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HomeMy WebLinkAboutSWG2025-00141 - SWG As-Built - 7/3/2026 s Mason County 0SS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2025-00141 Parcel # 42329-50-00035 Applicant Name KENNETH DIRKS - Subdivision (NamelDiv/Block/Lot) Applicant Address 852 N 145TH LANE City, State, Zip SHORELINE, WA. 98133 Installer Name SCHOENING EXCAVATION Site Address 30 N LAKESHORE PLACE Designer Name CINDY WAITS INSTALLATION CHECKLIST ® Full System Installation ❑ Tank(s) Only ❑ Drainfield Only ❑ Repair ❑Other System Type X02 TO OSCAR DRAINFIELD Pretreatment Type - - ❑>50 N/A Q YES ❑ NO ft. from wells? - - - - - - _ _ �r � ❑ � ❑ Z >50 ft. from surface water? - - - - tttt rr _ _ _ _ _ ❑ O ❑ Cleanout between building and tank - - - - - - - - -2_0261 _ U _ _ ❑ U Tank baffles present? - - - - _ _ _ _ _ _ _ ❑ a ❑ it ❑ 24" access risers over each compa - WEffluentfilterinstalled?- _ _ _ _ _ _ _ _ _ _ _ _ _ _ it ❑ ❑ Septic tank capacity (working) 1060 gal Manufacturer INFILTRATOR 0 D-box water level and speed levelers used? - _ _ _ _ _ _ _ _ _ _ _ _ _ _ >O Manifold/D-box accessible from surface?- - - - - - - - - - - - - - - - ❑ YES ❑ NO OOz - Check valves installed? - _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ❑ ❑ OQ A 'I M Transport Line Size 1 Schedule,B+ass Lf //41 Bedrooms installed (check one) ' ❑ 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10ft. fromfoundation? - - - - - - - - - - - - - - - - - - - - - - - - - - ❑ N/A ❑j YES ❑ NO >100ft. fromwells? - - - - - - - - - - - - - - - - - - - - - - - - - - - - ❑ 0 ❑ W >100ft. fromsurfacewater? - - - - - - - - - - - - - - - - - - - - - - - - ❑ it ❑ Z >10ft. frompotablewaterlines?- - - - - - - - - - - - - - - - - - - - - - ❑ 0 ❑ a > 5 ft. from property lines and easements?- _ _ _ _ _ _ _ _ _ _ _ _ _ _ - ❑ it ❑ W > 30 ft. from downgradient curtain/foundation drains? - - - - - - - - - - Drainfield level and observation ports present - - - - - - - - - - - - - - ❑ ® ❑ avcir c�azi�arrr[�err ^r yp�n�_r 7 (check one) O cc o Proper cover installed over drainfield? - - - - - - - - - - - - - - - - - - ❑ Ill ❑ Pump tank setbacks consistent with septic tank? - - - - - - - - - - - - - ❑ N/A © YES ❑ NO z Pump tank capacity (flood) 1287 gal Manufacturer INFILTRATOR 1060 24" access riser(s) and accessible from surface?- - - - - - - - - - - - - ❑ 0 ❑ Alarm or Control Panel installed? - - - - - - - - - - - - - - - - - - - - - ❑ ® ❑ Control Panel equipped with Timer/ ETM / Counter - - - - - - - - - - ❑ ® ❑ a Pump installed in ❑ Bucket or 0 On Block or ❑ Other Pump Make/Model , �Cd2 � ® Floats or ❑ Transducer Tank draw down n inmin Pump capacity/ gpm Squirt Height ft Pump on time 22SEC Pump off time 3.5 MIN Daily flow set at 90 gpd Updated 8/21/2018 f.. Mason County OSS Installation Report pg. 2 Parcel# 42329-50-00035 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 relocate 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. Tc=) k- /0 C l a a o yr a -/V / r.v f{mil ❑ 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 /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 ing is accurate. Signature of Installer Date R S�.Op asti �9� Printed ame of Signee 5100418 N O CINDY E WAITE �, MASON COUNTY PUBLIC HEALTH l LICENSED[) SIGNER The undersigned approves this Installation Repor4 nd RecordSi Drawing on behalf of Mason County Publir�F �0�6, Health: rt rti Signature of E vironmental Health Specia ist 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 :• 510 �' 40 Lakeshore PI, Hoodsport, WA 98548, USA, West Mason Township, Parcel Id 423295000035 suu //\\ ! '' \ I Primary drainfield - 2 �'% n ��� 79Ø.0 790 - 3 1000 tan um gallon an p p k 4 Transport line • " �P 1 5 Existing Pump vault Existing septic tank to be filled p C 9 _ 4+ with C-33 sand / /� •O r /BENCH MARK �fri o Original grade ; Septic tank 1 100.00 Pump Tank 2 99.50 Drainfield bottom of gravel 3 99.00 -_ F�i 4 r I o4p' nUQ .. J o \}Lc , / / 760.0 G -Led WA f.tas 1d'Contours , . 7aO,U r ` t l A 7S0•U ��J' Scale =>.1 in . 20 ft N •. •.m• . MASON COUNTY Public Health & Human Services FINAL INSPECTION: SWG2025-00141 ADDRESS: 30 N Lakeshore P1 PARCEL: 42329-50-00035 DATE: 6/23/2026 is HOUSE TO DRAINFIELD r >,r',_ s' ,un ..urn!IR.G r'. _ 1! =sue 3 DRAINFIELD TO HOUSE David Anderson From: DO NOT REPLY <noreply@masoncountywa.gov> Sent: Thursday,June 18, 2026 3:52 PM To: Environmentalhealth Subject: OSS inspection request for Ken Dirks - SWG2025-00241 Submittal request for: Ken Dirks Site Address: 30 N Lakeshore Place 00141 Permit Number:SWG2025-00241_ ✓b� Parcel Number:423295000035 Installer Name:Schoening Excavating Installer Phone Number:3607422982 Installer Email Address: brayden@schoeningex.com Designer Name: Cindy Waite Designer Email Address: cindyewaite@msn.com Inspection Request Date: 2026-06-18 Inspection Type: Full System Comment\ Notes: Repair.Tank location moved.Approved by designer. r submitting your final install request.The install should be complete and ready to inspect on the'Inspection Thank yo u fo Request Date' and remain uncovered site staff. Installer b is responsible l ortobtaining Septic Designer/Engineer installation contacting be accommodated by stem components. If no contact is made by the health department within the three approval prior to backfill of sy cover. Mason County Asbuilt Form, Record Drawing, and Installation fee must s of notice.the installer may business day approval. be submitted for final installation 1