Mason County - On-site Septic Homeowner Operation and Maintenance Report

To be used only for Conventional Gravity, Conventional Pressure, Sand Filter, Bottomless Sand Filter and Mound Systems
The following is a list of items that must be monitored and maintained to protect against failure of your on-site septic system. Inspection frequency is every three years for gravity and every year for all other system types. Please submit this report to comply with requirements of WAC246-272A-0270.
Homeowners are allowed to inspect the following system types in Mason County. Select your septic system type and provide answers to the relevant sections below, providing comments as needed.

Parcel Number:

Site Address:

Name:

Your Phone Number:

Your Email:

System Type:

General Site & System Conditions

The general Site and System Conditions were:

Components accessible for service:

All required service performed (if no - specify omitted inspection items in notes):

Surfacing effluent from any component (including mound seepage)

Components appear to be watertight - no visual leaks

Improper encroachment (structures/impervious surfaces)

All riser lids securely fastened upon departure

Electrical repairs needed. If YES describe in comments

Inspected components appear to be in good physical condition

Root intrusion on any components. If YES describe in comments

Settling problems observed. If YES describe in comments

The house/structure was vacant or used infrequently, assessment of the drainfield was not possible.

Septic Tank

This component was:

Effluent level within operational limits (if NO explain in comments)?

All required baffles in place (N/A = No baffles required):

Compartment 1 Scum accumulation (Inches, if other specify):

Compartment 1 Sludge accumulation (Inches, if other specify):

Compartment 2 Scum accumulation (Inches, if other specify):

Compartment 2 Sludge accumulation (Inches, if other specify):

Pumping recommended?

Distribution: D-Box

This component was:

D-Box in good condition?

D-Box outlets set to allow equal effluent distribution?

Pump Tank:

This component was:

Compartment 1 Scum accumulation (Inches, if other specify):

Compartment 1 Sludge accumulation (Inches, if other specify):

Pumping recommended?

Pump: Effluent Pump

This component was:

Controls functioning?

Panel: Alarm - High Water

This component was:

Alarm mechanism functioning as intended?

Media Filter:

Slope integrity maintained?

Media Filter:

Ponding present? If YES explain in comments.

Drainfield:

This component was:

Component appears to be functioning as intended?

Ponding present? If YES explain in comments

Comments:

Please click the check box: