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VAR2016-00009 Forestry Moratorium Waiver - VAR Letters / Memos - 6/24/2016
FINDING OF FACT WAIVER OF FOREST MORATORIUM # VAR 2016-00009 APPLICANT: Cedarland Forest Resources (Alderwood 2) APPLICATION DATE: 6/24/16 Mason County has reviewed the above referenced application for a 2-acre waiver of the six-year moratorium resulting from a permitted Class II forest practice activity(2418562) and finds it in conformance with all applicable County land use regulations in effect at the time of application. FINDINGS The proposed waiver of six year moratorium is compliant with the following conditions: The applicant has paid the prescribed fees. The applicant has filed a complete application. This six year moratorium waiver is in conformance with the following Mason County ordinances: Forest Practice Moratorium Ordinance 11.04 1. The development area is no larger than two (2)acres in size. See attached site map. The site is flagged. 2. The harvest and reforestation of the property shall be completed as specified in the approved forest practices application/notice. 2 acres not replanted and okay per Jason Sharp, DNR, 7120116. 3. There shall be no damage to a critical area or its associated vegetation area nor to the shoreline area(if any) or any damage to those areas is repairable with restoration. No such damage has occurred(within the waiver area). 4. The proposed development is consistent with the Mason County Comprehensive Plan and Development Regulations. 1 The proposed development is limited to residential use per the criteria of the waiver process. The location is zoned Rural Residential-5 which is consistent with residential development. 5. If necessary,mitigation shall be required for impacts to critical areas, stormwater, and shorelines. Other mitigation may be required to prevent adverse environmental impacts,pursuant to Mason County Ordinance#55-97,the Environmental Policy Ordinance. No mitigation required. Title 15 Mason Development Code This application for a waiver from the six year moratorium has been processed as a Type II permit with appropriate notices. Comprehensive Plan and Development Regulations The activity proposed for the site affected by this waiver from a six year moratorium is compatible with the Mason County Comprehensive Plan and Development Regulations. The site is zoned Rural Residential 5. Shoreline Master Program This property does not contain land that falls within the jurisdiction of the Mason County Shoreline Master Program. Designation: X. Any activity in those portions of this site shall be consistent with the requirements of the Shoreline Master Program. N/A Mason County Critical Areas Ordinance Site contains steep slopes over 15%. Geological assessment was prepared by N/A State Environmental Policy Act This application for waiver from the six year moratorium#VAR 2016-00009 leas been reviewed for SEPA compliance under case# SEP 2016-00060, and a mitigated determination of non-significance has been made. 2 CONCLUSIONS In conclusion,this application for a waiver from the six-year moratorium associated with FPA#2418564 is consistent with the above criteria. The following types of permits may be issued prior to 5/18/22 under this waiver. 1. Building permits for a single family residence and/or for a residential outbuilding. 2. Single-family on-site septic permit. 3. Road access permit. 4. Earth modification permits. 5. Shoreline Master Program approvals. 6. Well and potable water permits. 7. Other approvals necessary to the development of a single family residence and out buildings. Any permit issued under this waiver shall be conditioned, as necessary,to limit the approval to only that development consistent with the intent of section 11.04.340 of the Mason County Forest Practice Ordinance# 11.04. RECOMMENDATIONS I,being a duly appointed designee of the Mason County Department of Community Development Director,hereby attest to and certify that appropriate provisions have been made for this six year moratorium waiver and hereby recommend approval. Dave Windom, Director Community Services Dept. Date Michael MacSems, Forest Practices Planner Date 3 „ 1f�"v255' 1 �k PS _�4) 85c.o2 FPA/N#: MR WASHINGTON STATE DEPARTMENTOF Received Date: 4/2JP/1am Natural Resources v WDFW Concurrence Due Date: WDFW Concurrence Review Forest Practices Application/Notification Completed: Office Checklist Page 1 Comments Due Date: 5k—/1/lU South Puget Sound Region Decision Due Date: 5125/1 is FP Forester: ;3 q7n Shutdown Zone: (Uh RMAP#: / FPA/N CLASSIFICATION: [ ]II [P III ( ]IVG [ )IVS RMAP Exempt:( ]80/20 [ ]No Forest Roads ( )Ag [ )LLO Landowner L 'J"L y �a r Project Name: Name: W RIA: �� �_ .i (s n��5 6I u� WAU: /mot .lf O N WRIA: WAU: Legal Description: Activity Type: Harvest J� ac Spray ac Stream Crossing(s) Road Construction It Road Abandonment ft Rock Pit ac ALTERNATIVE PRESCRIPTIONS ( J Alternate Plan [ ] Habitat Conservation Plan [ ] Ten-Year Forest Management Plan [ ] Landowner Option Plan for Northern Spotted Owl [ ] Columbia River Gorge National Scenic Area ( J Cooperative Habitat Enhancement Agreement [ ] Watershed Analysis:_ RESOURCE REVIEW [ ) Unstable Slopes(Risk:Highway,Water, ) [ ] Bull Trout Overlay ( ) Soils Map(Highly Erodible$Very Unstable) [ ] HCP Bull Trout Population [ ] SLPSTAB [ j Bald Eagle nest or roost within 660 feet [ ] Landslide Hazard Zonation [ ] Group A or B Water Supply(TRAX code DM or MU) ( ) Landslide Polygon [ ) Hatchery(TRAX code S)(Name: ) [ ] Rain-on-Snow and Outside Approved WA [ ] Even-Aged Harvest greater than 120 Acres [ J Hydric Soils [ ] Ground-based Equipment on Slopes greater than 40% [ ]Wetland[ ] Forested,[ ]A, [ ]B [ ) Road Construction on Slopes greater than 65% [ ) In WMZ of[ ]A,or[ )B Wetland [ ] Saltwater Islands(Name: ) [ ] In RMZ/ELZ of Type[ ]S,( ]F, ( )N water ( ] Water Verification ASSOCIATED NON-SCANNED DOCUMENTS—On file with the FPA/N at the region office. [ ] SEPA Checklist/Documents [ J Large Landowner Road Maintenance and Abandonment Plan ASSOCIATED SCANNED DOCUMENTS [ ] Conversion Option Harvest Plan [ ] Hardwood Conversion Form [ ) FPHP Plans&Specifications [ ] Wetland Mitigation Plan •J[] Qualified Expert Report ( e o 14 55 e-55c�l e n t ( ] Water Protocol Surveys[ ]Modification [ ] Natural Regeneration Plan Form# [ ] Shoreline Permit ( ] Water Classification Worksheet [ ] Marbled Murrelet Form [ ] Shade Documentation(Stream Shade Assessment Worksheet) ( J FPBM Appendix(s) _ [ ) Watershed Analysis Worksheet [ ] Small Landowner RMAP Checklist [ ] DFC Printout [ J CMZ Assessment Form [ Slope Stability Informational Form EARR Tax Credit[ ]Yes[ ]No Form completed by ADDITIONAL COMMENTS: 17 V For DNR Region Office Use Only WASHINGTON STATE DEPARTMENTOF Q Natural Resources FPA/N#' Z4-� C� CD Region: Forest Practices Application/Notification Received Date: L - Western Washington PLEASE USE THE INSTRUCTIONS TO COMPLETE THIS APPLICATION. TYPE OR PRINT IN INK. 1. Landowner, Timber Owner and Operator Legal Name of LANDOWNER Legal Name of TIMBER OWNER Legal Name of OPERATOR (if different than Landowner) (if different than Landowner) Leon Taylor Cedarland Forest Resources Mailing Address: Mailing Address: Mailing Address: 8450 evergreen Ln PO Box 2264 City, State,Zip City, State, Zip City, State, Zip anta Clarita CA 91390 Gig Harbor WA 98335 Phone( ) Phone( } Phone( ) 253 208-7686 be cedarl and forestresources.corn Email: Email: Email: 2. Contact Person Contact Person: Phone( 253 ) 208-7686 Ben Cedarland ben a cedarl and forestresources.corn Email: NOTE: You are required to verify Type Np, and Ns water types within 200 feet of your proposed forest practices activities prior to submitting a Forest Practices Application/Notification. Use the Additional Information section, additional pages, the Water Type Classification Worksheet, and/or a Water Type Modification form to explain how you verified water types. See Water Typing Requirements in the instructions. 3. Landownership information: See instructions a. ❑No ❑X Yes Are you a small forest landowner per RCW 76.09.450? If Yes, go to b. b. ❑No ❑X Yes Is your entire proposed harvest area on a single contiguous ownership consisting of one or more parcel 4. If you are harvesting timber, enter the Forest Tax Reporting Account Number of the Timber Owner: 800059772 For tax reporting information or to receive a tax number, call the Department of Revenue at 1-800-548-8829. 5. Are you substituting prescriptions from an approved state or federal conservation agreement or watershed analysis? ❑X No ❑Yes Write"HCP" or"Using Prescriptions" in tables that apply. Attach or reference on file prescriptions and/or crosswalks. 5/9/2014 Page 11 of 7 Western Washington 6. What is the legal description of your forest practice? Section Township Range ENV Tax Parcel Number County 7 22N 1 w 122077500160 Mason 7. When are you planning to begin work on the proposed activity? : spring 2016 8. Is the taxpayer eligible for the EARR Tax Credit? ❑X No [:] Yes 9. Have you reviewed this forest practices activity area to determine whether it may involve historic sites and/or Native American cultural resources? Read the instructions before answering this question. ❑ No ❑X Yes 10. Do you have a DNR approved Road Maintenance and Abandonment Plan (RMAP)? a. ❑X No ❑Yes List the RMAP number: If no, go to b. b. ❑X No ❑Yes Is a Checklist RMAP required? (see instructions) 11. Are there potentially unstable slopes or landforms within the boundaries of your forest practices activity area? ❑X No ❑Yes—attach geotechnical report and "Slope Stability Informational Form." If applicable, attach the SEPA checklist, HCP or Watershed Analysis prescriptions. 