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HomeMy WebLinkAboutSWG2021-00610-ASBUILT - SWG As-Built - 8/21/2026 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG Z02. 1 - 00 ( 10 Parcel # ZZ2L1 51 -O'L CX) I Applicant Name /t(.c ..L I�<\vu-so. Subdivision (Name/Div/Block/Lot) Applicant Address CPC Sox IS IG 7-✓w- 1,r..d- D,r P-Z &L a ( / An Z- City, State, Zip S1 kic„ W/- g9Sgti Installer Name Oly.,,o � Co•sl�.,r F=a, CL(- SiteAddress ill c V,- . Is E'Z Dt" Designer Name M.ir.L Ndoll,e -� INSTALLATION CHECKLIST Ej Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑Repair ❑Other System Type &e Pretreatment Type Scpl_L T' 4L >5 ft. from foundation? - - -- - - - - - - - - - - - - - . ❑ N/A 0 YES NO >50 ft. from wells? - — ❑ ❑ ❑ 50 ft. from rom surface water? WpC zO� Z if �r � �- ❑ ❑ F Cleanout between building and tank? iI - t i- - ❑ ® ❑ V Tank baffles present? --- Il -AIIG1 1A73 _ll �_ - ❑ ® ❑ 4 24"access risers over each compartm nt?- - - - - ❑ ® ❑ rW Effluent filter installed?- - - - - - - - - ay- - - _ ❑ ® ❑ Septic tank capacity (working) 13g gal Manufacturer Son&. alcrx1 }- �0 D-box water level and speed levelers used? - - - - - - - - - - - - - - - ❑ NrA ❑ YES ® NO 00 Manifold/D-box accessible from surface? . ❑ IN ❑ mz Check valves installed? - - - - - ❑ Is ❑ 0< M Transport Line Size / Schedule/Class 1!© Bedrooms installed (check one) [&2 ❑3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10ft. from foundation?- - - - - - - - - - - - - - - - - - - - - - - - - - ❑ N/A ® YE5 NO 0 >100 ft. from wells?- - - - - - - - - - - - - - -- - - - - - - - - - - - - - >100 ft. f ❑ ® ❑ 1, Foz - 3 W rom surface water? - k- - - - 2 1 C - - - - - -O-t7- - - - - - - - - - -. ❑ ❑ LL >10 ft. from potable water lines?- ❑ ❑ > 5 ft. from property lines and easements?- -- - - - - - - - - - - - - - 0 ® ❑ > 30 ft from downgradient curtain/foundation drains? - - - - - - - - - - U [a ❑ Drainfield level and observation ports present - - ❑ ® ❑ ❑ Graveless chambers or Q Clean gravel used? (check one) Proper cover installed over drainfield? ❑ [4 ❑ Pump tank setbacks consistent with septic tank?--- - ❑ N/A ® YES ❑ NO ZPump tank capacity (flood) )2y'1 gal Manufacturer sin vlA PI.......... I— Q 24" access riser(s) and accessible from surface?- ❑ l ❑ o. Alarm or Control Panel Installed? - - - - -- - - - - - - - - - - - - - - - ❑ 29 ❑ Control Panel equipped with Timer/ETM/Counter- - - - - - - - - - - 0 ® ❑ - Pump installed in ❑ Bucket or ❑ On Block or Other[l� Floes I:,dvxer fPump Make/Model Gt'cv S SO32- 0L?O cl ❑ Floats or aTransducer a Tank draw down l in/min Pump capacity Z0 gpm Squirt Height /N ft Pump on time Pump offtime blt. Ce'_ Daily flow set at /fro gpd Updated 821)2018 Z2Z3 Si. _ OZ C0I Mason County OSS Installation Re ABA Parcel#NDONMENT RECORD Were existing septic components abandoned as part of this project? D YES PQ NO If yes, please describe: ___ _ _ _ _ _ yES NO Were all components pumped out and properly abandoned per WAC24G272A-0300? RECORD DRAWING velopment Typical Record Tma b s prtmanom recoN and mmr Ea tacuOu and deutlVaw Mtank location.gh to n in Me noed anew,resocvea Intenance pb existngCand prov«aa a Iwln9ivlfle!and future 5.I atim Nwells,waterliines. Drawings contain- ores,clew&manifold orientation&layout a aess pWmp _ final installation approval and related permits wells,0.1.dnn ports,deanowa.and wirer maintenance a«eaa palls. lnwnpWe Record Drawings may asst°aatlNMal delays in t1 'c Lru,S Record Drawing Attached CERTIFICATION OF INSTALLATION DESIGNER! ENGINEER INSTALLER I certi that the system has been installed in accor- I certify that I installed the system in accordance with dance with the septic design stamped APPROVED"by the septic design stamped"APPROVED"by Mason County Public Health and that any deviations shown Mason County Public Health and that any deviations desi ner shown here have been cleared/approved by both here have been cleared/approved b y both the g and Mason County Public Health and meet all State myself and Mason County Public Health and meet all State and Mason County Codes and Mason County Codes. I 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 d attached Record Drawing is accuratteo. Date Signature of Installer lLL cUevif•. ^_����..yyya,,,, Printed Name of Signee 3•�gL MASON COUNTY PUBLIC HEALTH striwoa The undersigned approves this Installation Report and NIcu+R,5100" Record Drawing on behalf Of Mason County Public t.ICEN ED DEBNYFER Health: _ T (�,, ( c,,•.c-<.re„nl Dr�l l�tZ4Iz Signature of Environmental Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE °°d°l°a Nsrm Parcel#22223-51-0LU01 rEME& G WAG TASK �u Property Address:211 E TRAILS END DR,BELFAIR 98528 SWG:SWG2021-00610 12-2633-HW H2O Traffic Rated Tank and Access ACI515.1R Coating Septic Tank W rfloo Volume: 13224 aI. Pump Chamber flood Capacity'.1244 Gal. pC1212.3R Krys[ol Internal Membrane(KIM) II 1 37 -- 48 H17 4 FA55-iHIVU III 2 I II II II II I 18 24 •I ' I 8490.. II II II III II 4 I III II I I I I II III III I I II II I I II it I ^e° H2O Access< MASTIC H20 Access 1-120 Access 24 T rK ADAPTERS 4' CAST-A-SEAL GASKET F1W0436-28 A Orenm ainilitEr 4 PVC BAFFLE FLOOD CAP68.. FLOOD CAP. 1092 GALS 53a8 GAL5. Flapper Check Valve 49 or¢n¢nenwmd�rer oaon4812 Transducer 54 30 Clarus Turbine Pump Mod.50320009 4 3. A P ` R 0 VI lk:U 2 1 � q t\ 575515Y flp .5Wd.4 .,X.14 :P!e19e1' N c o 3 T =thd- =N, 3m U m 3 mY o j m E -- = o o J� 181 +/- C m, 703 703 u r- o s9R R seise 59 Rese 3 e N VU LE D N IA rtt ` xl ti o - '3 ry rn w �aa I rat Fa 9P 1p oF���e u— > Z 9xj Oy� o X1 B O 3 OCTA W N � . o N o N xd J c d G n 2 d o o m ➢n O >= UNE wo gm mo t � � m o f s c Abbreviated Description: TRAILS END DIV #2 BLK: 2 LOT: 1 EX 1-A & 2 PCL 1 OF BLA#20-28 AF #2147085 S47/57, S 48/223 M.Halverson Design LLC Drawn For: Property Info: 22223-51-02001 0MBER PO Box 1519 Shelton Wa 98584 Micah Halverson 211 E TRAILS END DR 1 Halversondesi nllc outlook.comI BELFAIR 98528 R .