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HomeMy WebLinkAboutSWG2025-00463 - SWG As-Built - 3/6/2026 4 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH g } zz.,Al'PLIGANT/P,ERIVIR NEMNIATIQN `.s_ Permit Number SWG 2025-00463 Parcel# 22336-53-00044 Applicant Name Scott, Mark&Natsue Subdivision (Name/Div/Block/Lot) Applicant Address 20 NE Barbara Blvd City, State, Zip Belfair,WA 98528 Installer Name Josh Peterson/Kattrax Site Address 20 NE Barbara Blvd Designer Name Rod Left/Acme Design Inc rR... j . . , . :..... _. .:_ . IN TXW ATt04N_.C ee:-:K IS- F . 3 -'_ _ __3 . .. ` ' 0 Full System Installation ❑Tank(s)Only O Drainfield Only O Repair O Other AO _ 1 System Type Pressure Pretreatment Type NuWater BNR500 rz . 1 z, >5 ft. from foundation'? - O N/A Q YES ❑ NO >50 ft. from wells? - -p \ -i ❑ ■❑ ❑ 11-,:. >50 ft. from surface water? - I14}i-t tt ❑ 0 ❑ Cleanout between building and tank? -- `>-'A- t h-L 2 - - _tv Li CI t'\' A Tank baffles present? - � ❑ 0 ❑ F '24" access risers over each compartment?l- ,^lam- 0 ❑ ,,iiiLitl U,) Effluent filter installed?- r_— - 0 ❑ ❑ nacog tg-4 Septic tank size 1250 Trash gal Manufacturer Hagerman =sj `O D-box water level and speed levelers used? - - 0 N/A O YES ❑ NO „tit" Manifold/D-box accessible from surface?- - CI ❑■ ❑ 9,,Eti Check valves installed? - - ❑ ❑■ ❑ Transport Line Size 2" Schedule/Class 40 Bedrooms installed (check one) ❑ 2 0 3 ❑4 El 5 ❑6 ❑Commercial/Other >10ft.fromfoundation?- --r=- --= - / r N N/A ❑ YES >100 ft from wells?- a - ' - " fi aI1 ❑ NO J >100 ft. from surface water? - a- aq{ 0 ❑ ALL V-; 1 MAR -06 70;. u, >10 ft.from potable water lines?- --- „ K® 0 ❑ > 5 ft. from property lines and easement NCau-N?Y_E4V-RONMr-lTl4 NEA L.r l a 1 1 > 30 ft from downgradient curtain/foundation drains?Ja a - O 0 ❑ ®'_ Drainfield level and observation ports present - - ❑ © CI 0 Graveless chambers or ❑ Clean gravel used? (check one) ' Proper cover installed over drainfield?- - ❑ 0 O ii t A Pump tank setbacks consistant with septic tank?- - ❑ N/A ❑■ YES O NO .:: .1 z: Pump tank size 1250 gal Manufacturer Hagerman =B 24"access riser(s) and accessible from surface?- - O ® ❑ 7:*--„-_, Alarm or Control Panel Installed? - - ❑ ® ❑ 424 Control Panel equipped with Timer/ETM/Counter- - ❑ 0 ❑ ft Pump installed in 0 Bucket or O On Block or Li Other --''":41"" 4 Puma Make/Model Liberty 290 0 Floats or ❑ Transducer - Tank draw down 2 in/min Pump capacity 44 gpm Squirt Height +6 ft „ FI1,1 Pump on time 0:01:01 Pump off time 3:00:00 Daily flow set at 359.6 gpd Updated 8,21/2018 Mason. County •CSS,Installation Report pg. 2: Parcel# 223365300044 x. . t , r ; ABANBONMENT!R RQ .N�� , t �, 24x1 3 - 22x.._. �..,_ ,,..v,.z_ , _22,2.2. EC4 ?:f. : r.. �. .� _ Were existing septic components.abandoned es part of this project? - • - 0 -YES .o: NO • if yes, please-describe:Tantc.was pumped smashed and:removed . . Were all Components.pumped out end-properly abandoned per WAC246-272A-0300? - • j YEE El NO. _.. __2222 • .i� � 3 RE�CORC:_DRAINING:;;�� t t-. . ... �:{ ��3-.�i J,�. �x�r_{2222 '`_.