HomeMy WebLinkAboutCOM2007-00118 Final Tenant Review - COM Permit / Conditions - 5/14/2008 n
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11/14/2007
Conditions Associated With 3:13:38PM
Case#: COM2007-00118
8) 5045 FIELDCORRECT NOT MET 10/4/2007 DLC
CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY
BUILDING DEPARTMENT AND THE ADOPTED BUILDING CODE.
The construction of the permitted project is subject to inspections by the Mason County Building Department.
All construction must be in conformance with the international codes as amended and adopted by Mason
County. Any corrections,changes or alterations required by a Mason County Building Inspector shall be made
prior to requesting additional inspections.
X
9) 5600 FINAL INSPECTION REQUIRED NOT MET 10/4/2007 DLC
All building permits shall have a final inspection performed and approved by the Mason County Building
Department prior to permit expiration.The failure to request a final inspection or to obtain approval will be
documented in the legal property records on file with Mason County as being non-compliant with Mason
County ordinances and building regulations.
X
10) 5610 PERMIT EXPIRATION NOT MET 10/4/2007 DLC
All permits expire 180 days after permit issuance,or 180 days after the last inspection activity is performed.
The Building Official may extend the time for action for a period not exceeding 180 days,upon the receipt of a
written extension request indicating that circumstances beyond the control of the permit holder have prevented
action from being taken. No more than one extension may be granted.
X
's 1) 5710 SOLID WASTE STORAGE NOT MET 10/4/2007 DLC
Recyclable materials&Solid Waste Storage: Space shall be provided for the storage of recycled materials and
solid waste. The storage area shall be designed to meet the needs of the occupancy,efficiency of pick-up,and
shall be available to occupants and haulers.X
12) 1 WASTE STRENGTH TESTING NOT MET 10/10/2007 TW
WASTE STRENGTH TESTING WILL NEED TO BE COMPLETED IN 6 MONTHS AND ANNUALLY
AFTER THAT.
X
13) 270 Fire Marshal Comments NOT MET 10/4/2007 LAW
Install 2AlOBC fire extinguishers so the maximum distance of travel does not exceed 75 fie ' con.
The t t e no higher than 0 inches above the floor the top of the extinguisher. s4 L) TZ�
X 11—lLi-b7- 4$ -T*) w/LL oQ�nay.JT—
® A' n>r-'6 bv4- � S,,d D7 �6borQ
The structure and the site is subject to inspections and corrections as deemed necessary by the Mason County
Fire Marshal to insure the minimum fire and life safety requirements are met as adopted by Mason,Sounty.�/
m.1 X i.✓� ,ecl- ax, Sl�,-lJ�.
4) 1 HIGHWAY 3 WIDENING&SEWAGE NOT MET 10/18/2007 CMM
At the time of completion of the widening and sewage system placement along the Highway 3 corridor the
applicant will required to meet belfair's_UGA landscape buffer code requirenments
X
15) 1 OPERATION&MAINTENANCE NOT MET 11/6/2007 TW
OPERATION&MAINTENACE MUST BE COMPLETED BY AN O&M LICENSED PROVIDER
ANNUALLY. LAST MAINTENANCE REPORT COMPLETED ON 11.26.06.
X
Page 2 of 3 CaseConditions..rpt
11/14/2007
Conditions Associated With 3:13:37PM
Case#: COM2007-00118
1
1) 4999 Flammable+Combustible Liquids NOT MET 0/4/2007 LAW
The use,handling and storage of hazardous materials or flammable and combustible liquids in excess of 10
gallons is not allowed without the approval of the Mason County Fire Marshal.
X
2) 1 ACCESSIBILITY-EXISTING BUILDING NOT MET 10/4/2007 DLC
This project is approved subject to the following requirements:
1)At least one accessible building entrance.
2)At least one accessible route from an accessible building entrance to primary function area.
3)Accessible signage.
4)Accessible parking in accordance to approved standards.
X
} 1 EXISTING BUILDINGS NOT MET 10/4/2007 DLC
_ # This project is approved as an existing building. The occupancy classification has not changed,and no
alterations are proposed.
