HomeMy WebLinkAboutSWG2022-00505-ASBUILT - SWG As-Built - 6/15/2026 ' R
Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC h EALTH
APPLICANT/ PERMIT INFORMATION sW
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Permit Number SVUG �! �7 - (»�� _ Parcel # Z1 2 (7b 206
Applicant Name 1\;b____ Subdivision (Name/Div/Block/Lot)
Applicant Address _(La.
3 ,J
City, State. Zip �:l rC- 3P t P1 _ ) C1 try LD Installer Name
Site Address j j n �J( Designer Name
INSTALLATION CHECKLIST
❑ ❑
Full System Installa Drainfield on ❑Tank(s)Only ❑ Only Repair Other BNR5 0
System Type Qcc5s retreatf<nent Type Nu w�.�cl
-� N/A YES ❑ NO
>5 ft. from foundation? - - - - - - - - I❑ .�
>50ft. fromwells? - - - - - - - - - - - - _
Z >50 ft. from surfacewater? - - - - - - - - ❑
Cleano eenut betw building and tank?
lank baffles present? - - - - - - - - - - - - - _ __��.- ❑ j
a24' access risers over each compartment? - - - - - - - - - - - - —-- ❑ ❑
W Effluentfil:erirlstalled?- - - - - - - - - - - - - - - - - - - - - - - - / ❑ ❑I o c ;
Septic tank capacity (working) gal Manufacturer
YES NO
_Q D-box water level and speed levelers used? - - - - - - - - - - - - - -- N/A ❑ ❑
Manifold/D-box accessible from surface?- - - - - - - - - - - - - -
- 0
m— Check valves installed? - - - - - - - - - c\- - - - -
oQ
2 Transport Line Size 2" Schedule/Class 40
Bedrooms installed (check one) ❑ 2 ❑ 3 ®4 ❑ 5 ❑6 ❑Commercial/Other
>10ft. fromfoundation? - - - - - - - - - - - - - - - - - - ' - - - - - - N/A ❑ YES ❑ NO
❑ .� ❑ ��
>100ft. fromwells? - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
>100 ft. from surface water? - - - - - - - - - - - - - - - - - - - - - - ❑ /
�j ❑
W
LL >10 ft. from potable water lines?- - - - - 0 Z - - - - - - - - - - - - - - -
❑5 ft- from property lines and easements?- - - - - - - - - -
- - - - - - ❑ ❑
IX > 30 ft.from downgradient curtain/foundation drains? - - - - - - - - - - ❑
Dr infield level and observation ports present - - - - - - - - - - - - - -
Graveless chambers or ❑ Clean gravel used? (check one) ❑
Proper cover installed over drainfield?- - - - - - - - - - - - - .- ❑
NO
Pump tank setbacks consistent with septic tank? - - - - - - - - - - - - - ❑ N/A YES
Manufacturer eJ 12)0r
Y Pumo tank capacity(flood)_________gal
Q 24" access riser(s)and accessible from surface? - - - - - - - - - - - - - ❑
❑
AlarmorControlPanelInstalled? - - - - - - - - - - - - - - - - - - - -- ❑ t�
❑ ❑
Control Panel equipped with Timer/ ETM I Counter- - - - - - - - - - -
- Pump installed in ❑ Bucket or On Block or ❑ Other
Pump Make/Model 2Alor 153
Floats or ❑ Transducgr
72 m Squirt Height ft
Tank draw down �- 3 in/min Pump capacity _gp
Pump on time
1.1 M I N Pump off time Daily flow set at gpd
Mason County OSS Installation Report pg. 2
Parcel#
ABANDONMENT RECORD
Vere existing septic components abandoned as part of this project? - - - - - - - - - - - - - -
YES NO
If yes. please describe -tdo Nl
Were all components pumped out and properly abandoned per WAC246-272A - -
RECORD DRAWING
I Reccr;;
This is a permanent record and must be accurate and descriptive enough to re-locate in the need of maintenance actnities and fut tal development.
n`weyL a?etlmes.
Draxyngs cony^ C•a.ifleld&manl+ole or entatldn&layout SeptJUpump tank Iecanor \oc^a- .'ese e eram`:eld ec�sting and proposed du n9
s:,ells,o ervalton e •ctcanes.and ether mavtienance access pants. Incomplete Recd,:: ]'aKlncs mat c'eate additional delays in final irslatla`jon approval and•ela d oermd-.
Record Drawing ached
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 al*or-
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
l further certify that all information contained on this 1 further certify that all information contained on this
form and attached Record Drawing is accurate. form and attached Record Drawing is accurate.
Sign 1Ture of InstallerDate
Printed Name of Signee
MASON COUNTY PUBLIC HEALTH `~ T
The undersigned approves this Installation Report and
Record Drawing on behalf of Mason County Public ADAtI TER
•t..l ,r
Health >s S.'
. .-i 4
Signature of Environ ental Health Specialist Date (stamp. signature and date)
-HIS FrIRM MAY RF Sr.ANNF-n ANTI AVAII ARI F FnR Pt lRl Ir:VIFW nN THE MASON r.nl INTY VJFR SITE
ated&'21!2018
I
SCALE:1"=100FT DRAINFIELD AND R/A
I I 1094.3
4B RM RES
iI SEE DETAIL
RIVE
SHED/CARPORT
358.7
332.2
' ri-
TANKS
II
OFFICE
1234.0 WELL
I �
/ ,
/ //' /
/ / / PRESSURE TEST COMPLETED BY INSTALLER:
70.0/
.0 ERV// / 4 BDRM RES SQUIRT HEIGHT:60"
/ 2
INSPECTION PORTS/ T.CLEANOUTS DRAWDOWN:3 IN/MIN
MER SETTINGS-
/ // // ON:1.1 MIN
/ // // ;
TI OFF:4 HRS
/ / /I/D / STUBOUT/CLEANOUT
NWJATER BNR500 ATU
4]A
/ /70.0
HUNTER SEPTIC DESIGN CONTRACTOR:
2201 93rd Ave SW/Olympia,WA 98507 HOUSE BROTHERS
TIGHTUNE(CLEANOUTS EVERY 100FT) 380-890-2778/atlam@huntemeptictlesign.com INSTALL DATE:7162023
VALVE BOX PUMP CHAMBER SITE ADDRESS I LEGAL
NICOLAE NUTRECORD DRAWING FOR: 110 E ELDAMAR HOLLOW
SCALE:1"=30FT U
FINAL DATE: 7/72023
FORCEMAIN PARCEL NUMBER: ATE I PERMIT#:
221212002000 2022-OD505
APPROVED
.1UN 2 9 2026
MASON COUNTY ENVIRONMENTAL HEALTH
RET
y.
JUNE 10,2026
To whom it may concern,
My name is Talesha Tenorio, I am Nicolae Nutus personal
assistant and project manager for his new home Build, Parcel
number 221212002000 . we have decided to use a new septic
designer for finish our septic permit; we will be using Hunter
Septic Design to complete permit number SWG2022-00505 with
Mason County due to Larry with APEX being non responsive with
phone or email communication.
Thank you,
Talesha norio- Project ager Nicolae Nutu-HomeOwner
4