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Home My WebLink AboutSWG2025-00336 - SWG As-Built - 12/19/2025 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2025-00336 Parcel # 121084390071 Applicant Name ROBERT MEUCCI Subdivision (Name/Div/Block/Lot) Applicant Address PO BOX 1971 City, State, Zip ISSAQUAH, WA 98027 Installer Name LOGAN SPEARS Site Address 272 STRETCH IS. RD S Designer Name ALEX L. PAYSSE INSTALLATION CHECKLIST ❑ Full System Installation ®Tank(s)Only ❑ Drainfield Only ❑Repair ❑ Other System Type TANK REPLACEMENT Pretreatment Type NUWATER BNR500 >5 ft.from foundation? - - ❑ N/A ® YES ❑ NO >50 ft. from wells? - t..-- 19 S ❑ ❑ Y > . from surface water? - - � - - ❑ ❑ 0Z 50 ftHCleanout between building and tank? - - - p,� i-j-gi� ❑ 0 ❑ ra U Tank baffles present? - 0 ® ❑ I— 24" access risers over each compartment?-\ - -._ ■ © ❑ a W Effluent filter installed?- 13 - `- - - ❑j ❑ ❑ cn Septic tank capacity (working) BNR500 gal Manufacturer INFILTRATOR/ NUWATER CI D-box water level and speed levelers used? - - ® N/A ❑ YES ❑ NO �O Manifold/D-box accessible from surface?- - NI ❑ 0 °?E Check valves installed? - - M ❑ ❑ CaQ 2 Transport Line Size - Schedule/Class - Bedrooms installed (check one) ❑� 2 ❑ 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10 ft. from foundation? - - 0 N/A ❑ YES ❑ NO 0 >100 ft. from wells?- - 0 ❑ ❑ W >100 ft. from surface water? - - 0 El u.. >10 ft. from potable water lines?- - ❑� ❑ ❑ Z > 5 ft. from property lines and easements?- - 0 ❑ ❑ Q 0 ❑ 0 rY > 30 ft.from downgradient curtain/foundation drains? - - o Drainfield level and observation ports present 0 ❑ Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?- - 0 ❑ 0 Pump tank setbacks consistent with septic tank? - - ® N/A ❑ YES ❑ NO • Pump tank capacity(flood) gal Manufacturer < 24" access riser(s) and accessible from surface?- - ® ❑ ❑ ~ a Alarm or Control Panel Installed? - - 0 0 ❑ 2 Control Panel equipped with Timer/ ETM / Counter- - It ❑ ❑ m a Pump installed in ❑ Bucket or ❑ On Block or ❑ Other a• Pump Make/Model ❑ Floats or ❑ Transducer Q. a Tank draw down in/min Pump capacity gpm Squirt Height ft Pump on time Pump off time Daily flow set at qpd Updated 8/21/2018 Mason County OSS Installation Report pg. 2 Parcel# 121084390071 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - Li YES EI NO If yes. please describe: EXISTING SEPTIC TANK PUMPED/REMOVED Were all components puniped out and properly abandoned per WAC246-272A-0300? - - El 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.deanouts.and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and related pemtits • 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 I further certify that all information contained on this form and attached Record Drawing is accurate. form and attached Record Drawing is accurate. as. 11/Z9t/z5 Signs re of Ins Iler Date 12/13/2025 Lod-port S ea✓ • Printed Narhe of Signee • .I',, MASON COUNTY PUi3LIC HEALTH 1), The undersigned approves this Installation Report and . Record Drawing on behalf of Mason County Public �k A�_LOcIS*1331ti MOO �r Health: 61\SLAY\,CCOnZIIc1`ZS 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 wdrlu"A¢t r;u / / / / INFILTRATOR NUWATER / INSTALLED DUE TO ACCESS / ISSUES. INSTALLER SEALED / COMMUNITY WELL ALL PENETRATIONS WI BENTONITE, PER STATE & COUNTY INSTRUCTIONS. — �L - 150' 3" -----if I APPROX. WATERLINE 1 SHED 1ilv ,- \ v DRIVEWAY ��'' n \ i m \ &PARKING I -' i t N --- yr\ \ 0, i9 \ / Z / ;\ I\\ �, AEXISTING HOME \/ \ O \ �// (TO BE REMODELED) 0or--- __ __• ,, 1 e TABLE 10 NUWATER ATU / A RESERVE e � %// 1 (600SF SHOWN) � / / %.. EXISTING DRA RE IELD FIREPIT (PER COUNTY RECORDS ,X/ 1 & KNOWN TANK LOCATION) `' ctij� �® •' ED �\ ` \ DEC 1 2O2 MASON COUNIYENVIR NMEN t APPROXIMATE HEATH �';.': �� TOP OF BANK \\\ RETI t :_.L �;,�';'�.• .�r APPROXIMATE / ,.... :.,....... 1 \\ 1: t- _ "6- SHORELINE \\\ - , 4.` lil (OHWM CASE INLET) \\ --- i' ALEI LOUTS DAME : f N N. •; 1 N N. N O= AIR PUMP ALARM \\� RECORD DRAWING CUSTOMER: ROBERT MEUCCI TEST HOLE 1 TEST HOLE 2 TEST HOLE 3 / /. 0-12 GSL 0-20 GSL NA 1- 1.„...,.. ,.,,,,1 i PARCEL: 12108-43-90071 12+TILL 20+TILL ( ) ALPINE SEPTIC SITE:727 STRETCH IS.RD S ROOTS-12 ROOTS-20 -DESIGN. LLC- ALEX L PAYSSE,DESIGNER SHEET:ASBUILT SCALE: 1"=30' DISCLAIMER. THIS IS NOT A SURVEY. REFERENCES INCLUDE.APPLICANT/COUNTY PROVIDED PLATS OR 3089AND CUNTY GIS. DESIGN INTENDED FOR SEPTIC PURPOSES ONLY. G E MASON BEN SON RD SURVEYS.PROPOSEDFDEVE OIELD EPMENT MAYTS BE SUBJECT TO OTHER DEPARTMENT/AGENCY REVIEW. DESIGNER NOT RA 360 507-1 546 8546 Ir 10.5 11 12 RESPONSIBLE FOR SETBACKS UNRELATED TO SEPTIC COMPONENTS.