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HomeMy WebLinkAboutSWG2025-00259 - SWG As-Built - 2/2/2026 , Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Pkrrntl Number SING - 262.5"--a,es-1 Parcel# 5-2.07_5(7_g( -i/- 1a/, 47 .-- $ Applicant Name '},t v, (4 A/14,4 Subdivision (NameiDiv/B'srackJLot) Applicant Address _ 0O ✓3oX r'j'«l 6 4 4.2-ti : . ': zit-73 - City, State,Zip rO, vwG.c,.C,. ''' installer Name Aj'egtt it'Aim. t. 4-4-4—. Site Address U (A) `i lk iii Designer Name (7.,A .�,:t _E-.04,tr=Al - a _ INSTALLATION CHECKLIST I uti System insl.aff:ition O Thais,onv, O Dralnfield Oflly 0 Repay ❑Otrrr,r l System Type _„ eittrg _ Pretreatment Type _ >5 tt.from foundation? - U Nrr1 Gmss O NO >5f ft.from wells? i c-E-u-vi-Ei ❑ Q—>50 ft.from surface water's - - ❑ 1s ❑ t<- Cfcanouf between building and tank? y g ZQ - O B--- ❑ t3 Tank baffles present? • h--sal- _ - _ • ❑ Q'"'- ❑ i'— ?d'co..-ccss risers over each compartm •nt?- - -- - - - - -- - Q 9— ❑ f31 Effluent filter installed?. By- - - - --- O Q-•--- O to Septic tascic capacity(working) t 2—_,(-"'_.dal tvsanr facturur ,5r,',._,'(1r- i çc,,4 .i L e D•box water level and speed levelers used? ❑NIA U YES C .nru 0>--<2 Man told;O_box acc:et;si.3,. , '?. O cit-i check valves installed? ---- - - - - LJ ❑ in< C oi LID Bedrooms installed(check one) O 2 O 3 (t O 5 O 6 O Commerc allOtht:r >10 ft_from foundation? - - - -- O NJA EtYES O KG G >100 ft from wells? ❑ RI 0 W >100 I€•from surface.water? - - - - O Ef ti >10 it.Item potable water lines'. ._ O 1 ❑ Z =-5 f:.from property fines and easements?. - O EC 0 ` O G� >30 ft from c1,a•.a�ngraoieent curi2lnitvtrnd,3taor,drams'?, __.... _ ___. Drairt:tield levet arid observation ports present • - O re O O Graveiess chambers or O Clean gravel used? (check one) r-r� Proper cover installed over dramfield?- - ❑ l._ Q Pump tank•�ott,w,ck�consistant u:rtn;;optac tank? O N;A [/Yrr_n ❑ rat) Pump tank capacity(flood)/7-OD gal Manufacturer So Lipid ,P//c. ,�rae r('t'- s( ''.'E access riser-4s)and aocessibte from su i c,e?- - 0 11r O i - El O. Alarm or Control Panel installed'? -- - O tJ ❑ E Control Panel equipped with Ttrrzer I ETM i Counter- - ❑ Lala O A- Pump installed in 0 Bucket or r ak ck or O Outer __.. —_ L Hump ttMake/MattelMake/Matteli_R12/10? ID y 5 B r=iri;tts: ar O n slut r � ,- /� r it Tank draw down 3.j enlmfn Pump capacity F 0� pm Squirt Heignl _ _ Frump n tare-_._A 1- hl/ , Pump oil time !s,_, hp” t VS ,'t Vii. �?R FEBi FEB 0 2 2026 ..,.._..,.- . __ _- ....__.._.___---...w_.M_._.____ MASON COUNTY ENVIRONMENTAL HEALTH JBW Mason County OSS Installation Report pg. 2 Parc+i# -5—?—n e_r'" / la e., 1 ABANDONMENT RECORD , f 'Iv rf S Xi;i-tin components septic merits abdndoned as par'et ihls protect? O YES No 1 (f yes,pt++a se describe' _____......—. 1 Were aft tornpononN.pumpers out and property abandoned per WAC246-2 72A 03c a _ O YEs,�a 0 NO L 1 RECORD DRAWING _ w t,to raaocata in are need of,naM+ternarree a ar d furors ds.ai rest• t y;,e $' r Th.b a p�prnugant record ittd must be aSrWu)w end dt�e�+�ii�ai a+rt�'+9 l' iii,......r,.....xr.,_u(tk3ri th:4.:m;ii h r:nr?,trrt a+ardelna,6 t,y a!,y3,,41:11 )!ASA,4,7-#.,4,Noun:VI C,*rctr_>v:ei,,anAtil.exollol.rel Pit rv-.f,rti belt.a„,.lrrrOm„'iron W at!v.r .Se.reteaf.,t f,Or,Vera.tavrrtuwz and on,of MAT'O!r m 2.3060.t n' hro,r5*4fo Rrvrd rka%attlr r•yt t WOO u.9baxveu uaraya a,inai rmtnta.ur morn•w4 aril,".1.4,,i r-.