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Home My WebLink AboutSWG2026-00288/ASBUILT - SWG As-Built - 10/5/2026 RECORD DRAWING (ASBUILT) pg. 1 MASON COUNTY PUBLIC HEALTH PARCEL IDENTIFICATION Permit Number SWG 2026-00288 Assessor Parcel# 321046000010 Applicant Name Calina Martinez Subdivision (Name/Div/Block/Lot) Applicant Address 591 a country club dr a Alderbrook City, State, Zip Union WA 98592 - Installer Name Scott Johnson Site Address 591 E Country Club dr E Designer Name Adam Hunter INSTALLATION CHECKLIST • Full System Installation ❑ Septic Tank Only ❑ Drainfleld Only (1 Repair System Type sub surface drip Pretreatment Type Nu Water >5 ft. from foundation? ---------- {t }/��?' NIA •YES ❑ Nd >50 ft.from wells? ---- -- - ----- u -r r•= ❑ A ❑ >50 ft. from surface water? - - -- --- - ❑ Q ❑ Cleanoutbetween buildingand tank? - - - --- - -- -- - v - ❑ ❑ a Tank baffles present? ------- --- - - - --- - ❑ a 0 24 access risers over each compartme -- - ❑ [� ❑ W Effluentfllter installed?--- ---- ---- - - --- - - ------ --- - ® ❑ ❑ N -Septic tank size BNR 500 gal Manufacturer Sound Precast O D-box water level and speedlevelers used? ------ ----- - - -- • N/A DYES ❑ NO 0O Manifold/D-box accessible from surface?- - -- - - - - ----- - - -- e ❑ ❑ a0 z. Check valves Installed? -- -------- - - --- -- ------ --- E] ❑ ❑ Transport Line Size 1" Schedule/Class 40 • Bedrooms installed(check one) ❑ 2 ®3 ❑4 ❑ 5 ❑6 >10ft.from foundation?-- -- ------- - ---- - ----- -- - - ❑ NIA ® YES ❑ NO >100 ft.from wells?------- ------ - ---- ----------- ❑ ® ❑ W >100ft.fromsurfacewater?-- ------- --- --- ----- - --- ❑ a ❑ u >10ft. from potable water lines?---------- -- - ------ --- 0 ❑ Z >5 ft from property lines and easements?- - - --- - - ----- - - - ❑ d ❑ 9 >30 ft. from downgradlent curtaln/foundatlon drains? - ----- ---- ❑ 0 ❑ Drainfleld level and observation ports present - -- - - ------ - - - IN ❑ ❑ ❑ Graveless chambers or ❑ Clean gravel used? (check one) Proper cover installed overdralnfleld?---------- ----- - - -- ❑ It ❑ Pump tank setbacks consistent with septic tank?-- -- --------- ❑ N/A YES ❑ NO 1250 Sound Precast Y pump tank size al Manufacturer < 24'access dser(s) and accessible from surface?- --- ----- ---- 0 ❑ ~ -- -- - - Alarrn or Control Penal lnstalled7 -- --- - ----- --- ❑ ó ❑ Control Panel equipped with Timer/ETM I Counter- -- --- -- - -- ❑ 5 ❑ a Pump installed in ❑ Bucket or ❑ On Block or o Other 6' pipe OLPump Make/Model Ater 10 series-115 A Floats or ❑Transducer Tank draw down Ne 0.4 in/min Pump capacity 10 apm Squirt Height Dnp ft __ .,�_ 2S min o.,....,..rt H...e 2hr nl iiv flnw eat at 360 nnm RECORD DRAWING (ASBUILT) pg. 2 MASON COUNTY PUBLIC HEALTH RECORD DRAWING ❑ Grainfield& manifold orientation &layout Trenchmed dimensions and critical distances within layout fl septic/pump tank see attached placement ❑ Location of buildings ❑ Obsorvallon ports& clean-out locations fl Location of wells, surface water,& roads Undisturbed native ..It between trenches 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 separate page attached. No. Pages Attached 1 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 I further certify that all information contained on this I further certify that all information contained on this form and aattt aaria Recor mg is accurate. - form and attached Record Drawing is accurate. 9-28-2026 Signature of Installer Date --I SwuF o SO(J 9/29/26 Printed Name of Signee f:. G4=. MASON COUNTY PUBLIC HEALTH V *' The undersigned approves this Installation Report and Record Drawing on behalf of Mason County Public ,f•au' �"•••_ r.; Health: (D (S" Signature of Environmental Health Specialist Date (designer's stamp, signature and date) ° © ( | _ , e • w | ! ; !! § ; 5 § ® _ ! | � , § | ; u q ; |• ] � [ ) ! | | ! o -I ; ; , - k Ui ) | | � | \ � O m | | | | ! | | | | ± ° a 00000000+0+o a § c § n , 3\ \ \ /7` - P l ! F - - - " � \ } , \ (. \ _ -- - LI /J ' IUHU , - - '\ LLLL , \ g JI\ — - -« - - -- - : � ` .