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HomeMy WebLinkAboutSWG2024-00317 - SWG As-Built - 3/4/2026 t DocNign Envelope ID:493023CF-1O20-480C-8542-0CC253A6A29F Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2024-00317 Parcel# 320215902012 Applicant Name Treadwell Teresa Fleenor SHP Subdivision (Name/Div/Block/Lot) Applicant Address 2111 F Snttnrh,iew Dr shnrerrest heach estates#2 RI K• 2 1OT•17 City, State, Zip Shelton WA 98584 Installer Name Skinner Construntion Site Address 7O1 F Snundview Dr Designer Name Justin Russell INSTALLATION CHECKLIST 0 Full System Installation ❑Tank(s)Only ❑ Drainfield Only LI Repair ❑Other System Type Pressure Trenches .----'\, Pretreatment Type_NA >5 ft. from foundation? - , -; :-'-4�t-s - -- - El N/A ElYES ❑ NO >50 ft.from wells? - � - ��t r :7 \, ``,- - - x❑ ❑ ❑ Z >50 ft.from surface water? - - - - tjy - ''' 0 - - =-t,- -- O ❑ O H Cleanout between building and tan ?v'\--� 1�. - ❑ O U Tank baffles present? - •. - - - - ❑ x❑ ❑ a24" access risers over each compart ent?-- , - - El ❑ W Effluent filter installed?- S3J- - ❑ 0 ❑ co Septic tank capacity (working) 1250 gal Manufacturer Infiltrator O D-box water level and speed levelers used? - - O N/A ❑ YES ❑ NO DO Manifold/D-box accessible from surface?- - ❑ O ❑ QQ0Check valves installed? - - ❑ ❑ • Transport Line Size Tin Schedule/Class SCHD an Bedrooms installed (check one) x❑ 2 ❑3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10 ft. from foundation?- - ❑ N/A x❑ YES ❑ NO O >100 ft. from wells?- - x❑ ❑ ❑ W >100 ft. from surface water? - - 0 ❑ ❑ ti >10 ft. from potable water lines?- - ❑ O ❑ Z > 5 ft.from property lines and easements?- - ❑ 0 ❑ 04 > 30 ft. from downgradient curtain/foundation drains? - - ❑ O ❑ Ca Drainfield level and observation ports present - - ❑ 0 ❑ x❑ Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ x❑ ❑ Pump tank setbacks consistent with septic tank?- - ❑ NIA x❑ YES ❑ NO 94 6 Pump tank capacity (flood) 1-5-00(y-- gal Manufacturer Infiltrator < 24" access riser(s) and accessible from surface?- - ❑ © ❑ I— ii. Alarm or Control Panel Installed? - - ❑ © ❑ • Control Panel equipped with Timer/ETM/Counter- - ❑ ® ❑ C- Pump installed in ❑ Bucket or ❑ On Block or x❑ Other Pump Resin 11,• Pump Make/Model I iherty 281) x❑ Floats or ❑ Transducer a. Tank draw down 2/4in in/min Pump capacity 1A gpm Squirt Height ., ‘ ft Pump on time 9m ';0s Pump off time Rhrs Daily flow set at 180 gpd Updated 8121/2018 ' Docusign Envelope ID:493023CF-1D20-480C-8542-0CC253A6A29F Mason County OSS Installation Report pg. 2 Parcel# 320215902012 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - ❑ YES O NO If yes, please describe: Were all components pumped out and properly abandoned per WAC246-272A-0300? - - ❑ YES x❑ NO Ir 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: Drainrield&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. O 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 forrrpo t ratty ched Record Drawing is accurate. form and attached Record Drawing is accurate. Ap,.. )e:s.C-:--- 1n/7Ri7r, —2Jhbb9JUuA2b4AJ... Signature of Installer Date Same rat Skinner r•4 ,��, Printed Name of Signee4 . 44 ,ft MASON COUNTY PUBLIC HEALTH s, = v, 21202-6 ' •;•, , The undersigned approves this Instillation Rep nd 110 fry �&' °° ��� ��rr�� /�_ X2030834 Record Drawing on behalf of Mason qtly Puh�il 0 z .,'- JUSTIN S RUISE41 -'• QU "`LICENSED DESIGNER"` Health: 5( /Zt 'l6 %q�-ifie Signa ure of Environmental Health pecialist Date 6 447/6, (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Updated 8/21/2018 RIDGEVIEW �° ' ‘4125' n a3A h 62' 'e,' 9P M' 50' 1 sL- '± (y 22' 7 5 11),.. �c U LATERAL INSl'ECRON , 6OO FT'DRIP /i ��� &CLEAN=PORTS I RESERVE / v\CO L BPS L/26 ZZ CI CI RATER METER DRIVE P 4 EXISTING Yh" •'"_ Vt ,bz / 220308J4 t O SHED LIC NS 0 D IrYA RUSIITT SIGni. L 6 COVERED WATERPAilO J 0STUBOUT a� /�l ® m I e1VL SEPTIC TANK i Z.50 9a r� �4 WATER SHED . Q3 1' - L PUMP CHAMBER IZ U J al ® TIGHTLINE o ©VALVE BOX n DRAINFIELD INSTALLED WHERE DESIGNED 2 BDRM HOME 4 PRESSURE TEST SQUIRT HEIGHT=72" 0 20' PUMP CHAMBER DRAW DOWN=.75"/MINUTE TIMER SET FOR 2 MINUTES 30 ON,4 HOURS OFF 30 ♦1 r—.al I� —, .—,' DOSE VOLUME=45 GALLONS // 0 - 0 e N.O • V RECORD DRAWING 125 ALPHA SEPTIC SOLUTION,LLC. PO BOX 14531 TUMWATER WA 98511-4531 360-956-7242 CUSTOMER: TREADWELL,TERESA TAX PARCEL#: HOME/TANKS 32021-59-02013 DRAINFIELD 32021-59-02012 SITE ADDRESS: HOME/TANKS 221 E SOUNDVIEW DR DRAINFIFI D 201 F SOUNDVIEW DR LEGAL: SHORECREST BEACH ESTATES#2 BLK:2 LOT:12-13 PERMIT N: DATE INSTALLED: DATE INSPECTED: OTE:THE PROPERTY OWNER IS RESPONSIBLE FOR KEEPING SWG 2024-00317 10/28/2025 1 1-2-25 HE FLOW OF SEWAGE AT OR BELOW THE OPERATING CAPACITY INSTALLER: pF 270 GPD AND SEWAGE QUALITY. SKINNER CONSTRUCTION