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Home My WebLink AboutSWG2026-00007-ASBUILT - SWG As-Built - 6/15/2026 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2026-00007 Parcel# 22223-51-02061 Applicant Name Puget Sound Const.Services Subdivision (Name/Div/Block/Lot) Applicant Address PO Box 1876 TRAILS END DIV#2, Lot 61, Block 2 City, State, Zip Belfair,WA 98528 Installer Name Neil Triebenbach Site Address 1561 E Trails End Dr Designer Name Lawrence Purdum INSTALLATION CHECKLIST Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑ Repair ❑Other System Type Pressure Distribution Pretreatment Type ❑ N/A ijYE El NO ❑ Z >50 ft. from surface water? - - - - - --JUN - - - H Cleanout between building and tank? -= o ��6_ _ ❑ V Tank baffles present? - - - - - - - - - -RR-��- -- - - - - - - ❑ X ?' ❑ F- 24"access risers over each compart ets'tT ? - El i ❑ W Efuentfilterinstalled?- - - - - - - - - - - - - - - - - - - - - - - - - - - ❑ ❑■ ❑ U) Septic tank capacity(working) 1,000 gal Manufacturer Hagerman Precast D-box water level and speed levelers used? -- -- - - - - - - --- -- ❑ N/A ❑ YES ❑■ NO 0O Manifold/D-box accessible from surface?- -- - - - - - - -- - - - --- ❑ 0 ❑ QQCheck valves installed? - - - - - - - - - - - - - - -- - - - - - - - - - - ❑ ❑ N 2 Transport Line Size 2-in Schedule/Class 40 Bedrooms installed (check one) ❑ 2 ■❑3 ❑4 ❑ 5 ❑6 ❑Commercial/Other /4/ >10 ft.from foundation?-- - - - - - - - -- - - - - - - - - - - -- - - - ❑ N/A iJYEI7 ❑ NO >100ft. fromwells?---- - -- -- -- -- --- - ---- -- - - ---- ❑■ ❑ W >100ft. fromsurfacewater? - - - -- - ---- - --- - --- - --- -- 'fL QL ❑ LL >10ft. frompotablewaterlines?- -- --- - ---- - - - - - - --- -- ❑ ❑ Z >5ft.frompropertylinesandeasements?- -- -- - - - -- --- - - - ❑ ® ❑ > 30 ft. from downgradient curtain/foundation drains?-- - - - - - - - - ❑ 0 ❑ 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?-- ----- ------ ❑ N/A ❑l YES ❑ NO Pump tank capacity(flood) 1,455 gal Manufacturer Hagerman Precast Q24"access riser(s)and accessible from surface?--- -- - - --- - -- ❑ 0 ❑ Alarm or Control Panel Installed? -- - - - - - - -- - - - - - - - - - - - ❑ 0 ❑ Control Panel equipped with Timer/ETM/Counter - - - - - - - - - - ❑ 0 ❑ Pump installed in ❑ Bucket or ® On Block or ❑ Other IL Pump Make/Model Liberty LP-280 0 Floats or ❑ Transducer E D. Tank draw down 1.625 in/min Pump capacity 32.5 gpm Squirt Height 5 ft Pump on time 110 sec Pump off time 4 hrs Daily flow set at 357.42 gpd Updated 8121/2018 Mason County OSS Installation Report pg. 2 Parcel# 2222' S t - 0:1d 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? ---- ---- ❑ 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: Drainfleld&manifold orientation&layout,Septiclpump tank location,North arrow,reserve dralnfield,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 approvpl 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 accurate. ,72j I .L,J ,& 1'1 1 l 7.b Signature of Installer Date )JdFr4 1I 4) era<<:i+ �`.