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HomeMy WebLinkAboutSWG2025-00245 - SWG As-Built - 6/29/2026 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2025-00245 Parcel # 220297500010 Applicant Name Steve Perschon Subdivision (Name/Div/Block/Lot) Applicant Address P.O, Box 11265 City, State, Zip Olympia, WA 98508 Installer Name Steve Perschon Septic Specialists I Site Address 201 SE Lazy Dog LN Designer Name Adam Hunter @ Hunter INSTALLATION CHECKLIST ❑ Full System Installation ❑■ Tank(s) Only ❑ Drainfield Only ❑ Repair ❑Other System Type Simple Pressure retreatment Type >5ft. fromfoundation? - - - - - - - - - - - - - - - �Q�1- - -~ - ❑ N/A RYES NO >50 ft. from wells? - - - - - - - - - - - - - - - -- ---- - - - � r❑ X ❑ Z >50ft. fromsurfacewater? - - - - - - - - - - - -Iz- - --- ❑ ❑ Cleanout between building and tank? - - - ----E! 9-- -- ❑ 0 ❑ U Tank baffles present? - - - - - - - - - - - - - ❑ UI ❑ 24" access risers over each compartment?- - - - !/- - ❑ F ❑ WEffluent filter installed?- - - - - - - - - - - ---'z - - - - -t- - - ❑ ❑ Septic tank capacity (working) 2x1200 1X100 g an urer Sound Placement D-box water level and speed levelers used? - - - - - - - - - - - - - -- - N/A ❑ YES ❑ NO DO Manifold/D-box accessible frortp surface?- - - - - - - - - - - - - - - - - ® ❑ ❑ mZ Check valves installed? - - - - - - - - - - - - - - - - - - - - - - - - - - ❑ ❑ EXISTING EXISTING Transport Line Size Schedule/Class Bedrooms installed (check one) ❑ 2 ❑ 3 ❑4 ❑ 5 ❑■ 6 ❑Commercial/Other >10ft. fromfoundation?- - - - - - - - - - - - - - - - - - - - - - - - - - ❑ NIA OYES LINO >100ft. fromwells?- - - - - - - - - - - - - - - - - - - - - - - - - - - - - ❑ ❑■ ❑ —J >100ft. fromsurfacewater? - - - - - - - - - - - - - - - - - - - - - - - - ❑ ❑I ❑ W IZ >10ft. frompotablewaterlines?- - - - - - - - - - - - - - - - - - - - - - ❑ 0 ❑ Z > 5 ft. from property lines and easements?- - - - - - - - - - - - - - - - ❑ ❑ ❑ C > 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?- - - - - - - - - - - - - - - - - - - Li Eli ❑ Pump tank setbacks consistent with septic tank? - - - - - - - - - - - - - ❑ N/A ® YES ❑ NO Pump tank capacity (flood) 2700 gal Manufacturer Sound Placement Q24" access riser(s) and accessible from surface?- - - - - - - - - - - - - ❑ ■❑ ❑ Alarm or Control Panel Installed? - - - - - - - - - - - - - - - - ❑ © ❑ Control Panel equipped with Timer/ETM /Counter - - - - - - - - - - ❑ ® ❑ Pump installed in ❑ Bucket or ❑■ On Block or ❑ Other _ Pump Make/Model 2x Barnes 2SEV514L, Liberty LE71 ii Floats or ❑ Transducer d Tank draw down 2" in/min Pump capacity 90 gpm Squirt Height 3.6 ft Pump on time 1.33 min Pump off time 4hrs Daily flow set at 720 gpd Updated 8/21/2018 Mason County OSS Installation Report pg. 2 Parcel# 220297500010 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 Q 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,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 /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 l further certify that all information contained on this l further certify that all information contained on this form and ttached Record Drawing is accurate. form and attached Record Drawing is accurate. %42o Signature of Installer Date Printed Name of Signee /16/2. MASON COUNTY PUBLIC HEALTH :,, The undersigned approves this Installation Report and •' Record Drawing on behalf of Mason County Public Health: / ' T �DAfA J.HUNTER Signature of Environ ental Health Specialist 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 RECORD DRAWING (continued) p )- c 7/ is 39010 HAMMERSLEY INLET 4"71GHTLINE(I EPLUMB 10 2%SLOPE TO SEPTIC TANK) 1200GAL 2 C MP.SEPTIC TANK WITH PUMP IN SECOND COMPARTMENT (TANK RES T TO 2.5FT BELOW GRADE-CURRENTLY 1FT BELOW GRADE-TO GET FALL FROM BASEMENT) 2 BDRM RE / / ( 4'TIGHTLINE(REPLUMB 02%SLOPE T SEPTIC TANK) SEPTIC TANK WITH LIMP IN SECI D COMPARTMENT DID WITH B TH w / I EXIS7IN 7'FORCEMAIN c0 I O 1 'GL 4" 1GHT1JNE '- b7y 9y z V SPACES IIIIIIII I _� N IIII1111 I ��j S 'liii � l ' 11111 II t �/ WELL 1111I 1 III —{ O II IIIIII _ N `\ 11I III Z c' cii 1 1 1 11 1 1 1 1 EPTIC TANK I PRESSURE TEST COMPLETED BY INSTALLER �\ t III l l l III PUMP CHAMBER r 4"TIGHTLJNE(REP UMB TO 2%SLOPE TO SEPTIC TANK) SQUIRT HT: 3.BFT VIII r BATHROOMS I I DRAWDOWN: 2IN/MIN IIII III I TIMER SETTINGS- I2I ON: 1.33MIN OFF: 4HRS IIIII JIM HUNTER&ASSOC. CONTRACTOR P.O.BOX 162,OLY,WA 98507 SEPTIC SPECIALISTS 753-1226 JHANDASSOCIATES®HOTMNLCOM INSTALL 441306 5115-ADDRESS/LEGAL RECORD DRAWING 201 SE LAZY DOG LN OWNER- STEVE PERSCHON fgL SCALE-1" 50'-0" i7 FINAL DATE- 472D/26x • TPp SITE K SWG2025-00245 22029-75-00010