HomeMy WebLinkAboutGeologic Assessment for FPA - FPA Reports - 12/23/1999 CONSOLIDATED ENGINEERING
- CIVIL - STRUCTURAL - SOILS - PLANNING -
December 23, 1999
Jack Johnson, Contractor
P. 0. Box 1119
Belfair, WA 98528
RE: Report of Geological Assessment of Property Per Legal Description
Dear Sir;
This civil engineer made a preliminary soils reconnaissance of the
subject property on December 21st. The parcels slope downward to the
Northwest. The area is well-covered with timber on the slopes.
The soil is a glacial till covered with a 6 inch layer of forest
humous top-soil. The till is a typical mix of sand and gravel. The
material was noted to consist, primarily, of gravel. The slight slopes
of the parcels are very stable with a granular soil of this type. The
drainage is excellent.
The area is well timbered with a mixture of small trees and merchant-
able timber of Douglas Fir of 10 to 16 inches in diameter. Tree trunks were
noted to be straight and tall. Photographs of the site were taken for our
file and record.
The° gulley in the Southerly parcel was found to have a slope down of
about 6 as read on a "Smart Level". The knob in this parcel was read at
about 180 down to the West. Slopes were similar in the Northerly parcel.
Timbering off the parcels should not present any problem of instability
of the land.
The Coastal Zone Atlas of Washington shows the project to be in a
Stable Area. There are no nearby areas of Instability.
Yours truly, �,g. BOU
Q� oF wAs��y�L
R. B. Bough , P.
Geo-technical ngineer
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Encl- Legal Description & Map of Survey ONAI-
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FOREST PRACTICES
APPLICATION / NOTIFICATION
I. GENERAL INFORMATION SECTION f',ynaeRt ra
REFER TO THE INSTRUCTIONS TO ASSIST IN THE COMPLETION OF THIS FORM. TYPE OR PRINT IN PERMANENT INK.
1. FULL LEGAL NAME AND/OR 2. FULL LEGAL NAME AND/OR 3. FULL LEGAL NAME AND/OR
COMP NY/DIVISIOA NAME OF LANDOWNER COMPA Y/DIVISION NAME OF TIMBER OWNER COMPANY/DIVISION NAME OF OPERATOR
44
J j
1 l,�srl%SSD�RESS1(19 BUSINESS ADDRESS ,�BU�NE SAD�ES�k
CITY STATE ZIP CITY STATE ZIP CITY STATE 2
PHONE: 1 3 > 1 - 7�� PHONE: ( 1 PHONE: I C•' 1 —y�7
Unified Business Identifier(or SSN#) UBI Unified Business Identifier(or SSN #) UBI I I Unified Business Identifier(or SSN#1 UBI
SSN I I SSN I I SSr
4.TYPE OF LEGAL ENTITY TYPE OF LEGAL ENTITY TYPE OF LEGAL ENTITY
I I CORPORATION I I SOLE PROPRIETOR ( I CORPORATION [ I SOLE PROPRIETOR f I CORPORATION ( J SOLE PROPRIE
l I PARTNERSHIP ( J PARTNERSHIP ( J PARTNERSHIP
( J OTHER(specify): ( I OTHER(specify): I I OTHER(specify):('Or "1Jk
5. FOREST TAX REPORTING ACCOUNT NUMBER: D�Z 3� 1 For tax reporting information c
_ v numbers call 1-800-548-8829.
6. [ ] YES NO - IS THE OPERATION WITHIN CITY LIMITS? 6A. COUNTY
NAME OF CI Y(s): /
7. [ ] YES ['']ENO - IS THE OPERATION WITHIN A PUBLIC PARK? If yes, an Environmental Checklist is required.
[ ] YES (-n10 - IS THE OPERATION WITHIN 500 FEET OF A PUBLIC PARK?
NAME OF PARK:
8 a. LEGAL SUB-DIVISION OF OPERATION(S): 8 b. PARCEL OR LOT NU
SUB-DIVISION (1/4, 1/4) SECTION TWP RANGE PARCEL OR T/
(E)(W) LOT NUMBER(
1 Z
9. [ ] YES [ ] NO - WAS THE LAND PLATTED AFTER JANUARY 1, 1960 (INCLUDING SHORT PLATS)?
