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HomeMy WebLinkAboutSWG2024-00015-ASBUILT - SWG As-Built - 7/7/2026 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT! PERMIT INFORMATION Permit Number SWG 2024-00015 Parcel# 12306-50-01002 Applicant Name Debra Triplett Subdivision (Name/Div/Block/Lot) Applicant Address 13330 Lester Rd NW Panther Lake Tracts, BLK:A, TR 2 City, State, Zip Silverdale,WA 98383 Installer Name ABBA Excavating, LLC Site Address 3770 NE Bear Creek Dewatto Rd Designer Name Arrow Septic Designs, Inc INSTALLATION CHECKLIST W Full System Installation ❑Tank(s) Only ❑ Drainfield Only ❑ Repair ®Other 500-Gal Pre-Trash Tank System Type Shallow Pressure Trench Pretreatment Type NuWater BNR-500 >5ft. fromfoundation? - - - - - - - - - - -- - - - - - - - - - - N/A F§ YES ❑ NO >50ft. fromwells? - - - - - - - - - - - - - 0 V E ❑ - - ❑El>50 ft.from surface water? - - - - - - - - - ' � Cleanout between building and tank? - - - -jut.-��- W p-� 225 ❑ Tank baffles present? - - - - - - - - - - - - - - El -ceifN E 'PONMENTAL HE/ ❑ 24" access risers over each compartment ff - - - - - - - --- WEffluent filter installed?- - - -- - - - - - - - y-. - - - - - - - " El N Septic tank capacity(working) NuWater 500 gal Manufacturer Hagerman Q D-box water level and speed levelers used? - - - - -- - - - - - - - - - ❑ N/A ❑ YES 0 No 0� Manifold/D-box accessible from surface? - - - - - - - - - - - - - - - - ❑ El mz_ Check valves installed? - - - - - - - - - - - - - - - - - - - - - - - - - - ❑ ❑ as Transport Line Size 2" Schedule/Class 40 � Bedrooms installed (check one) ❑ 2 W 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10 ft.from foundation?- - - - - - - - - - - - - - - - - - - - - - - - - - ❑ N/A NYES ❑ NO >100ft. fromwells?-- - - - - - - - - - - - - -- - - - - - - -- - - - - - ❑ iii ❑ W >100ft. fromsurfacewater? - - - - - - - - -- - - - - - -- - - - - - - - ❑ AN El LL >10ft.frompotablewaterlines?- - - - - - - - - - - - - - - - - - - - - - ❑ 0 ❑ Z > 5ft. frompropertylinesandeasements?- - - - - - - - - - - - - - - - ❑ II ❑ W > 30 ft. from downgradient curtain/foundation drains?- - - - - - - - - - ❑ ® ❑ Drainfield level and observation ports present - - - - - - - - - - - - - - ❑ El ❑ Graveless chambers or © Clean gravel used? (check one) Proper cover installed over drainfield?- -- - - - - - -- - - -- - - - - - El F ❑ Pump tank setbacks consistent with septic tank? - - - - -- - - - - - -- ❑ N/A Q YES ❑ NO Pump tank capacity (flood) 1,000 gal Manufacturer Hagerman Q 24" access riser(s) and accessible from surface?- - - - - - - - - - - - - ❑ D Alarm or Control Panel Installed? - - - - - - - - - - - - - - - - - - - - - ❑ © ❑ Control Panel equipped with Timer/ETM/Counter - - - - - - - - - - ❑ D d Pump installed in ❑ Bucket or On Block or ❑ Other Pump Make/Model Liberty 290 * Floats or ❑ Transducer Tank draw down 2.25 in/min Pump capacity 43 gpm Squirt Height 5 ft Pump on time 2 min Pump off time 6 hr Daily flow set at 360 gpd Updated 821/20/8 Mason County OSS installation Report pg. 2 Parcel r srj - Q02_ B i Q1 14 E[�iT'F OR Were existing septic compon-ents abandoned as part of this project? -------- ------- ❑ YES NO If yes,please describe: ES ❑ Were all components pumped out and properly abandoned per lAC246 27?A J30G? - ----- ❑ Y NO This 1a d cermanert record and:.^,:t5:be accu ale and desc:?pbve enough to re-locate its the need of.:aintea2nce 2c`uvthes and future deve&oprnent Typical Record Drawings contain: Drain5eld&maneoId orientation&layad.Sep6Jpurnp tank(oration.North arow,reserve dzaintiefd,exsting and proposed bukdings,location of welts,waterlines, weds,o sz vabon ports,deanouts,and other maintenance access points. Incomplete Record D aw ngs maypea a adotf onai delays in final its Cation appto'va!and related permits. PROVE JUL 0 8 '232 MASON COUNTY ENVIRONMENTAL ❑ Record Drawing Attached INSTALLER DESIGNER!ENGINEER t certify that I installed the system in accordance with I certify that the system has been installed in actor- the septic design stamped APPROVED"by Mason dance with the septic design stamped-APPROVED by County Public Health and,hat 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 further certify that all information contained on this l further certify,hat all information contained on this form and attached Record Drawing is accurate. form and attached Record Drawing is accurate. I S 2(o Sign attire of Installer Date Printed ivame of Signee MASON COUNTY PUBLIC HEALTH 4h} The undersigned approves this Installation Report and 52ooaas >. Record Drawing on behalf of Mason County Public ' PAULA,loY JOHNSON '�"'� Sr at r of nvironmental Heald Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR P!UB'LtC ViEA1 ON THE MASON cOuNTY WEB SITE - 2 � •'� r ntp,�,t�t�•.�r� \ ' NNNk '\J\ ' I\ \ \\ : i\ \\ F ___ �D r tr � • 1 OO 1 t "( (n� � ,�.• � �,v1 � �� \ � Tom^-.�J fL . • MASON COUNTY Public Health & Human Services FINAL INSPECTION: SWG2024-00015 ADDRESS: 3770 NE Bear Creek Dewatto Rd PARCEL: 123065001002 DATE: 6/15/2026 t _ 2'!- IF' :: ç HOUSE TO DRAINFIELD DRAINFIELD TO HOUSE Kaja Milam From: Sent: DO NOT REPLY <noreply@masoncountywa.gov> To: Friday,June 12, 2026 8:07 AM Subject: Environmentalhealth OSS Inspection request for DEB TRIPPLET - SWG2024-00015 Submittal request for: DEB TRIPPLET Site Address: 3770 BEAR CREEK RD Permit Number: SWG2024-00015 Parcel Number: 123065001002 1! JUN ? 2 2026 Installer Name: ABBA EXCAVATING By Installer Phone Number: 253-405-2576 / J Installer Installer Email Address: PAMBUSEK@GMAIL.COM Designer Name: PAULA JOHNSON Designer Email Address: PAULAJ@HCTC.COM Inspection Request Date: 2026-06-15 Inspection Type: Full System Comment\ Notes: ANY DAY NEXT WEEK WORKS 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