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HomeMy WebLinkAboutSWG2025-00337 - SWG As-Built - 4/30/2026 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/-PERMIT INFORMATION Permit Number SWG 2025-00337 Parcel# 22018-53-00037 Applicant Name Michelle Hooton Subdivision (Name/Div/Block/Lot) Applicant Address 2171 E Timberlake West Dr City, State, Zip Shelton, WA 98584 Installer Name House Brothers Const. Site Address 2171 E Timberlake West Dr Designer Name Adam Hunter INSTALLATION CHECKLIST O Full System Installation ❑Tank(s)Only ❑ Drainfield Only 0 Repair ❑Other -gym System Type ATU/D tii P 0 ,F. Pretreatment Type Rnft; 600 >5 ft.from foundation? - -- - - - - - - - -- ❑ NIA ®YES ❑ NO >50ft.fromwells? - -- - ---- - - }'�}I- ! 0 © ❑ >50 ft.from surface water? - - - -- ' -- - -- - -+--- - -- ❑ Iii ❑ H Cleanout between building and tank? - -APR 3-O...ZO E - U -- ❑ iii ❑ Tank baffles present? -- - - - - - - - --- - - - - - - ---- -- ❑ .1 ❑ 0~. 24"access risers over each compartn e - - - ------- - ❑ II ❑ W Efuentfilterinstalled?- --- --- - - --- - - - - - -- - - - - --- - ❑ ® ❑ Septic tank capacity(working) BNR500 gal Manufacturer Sound Placement D-box water level and speed levelers used? ---- - ---- ----- - �] NIA ❑ YES ❑ NO DO ManifoldlD-box accessible from surface?-- -- - - - - --- - - -- - - © ❑ ❑ mz Check valves installed? - - - - -- - - - -- - - -- - - - - - - - - --- © ❑ ❑ ❑Q 2 Transport Line Size 1" Schedule/Class Schedule 40 Bedrooms installed (check one) 9 2 ❑3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10ft.fromfoundation?- - - - - - - - - - - - - - - - - - - - -- - - -- NIA ® YES NO >100ft.fromwells?- -- -- - - - - ' - - --- - - -- -- -- ❑ 0 ❑ W >100ft.fromsurfacewater? - U, �- �- ��. =-i-- -- - - u- >10 ft from potable water lines?— ¢ ---- - !- � fi�i"�?"' ❑ ® ❑ Z >5 ft.from property lines and ease n s?-ARP 11 -- .:- rw; ❑ ® ❑ Nl rti �6p >30 ft from downgradient curtain/foNndatWtildr ��s? -- - - -�- - ❑ ® ❑ Drainfield level and observation ports present - - n- - -_ ❑ ® ❑ ❑ Graveless chambers or 0 Clean gravel used? (check o�ne)H Proper cover installed over drainfield?---- - - - -- - - -- -- -- -- ❑ ® ❑ Pump tank setbacks consistent with septic tank?- ----------- - ❑ N/A 0 YES ❑ NO Pump tank capacity(flood) I OULo gal Manufacturer Q24"access riser(s)and accessible from surface?- -- - -- -- - ---- ❑ a] O D: . Alarm or Control Panel Installed? - -- - -- --- - - --- -- - - - - ❑ UI ❑ Control Panel equipped with Timer/ETM/Counter- -- -- -- - - - - ❑ UI ❑ Pump installed in ❑ Bucket or ® On Block or ❑ Other Pump Make/Model c(Ae-' P 1-266 5 I I Floats or ❑ Transducer a Tank draw down 2 in/min Pump capacity ICS 20 gpm Squirt Height p1 A ft Pump on time 2 n+:o on Pump off time 2. 6,311. Daily flow set at 2y0 gpd Updated 8/212018 Mason County OSS Installation Report pg. 2 Parcel# 22018-53-00037 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - -- - - - ------- --- ❑ YES [] NO If yes, please describe: Were all components pumped out and properly abandoned per WAC246-272A-0300? -- ---- -- 0 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,Septiclpump tank location,North arrow,reserve drainfield,existing and proposed buildings,location of wells,waterlines, wells,observation ports,deanouts,and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and related permits. pz� R14SON NVIR ON � MNrq�yFgCry ❑ Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ENGINEER i 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. Sig ture of Installer Date `v;. • Printed Name of Signee .7 y MASON COUNTY PUBLIC HEALTH 11 The undersigned approves this Installation Report and I-c ... I.t:.r'- Record Drawing on behalf of Mason County Public Z_.� ' (IjA4 Siat1J .j Environmental Health Specialist Date (stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Updated 8121/2018 SCALE-1"=20'-0" 1/7 GARAGE 60'± FRC//yc� GARAGE / ftftc 4 , :z• ' r 8' Y. FDAI'.1 J.HUi17�h / / EXISTING 2 BDRM RES 100'-1"SCH40 SUPPLY!RETURN LINES / EXISTING STUBOUT(ADDED C EANOUT) / IN TRATOR IM540 TRASH T K / WATERLINE(ABANDON /O / SEPTIC (ABANDON PER CODE) 199± / UWATER 00 ATU IN INFILTRAT R IM1060 / AILED SEEPAGE PIT(ABANDONED) PRESSURE TEST COMPLETED BY INSTALLER O / O INFILTRATOR IM1060 PUMP CAMBER of �V SQUIRT HT: ��\P / CK HEAWORKS(SEE DETAI G2) DRAWDOWN: oTIMER SETTINGS - O 11 1p- lea / S N °UNT��CnJV� t— I- r OFF: -L JIM HUNTER & ASSOC. CONTRACTOR P.O. BOX 162, OLY,WA 98507 HOUSE BROTHERS 753-1226 JHANDASSOCIATES@H0TMAIL.COM INSTALL DATE- 1113/25 RECORD DRAWING SITE ADDRESS/LEGAL 2171 E TIMBERLAKE WEST DR OWNER- MICHELLEHOOT0N FINAL DATE- 11/4/25 TIMBER LAKE TP# 220185300037 SITE# SWG2025-00337