(You May Contact County Assessor for Verification). If Yes, Environmental Checklist Is Required.
10. (,7 YES [ ] NO - LANDOWNER INTENDS TO CLEAR, IMPROVE OR DEVELOP LAND WITHIN THREE YEARS?
NOTE: 1. If yes, attach a completed Environmental Checklist.
2. A local government clearing and/or grading permit may be required.
3. See the instructions for more information relating to conversions.
THE FOLLOWING IS PROVIDED FOR YOUR INFORMATION: . If the Forest Practices Application or Notification does not stal
there is an intent to convert the forest land to non-forestry uses the county, city, town or regional governments may deny any p
or approvals for conversion to non-forestry land uses for a period of six (6) years from the date of the application or notificatior
the Instructions under item # 10, and regulations, including but not limited to, RCW 76.09.060,
RCW 76.09.170(7), WAC 222-20-010, WAC 222-20-040 and 222-20-050.
11. [ ] YES [4/NO - DO YOU HAVE AN APPROVED CONVERSION OPTION HARVEST PLAN (COHP)? NOV
If yes, include a copy of the approved plan. NOTE: Not all Local Governments issue COHP's.
1 �
IL
FORM DNR QQ-19 (1-95)
(For FPA Fee Information see the Instructions) 2406599
11. WATER SECTION
all work within Type 1-3 Waters will require a Hydraulics Pro1'ect Approval (HPA). Work within Type 4-5 Waters may require an HPA.
ompletion of this section will serve as your request for an HPA from the Department of Fish and Wildlife. If you are operating within
200 feet of a Type 1 or 1 + Water, contact the local government for shoreline management information.
12. [ 1 YES [I/NO - WILL THERE BE ANY ACTIVITIES THAT WILL BE WITHIN OR OVER THE ORDINARY HIGH WATER
MARK OF ANY WATER? (If you will not be working in or above any typed water, go to question 13.)
f YES, check W) the activities you will be doing in each type of water. The location of all culverts and bridges must be shown on
he base map. Culvert Base Map Information must include culvert diameter. Bridge location information must show whether the
)ridge is temporary or permanent. (For Water Type information see WAC 222-16-030.
[ 1 YES ( 1 NO Are all waters shown on the Base Map. (If No, please show all unmarked water locations.)
(A) (B) (C) (D) (E) (F) (G) (H) (II
Water Road Water Falling & Cable Suspending Ground Operate Apply Other Activity
Type Const. Crossing Bucking Yarding Cables Skidding Other Chemicals (Show under
Over (Skidder or Equipment question 29)
Water Tractor)
1
2
3
4
5
13. [ 1 YES [-1 NO WILL THERE BE ANY ACTIVITIES WITHIN 200 FEET OF A TYPE 1 - 3 WATERS?
FEET If Yes, how close? (Measure a#distances horzontalty.) Show the location of all
Riparian Management Zones (RMZs) on the Base Map. (See WAC Chapter 222-30.)
14. [ 1 YES [I NO - WILL THERE BE ANY ACTIVITIES WITHIN 25 FEET OF TYPE 4-5 WATERS?
15. [ 1 YES [ I NO - ARE YOU AWARE OF ANY WATER INTAKES IN YOUR UNIT OR WITHIN 1/2 MILE
DOWNSTREAM OF THIS OPERATION?
16. [ 1 YES F] NO - WILL YOU BE REMOVING TREES WITHIN THE MAXIMUM WIDTH RIPARIAN MANAGEMENT ZONE?
(For maximum Width Riparian Zone Information see WAC 222-30-020(3) and (4).)
(For Information Relating to Shade Requirements see WAC 222-30-040.)
III. WETLAND SECTION
17. [ 1 YES [I NO - DO WETLANDS EXIST INSIDE OR WITHIN 200 FEET (horizontally) OF YOUR PROPOSED FOREST
PRACTICES BOUNDARY? (If wetlands do not exist within or around this application go to Section IV.)
If YES, show the location and classification of all Wetlands and Wetland Management Zones on the Base Map, and check
( ✓ ) the appropriate squares in the following table describing your work within a Wetland or Wetland Management Zone.
