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HomeMy WebLinkAboutSWG2026-00056 - SWG As-Built - 5/8/2026 � f Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2,y2�o- Parcel # ljLaq - - -9oo Applicant Name Pry- ilk Subdivision (Name/Div/Block/Lot) Applicant Address 212\ Rh'- City, State, Zip Oçcs,� cjBVL Installer Name e Site Address 9b ' . aVc \ &\\ c . Designer Name &oM 't ly4 r INSTALLATION CHECKLIST Full System Installation ❑Tank(s)Only ❑ Drainfield Only E4 Repair ❑Other System Type `C atment Type >5 ft.from foundation? - - - - - - - - -��' - - ❑ NIA YES ❑ NO >50ft.fromwells? -- -- - -- -- - - -- - - - - - - --__ I ❑ >50ft.fromsurfacewater? - - - - - - �fi _ ❑ z - -�� ZQr tJ ❑ ❑ HCleanout between building and tank? - - - - - - - - _ _ __ ❑ ❑ L) Tank baffles present? - - - - - - - - - - -BT - - ❑ ❑ 24"access risers over each compartme . - -- -- - - - - - - -- - - . ❑ ❑ LUEffluent filter installed?-- -- --- - -- -- - - - - - - - - - - - - - - - ❑ ❑ Septic tank capacity(working) \2 ' gal Manufacturer_ -\L ke ' - 0 D-box water level and speed levelers used? - - - - - - - - ------ - © NIA ❑ YES ❑ NO 0 ManifoldlD-box accessible from surface?- - - - - - - - - - - - -- -- - ® - ❑ ❑ mz Check valves installed? - - - - - - - - -- - - - - - - - - - - - - - - -- � ❑ c- 2 Transport Line Size _u Schedule/Class �(}1 /tT Bedrooms installed(check one) ❑ 2 [V 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10ft.fromfoundation?- - - - - - - - - - - - - - - - - - - - - - - - -- ❑ NIA DYES ❑ No >100ft.fromwells?- - - - -- - - - - - - - - - - - - - - -- -- - - - -- ❑ ❑ W >100ft. fromsurfacewater? - - - - --- -- - - - -- - - - -- - --- - ❑ ❑ M >10 ft.from potable water lines?- - - - - - - - - - - - - - - -- - - - - - ❑ ❑ > 5 ft.from property lines and easements?- - - - - - - - - - - - - - -- ❑ ❑ > 30 ft.from downgradient curtain/foundation drains? - - - - - - - -- - ❑ ❑ Drainfield level and observation ports present - - - - - - - - - - - - - - ❑ ❑ ❑ Graveless chambers or Clean gravel used? (check one) Proper coverinstalledoverdrainfield?-- - - - - --- - - -- - - - --- ❑ ❑ Pump tank setbacks consistent with septic tank? - -- --- - - - - -- - ❑ N/A [ YES ❑ NO Pump tank capacity(flood) \2W gal Manufacturer c\c7 r2.e&1 \- 24" access riser(s)and accessible from surface?- --- -- - - - - - -- ❑ ❑ a. Alarm or Control Panel Installed? - -- - - - - -- - - - - - - --- - - - ❑ ❑ Control Panel equipped with Timer/ETM/Counter- -- - - - - - - - - ❑ N ❑ a Pump installed in ❑ Bucket or On Block or ❑ Other Pump Make/Model '2,S 'E i 't-%s 2-At [9Floats or ❑ Transducer Tank draw down 0%'- in/min Pump capacity S gpm Squirt Height MPr ft Pump on time M r. Pump off time 2- \r• Daily flow set at I?b gpd Updated 8/2112018 Mason County OSS Installation Report pg. 2 Parcel# ABANDONMENT RECORD Were existing septic components abandoned j� part of this project? -- - - - - -- - - - - - - -- YES 0 NO n If yes, please describe: i P.OI_• k _ Were all components pumped out and properly abandoned per WAC246-272A-0300? - - -- - - -- YES [] 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,deanouls,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 I further certify that all information contained on this fo and attached Record Drawing is accurate, form and attached Record Drawing is accurate. i nature of Installer Date Printed Name of Signee /2; ' MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and '� ADAr�A J.HUDITGR Record Drawing on behalf of Mason County Public • ti fr/ SZCNco�'NryF , �8 Signs ure of Environmental Health Specialist D Je4 NiWFN1 (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUeLIA VIEW ON THE MASON COUNTY WEB SITE Updated 8/21/2018 \ 9SX O1 EXISTING 4 BDRM RES \ O EXISTING SHOP/GARAGE \ O EXISTING DRIVE \ SCALE-1"=60'-0" L1Ak \\ WELL 4 EXISTING SEPTIC TANK(PER 1976 PERMIT!INSTALLATION)FAILED(ABANDONED PER CODE) 4, O5 EXISTING D.F.(FAILED DUE TO AGE)-ABANDONED \\ �7� O PROPOSED 3 BDRM ADU(ADU NOT INSTALLED YET-UNDER SEPARATE PERMIT) \\ 4 O7 DRIVE \\ Q O6 ADU CLEANOUT/SEPTIC TANK/PUMP CHAMBER \ O9 EXISTING STUBOUT/CLEANOUT FOR PRIMARY RES \ 10 1200GAL.SEPTIC TANK \ 11 1200GAL.PUMP CHAMBER \ 7 CC, 12 900F2 DRIP DRAINFIELD(25FTX36FT)-4 LATERALS-150FT EACH \ 900FT2 DRIP R/A N N H 12 ADU DRIP DRAINKIELD D <`%.� •s•;:,. `(/ �: ADn.ra�.IIUNTEr. '�tz� I U! C SEE DETAIL 445'+ 1 / N100' N v 1O PRESSURE TEST COMPLETED BY INSTALLER 3 O o r� SQUIRT HT: N lk HEADWORKS(SEE DETAIL PG 2 Y O DRAWDOWN: O;z IN1� 11 TIMER SETTINGS - / ON: 6 ,- OFF: 12 JIM HUNTER & ASSOC. CONTRACTOR P.O. BOX 162, 0LY, WA 98507 JOE HOUSE 753-1226 INSTALL DATE- 4/1/26 220'-1"SCH40 SUPPLY f RETURN LI ES JHANDASSOCIATES@HOTMAILCOM Q 4t 00g RECORD DRAWING SITE AD 90EEQUAILHILC'LRD R4'SO4vcoo Y ?o�� 1 OWNER- MIKE YOUNG FINAL DATE- 4/3/26 F�/V/RO �� TP# 12209-34-90090 SITE# SWG2 05F �t4j SCALE-1"=60'-0"