HomeMy WebLinkAboutSWG2025-00090 - SWG As-Built - 11/18/2025 I
Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH
APPLICANT/ PERMIT INFORMATION
Permit Number SWG 2025-00090 Parcel# 321045600001
Applicant Name PWW Property Development LLC Subdivision (Name/Div/Block/Lot)
Applicant Address 410 W Clear Lake Dr
City, State, Zip Shelton Wa 98584 Installer Name Schoening Excavating LLC
Site Address 11 E Flaggwood Ln Designer Name Jim Hunter
INSTALLATION CHECKLIST
EH Full System Installation ❑Tank(s)Only 0 Drainfield Only 0 Repair ❑Other
System Type 2Bdrm Nuwater Shallow Pressure Pretreatment Type Nuwater
>5 ft.from foundation? - - ❑ N/A ®YES 0 NO
>50 ft.from wells? - 0 Pi 0
Z >50 ft.from surface water? - - ❑ LE ❑
< Cleanout between building and tank? - - ❑ ® 0
U Tank baffles present? - - ❑ ® 0
P.. 24"access risers over each compartment?- - 0 II
W Effluent filter installed?- - ❑ ® ❑
N
Septic tank capacity(working) 1000 gal Manufacturer Hagerman Pre Cast
0 D-box water level and speed levelers used? - - INN/A ElYES El NO
O0 Manifold/D-box accessible from surface?- - ❑ MI El
00Z Check valves installed? - - ❑ IN 0
0Q
2 Transport Line Size 2" Schedule/Class SCH40
Bedrooms installed (check one) ❑■ 2 ❑3 0 4 0 5 ❑6 ❑Commercial/Other
4 >10 ft.from foundation?- - ❑ N/A 1.1 YES ❑ NO
• >100 ft. from wells?- - 0 ® ❑
W >100 ft. from surface water? - TCEGIVE - ❑ NI 0
1i >10 ft. from potable water lines?-- - - ❑ El ❑
Z >5 ft.from property lines and easeme El ill 0
d >30 ft. from downgradient curtain/foun n drainns4-3- -25 - - 0 Q 0
• Drainfield level and observation ports r;nt - - - - - - -- - ❑ . 0
0 Graveless chambers or ❑ Cle one
Proper cover installed over drainfield?- - ❑ ® ❑
Pump tank setbacks consistent with septic tank?- - 0 N/A ® YES ❑ NO
• Pump tank capacity(flood) 1455 gal Manufacturer Hagerman Pre Cast
et24"access riser(s)and accessible from surface?- - ❑ II 0
I—
a. Alarm or Control Panel Installed? - - ❑ IN 0
4 2 Control Panel equipped with Timer/ ETM/Counter- - 0 0 0
D
a Pump installed in ❑ Bucket or 0 On Block or ❑ Other
a• Pump Make/Model Liberty 289 NI Floats or ❑ Transducer
a Tank draw down 2 in/min Pump capacity 30 gpm Squirt Height 2 ft
Pump on time 1 min 42sec Pump off time 240min or 4hr Daily flow set at 180 gpd
Updated 821/2018
Mason County OSS Installation Report pg. 2 Parcel# 321045600001
ABANDONMENT RECORD
Were existing septic components abandoned as part of this project? • - ❑ YES 0 NO
If yes, please describe:
Were all components pumped out and properly abandoned per WAC246-272A-0300? - - YES 0 NO
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 orientation&layout,Septic/pump tank location,North arrow,reserve drainfiekt,existing and proposed buildings,location of wells,waterlines,
wells,observation ports,cleanouts,and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and related permits.
0 Record Drawing Attached
CERTIFICATION OF INSTALLATION
INSTALLER DESIGNER/ENGINEER
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 1 further certify that all information contained on this
form and attached Record Drawing is accurate. form and attached Re •rd Drawing is ac
urate.
1,4,4441
10/31/2025 /•/AO,
Signature of Installer Date , . ,
f1 ( 13 -2S
ABravden Schoening i
Printed Name of Signee h• ~+ "°o
z`1!
MASON COUNTY PUBLIC HEALTH •• ��„ 2 �1
41
The undersigned approves this Installation Report and i 5i00=73IAMB R.MIN s
Record Drawing on behalf of Mason County Public ilcrry fb ofsfcivR ER t�
Health: Nwsobelb. SZS,
( (� I( 5( E_XlfirS: 03/22/2 p
Signature of Environmental Hea th Specialist Date (stamp, signature and date)
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE updated 8/21/2018
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