No change shall be made in the use or occupancy of any building that would place the building in a different
division group of occupancies,unless the building is made to comply with the requirements of this code for
such division or group of occupancy.
X
4) 1 WALL&CEILING COVERINGS NOT MET 10/4/2007 DLC
Rooms and enclosed spaces shall have Class C interior wall and ceiling finishes or better. Class C finishes shall
have a smoke developed index of 0-450 and a flame spread index of 76-450. Provide classification information
during inspection.
X
1001 PLANS REQUIRED ON SITE NOT MET 10/4/2007 DLC
All approved plans are required to be on-site for inspection purposes. If inspection is called for and plans are
not on site,Approval WILL NOT be granted. In addition,a reinspection fee,based on the current fee schedule,
minimum one-hour will be charged and collected by the Mason County Building Department prior to any
further inspections being performed or approvals granted.X
6) 1002 ADDRESS/ROAD SIGNING NOT MET 10/4/2007 DLC
Owner/Agent is responsible to post the assigned address and/or purchase and post private road signs in
accordance with Mason County Title 14.28.
X
7) 5030 Changes to Approved Plans NOT MET 10/4/2007 DLC
Changes to approved building plans that affect compliance to the current Washington State Energy Code
(WSEC),ventilation and Indoor Air Quality Code(VIAQ),Building/Plumbing/Mechanical Codes and/or
Mason County Regulations shall be approved prior to construction.
X
Page 1 of 3 CaseConditions..rpt
11/14/2007
Conditions Associated With 3:13:37PM
Case#: COM2007-00118
1 ) 7000 SMOKE MANAGEMENT ZONE NOT MET 11/7/2007 CMH
This parcel is located in a smoke management zone.Please contact a fire warden at(360)427-9670 ext.459 for
further information.
X
tf
4.,
III
I
Page 3 of 3 caseConditions..rpt
n
N CONCRETE MECHANICAL MANUFACTURED HOME c
Z
oFootings!Setbacks Date tics Piping By Rlbl�ons C
o interior Date By Interior-Date By Date By
Exterior Die By Exterior-Dam By Sat-up
Point Load!Isolated Footings INSULATION Date By
Date By SO!SLAB INSULATION
Date By FIRE DEPARTMENT
Foundation Walls Floors Data By
Date By Data By DECKS
FRAMING Walls Dale By
Date By Data By PROPANE TANKS
PLUMBING Vault Data By
Date By OTHER
Groundwork Attic
Data By Type.
Date By Dade By
p.W.V DRYWALL O
Type:
Int Brace Wall Date By 3
Date By Date By IN)INSPECTION IN)
O
Water Line Fin Separation
Date By Data By Data By ,4
Pass or Request Inspect. o
Type of Insp. Fail Date Date Done By Comments o
17 , /
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N CONCRETE MECHANICAL MANUFACTURED HOME
o Footings t Setbacks as By Ribbons _
t3ea Piping C
o InteriorDate By Interior-gate By Date By
EXt8rJ0r Date By Exterior-Date B
00 INSULA1I0N
Point Load!Isolated Footings Data By
SO BLAB INSULATION
Cate By Data By FIRE DEPARTMENT
Foundation Wails Floors Date By
Date By Date By DECKS
FRAMING waft Dabs By
Date By Dale By PROPANE TANKS
PLUMBING vault Date By
Data By OTHER
Groundwork !Attic
Data By Date By Type:
Data By
aw,v ���1�NAI.L Type;
Int.Brace Wan Owe B C
Date ByDate y 3
By
FINAL INSPECTION c
WAW Une Fire Separation p
Date By Date By Date By y
b
Pass or Request Inspect.
