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HomeMy WebLinkAboutSWG2021-00327 - SWG As-Built - 3/9/2026 Mason County 0SS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH 1 APPLICANT/ PERMIT INFORMATION Permit Number SWG 2021-00327 Parcel # 22105-50-00049 Applicant Name MCGRAW C/O B-LINE CONST. Subdivision (Name/Div/Block/Lot) Applicant Address 2971 E PHILLIPS LK LP RD City, State, Zip SHELTON, WA, 98584 Installer Name B-LINE CONST. Site Address 711 E MASON LAKE DR E Designer Name TOBY TAHJA-SYRETT INSTALLATION CHECKLIST Q Full System Installation ❑Tank(s)O I - 'nfield Only ICI Repair ❑ Other_ �1 a r-;j System Type PRESS,U,RE+ , ,l rte_' a L p r-, e reatment Type SAND LINED DRAINFIELD / >5 ft. from foundation? ' v ' '';1_;- -- ❑ N/A 0 YES , ❑ NO 14R n >50 ft. from wells? - ��' 6-U - r ❑ ® CI z • >50 ft. from surface water? - - - - --/-L-1.1„- - - - 'r' ❑ CI ❑ • Cleanout between building and tank?-----z-7--t------/ ` ❑ U] IIIo Tank baffles present? - - - - ❑ [I ❑ P24" access risers over each compartment?- - ❑ NI ❑ ILI Effluent filter installed?- •- ❑ [] ❑ cn Septic tank size 1500 gal Manufacturer SOUND PLACEMENT ® D-box water level and speed levelers used? - - 0 N/A ❑ YES ❑ NO DO Manifold/D-box accessible from surface? - ❑ 0 ❑ u. 03. Check valves installed? - - ❑ ❑! ❑ ®g 2 Transport Line Size 2" Schedule/Class 40 Bedrooms installed (check one) ❑ 2 ❑ 3 0 4 El 5 ❑6 ['Commercial/Other >10 ft. from foundation? - - El N/A 0 YES ❑ NO ® >100 ft. from wells? - - ❑ ❑ 0 W >100 ft. from surface water? - - ❑ © El E >10 ft. from potable water lines?- - ❑ El ❑ Z > 5 ft. from property lines and easements?- - ❑ 0 ❑ a > 30 ft. from downgradient curtain/foundation drains?- - ❑ 0 ❑ ® Drainfield level and observation ports present - - El ® ❑ ❑ Graveless chambers or 0 Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ 0 El Pump tank setbacks donsistant with septic tank? - ❑ N/A U] YES ❑ NO • Pump tank size 1500 gal Manufacturer SOUND PLACEMENT Q 24" access riser(s) and accessible from surface?- - ❑ it ❑ Alarm or Control Panel Installed? - - 0 ® ❑ M Control Panel equipped with Timer/ ETM /Counter- - ❑ ® ❑ m a- Pump installed in ❑ Bucket or El On Block or 0 Other PUMP VAULT 2 Pump Make/Model LIBERTY FLH61 0 Floats or ❑ Transducer a Tank draw down 42.42 in/min Pump capacity 70 gpm Squirt Height 1.17 ft Pump on time 36:.sec Pump off time 3 hr Daily flow set at 336 gpd Updated 8/21/2018 Mason County OSS Installation Report pg. 2 Parcel# Z.`oS -50 - oao 9 9 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - ® YES El NO If yes, please describe: Were all components pumped out and properly abandoned per WAC246-272A-0300? - - m YES El 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. Typical Record Drawings contain: Draintield&manifold orientation 8 layout,Septicfpump 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. III 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 1 further certify that all information contained on this form and hed Rec Drawing is accurate. form and attached Record Drawing is accurate. I q-10- Sig ture of installer Date w A;1 b - Printed Name of Signee / re) �°Y "��. MASON COUNTY PUBLIC HEALTH w `+ ;�~'� 5100299 tp`r> +� The undersigned approves this Installation Report and /O, TORY J.TAHJA-SYRETT . • LICENSED DESIGtJER Record Drawing on behalf of Mason County Public Health: EXPIRES: 06/07/21 Signature of Environmental Health Specialist Date (stamp, signature and date), THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Updated 8/21/2018 r / \ A SOIL LOGS: / / t ` /MASON LAKE i • t t \ % 0-36"GLS ' / EXT WELL t /2\ 36-60"GMS OHWM /`/ I i LOTS 47&48 1 OVER RESTRICTIVE (BULKHEAD) ��/' 1 11 11 I1 HOUSE r i PRESSURE SEWER TRANSPORT LINE / LOT 48 �` r I DOUBLE ENCASED AND LEAK TESTED / 7 � 50'R r I PER CLASS A WAIVER / 77/p77 ` r r r I MITIGATION GUIDELINES // 7/47j�G4J/ • ` / / /r • / / / EXISTING POWER POLES // ,' / / (POWR TO GO UNDERGROUND) / i EXT I / / HOUSE \ / / 1 LOT 49 ` ' - ' / / ' / t c '' / t ' r ♦ / PARKING/ - \ \ k% LOT 47 LOT 50 / / I`\ t 100' R _ r. 25' R 75'R WATER LINES i I �� I I C.� ,/ SHOP r -/ • / r / EXT WELL \ / / / / / / 50'R o , -/- - Li 1 li // • \ i ' ` // GARAGE O �R/(/�. o •1 o ` ' EXT WELL 50.00 R r r / , / / /f/, / ' , i ,_:z rn I� LOTS 50&51 / r 840 , /, ,,2 // /,, 1 ! t �/ r , p� / I/// r e may° t / / / I -fir, / f/' Q 1tip r , / (.9•:;;-'," �'-1 / / � 1 I , ,I SITE.PLAN -SEPTIC SYSTEM 'n �ft r / �" • r ` .Q. FOR: MCGRAW JOB#: v • -- \ • .,r • `� I WELL PARCEL#: 22105-50-00049 DATE: 28 JUNE 2021 o: !"L I. T? '.y`.) I I °o ACROSS BY: TJS r r • IC �:`;: I Q- STREET DESIGN PAGE (a OF « - __; I I 22104- NORTH ARROW: `cis'';= : :;;;,/,. 7.1 L`L I SCALE: 5z- 1"= 40' , 1 00011 o - 401 80' - © B-LINE CONSTRUCTION, INC. 1