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HomeMy WebLinkAboutSWG2026-00146 - SWG As-Built - 7/29/2026 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2026-00146 Parcel # 22318-75-00070 Applicant Name Robert Ramsey Subdivision (Name/Div/Block/Lot) Applicant Address 31 NW Lakeway Dr City, State, Zip Belfair, WA 98528 Installer Name Dave Needham Site Address 640 NE Dewatto Hills Rd, Tahuya Designer Name Rod Left INSTALLATION CHECKLIST Q Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑ Repair ❑ Other System Type Pretreatment to Drip Pretreatment Type Nuwater BNR-500 >5 ft. from foundation? - - - - - -Fr- - ❑ N/A *YES ❑ No >50 ft. from wells? - - - - - - - - - - - - �' �� ❑ ® ❑ Z >50 ft. from surface water? - - - - - - -!- UIJJ ❑ A ❑ Cleanout between building and tank? - 1 - - --- ❑�❑ ❑ V Tank baffles present? - - - - - -- - - J11L - -'- 4 2QZ6 ❑ It ❑ a24" access risers over each compartm rh?. - - ---I- ❑ ❑ ❑ WEffluent filter installed?- - - - - - - ---- !- 0 ❑ ❑ Septic tank size 1000 gal Manufacturer Hagerman & Nuwater D D-box water level and speed levelers used? - - - - - - - - - - - - - - - 0 N/A ❑ YES ❑ NO �0 Manifold/D-box accessible from surface? - - - - - - - - - - - - - - - - ❑ ® El QQCheck valves installed? - - - - - - - - - - - - - - - - - - - - - - - - - - A ❑ ❑ 2 Transport Line Size 1.25" Schedule/Class 40 Bedrooms installed (check one) ❑ 2 ❑� 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10 ft. from foundation?- - - - - - - - - - - - - - - - - - - - - - - - - - ❑ N/A A YES ❑ NO ❑ >100ft. fromwells?- - - - - - - - - - - - - - - - - - - - - - - - - - - - - ❑ ❑l ❑ W >100ft. fromsurfacewater? - - - - - - - - - - - - - - - - - - - - - - - - ❑ 0 ❑ u., >10ft. frompotablewaterlines?- - - - - - - - - - - - - - - - - - - - - - ❑ A ❑ Z > 5 ft. from property lines and easements?- - - - - - - - - - - - - - - - ❑ It ❑ > 30 ft. from downgradient curtain/foundation drains? - - - - - - - - - - ❑ A ❑ Drainfield level and observation ports present - - - - - - - - - - - - - - ❑ © El ❑ Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed overdrainfield?- - - - - - - - - - - - - - - - - - - ❑ A ❑ Pump tank setbacks consistant with septic tank? - - - -- - - - - - - - - ❑ N/A 0 YES ❑ NO Pump tank size 1250 gal Manufacturer Hagerman Z 24"access riser(s)and accessible from surface?- - - -- - - - - - - - ❑ • ❑ H Alarm or Control Panel Installed? - a ❑ ® ❑ Control Panel equipped with Timer/ETM /Counter- - - - - - - - - - - ❑ A ❑ - Pump installed in 0 Bucket or ❑ On Block or ❑ Other a' Pump Make/Model STA-RITE Step 20-03 ❑■ Floats or ❑ Transducer n Tank draw down N/APump capacity in/min ca acit 4 m Squirt Height N/A ft 9P q 9 Pump on time 3 min 45 sec Pump off time 1 HR Daily flow set at 360 gpd Updated 8/21/2018 Mason County OSS Installation Report pg. 2 Parcel# ABANDONMENT RECORD Were existing septic components abandoned as part of this project? ------------- -- ❑ YES NO If yes, please describe: Were aA components pumped out and properly abandoned per WAC246-272A-0300? -------- O YES ❑ NO RECORD DRAWING THae to a pm tec«d wW nand 1»accurate and saecrfpttre ww4h eo rsdocate In the nee or rnkrbenw"wftr3&s and ruhn. Typ w Reoord Drowrye cvrtrn Oranhafd&mw of d onentalron 1 tayo.A,Sepfidpurnp tank bcabon,North arrow,re,e w dralntldd,ezrstng end proposed boa.kxehon of wela,watadmee, weaa obeerv~port+,cwwoo a,and otlmr rnainb -roe 900M pant- krmmp ate Record Draw inpa may create eddtbond detrya in tkud nataMatIon approval and rehrDrd p+muts N 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 /fifheer certify that all information contained on this I further certify that all information contained on this ( _jend aLtated Record Drawl g is accurate. form and attached Record Drawing is accurate. T5- ;7 Slgneture of Installer Date Dav+d Needham Punted Name of Signee MASON COUNTY PUBLIC HEALTH s, The undersigned approves this Installation Report and N� Record Drawing on behalf of Mason County Public LICENSED0ESIGNER ��{ EXPIRES 121151 Heath►: 1 Siynatun of Environmental h speael/at Dete (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Upda d a2vmu AiM !sJrs1u11' 1 11 � . " ' 111 1 •! 1flP1, .• C a 3.av'"(- j1 r • • riii ` r. ,1� tT 1 ' ` I) • • David Anderson From: DO NOT REPLY <noreply@masoncountywa.gov> Sent: Thursday,July 16, 2026 10:19 AM To: Environmentalhealth Subject: OSS Inspection request for Solid Ground Sitework for Robert Ramsey(homeowner) - SWG 2026-00146 Submittal request for: Solid Ground Sitework for Robert Ramsey(homeowner) Site Address: 640 NE Dewatto Hills Rd Permit Number:SWG 2026-00146 Parcel Number: 223187500070 Installer Name: Dave Needham, Solid Ground Sitework Installer Phone Number: 360-340-8001 Installer Email Address: shannon@solidgroundsitework.com Designer Name: Rod Left,Acme Septic Design Designer Email Address: info@acmeseptic.com Inspection Request Date: 2026-07-16 Inspection Type: Full System Comment\ Notes: Please call installer cell, Dave Needham at 360-340-8001 with any questions.Thank you! Thank you for submitting your final install request.The install should be complete and ready to inspect on the 'Inspection Request Date' and remain uncovered for three business days to allow staff time to inspect. Poor weather situations may be accommodated by contacting onsite staff. Installer is responsible for obtaining Septic Designer/Engineer installation approval prior to backfill of system components. If no contact is made by the health department within the three 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 - - 643.64' EXISTING WL 100' 50' TO WELL TO WELL a '?' . I3 r O D AY PANEL 100"%O RESERVE Gj Yr.�K MASON COUNT`(ENVIRONMENTAL HEALTHY^ T s� RE I ROOD IE �� UCENS O U TONER EXPIRES 121151 0' 20' 30 40' 50' 60' 80' 100' RECORD OF CONSTRUCTION SCALE(FEET) THIS /S NOT A SURVEY ALL PROPERTY LINES/BOUNDARIES HAVE LEGEND BEEN DEMONSTRATED BY THE OWNER(S) AND/OR THEIR AGENT(S). �` g SOIL AC UI E D E S I G N --- - NO BUILD ZONE * ALL MEASUREMENTS WERE TAKEN FROM KNOWN POINTS DEMONSTRATED BY THE PROPERTY OWNER. = AREA -- =CLEARING LIMITS DATE- 20 JULY 2026 LOW S • P.O. BOX 2954 * ALL MEASUREMENTS WERE TAKEN WITH AN OPEN-REEL FIBERGLASS TAPE MEASURE. :TREES- 12"DIA NAME- RAMSEY SILVERDALE, WA. * NO FOUNDATION SPOILS OR BURNING ON DRAINFIELD AREAS. Q = CLEAN OUT 98383 * DUE TO UNFORESEEN WATER TABLES, A CURTAIN DRAIN MAY BE REQUIRED. O =ATU DEVICE TAX ID- 22318-75-00070 * DIRECT ALL DOWNSPOUT/SURFACE WATER AWAY FROM DRAINFIELD AREAS. O = 1200-GAL PUMP TANK STREET- 640 NE DEWATTO HILLS RD TEL. 360-698-8488 * ALL TANK ACCESS COVERS ARE RISERED TO FINISHED GRADE. Q =HEADWORKS INF0@ACMESEPTIC.00M ® =AIR-RELIEF VALVE SCALE: 1" 50' ROC 0' 20 30' 40' 50' 60' 80' 100' SCALE: 1 =50 SCALE(FEET) 643.64' EXISTING W L 100' 50' TO WELL TO WELLN 'V r r ` . s a S Ct ® I f O ':+` CD DV. AY s PAN I RESERVE GJv }?iD = CLEAN OUT Pp UCEN! 910NER zQ =ATU DEVICE R®,/ EXPIRES 12/1S/. Q - 1200 GAL PUMP TANK Ju Y E�f 0 =HEADW0RKS MASON L 292026 Q =AIR-RELIEF VALVE COUNrYENpON ,IT REr ME'l IAL HEALTH 660.63' ISTING 30' A ESS/UTILI EASEMEN