�. •This is.e:permanent record and must.he accurate end descriptive enough to re-locate in the need of maintenance activitim:and•future"development+ Typical Record ' Drawings Contain: Drainfleld&.manifold orientation.*layout;Septklpurop tank location.North arrow,reserve dra[nflefd,existing and proposed buildings,Iocattortof wells;waterlines, - welle;.observallcn ports;eleanouts,and other maintenance access points..Incomplete Record Drawings may.create additional delays in flnatfnstaiationapproval and related permits. "G i HVE ,` i 11 . BAR 0 6 E . .,. : • MASON COUNTY ENVIRONMENTA L HEALTH • • • J • • i Record Drawing Attached . _-2222 , r _ naCERTI:EICATION OE,INSTALLATION �:x > ,. ` : . <':.N S F -J' t' ''f -. INSTALLER - DESIGNER/ENGINEER 1 certify that I installed.the system in accordance with l certify that the system has been installed In actor- . the septic design stamped"APPROVED"-by Meson _dance with the septic design stamped'APPR.OVED"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 GountyCodes.- State and.Mason County Codes . 1 further certify that all information:contained.on this 1 further certify-:that:all Information contained omthis form.and attached_Record Drawing is accurate:: form and attached Record Drawing is.accurate. 7 - 2/26/26 Signature of Installer Date ;;. • -Josh Peterson _ _ -_ _ _ _ - . -Printed Name of Signee- - . . 222 2 . .- . - MAS.ON.C.OUNTY PUBLIC.HEA TH •- =/, �� . t •The undersigned-approves thls.Installation Report and. ' . ilk N, a. . SIGNER w Recrrl.Drawing on behalf of Mason County Public io.riosii iiszsz lien -Health, S. ... ( EXPIRES 121/SL1 • ,. V�► a 7 --(a— .. . .. ' Sign tu. vironrirentel Health -pecialist • Date (stamp,signature and date) THIS:FORM MAY BE'_$CANNED AND AVAILABLE FOR=PUBLIC VIEW ON THE MASON COUNTY WEB SITE updeud e/21rsote :DATER LINE DISCLAIMER: IF WATER LINE RESIDES WITHIN PROPOSED DRAINFIELDS AND/OR NEEDS TO BE RELOCATED FOR ANY REASON HOMEOWNER CONSUMES ALL FINANCIAL RESPONSIBILITY 0' 5'10' 20' 30' 50' , SCALE (FEET) r°?0s, c, GARAGE . EXISTIN•G4 - • - a 110' : 6.r -DRIVEWAY < \ Dh, P .- _t . . . • • • ; v 3-BR HO E i SHED ♦ ♦ • o o - . :. • • Al- MOTOR �' . , - - - _ _ 4 - PANEL j ,-- - _ N . ; . • VI" - 4 �C/ YVVY , �, . , ., . - 115' 66.2 ' - -lk.I_ �.4411i.yv' A : YK2 S iiiiEXPIRES 121151 MASON COUE ,,„..,,„,. NTY ENVIRONMENTAL HEALTH o "" 9 i - - ; - • RECORD OF CONSTRUCTION - THIS IS NOT A SURVEY. ALL PROPERTY LINES/BOUNDARIES HAVE LEGEND BEEN DEMONSTRATED BY THE OWNER(S) AND/OR THEIR AGENT(S). =SOIL LOG AcmE DEsIGN = NO BUILD ZONE *ALL MEASUREMENTS WERE TAKEN FROM KNOWN POINTS DEMONSTRATED BY THE PROPERTY OWNER. =CLEARING LIMITS DATE- =LOW AREAS 26 FEB 2026 *ALL MEASUREMENTS WERE TAKEN WITH AN OPEN-REEL FIBERGLASS TAPE MEASURE. fP.O. BOX 2954 � =TREES> 12" olA NAME- SCOTT � SILVERDALE, WA. * NO FOUNDATION SPOILS OR BURNING ON DRAINFIELD AREAS. 0 = CLEAN OUT 98383 *DUE TO UNFORESEEN WATER TABLES,A CURTAIN DRAIN MAY BE REQUIRED. O =TRASH TRAP TAX ID-D- 22336-53-00044 * DIRECT ALL DOWNSPOUT/SURFACE WATER AWAY FROM DRAINFIELD AREAS. Q =ATU DEVICE STREET- 20 NE BARBARA BLVD *ALL TANK ACCESS COVERS ARE RISERED TO FINISHED GRADE. Q = 1250-GAL PUMP TANK TEL. 360-698-8488 Q = SPLITTER SCALE: r=20' ROC INFO@ACMESEPTIC.COM