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Home My WebLink AboutSWG2022-00608 - SWG As-Built - 5/6/2026 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2022-00608 Parcel# 323342400000 Applicant Name CRYSTAL MATTSON Subdivision (Name/Div/Block/Lot) Applicant Address P.O.BOX 867 City, State, Zip MCKENNA,WA 98558 Installer Name CORY BROWNSON (B&C BUILD Site Address 310 NE KISSIN TREE LN Designer Name ADAM HUNTER INSTALLATION CHECKLIST Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑Repair ❑Other System Type PRESSURE Pretreatment Type N/A >5ft.fromfoundation? --- --- ---- -- ----- -- -- ------ ❑N/A ®YES NO >50ft.fromwells? ----- -- -- ---- --- ---------- --•- ❑ ® ❑ >50ft.fromsurfacewater? -- ----- - --- - - - - - - - -- - - -- ❑ ❑ Z Cleanout between building and tank? - - --- --- ----- ---- -- ❑ ® ❑ Tank baffles present? - - ------ ------ - - - - --- -- ---- ❑ ® ❑ 24"access risers over each compartment?--- ----------- - - ❑ ® ❑ W Effluent filter installed?----- --- ------ ------- - --- - ❑ ❑ Septic tank capacity(working) 1250 gal Manufacturer HAGERMAN O D-box water level and speed levelers used? -- ------- --- - - - ® NIA ❑YES ❑ NO OManifold/D-box accessible from surface?- --- ------------ - ❑ ® ❑ mz Check valves installed? - - - - - - - -- - - - - - --- - - - ---- -- ❑ ❑ OQ 2 Transport Line Size 2" Schedule/Class SCH40 Bedrooms installed (check one) ❑ 2 0 3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10ft.fromfoundation?- - - - - - ---- - -- --- -- - - ------ ❑ N/A ®YES [] No O >100ft.fromwells?----- --- ------ ---- --- ---- -- -- ❑ ® ❑ W >100 ft.from surface water? - -- -- ---- -- - - --- -- -- - - - - ❑ ® ❑ ti >10 ft.from potable water lines?- -- ---- -- ---- --- -- - -- - ❑ III ❑ Z >5 ft.from property lines and easements?- - - -- -- - -- -- ---- ❑ I ❑ >30 ft.from downgradient curtain/foundation drains? - - - - - - ---- ❑ ❑ Drainfleld level and observation ports present - -- - - - - - ------ ❑ Q ❑ ® Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?-- --------- ---- ---- ❑ ] ❑ Pump tank setbacks consistent with septic tank?----- ---- -- - - ❑ N/A Q YES ❑ NO Pump tank capacity(flood) 1250 gal Manufacturer HAGERMAN Q24"access riser(s)and accessible from surface?---- --- ------ ❑ ® ❑ H Alarm or Control Panel Installed? ---- -- ---- --- ---- --- - ❑ Q ❑ Control Panel equipped with Timer I ETM I Counter- - - - - - - - - - - ❑ ❑ IL Pump installed in ❑ Bucket or ® On Block or ❑ Other a' Pump Pum Make/Model LIBERTY L280 ® Floats or ❑Transducer Tank draw down 2-1/4 IN in/min Pump capacity 54 gpm Squirt Height 2 ft Pump on time 1 MIN .07 SEC Pump off time 4 HRS Daily flow set at 360 gpd Updated an+rzota Mason County OSS Installation Report pg. 2 Parcel# 323342400000 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? --------- - -- --- ❑ YES Q NO If yes, please describe: Were all components pumped out and properly abandoned per WAC246-272A-0300? - ------- ❑ YES [] NO 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: Drainfield&manifold orientation&layout,Septic/pump tank location,North arrow,reserve drainfield,existing and proposed buildings,location of wells,waterlines, wells,observation ports,cleanouts,and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and related permits. ❑ Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ENGINEER I certify that I installed the system in accordance with !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 t further certify that all information contained on this form and attached Record Drawing is accurate. form and attached Record Drawing is accurate. 10/24/2024 Signature,J Installer Date CORY BROWNSON Printed Name of Signee 04//28/26 MASON COUNTY PUBLIC HEALTLl° ' �,sr .; The undersigned approves this Insta!!a on yep Record Drawing on behalf of Mason County PublitcQJ " Health: q ® AD-0r.,J HUNTER A y®6 6 Signal a of Environmental Health Specialist �✓ ft, (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PI1 LIC VIEW ON THE MASON COUNTY WEB SITE Updated 5O1/2018 RECORD DRAWING (continued) 4, 04 � FyT's'l y�q�r� 675' 2 E) SCALE-1"=100'-0" 30' ast ' I 1 N PORT U� • / , I I IIII I I i3 n,�:_: �,;_.: w I I I I I I I I f'-:•:..nunri,L`iiri R ',;. i. j• � y 1ItIP/ R w IIII CLEAN O m• O EXISTING 5 BEDROOM RESIDENCE r ! SCALE-1"3O-0" EXISTING WELL i1 / EXISTING SEPTIC TANK wll 'EXISTING DRAINFIELD I RIA 1 O5 EXISTING DRIVE In� O6 DRIVE O8 I PRESSURE TEST COMPLETED BY INSTALLER STUBOUT/CLEANOUT ' SEPTIC TANK ` SQUIRTHT: Z� 10 PUMP CHAMBER \ O7 3S-2 \ "PVCTIGHTLINE(SCH40) DRAWDOWN: -� VALVE BOX \ 13 60'DOWNSLOPE ATTENUATION ZONE \\ TIMER SETTINGS- ON: (,b-7 w.-,.' OFF:'rOJIM HUNTER&ASSOC. CONTRACTOR O4s°ti yO � * Mg CO P.O.BOX 162, 26OLY WA 98507 753-1226 )HANDASSOCIATES@HOTMAILCOM INSTALL DATE-10131/24 NTj,FN�/Ro p�� RECORD DRAWING SITE ADDRESS/LEGAL 310 NE KISSIN TREE LN ,ry H/y�FNTq�yF OWNER- CRYSTAL MATTSON FINAL DATE- 111624 TPIt 323342400000 SITE a SWG2022.00608