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HomeMy WebLinkAboutSWG2025-00281 - SWG As-Built - 4/22/2026 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/PERMIT INFORMATION Permit Number SWG 2025-00281 Parcel# 319041190020 Applicant Name Dan Hess Subdivision (Name/Div/Block/Lot) Applicant Address ,Q(Pa,El L a t City, State, Zip i4 �57 Installer Name Andrew Lehman Site Address 150 SE Sister Meadows Ln Designer Name Jim Hunter • INSTALLATION CHECKLIST • © Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑Repair ❑Other System Type Standard Pressure Pretreatment Type >5 ft.from foundation? ------------ --- - --- -- - N/A ©YES NO >50ft.fromwells? ---------- >50ft.fromsurfacewater? ---- -- --- - - - - - - -- Q ❑ Q `Cleanout between building and tank? ---- ® ❑ Tank baffles present? -- -- --- - --- - --- - -- -- --- L['] ❑■ ❑ o~. 24"access risers over each compartment?- --- ❑ [■J ❑ W Effluent filter installed?--- -- - ----- - ® ❑ W. Septic tank capacity(working) 1200 gal Manufacturer HB Precast C] 'D-box water level and speed levelers used? ---- --- - --- --- - ® N/A ❑YES ❑ NO ❑ © ❑Manifold/D-box accessible from surface?--------- ---- --- - G;1:Z Check valves installed? - --- - --- ----- -- - --- -- - -- -- Iii ❑ ❑ E Transport Line Size 2 Inch Schedule/Class sch 40 Bedrooms installed (check one) ■❑ 2 ❑3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10ft.fromfoundation?------- - -- - --- ---- -- - ----- ❑ N/A ®YES ❑ N0 •>100ft.fromwells?-------- -- ------------- - ----- ❑ 0 ❑ W >100 ft.from surface water? ----- ------------------- ❑ ® ❑ M >10 ft.from potable water lines?---- -------- ------ - - -- ❑ Q ❑ >5 ft.from property lines and easements?------- - - ----- -- ❑ ® ❑ >30 ft.from downgradient curtain/foundation drains? -- -- -- - --- ❑ ® ❑ Drainfield level and observation ports present --- --- --- ❑ ❑ 0 Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?---- -- - ------- -- --- ❑ ® ❑ Pump tank setbacks consistent with septic tank?------------ - ❑ N/A ❑� YES ❑ NO ZPump tank capacity(flood) 1250 gal Manufacturer HB Precast Q 24"access riser(s)and accessible from surface?--- --- ------- ❑ ii ❑ I-- AlarmorControlPanellnstalled? -- - -- -------------- - . ❑ 0 ❑ a .Control Panel equipped with Timer/ETM/Counter--- - -- - - - -- ❑ Q ❑ IL Pump installed in ❑ Bucket or ! On Block or ❑ Other C" Pump Make/Model Liberty 280 0 Floats or O Transducer •Tank draw down .75 in/min Pump capacity 17 gpm Squirt Height 2.1 ft Pump on time 2 min 20 sec Pump off time 4 hrs Daily flow set at 240 gpd Updated 8/21/2018 Mason County OSS Installation Report pg. 2 Parcel# 319041190020 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? -- -- ----------- YES NO If yes, please describe: Were all components pumped out and properly abandoned per WAC246-272A-0300? ---- ---- O YES ■0 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: Drainfield&manifold orientation&layout,Septic/pump 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. ;_ [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 attached Record Drawing is accurate. form and attached Record Drawing is accura e. 4/17/26 Signature of Installer Date Andrew Lehman �, Printed Name of Signee MASON COUNTY PUBLIC HEALTH 4 The undersigned approves this Installation Report and1 0 , " 5i R;;;3 JA Record Dra ' g on behalf of Mason County 2 o� j'aiEs rI , TFg Health: . ir `r�ri,rlfttri��R 2R; EXP! [m: 03/22/, Signat re of Environmental Health Specialist Date Wkz' �6 (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBL► VIEW ON THE MASON COUNTY WEB SITE Updated 8/21/2018 RECORD DRAWING (continued) • -s�' y vl \pa �o S 1 i St Jam _ l.. - -- d `qQ -. - - �. - =1- N.- - 20 a�£. - Z)-, - / - -- _ _≥OM - lk LL / -- : - sv1 _ 5 \ ?��Kb� `y\\ \ I x( 20 -v(p 1 • I �� �, P f 1M f �PoMPLC L ►N57\1 LGt2 c ( Fyn SQS�!rn�[T • '!s_� L4• o`'' ,n;a.�n,�rrm � Dcte�wbaur�• c�_'15 •• �!,�.-- — �L. LICr_Fitcf)pE5!GNLR L= LslIri �t. TIML-�'�b1J `�i maL ZO 44s� 2 _- -n. ------.. ]=M HUNTER�ASSOC. .., eoN-rFeAeToft P.O-HOX 162 OLY,W,A sa5O7 56-ZWfCC .A. _`.C --� �- y_ ,.( �.l•�� �_�. .._-�.�:C( -'U -- 753-1226 •xNsrsaLL o.aTe?-Zg 7- SITE f+.DDRt-'SS/LEGAL /�gSO�C'0 ��2 RECORD DRAWING l5�SisrF/en�Ftackw s W U�/F41111 `6 DW[JER- ) f1G]S 0, FSNAL DATE 3- O'c0 O OJT ,ji4,.iV ___ __ ____ _____ �Ty