Type of Insp. Fall Date Date Darn:6y Comments a,
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Af fir✓ C .O -P— cf/
01
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CA
COM
MASON COUNTY Cct
CHANGE IN TENANT APPLICATION
Complete the Change in Tenant Application and return with a floor plan,site plan,septic pumper's report,septic records and
$125 fee to the Mason County,Permit Center,P.O. Box 186,Shelton,WA 98584. During the evaluation of your Change in Tenant
Application staff members from the Building,Fire Marshal, Environmental Health,Planning and Public Works offices will identify
compliance requirements. This application is intended for tenant change only. If construction or remodeling Is proposed/required a
separate building permit will be necessary. Upon approval the permit will be issued t0.the applicant/tenant. After the permit is issued,
schedule a site inspection by calling(360)427-7262.Upon satisfactory inspection a Certificate of Occupancy will be issued and must be
oDate:stecd,in a cons icuous lace the remises.
Assessor's Parcel Number: a - 60110
15
Legal Description:
,.
Building Site Address: �55 I n Er 5+A e I. tA� �49-8613
Method of sewage disposal: & Septic O Sewer-name of district:
Water source: O Individual Well O Community Well •Public System, name of system:
Name of Applicant: , I Yl
Mailing address: 1 --
City: 1 0 n State: W A Zip:
Day phone:31ooSBI_i9q8W Contact Person:3?�tj V%t Message phone: cg do a gap (0005
Proposed business name: p b
Proposed use. Number o mployees: �q2,
Previous business nam
Describe previous use:
Check one: • Detached single level/single tenant O Single level/multi tenant
O Multi level/single tenant O Multi level/multi tenant
Age of structure: Is structure currently If not occupied, how long has it been vacant? 2
occupied? Yes No Yrs mos. •
Square footage: Basement: First: Mezzanine: Second: Third:
Is the structu heated? Heating type: Circle one:
Circle one: es ? No Electric Liquid Propane Natural Gas Oil
Type of heat: Circle one: Furnace Heat Pump Electric baseboard or wall mount Radiant
Will there be any changes to the following? Circle yes or no,If applicable:
Floor lay-out: Yes No Lighting: Yes Heating: Yes
Exterior Finishes: Yes o Interior Finishes: Yes No Parking: Yes No
Number of restrooms provided: Number of fixtures in each
Is structure handicap accessible? Circle one Yes No ?
Is the structure equipped with a fire sprinkler system? Yes No Fire alarm system? Yes No
Monitoring Station Name: Phone number:
1. Floor Plan(5 sets): • Use of rooms
• Draw the floor plan to scale • Location of all exits and windows(include dimensions)
• Room Dimensions • Interior doors with swing radius
• Location of plumbing and mechanical fixtures
2. Site Plan(5 sets): Note scale used 0 Location of all existing structures&dimensions
• Property lines,easements,&right of ways • Landscape buffer yards
• Distance,in feet,from property line&structures • Well location
• On-site sewage tanks and drain fields,&reserve • Parking areas(number&arrangement)
• Surface&storm water run-off routes
• Location of fire hydrants&vehicle access roads
3. Septic records,pumper's report or O&M report
4. Fees will be collected at time of submittal
7AcceP7tedbyj2gaU..,jDated2 - Submittal Amount $ Recei t number
t 4iview Initials Date Comments
Building
Environmental Health
Fire Marshal
Planning
Public Works
Pre Application required? (circle one) Yes No Building Permit required? (circle one) Yes No
Engineering Required?(circle one) Yes No Occupancy Classification:
Occupancy Change? (circle one) Yes No Type of construction
Occupancy classification change from to Occupant load calculated: persons
Existing occupant load design persons.
i
COM-2QD2-
MASON COUNTY C��f
CHANGE IN TENANT APPLICATION L
Complete the Change in Tenant Application and return with a floor plan,site plan,septic pumpees report,septic records and
$125 fee to the Mason.County,Permit Center,P.O.Box 186,Shelton,WA 98584. During the evaluation of your Change in Tenant
Application staff members from the Building,Fire Marshal, Environmental Health,Planning and Public Works offices will identify
compliance requirements. This application is intended for tenant change only. If construction or remodeling Is proposed/required a
separate building permit will be necessary, Upon approval the permit will be issued to the applicant/tenant. After the permit is issued,
schedule a site inspection by calling(360)427-7262.Upon satisfactory inspection a Certificate of Occupancy will be issued and must be
sted In a cons icuous lace n the Premises.