12. Are there potentially unstable slopes or landforms adjacent to your forest practices activity area? ❑No X❑Yes—complete and attach the"Slope Stability Informational Form." If applicable, attach geotechnical report, HCP or Watershed Analysis prescriptions. 13. Is this forest practice application/notification: (Answer every question) a. 0 No []Yes Within city limits or inside an urban growth area? (IF YES SEE INSTRUCTIONS FOR ADDITIONAL REQUIRED DOCUMENTS.) b. X❑ No ❑Yes For road work that is included in an approved Road Maintenance and Abandonment Plan (RMAP)? c. Z No ❑Yes Within a public park? If Yes, include SEPA Environmental Checklist or SEPA Determination -except for harvesting/salvaging less than 5,000 board feet within a developed public park. d. 0 No ❑Yes Within 500 feet of a public park? Park name: e. 0 No ❑Yes In an approved Conversion Option Harvest Plan (COHP)from the local government? If yes, include a copy. This only applies to proposals within urban growth areas. f. ❑X No ❑Yes Within 200' of the Ordinary High Water Mark(OHWM)or floodway of Type S water? If yes, check with the county or city to determine whether a substantial development permit is required under the local shorelines master plan. 5/9/2014 Page 2 of 7 Western Washington g. ❑X No [:]Yes A request for a multi-year permit? If yes, length requested:❑4 years or❑ 5 years. Not everyone qualifies for a multi-year permit. See instructions for details. h. Q No ❑Yes An Alternate Plan? If yes, include a copy. i. Q No ❑Yes Within 50 miles of saltwater and do you own more than 500 acres of forest land in Washington State? If Yes- include the"Marbled Murrelet Form" or attach/reference HCP prescriptions. j. ❑X No ❑Yes In or directly adjacent to a potential Channel Migration Zone (CMZ)? If Yes— include the "CMZ Assessment Form."Attach/reference applicable HCP and/or Watershed Analysis prescriptions. * * ** * If not working in or over typed waters, skip to number 18 Prior to answering number 14-17 in this section please refer to the Forest Practices Application Instructions and Forest Practices Board Manual Section 5 (BM 5). 14. Are you proposing any of the following projects NOT permitted by current HPAs from WDFW? a. ❑ No []Yes Installing, replacing or repairing a culvert at or below the bankfull width of Type S or F Water(s)that exceeds a five percent gradient? b. ❑ No ❑Yes Constructing, replacing, or repairing a bridge at or below the bankfull width of unconfined streams in Type S or F water(s)? c. ❑ No ❑Yes Placing fill material within the 100-year flood level of unconfined streams in Type S or F water(s)? 15. Have you consulted with DNR and/or WDFW about the proposed hydraulic project(s) in or over Type S or F water? ❑ No ❑Yes 16. If installing, replacing, removing or maintaining structures in or over any typed water,complete the table below. Type S and F waters require detailed plan information. Provide plan details in number 31 or attach plan to the FPA/N. Provide crossing locations and identifiers on your Activity Map. (A detailed plan with profiles may also be required for more complex hydraulic projects in Type N Waters per WAC 222-24-042(2)). d a� o W > •` A= E r EEi P n t 2 � a r � � oo d � � � -- 3 d acid d •�-• 2 rn2 N o wo �Z x n ay V o � omo o C � � a v dc , o ZQd 2 w � aZ W C N Gin " y c O c R < Z a N �`o 2 o � � oo cc o � w FL `2 � a a � 0 0 0 � LLu_ Existing HPAs issued by WDFW will be complied and enforced by WDFW until expiration. Plan details are not required for hydraulic projects permitted with an existing HPA(see instructions). ** Fords and equipment crossings on Type S and F Waters may result in an unauthorized incidental take of certain endangered or threatened fish species. For more information, see"Background for the state's Incidental Take Permits for certain endangered and threatened fish species"following number 24 of the FPA/N Instructions. 5/9/2014 Page 3 of 7 Western Washington 17. If conducting any of the following activities in or over typed water,complete the table below. Some activities will require identifiers on your Activity map and/or more information in number 31, Additional Information. See instructions. *Activity Type S Water Type F Water Type Np Water Type Ns Water Equipment Crossing— Suspending Cables Cable Yarding LWD Piacement/Removal Beaver Dam Removal Felling and Bucking Other(describe in number 31) *Existing HPAs issued by WDFW will be complied and enforced by WDFW until expiration. Plan details are not required for hydraulic projects permitted with an existing HPA(see instructions). **Fords and equipment crossings on Type S and F Waters may result in an unauthorized incidental take of certain endangered or threatened fish species. For more information, see"Background for the state's Incidental Take Permits for certain endangered and threatened fish species'following number 24 of the FPA/N Instructions. 18. If constructing or abandoning forest roads complete the table below. Show the road locations and identifiers on your Activity Map. Include abandonment plans for temporary roads and abandonment projects. Road Construction Road Abandonment Road Identifier name,number) Steepest ( Length(feet) o Length(feet) Abandonment Date Side-slope(/o) na 19. If depositing spoils and/or expanding or developing a rock pit for forestry use, complete the table below. Show locations and identifiers on your Activity Map. Spoil Area Identifier Amount of Spoils Rock Pit Identifier Acres of New Rock Acres of Existing (letter, number) Deposited (name, number or Pit Developed Rock Pit Expanded (cubic yards) letter) na 20. If operating in or within 200 feet of a wetland, complete the table below. Show the boundaries of each wetland,along with its identifier,and WMZ on your Activity Map. See instructions for information. Wetland Wetland Type Planned Planned Total Wetland How many How many Identifier Activities in (number, (A, B,or Activities in Maximum Area acres are you acres are you letter) Forested) Wetland Width WMZ (acres) draining. filling. na * ** * * If not harvesting or salvaging timber, skip to number 29 5/9/2014 Page 4 of 7 Western Washington 21. If harvesting or salvaging timber, complete the table below. Show all harvest areas and unit numbers on your Activity Map. For even-aged harvest units also show surrounding stand information on your Activity Map. N Harvest Method c m (Rubber Tired Skidder, a Harvest Type Tracked Skidder, Dozer, E � C 4 — o - a (Even-aged, = Shovel, Full Suspension ,c ,0 o a o v 2 010 Uneven aged, Salvage, H Cable, Lead-end Suspension Q U, a, 01 a, °' N a) °' a �. z Right-of-Way) z Cable, Helicopter,Animal, ai 0) E ai E ai E E d aa) c Chipper-forwarder,Slash u M o M o M Z o M °'43 M m Bundler) Q = > _ > x -- > S cn 2 1 even-aged n RTS/Shovel 5 100mbf na 100% 10% 22. Reforestation. Check the appropriate box(es). Planting. Tree Species:D ❑ Natural. Include a Natural Regeneration Plan ❑ Not required because of one or more of the following: ❑ I am converting some or all of this land to non-forest land in the next 3 years or lands are exempted under WAC 222-34-050. ❑ Individual dead, dying, down, or wind-thrown trees will be salvaged. ❑Trees are removed under a thinning program reasonably expected to maximize the long-term productivity of commercial timber. ❑ I am leaving at least 100 vigorous, undamaged, and well-distributed saplings or merchantable trees per acre. ❑An average of 190 tree seedlings per acre are established on the harvest area and my harvest will not damage it. ❑ Road right-of-way or rock pit development harvest only. * * ** If you own MORE than 80 forested acres in Washington, skip to number 27 23. Are you using the exempt 20-acre parcel riparian management zone (RMZ) rule on type S, F, or Np waters? ❑X No If no, continue to number 27. ❑ Yes If yes, continue to number 24. See instructions for qualifications and information. 24. Choose the answer below that best fits your situation. Show all RMZs on your Activity Map. ❑ a. ALL of the following apply to me and my land: (If no, answer b.) • Between June 5, 2006 and today's date I have always owned less than 80 acres of forestland in Washington. • Between June 5, 2006 and today's date this parcel has always been 20 acres or less of contiguous ownership. • Between June 5, 2006 and today's date this parcel has always been owned by me or someone else that has owned less than 80 acres of forestland in Washington. 5/9/2014 Page 5 of 7 Western Washington b. ONE OR MORE of the following apply to me and/or my land (check all that apply): ❑ I currently own more than 80 acres of forestland in Washington. ❑ Between June 5, 2006 and today's date I have owned more than 80 acres of forestland in Washington. ❑ Between June 5, 2006 and today's date this parcel has been more than 20 acres of contiguous ownership. ❑ Between June 5, 2006 and today's date this parcel has been owned by someone that has owned more than 80 forested acres in Washington. 