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HomeMy WebLinkAboutSWG2025-00148 - SWG As-Built - 7/29/2026 .y Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2025-00148 Parcel# 22005-52-00064 Applicant Name Adam Hunter Subdivision (Name/Div/Block/Lot) Applicant Address 2201 93rd Ave Sw City, State, Zip Olympia,WA 98512 Installer Name Joe House Site Address 2910 E Phillips Lake Loop Rd. Designer Name Adam Hunter INSTALLATION.CHECKLIST ❑ Full System Installation ]Tank(s)Only ❑ Drainfield Only 0 Repair ❑Other System Type pressure Pretreatment Type >5 ft. from foundation? --- ---- - - - ------- ❑ NIA YES ❑ Na >50 ft,from wells? - - - - -- -- -- - , �q ❑ © ❑ >50 ft.from surface water? -- - �/ '- ❑ ❑ H Cleanout between building and tank? ❑ ® ❑ �y . Tank baffles present? -__ __ __ _ ❑ ❑ I'-'. 24"access risers over each compart ----- - - ---r - ❑ ® ❑ fW Effluent filter Installed?-- - - -- - ! .. ❑ ® ❑ Septic tank capacity(working) 1100 gal Manufacturer HB Precast D-box water level and speed levelers used? -- - - -- -------- - ❑ N/A [] YES ❑ NO O Manifold/D-box accessible from surface?---- ---- -- ------ - ❑ O ❑ Q.z • Check valves installed? --- -- -- - - ---- ---- - -- --- --- ❑ ❑ ❑ 9 Transport Line Size 2" Schedule/Class Schedule 40 Bedrooms installed (check ❑3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10 ft.from foundation?- - -- - ---- -- ---- - -- - - - - - - - -- ❑ N/A JYE8 ❑ NO Q >100 ft. from wells?-------- --- --- ---- -- ------- -- ❑ ® ❑ O,W . >100 ft. from surface water? --- --- ---- --- ---- - - --- - - ❑ III ❑ Ii. >10 ft.from potable water lines?- --- ----- - --- -- - - --- - - ❑ © ❑ •? > 5 ft.from property lines and easements?- -- - --- -- - - - ---- ❑ ® ❑ >30 ft.from downgradient curtain/foundation drains?- -- - - - - - - - ❑ Q ❑ • Drainfield level and observation ports present - -- -- - -- - - -- -- ❑ ® ❑ ❑ Graveless chambers or i] Clean gravel used? (check one) o N �E,) Proper cover installed over drainfield?- -- - - ---- -- - -- - - --- ❑ ® ❑ Pump tank setbacks consistent with septic tank? -- -- -- -- ---- - ❑ N/A ® YES ❑ NO •Pump tank capacity(flood) 1100 gal Manufacturer HB Precast .24"access riser(s)and accessible from surface?------- - ----- ❑ ® ❑ a Alarm or Control Panel Installed? - -- -- - -- --- --- - ---- - - ❑ 0 ❑ • Control Panel equipped with Timer!ETM/Counter-- -- --- -- - ---- -- - - ❑ ® ❑ Pump installed in ❑ Bucket or ® On Block or ❑ Other IL Pump'Make/Model Liberty PRG101A ® Floats or ❑ Transducer p=- Tank draw down ---- In/min Pump capacity — gpm Squirt Height G L OW '» ft Pump on time Pump off time Dally flow set at 120 gpd Updated 8121/2018 Mason County OSS Installation Report pg. 2 Parcel# 22005-52-00064 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? ---- -- ----- - --- 0 YES O NO If yes, please describe:pumped and abandoned 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,cteanouls,and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and related permits. Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNERI 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 I further certify that all information contained on this for and attached Record Drawing is accurate. form and attached Record Drawing is accurate. ignature of Installer Date Printed Name of Signee MASON COUNTY PUBLIC HEALTH ^• i : '/ The undersigned approves this Installation Report and / ., •�� Record Drawing on behalf of Mason County Public ADALQ J.HUNTGR Health: "7 rM^ 1'ii fr;fiLtj 141'?;;i'N . .:. �,V 1 J2_t Lit%,rS 071121 Signature of Environmental Health Specialist -I Date// (stamp, signature andB date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Updated 81212018 NOTE:THE ADDITIONAL SEPTIC TANK IS T HELP MITIGATE THE LURRY DUE TO THE UMP BAST 1 AND GRINDER PUMP BY THE CABIN BY DOUBLING THE NUMBER OF COMPARTMENTS AND SOAK TIME SD" Q EXISTING WELL - PUMP HAMBERcoI / I 27' / 2 COMP.SEPTIC TAN �O5GP / 2 COMP.SEPTIC TA K X50'-?2 PVC TIGHTLINE(SCH40) 4"FLOW R CER WITHIN 5FT OF SEE/ PIT 3 \ 1 10 EXISTING DRIV EXISTING PERMITTED SEEPAGE PIT(#3630) r EXISTING 1 BDRM AB FORCEMAIN \ CRUSHPROOF SLEEVE U R DRIVE / 4"FLOW REDUCER REQUIRED WITHIN 5FT OF TA LET SUN DE TIGHTLIN ANDONED) / EXISTIN ST'BOUT E NOUT) , DOCK !•:_... IZO .� C.e. FAILED SEPTIC/PUMP TANK(ABANDO PER COD / 6FT RETAINING PUMP BAS / •.v, fix'• V:1: ADAI.I J.IIl1YTER 1};i P�IILLIPS ''i'i'1';;,tS ih 5':+f T SCALE-1"=30'-0" Ir PUMP TO GRAVITY APPROVED JUL 292026 . MASON COUNTY ENVIRONMENTAL HEALTH RET JIM HUNTER & ASSOC. CONTRACTOR P.O. BOX 162,OLY,WA98507 HOUSE BROTHERS 753-1226 JHANDASSOCIATES@HOTMAIL.COM INSTALL DATE- 5/28/26 RECORD DRAWING SITE ADDRESS/LEGAL 2910 E PHILLIPS LAKE LOOP RD OWNER- JEFF BOWERS FINAL DATE- 5/28/26 TP# 220055200064 SITE# 2025-00148