Date: V Assessor's Parcel Number: a
Legal Description: 12
SN
Building Site Address: GLIII 5J
Method of sewage disposal: • Septic O Sewer—name of district:
Water source:: O Individual Well O Community Well Public System, name of system:
At A
Name of Applicant:, L)ri Yi
Mailing address:
City' i'�OI'l State: Zip-
Day phone:3�p Contact Person:Jan pj t 4-# Message phone:
Proposed business name: b
Proposed use. aaR
Number o employees:
Previous business nam :
Describe previous use: /
Check one: • Detached single level/single tenant O Single level/multi tenant
O Multi level/single tenantaa O Multi level/multi tenant
Age&structure: Is structure currently _ If not occupied, how long has it been vacant? 2
occu led? Yes No Yrs mos.
Square footage: Basement: First: Mezzanine: Second: Third:
Is the'as
heated? Heating type: Circle one:
Clrale one: es ? No Electric Li uid Pro are Natural Gas Oil
Type of heat: Circle one: Furnace Heat Pump Electric baseboard or wall mount Radiant
Wi
ll there be an changes y g to the or es foil owin ? Circle
9 y no,if applicable:
Floor lay-out: Yes No' Li htin
III 9 g• Yes
Exterior Finishes: Yes o Interior Finishes: Yes No Heating: Yes
Number of restrooms provided: Number of fixtures in each Parkin : Yes No
Is structure handicap accessible? Circle one Yes No ? '
Is the structure equipped with a fire sprinkler system? Yes No Fire alarm system? Yes No
Monitoring Station Name: Phone number:
1. Floor Plan(5 sets): . Use of rooms
• Draw the floor plan to scale • Location of all exits and windows(include dimensions)
• Room Dimensions • Interior doors with swing radius
• Location of lumbin and mechanical fixtures
2. Site Plan(5 sets): Note scale used • Location of all existing structures&dimensions
• Property lines,easements,&right of ways
Distance,in feet property Landscape buffer yards
• �from p party line&structures • Well location
• On-site sewage tanks and drain fields,&reserve
• Surface&storm water run-off routes Parking areas(number&arrangement)
• Location of fire h drants&vehicle access roads
3. Septic records,pumper's report or O&M report.
4. Fees will be collected at time of submittal
Acce tad b Dated 2 - Submittal Amount$ r7v Receipt number
------------
De artm' t view Initials Date Comments
Building
Envitommn HHealth.
Fire ------------
Marshal
Planning
Public Works
Pre Application required? (circle one) Yes No Building Permit required?(circle one) Yes No
Engineering Required?(circle one) Yes None) Occupancy Classification:
Occupancy Change? (circle one) Yes No Type of construction
Occupancy classification change from to Occupant load calculated:Existing occupant load design persons. persons
��-
MASON COUNTY COM LC��
CHANGE IN TENANT APPLICATION
Complete the Change in Tenant Application and return with a floor plan,site plan,septic pumper's report,septic records and
$125 fee to the Mason.County.Permft Center,P.O.Box 186,Shelton,WA 98584. During the evaluation of your Change in Tenant
Application staff members from the Building,Fire Marshal,Environmental Health,Planning and Public Works offices will identify
compliance requirements. This application is intended for tenant change only. If construction or remodeling is proposed/reguired a
separate building permit will be necessary, Upon approval the permit will be issued to the applicant/tenant. After the permit is issued,
schedule a site inspection by calling(36o)427-7262. Upon satisfactory inspection a Certificate of Occupancy will be issued and must be
sted in a cons icuous ace n the remises.