25. If harvesting within 115 feet of a Type S or F water on an exempt 20-acre parcel, complete the table below. Show RMZs and stream segment identifiers on your Activity Map. (Include stream shade assessment methodology if you are harvesting within 75 feet, or the maximum RMZ, whichever is LESS. If using BM1 to evaluate shade, you may use the"Stream Shade Assessment Worksheet"). Are you Stream Segment Water Type Segment Length Bankfull Width Maximum RMZ harvesting within Identifier Width the maximum (letter) (S, F) (feet) (feet) (feet) RMZ? (Y or N) na 26. Are you harvesting within 29 feet of a Type Np water on a 20-acre exempt parcel? ❑X No Continue to number 29. ❑Yes See instructions and describe leave tree strategy in number 31. Then continue to number 29. 27. If harvesting within 200 feet of any of Type S or F waters, complete the table below. Include DFC for all inner zone harvests unless you have an HCP prescription. Show RMZs, CMZs, and stream segment identifiers on your Activity Map. (Include stream shade assessment methodology if you are harvesting within 75 feet of S or F waters. If using BM1 to evaluate shade, you may use the"Stream Shade Assessment Worksheet"). Stream RMZ T Stream Is there a Harvest Total width Segment Water Type Site Class DFC Run Identifier (S or F) (I-V) width CMZ? Code(s) Number of RMZ (feet) (Y1N) (see (feet) (letter) instructions) na 28. If harvesting within 50 feet of Type Np water, complete the table(s) below. Show RMZs and stream segment identifiers on your Activity Map. Stream Total Length of No-Harvest, Stream Stream Length of No-Harvest, Stream Segment Length in 50-foot Buffers in Segment Length in 50-foot Buffers in g Identifier Harvest Unit Identifier Harvest Unit (letter) Harvest Unit (feet) (letter) Harvest Unit (feet) (feet) (feet) na 5/9/2014 Page 6 of 7 Western Washington 29. How are the following marked on the ground? (Flagging. paint, road, fence, etc.) Harvest Boundaries: Orange/pink flagging Clumped Wildlife Reserve Trees/Green Recruitment Trees: scattered Right-of-way limits/road centerlines: na Stream Crossing Work: na Riparian Management Zone Boundaries and Leave/Take Trees: na Channel Migration Zone: na Wetland Management Zone Boundaries and Leave/Take Trees: na 30. Are you converting the land to non-forestry use within 3 years of harvest? ❑X No ❑Yes If yes, include your SEPA Determination and/or SEPA checklist. 31. Additional Information (attach additional pages if necessary): For hydraulic pro jects in or over S or F water(s) see instructions for required plan information. According to C 1S mapping there are deep seated landslide charicte-ristics located 11 1-feet to the west of the harvest unit. An onsite meeting with a DNR geoligist and DNR forester detemined that this was probaly a relict slide but they requested that a letter be provided from a geological engineer to determine the following:Is the the slide a relict slide?Is the the proposal in the slide area or adjacent to it?Is the proposal in the ground water recharge area and if so would the proposal affect the ground water recharge.The attached letter from Geo Resources LLC will answer all of these questions. 32. We acknowledge the following: The information on this application/notification is true. We understand this proposed forest practice is subject to: o The Forest Practices Act and Rules AND c All other federal, state or local regulations. • Compliance with the Forest Practices Act and Rules does not ensure compliance with the Endangered Species Act or other federal, state or local laws. • If we said that we would not convert the land to non-forestry use, the county or city may deny development permits on this parcel for the next 6 years. • The following may result in an unauthorized incidental take of certain endangered or threatened fish species: Conversion of land to non-forestry use. o Harvesting within the maximum RMZ on a 20-acre exempt parcel that was acquired after June 5, 2006. o Equipment Crossings/Fords in or over Type S and F Waters. Sig tur f LA WNER Signature of TIMBER OWNER* Signa a t OPER (If different than landowner) (If di rentithP h%1 Print Name: Pr'Leon aylor&IorrainTaylor Ce land Date: ; V/z z /(, Date: Date:444 , y 2z//& *NOTE: If you are a "Perpetual Timber Rights Owner,"and are submitting this without the Landowner's Signature,provide written evidence the landowner has been notified. Please make a copy of this FPA/N for your records. If this FPA/N contains a hydraulic project requiring WDFW concurrence review, it will not be available online for public review until after the WDFW concurrence review period. 5/9/2014 Page 7 of 7 Western Washington Slope Stability Informational Form Forest Practices Application/Notification Note: Complete and attach this form to your FPA if you answered "Yes" to FPA question 11 or 12. "Potentially unstable slopes or landforms" are defined in WAC 222-16-050(1)(d). See Board Manual Section 16 part 2.1 for descriptions of potentially unstable slopes. 1. What screening tools were used? X❑ GIS, ❑X Aerial Photo, ❑ LiDAR, ❑ Other(describe): 2. What potentially unstable slopes were identified within the boundaries of your forest practices activity area? Check all that apply: ❑ inner Gorge ❑ Groundwater recharge areas for glacial deep-seated landslides ❑ Bedrock Hollow ❑ Convergent Headwall ❑ Toe of deep-seated landslide ❑ Outer edges of meander bends El Other(describe): None were identified within the proposal 3. What potentially unstable slopes were identified adiacent to your forest practices activity area? Check all that apply: ❑ Inner Gorge ❑X Groundwater recharge areas for glacial deep-seated landslides ❑ Bedrock Hollow ❑ Convergent Headwall ❑ Toe of deep-seated landslide ❑ Outer edges of meander bends ❑ Other (describe): 4. Date of field review: 4/13/16-4116/16 5. Person(s) that conducted field review: ``vv,0, Name Title/position Brad Biggerstaff Owner/Geo Resources LLC Name Title/position 6. If any features identified in #2 and/or#3 were bounded out, describe the manner in which the boundary was determined: Please see letter from Geo Resources LLC for further information on geographical areas,limits and boundaries 7. Show all field reviewed areas for potentially unstable slopes or landforms on a map (may use a forest practices activity map, harvest map or GIS map—See map example on page 35). This map is intended to be developed by the field practitioner. a ... V Approximate Site Location LiDAR Imagery taken from Puget Sound UDAR Consortium f Ly 1 p Not to Scale SlC �. Si0.b L�l Th ttJ 1'iMa�tO vial �b 'M .., GeoResources, LLC UDAR Imagery 5007 Pacific Highway East, Suite 16 Proposed Timber Harvest Fife,Washington 98424 E Alderwood Rd Phone: 253-896-1011 Mason County, Washington Fax: 253-896-2633 DocID:Cedarland.EAlderwoodRd.F April 2016 Figure 3 FOREST PRACTICE ACTIVITY MAP TOWNSHIP 22 NORTH HALF 0,RANGE 01 WEST �(/W�.M.)HALF 0,SECTION 7 Application#: 2 Q 4-1 O✓tY 2 U. S Puget Sound 1707� ?7r rc 170 600+65 2 2/ k 1706586 1706588 17 680 T 4 W x x 12 8 �Ur %' 6 1706568 +1 660 dr 1 + + r � S Devereaux Lake +1706546 +17 548 +1 06640 —N 13 18 17 526 , 1706528 706620 �f + 71 Feet Please use the legend from the FPA Instruction or provide a list of symbols used. Date:4/22/2016 Time:3:03:51 PM NAD 83 �/� � Contour Interval:40 Feet GeoResources, LLC Ph. 253-896-1011 5007 Pacific liwy. E., Suite. 16 Fx. 253-896-2633 Fife, Washington 98424 April 20, 2016 Cedarland Forest Products LLC Joseph T. Cedarland P.O. Box 2264 Gig Harbor,WA 98335 (253)208-8136 Geological Reconnaissance Report Proposed Timber Harvest E Alderwood Road Mason County, Washington PN: 122077500160 Doc ID:Cedarland.AlderwoodRd.FPA.L This letter addresses concerns DNR has regarding the proposed timber harvest on the above referenced parcel. It is our understanding DNR has not requested a full Qualified Expert Report, but has requested that an assessment be completed of the potential groundwater recharge area for the mapped glacial deep-seated landslide located about 750 to 1,100 feet to the northwest of the site. This letter summarizes our literature and map review, along with our April 11, 2016 site reconnaissance, and provides our opinion of the potential groundwater recharge area within the vicinity of the proposed timber harvest. The site is located at the at approximately 1100 E Alderwood Road. The site area is rectangular in shape and measures approximately 296 to 385 feet wide (east to west) by about 620 to 663 feet deep (north to south), and encompasses 5.01 acres. A map depicting the proposed harvest area's approximate location is included as Figure 1. The proposed harvest area is situated on a broad topographic upland area with shallow, linear swales and broad ridges that trend southwest to northeast. The site is vegetated with mixed second growth timber and situated in an area of rural residential development. The proposed harvest area extends across the entire tax parcel and is bounded on the east, north and west by residential development and on the south by East Alderwood Road. SITE CONDITIONS According to topographic information obtained from the USGS and Mason County Public GIS, and generally confirmed in the field, the proposed harvest area slopes down from the east and west towards the center of the site at inclinations of 2 to 4 percent. Regionally, the harvest area is situated in gently undulating terrain that is dissected by southwest- to northeast-trending linear glacial striations or troughs. Based on the topographic maps and confirmed by field observations, these striations extend for 1/z-mile or greater in each direction from the site. The harvest area is situated within one of these topographic features. Based on