HomeMy WebLinkAboutSWG2023-00438 ASBUILT - SWG As-Built - 1/23/2025 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH
APPLICANT!+NT! PERMIT INFORMATION
Permit Number SWG 2023-00438 Parcel# 32011-44-00050
Applicant Name Chris Schreiber Subdivision (Name/Div/Block/Lot)
Applicant Address 350E.Agate Loop Rd.
City, State, Zip Shelton, WA 98584 Installer Name T.J. Goos
Site Address 180 E.Agate Loop Rd., Shelton Designer Name Dale L.Tahja
INSTALLATIONCHECKLIST
® Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑Repair ❑Other
System Type Pressure Trench Pretreatment Type N/A
>5 ft.from foundation? •- ----- - - 1 ❑ NIA YES
❑ NO
>50ft. fromwells? - ---- -- - ---- -
_ _?__- _-_ ❑
• >50 ft.from surface water? - - - --- - -JIII, 2�7F_ _ ❑ ® ❑
= LI
Cleanout between building and tank? - --- - - --- - -- 0 1!J 0
o Tank baffles present? - - - - - - -- - -- - - - - -- - --- __ _ ❑ ® ❑
24"access risers over each compartmen _____ ____ _ ❑ ® ❑
Iii Effluentfilterinstalled?- - - ---- - --------- -- -- - ❑
Septic tank capacity(working) 1,250 gal Manufacturer Hagerman
D-box water level and speed levelers used? -------------- - N/A ❑YES NO
Manifold/D-box accessible from surface?- -- ------------- . ❑
.. Check valves installed? - - --- - - - -- - --- - - - ---- ---- ❑ ® ❑
0<
• i 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 NO
>100ft.fromwells?----- -- - --------------------- ❑ ® ❑
• >100 ft.from surface water? -------- -- -- ----- ------ - ❑ ® ❑
>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 cover installed over drainfield? ----------- ------- ❑ ® ❑
• Pump tank setbacks consistent with septic tank?------------ - ❑ NSA ® YES ❑ NO
• Pump tank capacity(flood) 1,000 gal Manufacturer Hagerman
24"access riser(s)and accessible from surface?------------- ❑ ® ❑
Alarm or Control Panel Installed? - ------------- ------._ ❑
Control Panel equipped with Timer/ETM/Counter - - - -- -- - - - ❑ ! .1 ❑
Pump installed in ❑ Bucket or ® On Block or ❑ Other• !yn'
Pump Make/Model Libe 290
rtY ❑ Floats or Transducer
"Tank draw down 2Pump capacity in/min ca aci 44
:., gpm Squirt Height 8 ft
Pump on time 2 min Pump off time 5 hrs 58 min Daily flow set at 270 apd
Updated 8/21/2018
sj
Mesa=County 058 base Report pg.2 I
It yes p
Wets al!cam o is p nnped out andp>'apeiq► pea ------- Q tit3
'mts In a pine bawd aM evert W cui a sad d A R I *C04=M&I QN am oa ii 1IM.sc teii*'N Ramd
VwJlca a+ae�X4ldaan .metre►�Naa.t�anastwdr�WtA �R�P� �oalonartr�lt,w ,
tN4b!aIJflpottr,+d wauadath P boa Reoo�aae rctMf►awiM�Ya�l r+tntlwt�tel�lonappow�ad cpa
■ RmrdOrewlngarmed
T#ON OF sAuTION.
RWAU ER I DEsloNERl ENINEER
i
lylhatllnsf&ledtheaystem h earn Bence Ui I oertlPrthat the arum has been dtsmllad!,?aaeor-V
the septic din ngaed APPROvMa-by Mason denca nft tho asptidastgn stamped',4PPROVED"by
County Pubiba Health and that anydeviat₹6as shown Meson i t Public Health and that any deviations
here have been dawedlapmved by ;*deenec dam tears have been cteamdäppmved by both
and Masan County Public Health end meètoff Stalls myself end Mason CauntyPublic HesWi end meet all
and Mason Cow4y CodM State and Msao)t County Codes
Hlutharoerthjr that all Infonnataon on ihta Mjziherce#Ifythaf WI Info, ton caned thie
ttu►n and a Dmw fti h acrd atoadhed Recosd f to acrwrate.
V H .
sera ! a -
V / V
ttedlVame.af
Q��ra
MASON COUNTY PUBLIC HEAL'f H i
77re underarfhned a vrss this Installation R+edaort and 5100214
Record Dtawbig on behalf of Meson CountyPublic i - DalaL.Tali .
Health i ' LICENSED DE PER .z )f\QJvT\ e
CJoz f&A*aMenWl Dale lip, )
- �tr�r��a�av �ct�ucv�rcmrtr�eev� w�srrg sae
- 3— Y3c \ \ \
.,.
T
l� d
o � r
k0c ®
x C=
r�
rn
r
.fit
f j
I c-p ?i