The URL can be used to link to this page

Home My WebLink AboutSWG2025-00109 - SWG As-Built - 6/5/2026 I RECORD DRAWING (ASBUILT) pg. 1 MASON COUNTY PUBLIC HEALTH PARCEL IDENTIFICATION Permit Number SWG zQ� � _coo f� 1 Assessor Parcel# 2/7 Q CrX)b. Applicant Name 'vl,,` Subdivision (Name/Div/Block/Lot) Applicant Address City, State, Zip r. -lY,V'4-P Installer Name j ai ` Site Address ' 1C7/ ) }.ic ,L4t 61j / 6esigner Name JV V INSTALLATION CHECKLIST Full System Installation ❑Tank(s)Only ❑ Drainfield Only ❑Repair ❑Other System Type I Iit eatment Type >5 ft.from foundation? - --- - - - - ❑ N/A 5-YES ❑ NO >50ft.fromwells? --- - --- --- -- ----- >50ft.fromsurfacewater? - - - --- - - -� �U�-6 - - - ❑ ® ❑ F<_ Cleanout between building and tank? - -VA—----- ---- ❑ ❑ V Tank baffles present? -- - - - - -- - - -- - - - - - - -- - ❑ ❑ I— 24"access risers over each compartme �y-- - - --- - -- ❑ [ ❑ `W Effluent filter installed?-- - - -- - --- --------- ---- - ❑ &• ❑ Septic tank size / O - la. gal Manufacturer m ) D-box water level and speed levelers used? -- - - - - ------ -- - RN/A ❑ YES ❑ NO 0 O Manifold/D-box accessible from surface?- --- --- - ---- - --- - ❑ ❑ mz Check valves installed? - - - ---- - - ---- - -- -- --- - ---•- ❑ [} ❑ oQ 2 Transport Line Size /" Schedule/Class �adc_ L-fO Bedrooms installed (check one) [R2 ❑3 ❑4 ❑ 5 ❑6 ❑Commercial/Other >10ft.fromfoundation?--- - - ------- - - - - -- - -- ------ ❑ N/A 5'YES ❑ NO >100 ft.from wells?--- - ---- ---- - -- -- - --- -- ---- -- ❑ ❑ >100ft.fromsurfacewater? - - ----- - ----------- ----- ❑ ❑ Z >10ft.frompotablewaterlines?----- - -- - -- -- --- - ----- ❑ I ❑ Q >5 ft.from property lines and easements?---- -- - - ---- - -- - ❑ ❑ W >30 ft.from downgradient curtain/foundation drains?- - --- - - - -- ❑ l ❑ Drainfield level and observation ports present -- - - - -- - - - - - -- O E ❑ [[ Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed over drainfield?-- - ------- ---- - --- - ❑ ❑ Pump tank setbacks consistant with septic tank? ----- ------- - ❑ N/A YES ❑ NO ZPump tank size / "9d gal Manufacturer 5C; rid 24"access riser(s) and accessible from surface?- -- ------ --- - ❑ ❑ d Alarm or Control Panel Installed? --- -- - -- -- - --- - - - - -- - ❑ J1 ❑ 5 Control Panel equipped with Timer/ETM/Counter--- - - - - - --- ❑ 12 ❑ D - Pump installed in ❑ Bucket or 'On Block or ❑ Other 2 Pump Make/Model ) � / �S'U �ham/ Iloata or ❑ Transducer a Tank draw down /- l. in/min Pump capacity `C4'f,v& gpm Squirt Height i ' ft Pump on time ftyn /C Pump off time J O Daily flow set at 24bgpd Updated 12/7/2015 MCPH RECORD DRAWING (ASBUILT) pg. 2 Assessor Parcel# RECORD DRAWING ❑ Drainfield&manifold orientation&layout w/dimensions for re-location. ❑ Trench/bed dimensions and critical distances within layout ❑ Septic/pump tank placement ❑ Location of buildings existing/proposed ❑ Observation ports, Z clean-out locations, &manifolds/d-boxes ❑ Location of wells, surface water,roads, &waterlines. ❑ Reserve area(s) ❑ 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 INSTALLER DESIGNER 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 t further certify/t all information contained on this I further certify that all information contained on this form and a hed rd Drawing is accurate. form and attached Record Drawing is accurate. 4i '//e aof Installer Date C �"" Printed Name of Signee .;�MASON COUNTY PUBLIC HEALTH h 14 r� The undersigned approves this installation Report and ,o' 2203003+ ��, . 1U511N 511U55t11 _ , Record Drawing on behalf of Mason County Public LICENSED OESic;NFR Health: L/S/z 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 Updated 12/7/2015 Kayla Milam From: DO NOT REPLY <noreply@masoncountywa.gov> Sent: Tuesday, May 5, 202.6 11:20 AM To: Environmentalheallh Subject: OSS Inspection request for Anderson Cheryl D Mitchell L - 2025-0010' Submittal request for: Anderson Cheryl I) Mitchell L Site Address: 8101 NE North Shore RD Permit Number: 2025-00109 Parcel Number: 222175000002 Installer Name: ck construction Installer Phone Number: 3607891763 Installer Email Address: CKEXCAVATING@GMAIL.COM Designer Name: Justin Russel By Designer Email Address: jrussel@alpha-septic.com Inspection Request Date: 2026-05-07 Inspection Type: Full System Comment \ Notes: Thank you for submitting your final install request. The install should be time to lldomand inspect. Poor ready to insp s Request Date' and remain uncovered for three business days to allow e be accommodated by contacting onsite staff. Installer is responsible for obtaining btai igSeptic Designer/E health approval prior to backfill of system components. If no contact is made by the department wi business days of notice, the installer may cover. Mason County Asbuilt Form, Record Drawing, and I be submitted for final installation approval. MASON COUNTY Public Health & Human Services FINAL INSPECTION: SWG2025-00109 ADDRESS: 8101 NE North Shore Rd PARCEL: 222175000002 DATE: 5/6/2026 _ y yY � � r HOUSE TO DRAINFIELD # i _ -GiJ1 r y�y f W�aa DRAINFIELD TO HOUSE i LATERAL i INSP.&CLEAN - - OUT PORT i i i PP(2�E�Dap X30 20'BUILDING 222`1 Zp0 \0' ' \� SETBACK 5 APPROVED lo,X 2A - JUN 05 2026 MASON COUNTY ENVIRONMENTAL HEALi RET 0 STUBOUT/ CLEANOUT 1200-GAL SEPTIC TANK ORSNSNOR�R0 5 Q 1200-GAL PUMP CHAMBER TIGHTLINE CROSSING PER DESIGN NEN SO 1-INCH DRY LINE FOR FUTURE SHOP WITH BATH ON PARCEL 22217-24-00080 WATER 32 ' PUD WATER LINE / METER 0 30 DRAINFIELD INSTALLED WHERE DESIGNED PRESSURE TEST SQUIRT HEIGHT= 33" 2 PUMP CHAMBER DRAW DOWN = 1.5"! MINUTE 72 TIMER SET FOR 1 MINUTE 10 SECONDS ON, 6 HOURS OFF DRIVE DOSE VOLUME = 45 GALLONS O p WATER EXISTING HOME R � 2HOME 15.124 30'BULKHEAD HWM SETBACK EXISTING HOME 27.6' 35' !r <• FROM 000 r rx � COMMON LINE FL E �� i ? 2flfl54 l l�%{`SC7\ - -- --' .-' .---' r . i JU571N 9(3US5ELL._ .' cP. PERP�pN r ICENSCDhL51GNER — r r - - — r r r r ,---' r r rrrrrr r — rrr r — rr HOOD r r r rrr r EXISTING CANAL r r r r r RECORD DRAWING BULKHEAD r r r r r r r r r COMMON LINE' r r r r r r r PER SURVEY ALPHA SEPTIC SOLUTION, LLC. r r r r r r r r r r r r PO BOX 14531 TUMWATER WA 98511-4531 360-956-7242 -BEL AIRE COVE TR A COMMUNITY TIDELANDS r r CUSTOMER: - - r - r - r r - r MITCH ANDERSON r r r r TAX PARCEL#: HOME TANKS 22217-50-00002 - � � � � � � � 64.66 DRAINFIELD 22217-24-00080 r ' ' ,- r r r ' ' r r r '' - r 'J ' ' ' ' 'J ' SITE ADDRESS: 8101 NE NORTH SHORE RD r ,--- r r r r r r r 63.43' LEGAL: BEL AIRE COVE TR 2 PERMIT#: DATE INSTALLED: I DATE INSPECTED: 74.84 NOTE: THE PROPERTY OWNER IS RESPONSIBLE FOR KNJ SWG 2025-00109 5/19/26 5/20/26 HE FLOW OF SEWAGE AT OR BELOW THE OPERATING CAPACITY INSTALLER: CK CONSTRUCTION F 180 GPD AND SEWAGE QUALITY.