(For wetland typing Information see WAC 222-16-035.)
Wetland (A) (B) (C) (D) (E) (F) (G) (H) (U
Road Water Falling& Cable Suspending Ground Operate Apply Other
Type Constr. Crossing Bucking Yarding Cables Over Skidding Other Chemicals (Show under
Wetlands (Skidder or Equipment question 29)
Tractor)
A
B
Forested
18. [ 1 YES [If-NO - WILL YOUR PROJECT BE FILLING OR DRAINING A WETLAND?
( ACRES) If Yes, how many acres will you be filling or draining? (Enter acreage to the nearest 1/10 acre)
A mitigation plan and a SEPA checklist must accompany this application if you are filling or draining
more than 1/2 acre of any wetland.
FORM DNR 00-19(1-95)
2
IV. ROAD SECTION
9. ( 1 YES [I NO - IS THERE ANY ROAD WORK OR ROCK PIT DEVELOPMENT ASSOCIATED WITH THIS APPLICATION:
(If YES, complete all blocks that apply and LABEL EACH TYPE SEPARATELY ON MAP.) (If you will not be doing any work
involving roads go to Section V.)
TYPE OF ACTIVITY TOTAL LENGTH TOTAL LENGTH OF STEEPEST SIDE
IN FEET ENDHAUL/OVERHAUL SLOPE ROAD
(no sidecast/ CROSSES
CONSTRUCTION (in percent)
Show All Locations
On Map
I 1 NEW ROAD CONSTRUCTION
I 1 EXISTING ROAD RECONSTRUCTION
I I EXISTING ROAD MAINTENANCE
[I ROAD ABANDONMENT(Provide a Detailed Plan)
[I ROCK PIT DEVELOPMENT Indicate Pit Locations on Show timber harvest volumes and acreage in question 20.
Map.
/ V. TIMBER HARVEST SECTION
20. (I YES I 1 NO - WILL YOU BE HARVESTING TIMBER AS A PART OF THIS PROPOSAL? (If YES, complete
all blocks that apply and show on map.) (If you will not be harvesting timber as a part of this proposal, go to
Section VI.)
UNIT TYPE OF HARVEST TREES PER METHOD OF ACRES PERCENT OF ESTIMATED
# '(Even-aged,Uneven-aged ACRE HARVEST VOLUME TO VOLUME TO BE
Salvage and/or REMAINING (per BE CUT HARVESTED
Right of Way) AFTER (Ground Cable, Highlead, type of
HARVEST Skyyline, Shovel, Rubber Tired harvest) (in MBF)
(For Harvest Type Information Skcider, Tracked Skidder,
see"Even-aged Harvest" (Only count Animal,Helicopter or Balloon.)
under trees that meet
WAC 222-16-010) the
requirements
Show the location of each under Even-a ed
harvest type on Map. harvest in WAC
222-16-010)
O m h
For even-aged harvests, provide surrounding stand information on the base map as required under
WAC 2222-30-025. See instructions.
21. [ ] YES [-j NO - WILL YOU BE HARVESTING TIMBER OR LEAVING TREES WITHIN TWO TREE LENGTHS OF ANY
OVERHEAD POWER LINES? (If yes, the applicant needs to notify the appropriate Power Company.)
22. INDICATE HOW THE FOLLOWING WILDLIFE TREES WILL BE LEFT: (Check all that apply)
See WAC 222-30-020 (1 1) for Wildlife Reserve Tree, Green Recruitment Tree and Down Log leave requirements.
WILDLIFE RESERVE TREES GREEN RECRUITMENT TREES
( ] YES ( 1 NO - CLUMPED (Show on Map) [ 1 YES ( 1 NO CLUMPED (Show on Map)
[ 1 YES ( 1 NO - EVENLY DISTRIBUTED (Throughout Unit) I 1 YES [ 1 NO EVENLY DISTRIBUTED (Throughout Unit)
NOTE: WAC 222-307020(11) requires that 2 down logs per acre be left in areas where green recruitment trees are required.