observed standing water to the north of the site, it appears surface and shallow subsurface water flow is intercepted by these features. Based on information provided by DNR, approximately 750 to 1,110 feet northwest of the site, the head-scarp of a relict glacial deep-seated landslide has been identified. The Cedarland—Alderwood Rd FPA April 20, 2016 Page 2 ground surface in this area slopes down abruptly to the west at inclinations of up to 100 percent. This feature is likely associated with the retreat of the Vashon continental ice mass, some 10-to 12,000 years ago. According to Table 2 of the DNR Forest Practice Board Manual, we concur that the mapped landslide meets the definition of a relict landslide. A topographic map of the site and surrounding area is included as Figure 2. LiDAR imagery for the proposed harvest area and surroundings is included as Figure 3. No evidence of movement has been reported or documented in this area. The proposed harvest area is vegetated with mature second growth timber, primarily fir with a moderate to dense understory of vine maple, ferns, salal, and other native vegetation occurs over most of the site. The adjacent developed parcels are covered with combinations of grass lawns, ornamental landscaping, and similar forested/native understory. The head-scarp and body of the adjacent deep-seated landslide are also well vegetated, and appear to have similar densities and types of vegetation in both areas. Soil Conditions The Soil Survey for Mason County (USDA Natural Resource Conservation Service Web Soil Survey) indicates the proposed harvest area is underlain by Alderwood (Ab) gravelly sandy loam. The Alderwood soils are derived from glacial till, form on slopes of 8 to 15 percent(although site and adjacent ground surfaces are flatter), have a moderate erosion hazard when exposed, and are in hydrologic soils group C. The deeper, un- weathered, indurate layers of the Alderwood soils are more consistent with hydrologic soils group D, and are generally considered an aquitard. A copy of the NRCS-SCS map for the site vicinity is attached as Figure 4. Geologic Conditions The Geologic Map of Belfair 7.5-minute Quadrangle, Mason, Kitsap, and Pierce Counties, Washington maps the harvest area and vicinity as being underlain by Vashon till (Qgt). The glacial till consists of a heterogeneous mixture of clay, silt, sand, and gravel that was deposited at the base of the continental ice mass associated with the most recent Vashon stade of the Fraser Glaciation. The till was overridden by the ice mass and as such, is considered over-consolidated and exhibits high strength and low compressibility characteristics where undisturbed. The till is mapped as extending north and west to the top of the mapped landslide deposit(Qls) discussed above. The slide area is approximately 750 to 1,100 feet west-northwest of the proposed timber harvest area. Adjacent areas to the east and southeast are mapped as being underlain by ice-contact deposits (Qgic). An excerpt of the above referenced map is included as Figure 5. Hydrogeologic Conditions Our interpretation of the hydrogeologic conditions at the site is based on the subsurface conditions listed in the available well logs for the site area, the available topographic and geologic information, our site observations and experience in the area. The reported soil and groundwater conditions in the well logs for the site area generally confirms the mapped stratigraphy; with the upland area being underlain by a thick dense to very dense glacial till cap(typically referred to as hard pan or clay on the water well logs). The glacial till, as indicated above, is generally considered an aquitard, having a very low infiltration rate. The till is underlain by advance outwash and older glacial and interglacial materials below, typically more granular soils that are locally identified as aquifers. Well logs from the adjacent site areas are included in Appendix "A" along with an approximate location map. Based on the well data and general geology of the area, there appears to be a deeper, regional aquifer and a local intermittent/seasonal perched aquifer above the glacial till Cedarland—Alderwood Rd FPA April 20,2016 Page 3 soils. Water wells in the upland area in the vicinity of the site produce water from about 250 feet below the ground surface, or elevations 58 to 65. Water wells from the body of the relict landslide produce water from 140 feet below the ground surface or elevation 50 to 60. Wells to the east and southeast of the site produce water from shallow depths of 40 to 50 feet below the ground surface or elevation 269 to 275. The deeper, regional groundwater flow is likely to the west-northwest, tows rds Hood Canal. Surface and shallow subsurface perched water on the glacial till is typically concentrated in the lower glacial striation areas, and flows to the northeast and southwest. Based on the available topographic information and our reconnaissance of the general area, there are two distinct striations between the subject site and the identified relict landslide area. Wetlands were observed in portions of these lower trough areas,with surface flow following the lower striation topography. Base on this, there is little or no water flow towards the deep-seated glacial relict landslide area. Within the relict slide area, we did not observe any evidence seeps or springs at the time of our site visit (following a record level wet weather period). CONCLUSIONS Based on our data review and geologic reconnaissance of the site and relict slide area, we offer the following conclusions regarding the proposed timber harvest and its proximity to the relict landslide area and potential groundwater recharge. The site is located between 750 to 1,110 feet from the relict landslide area. The upland area is underlain by a thick sequence of glacial till, generally considered an aquitard. The surface of the glacial till upland area is glacially striated, creating linear topographic troughs that trend southwest and northeast, generally away from the relict slide area. The site is situated within one of these features. Surface water runoff and shallow subsurface flow (perched water)that develops on the site,the proposed timber harvest area, would be contained within this feature and directed away from the relict slide area. It is therefore our opinion that no measurable recharge would flow toward or reach the relict slide area from the subject site. Lastly, the scale of the proposed harvest area relative to the size of the potential groundwater recharge area (approximately 5 acres to 300 acres)would limit any potential recharge to an insignificant and likely non-measurable level. CLOSURE We have prepared this report for Cedarland Forest Products LLC and members of the harvest team for use in evaluating the potential timber harvest related risk of this project. The data and report can be utilized for planning and permitting purposes, but our report, conclusions and recommendations should not be construed as a warranty of the subsurface conditions, as they may vary both vertically and laterally. No subsurface explorations were performed in preparation of this report. If there are changes in the locations or assumptions stated for this project, the conclusions and recommendations presented may not be fully applicable. If design changes are made, we should review the proposed changes to verify the applicability of our conclusions and recommendations. Within the limitations of scope, schedule and budget, our services have been executed in accordance with generally accepted practices in this area at the time this report was prepared. No warranty, expressed or implied, should be understood. Cedarland—Alderwood Rd FPA April 20,2016 Page 4 We appreciate the opportunity to be of service to you on this project. Please call if you have any questions regarding this submittal, or if we can provide additional services. Yours very truly, GeoResources, LLC `a t Washi� ea BRAD Y P BIGGERSTI�fiF i Seth Mattos, GIT Brad Biggerstaff, LEG Principal/DNR Qualified Expert srM:RPr�Stm Docl D.Cedadand.Aiderwood.FPA.RG Attachment Figure t-Sitc Locafion Map Figure 2—Site Air Photo Figure a-LIDAR Imagery Figure 4, USDA Soils Map rigu re S-Geologic Map Appendix w-Well Legs and kWcations NL Ml•�EN OH t0 f NEEgtCIVC Ft E%SO p0 •; w b� ob a �q�►14 -- �. EALTA DR 49-V .a � �E SKYLARK Ci E CAMNAL CT 1r a � Dereneua Lake ? \ �y a i 1 10 ` 4 R JAY t Approximate Site Location (map created from Mason County Public GIS) Not to Scale GeoResources, LLC Site Location Map 5007 Pacific Highway East, Suite 16 Proposed Timber Harvest Fife,Washington 98424 E Alderwood Rd Phone: 253-896-1011 Mason County, Washington Fax: 253-896-2633 DocID:Cedarland.EAlderwoodRd.F April 2016 _ Figure 1— .r 4' }+ ,c �f ii'ARRfJw CI � r IlY-kkYilA�� ' e 1 .JWL. a f �� P � i��,.