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HomeMy WebLinkAboutSWG2026-00007-ASBUILT - SWG As-Built - 6/15/2026 (2) Mason County ass Instatlbtlon Report pg, 1 MASON COUNTY PUBUC HEALTH APPLICAN at PERMIT INFORMATION 2t '7 a4r( f l 22223 51 0 t Femtlt Ncatttr . ,cart ritost (Warn ►4)v1Rh lint) Updated 7/8/26 Applicant Nt3I►► kart Address 1e T 12 t c.ot s 1, m k 2 by installer email ,rtn f;WA X925 Installer Name Neil Trt nbar;h City, Stag. 7P Site Address t961 7ra�tls�End l r Designer Name Purdurn IN3TALLATiON CHECKLIST O Tart .%)fatly' O nr !tnfkf Only ❑R p +r E] ther rtre"sure EMtrbutfrrn pretreatment Type S fj from found r1' O NIA Yf Cl Xlty ~"5 from wells" ❑ X > it.from su water'' - _ - - < Cteaeraaut ttetr+ en building and tank? }- - _ _ -,_ ❑ ❑ a ❑ 3 24 access risers over each corraport ❑ O us fluent filter installed?- - - - - - -[--- - - - - - - - - - - - - [ i❑ Septic tank capacity(working) -tttee- gal Manufacturer Hagerman Precast a D-box water level and speed levelers used? - - - - - - - - - - - - - - - ❑ NIA 0 YES NO Manifold!D-box accessible from surface?- - - - - - - - -- - - - - -- - ❑ Li t3 Chexk valves installed? - - - - - - - - - - - - - - - - - - - - - - - - - - < I Transport Line Size 2-in Schedule/Class 40 Bedrooms installed(check one) 0 2 Q 3 ❑4 ❑ 5 06 ❑CommerciallOther >10 ft. from foundation?- - -- - - - - - - - - - - - - - - - - - - - - - - ONWA y C >100ff. frcm7 wells?- -- - - - -- - - - - - - - - - - - - - - - - - - - - - F1 u >100 ft. from surface water? - - - - - - - >10ft- from potable water lines?- -- - -- - - - - -- - - > 5ft, from property lines and ea�ents?- - - - - - - - - - - - - - - - ❑ ❑ > 30 ft. from downgradient curtain/foundation drains? - - - - - - - - - - O E Dra,nfield level and observation ports present - -- - - - - - - - - - - - ❑ Graveless chambers or Clean gravel used? (check one) Proper cover installed Over drainfseld?- -- - - - - - - - - - - - - ❑ Pump tank setbacks consistent with septic tank? - - _ - - - - - - - - ia O•NCB Pump tank capacity (flood} t,a al Manufacturer H rr lrl Fracas( 24"ass riser(s)and accessible from surface?- - - -- - - - - - - - - 41arm or Control Panel Installed? - - - - - - - - - - " ❑ oortir+a#Panel equipP _ - - - - - - - - - - O U ❑ er!i MlCounter- - - - - `bmp Installed artØdtet or � .- .. - On Block or Other ump Make/Model Libert LP. • Floats or ink draw down 1.625 ❑ Transducer n/min Pump capacity 32,b pm Squirt Height 5 ft IIYsr airnt~ 11p se Pump off time 4 hrs . ..-....r.,...- Dally flow set at 7 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2026-00007 Parcel# 22223-51-02061 22223-51-02061 Applicant Name Puget Sound Const.Services Subdivision (Name/Div/Block/Lot) Applicant Address PO Box 1876 TRAILS END DIV#2,Lot 61, Block 2 City, State, Zip Belfair,WA 98528 Installer Name Neil Triebenbach Site Address 1561 E Trails End Dr Designer Name Lawrence Purdum INSTALLATION CHECKLIST Full System Installation 0 Tank(s)Only ❑ Drainfield Only ❑Repair ❑Other System Type Pressure Distribution Pretreatment Type >5 ft. from foundation? - T�fJ (� ' N/A Q• YE ❑ NO >50ft. fromwells? -- - - - - - - - - -t ��"�j-.� I-�� >50ft. from surfacewater? - - - - - - ; z ❑ El 4 Cleanout between building and tank? �TF-- 1- -�2 ---6- - ❑ I ❑ Tank bafflesresent? - - - - - - - - - - - - - - - - - - ❑ ❑ U p � O~. 24"access risers over each compact ettty? - ❑ I \` ❑ W Effuentfilterinstalled?- - - - - - - - - - - - - - - - - - - - - - - - - - - ❑ U ❑ U) Septic tank capacity(working) 1,000 gal Manufacturer Hagerman Precast 0 D-box water level and speed levelers used? - - - - - - - - - - - - - - - ❑ N/A ❑ YES [■] NO 0O Manifold/D-box accessible from surface? - - - - - - - - - - - - - - - - ❑ 0 ❑ 0°Z Check valves installed? - - - - - - - - - - - - - - - - - - - - - - - - - - ❑ ❑ EU ❑a 2 Transport Line Size 2-in Schedule/Class 40 Bedrooms installed (check one) ❑ 2 ■❑3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10ft. fromfoundation?- - - - - - - - - - - - - - - - - - - - - - - - - - ❑ N/A [UYEf7 ❑ NO >100ft. fromwells?