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HomeMy WebLinkAboutSWG2024-00255 - SWG As-Built - 2/25/2026 A Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2024-00255 Parcel# 31902-41-90003 Applicant Name logan spear Subdivision (Name/Div/Block/Lot) Applicant Address 2000 W Shelton Rd City, State, Zip Shelton, WA 98584 Installer Name House Brothers Const. Site Address LQ8 I SE Lynch Rd. Designer Name Micah Halverson INSTALLATION CHECKLIST ® Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑ Repair ❑ Other System Type Oscar X02 _ Pretreatment Type >5 ft.from foundation? • •--•;�, • \Vi A•i. t - - -• ❑ N/A 0 YES ❑ NO C' ' >50 ft.from wells? t'�-, ' %;.;1 '� � - - .. ❑ ® ❑ �str� >50 ft,from surface water? - - - -\-Vg; ~ �O,- - - - -Z 21k O ® O Ft- Cleanout between building and tan - • 3 - - - 0 N O ✓ Tank baffles present? - 1 - -Ai,----�•- - - ❑ N 0 a24" access risers over each compart ?- - - ❑ ® ❑ LW Effluent filter installed?- - O N O Septic tank capacity(working) 1100 gal Manufacturer HB Precast a D-box water level arid speed levelers used? - - ❑ N/A ❑ YES ❑ NO DO Manifold/D-box accessible from surface?- - El ❑ u. f9 Check valves installed? - ❑ ❑ ❑ oQ 2 Transport Line Size 1" Schedule/Class Schedule 40 Bedrooms installed (check one) O 2 El 3 ❑4 O 5 O 6 ❑Commercial/Other . >10 ft.from foundation?- - ❑ N/A 0 YES ❑ NO O >100 ft. from wells? - - O ® ❑ W >100 ft. from surface water? - ❑ IN ❑ IT >10 ft.from potable water lines?- - ❑ N ❑ • > 5 ft.from property lines and easements?- - ❑ © ❑ 0.2 > 30 ft.from downgradient curtain/foundation drains? ❑ ® ❑ cl Drainfield level and observation ports present - • ❑ ® 0 ❑ Graveless chambers or 0 Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ 0 ❑ Pump tank setbacks consistent with septic tank? - • ❑ N/A IN YES ❑ NO • Pump tank capacity (flood) 1200 gal Manufacturer HB Precast 2 • 24"access riser(s)and accessible from surface?- - ❑ ® ❑ h- 4, Alarm or Control Panel Installed? - ❑ ® ❑ • Control Panel equipped with Timer/ETM/Counter- • ❑ ® ❑ Q- Pump Installed In ❑ Bucket or ® On Block or ❑ Other d Pump Make/Model Liberty 290 ® Floats or ❑ Transducer ate„ Tank draw down in/min Pump capacity 6.2 gpm Squirt Height NA ft Pump on time Oscar Preset Pump off time Oscar Preset Daily flow set at 270 gpd llazwea?2•Z7'2 Mason County OSS Installation Report pg. 2 Parcel# 31902-41-90003 ABANDONMENT RECORD Were existing septic components abandoned as part 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. _ r«.. . Drawings contain: Drainfield&manifold orientation&layout.Septic/pump tank location.Nc-th arrow reserve dram`elc exist r•g aad proaDsec b:;,-c-as ,cos: ._ ..et e wells,observation ports,cleanouts.and other maintenance access points. Incomplete Record Drawings may create add tonal delays in 6xai instai:at or a o.a a•,;;--aa.._- - ❑ Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ ENGINEER I certify that t 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 for and attached Record Drawing is accurate. form and attached Record Drawing is accurate. W \> 1.),.p\-/ 2/19/26 Si ature of Installer Date '' Joe House 2ri,:/-t..G Printed Name of Signee J MASON COUNTY PUBLIC HEALTH , --,, ;. qtr, The undersigned approves this Installation Report and ;-k '. •?;(J,, Record Drawing on behalf of Mason County Public ,,,,,,.;l2 „� Health ,;o`; /DJJic;.1, f-Iluf.TER I t" E S�^«`rY : ._`_•^_` J.s:s- tit Signature of Environmenta Health Specialist Date (stamp. signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE ': - - • • --._3t1.. .�.__-_._-_-- _ __ / .- . 6/k0-9 tOrs./° . .• ' x✓ 1 ? 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