�K��R #• Jet..X' 4 Approximate Site Location (map created from Mason County Public GIS) Not to Scale GeoResources, LLC Site Air Photo and Topography 5007 Pacific Highway East,Suite 16 Proposed Timber Harvest Fife,Washington 98424 E Alderwood Rd Phone: 253-896-1011 Mason County, Washington Fax: 253-896-2633 DocID:Cedarland.EAlderwoodlid.F April 2016 Figure 2 r d } a Approximate Site Location UDAR Imagery taken from Puget Sound UDAR Consortium t F Not to Scale GeoResources, LLC UDAR Imagery 5007 Pacific Highway East, Suite 16 Proposed Timber Harvest Fife,Washington 98424 E Alderwood Rd Phone: 253-896-1011 Mason County, Washington Fax: 253-896-2633 DocID:Cedarland.EAlderwoodRd.F April 2016 Figure 3 A. 3 f J- k V r r Approximate Site Location Map created from Web Soil Survey(http://websoilsurvey.sc.egov.usda.gov/App/WebSoilSurvey.aspx) Soil Soil Name Parent Material Slopes Erosion Hazard Hydrologic Type Soils Group Ab Alderwood gravelly sandy loam Glacial till 0 to 6 Slight C Ac Alderwood gravelly sandy loam Glacial till 6 to 15 moderate C� Eh Everett very gravelly sandy loam Gravelly outwash 8 to 15 Slight Ap 1 r Not to Scale GeoResources, LLC SCS Soil Map 5007 Pacific Highway East, Suite 16 Proposed Timber Harvest Fife,Washington 98424 E Alderwood Rd Phone: 253-896-1011 Mason County, Washington Fax: 253-896-2633 DocID:Cedarland.EAlderwoodRd.F April 20f6 Figure 3 l } 'ti 0k ( CIO /j ,.qm,� ogt °p 0 €} OC COTS Qaf / o9ic r, Osi; oou I � c aga l s f COgt . ; UOa� — (� ` � Oa COB s r G Om oa l <T f � `l ctr flat ( oo r , Qut � Yf ,x+ Qb. r `• � lCM y COyt Approximate Site Location An excerpt from the Geologic Map of the Belfair 7.5-minute Quadrangle, Mason, Kitsap and Pierce Counties, Washington by Polenz et al. 2009 Qls Landslide deposits Q is Ice-contact deposits Q t Glacial till i I I GeoResources, LLC Geologic Map 5007 Pacific Highway East,Suite 16 Proposed Timber Harvest Fife,Washington 98424 E Alderwood Rd Phone: 253-896-1011 Mason County, Washington Fax: 253-896-2633 J DocID:Cedarland.EAlderwoodRd.F April 2016 Figure 4 .�' .+ r•ti� :i . N cho 5 26ft , iJ.1 'llf' k � � IM t •� n.y�� •a • - 3; Bell•,a t� ,�, a � f. Approximate Imagery . Locations accessed from Google Earth a Not to Scale- GeoResources, LLC Well Location Map 5007 Pacific Highway East, Suite 16 Proposed Timber Washington 98424 E Alderwood - . Phone: 253-896-1011 Mason County, Washington Fax: 253-896-2633 .. . rFigure A-1 Start Card No. Department-aild FloatCopy with WATER WELL REPORT UNIQUE WELLLO.,:._A��5�; Dpertment a Ecology Second Copy—il ' 'a Copy Third STATE OF WASHINGTON ThirdCopy-DMtvler s a Copy Water Right Permit No. (1) OWNER: N9.•re-T014 (2) LOCATION OF WELL: County M Swi ON J-J&A t.< Y�wS•ti ._ _ °��r ,a w.M. (2a) STREET ADDRESS OF WELL(or rearested2m) N�tJ S� '( ��j.►W (3) PROPOSED USE: bP Domestic Industrial ❑ Municipal Cl (10) WELL LOG or ABANDONMENT PROCEDURE DESCRIPTION ❑ IrriDo atiorf For T.atsxl;Describe b color.character,sae of rnatenai and structure,aria a1Ww thickness a a fifers ❑ DeWaler Test Well U Other l7 Y W and the kind and nature of the material in each stra¢m penMraW,with ai feast one entry for each - (4) TYPE OF WORK: Owner's number of web charge of information. ,(It more than one) MATERIAL FROM TO Abardc^ec O New well Method:Dug U Bored D _ o 8 DrvnQ �trDmepened Q t1tK (J D Reconditioned ED 'Rotary❑ Jetted (5) DIMENSIONS: Diameter of wen 6 inches. 6 RA t, l�ubtt � Depth'of completed well q.g-�—_^ ft (6) CONSTRUCTION DETAILS. Casing Installed: ! ►�" Diam.fronr)6--�ft to ft. V trA - Ow l.f Welded Diam.from ft.to ft. Liner installed -' Threaded 0 Diam,horn.— __ft.to _ft. Perforations: Yes ❑ No Type of perforator used _ s e SIZE of perforations in.by in. Fj perforations from h.to ft- q ft. -- perforations from ------Tit to.-----------"- 5y Screens: Yes�I No O Manufacturer's Name 14a sue J0 Type T rrnr L as C-6 a1,r Model No. Diem.s!�. Slot size It to _� h - Diam._Slot size irortt —ft ro ft Gravel packed: Yes ❑ No K, Size of gravel IN q 7 Gravel placed from h.to r' "- nE C Surface seal: Yes No To what depth? X�_ _ ft Material used in seal "I JILb��trw/JnCWj TY -------D !)i{t iAt.-Vi_.ECOL WY Did any strata contain unusable water? Yet❑ NoOK Type of water?-- _ Depth of strata-- -----_---- Method of sealing strata oil p —_ (7) PUMP: Ma wtaCturer's Marne.`�a �'�c kec r Type: _ -S_Ly_n- H.P.. ------ (8) WATERLEYELS: LandsuriaceeleveNon — Q) /above mean eta level it. slack level �.d�-7 R tNbw top at well 'Dale --.-----_---.-__ - --. Anasian pressure Rrs,per square Inch Dale -- . Artesian water is Controlled by ' (Cap.va . Work Staved-- _ �_ _9.�19.' Campteled_s�. �_ Y.19_ (9) WELL TESTS: Drawdown Is amount water savel is lowwsd bebw sta"c hroM Was a pu teat made?vas JK No❑ If yes,by whom? fJ 9 ar_ WELL CONSTRUCTOR.CERTIFICATION: Yield: D__gat./min.with��-ft drawdown attar_ fors. I constructed and/or accept responsibility for construction Of this well.and its compliance with all Washington well construction standards.Materials used and the information reported above are true to my best knowledge and belief. Reowery data(time taken as zero when pump turned off)(water level measured from WON NAME N�l k �- V G,tv 4 top to water level) (PEFWN,F TQN) ttyPE OR-6*M Time Water Level .�Time Water Level Time Water Level _1WQ_._-* 44 - &'06— A:2,6 Address o 1 �/y/V �— SSW —v-- (Signed) License No p' i�E.cp�R Bailer feat gal./min,with ft.drawdown after__.__._.----.fus. Contractor's_ ' Airlest /min,with stem set at R for hrs. Registration wl• No.mTj4NFwb�(p(.Ht Date G 9y,tg-_ ArtesianAow g.p.m. Date Temperature of water Was a chemical analysts made? Yas No❑ (USE ADDITIONAL SHEETS IF NECESSARY) ECL 050-1-20(29a)••1 0 WATER WELL REPORT CURRENT ' Original&1"copy-Ecology,I't copy-owner,3"'entry-driller Notice of Intent No. � nn i'e'o'L'0 c'r Unique Ecology Well ID Tag No. V�Z Construction/Decommission("x"in circle) C1. �Construction Water Right Permit No. O Decommission ORIGINAL INSTALLATION Notice Property Owner Name of Intent Number Well Street ?. -/n , — � �►le IV PROPOSED USE: Domest�ic ❑ I d uhial ❑ Mumnpal CO"ty /iJw /J 5� ,t1 O DeWncr ❑' Irrigation O Test Well ❑ Other C —- �/- EW L s — Locationfll4 t/ Lt}I/4 Sec Twn�R! E"nt ��� N1 TYPE OF WORK: Owner's number of wen(if more than one) ,;.i � New well ❑ Reconditioned Method.❑ Dug ❑ Bored ❑Driven Lt/C on , r Lat Deg_ Lot MInlSeC Deepened Cable ❑ Rotary ❑ Jetted a gs 5 DIMENSIONS: Diamxter of nsell-49- inches,drilled _ft. Still REQUIRED) Long Deg Long Min/See e Depth ofcompleted well ft 7/ f CONS-MU ION DETAILS l2�`/ Tax Parcel No.. / 2 — !J � ,Q e7(n 10 Cuing Welded A Diam from ft,to_`��__fl. Installed: ❑ Line"installed Diam from fl.to 7'�'-- ft CONSTRUCTION OR DECOMMISSION PROCEDURE ❑Threaded Diam from ft.to R Perforations: ❑ Yes No Formation: Describe by color,character,size of material and structure,and the kind and nature ofthe material in each stratum penetrated,with at least one entry for each change of Type of perforator used information. USE ADDITIONAL SHEETS 1F NECESSARY. Sl ZE of perfs__ in by in.aM no of perfs from ft to ft. e — -- --- MATERIAL FROM TO Screens: Yea ❑No K-Pac Location_ Manufacturer's 'ame / Type Model No. Diam. r _sloflh frnm _ft to ft 0 Dram lot size from__ ft to R. / '-+ GravelfFi ttr pocked: ❑ Yes No ❑ Size org ivellsand Materials placed from tt to ft. Surface Seat: Yes 07yNo To what detNhl R Material used to wal—/f��� �/rf/ /! rV Did any strata contain unusable waicfl ❑ Yes A No tJ i Type of water? ----- -..__-_-----Depth or strata Method of sealing strata off PUMP: Manuf turer.44ame 611,0 14 1 5 TYPc _ --- WATER LEVELS: Land-surfart:elevation above mean sea level ft. Static level ft.blow top of well Date Artesian pressure lbs per square inch Date lr V Artesian water is controlled by (cap,valve etc WELL TESTS: Drawdown is amotaa water level is lowered below static level ,. Was a pump test made? ❑ Yes XNo If yes,by whom? � WA CytalP IJc�u llul t Yield:__ galJmin with fl lowdown after_ hrs. Yield cal/mm with_ ft dttwdown after hrs. �(` �n (`'�l 1 ...111Lf7 Yield. Kalfain.with -...._ fl drawdown after- ttra. Recovrry data(time taken at zero when pump turned ofn(%rater level measuredfrom well top to waterlerel) Time Water Level Time Water Level Time Water Level ' Date orte'st —__. wBailer lest lain.with _R dowdown after_./hrs. I Airiest gal./min with stem set at ft,for lus. Artesian flow B p-m. Date Tcmpcnat=of water Was a chemical analysis%rode? ❑ Y- No ' Start Date Completed Date i E WELL CONSTRUCTION CERTIFICATION: I constructed and/or accept responsibi try for construction of this well,and its compliance with all Washington well construction standards. Materials used d the information repo//r�ed above arc true t9 my best know[edd nand belief. �Dnner ❑Engineer ❑Trainee Nana(Print) ���•s[tilling Company�/' �� DrilkrtF.ngirceJrrunee Signatwe ^ Address-47 Driller or trainee License No. City,State,Zip v -�..� - If TRAINEE, Contractor's �` Driller's Licensed Ne. Registration No. AIr.�,4�1>�'/�zmA Date f�/(� & r Cam/ Driller's Signature Ecology is an F_gwl Opporumiry Employer. ECY 050-1.20(Rev 3105) The Department of Ecology does NOT warranty the Data andlor Information on this Well Report. 1 11'�f i File Originalwdh WATER WELL REPORT Notice ofhillent_v_y2Jn6_ __ Depanmem of Ecology Second Copy-Owners Copy STATE Of wASHiNGTON UNIOUE WELL IA-1 AM ]29 _ Third Copy-Drillers Copy Water Pod Permit No L C (1) OWNER: Name Dennis Bell_ � Address_--2655 Amen U-SE. -Port Orchards WA.9$366 (2) LOCATION OF WELL: (2a) STR EET ADDRESS OF WELL:(or nearest addre") E 181 Firwood Hieghts Belfair, WA 98528 TAX PARCEL NO.: -- UI (3) PROPOSED USE: -it Domestic 7 Iridustnal Municipal (10) WELL 1,17431 or DECOMMiSSIOWNG PROCEDURE DESCRIPTION krication = Test Well G Other Formation'Describe by Color,Character,size of materiel and structure,and ++ De Water the kind and nature of tie material in each stratum penetrated,with at least O (4) TYPE Of WORK: Owner's number of wen(d rrtae then one) one er"for each change of mbrmation.Indicate aH water encountered $New well Method: MATERIAL FROM TO C -1 Deepened 2 Dug ❑ Barad O Recondihoned �xCaeis rJ Drwen u _ Decommission = Rolary D Jetted TOD Soil 2 t4 E (5) DIMENSIONyS: Diameter of wen 6 inches L Drilled _y1 1 _.