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Home My WebLink AboutSWG2025-00096 - SWG As-Built - 3/17/2026 - e Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION , Permit Number SWG 2025-00096 Parcel# 22110-32-90023 Applicant Name Justin Clair Subdivision (Name/Div/Block/Lot) Applicant Address 751 E. Mason Benson Rd City, State, Zip Grapeview,Wa 98546 Installer Name Spear Construction Site Address Same Designer Name Bob Paysse INSTALLATION CHECKLIST ® Full System Installation ❑Tank(s)Only O Drainfield Only O Repair O Other System Type -?-treatment Type >5 ft.from foundation? - k... \ •. ❑N/A ®YES O NO >50 ft.from wells? - - O El O >50 ft.from surface water? T, __,__ 6.-a Cleanout between building and tank? •- - O 0 O VTank baffles present? - 'v_`, 1' - - - - ❑ ❑l O H 24"access risers over each compartment?--- -Vii-- - O NI O a. to Effluent filter installed?- t`;,.-� - O ® O Septic tank capacity(working) 1200 gal Manufacturer Sound Placement D-box water level and speed levelers used? - - ❑ N/A NI YES O NO CLL Manifold/D-box accessible from surface? - O NI O mz Check valves installed? - - © O O tiQ 2 Transport Line Size 4" Schedule/Class SDR 35 Bedrooms installed(check one) 0 2 •❑3 ❑4 0 5 ❑6 ❑Commercial/Other >10 ft.from foundation?- •- O N/A ®YES ❑ NO ea >100 ft.from wells?- - O ® O W >100 ft.from surface water? - - O MI O z >10 ft.from potable water lines?- - O © O icr >5 ft.from property lines and easements?- - 0 MI O •>30 ft.from downgradient curtain/foundation drains?- - IN 0 0 Drainfield level and observation ports present - - O ® O ❑ Graveless chambers or 0 Clean gravel used? (check one) Proper cover installed over drainfield?- - O 0 O Pump tank setbacks consistent with septic tank?- - 1 NiA El YES O NO �ra Pump tank capacity(flood) gal Manufacturer 24"access risers)and accessible from surface? ® ❑ ❑ -- Alarm or Control Panel Installed? - - ElO ❑ Control Panel equipped with Timer/ETM/Counter- - 0 O O a Pump installed in O Bucket or 0 On Block or El Other 2 . Pump Make/Model O Floats or ❑ Transducer R Tank draw down in/min Pump capacity gpm Squirt Height ft Pump on time Pump off time ' Daily flow set at gpd Updated 8/21/2018 Mason County OSS Installation Report pg.2 Parcel# 22110-32-90023 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - • O YES 0 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 tho need of maintenance activities and future development. Typical Record Drawings contain:!Dralnfield 8 manifold orientation&layout,Septic/pump tank location,North arrow,reserve drainfield,existing and proposed buildings,location of wells,waterlines, wells,observation ports,cloanouts,and other maintenance access paints. Incomplete Record Drawings may create additional delays in final Installation approval and related permits. PPR t�ri'. t '' MAR 17 2 n fix. l MASON COUNTY ENVIRONMENTAL HEALTH J B ® 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 Codas. State and Mason County Codes I further certify that all information contained on this l further certify that all information contained on this form and attached Record Drawing is accurate. form and attached Record Drawing is accurate. 