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HomeMy WebLinkAboutSWG2026-00204 - SWG As-Built - 9/4/2026 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2026-00204 Parcel# 12232-34-90150 Applicant Name John Morrow Subdivision (Name/Div/Block/Lot) Applicant Address 221 E Country Ln City, State, Zip Allyn WA 98524 Installer Name Final Vision Site Address same Designer Name Arrow Septic Designs Inc INSTALLATION CHECKLIST •Full System Installation ❑Tank(s)Only ❑ Drainfield Only ® Repair ❑Other System Type Shallow Pressure Pretreatment Type >5 ft.from foundation? -- ----- - - - - -- -- -- - - - -- ❑N/A DYES NO >50 ft.from wells? -- - - - - - - - - -- - - ❑ ❑ 2 >50 ft.from surface water? -- - L? " " - - ❑ ® ❑ 4 Cleanout between building and ----'--- -"" - ❑ ® ❑ Tank baffles present? -- - --- -SEFO -2Ofg - - ❑ ® ❑ 24'access risers over each c m a ant?- -- - --y-- ---- ❑ ® O w Effluent filter installed?-- - - --- - -- - - -- - - ❑ ® ❑ rn E fisting Concrete Septic tank capacity(working) - — .2t)O- ref C D-box water level and speed levelers used? -- - -- -- --- -- -- - ❑ WA fl YES NO QJ O Manifold/D-box accessible from surface?-- - - - ---- -------- ❑ _ mz Check valves installed? -- - - - - - - - - -- --- -- -- - ❑ 4 U o a Transport Line Size 2' Schedule/Class 40 Bedrooms installed(check one) ❑2� ❑I3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10 ft.from foundation?- - - -i'44&� -- - - -- - ---- --- - - ❑ WA ❑ YES © NO >100 ft.from wells?-- ---- ---------- - --- "-------- ❑ ❑� >100ft.from surfacewater?- - - -- - -- -- - ------------ - ❑ ® ❑ w a >loft.from potablewater lines?- --- ---- -- - --- --""""-- ❑ UI ❑ Z > 5ft.from property lines and easements?---- - - - - --- --- -- ❑ UI ❑ fY > 30 ft.from tlowngredient curtain/foundation drains?---- - --- - - O © ElDrainfieldlevelandobservationportspresent - - - --- - - - --- -- ❑ ® ❑ ® Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfeld?--- --------------- - ❑ ® ❑ Pump tank setbacks consistent with septic tank?------ ---- -- - ❑ N/A ® YES ❑ NO Y Pump tank capacity(flood) 1.250 gal Manufacturer Hagerman Z 24 access riser(s)and accessible from surface?-------- ---- - ❑ Iff 0 Alarm or Control Panel Installed? -- - - ---- - -- - ---- ---- ❑ © ❑ 5 Control Panel equipped with Timer/ETM/Counter-- - - - ------ ❑ © ❑ . Pump installed in ❑ Bucket or ® On Block or ❑ Other Pump Make/Model Liberty 290 ® Floats or ❑ Transducer Tank draw down 1.75 iNmin Pump capacity 42 gpm Squirt Height 4 ft Pump on time 2.15 min Pump off time 6 hr Daily flow set at 360 gpd Mason County OSS Installation Report pg.2 Parcel# 2Z3Z 3y' 4 oI Sa War, e)Mng saPGc components abandoned as part of this project? ---- ----- ' YES ❑ ND If vas,Please describe: 04- &-rt xn '��-""'�"�J' --- Alan,all components Pumped out and property abandoned per WAC24G272A-0300? -'--' - ' ❑YES ❑ NO TbszwrmhnenvtlaM vu!be s ndi aide nil ..nugtl m robot in ae n«a at misbvinw.ctMte.M lulu.ay.W�a. T# I Rawl pzuige 00r n: Dninleld 8 manEc anxmafnn s I vouS seyclpn ark IovEon Not snow,.serve E.'m4ea,aawq and PWtlevI tn`sI P.lea.^Nwak wWRnez. wYs,ob.&,adT pFa,a®nmlm,and oadr ma4it an e¢fl44 pain. Incomplete Recur IXm1ryz may vealeaCtlPmzl Etlayz'm McIm.Btltli iiww nx, perto.. Record Drawing Attached INSTALLER DESIGNER/ENGINEER I certify That!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 clearedrappmved by both the designer shown here have been clearsdlapproved by both and Mason County Public Health and meet at)State myself and Mason County Public Health and meet all and Mason County Codes. State and Mason County Codes I further certy 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. Slgnetvre of llnnstS/ier Date Pdnte d Name of Signs stti�� MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and r, y Record Drawing on behalf of Masgn County Public cmca ;m�9 1N [.., PAULA JOY JOHNSON " Health: Q /,/['b/'�'/ q l I 16 rj I4F'}J�_-R 1'ril7� '. I as �� Signature ofEnvuonmental setm Specialist Date (stamp,signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE �4Ca.aflMrane 175.44' SI 5apEvc ASS- &L4 Jc JOhN1 N orrow )2-d C01o= IScLF 4jjy.j 127_'32- 34- 1 St D6 3` 2.t\ a CAwn}r L++ A 'k1 +. a—.e ' 'oc Ka'. Nw,�+ t oFF w-se Sca -ca : I " = 'to' Lu u o 20 4= boo $o EK ns, 38R .. xuAr 76 /, = rtg5} I- o-. hf �y y� K%j I1 90 Sf�gb LS c n M UTO-Visual Alarm LF .7` fl Ceanout-csdco-..eA RaS tqv F L200 G on Septic Tank 2-Co-Co G mpartment- p„g�1dl Effluent Fite, itro Gallon Pump Chamber OValve VaValve Control Box © AtoQN& 0 Ia�rek.(esL APPROVED '�' PAULA JOY JOHNSON r 'Cf0 _ED isNEx.. SEP 042026 C)- (-z. MASON COUNTYENVIRGNMENTAL HEALTH RET Ka la Milam From: DO NOT REPLY <noreply@masoncountywa.gov> Sent: Monday, August 24, 2026 3:40 PM To: Environmentalhealth Subject: OSS Inspection request for JOHN MORROW-SWG2026-00204 ubmittal request for:JOHN MORROW bite Address:221 E COUNTRY LN.ALLYN WA Permit Number:SWG2026-00204 Parcel Number:122323490150 Installer Name:JASON SCHAUER FINAL VISION INC. Installer Phone Number:360-801-5681 Installer Email Address:SCHAUER9@MSN.COM ' r- Designer Name:PAULA JOHNSON I AUG 24 4 2026 Designer Email Address: IMNOTSURE@MSN.COM Bi_ D Inspection Request Date:2026-08-25 Inspection Type: Full System Comment\Notes:SITE 15 OPEN.THIS IS A REPAIR USING EXISTING SEPTIC SYSTEM 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 departmentwithin 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. MASON COUNTY Public Health & Human Services FINAL INSPECTION: 5WG2026-00204 ADDRESS: 221 E Country Ln PARCEL: 122323490150 DATE: 8/25/2026 (/2 HOUSE TO DRAINFIELD DRAINFIELD TO HOUSE