„e.%• 1 i' !, si d 0 O 2 ',.7 -'7" '1/1#'e,`tr s 4,f - IC.PO V .4tir Pp Vcn 1/4,,0 oUiyTC�l/h� 2,9,-,,A, I., l ,,..,- 1 cr Record Dravantci Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNERI 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 :mite with the septic design stamped'APPROVED"by County Public Health and that any deviations shown Mason County Public Health and that any deviations hare have bean ctearedJapp;caved by both the dosignorr shown here have been neared/approved by both and Mason County Public Health arid meet all Slate 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 t further certify that all►nlormatictn contained on this frrrrn and ached rd Drawing is accurate. form and attached Record Drawing as accurate. %� -''`" �a/q fay A''''' Signature of tnVaiter Daft: .e Pi;nted',Mela of Signet) t MASON COUNTY PUBLIC HEALTH ` '4, f y. the undersigned approves this installation Report and rte,''r5F ter Record Drawing ore behalf of Mason County Public ifc.,t,; -C,_ r r-LLA;-.tn:3 a nvinNIrnt,n,Zi H,-...aunt Spor.inli:r C?:.tt (stamp.,signature and date) s n-as.rORb.MAY BL SCAP NLO MID AVAILABLE.rOB pllal IC VIEW ON i ML MASON COt ihlt V WU3 Sri 1L tfy ile6e4"''ct,1S' 66f 37 l / . . _ _ :_____. ____ 18 // / , �� t�WI-- Go G S: _,i 0 ;;:' .541 L/2 G"e I w 0 � �� Pyra�n , ( / / , 1 \ 3v 41 z) 6:1- 30 5.4 G f: N\S/ aT J . �_�.�, l' 3�-t/z" urr� ,1-,•/.,_‘, rr e s,t'� sip Pa �C1 19 \,.k. fi I / " \e. .J O - 3 o SA e r>7 c' Gil\ -\ �, S/IaP e 3a- `/s'" 4." i T-<GG `i`as�'�., , �°r Creek / ¢, (/ _ �_ err,J �� P��� - REC® DRAWING �- 1 / w N i? �.usr /Li9u f / t�.vsT, 4 4� ►�i4�iC40 tf`9 ® �4'�► Z1\/- 36 3 a v 3 It 414c-c-5 5 orr'�G/nz.a ,�G "e0. I . \ I . a i ki \ FEB022026AP/P/4-'1 VI li �1s_ 4(�: ( 4�iITE1I& \ iv �; MASON COUNTY ENVIRONMENTAL HEALTH .L `/'0a G.P.D. (primary)Bedroom residence=,��� 3 gisbG.P.D. (reserve) ' N i • I \kli- 1 ,Y 44/43R higivw.s . J S/B0 G.P.D. _ BOO �� (primary) ♦ O. G.P.D./S.F. ~ Ly = yf�U G.P.D. a gi,"J/f/ (reserve) t t•-•'''/ Q. 6 G.P.D./S.F. 6 `L C� O ,p(� `{I f CAPAG../ry f[-1 - 36d g7cl. V� • //All �\ 28808 y - // a: ssoDiNI - / .\11 / \_. t-4. 1 ,4 1. DRAINFIELD. /� � 2. BENCHMARK EL. = 100' \ iv.. \ G 3i 25 3. /20b CAL. CONCRETE SEPTIC TAN);. N I /›F Dc3sz.R✓A7xJN ��/ \6 �.c... \\ 4. loo G19Y_. Gcnvc. �vm� T�iKK. �h- / �� p`n - ii 5E. \ . Z. ScIF 41O PVC DELIVERY LINE.8-1>: .\,. / yLA / 6. 4•• PVC ASTM 3034 TIGHTLINE. 6 X ::111:11FG•A T © 1/.0 MIN. SLOPE = 2% �$3 �/ o OZ '7. 4" PVC CLEANOUT, . /e)-"b, V8 /rof arss,✓Ano.✓ i'cvzr r4 crcouvv WATERLINE. MUST BE LOCATED MIN. 10' w- ` '� #6g i f �S 2( -R ®� F1itOM ALL SEPTIC SYSTEM COMPONENTS. O -96 i_EGAL DESCRIPTION 2 $a `/z y ADVANCED ENGINEERING OWNER. �qu l ) JOB NUMBER 128 N. River Street - :S:zit T:20 R:S,,,)T_P.# '5-202,1-//-90//a yv. 8D' � /Z- 3-Z /�O /..r.Ox !y/� Montesano, WA 98563 „ DATE ua 1d%seQi ziQl-a.v viLc� �✓fI 5763 2-0 ';S % .'../s /- i • - '� .. SCALE:/ s 5/O -+ r a/f1 i>r ti BHT OF