HomeMy WebLinkAboutLower Hood Canal Survey - SWG Onsite Survey - 8/27/1996 ' ON-SITE SEWAGE SYSTEM SURVEY
LOWER HOOD CANAL CLEAN WATER DISTRICT
Project: LIiC
Area: 11 Toonerville Date: -2 7- 96;
OWNER INFORMATION :
Michael L & Penny M Fullaway
30206 25th Avenue SW
Federal Way WA 98023
SITE INFORMATION : �A lAA,� LAltc ur-a-.S
Parcel# ; 2 2 3 3 0—5 0—0 0 0 2 5 Owner's Phone: $�y- ��7
Address: _3c>� .2sAve-S.ce). City: �� & ,g State: W_ Zip: 9LO,;�3
Building Type: (F-Full Time Residence; S - Seasonal Residence; C -Commercial;
M - Multi-family Residence; V - Vacant )
Septic System Type: _�T (S - Standard tank and drainfield; P - Pressure Distribution;
F - Sand Filter; M - Mound; T - Deep Trench; H - Out House;
O - Other; U - Unknown)
Installation Date: Year Last Pumped: �7/ S (Enter Year or U- Unknown)
System Location:_ (F -Front Yard; B - Back Yard; S -Side Yard; A - Adjacent Lot;
U - Unlmown)
Y/
Number of Residents: 2 Shoreline_ ( N): .�—
OCCUPANT INFORMATION(complete only if different than owner):
Occupant's Title: (tam, mms, ms) First Name: Name-
Occupant's Phone:
Would you like Information on Water Conservation? (Y/N)
Would you be interested in a Community Workshop? (Y/N)
PERMISSION FOR ACCESS TO IN PECT THE SEPTIC SYSTEM: (Y/N)
SIGNATURE: -, L Date: �"-�3 7- 96
Comments: f,c�, `�
in `> aA - L r
540 Q L'C'ASS //�_S 'P cr !A occ
Area Parcel Team # L P
Name Address 4,
Phone Number
Site Visit #1 Date Time
Notes/observations:
Permission to inspect? Initial
Vhon* Call #1 Date Time
Notts/Observations:
Permission to inspect? Initial
Site Visit #2 Date V.., Time 10
Notes/observations:
I A
Pqrmission to inspect? Initial
Phone Call #2 Date Time
Notes/observations:
Permission to inspect? Initial
Ph*21*i Call #3 Date!R 112:96— Time—I
Notes/Observations: '
( 0 0
Permission to inspect? Initial—�
,MASON CQUNT0
DEPARTMENT of HEALTH SERVICES
Shelton,Washington 98584
(360)427-9670• Belfair:275-4467
ENVIRONMENTAL HEALTH PERSONAL HEALTH WATER QUALITY
P.O. BOX 1666 303 N. FOURTH P.O. BOX 1666
August 9, 1996
Michael L & Penny M Fullaway
30206 25th Avenue SW
Federal Way, WA 98023
Re: Parcel Number: 22330-50-00025
Dear Homeowner,
The Mason County Department of Health Services, Office of Water Quality,
is conducting sanitary surveys of on-site sewage disposal systems within
the Lower Hood Canal Clean Water District. The goal is to survey all
homes within the District. To date we have surveyed over 70% of the
residences and identified 455 failures.
We are attempting to complete this project ahead of schedule and would
appreciate your cooperation. Our office has attempted to contact the
property owner on a number of occasions. These efforts include a series
of letters, phone calls and on-site visits. Please help us by completing
the enclosed survey form and mailing it back to our department within two
weeks in the envelope provided.
Enclosed is an informational pamphlet on our department's survey process.
If you have any questions regarding the project or survey form, please
feel free to contact me at (360) 275-8733. In addition, if your property
has already been surveyed please contact me to correct our records.
Sincerely,
Grant Holdcroft
Environmental Health Specialist III
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