HomeMy WebLinkAboutSWG2025-00029 - SWG As-Built - 2/25/2025 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH
APPLICANTI PERMIT INFORMATION
Permit Number SWG 2025-00029 Parcel # 42012-54-00015
Applicant Name GEOFFREY FARRINGTON Subdivision (Name/Div/Block/Lot)
Applicant Address PO BOX 1247
City, State, Zip SHELTON,WA. 98584 Installer Name MANKE EXCAVATING
Site Address 15 E CHERRY PARK Designer Name CINDY WAITE
INSTALLATION CHECKLIST
Full System Installation ❑Tank(s)Only ❑Drainfield Only ❑Repair ❑Other
System Type SAND AUGMENTED PRESSURE BED Pretreatment Type
>5 ft.from foundation? .-------------------------. El WA ONES No
R M
>50ft.from wells? - ---------------------------- ❑
Z >50 ft.from surface water? -------- ❑ fT+"I
FCleanout between building and tank? ------------------- ❑ m
V Tank baffles present? - - ----- - -. ❑ �. �.
1 24"access risers over each compartment?---------------. ❑ Jr
W Effluent filter installed?-- ----- -- ---- ----- -------- , ❑ r� ��ti.1ri
Septic tank capacity(working) 1530 gal Manufacturer INFILTRATOR �I
O D-box water level and speed levelers used? --------------. NNtA ❑ras NO
O0 Manifold/D-box accessible from surface?----------------- ❑ ❑ ❑
�2 Check valves installed? --- ----------------- - ---- . ❑ ❑ ❑
0
Transport Line Size rl Schedule/Class 5 ,A tr,)ate ill
Bedrooms installed(check one) ❑2 03 ❑4 ❑ 5 ❑6 ❑Commerciavother
>10ft.from foundation?-------------------------- ❑ WA Iff-YES ❑ No
G >100 fL from wells?--- �r ❑ ❑
W >700 ft.from surface water7--____- ❑ fT ❑
LL >10ft.from potable water lines?---------------------. ❑ El
>5ft.from property . ❑ ❑
a party lines and easements?-------------
Q >30ft.from downgradient curtain/foundation drains?---------- -� ❑ ❑
Drainfleld level and observation ports present -- - ----------- ❑ �'' ❑
❑ Graveless chambers or Oclean gravel used? (check one)
Proper cover installed over drainfield?--- ---------------- ❑ ❑
Pump tank setbacks consistent with septic tank?------------- ❑ W fires ❑ No
Z Pump tank capacity(flood) 1287 gal Manufacturer INFILTRATOR 1060
24'access riser(s)and accessible from surface?------------- ❑ Dr ❑
aAlarm or Control Panel Installed? --------------------- ❑ ❑
7 Control Panel equipped with TimerIETM/Counter------- --- ❑ ❑
c-XPump installed in ❑ Bucket or W On Block or ❑ Other
IL PumpMake/Model i
Q JE}Floats or ❑ Transducer
M Tank draw down 1 2f in/min PUMP ce r 1 p pacity fj&'75 ' opm Squirt Height ft
Pump on time_ Sss Pump off 5rne y /1ci' Daily flow set at 2 L gpd
U'.smrzo+e
Mason County OSS Installation Report pg. 2 Parcel a 42012-54-00015
ABANDONMENTRECORD
Were existing septic components abandoned as Part of this project? -------------- - yes ❑ NO
If yes, pease describe:
Were ail components pumped out and properly abandoned par WAC246-272A-03007 ------- - 0 YES ❑ NO
RECORD DRAWING
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❑ Record Drawing Attached
CERTIFICATION OF INSTALLATION
INSTALLER DESIGNER/ENGINEER
I certify that/installed the system in accordance with I certiry 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
hem have been cleared/approved 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 moot all
and Mason County Codes. State and Mason County Codes
I further certify 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.
*dature of Installer Date �3
Lac.lfPi1CP atilt 3T
rioted Name of Signee �k~/W,��`d't 0.say
MASON COUNTY PUBLIC HEALTH t�
1' E AI E-
The undersigned approves this Iqs.tallafion R a Y UCENSFD DESIGN
Record Drawing on behaH of M65",Only vF
Health: CpU/ ,20 Q EvexEs nm
0� MFg7
Signature of Envimnmentel Health Specialist Date q y
Fq (stamp,signature and date)
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUIM WEB SITE uwwaenirmie
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FEB 14 203
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