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HomeMy WebLinkAboutSWG2022-00202 - SWG As-Built - 2/27/2024 Mason County OSS Installation Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2022-00202 Parcel # 320215008001 Applicant Name BRAD ROHR Subdivision (Name/Div/Block/Lot) Applicant Address 2027 WALKER PARK RD City, State, Zip SHELTON Installer Name TRAVIS VILLINES Site Address 100 SE ALDER RD Designer Name JUSTIN RUSSELL INSTALLATION CHECKLIST ❑ Full System Installation ❑ Tank(s)Only ❑ Drainfield Only ❑ Repair ❑Other System Type GLENDON Pretreatment Type >5 ft. from foundation? - - ❑ N/A 0 YES ❑ NO >50 ft. from wells? - - ❑ 0 ❑ Z• >50 ft. from surface water? - - El 0 ❑ H• Cleanout between building and tank? - - ❑ ❑■ ❑ U Tank baffles present? - - ❑ El ❑ 1-7- 24" access risers over each compartment?- - ❑ ❑■ ❑ W Effluent filter installed?- - - - ❑ 0 ❑ co Septic tank capacity (working) 1000 gal Manufacturer PREMIER Ca D-box water level and speed levelers used? - - ❑ N/A ElYES El NO O Manifold/D-box accessible from surface?- - ❑I ❑ ❑ 00 Z Check valves installed? - - 0 ❑ ❑ 6.4( 2 Transport Line Size Schedule/Class Bedrooms installed (check one) 0 2 ❑ 3 ❑4 ❑ 5 ❑6 ['Commercial/Other >10 ft. from foundation?- - ❑ N/A ❑■ YES ❑ NO O >100 ft. from wells?- - ❑ ❑■ ❑ W >100 ft. from surface water? - - ❑ El ❑ LT >10 ft. from potable water lines?- - ❑ ❑� ❑ Z > 5 ft. from property lines and easements?- - ❑ 0 ❑ Q CL > 30 ft. from downgradient curtain/foundation drains? - - ❑ ❑■ ❑ o Drainfield level and observation ports present - - ❑ ® ❑ ❑ Graveless chambers or ® Clean gravel used? (check one) Proper cover installed over drainfield?- - X ❑ ❑ Pump tank setbacks consistent with septic tank? - - ❑ N/A 0 YES ❑ NO • Pump tank capacity(flood) 1000 gal Manufacturer PREMIER PLASTICS Q24" access riser(s) and accessible from surface?- - ❑ ■❑ ❑ ~ Alarm or Control Panel Installed? - - ❑ I. ❑ a 2 Control Panel equipped with Timer/ ETM/Counter- - ❑ ❑ ❑ D 11- Pump installed in ❑ Bucket or Li On Block or ❑ Other n'• Pump Make/Model PER GLENDON ❑ Floats or 1 Transducer n. Tank draw down GLENDON in/min Pump capacity --- gpm Squirt Height NA ft Pump on time PROPRIETARY Pump off time PROPRIETARY Daily flow set at gpd Updated 0/21/2018 • RECORD DRAWING (ASBUILT) pg. 2 MASON COUNTY PUBLIC HEALTH RECORD DRAWING Drainfield& manifold orientation &layout O Trench/bed dimensions and critical distances within layout • Septic/pump tank placement • Location of buildings Observation ports& clean-out locations • Location of wells, surface water,& roads Undisturbed native soil between trenches 0 North Arrow If the designer or installer feel the need for additional information/comments,it may be attached. Record drawing may also be on a seperate page attached. No. Pages Attached CERTIFICATION OF INSTALLATION • 1• . INSTALLER DESIGNER I certify that 1 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 .1 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. Z/2-314_1 Signature of Installer Date C :',5. , tl((.ems Printed Name of Signee MASON COUNTY PUBLIC HEALTH 5J2)2 The undersigned approves this installation Report and Record Drawing on behalf of Mason County Public Health: V-77(T Signature of Environmental Health Specialist Date (designer's stamp, signature and date) THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE revised 1/22/2014 r .» ‘11A4al -:"1 LIIW N D z -o 0 C "r1 13 z m T N © m N 3 �, z N e. m 73 ' N Z 0 rn 71 T i = a . i °l i P40 i 0Tn': 0 p OT: N 11O m y / , F: / p �`, Y o p m y X p r .m 3 D <oAA" ▪ fT n m "y Ox� mrCER mmO N O fk 11n - , , [ .1 -or- y A pAzF ti N nn i m G,rn Q q Cm• m m A Om� DDn• 8go ._ O §z c) A > A,,=%°Da y2 - mH u N r 2 D Pn m N 9 N ° A `A my <a O 0 1 Rhonda Thompson From: Justin Russell <jrussell@alpha-septic.com> Sent: Friday, February 23, 2024 2:33 PM To: Jeff Wilmoth; Rhonda Thompson;Travis Villines; Brad Rohr Subject: 100 SE ALDER Attachments: 20240223144954398.pdf; 20240223144945976.pdf Caution: External Email Warning!This email has originated from outside of the Mason County Network. Do not click links or open attachments unless you recognize the sender, are expecting the email, and know the content is safe. If a link sends you to a website where you are asked to validate using your Account and Password, DO NOT DO SO! Instead, report the incident. Sanitarian, Attached is the record drawing for 100 SE Alder. The original designer was Adam Hunter. Due to an agreement between Brad Rohr and I, Alpha Septic is completing the record drawing. Adam Hunter is aware of this. 'Thank,4.4w, Justin Russell Alpha Septic Solution, LLC. Office 360-956-7242 1