The URL can be used to link to this page

Home My WebLink AboutSWG2025-00149 - SWG As-Built - 6/9/2025 , Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2025-00149 Parcel# 42036-75-00030 Applicant Name Thomas Barwick Subdivision (Name/Div/Block/Lot) Applicant Address 141 W Marvin Way TR 3 OF SURVEY 21/246-247 City, State, Zip Shelton, WA 98584 Installer Name Maples Excavating Site Address 141 W Marvin Way Designer Name Arrow Sepitc Designs Inc. INSTALLATION CHECKLIST 0 Full System Installation ❑Tank(s)Only ❑ Drainfield Only 0 Repair ❑ Other System Type Shallow Pressure Pretreatment Type >5 ft.from foundation? - '1 - ❑ NIA 0 YES ❑ NO >50 ft. from wells? - lEIVEM/E- - F ❑ 0 ❑ >50 ft. from surface water? - - - - ❑ 0 ❑ z JUN- 01-202 Q Cleanout between building and tank? _J _ 0 a ❑ 1- 0 Cl Tank baffles present? - - 0 P 24" access risers over each compartnAY - - - - - - ❑ 0 ❑ a G CIW Effluent filter installed?- ❑ N Infiltrator Septic tank capacity(working) 1,250 gal Manufacturer 0 D-box water level and speed levelers used? - - ❑ N/A ❑ YES 0 NO J CI NI CI Manifold/D-box accessible from surface?- mZ Check valves installed? - ak W,V '? tc-h-k' - ❑ 0 ❑ OQ 2" Schedule/Class 40 2 Transport Line Size Bedrooms installed (check one) ❑ 2 0 3 ❑4 ❑ 5 ❑ 6 ❑Commercial/Other >10 ft. from foundation?- - ❑ N/A 0 YES El NO • 0 >100 ft. from wells?- - 0 0 ❑ W >100 ft. from surface water? - - CI ® 0 LL >10 ft. from potable water lines?- _ El I ❑ Z > 5 ft.from property lines and easements?- - ❑ 0 ❑ it > 30 ft. from downgradient curtain/foundation drains?- - ❑ 0 ❑ ci Drainfield level and observation ports present - - ❑ a ❑ ❑ Graveless chambers or NE Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ 0 ❑ Pump tank setbacks consistent with septic tank?- - ❑ N/A 0 YES ElNO • Pump tank capacity (flood) 1,060 gal V. Manufacturer Infiltrator Z CI r24" access riser(s) and accessible from surface? ❑ 0 Alarm or Control Panel Installed? - - - - -R-n -?fit CI ID© a• Control Panel equipped with Timer/ ETM /Counter- - CICI n- Pump installed in ❑ Bucket or 0 On Block or ❑ Other a'• Pump Make/Model Zoeller N152 0 Floats or ❑ Transducer a Tank draw down 4 in/min Pump capacity 100 gpm Squirt Height 11 ft 0 Pump on time .9 min Pump off time 6 hr Daily flow set at 360 gpd Updated 8212018 i li Mason County OSS Installation Report pg. 2 Parcel# L-E Z0 3L —1 — 00030 ABANDONMENT RECORD NO Were existing septic components abandoned as part of this project? - � If yes, please describe: 0� Ov�y �` �h QanAtiNstalNiLik ® YES El NO Were all components pumped out and properly abandoned per WAC246-272A-0300? RECORD DRAWING This is a permanent record and must be accurate and descriptive enough to re-locate in the need of maintenance activities and future development Typical Record Drawings contain: Drairtfield&manifold orientation&layout.Septiclpump tank location,North crow.reserve drairfield,etsting and proposed buildings,location of wells,waterlines, wells,observation ports,deanouts,and other maintenance access points. Incomplete Record Drawings may ceate additional delays in final installation approval and related permits. Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ENGINEER 1 certify that I 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 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 meet 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. Ajk •"Signature of Installer Date • '•jt,` Printed Name of Signee MASON COUNTY PUBLIC HEALTH j r The undersigned approves this Installation Report and 510(,349 ••�v) Record Drawingon behalf of Mason CountyPublic e: PAULA JOY JOHNSON '•�"'�i, Health: ''rr`` G rr EXPIRES Ua 1 / ` 'I V iq S (4)— Signature of Environ ental Health Specialist Date (stamp, signature and date) 1 THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE updatec 82t2o'8 I , \ 41) . ------\ , i • , • I . • _.; v,?,_;.., . --..............................1-47 M&• .i .NIN ,,_ w-1/ fix.IViincl-E--) , .• I • , ( (-," "F..: Y. 5-;. .5 (-1' o•c- _.____._.____ . / -... _-_. . . • . . . ( I .• \ \ 0 0 1 .2s' • . _ 4 , APPROVED . I . I., jUN 09 2025 ,-... MASON COUNTY E ; . •' f; (,-r- ' SC-Pc- NVIRrt1.1 .,,,,„,yENTA, RET , r".HEALTH r - ..._.--,---- r . 5 e._ -K-zs-c_ - e)ua. (7.) .i.'•..-adio-vis-{.1-...1 Alarm, ' ...--1 ,.z ', r ; . ,-- __,-7--c .--,--,_ I...,.--717% • va:tve :...0 7.17-r 0 i 3.0"Z lil .• VC I '-'(`i l; -.w -- Tr" ':<:-.:, , ,.; . „D „ : '\...:-) ?^C...g.,577.c c-).7:: Co F...k?.4:!..."7-Lf:`, .2. .7..) L'•-- -OA'- ki; 104 Aec- ,..v:s vitevted a= v ewyso,z ea - .,;:...5....ik, . • 1) ,ictir i;t \, 4 14 f •t• , . 04. e:• 4; ,,..• 2'.IP•• ..' *.urs:,p• • . . . .1--r. • PA 5100349 .A....,%). ULA _ , reDli5ajbMe314ri:1:. .. IKXPIrms-\a-11 ,--iy-ZS.C; :.