-_ -- lee! Depth of compleled wen 9.5 Sandyn. O 16) CONSTRUCTION DETAILS Casing Installed: m S X welded 6 Dam-from—9_ft to__---9()-tL Liner installed Dom-from_ fl to Mn. 4-j Threaded " Dam.fromn.to n. ---- - ; --� 0 r Perforations: Yes ig No C Type of perforator used_ SIZE of perforatlor+t ._..__in.by � perforations from n to___ Y 0 — Screens Yea C No !ZK41 c Location— 93 6te-1 ManulacturK's Name - Ty,e stainless Wire tGi> Modef No. a Diam._ 5 Slot Size .-tLz_kom_-�_R.b _t:. M Diam._--_Slot Sae ---__Irom_---- fL 10 K L � L t4 OreveMner psieNed: Yes $No CI Size of Material placed from_,. --- _— _ ft.to i F-- 1g —tie ll't tile( 6TEci"Ovy, 7-- Surface tteai: -3y" i_No To what depth? n- Z Material used in seal- Betonite D d airy strata contain unusable water? Yes X No IA Type of water? _—_ Depth tit atrele QMethod of seating strata am (7) PUMP: Manuiadurer's Name _-jaQU721 - Type:_ _sub.. H.P. 314 a) 78 0 (a) WATE14 LEVELS: Land-syr�elevation above mean sea level_- ft Static level Kb N,below top of well Date. . work Starled- S 28 00 . o rN"ted 6 1 S QO W Artesian pressure _—Iba.per square inch Date-_ Artesian warier is controlled by - 4" lCap•valve,etc-) WELL CONSTRUCTION CERTIFICATION: O _ (2) WELL TESTS: Drawdown is amount water level is lowered below static level I constructed and/or accept rosponsbi ly for construction of this wan,and its Was a pump test made? Yes XNo ,f yes-by whom? Compliance with all Washington:well construction standards. Materials used knowledge the information reported above are true to my best knowAege and belief.E Yield _-_galJmin.wits -ft drawdown after -_ hm 411 Yield gal.fnvn with tL drawdown after_ tint. Type of Print Nano- Mike_ D$V i R License No QM Yield: _. _--gallrin with ----- _n.drawtlownafter__ ire ILicensedDn1IerrEngineer) Q Recovery data(time taken as zero when pump turned om]i(water level measured from well top to water level) Trainee Name _• License No Tuns Water Levu[ Time Water Level Time Water Level Drilling Company Srillin� (Simdl^ -- B No 0797 _ '(Lken3ee DrilleNfnyineer) — -.-- - -- --. _— ,__— --- Address_ Bel ir WA 98528 Date of test _-•-- --. _-- -SS Contractor's t�At'TC11T1 rye♦ T M Bailer lest —�L_ —gel tmin-wiifh._..- � n.drawdown after_-2_tin Registration No.J)AV .DI11Q0A ..._Date June _—_QQ Airiest --- -gal,lntin-with-- n drawdowna�lot his. Artesian now_—. ._ _ ,------g.pm. Date ((JSE ADDITIONAL SHEETS IF NECESSARY) Temperature of wafer---_Wes a chemical analysis made? [Yes EI No 1=eotoQy r an Equal Opporturtlty arnd Affirmative Amon emptgrer.For special ECY 050-t•20(11/98) accommodation needs.contact Ifte Water Resource&Program at (360) 407- 6600,Tho TDD numoer is(360)407.WM. Fife rtm n t and First Copy with WATER WELL REPORT "° 01'"` w 093247 _ 0 Department y Ecology AGE138 O 1':.Seed�GY_is boy ^ UNtOUE WELL I.D.>t - Third Copy-Dritler8 copy 'N STATE OF WASHINGTON W�Right Permit No. N/A -- IX (1)OWNER: Name FREDAND_DIA PARE _ _ _ Addfeas PO-ROX 865,_BELFAIR._WA 98528_____ -- (2)LOCATION OF WELL: county� pW — -- SY11 1/4 .NW 114 Sec 7 T._22 N.,R _W W-M. (2a)STREET ADDRESS OF WELL(afnanataddwaa) rn TAX PARCEL NO. 12207-75-�7 .� (3)PROPOSED USE: X]Domestic [1Induaftl ❑Akn*ipd (10)WELL LOG or DECOMMISSIONING PROCEDURE DESCRIPTION: Irrigation g ❑Test Well [-]OtlMf Formation:DssalDa by odor,character,sirs or maurMl and suuaws,aria the kind and DeWater aft"of the moo"in sack waitm parrtraa4 with at least one artsy for each charge tDwners number of well M more than one) of intermatlon adiaste ali war encoun)and. (4)TYPE OF WORK: ( -------- XjNew Well Method: MATERIAL . .—.__ -- FRAM- TQ- 0 _j Deepened FU Dug ❑Bored ROWN SANO A LAY ]Reconditioned [';Cable []Driven GREYCLgY_, ]Decommission EX]Rotary ❑.lotted BROWN CLAY AND SILTS 235 L (5)DIMENSIONS: Diameter of wets --—Ste_---inches. EAM-S OF_SA(ND AND GRAVEL W/B -_---. _ _20 _nQ_ Drilled -260 __ feet. Depth of completed well 260-— -R. -- --- ---. C (6)CONSTRUCTION DETAILS: tL Casing Installed: - - ------- — -- ----- -_ [)]welded _� ' Diam.from +1.5 R to 2N R - 1.+ Liner installed " Diam.from R.to A i 'Threaded Diem.ham R.to O ">D Perforations: DYes DONO -- -- -.—• Type of perforator used - .. SIZE of perforations in.by in. perforations dom _-_ R.to R perforations from R.1D R 0 perforations from f IL to R. Screens: [XJYes [!No XK-Pac Location 4 — - - --�-— --.— _----_ — Manu`.acturer's Name J-O"-SON- T S_TAINLESS_STEEL___ ,Modd No. TEL —.-- C Dram. 6 Slot sire 14 from 255 ft.to 260 ft t. Diem Slot size from R to IL - f3 GrayellFliter packed: ❑Yes [X No [J Size of gravel/sand ---- Material placed from R.m—_ R -— -- - -— (- Surface sea[• LXYes ❑No Townatdepth? --R -_ ----- ---•_ - O Material used in seal VENT-ObM z Did any strata contain unusabie waters [I Yes [Xi No _ Type of water? Depth Of strals — DLI Q) Method cf sealing strata off —__-- _-- - _ "C (7)PUMP: Manufacturer's Name RFRKFI Y_---- --- _ -- ----- Wr•�,�•}�'1E�t 'S{'dtY- _---_� Type: SUB_ -------- -- - H.P. --_1.5 - ---.— eparloeilt 011EcLt)j pgy (8)WATER LEVELS: Land-surface elevation O above mean sea level R. Work Started (12=02__— .19, cOm~8712002 -_._ ,7e_ V static level ft beiaw top of welt Date $<7/2002_ WELL CONSTRUCTION CERTIFICATION: Artesian pressure lbs.per square inch Date LLI _— -------- 1 constnncted and/or accept responsibility for construction of this well,and Its Artesian water is controlled by compliance with all Washington well conavuclio i standards. Materials used Q `__._ valtro,etch — and the information reported above are true to my best knowledge and belief (9)WELL TESTS:Drawdown is amount water level is lowered below static level T Was a pump teat made? [X Yes ❑NO If yes,by whom? YDe or PrirK Name NIC NOLA3.1.�BN$I---- license No. 214E Cl TDB (Licensed 0n1#erlE091rros0 E Yield: — S gNJmin-with—2_5 tl.drawdown after 4 MR hra. Trainee Name License No. hr Yield: gel./min.with R.drawdown after s. ---. -_._—_--- Yield: gal./min.with R.drawdown after - -- in, DnlRng company TOP DOG-DRILUNG C.O__CL -- 4) Recovery data(time taken as zero when pump tuned off)(water level measured c from well top water level) (Signed) _'z: - License No- ZM7--__--- 4) Time Water Level Time Water Level Time Water Leval (Licansad DnivalEnpnssr) —5 - 143— - -- Add— PO-WX.2227- SELFAIRr WA. — - ContracWs --- -- — — --- Registration NO. TOP_DQDC054RA______ Date 8/1.012002__.-•19 _— Baiter test 15 gal./min.with _5_ R drawdown after,_ hrs. (USE ADDITIONAL SHEETS IF NECESSARY) Ainest —— gat./min.with stem set at It for hrs. Ecology is an Equal Opportunity and Affirmaiive Action employer. For Artesian now --- -- 9-P.M. Date _- spwA ac commodabon needs,contact the Water Resources Program at Temperature of water Was a chemical analyses made? ='Yes _X'No 1 (360)4074". The TDO number is(360)407-WW. Dep�entt cf�c Copy with WATER WELL REPORT Noace af'rnt w 093247 0 Second Copy.Ownees Copy` �y STATE OF WASHINGGTON UNIQUE WELL I.D.4_AGE138 CL Third Copy-Drillers copy t N a 1 Water Right Perml No. NIA 4J .1 - (1)OWNER: Narita FJRED-AKaD191"AEE__- AR-1N&M28- (2)LOCATION OF WELL: Couctty _Sty ire W 114 Sew 7 T. � N.,R E_ W.M. (2a)STREET ADDRESS OF WELL for nearest address 6T0 E_ALDERYItOOD N TAX PARCEL NO. 122Q7=T.5 y (3)PROPOSED USE: k;l]omesGc =�kldustrial f-Imutfcipai (10)WELL LOG or DECOMVIS,310141N0 PROCEDURE DESCRIPTION: Irrtgadon Test Well ❑Other romaton Dwsatba by cow,avroanr•s u d mutwim surd w imra,andihe kind and _J DeWater nsbaa ef ma matwlaf to each afwtwe Vwrsaaad,him at IMst aw army for asch d+m+pa 0 or WMnatlon Indlarte aN WSW erxx unterad. (4)TYPE OF WORK: Owners number of well(if more trtan one)tb -— O New Well Maal ----- MATERIAL FROM TQ. ;Deepened C,Dug Dgaed BROWN SAND AND CLAY 0 37 J'Recondidor" [Cade ❑Driven GREY CLAY 37 238_ ❑Decammise on x Rotary ❑letfad RQWN COY AMP-$J 235 24--- Drameter of well ;n F SAND AND GRAVEL W1B 2401 260 (5)DIMENSIONS: SIX___ I wc,uad 260_— feet Depth of completed wail 260 _ft (6)CONSTRUCTION DETAILS: Casing installed: [X]Welded _8- " Dfem.from t1.5_ Rto _25S ti i Uner!n�tatfed Diam.from ft ho ft. O 1.-IThreedrd Dism.from fL to - Porfort; Ong: ❑Yea U0140 -- Type of perbratof used -- — — R SIZE of perfmbons In.by in +-r lomfwabons from IL b �. ped0n3hma from - -- perforatltxts from R b '= Screams: Wyes DNo kK-Pac Location 2r - Manufacture s Name JOHN&ON---- _ 1 C Tfpe STAINLESS STEEL_--- _ Model No TEL_ ----_-- —� ----- Diam. 6 Stot stzo 14 from 266 n_to 200 R - Diem. Scot stze from ft,to ft I GraveifFiftr packod. DYW _)ONO F� Size argr3vWsand ` Uatedal placed from rt __-- R ----------— _. __-- -.. OSurface sea I: ix1 Yes ::)NO To what depth? _-_1$-_fL -- _` + �/ jF-i-D Z Material used in seer BENT-ONITE _-- _ I x )jr- Old any strata contain unusab!a water? as X]N. N Type of waRin Depa,or mew _ Loititj O) ntetfw of!seating strata O - -- - (7)PUMP: Wnurac:urrars Name BERKELIL __ {p`•-`�( � Tree 5U8 - — KID- O (8)WATER LEVELS:O abovee rneaw eielevel ft work Started 602002____- .tg. Completed&9=02 ,is W Static iewal 1-4$ IL below top of well DRte 8g 2002 WELL CONSTRUCTION CERTIFICATION: Arteman pressure lbs.per squareincn Data Y.. - --- I constructed ervdror accept responalbli4ty forconatnrc;tlon of this well,and its Artesian water is confrow by _ _ comPl►ence with all Washl roan wail construction standards. wertats used y,e (D�7�)-- RM the information reported above am true to my best wowlodpe and beilef. 