Date: Assessor's Parcel Number: ;� — (�IO
Legal Description:
Building Site Address: GL,,;j 55 j Yl E 5
Method of sewage disposal: 1 Septic 2��e
name
r
P O Sewer—name of district:
Water source: O Individual Well O Community Well *Public System, name of system:
Name of Applicant:, I
Mailing address:
City: I State: Zip: G
Day phone:3�psgJ { Contact Person:3n•t ,��. Message phone: �� 9v'10 (gaps
Proposed business name: D b
A CC
Proposed use. AAA, Number o mployees:
Previous business nam :
Describe previous e: /
Check one: • Detached single level/single tenant O. Single level/multi tenant
O Multi level/single tenant O Multi level/multi tenant
Age of structure: Is structure currently If not occupied, how long has it been vacant? 2
occupied? Yes N Yrs mos.
Square footage: Basement: First: Mezzanine: Second: Third:
Is the structu heated? Heating type: Circle one:
Circle one: es ? No Electric Liquid Propane Natural Gas Oil
Type of heat: Circle one: Furnace Heat Pump Electric baseboard or wall mount Radiant
Will there be any changes to the following? Circle yes or no,If applica /e:
Floor lay-out: Yes No' Lighting: YesLeach
Heating: Yes
Exterior Finishes: Yes o Interior Finishes: YesParkin : Yes No j Number of restrooms provided: Number of fixture
Is structure handicap accessible? Circle one Yes No
Is the structure equipped with a fire sprinkler system? Yes alarm system? Yes No
Monitoring Station Name: ne number:
1. Flvor Plan(5 sets): Use of rooms
• Draw the floor plan to scale •
• Room Dimensions • Location of all exits and windows(include dimensions)
Location of lumbin and mechanical fixtures ' Interior doors with swing radius
2. Site Plan(5 sets): Note scale used
• Property lines,easements,&right of ways : Location of all existing structures&dimensions
• Distance,in feet,from property line&structures • Landscape buffer yards
• On-site-sewage tanks and drain fields,&reserve • Well location
• Surface&storm water run-off routes Parking areas(number&arrangement)
• .Location of fire hydrants&vehicle access roads
3. Septic records,pumper's report or O&M report.
4. Fees will be co/iecfed of time of submittal
Acce tea b Dated 2(0- Submittal Amount $ Ov Receipt number
De artm. t view Initials Date Comments
Building
Environmental Health.
Fire Marshal
Planning to _I S5W�71 ^v
Public Works
Pre Application required? (circle one) Yes No Building Permit required?(circle one) Yes No
Engineering Required?(circle one) Yes No Occupancy Classification:
Occupancy Change? (circle one) Yes No
Occupancy classification change from to Type of construction
Existing occupant load design persons. Occupant load calculated: persons
MASON COUNTY �����
CHANGE IN TENANT APPLICATION
Complete the Change In Tenant Application and return with a floor plan,site plan,septic pumper's report,septic records and
$125 fee to the Mason CCounty.Permit Center,P.O.Box 186,Shelton,WA 98584. During the evaluation of your Change in Tenant
Application staff members from the Building,Fire Marshal,Environmental Health, Planning and Public Works offices will identify
compliance requirements. This application is intended for tenant change only. If construction or remodeling is proposed/required a
separate building permit will be necessary. Upon approval the permit will be issued to the applicant/tenant. After the permit is issued,
schedule a site Inspection by calling(360)427-7262.Upon satisfactory inspection a Certificate of Occupancy will be issued and must be
"sted in a conspicuous place on the premises.
Date: Assessor's Parcel Number:
Legal Description:
Building Site Address: . Gk.,;j 5E;j n E- cv I Gi uLj
Method of sewage disposal: • Septic O Sewer—name of district:
Water source: O Individual Well O Community Well •Public System, name of system:
At A
Name of Applicant:. tj I Yi
Mailing address: i
city: State: zip: G
Day phone:3lop�g13c� Contact Person:3 Irj t ,tom- Message phone: &4t, 9a� (opus
Proposed business name: O b
Proposed use. Number o mployees:
Previous business nam jt
Describe previous use: /
Check one: • Detached single level/single tenant O Single level/multi tenant
O Multi level/single tenant O Multi level/multi tenant
Age of structure: Is structure currently If not occupied, how long has it been vacant? 2
occupied? Yes No Yrs mos. ,
Square footage: Basement: First: Mezzanine: Second: Third: 7
Third-
Is the structu heated? Heating type: Circle one:
Circle one: es ? No Electric Liquid Propane Natural Gas Oil
Type of heat: Circle one: Furnace Heat Pump Electric baseboard or wail mount Radiant
--Will there be any changes to the following? Circle yes or no,ifapplfca /e:
Floor lay-out: Yes No' Lighting: Yes Heating: Yes
Exterior Finishes: Yes o Interior Finishes: Yes No Parkin :Yes No
Number of restrooms provided: Number of fixtures in each
Is structure handicap accessible? Circle one Yes No ?
