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HomeMy WebLinkAboutSWG2026-00204/ASBUILT - 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 221E 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 ,5ft.from foundation? -- ----' --- - -- ---- - -- -- ❑ N/A DYES ® NO >50 ft.from wells? -- - - -- -- - - - - - - - - - ❑ ® Cl z >5o ft.from surfacewater? -- - aY - -- ❑ 0 ❑ FCleanout between building and -------' - ❑ o Tank baffles present? -- ---- -SEP6i [6 i, ❑ I ❑ P 24"access risers over eachc ma ant?-- -- - -- ---- ❑ 0 ❑ W Effluent filter installed?--- - --- - - --- - 1--- - ❑ ® ❑ w - Existing Concrete Septic tank capacity(working) ---Y�200.--oaF�- — cturer O D-box water level and speedlevelers used? -- ----- - -- ---- - ❑ N/A DYES NO 1 0O Manifold/D-box accessible from surface?-- - --- - -- -- ----- - ❑ ❑ mz Check valves installed? -- - - - - - - -- - - - - - -- - - - - -- - - - ❑ ❑ f]< Transport Line Size 2" Schedule/Class 40 2 Bedrooms installed (check one) ❑�2� I 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10ft.fromfoundation?--- -'1-'FT- - - - - - - - - - ---- - - ❑ Nu DYES NO 0 >100 ft.from wells?------- - --- ------ -- - -- - ---- - ❑ ® ❑ >100 ft.from surfacewater?- - - - ----- -- - - - -- -- - - -- - - ❑ © ❑ Y >10ft from potable water lines?- --- --- - - - -- -- -- - - -- - - ❑ II ❑ Z > 5ft. from property lines and easements?---- - - - - - - - -- - - - ❑ ® ❑ o! > 30 ft.from downgradient curtain/foundation drains?- -- - - - -- - - C U ❑ Drainfield level and observation ports present ----- - - - - - ---- ❑ 0 ❑ ® Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?---- -- -------- --- -- ❑ ® ❑ Pump tank setbacks consistent with septic tank?------ -- ----- ❑ WA (t] YES ❑ No Pump tank capacity(flood) 1,250 gal Manufacturer Hagerman 24 accessriser(s) and accessible from surface?----- ----- --- ❑ ff ❑ F- AlarnorControlPanelInstalled? - - - -- - - --- -- ---- -- - -- ❑ 0 ❑ d Control Panel equipped with Timer/ETM/Counter-- - -- - - - - - - ❑ ❑ o_ Pump installed in ❑ Bucket or ® On Block or ❑ Other a ,Pump Make/Model Liberty 290 ® Floats or ❑ Transducer Tank draw down 1.75 in/min 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 upload b11218 Mason County ass Installation Report pg. 2 Parcel# ,,; ,..,r .. 7-. 2B_A.LfDO$hEN .r�c»c3RII Were ewsting septic mtnponenis aoantloned as pan of this p�olect� --- ------- -- - ■ rEs ❑ NO If yes,please describe' ❑ YES ❑ NO Were all components pumped out and properly abandoned per WAC246-272A-0300? - -'--- ' _y s h b Mccele Na need of CS activltln and NWI.d.vNop TW of Hund TMp iA aryim t. wrtl aM vuW 6e rsuM aM dmrr,W anOu 9 hwkmez,ImM d Us xaWrlines. pmwngs mnaurt 0n'mReNamani(oW vMNatbn Blayout SeydpumpfanN laredpn,NoM a,Ww,rese yaea reld eanu,q eM pT'P^aed wYa,ohaen,adanpe .cMnai6,and ofa,miu1I2ar amsv pons_ Nwmp,dm Fem,d IXawings ma to add'rtuvldtla}z m final lrsbNdm epgm2l a"nasom penny. ■ Record Drawing Attached INSTALLER DESIGNERI ENGINEER l certify that I installed the system'i n accordance with I certify that the system has been installed in actor- the septic design stamped"APP1OVED by Mason dance with the septic design stamped'APPROVED-by County Public Health and that end+deviations shown Mason County Public Health and that any deviations here have been cieared/appmved by both the designer shown here have been cleared/approved by both and Mason County Public Health and meet all State myself and Mason County Public Health and meet all and Mason County Codes. I State and Mason County Codes I further testy that all information1contained on this I further certify that all information contained on this form and attached Record Drawinp is accurate. form and attached Record Drawing is accurate. Signature ofl/nsta/Ner Date t 4gn�icvr1 Jfi`�Qrt.!/ r. Panted Name of Signee F ' A.u.w MASON COUNTY PUBLIC HEAL H The undersigned approves this Installation Report and Record Drawing on behalf of Mason County Public 'PAULA Joy aJOHNSON \ I iCK�6f E DE91BNER" Health: 1(76 Signature of Envupnmenlal aim Sp$ciallst Data (stamp,signature and date) THIS FORM MAY BE SCANNED AND AVAMBLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE 4NaaadVmadn' zs. I Sc4* c w Jocw N orrow cJ C1\ o + (a)1�= tsoLF A# to z-34-9DcSc Cown�r L.+ .��T"� 221 E } Mtf..rsc •f SD.C.KI. NN Cps OQf V:.-a Sca-A.o_: t " '-to ' Lc ' Usv. Hft 1 i& 2l kyyy d /.� � � I � I � O-28�� LS t (Cwts SP+a^t sQ IOI Ab T'\l i _ _ p_ 3�f�3b L.S n M 'so * � - �'`ti Key: / I -4udio-Nils t!Alarm J� LF -7` Cleanorutpp-o c+Rcs 0.v¢{)F O 1200 UaLLon Septic Tank 2-Compartment- Effluent Filter NU+� Ot vso Callon Pump Chamber Valve Vaalve Control Box APPROVED PAULAIOY Y JOHNSON p NNSX � P uc S` 0 4 2026 1 Zcs ASON COUNTY ENVIRONMENTAL HEALTH PET Kayla Mi%arn From: DO NOT REPLY <noreply@masoncountywa.gov> Sent: Monday, August 24, 2026 3:40 PM To: Environmentalhealth Subject: OSS Inspection request for JOHN MORROW-5WG2026-00204 Submittal request for:JOHN MORROW Site 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 Designer Name: PAULA JOHNSON AUG n2 y 2026 Designer Email Address:IMNOTSURE@MSN.COM By.,__i r� Inspection Request Date:2026-08-25 Cam' ��.- Inspection Type: Full System Comment\Notes:SITE IS 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 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. MASON COUNTY Public Health & Human Services FINAL INSPECTION: SWG2026-00204 ADDRESS: 221 E Country Ln PARCEL: 122323490150 DATE:8/25/2026 "f rs HOUSE TO DRAINFIELD Ifj DRAINI IELD 10 HOUSE