7sita• , { 155 LIneo fee{- PCimercy ODE As r� 4ir°, c5 6 q' 0.G- Exc'Otis \c,Qts � ;'e 3., '? 'on Par ct[ #.22Z21-52--0 k o o ' ' ahoh AL ,z4:1,;,;tv,-e n . C ?ud'' o-Visual Ala: -ov' Pos',- 3 Cleanout 0 S C/" GHQ ••V V� ! 500 Galion Pre-Trash tank 0 NuWater BNK-500 A3U Tank Ilk ,000 G o Pump C' nbe1 ni r APPROVED 4-. �' Valve Control Box A NOV 19 2025 r�'; !.d -:- • nh MASON COUNTY ENVIRONMENTAL "' 4D # l err ' .,.5 5100349 ••tom N�Z�PAULA JOY JOHNSON •y t � . .i� rti�E�i ti�a • aw+F.esS.i?) I.c-c 1-Zr