- --- - - - - - ---- -- - - -- - - -- - - -- - - ❑Q ,/ ❑ w >100ft. fromsurfacewater? - - - - - - -- - - - --- - --- - - -- - - [ ❑ ti >10ft. frompotablewaterlines?- - - - - - - - - - - - - - - - - -- - - - ❑ ❑ Z >5 ft. from property lines and easements?- - - -- - - - - -- -- - - - El © )' El > 30 ft, from downgradient curtain/foundation drains?- - - - - - - - - - ❑ 0 \ El Drainfield level and observation ports present - - - - - - - - - - - - -- ❑ EU ❑ LI Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?- - - - - - - - - - ---- - -- - - ❑ ■❑ ❑ Pump tank setbacks consistent with septic tank?- - - - - - - - --- - - ❑ N/A El YES ❑ NO Pump tank capacity (flood) 1,455 gal Manufacturer Hagerman Precast Q24"access riser(s)and accessible from surface?- -- - - - - - -- - - - ❑ ❑ Alarm or Control Panel Installed. ❑ UI ❑ Control Panel equipped with Timer/ETM /Counter- - - - - - - - - - - ❑ ❑ d Pump installed in ❑ Bucket or ® On Block or ❑ Other fl Pump Make/Model Liberty LP-280 0 Floats or ❑ Transducer Tank draw down 1.625 in/min Pump capacity 32.5 gpm Squirt Height 5 ft Pump on time 110 sec Pump off time 4 hrs Daily flow set at 357.42 qpd Updated 8/21/2013 Printed from Mason County DMS Mason County OSS Installation Report pg. 2 Parcel# 22`1.21 - d 7 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 D 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 dralnfield,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 alpprovpl and related permits. [ Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNERI ENGINEER I certify that 1 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 Record Drawing is accurate. j JJ Lf Signature of Installer Date Printed Name of Signee •c� MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and % Record Drawing on behalf of Mason County Public °'......cgM. .....rn... LICENSED DESIGNER Health: f(J C- /5 EXPIRES Signature of of Environment 1 Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Updated 9121/2018 OSS INFORMATION: OSS TYPE:PRESSURE DISTRIBUTION DAILY SEWAGE FLOW:360 GPO LI DRAINFIELD INFILTRATIVE SURFACE:600 SO FT DRAINFIELD LENGTH:20DLF DRAINFIELD CONSTRUCTION:HANCOR ARC 36 LP CHAMBERS LATERAL PIPE SIZE:1—IN ORIFICE SIZE:1/8—IN ORIFICE SP CING:48—IN TRENCH INSTALLATION DEPTH:6—IN ADDITIONAL OF COVER:12—IN PUMP CONTROL PANEL:SJE—RHOMBUS TO 1 W914H4DBAC I DE 17W ill op R/ PUMP:LIBERTY LP-280,115V.1/2 HP F DRAWDOWN:1.625"/MIN Cl) [{- PUMP FLOW:32.5 CPU J 3 4 RESIDIAL HEAD AT LAST ORIFICE:5 FEET ON TIME:110 SECONDS OFF TIME:4 HRS S GALLONS PER DOSE:59.57 oq PANEL ?33, DOSES PER DAY:6 l MAXIMUM DAILY SEWAGE FLOW:357.42 GPO jp CC:c/a .2j. EfM99a000118 SEPTIC TANK:HAGERMAN PRECAST.1.000-GAL,CONCRETE PUMP TANK:HAGERMAN PRECAST.1.250-GAL,CONCRETE INSTALLER:NEIL TRIEBENBACH SERVICES.(360)670-8119 3-BR SFR SEPTIC TANK 464b , OSS RECORD DRAWING PuuPTANK , ab SCALE, 1" = 20' \ f ,` r 46 3 �' F1RAIVF/ : i T % 6"FLUSH PORT(TYP) 1 C F Jg3 oy 611/x6 2ox7.. m ni O U7 ® NIfOLD O Q NOTE: rtttTTT PLASTIC SHEETING MUST BE REMOVE FROM DRAINFIELD IN ORDER DTO PREVENT FAILURE II}8 NOT A SNAM• 5EPiC SrirF91 NOBS Iq imla.ANoacrNulas ,, �N[�TN[ °R�na�' R�A�AE uIa°i i Nir ron n �onvA'"Yi��s EPIC O61ON" "i ARD a ue "t MIA s To r arrasvnc CLIENT: P"o�°i6 i6. R I9°tils N aclwwr. na tsTme 9moucoImWPROPEAn A�xo"jwr"RRAMAu 6rttPAN 6� tAIj rpm 1 ) PUGET SOUND CONSTRUCTION SERVICES 06 wEM6AYD[oUiw[Mf ANDOTNEIEAARA[tdlRC6 AALMr1D 6E WNMECRO —� 1166 A6URIAr.ii1E RAlUR6. RIWIr T1I[owlmewroP rl211wo RE nlom MfO1RM AMD 9N1.Y IORTNER I!M'A OGONSIRUCImM DONMRA7N VAOIfM IN SNAORORAsms R o 6 " o A� " 6�� MU= DX--a&- PN:22223-51-02061 SEPTIC DESIGN. LLC rorAs9rAnou mxw Roeonc>Rw ro°vc�w: iIoArAtot�cran tRna1°w MIA SITE ADDRESS:1561 E TRAILS END DR PO Box 794,Youghn.WA 98394 253.509.9922 AMDlwo rAPc o IqT PAAA ONow"raloA6rAs o9Nm rRUWn nrro oAr�xru9 APOl SEPTICOEWEEILREwwwEwsTIwTA PAarmalwA MOG.wvct 1 senaR ae t"esorcN Rrto nu r¢w oRrAwKuw pM�� 1 roro 5ErcoM MAP r4u SXU sw�Ax�w+� As s Pt�sy�o�lem�t' °L R m t s-nzA DRAWN: LP, 6/1/2026 PAGE 1 OF 1