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Home My WebLink AboutSWG2025-00293 - SWG Application / Design - 4/1/2026 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANTf PERMIT,tN':F®FdIViA►TION „ . '.. :_K ,' Permit Number SWG 2025-00293 Parcel# 32232-50-78009 Applicant Name Aaron Buechel Subdivision (Name/Div/Block/Lot) Applicant Address 6381 W Shelton Matlock Rd UNION HOOD CANAL LAND&IMP CO BLK: 78 City, State, Zip Shelton,WA 98584 Installer Name South Shore Construction Site Address 121 E Sharpe St, Union,WA Designer Name Arrow Septic Designs < � t, INSTALLATION GHECKL`'IST � Q Full System Installation ❑Tank(s)Only ❑ Drainfi ❑ Repair ® Other 500 Gallon pre-trash tank System Type NuWater-->OS reatment Type NuWater BNR-500 - - - ❑ N/A •YES ❑ NO >50ft. fromwells? -- -------- -- --��-- --- ❑ ® ❑ >50ft. fromsurfacewater? --- --- ❑ ❑■ ❑ ❑ ❑ may Cleanout between building and tank? - ---- ❑ Tank baffles present? --- ------ -- - - -- ❑- -' ---' ■ rH 24"access risers over each compartment? 164----------- ❑ © ❑ E1.I Effluent filter installed?-- - ---- ------------ - -- - ---- ❑ 0 0 F Infiltrator ,Septic tank capacity(working) NuWater BNR gal Manufacturer x� D-box water level and speed levelers used? --------------- ❑ N/A ❑YES 0 NO -W Manifold/D-box accessible from surface?----------- --- ❑ ® ❑ 'C3u.mZ Checkvalvesinstalled? ---- ----- ----- -- ------- ❑ ❑ ❑ GQ ; Transport Line Size 1 inch Schedule/Class 40 ,G Bedrooms installed (check one) ❑ 2 0 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other '.>10 ft. from foundation?--- - ---- ------ ------ --- - - - ❑ N/A ❑■ YES ❑ NO >100ft.from wells?------------------ --------- -- ❑ 0 ❑ h >100ft. fromsurfacewater?-- - ------------------ -- - ❑ ® ❑ >10ft.frompotablewaterlines?-- - ----------------- -- ❑ ■❑ ❑ Z > 5ft. frompropertylinesandeasements?------- ------ -- - ❑ © ❑da - 30 ft.from downgradient curtain/foundation drains?--- - ----- ❑ UI ❑ DrainfieId level and observation ports present - - - ---- - - --- -- ❑ 0 ❑ y._ Proper cover installed over drainfield?------------------- ❑ © ❑ Pump tank setbacks consistent with septic tank?-- ----------- 0 N/A ■❑ YES ❑ NO viY°R Pump tank capacity(flood) 1,060 gal Manufacturer Infiltrator Zt F 24"access riser(s)and accessible from surface?----- ---- ---- ❑ ® ❑ Alarm or Control Panel Installed? ---- - - -- -- -- - -- -- ---- ❑ 0 d ;.4 Control Panel equipped with Timer/ETM/Counter-- -- ------ - 0 ® ❑ 0� ti Pump installed in ❑ Bucket or ❑ On Block or Q Other on bottom of tank Pump Make/Model AY McDonald E-30 ❑■ Floats or ❑ Transducer a� Tank draw down — in/min Pump capacity 9.2 gpm Squirt Height -- ft Pump on time 22 seconds Pump off time 3 min 44 sec Daily flow set at 360 gpd Updated 8/21/2018 - 2232-50--1009 Mason County OSS Installation Report pg.2 Parcel# 3 ABANDONMENT RECORD Were existing septic components,abandoned as part of this project? -------------—- ❑ YES NO If yes,please describe: ❑ NO Were all components pumped out and property abandoned per WAC246-272A-0300?---''''- ❑YES s.' RECORD DRAWING This b a V fnIflt neordsnd must 6e aeeursta ad descriptive enough to re.locat In the need of malatanarrco activities anTYPC d town dswb ofioca4on weCA rratReen , pmvdeys Cotdnitl:Drautifeld&.marritold odentahen&tayO t,Septclpump tank bcetion.North arrow,reserve draUdield.exisbn0 and prof ekeneu an h, d odter maintenarKe eema s Pelota. incomplete Beard Drawings may create dditIonat data s in foal lnstzttetbrf appr 1elated peks. wells.cbsenb tian tom. Record Drawing Attached CER tiFICATION�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- !further certify that all information contained on this I further certify that all information contained on this fa a ed R raving is a rate. form and attached Record Drawing is accurate. l`I Zo Z5 Signature of Installer Date Rtcf Me2F - � y Printed Name of Signee MASON COUNTY PUBLIC HEALTH /4 fQGJI' 5100349 y"� Y JOHNSON The undersigned approves this Installation ept3tt a11t1 PAULAJO Llt;l t$1JO 10t= 16td�a Public Record Drawing on behalf of Mason County H • APRON 026VA,' 7( /( ?C/Z6 MASON COUNTY ature of E- specialist Date N�iENTAL HEALTH (stamp,signature and date) Si nn vita Health Spect DJq THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBUC VIEW ON THE MASON COUNTY WEB SITE Updmd tim2ot5 lu RaiAv ��,s��sE�a v� t : o t --- A� QL1 �ZZ2-50- 51•� � 5 .- r-• Wes• , r• - V � �y�oPoSE- AP pTf RV APp0 CQUNryFN ?6 1 i '1 �iRoN�F•F 1 OJq NTA(yFq�TH. Ol Audio-Visual Alarm • _.i E Cleanout rz �• 44aPo5£a �1 j i} O3 500 Gallon Pre-Trash Tank e O4 NuWater BNR-500 Pretreatment Tank Q 5 1,000 Gallon Single Compartment os 0" o � I Pump Chamber/Clarifier Tank 0 - '- I tj Oa B • - - • L � Z i�t` 5100349 � y PAULA JOY;JOHNSON installer** "Note to i .Q Z� Sleeve waterline when within 10' a r V of septic transport line. Maintain 10' minimum between water line and septic tanks/drainfield.