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HomeMy WebLinkAboutSWG2026-00105 - SWG As-Built - 7/23/2026 ? R Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2026-00105 Parcel # 12107-41-90130 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 3550 E Grapeview Loop Rd. Designer Name Adam Hunter INSTALLATION CHECKLIST ❑ Full System Installation ❑Tank(s)Only ❑ Drainfield Only 0 Repair ❑Other System Type Nuwater ^ Pretreatment Type f3v-. Shv >5 ft. from foundation? - - ------ -- ff� - -- ❑ N/A ®YES ❑ No >50ft.fromwells? - -- --- - -- - --- - - ; _I�� -�/7 © ❑ Z >50 ft.from surface water? - - - - - -- - - 1�-- - ❑ ❑ < Cleanout between building and tank? - - -- - -J -��E - ❑ V Tank baffles present? - - 0 LI ❑ a24"access risers over each compartment?--- - -- - - -- --- - ❑ ® ❑ W Effluent filter installed?- ------- --- -- -- - ---- -- - - - 0 Elrn Septic tank capacity(working) BNR 500 gal Manufacturer Sound Placement 0 D-box water level and speed levelers used? - --- --- - --- --- - ❑ NIA ❑ YES 0 NO M Manifold/D-box accessible from surface?---- -- ------- --- - ❑ ❑ ❑ oaCheck valves installed? ---- - -- - - - - - -- - --- - - - - - - -- ❑ ❑ ❑ 2 Transport Line Size 1.25" Schedule/Class schedule 40 Bedrooms installed (check one) ❑ 2 ❑3 ❑■ 4 ❑ 5 ❑6 ❑Commercial/Other >10ft.fromfoundation?- ---- - - - -- - - - ---- -- -- -- - -- ❑•NIA ® YES ❑ NO O >100ft. fromwells?- - ------- -- -- -- - -- ---- --- -- -- ❑ ® ❑ W >100ft.fromsurfacewater? -------- - - - ------- - --- - - ❑ ® ❑ u- >10ft.frompotablewaterlines?--------- -- -- -- ------ - ❑ ❑■ ❑ Q > 5 ft.from property lines and easements?- - - - - -- -- - - - - - -- ❑ © ❑ G > 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?- - ---- -- --- ------ -- ❑ © ❑ Pump tank setbacks consistent with septic tank?-- ---------- - ❑ NIA U YES ❑ NO `-r Pump tank capacity(flood) 1200 gal Manufacturer HB Precast Q24"access riser(s)and accessible from surface?-- -- - - -- - -- -- ❑ © ❑ Alarm or Control Panel Installed? -- --- - -- -- - -- - --- ❑ U] ❑ Control Panel equipped with Timer/ETM/Counter-- - - -- - -- - - ❑ 0 ❑ . Pump installed in ❑ Bucket or 0 On Block or ❑ Other U' Pump Make/Model Orenco PF200511 ® Floats or ❑ Transducer Tank draw down in/min Pump capacity gpm Squirt Height NA ft Pump on time LM -7•l L.,, Pump off time 2hr Daily flow set at -300 gpd Updated 812112018 JJ Mason County OSS Installation Report pg. 2 Parcel# 12107-41-90130 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - - ----- -- ---- - -- 0 YES ❑ NO If yes, please describe:tank abandoned per code Were all components pumped out and properly abandoned per WAC246-272A-0300? --- -- - -- Ill 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.Septicipump 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. ❑ 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 I further certify that all information contained on this form and attached Record Drawing is accurate. form and attached Recor Drawing is accurate. b4 2L igna utre of Install r Date �,_:. Printed Name of Signee MASON COUNTY PUBLIC HEALTH 51 UU412 ''•�% The undersigned approves this Installation Report and -� `.;: ADAPA J.HUNTER `( Record Drawing on behalf of Mason County Public )'I�t;' i;` ';;1 : ] 'i' ' Health: rS k`,: `•. -c iJ7:f4 Signature of Environme tat Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Updated 821/2018 / I 456.6 SCALE: 1" = 60FT 1 { SUhL 12 T � 2 T lea--465 5 260.2 ' J 24.o s OSCAR a p IIR/A9 %00 99 98 96 L -1 / I SCALE: 1" - 30FT iO EXISTING 4 BDRM RES / 4 12 O EXISTING WELL ` ' I EXISTING DRIVE 05/21/2026 4O EXISTING STUBOUT I CLEANOUT(IE.-97.5) 36.0 ABANDONED SEPTIC TANK(PER CODE) 6 6 NUWATER BNR500 ATU .`'•r ° \\ O PUMP CHAMBER ~AD U TEs;V :.I.i.I Fi "ill"'"!ii•i:ice+ \ 7.11l?S11tiXt\C`�V! p _ 8O 1.25"PVC SUPPLY AND RETURN LINES(SCH40) 40.0 1 1 O 9O EXISTING DRAINFIELD(LOCATED BY OTHERS)-ABANDONED 190' I O 10 SHEDS/BARNS/CARPORT PRESSURE TEST COMPLETED BY INSTALLER: 11 WATERLINES SQUIRT HEIGHT: EV 1k 12 DRIP D.F.(1440FT2/6 LATERALS 160FT EACH) 13 DRAWDOWN: j.l I RBM IS GROUND EL.@ HOUSE CORNER(RBM=100.0) TIMER SETTINGS- ON: OFF: L t-+F- APPROVED J U L 2 3 20Z6 CONTRACTOR: MASON COUNTY ENVIRONMENTAL HEALTH 2201 SEPTIC DESIGN HOUSE BROTHERS RET 2201 93rd Ave SW/Olympia,WA 98507 360-890-2778/designs@hunterseptic.com INSTALL DATE: 5/22/26 SITE ADDRESS I LEGAL: RECORD DRAWING FOR: 3550 E GRAPEVIEW LP RD DEBRA HALL FINAL DATE: 5122/26 SITE I P ERMIT#: PARCEL NUMBER: 121074190130 SWG 2026-00105