23. ( 1 YES [f NO - WILL YOU BE LEAVING A DOUBLE-WIDE RMZ(s) FOR GREEN-UP? (For Western Washington Only)
INDICATE DOUBLE-WIDE RMZ LOCATION(s) ON MAP
24. REFORESTATION METHOD: Reforestation is required for lands harvested after January 1, 1975 as shown under
WAC 222-34-010 (West of Cascades Summit), or WAC 222-34-020 (East of Cascades Summit).
[ 1 PLANTING (Species: )
[ ] NATURAL (Applicant must submit a Reforestation Plan - See Instructions.)
(fREFORESTATION NOT REQUIRED under WAC 222-34-010, 222-34-020 or 222-34-050.
FORM DNR 00-19(1-95) 3
VI. CHEMICAL APPLICATION SECTION 24065991
25. ( j YES NO - THIS FOREST PRACTICE INVOLVES THE APPLICATION OF PESTICIDES OR FERTILIZER?
If YES, answer the questions below.) (If no, go to Section VII.)
[ j FERTILIZER APPLICATION - ACRES ( ) - For fertilizer applications answer question 28 and show
application locations on the Base Map..
[ I PESTICIDE TREATMENT - ACRES ( ) - For pesticide applications answer questions 26 27 and 28, and
indicate areas to be treated on the Base Map. Describe in the "General Description Section", the purpose of the pesticide
treatment(s) you are proposing.
26. LIST THE EPA REGISTRATION NUMBERS, TRADE NAMES, AND RATES OF APPLICATION FOR ALL CHEMICALS
PROPOSED, INCLUDING ALL ADJUVANTS.
EPA REG. No. Trade Name of Chemical Application Unit of Measure
Rate of Active
Ingredient
Per Acre
27. ( j YES [1 NO - WILL THIS PESTICIDE BE USED UNDER A DEPARTMENT OF AGRICULTURE EXPERIMENTAL USE
PERMIT? If yes, include a copy of the Experimental Use Permit.
28. CHEMICAL INFORMATION CONTACT PERSON PHONE # ( )
(Additional information may be required for activities relating to the application of pesticides.)
VII. GENERAL DESCRIPTION SECTION / /
29. Provide any d ails that will give a better understanding of your project. �/ / Ay,'-fC(P.le-
THE FOLLOWING IS PROVIDED FOR YOUR INFORMATION:
RCW 76.09.220 (8) provides any aggrieved person the right to appeal the approval or disapproval of a forest practices application. RCW 43.21C.075 provides any
aggrieved person the right to appeal issues arising under the State Environmental Policy Act. Appeals must be filed within 30 days of the approval or disapproval of the
forest practices application. Appeals must be filed with the FOREST PRACTICES APPEALS BOARD,PO BOX 40903,4224-6th Ave SE Bldg k2, Lacey,WA 98504-0903.
Appeals must be filed in writing on the form required in Title 223-08. Concurrently with filing of the Forest Practices Appeals Board,copies of the appeals must also be
filed with the OFFICE OF THE SUPERVISOR, DEPT OF NATURAL RESOURCES, 1111 Washington St SE,4th Floor Natural resources Bldg., PO BOX 47001,Olympia,
WA 98504-7001, and with the ATTORNEY GENERAL,PO BOX 40100,OLYMPIA,WA 98504-0100.
Compliance with this application/ notification does not ensure compliance with the Endangered Species Act, or other federal, state,
or local laws.
SIGNATURE BLOCKS
We affirm that the information contained herein is true, and understand that this proposed Forest Practice is subject to the current
rules and regulations of the forest practices act, as well as any applicable Federal, State or Local rules and regulations.
LANDOWNER TIMBER OWNER OPERATOR
ature Si lure: Signature
n �
P e UPri /� Print:
Date of Lan own r Signature: Date of Timber ner Signature: Date of Operator Signature:
I t i112A
FORM DNR QQ-19(1-95) 5
09/13 '99 09:41 1D:SPS REGION ENVMCLAW WA FAX:
PAGE 2
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UISCLAIVER: See legend
water/Wet)ends including their location and clbas mey .tie 1)lcorrectly ol8olaye0 or not shown
Un the Base Map. Applicants are responsible for Kddl ficatfon and Correction.
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