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Home My WebLink AboutSWG2024-00050/ASBUILT - SWG As-Built - 9/4/2026 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/PERMIT INFORMATION Permit Number SWG 2024-00050 Parcel# 31910-14-00021 Applicant Name Gavin Layton Subdivision(Name/Div/Block/Lot) Applicant Address 17913 Interurban Blvd. City, State, Zip Snohomish,We 98295 Installer Name Maples Excavating Site Address 231 Mable Taylor Lane Designer Name Bob Paysse INSTALLATION CHECKLIST Full System Installation ❑Tank(s)Only ❑Dralnfieid Only ❑Repair ❑Other System Type Drip Pretreatment Type NuWater BNR 600 >6 ft.from foundation? ------- R ❑NIA NO >50 ft.from wells? ----------j ----- - -- - - - -- >50ft.from surface water? ----- - ❑ ■ ❑ Cleanout between building and tint UL--- ----tu----- - ❑ ® ❑ a Tank baffles present? ------- ____ __ --- ❑ ® 0 E24'access risers over each compa _ e__ ❑ a ❑ WEffluent(ilterinstalled?-_________________________ _ ® 0 ❑ Septic tank capacity(working) 1000 trash gel Manufacturer Sound Placement �9 D-box water level and speed levelers used? ----- ---------- AMA ❑YES ❑ No OLL Manifold/D-box accessiblefrom surface?---------------- - ❑ . ❑ G< Check valvesinstalled? --- _-- ❑ U ❑ Transport Line Size 1.25 Schedule/Class 40 Bedrooms installed(check one) ❑2 ❑3 ❑4 ®5 ❑6 ❑Commercial/Other >I0 ft.fromfoundation?---______________________-- ❑N/A ®YES 0 N o >100 ft.from wells?_______________________ _____- ❑ ® ❑ W >100 ft.from surfacewater? -_______________________ ❑ U ❑ it >10ft.frompotablewaterlines?---------------------- Cl ® 0 >51t.from property lines and easements?------------___ - ❑ ® ❑ >30ft.from downgredient curtain/foundation drains?---------- ❑ ® ❑ Dreinield level and observation ports present -- --------- --- ❑ ® ❑ ❑ Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfleld?------------------ - ❑ ® ❑ Pump tank setbacks consistent with septic tank?------------ - ❑ N/A We no 2'4 Pump lank capacity(flood) 1800 gal Manufacturer Sound Placement 24'access dset(s)and accessible from surface?------------ - ❑ ❑ AlemnorControlPanelInstalled? -- ------------------- ❑ ■ ❑ Control Panel equipped with Tamer/ETM/Counter-- --------- ❑ ■ ❑ Pump installed In ❑ Bucket or ❑ On Block or ❑ Other Turbin free standing Pump Make/Model Turbin U Floats or ❑Transducer Tank draw down .33 INmin Pump capacity 8.4 gpm Squirt Height N/A ft Pump on fl ras 8 min Pump o4 time 2 hrs Daily flow set at 600 gpd ue16y NH21u Mason County OSS Installation Report pg. 2 Percent 3191O-14-OOO21 ABANDONMENT RECORD were existing septic components abandoned as pan of this project? -------------- - ❑ YES ® No If yes, please describe, Were all components pumped out and properly abandoned per WAC24B-272AM300? - - - - - - 0 YES No RECORD DRAWING 1LY I..p.marant Isola and TUR to iait. B4 NacXVav'..neuoh to iVKK.b In M nwd W mnM.n.nu x Iis.and thin d.v.M MWc Typal RMor omrn0.contain. Manh.ld a nw,*dcdaads&Yyzl.S.pWKW tank Imbn North arrow.r.t.rra oeaw.N,.xtne and pr po..d WIwM9a.Io bon of wae,aatwfsa. NNs.nbwya[pn fin.,cJyryryu.a Man a nnNMBriarce...pooh rn v, So Al Dodo may hsb addianS da.ya'in Rny lndvapan.,Va'.I ad rNakd outride. N Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER!ENGINEER I certify that!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 hem 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 Masan County Codes. State and Mason County Codes I further ceniry that ell 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. jh P. ti112/- Signature of Installer Dale Shane Maples Printed Name of Sign. MASON COUNTY PUBLIC HEALTH The undersigned approves this Installation Report and abw7Y°'&va.a Record Drawing on behalf of Mason County Public Health: aa.wss �C7t1�4N�pl �(K�z� Signalure of Environments Health Specialist Data (stamp,signature and date) THIS FORM MAYBE SCANN EDANO AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Waad.maa. LImE SKOOKUMI 1 INLLET / \ \ I aS1+1e . 1 �n EXIST. \ PRIMARY WELL A 1 -' ' / I I TANKS /'' I 1 \ 1000TSASH TAN I \\ r S 1BDOPUMPTA / / I EXIST. CABIN / I SEASONAL REMOVE LARGE RUNOFF MAPLE TREE — RESERVE \ 11 I I � C/O I PPRI ED \ I FUTURE BUILDING SEP 0 2026 I LOCATION MASON COUNTY ENNR0NYENTALHEAL' I .wg. I I I SET 1 N7 AN ABBWLTI INSTALL BgNOFF FEE WILL �}�!�^p �/�E�{/'` INCE CHARGED AT TIME OF INSTALLATION PIONEERDIGGQJGE, l�llw ClRCELt31GAY00021 N 1R.gIJIJ't 1161lhl '_ hVl3 IltlII.IIY PARCEL 131910 K000'll U)2NI. FUJI. 03x:T I. UNiI. 3].u.a 3L13.U' llr3lS RNU.V SEPTIC DESIGNS ADDR6�v 33lM ETAriO R w*v 14 &'3083E M t BDNi1N RD. GRMENEW.WA 98W DF]IGNER: ROBULT Ii PAYSSE RxE-3Mwdkun FAX 360137-]353 SHED. STEAM! SCALE PAW MASON COUNTY Public Health & Human Services FINAL INSPECTION: SWG2024-00050 ADDRESS: 231 Mable Taylor Lane PARCEL: 319101400020 DATE: 8/11/2026 �^ f G HOUSE TO DRAINFIELD ;,m ,✓1Z- Y ia1c-v ' Ar DRAINFIELD TO HOUSE Ka la Milam From. Sent: DO NOT REPLY more To: nv Friday,August 7,20261 O.@46 AM n<aunt a9, ov> Environmentalhealth Subject: OSS Inspection request for Gvain Layton-SWG2024-00050 Submittal request for:Gvain Layton Site Address:231 SE Mable Taylor In Ir f�i 'r]'-' r y q il ` Permit Number:SWG2024-00050 J` AUG 0 7 2026 Parcel Number:319101400021 Installer Name:Shane Maples Installer Phone Number:3602293043 Installer Email Address: maplesexcavating@hotmail.com Designer Name: Bob Paysse Designer Email Address:pioneerdigging@yahoo.com Inspection Request Date:2026-08-07 Inspection Type: Full System Comment\Notes: Thank you for submitting your final install request.The install should be complete and ready to inspect on the Inspection Request Date'and remain uncovered for three business days to allow staff time to inspect.Poor weather situafions may be accommodated by contacting onsite staff.Installer is responsible for obtaining Septic Designer/Engineer installation approval prior to backfill of system components.if no contact is made by the health department within the three business days of notice,the installer may cover.Mason County Asbuilt Form,Record Drawing,and Installation fee must. .. be submitted for final installation approval.