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HomeMy WebLinkAboutSWG2025-00396 - SWG As-Built - 12/19/2025 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2025-00396 Parcel # 42214-24-90104 Applicant Name Skip Hash Subdivision (Name/Div/Block/Lot) Applicant Address P.O. Box 1239 LOT:4 OF SP#2510 PTN TR 10 OF NW1/4 City, State, Zip Hoodsport, WA 98548 Installer Name Maples Excavating Site Address 21 N Sun Place, Hoodsport, WA Designer Name Arrow Septic Designs INSTALLATION CHECKLIST Q Full System Installation ❑Tank(s) Only ❑ Drainfield Only ❑ Repair ❑ Otner System Type Shallow Presure Pretreatment Type >5 ft. from foundation? - I J - - - - - ❑ N/A ❑■ YES ❑ NO >50 ft. from wells? (� n-1-RIVE ❑ U ❑ ' ��j �r�y� 0 ❑ Z >50 ft. from surface water? J j t - DEC FQ- Cleanout between building and tank? -i' C 1 1 5 - - ❑ ❑■ ❑ U Tank baffles present? - y ❑ • ❑ d24" access risers over each compartment?- - - - � - ❑ 0 ❑ W Effluent filter installed?- — - - ❑ 0 ❑ co Septic tank capacity (working) 1,250 gal Manufacturer Infiltrator 0 D-box water level and speed levelers used? - - ❑ N/A ❑ YES Q NO J ❑ 0 CI Manifold/D-box accessible from surface?- - 9 Check valves installed? - - ❑ 0 ❑ ❑Q 2 Transport Line Size 2 inch Schedule/Class 40 Bedrooms installed (check one) ❑ 2 E 3 ❑4 ❑ 5 ❑ 6 ❑Commercial/Other >10 ft. from foundation?- - ❑ N/A 0 YES ❑ NO CI >100 ft. from wells?- - ❑ ■❑ ❑ W >100 ft. from surface water?- - ❑ ❑I■ ❑ ii >10 ft. from potable water lines?- - ❑ . ❑ Z > 5 ft. from property lines and easements?- - ❑ PI El re > 30 ft. from downgradient curtain/foundation drains?- - ❑ 0 ❑ • Drainfield level and observation ports present - - ❑ © ❑ ❑ Graveless chambers or 0 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) 1,060 gal Manufacturer Infiltrator < 24" access riser(s) and accessible from surface?- - ❑ ® ❑ H a Alarm or Control Panel Installed? - - ❑ UI ❑ • Control Panel equipped with Timer/ ETM/Counter- - ❑ ® ❑ a Pump installed in 1:] Bucket or NEOn Block or ElOther _ a-• Pump Make/Model Zoeller N152 © Floats or ❑ Transducer a Tank draw down 2 in/min Pump capacity 50 gpm Squirt Height 8 ft Pump on time 1.8 minutes Pump off time 6 hours Daily flow set at 360 gpd Updated 8/21/2018 Mason County OSS Installation Report pg. 2 Parcel# 422 `Z1 01e4 ABANDONMENT RECORD Were existing septic components abandoned as par, of this project? - - ❑ YES NO If yes, please describe: 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 bu ldings,location of wells,waterlines, wets.observation ports,deanouts,and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and related permits. yRecord 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 form and attached Record Drawing is accurate. form and attached Record Drawing is accurate. it t 2 7 0 °1/ZS- Signature of Installer D to y� A. Printed Name of Signee 0- I' MASON COUNTY PUBLIC HEALTH ! ::'� 11,0"• '. The undersigned approves this Installation Report and R� w tir ;.• Record Drawing on behalf of Mason County Public r,�?,' S100349 faNA/PC‘Vil PAULA 1pyJOiiNSON Health: l�J Z� �IC 1�� SIGNEa • I -1 ( Exws d Signature of Environmehtal Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE 8'2112o18 —& 5— � Z 1 \ ,k;k,..0i.,-. 5l� SLePE � C4 2J` �c fig ' Pi m(4-LA, y D.c . c= � s cc i ?'� 7-fr;7 , t \ 0 . c. Ez t-r-H- 4ES Fte- E_ B ^—ter `` /i '/ / / A ‘4,° ,.,,-• T 4-c i &t.t' j ( \<:,(ff . ^ c i \ COS Oa A Cs -' ,\ \ -\„ \ .,,,,, , Ni �ic,.. l oss-,—c,Le- 7 c.f\ \ Fak e-35R \ --.2- \ Li-kicw,4- s,-Yz-_____J \ \ \ 1 4 . DZ t,r^'tC1 fl az etc bc a APPROVED S ikkt° ) . DEC 19 2025 -A-q(-E-L-44Z2c4_2A _ qvl Dk MASON COUNTY ENVIRONMENTAL HEALTH 2 1 N So r PLPrLE RET olD&oRT3 CkA 61 P5 54- Afr **Note to installer** t?� '•= -V�sra:a as�t Sleeve waterline when within 10' ( )J' Ci �t of septic transport line.Maintain ,x �20o C2Ilca Septic Tmk 10' minimum between water I , ¢ \ ,i 2-Co _� , �drainL1eld. �r. ::e=t Filt line and septic tanks, 510.34fl �} mot. PAULA JOY JOMNSON• i ` O .O0O C- P p Cj P-^'oeS �' U 11S�ii r� SiGN�a ttt �T1 be s 3 Valve Co^toi Box 2-1 I-ZS.-