110/31/2 Si nat of Inst ler Date • Logan Spear ` WsG Printed Name of Signee y .4)4 .iti�' rat MASON COUNTY PUBLIC HEALTH R01017. , , The undersigned approves this Installation Report and • Recor raving on behalf of Mason County Public EXPIRES He lth: r • Sign o vironrnentsl Health Specialist Date (stamp,signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Updated 8121/2018 I I I [ EXIST. HOME N *"' I I I I EXIST. TANKS IPROPOSED ADU I -I t I I I I I 0619-6;149U/ I 1 SEPTIC TANK L_- J II II%II r----_.1I .I EXIST. ATTN. L�,16I I v___ ZONE 1, 11 II II I I� I ADU 0% SLOPE I SEPTIC SYSTEM EXIST. PRIMARY EXIST. RESERVE I APPROXIMATE ,. , . i EXISTING WATERLIN EXISTING HOME -..'. I p :,- 0 V E - '' ' AND SEPTIC SYSTEM A tr • „p≤ I AREAPPROX. , MAR 1 �r � z. I-__ " .,. �( L1H I LOCATIONS BASED MASON COUNTY ENVIRONM�FN I \ 6 ON FIELD VISIT, GIS, J AND RECORDS. / \ < / \ -9� / \ / \ (N j EXIST. WELL I 0 �\ 1 I X10 (� 1 N �',4 N. I ;vas ! -- tom„ S,C0z. r d. 1 _ 163'-5" " &.O': RCBBfIT I, w,rsse l 61:F1'n- \ / AN ASBUILT/INSTALL SIGNOFF FEE WILL \ / / BE CHARGED AT TIME OF INSTALLATION CUSTOMER: JUSTINCI.AIIi. TEST HOLE I: TEST HOLE 2 PIONEER. DIGGING, INC. PARCEL# 22ll0 32-90023 °i5 MS ;,��, ts SEPTIC DESIGNS ADDRESS: 751 MASON BENSON RD 3083 E MASON BENSON RD. GRAPEVIEW,WA 98546 DESIGNER: ROBERT H.PAYSSE PLATS OR SUR THIS FIELD IS DOT AMEAS�MENTS AND REFERENCES O INCLUDE: Ol APPLICANT/COUNTY ESIGf NN INTFE.rNDED FOR S�EPTIIC OFFICE /�' PURPOSES ONLY. PROPOSED DEVELOPMENT MAY BE SUBJECT TO OTHER 3604261803 FAX 3604272353 SHEET: PLOT PLAN SCALE 1' 5V DEPARTMENNAOENCY RENEW.DESIGNER NOT RESPONSIBLE FOR SETBACKS UNRELATED TO SEPTIC COMPONENTS. I • 0 I I 1 \___ ! I o C/O PROPOSED ADU ......._ 5,÷ __,,..L. N �.� J o 7 I O SEPTIC TANK D-BOX // / /I N N ,././, N li: 0/LI: v , Li: y (-Q /e -„ "„, , , , -Q % ,_ ,7,-,‘ 7. / D„. 7 > , > › `< 1 -< 1 -mot I _ q� .r O // O // O / O ORIGINAL & FINISHED GRADE H 3' ff. OB PORT I OB PORT (X4) USE SPEED LEVELERS TO EQUALIZE FLOWS FILTER I . V - FABRIC I <° I . ( I . N I I 4__,..„,,s40,,,„ , , _ - _ . ,, ,... _ , ... ,:„ _ , .., . o rY" N N-- GLUED TEE D-BOX WASHED ROCK RISER/LID TO FIN. GRADE A, {j1}�; .f•`�OF W.5S15.1 �1 M (24 515937XyJ: RCCE....T II L'AYSSE .1ri41R'EJ AN ASBUILT!INSTALL SIGNOFF FEE WILL BE CHARGED AT TIME OF INSTALLATION CUSTOMER JUSTINCLAIR. TEST HOLE I: TEST HOLE 2: PIONEER, DIGGING NC. #:221103290023 0 `S 0-11 GCS 22-65 MS SEPTIC DESIGNS ADDRESS: 751 MASON BENSON RD DISCLAIMER:THIS IS NOT A SURVEY.REFERENCES INCLUDE:APPUCANT/CCUNTY PROVIDED 3083 E MASON BENSON RD. GR.APEVIEW,WA 98546 DESIGNER: ROBERT H.PAYSSE PLATS OR SURVEYS.FIELD MEASUREMENTS AND COUNTY GIS.DESIGN INTENDED FOR SEPTIC OFFICE-360-426-1803 FAX-360-427-2353 PURPOSES ONLY. PROPOSED DEVELOPMENT MAY EE SUBJECT TO OTHER SHEET: DF DETAIL SCALE 1n=10' DEPARTMENT/AGENCY REVIEW.DESIGNER NOT RESPONSIBLE FOR SETBACKS UNRELATED TO SEPTIC COMPONENTS.