Loading...
HomeMy WebLinkAboutSWG2025-00037 - SWG As-Built - 12/8/2025 Docusign Envelope ID: 1 F286359-9515-49E4-A8BD-F9C7632E2470 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG SWG2025-00037 Parcel # 22017-50-00029 Applicant Name Scntt R Hunter Subdivision (Name/Div/Block/Lot) Applicant Address 501 F I AKFSHORF r)R F TIMRFRI AKF#2 I C)TS- 99 City, State, Zip Shelton Wa 98584 Installer Name Schoening Fxcavating Site Address same as mailing Designer Name Micah Halverson INSTALLATION CHECKLIST ® Full System Installation ❑ Tank(s) Only ❑ Drainfield Only ❑ Repair ❑ Other Repai r System Type Precsure Red Pretreatment Type Septic tank >5 ft. from foundation? - - - ❑ N/A ® YES ❑ NO >50 ft. from wells? - — r — - ❑ El ❑ • >50 ft. from surface water? - �l`�—��� - ❑ El ❑ Z HCleanout between building and tank? - -0 ( - `2)- - ,- ❑ El ❑ U Tank baffles present? - - - - - - ❑ ® ❑ a24" access risers over each compartme t?- - - - - - - - ❑ 00 IW Effluent filter installed?- BX - - ❑ ® ❑ Septic tank capacity (working) 1250 gal Manufacturer Hagerman 0 D-box water level and speed levelers used? - - ® N/A ❑ YES ❑ NO oO Manifold/D-box accessible from surface?- - ❑ ® ❑ co, Z Check valves installed? - - ® ❑ ❑ •Q E Transport Line Size 2" Schedule/Class 40 Bedrooms installed (check one) El 2 ❑ 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10 ft. from foundation? - - ❑ N/A El YES ❑ NO CD >100 ft. from wells? - - ❑ ® ❑ W >100 ft. from surface water? - - ❑ El El u. >10 ft. from potable water lines?- - ❑ ® ❑ Z > 5 ft. from property lines and easements?- - ❑ ® ❑ Q ce > 30 ft. from downgradient curtain/foundation drains? - - ❑ 00 Drainfield level and observation ports present - - ❑ x❑ ❑ ❑ Graveless chambers or ® Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ ® ❑ Pump tank setbacks consistent with septic tank? - - ❑ N/A ® YES ❑ NO • Pump tank capacity (flood) 1000 gal Manufacturer Hagerman < 24" access riser(s)and accessible from surface?- - ❑ El ❑ I— a Alarm or Control Panel Installed? - - ❑ El E Control Panel equipped with Timer/ETM / Counter- - ❑ El ❑ D 4 _- Pump installed in ❑ Bucket or ❑ On Block or x❑ Other Orencn Pump vault a Pump Make/Model Orenrn pf3n0511 El Floats or ❑ Transducer M d Tank draw down 1 75" in/min Pump capacity 30gpm gpm Squirt Height 7ft ft Pump on time 1.05 min Pump off time 5hrs Daily flow set at 170 gpd Updated 821/2018 a Docusign Envelope ID: 1 F286359-9515-49E4-A8BD-F9C7632E2470 Mason County OSS Installation Report pg. 2 Parcel # 22017-50-00029 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - ® YES El NO If yes, please describe:Pumped out& filled ion per WAC Were all components pumped out and properly abandoned per WAC246-272A-0300? - - ® YES ❑ 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 drainfield,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. Owners Initial: ,-Initial St % ® 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 1 further certify that all information contained on this I further certify that all information contained on this forrwc,,attached Record Drawing is accurate. form and attached Record Drawing is accurate. we% 44 lUUSL`U4 tL9U441tl.. ��-3-,� O�` y Signature of Installer Date t 1 c : 41 Prayden Schoening II Printed Name of Signee , 01; ^' \ II MASON COUNTY PUBLIC HEALTH DEC 1 0 2025 r ",6 The undersigned approves this Installation Report and 5100109 1� 4. iIrCAH IMAM HALVERSON 1 Record D awing on behalf of Mason County=l�ie 1:NTY EN4 •fr1ENTAl HE;.' S LKBED OE810llER Heal 0 1l� :%.....-......%.%,.�..% /7 7207 EXPIRES ORM sr Signature of Environmental Health 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 ,v 0 n u N_ `r�1 7(Q 7 ;n � �n° � �• m i a n w s m < 3niclac3aa. C} fD (TA 3 m a• • ,,- a N �J O w$.d3n" N 3aa 'wgm3 � a o o y b 1 3 s av cv ad3 �O�\ rem P. s • s - a3fl T `.J -o mto la1 G2, m /��J_ N co muu !l O \ c0 (17 UHli O ZN. ca om°03od N o S _� m ,k(7. 3 0 �f Z •• 6' D r X� 00 a o W -v 0 341 D o O a K.) 41 CD "6'1 t Z Tl N A 1 - -.ti n - - z 1 .\ ,ii ,,,,,‘,,\``�-nti# 1, ---c—:. ,-, • CO ,Ili s CS K3 J/ ��� _ i • j� • / • Mlb . , . 4.) ig CO t-1 . , • ill Q_ / .„„1- m CD • . / r N11 O I o r CD 0mo H • lt -, © Q. co Block Y�(al' a J/ 4. my Ov /,... • \) )P° Ae 1 • - / 30' ( / -tea =D-°un ua, • • A A° N 0D O O —— 1lIIy / ::.2. =.6 o = .6n ti, ,- mc 3 o �, / w ? m / ° �. ifl co iy / a 0 0 o Lt.) y 0 toO E-o s ON m IQ -o W la tL aka shOP O Dr 4., ;Zile Info' SHEET NUMBER M.Halverson Design LLC Owner/Applicant. Scott B Hunter 22017-50-00029 Mailing: 501E LAKESHORE DR E, 501 E LAKESHORE DR E PO Box 1519 Shelton Wa 98584 SHELTON WA 98584 REVISION p: HalversondesignlIc(o�outlook.com