•' Printed Name of Signee c, MASON COUNTY PUBLIC HEALTH .' The undersigned approves this installation Report and 510 3 "; Record Drawing on behalf of Mason County Public �'Lawrence M;Purdum;• LICENSED DESIGNER C� J EXPIRES 2J2512p'2�' Signature of Environment 1 Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Updated 8/2112015 OSS INFORMATION: OSS TYPE:PRESSURE DISTRIBUTION DAILY SEWAGE FLOW:360 GPD DRAINFIELD INFILTRATIVE SURFACE:600 SO FT _� DRAINFIELD LENGTH:200LF DRAINFIELD CONSTRUCTION:HANCOR ARC 36 LP CHAMBERS LATERAL PIPE SIZE:1-IN ORIFICE SIZE:1/8-IN ORIFICE SPACING:48-IN TRENCH INSTALLATION DEPTH:6-IN ADDITIONAL DF COVER:12-IN R / PUMP CONTROL PANEL:SJE-RHOMBUS TD1W914H4DBAC1OE17W PUMP:LIBERTY LP-280,115V.1/2 HP DRAWDOWN:1.625"/MIN PUMP FLOW:32.5 GPM 3 4 Y RESIDIAL HEAD AT LAST ORIFICE:5 FEET ON TIME:110 SECONDS Q M OFF TIME:4 HRS GO .5' GALLONS PER DOSE:59.57 ;� PANEL ?33, DOSES PER DAY:6 2g„ MAXIMUM DAILY SEWAGE FLOW:357.42 GPD ETM990000116 SEPTIC TANK:HAGERMAN PRECAST.1.0 -GAL.CONCRETE PUMP TANK:HAGERMAN PRECAST.1.250-GAL,CONCRETE INSTALLER:NEIL TRIEBENBACH SERVICES,(360)670-8119 3 BR SEPTIC TANK SFR PUMP TANK 46 / OSS RECORD DRAWING ��+++►►► , ; 4646 , SCALE: 1" = 20' ; a 2a RAAFIF4_D / O .%' ' FLUSH PORT(TYP) O� LICENSED DESIGTI"'R IXPIRE52/25/2@] 6/1/26 --0 U, ® NIFOLD 4v ---E ®7 m �ryoi NOTE: PLASTIC SHEETING MUST BE REMOVED FROM DRAINFIELD --9 IN ORDER TO PREVENT FAILURE THIS IS NOT A SURVEY SEPTIC SYSTEM NOTES SITE FEATURES TOPOGRAPHY.ELEVATIONS.AND BENCHMARKS THE ONSRE SEPTIC SYSTEM DESIGNED FOR TMS PROPERTY ME EASED ON ASSUMED DATUM PROVIDED BY THE OWNER ANDPI ISIS THENOTRATE USE WRHASINK GARBAGE DISPOSAL. TOE EIEW CONSTRUCTION PLANNINU REON OF PR POE SED SEPTICDED ,STEMY FOR USE OFA GARBAGE DISPOSAL CAR INCREASE THE WASTE STRENGTH THE REVIEW AND OF THE PROPOSED SEPTIC SENTEM OF THE SEWAGE AND LEAD TO PREMATURE FAILURE OF THE SEPTIC PROFESSIONAL LAND SURVEYOR ALWAYS BE USED TOO CORNERSS.. DESIGN.MIX SEPTIC DESIGN.SIC RECOMMENDS A LICENSED SYSTEM.FOR WHICH THE OWNER I5 RESPONSIBLE. CLIENT: SET RANDOR PRLOT DE A LEGAL SITE PLAN.ELEV SAND TOPOGRAPHY, THE ONSRE SEPTIC SYSTEM DESIGNED FOR THIS PROPERTY 15 INTENDED FOR HOUSEHOLD GREY WATER ANOBLACKWATER PUGET SOUND CONSTRUCTION SERVICES METHODS RND EQUIPMENT C SEWAGE R DRAINS FROMOVERFLOW AND SHOWERS, NIICAL SINKS. SC.STORM *APAVC THIS IS 60TH SURVEY.SITE FEATURES.TOPOGRAPHY.ELEVATIONS DRAINS AND OTHER DRAINAGE SOURCES ME NOT TO RECONNECTED ANDBdCHYARK5 ARE BASED ON ASSUMED DATUM PROVIDED BY TO TOG PRETTY SEWCE SYSTEu THE OWNER AND PIERCE COUNTY PLANNING RECORDS.AND GIS PROPERTY INFORMATION: INFORMATION.AND INTENDED ONLY FOR THE REVIEW AND CONSTRUCTION DO NOT WASH PRIM BRUSHES/ROLLER IN SINKS OR DRAINS THAT OF THE SEPTIC SYSTEM DESIGN. DRAIN TRAT OR SEPTIC TANKS. NOT POUR PAINT INTO SINKS OR 22223-51- 222 r� DRAINS THAT DRAIN INTO THE SE➢TIC TANKS.UYRTHEUSEOFBLFACM, PN: 22223-51-02061 TOTAL MEASUREMENTS PCON ROBOTIC PRISM.R TOP OA FC-2IO DATA COLLECTOR "THAT DRAIN INTOTNOE SEPTIC TASK5�TERM-KILLINGCHEMICALS SITE ADDRESS:1551 E TRAILS END DR SEPTIC DESIGN. L L C AND RAG TAPE PO Box 794.Vaughn,WA 98394 253.509.9922 APEK SEPTIC DESIGN,LIZ RECOMMENDS THAT A LICENSED PROFESSIONAL AREA.M NOT DOSE KE CUTS BR ELOW DRAIK ON NFOELD OR ENCROACH ODACH IMO THT VE DRAINATE RIELU OR TANK AREA LAND SURVEYOR ALWAYS BE USED TO SET CORNERS.ESTABLISH LOT ONES IN ANY WAY THAT WOULD DAMAGE SEPTIC COMPONENTS OR VIOLATE PRESCRIBED SEPTIC �T �T 02 DETERMINE SRE ELEVATIONSANDTOPOGRAPH AND D PROVIDEA LEGAL SITE PLA TEM AS IT. STSCOMPONENTSETBACKS NOTED ON THEAPPROVED SEPDCDESIGN DR MMC2A8-2]2A DRAWN: LP, 6/1/26 PAGE 1 OF 1