9 WELL TESTS:Drowit is amount water level to lowered below staticvee Type a Print Name NtCHO ftSL ucense No. 2]4T- le E { ) � Was a pump teat made? Yes No 1 yea.by whom? TDDCr _ -__. o a IX ❑ ----- a.+ AW Yield. - gai✓m(n_wf h - + R dnwvdown after_4 JAg hrs. L Yield gai.hrtin,with ft.drawdown after hra. Trainee Name license No. C Yield , gas✓min.with R drzwdown aver hra. O"*V Cmnpwty TO-I)O_G_DFULLING GO. 0 R---y data(tune taken as zero when pump tamed off)(water Wal meseunad ////,c r1' from r06ll top to water late!) (Signed) Vv License No. 21_47 --- ZTime Water Level Time Water Leval Ttme Welter L.eK9 tl!ca aN DAIIrIEnylnaart -- 5 143 Address P0-BOX-2227 BELFAR;;LWA.__98528_- Coniraemra Q - data o�tea(- - - Regtetratwn No. TOP-DOQC-0i4SA__-_.— Dam 8L10i'2002 •to_ am2oo2 Bailer test_15 pat✓m1n.wfth _$ fl.drawdown after 1_ ton. (USE ADDITIONAL SHEETS IF NECESSARY) Now _ Orin_with stern set at R for _ hrs. Ec,*W Ir>an Equal 0wortunity and Affimtgb a Achm fir 0oyer. For I— Artesian tbw - - g-p-rn- Oats 8X=02_ spec-&W accdmmodabW needs,corttact the Water Rasar ces Progr"M at Temperature of water Was a chamleof analyses made? 0Ye a 0151 No (360)407-66W. The TDD mxrZer Is(360)407-80W. '. FPA/N No: 2418562 WASHINGTON STATE DEPARTMENT OF Effective Date: 5/17/2016 Natural Resources _r I rc es v Peter_ Goldmark-Commissioner of Public Lands Expiration Date: 5/17/2019 Shut Down Zone: 654 Forest Practices Application/Notification Notice of Decision EARR Tax Credit: ❑ Eligible © Non-eligible Reference: Decision ❑ Notification Operations shall not begin before the effective date. in Approved This Forest Practices Application is subject to the conditions listed below. ❑ Disapproved This Forest Practices Application is disapproved for the reasons listed below. ❑Closed Applicant has withdrawn approved FPA/N FPA/N Classification Number of Years Granted on Multi-Year Request I)Class II m Class III ❑ Class IVG n Class IVS 4 yrs 5 yrs Conditions on Approval / Reasons for Disapproval Issued By: Jason Sharp Region: South Puget Sound Title: Resource Protection Forester Date: 5/17/2016 Copies to: ® Landowner,Timber Owner and Operator. Issued in person: ❑ Landowner❑Timber Owner❑ Operator By: Washington State Department of Natural Resources•Notice of Decision•July 10,2012 Page 1 of 2 • Q2nealInformaion You have thirty(30)days to appeal this Decision and any related State Environmental Policy Act determinations to the Pollution Control Hearings Board in writing at the following addresses: Physical address: 1111 Israel Rd.SW, Ste 301, Tumwater,WA 98501 Mailing address: P.O. BOX 40903, OLYMPIA,WA 98504-0903 Information regarding the Pollution Control Hearings Board can be found at: http://www.eho,wa.gov/ At the same time you file an appeal with the Pollution Control Hearings Board, also send a copy of the appeal to the Department of Natural Resources' region office and the Office of the Attorney General at the following addresses: Office of the Attorney General Department Of Natural Resources Natural Resources Division South Puget Sound Region 1125 Washington Street SE And 950 Farman Ave. N PO Box 40100 Enumclaw,WA 98022 Olympia, WA 98504-0100 Other A22licable Laws Operating as described in this application/notification does not ensure compliance with the Endangered Species Act, or other federal, state, or local laws. Hydraulic Project Aooroval (HPA1(Chanter 77.55RCW and WAC 222-50-020(211 The Department of Fish and Wildlife(WDFW), as the jurisdictional agency issuing HPAs, has final authority for approving water crossing structures in Type S and F waters.WDFW continues to have authority on Type N waters and may exercise that authority on some Type N waters. Notice: The HPA water crossing requirements supersede what is indicated on the FPA. Landowners are required by law to follow the provisions as directed on the HPA. Transfer of Forest Practices Application/Notification (WAC 222-20-0101 Use the"Notice of Transfer of Approved Forest Practices Application/Notification"form. This form is available at region offices and on the Forest Practices website: htto://www.dnr.wa.gov/businesses rmits/forestnractices. Notify DNR of new Operators within 48 hours. Continuing Forest Land Obligations(RCW 76,09,060. RCW 76.09,070. RCW 76.09.390.and WAC 222-20-055) Obligations include reforestation, road maintenance and abandonment plans, conversions of forest land to non- forestry use and/or harvest strategies on perennial non-fish habitat(Type Np)waters in Eastern Washington. Before the sale or transfer of land or perpetual timber rights subject to continuing forest land obligations, the seller must notify the buyer of such an obligation on a form titled "Notice of Continuing Forest Land Obligation". The seller and buyer must both sign the"Notice of Continuing Forest Land Obligation"form and send it to the DNR Region Office for retention. This form is available at DNR region offices. If the seller fails to notify the buyer about the continuing forest land obligation, the seller must pay the buyer's costs related to continuing forest land obligations, including all legal costs and reasonable attorneys'fees incurred by the buyer in enforcing the continuing forest land obligation against the seller. Failure by the seller to send the required notice to the DNR at the time of sale will be prima facie evidence in an action by the buyer against the seller for costs related to the continuing forest land obligation prior to sale. DNR affidavit of mailing: On this day 5/18/2016 1 placed in the United States mail at Enumclaw WA, (date mm/dd/yyyy) (post office location) postage paid, a true and accurate copy of thi document. Not ce of Decision FPA#2418562 Meredith Dessens 1 (Printed name) ignature) Washington State Department of Natural Resources•Notice of Decision•July 10,2012 Page 2 of 2 Revisions to FPA/N 2418562 DATE DOCUMENT DESCRIPTION 6/20/2016 Notice of Transfer Change of Landowner and"Timber Owner i i i WASHINGTON STATE DEPARTMENTOF Natural Resources Forest Practices Application/Notification NOTICE OF TRANSFER I/we transfer my/our rights, privileges, and obligations under this approved Forest Practices Application or Notification. I/we affirm that the information contained below is true and agree to comply with the rules authorized by the Forest Practices Act and to be bound by all conditions on the approved application or notification. FPAIN Number: 2418562 Section(s): 7 Township: 22N Ranger Original Landowner(Signature): _ '_z Original Landowner(Printed): Leon & Lorraine Taylor Date: (3/13/16 New Operator—Fill out this section only if you are changing or adding an operator Legal Name of New Operator. (Print) — TMailing Address: Phone: Email- Date- New Operator Signature: New Landowner—Fill out this section only if you are transferring your FPA to a new landowner Legal Name of New Landowner: (Print) Mailing Address: PO Box 2264 Gig Harbor WA 98335 Cedarland Forest Resources LLC Phone: 253-208-7686 Ema;l ben -cedarlandforestresources.com Date- New Landowner Signature: 6/13/16 New Timber Owner—Fill out this section only if you are transferring your timber rights Legal Name of Timber Owner: (Print) Mailing Address: same Cedarland Forest Resources LLC Phone: same Email: same Forest Tax Reporting Account Number.(Contact Dept. of Revenue to et this number: 1-800-548-8829) 800059772 _ Date: New Timber Owner Si nature: r 6/13/16 NNW [/Received Dater!2-2--1 1�0 �(D_NX Forest Practices Staff Signature) Form Q050(11-0a-2oo5) RECEIVED JUN 2 0 2016 DNR-SpS i - 4 y i I } i yam,,. M ' ! ..t < < �,' �•^ ��, „.[J/{per iY �r�. a STATE OF WASHINGTON DEPARTMENT OF ECOLOGY PO Box 47775 -Olympia, Washington 98504-7775 -(360)407-6300 711 for Washington Relay Service -Persons with a speech disability can call 877-833-6341 October 6, 2016 Mr.Michael MacSems Mason County Department of Community Development Planning Division PO Box 279 Shelton, WA 98584 Dear Mr. MacSems: Thank you for the opportunity to comment on the mitigated determination of nonsignificance for the Alderwood 2 Project(SEP2016-00060) located off of East Alderwood Road in Belfair as proposed by Cedarland Forest Resources. The Department of Ecology(Ecology)reviewed the environmental checklist and has the following comment(s): WATER RESOURCES: Vicki Cline(360)407-0278 Any ground water withdrawals in excess of 5,000 gallons per day or for the irrigation of more than one-half acre of lawn or noncommercial garden, requires a water right permit from Ecology. All water wells shall be constructed in accordance with the provisions of Chapter 173-160 WAC by a driller licensed in the State of Washington. Well reports must be submitted to Ecology within 30 days after completion of a well. All water wells that may be drilled must be a minimum of 100 feet from any known, suspected, or potential source of contamination. Wells shall not be located within 1,000 feet of a solid waste landfill. WAC 173-160-171(1)The proposed water well shall be located where it is not subject to ponding and is not in the floodway, except as provided in Chapter 86.16 RCW. (2)It shall be protected from a one hundred year flood and from any surface or subsurface drainage capable of impairing the quality of the ground water supply. The Growth Management Act(RCW 19.27.097)requires an applicant to submit evidence of an adequate water supply before a building permit can be issued for any building requiring