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HomeMy WebLinkAboutSWG2025-00274 - SWG As-Built - 6/4/2026 Masontounty OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2025-00274 Parcel # 222127590022 Applicant Name Timothy Jarrett Subdivision (Name/Div/Block/Lot) Applicant Address 120 RIDGE DR City, State, Zip PORT TOWNSEND,WA 98368 Installer Name MIKE SKINNER Site Address 884 E. CEDAR ST. Designer Name BRANDON JONES INSTALLATION CHECKLIST UI Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑ Repair ❑Other System Type AEROBIC TO PRESSURE cetçeatment Type BNR500 >5 ft.from foundation? - - - - - - - - - - - - - - - N/A ❑■ YES NO >50 ft.from wells? - - - - - - - - - - - - - - ❑ >50 ft.from surface water? - - III 0 ❑ Cleanout between building and tank? - - - - - - -- ❑ UI ❑ V Tank baffles present? - - - - - - - - - - - -\. - - - - - - - - - - ❑ 0 ❑ a24"access risers over each compartment? g�- - - - - - - - - ❑ © ❑ W Effluent filter installed?- - - - - - - - - - - - - - - - - - - - - - - - -- 0 ❑ ❑ Septic tank capacity(working) 1,200 gal Manufacturer Hagerman Q D-box water level and speed levelers used? - - - - - - - - - - - - - - - ❑■ NSA ❑ YES ❑ NO 0O Manifold/D-box accessible from surface? - - - - - - - - - - - - - - - - ❑ © ❑ 0°Z Check valves installed? - - - - - - - - - - - - - - - - - - - - - - - - -- 0 ❑ ❑ CQ M Transport Line Size 2" Schedule/Class 40 Bedrooms installed (check one) ❑ 2 ❑3 ❑■ 4 ❑ 5 ❑6 ❑Commercial/Other >10ft.fromfoundation?- - - - - - - - - - - ❑ N/A AYES ❑ NO >100ft.fromwells?- - - - - - - - - - - - - - - - -- ❑■ ❑ ❑ .. >100ft.from surface water? - - - - - =`' - - - - - - - - ❑ III ❑ W M >10 ft.from potable waterlines?- - - . - - - N- - - - 0 ❑ �D � r7? e> 5 ft.from property lines and easements?- � T� - -I / © ❑ >30 ft.from downgradient curtain/foundation drain - /4j - - © ❑ ❑ Drainfield level and observation ports present - - -` - �- - - z- - ❑ 0 ❑ ry UI Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?- - - - - - - - - - - - - - - - - -- ❑ ❑■ ❑ Pump tank setbacks consistent with septic tank? - -- - - - -- - -- - - ❑ N/A ❑■ YES ❑ NO Y Pump tank capacity(flood) 1200 gal Manufacturer Hagerman 24"access riser(s)and accessible from surface?- - - - - - - - - - - -- ❑ ® ❑ Alarm or Control Panel Installed? - - - - - - - - - - - - - - - - - - - - - ❑ 9 ❑ Control Panel equipped with Timer/ETM/Counter- - - - - - - - - - - ❑ 0 ❑ Pump installed in , ❑ Bucket or ❑ On Block or UI Other FLOW INDUCER (' Pump Make/Model ORENCO PF5005 0 Floats or ❑ Transducer Tank draw down 2.5 in/min Pump capacity 55 gpm Squirt Height 8 ft Pump on time 43S Pump off time 2H Daily flow set at 480 gpd Updated 8/21/2018 Mason County OSS Installation Report pg. 2 Parcel# 222127590022 ar y ABANDONMENT RECORD Were existing septic components abandoned as part of this project? -- - - - - - - - - - - - -- ❑ YES Q NO If yes, please describe: 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,cleanouts,and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and related permits. ' r i Q Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ENGINEER 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. A k--Mik Inner(May 28,2026 09:10:19 PDT) 05/28/2026 Signature of Installer Date Mike Skinner Printed Name of Signee £ �i� F WAS MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and Z 'sue Record Drawing on behalf of Mason County Public o?' 5100388 He Brandon R. Jones L E S D �IGNER Y 5/28/2026 Sig t o Environment Hea h 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 CLIENT: � I TIMOTHY JARRETT PARCEL #: 22212-75-90022 PROJECT ADDRESS: 884 E CEDAR ST BELFAIR, 98528 •�� -- 321,E 1,800 FT2 RESERVE AREA 4-BED PRESSURE PRIMARY, ® . (SEE SHEET 0201) •::::::•:::• SHEET ID: OBSERVATION PORT (TYP) \: ;??:: � R-02 BNR500 ATU I I-H o � 1,200gaI PUMP TANK O o P 1,000gal TRASH TANK I C/O 4-BED HOME-\\ WATER & UTILITIES a1 REVISIONS: I •ii�ti�k.:l. 4t.e•.nt; I I HORIZON a tD,lei.•. tcx,.• • WASTEWATER (360) . 550 . 4277 ftI ® ___ • —__ ___ ___ ___ ___. 3�f• __— • �� • •"4:: ,{�� "'�s:.•: P.O. Box 3031 .ir Arl; •a,;;;:.•i;,:ti_ i Silverdale, WA 98383 .et{7:?.Y nr�,;.91�!:'•;ai'Laf wi�.•.:k:�.w•.'.;'•y t.JU•, ;>''.4ta !ll•y:%4'•m-"ra.!.S tt�'rC:t.•2..!•F,y:?It il. :t(:'i•h<<tai Swh{(.•'y••�4Y{aN.!�,��'b M� N 0 y OZ� ��•. SONCOUNTYFNVIR 2 �� MENTAL HEALTH. P;'oF WASyrfi RECORD DRAWING 1 Q?• 5100388 Brandon R. Jones N OTES E S 0 20 40 80 N dEN NER 1. THIS SITE PLAN IS NOT A SURVEY, NOR DOES IT PURPORT TO REPRESENT ANY SURVEY 5/28/2026 INFORMATION. ALL PROPERTY BOUNDARIES SHOWN PER PUBLICLY AVAILABLE G.I.S. DATA. SITE MEASUREMENTS TAKEN WITH A TOTAL-STATION FROM EXISTING PROPERTY BOUNDARY FEATURES. [SHEET OF