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HomeMy WebLinkAboutSWG2023-00004 - SWG As-Built - 11/5/2025Mc r RECORD DRAWING (ASBUILT) pg. 1 MASON COUNTY PUBLIC HEALTH PARCEL IDENTIFICATION Permit Number SWG2023-00004 Assessor Parcel # 22223-76-00130 Applicant Name Todd & Jordyn Hinders Subdivision (Name/Div/Block/Lot) Applicant Address 351 E Greenberg Lane City, State, Zip Belfair,WA 98528 Installer Name Jason Schauer-Final Vision Site Address 351 E Greenberg Lane, Belfair Designer Name Becky Rieger 4 INSTALLATION CHECKLIST 0 Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑ Repair ❑Other System Type Pressure Preu--tment Type NuWater j�ti,, >5 ft. from foundation? - .<`�`N� - - - ❑ N/A ®YES ❑ NO >50 ft. from wells? - Y.?:� - - - - - ❑ x❑ ❑ • >50 ft. from surface water? :��,-.-\`=- - -4,- - - El ❑x ❑ H Cleanout between building and tan gy L-���t El ❑ El U Tank baffles present? - - - - ❑ 0 ❑ h- 24" access risers over each compartment?, - - - - - - -- - - ❑ E ❑ W Effluent filter installed?- '✓ - ❑ Cl ❑ co Septic tank size 1200 gal Manufacturer Hagerman P . � 9 0 D-box water level and speed levelers used? - - © N/A ElYES ❑ NO DO Manifold/D-box accessible from surface?- - ❑ El ❑ C11 Check valves installed? - - ❑ © ❑ ❑Q 2 Transport Line Size 1.5" Schedule/Class SCHD 40 Bedrooms installed (check one) ❑ 2 El 3 x❑4 ❑ 5 ❑6 El Commercial/Other >10 ft. from foundation?- - ❑ N/A x❑ YES ❑ NO ❑ >100 ft. from wells?- - ❑ El ❑ J >100 ft. from surface water? - - ❑ ❑x El W u. >10 ft.from potable water lines?- - ❑ x❑ ❑ Z > 5 ft. from property lines and easements?- - El ❑x ❑ Q re > 30 ft. from downgradient curtain/foundation drains? - - El ❑x ❑ ca Drainfield level and observation ports present - - ❑ 0 El ❑x Graveless chambers or El Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ 0 ❑ Pump tank setbacks consistant with septic tank? - - El N/A x❑ YES El NO Pump tank size 1200 gal Manufacturer Hagerman < 24" access riser(s) and accessible from surface?- - El 0 El ~ a Alarm or Control Panel Installed? - - El 0 El 2 Control Panel equipped with Timer/ ETM/Counter- - ❑ 0 El D n- Pump installed in ❑ Bucket or ® On Block or ❑ Other a• Pump Make/Model Liberty 290 x❑ Floats or ❑ Transducer a Tank draw down 1 in/min Pump capacity 24 gpm Squirt Height 7 ft Pump on time 3.5 min Pump off time 4 hrs Daily flow set at 480 gpd Updated 12r/2015 MCPH RECORD DRAWING (ASBUILT) pg. 2 Assessor Parcel# 22223-76-00130 RECORD DRAWING Q Drainfield&manifold orientation&layout wldimensions for re-location. X❑ Trench/bed dimensions and critical distances within layout © Septic/pump tank placement x0 Location of buildings existing/proposed O Observation ports. clean-out locations, &manifolds/d-boxes x❑ Location of wells, surface water.roads, &waterlines. ❑Q Reserve area(s) QX 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 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 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. 41410g Sdazeez 11.01.2025 Signature of Installer Date Jason Schauer ;••• p+ Printed Name of Signee MASON COUNTY PUBLIC HEALTH 's +'y+ sue►+ The undersigned approves this Installation Report and : 51 sesr+ Becky J.Rieger Record Drawing on behalf of Mason County Public ki ,VS1YB�^�rNk"' + Health: EXP14E5 arr13/ IiZS 6 11.01.2025 Signature of Environmenta 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 Updated 12/7/2015 u0 J - 3 O J . wo i i a w g o co a z 0 QlG w 2 Z a 2Zw s d • w e W € z - > o LL v GJ e` "'r> ay =ram ' : w ao r Q Z� OD w Q a'v r z 0) -�• •Fc�. % N y O m f° o x z u)w m •'�':_.• S. 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