potable water. WATER QUALITY: Chris Montague-Breakwell (360)407-6364 Erosion control measures must be in place prior to any clearing, grading, or construction. These control measures must be effective to prevent stormwater runoff from carrying soil Mr.Michael MacSems October 6,2016 Page 2 and other pollutants into surface water or stormdrains that lead to waters of the state. Sand, silt, clay particles,and soil will damage aquatic habitat and are considered to be pollutants. The following construction activities require coverage under the Construction Stormwater General Permit: 1. Clearing, grading and/or excavation that results in the disturbance of one or more acres and discharges stormwater to surface waters of the State; and 2. Clearing, grading and/or excavation on sites smaller than one acre that are part of a larger common plan of development or sale, if the common plan of development or sale will ultimately disturb one acre or more and discharge stormwater to surface waters of the State. a) This includes forest practices(including,but not limited to, class N conversions) that are part of a construction activity that will result in the disturbance of one or more acres, and discharge to surface waters of the State; and 3. Any size construction activity discharging stormwater to waters of the State that Ecology: a) Determines to be a significant contributor of pollutants to waters of the State of Washington. b) Reasonably expects to cause a violation of any water quality standard. If there are known soil/ground water contaminants present on-site,additional information (including, but not limited to:temporary erosion and sediment control plans; stormwater pollution prevention plan; list of known contaminants with concentrations and depths found; a site map depicting the sample location(s); and additional studies/reports regarding contaminant(s))will be required to be submitted. You may apply online or obtain an application from Ecology's website at: http://www.ecy.wa.gov/programs/wq/storinwater/construction/-Application. Construction site operators must apply for a permit at least 60 days prior to discharging stormwater from construction activities and must submit it on or before the date of the first public notice. Ecology's comments are based upon information provided by the lead agency. As such,they may not constitute an exhaustive list of the various authorizations that must be obtained or legal requirements that must be fulfilled in order to carry out the proposed action. If you have any questions or would like to respond to these comments,please contact the appropriate reviewing staff listed above. Department of Ecology Southwest Regional Office (SM:16-5217) cc: Vicki Cline, WR Chris Montague-Breakwell, WQ Cedarland Forest Resources(Proponent) 1MZVwC70Cf 4 L FPA Construction SWPPP Elements Narrative (Follows Template Guidelines) Project Description: The project involves the application for waiver of forest moratorium (VAR2016-00009) for construction of a single family residence on a recently harvested 5 parcel under FPA#2418562. The property is located off of East Alderwood Road Belfair, WA and is under Mason County jurisdiction. The project is accessed off of East Alderwood Road. No new road construction is necessary. The proposed construction surrounding area is relatively flat to gently sloping to the west- northwest at inclinations of approximately 2 % or less. The area is situated on a broad topographic upland area with shallow, linear swales and broad ridges that trend southwest to northeast. Soils in the area are comprised of alderwood gravelly sandy loam and Everett very gravely sandy loam and are well draining. The site is bounded by rural residential property on the west, south and north, come of which is forested. The project planned start date is to be determined and will take approximately 6 months to complete. Logging project on this parcel is complete. Expected future single family residence. Element 1: Construction area limits will be clearly marked and/or ribboned off. Any natural vegetation and native topsoil will be retained in an undisturbed state to the maximum extent possible. Element 2: Construction access shall occur onPrit_aj3d access from cta�or Read. Sediment control is highly unlikely however, shoveling or sweeping will be used if necessary. Element 3: The project area is situated in gently undulating terrain that is dissected southwest—to- northeast-trending linear glacial striations or troughs. These striations extend or%-1 mile or greater in each direction from the site. Surface and shallow subsurface water flow from the site is intercepted by these features therefore, no offsite runoff is anticipated however, straw and silt fence will be used as needed should any erosion occur. Element 4: No additional BMP's are proposed. See Element 3. Element 5: N/A, no new road construction or cut and fills. Element 6: N/A no cut and fill slopes. Element 7: N/A for same reasons stated above. Element 8: N/A for same reasons stated above. Element 9: Any onsite pollutant sources will be handled and disposed of in a manner that does not cause contamination of storm water. Good housekeeping and preventative measures will be taken to ensure the site will be kept clean, organized and free of unnecessary debris. Element 10: N/A Element 11: All erosion and sediment control BMP's shall be maintained. Seedlings will be replanted and site will be thoroughly monitored to maintain all ESC measures. Element 12: Project management shall incorporate practices stated in Element 12. Construction to be completed prior to December 31, 2018. �I --�� RECEIVED JUN 2 4 2016 Forest Moratorium Waiver/Release Application 615 W. Alder Street This application is to be used to waiver a portion of a parcel for development permits or to release the entire tract from the six year moratorium for development permits. This process was created under the guidance of RCW 76.09.060. This application needs to be filled out completely, so that we have all the information to process this in an expedient manner. Are you requesting a Waiver or a Release from the Moratorium? 4waiver ❑ Release 4 Applicant's Name: QJMn 12 UP�D , QV— —J R G5W r,, Applicant's Address: i U cM Operator's Address: G)�}�}'�C, Parcel number of effected Parcel: - -(VII ( Parcel size in acres: Q Identify what type of timber iwis removed, ie: Douglas Fir, Western Red Cedar, Alder, Maple, etc: I O. HU �— � Was the timber harvest done under an approved forest practice application:Y-Yes ❑No Was there n enforcement action taken by the Department of Natural Resources (DNR): ❑ Yes No Forest Practice Application Number: Forest Practice Application Date of Approval: T t is y U �r intention to do ith h effected arcel: LEI Are there any critical areas on your site? ie: wetlands, streams, creeks, steep slopes, etc..: 0 Yes 0 No Identify the type critical area/s: Please list conditions of approvals by DNR for your forest practice application: iV O E Were any of the buffer areas effected by the timber harvest? ❑ Yes ''No Identify if you harvested any timber in the critical areas on your site: ❑ Yes Niz iQo Did you replant per DNR standards: ❑ Yes *00 APPLICATION SIGNATURE 1) I certify that I am the forest land owner, as that term is defined in RCW 76.09.020 and WAC 222-16-010, and that am familiar with the requirements of the Forest Practices Act, RCW 76.09 and the forest practices rules, WAC Title 222. I am specifically familiar with RCW 76.09.060(3) and its effects. 2) I certify and declare under penalty of perjury under the laws of the state of Washington that the foregoing is true and correct. Zd�d Signed this 7�tIv of Jtil✓G , f9_at ` (month) ity) (State) STATE OF WASMNGTON) 'P>l�e-x& ) SS COUNTY OF MA9BPI� ) ���� On this day of U ��'. efore me, the undersigned, a Notary Public in and shi for the St to of Wa on, duly commissioned and sworn, personally appeared k Nc),240h� to me known to be the individ al described in and who=execud the ithin and fjoregoing instrument, and acknowledged that ikid signed the same as �n i 1�a free and voluntary act and deed, for the uses and purposes therein mgntioned. +L'GIVEN under my hand and official seal this f \ju— ell , ��r•c°MMrSs�••�y t ti oti:� NOT IC ' an for t State a � Lo of Washington resid gat mS 7 &\ p m�Z 4Gs.;6 17 *.• h'�NMot' 4 •ori eon 3QQi1d3S 31tS NOy� �V 1 1 J�:9: W WOMW gym't •r M Hlll�S 3 a ate^" ON r i i • axaiawzrtsa 3-41 ao •Jt�t �01 °idS PI1CIi.L �,LW32[J .LfiO 'I Y8?IK t1'tBZdlixY�ll 3ita i 80 dSi PtiHa i!! aSMOZT[ 88 'T'11lIiit`.• aaamn ate 9RtOrail'8l1 OR •ZI } , A "1tsO�t3la 89Y81i�9 Y a0aj a$PIP1 iS30 tOtq *It �, -aai�Ia:sRoa s�xo 4sa+r azsT3Pri�Q, ss�a ` � r•�1ad - Ha&o gWio•7Tf SS 'T'I?HS OZAAM.Wr=IRSA no at1L81tdllltkd XAeBS 0 'Ot 1 ••iIOs SMlvrloo dd aOgd OZ VZW a-MfJWX.VW RI 3HOU SH Ill^ "TOE 'VRXNIIs •iJllIOttllddlOO 8310tIHH i�PtOI b•80 } �•� I+tLOIQ 'AOI.tOI1tI.Lta't�Q 1s=m aawAmmim mm Imlos Mod SI °f awrasr w moaa .rmy aaaaasi(r ly fS- SPIN joo'S. an slC SAINa HOW J Mftll WA� �3Stt�tis '3'3� •l. ., _ � //a}is*�-i�x/yiit.=�Hb;°6 « g �� 4Ay1 W..Y1V".i:.R.tia iL 5t l�.OIadSS •i•WeOaSdHoo.:,u) :°':1'•.+•� �VJ.♦iW4i- R�. ° • / 4 w�-...»•sue `` •sue OPII64 )-rm,8 '3SAW1'as ox smoms" 61314HItt"!Ia S ' » -. ;... .. - 4.....1f._.-_; t► f d8 88aAaIJ �RZYilttIl[J{ •�RdO'n/�fwta�JlTiIt.LyS�Y/]yC/t L DCOMM ! •1t3PITJ�i { ��g8 YQlpn/ M ?si}( lL{4ai •/ �• . 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