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HomeMy WebLinkAboutSWG2026-00182 - SWG Application / Design - 7/29/2026 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2026-0Q182 Parcel # 32006-50-02104 Applicant Name THOMAS PAUL Subdivision (Name/Div/Block/Lot) Applicant Address 2220 E ISLAND LAKE DR City, State, Zip SHELTON, WAi. 98584 Installer Name SCHOENING EXCAVATION Site Address 2220 E ISLAND LAKE DR Designer Name CINDY WAITE INSTALLATION CHECKLIST ® Full System Installation O Tank(s)Only ❑ Drainfield Only ❑ Repair ❑Other System Type PRESSURE Pretreatment Type SAND AUGMENTED >5 ft. from foundation? - _ _ rte. >50 ft. from wells? - - - - - - - - - B �� N/A- ❑ 01 0 NO >50 ft. from surface water? - - - - - Cleanout between building and tan _ ,J_ 02E_ _ _ ❑ �, ❑ ❑ ❑, ❑ 24"access risers over each compartr t?- _ ____ 4 -_. ❑ ❑, ❑ NEffluent filter installed?- _ _ _ _ _ _ _ _ _ ❑ ❑, ❑ Septic tank capacity (working) Jr? / 7..5p gal Manufacturer .L ,•/ 0 D-box water level and speed levelers used? - - - - - - , - - - - - - - - N/A ❑ YES ❑ NO m O Manifold/D-box accessible from surface?- _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - ❑ � ❑ QQ Check valves installed? - _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ❑ ❑ 2 Transport Line Size 2 ' Schedule/Class Sch cic.r( '-10 Bedrooms installed (check one) Q 2. ['3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10ft. fromfoundation?- - - - - - - - - - - - - - - - - - - - - - - - - ❑ NIA YES NO >100ft. fromwells?- _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ ❑ ❑ W >100ft.fromsurfacewater? - - - - - - - - - - - - - - - - - - - - - - - ❑ ❑ z >10ft. frompotablewaterlines?- _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _. ❑ ❑ > 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? - - - - - - - - - - - - - - - - - _ ❑ O Pump tank setbacks consistent with septic tank?-- -fl1- 12SO __ . ❑ N/A YES ❑ NO Y Pump tank capacity(flood) 4l V" "_gal Manufacturer JJ rl \ r \ l2-. C) Z < 24"access riser(s)and accessible from surface?- - - - - - - - - - - - _ ❑ ❑ Alarm or Control Panel Installed? • - - - - - - - - - - - - - - - - - - - - ❑ ❑ D Control Panel equipped with Timer/ ETM/Counter- - - - - - - - - - - ❑ ❑ Pump installed in ❑ Bucket or ['On Block or ❑ Other 2 d Pump Make/Model ? 2 r(? ❑ Floats or [Transducer Tank draw down f,'7 in4nin Pump capacity '-y7,...f/ gpm Squirt Height / ft Pump on time- ( . ,, , Pump off time G A Daily flow set at .2 JPS gpd Updated 8/21/2018 Mason County OSS Installation Report pg. 2 Parcel # 32006-50-02104 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - - - - - - - - - - - - - - 'YES ❑ NO If yes, please describe: Qw& R e mNr Z 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. /^v r/r.GJr J a-, 2 '? cif,✓ ❑ Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ENGINEER /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 form and attached Record Drawing is accurate. form and attached Record Drawing is accurate. Signature of Installer Date Printed Name of Signee 4 insq' MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and y > >s CINDY E WAIVE Record Drawing on behalf of Mason County Public LICENSED DDSIGNER Health y O ExtiRLs osno; f Signature of Environmental Health Specialist Date r;' (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Updated 8/21/2018 6•��v c ' 'aria Lake or, Shelton, WA 98584, USA, Shelton Township, Parcel Id: 32006500.,- 04 GlS Legend WA Mason 10�. Cont �l0 ours ` f-_ v LL __�l v ,3�' � rQ - L v `• al�y uYp!U: y N . .v T h QZ .Residence - 2- 1200 9a11ori septic tank + `J !6 3 -1200 gailon pumptank - 4 - - ~' Audiblejvisual alarm 1 5- _Outbuildings '• 6 Primary dralnfield 7 _Owners w�e11 8 Waterline so ' 141TranPort line r , Clean out 11 NOJ9hbors well - fl 2 ,v Td— E CH MARK oundatlon 1 100.6 6sPtic bank 2 09.50 I PUMA Tank 3 09,94 tt�fn of drainflolra 4 97.0 9 L4 . poi • A I " : ya- " 1In : 4oft N DRAINFIELD LAYOUT l %4 oN��NTq�ti _._.,....n-��.._.._ roe d Yg y X1=CLEANOUT/OBS PORTS 4' `� `� �y cam, X2=D BOX/VALVE BOX P '" '. X3=Check Valves s,aoa `�� X4=Flow Control CINOY E.WAITE' � . LICENSED CFSIGNfR f ontrol Valves X5=Soil Logs LXPIRES 0510 O.8r p , -�-v �� / .:c ,ti s�,,d I • 11 tQr1 ,J '* ;- S�. hd •rz. err t • �► r @ 41 � ,,.:k' yr,,.,,.,.-.�,., DO NOT REPLY <noreply@masoncountywa.gov> Sen : Monday,July 13, 2026 12:01 PM To: Environmental health Subject: OSS Inspection request for Thomas&Sandra Paul-Swg2026-00182 Submittal request for:Thomas&Sandra Paul • Site Address:2220 e island lake dr Permit Number:Swg2026-00182 Parcel Number: 320065002104 Installer Name:Schoening excavating Ilc D L-,lJ \/ Installer Phone Number: 3607422982 RM JUL 1 3 2026 r Installer Email Address: brayde@schoeningex.com By Designer Name: Cindy Waite Designer Email Address: cindyewaite@msn.com Inspection Request Date:2026-07-13 Inspection Type: Full System Comment\Notes: Repair. Full system.Tanks&sand lined bed Thank you for submitting your final install request.us business daasl should to allowb tall time lete to insdpectready .Poor weather s'tuationpsemayn Request Date' and remain uncovered for three days be accommodated by contacting onsite staff. t If no o tact is Ier is responsible mlade by obtaining health depaartmentrwithin the three/Engineer approval prior to backfill of system components. business days of notice,the installer may cover. Mason County Asbuilt Form, Record Drawing,and Installation fee must be submitted for final installation approval. 1