HomeMy WebLinkAboutSWG2024-00207 - SWG As-Built - 3/24/2026 RECORD DRAWING (ASBUILT) pg. 1 MASON COUNTY PUBLIC HEALTH
' PARCEL ID NTIFICATIO.N
Permit Number SW 2024-00207 Assessor Parcel # 320065002077
Applicant Name iKen and Tine Slater Subdivision (Name/Div/Block/Lot)
Applicant Address 1940..EisIandLake Dr
City, State, Zip Shelton WA, x$584 Installer Name Rosch Smith
Site Address J.. 0E Island Lake Dr Designer Name Adam Hunter
INSTALLATION CHECKLIST:
Full System installation ❑ Septic Tank Only ❑ Drainfield Only ❑ Repair
System Type Sand Bed Pretreatment Type None
>5ft. fromfoundation? ----- - - - - _ - - - _- ,, . ❑ NIA YES NO
>50 ft. from surface water? - - -- - -
;Q. : Cleanout between building and tank? - - � - 02� - -- • ❑ ❑
Tank baffles present? » -- - - _ - - _ - - - - - - - ❑ ❑
24"access risers.over each compartment - »; _- »
�y.
;W:' Effluent filter Installed?. _ .. _.- _ ...... .. ., ❑ ❑
Septic tank size 1200 gal Manufacturer Sound Placement
D-box water level and speed levelers used? - --- - - - - ---- - --- - - N/A ❑ YES ❑ NO
O Manifold/D-box:accessible from surface?---- - - -- -. - ----- --- - --- ❑ X
Checkvalves'in:stalled? - - - - ----- ----- - ----- ---.--- --- ---- -- -- -- - - - ❑
Transport Line size 2" PVC Pipe Sohedule/Class, .SQH 40.
Bedrooms installed (check one) 0 2 DF3 '4a .❑s 5 6
>10 ft.from foundation?-_ .. .. . E - - - - - -- • :- - - O N/A Yas [I ro.
>100 ft from wells? --- ---- - ---- "`tea ❑ ❑
>1.00 ft.from surface water? -------- ----- --------------- - -o
` �r
1N COUNTY F E` LI ❑
>10 ft, from potable waterlines?--- �- - -- - _ -- -- -» ❑ ❑
> 5 ft. from property lines and easements?-.-- - - - -- - - - -- - ❑ ❑
_.: > 30 ft, from downgra.dient curtainIfoundation drains? » - - - - - - - - - ❑ ❑
® Drainfield level and.observation.ports present - -- _ - -- - - - - - ❑ ❑
Graveless:chambers or ❑ Clean gravel used? (check one)
Proper cover Installed over drainfield?-- - - - -- -- - --- - - ----- - -
Pump tank setbacks consistant with septic tank? --- --- - ------- - --- - ❑ NIA YES 0 NO
Pump tank size 1200 gal Manufacturer Sound Placement.
Q 24" access riser(s) and accessible from surface?-- - --- -- - - - --- - ❑
Alarm or Control Panel Installed? -- - - - ----------- ---- ----- ------ ❑ ❑
Control Panel.equipped with Timer/ ETM/Counter- - - ---- - - - --- ❑ X .0
Pump installed in ❑ Bucket or X On Block or ❑ Other
Pump MaKe/Model Zoeller N161 Effluent Pump gFloats or ❑ Transducer
Tank draw down 1.75 in/min Pump capacity 44.5 _gpm Squirt Height 5ft 8in .ft
Pump on time_2.72 Pump off time. 6 hrs . Dally flow set at. 480 ,gpm
RD DRAWING (ASBUILT) pg. 2 MASON COUNTY PUBLIC HEALTH
RECORD DRAWING
A Drainfield&
manifold orientation
&layout -
O Trench/bed
dimensions and
critical distances
within layout
O Septic/pump tank
placement
SEE ATTACHED
Location of
buildings
O Observation ports&
clean-out locations
® Location of wells,
surface water,& 2.t b _
roads '
❑V Undisturbed native ,µY VIRONMENTALHEA��N
soil between 1
trenches MASON CO ��
North Arrow
If the designer or installer feel the need for additional information/comments, it may be attached.
1
Record drawing may also be on a seperate page attached. No. Pages Attached
.CERTIFICATION.OF )N$TALLATI0N
INSTALLER DESIGNER
I certify that 1 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
form and attached Record Drawing is accurate. form and attached Record Drawing is accurate.
3%t I/2
Signature of Installer Date
F o& d rr &L �t 1
Printed Name of Signee
MASON COUNTY PUBLIC HEALTH hr rr . ..
1
The undersigned approves this Installation Report and ADAr.9 J.HUNTER
Record Drawing on behalf of Mason County Public
Health: -i6
Sig atu a Environmental Health Specialist Date (designer's stamp, signature and date)
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE
revised 1/22/2014
300'
SCALE-1"=60'-0"
0
'�w PROPOSED 4 BDRA
(NOT A PART OF TF
3
93 1 Q0
tBiO iP.020006002026
WELL- /
6
0'r _ -
� In
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ISLAND LAKE m I I
O � L r
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R O J
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O1 EXISTING RESIDENCE(DEMOLISHED) 9 / � �.�
EXISTING DRIVE I r
8 11 0 4 q
3 1I'
g�
O4 EXISTING WELL IgSQN C k1'7�
O5 4BDRMRES - ,NV/Ro : SCALE-
1"=30'-P
SEPTICTANK(ABANDONEDPERCODE) 100' J MFNTq�yFALTy DETAIL#1
O7 APPROXIMATE LOCATION OF EXISTING D.F.(ABANDONED) L J
O6 STUBOUT/CLEANOUT
O9 SEPTIC TANK
10 PUMP CHAMBER
11 560'-2"PVC TIGHTLINE(SCH40)
12 VALVE BOX
13J DRAINFIELD(480FT2) PRESSURE TEST COMPLETED BY INSTALLER
14 R/A FOR 1960-TP:320065002077 4'
16 3 BDRM R/A FOR 1940 TP:320065002075 SQUIRT HT: (j 8 !t,
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