HomeMy WebLinkAboutSWG2025-00043 - SWG As-Built - 9/15/2026 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH
APPLICANT/PERMIT INFORMATION
Permit Number SWG 2025-00043 Parcel# 321275100042
Applicant Name Marshall, Renee Subdivision (Name/Div/BlocklLot)
Applicant Address 8668 N Hwy 79 Lot F66
City, State,Zip Florence,AZ,85132 Installer Name Schoening Excavating LLC
Site Address 151 E Dunoon PI Designer Name Cindy Waite
INSTALLATION CHECKLIST
❑ Full System Installation 0 Tank(s)Only ❑ Drainfleld Only 0 Repair 0 Other
System Type Holding Tank Only Pretreatment Type
>5 ft.tom foundation? ---------------- ---- ------- ❑ NA YES NO
>50ft.fromwells? --------------1 --� , r u,—rl1❑ ■ ❑
>50 ft.fromsurfaoe wateR ------ __. _ "'111'❑ . 0
Cleankbelflesnout etween p gem?kung and tank? - T - D-7a .f ❑ ■ ❑
-
-
24°access risers over each compartment? ---- ----- !❑ U ❑
Effluent filter installed?.-- ----- _.--- -{- - _-- - i ■ ❑ ❑
Septic tank capacity(working) 1261 gal Manufacturer Hangemurn Pre Cast
D-box water level and speed levelers used? --- -- ----- --- - - ■ wA DYES O N
RO ManifoldiD-box accessible from surface?-------- ---- - --- - - ❑ ❑
Check valvesinstalled? --- -- ---- - ------ ---- ---- -- ■ ❑ ❑
Transport Line Size Schedule/Class
Bedrooms installed(check one) ❑ 2 ❑3 ❑4 ❑ 5 ❑6 ❑Commercia6Other
>10ft.from foundation?- --- --- ---- --- - --- - --- -- -- ® wA ❑ ❑ NO
>100 ft.from wells?----------- ---- - -------- ----- i ❑ ❑
>lcoft.fiomsurfacewater? - - ---------- ----------- - - ❑ ❑
>10ft.from potable water lines?- --------- ------ ----- U ❑ ❑
>5ft.from property lines andeasements?---- ---- --- -- --- ! ❑ 0
>30 ft.from downgredlent curtalnlfoundation drains?--- ----- - - U ❑ O
GGG Drainfeld level and observation ports present-- - ------- - - -- U ❑ ❑
❑ Graveless chambers or ❑ Clean grevel used? (check one)
Proper cover installed over drelnfleld?------------------- U ❑ ❑
Pump tank setbacks consistent with septic tank?------------ - - WA ❑ Yes ❑ No
NC Pump tank capacity(flood) oat Manufacturer
24'access risers)and auxssible from surface?---- ---- - - . ❑ 0
Alarm or Control Panellnstalled? ----------- - — ❑ ❑
Control Panel equipped with Timer I ETM/Counter- --- - ----- - U ❑ ❑
Pump installed in ❑ Bucket or 0 On Block or ❑ Other
LL Pump Make/Model ❑ Floats or ❑ Transducer
Tank draw down in/min Pump capacity pm Squirt Height ft
Pump on time Pump oft time Daily flow set at gpd
upb 0112011
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APPROVED
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Mason County OSS Installation Report pg. 2 Parcel# 321275100042
ABANDONMENT RECORD
Were eweang septic components abandoned as part of thIs project? ------------- -- ❑ YES ® NO
If yes, please desalbe:
Were all components pumped out and property abandoned per WAC246-272A-0300? -- --- - -- O YES ❑ NO
RECORD DRAWING
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• Record Drawing Attached
CERTIFICATION OF INSTALLATION
INSTALLER DESIGNER!ENGINEER
I canny that I installed the system in accordance with I certify that the system has been Installed In eccor-
the septic design stamped APPROVED-by Mason dance with the septic design stamped'APPROVED by
County Public Health and that any deviations shown Meson County Public Health and that any deviations
hem have been cleared/approved by both the designer shown here have been dearsd/appmved by both
and Mason County Public Health and meet all State myseHend Mason County Public Health and meet all
and Mason County Codes. State and Meson County Codes
I further carfiy 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.
pa
9-11.28
Slgea d lnatelter Date
BreydBn Shcoenin0
Printed Name ofSlgnee G - 9
a3 w
� 1,
MASON COUNTY PUBLIC HEALTH
The undersigned approves this Installation Report and ,y
� aPPm Po '.� g clwov E wnne
Record Drawing on behalf of Mason County Public LICENSED 9E5IGNER
Health:
signature of EnwronmenwWealth spedaffat Date (stamp,signature and date)
THIS FORM MAY BE SCANNEDAND AVAILABLE FOR PUBLIC VIEW ON TIE MASON COUNTY WEB SITE upww! 1a18