Is the structure equipped with a fire sprinkler system? Yes No Fire alarm system? Yes No
Monitoring Station Name: Phone number:
I. Floor Plan(5 sets): Use of rooms
• Draw the floor plan to scale Location of all exits and windows(include dimensions)
• Room Dimensions
•
Location ofplumbing and mechanical fixtures Interior doors with swing radius
2. Site Plan(5 sets): Note scale usedT
ocation of all existing structures&dimensions
• Property lines,easements,&right of ways andscape buffer yards
• Distance,in feet,from property line&structures• On-site sewage tanks and drain fields,&reserveell location
arking areas(number&arrangement)
• Surface&storm water run-off routes
• Location of fire hydrants&vehicle access roads
3. Septic records,pumpoes report or O&M report
A Fees will be collected at time of submittal
Acce ted b Dated 2 - Submittal Amount $ Ov Receipt number
De artm t view Initials Date
Building Comments
C Environmental Health. '
t
Fire Marshal
Planning
Public Works
Pre Application required? (circle one) Yes No Building Permit required? (circle one) Yes No
Engineering Required?(circle one) Yes No Occupancy Classification:
Occupancy Change? (circle one) Yes No
Occupancy classification change from to Type a construction
Existing occupant load design persons. Occupant load calculated: persons
MASON COUNTY COM_
CHANGE-IN TENANT APPLICATION
Complete the Change in Tenant Application and return with a floor plan,site plan,septic pumper's report,septic records and
$125 fee to the Mason.County.Permlt Center,P.O.Box 186,Shelton,WA 98584. During the evaluation of your Change In Tenant
Application staff members from the Building,Fire Marshal, Environmental Health,Planning and Public Works offices will identify
compliance requirements. This application is intended for tenant change only. If construction or remodeling Is Pr000sed/reauired a
separate building Deffnit will be necessary, Upon approval the permit will be issued to the applicant/tenant. After the permit is issued,
schedule a site inspection by calling(360)427-7262. Upon satisfactory inspection a Certificate of Occupancy will be issued and must be
steel in a cons Icuo s Dlace on the Dremises.
Date: Assessor's Parcel Number: a . (�10
Legal Description: Ohl _ ..� 5,. fi?.
Building Site Address: G JrrJ n t- 5.f-A
Method of sewage disposal: Septic CWU ri
p O Sewer—name of district:
Water source: O Individual Well 0 Community Well •Public System, name of system:
At Al
Name of Applicant:, i
Mailing address:
City: !-gyp 1'l State: Zip:
Day phoneSWOB)qq Contact Person:3r-Tr t r Message phone: C)Olz 9aQ (ohs
Proposed business name: RN
b
Proposed use. Number o mployees:
Previous business nam
Describe previous use: n I
re
Check one: • Detached single level/single tenant 0 Single level/multi tenant
0 Multi level/single tenant 0 Multi level/multi tenant
Age of structure: Is structure currently _ If not occupied, how long has it been vacant? 2
occu led? Yes No Yrs mos.
Square footage: Basement: First: Mezzanine: Second: Third:
Is the structu heated? Heating type: Circle one:
Circle one. es ? No Electric Liquid Propane Natural Gas Oil Type of heat: Circle one: Furnace Heat Pump Electric baseboard or wall mount Radiant
Will there be any changes to the following? Circle yes orno,lra Hca /e:
Floor lay-out: Yes No' Lighting: Yes
Exterior Finishes: Yes o Interior Finishes: Yes No Heating. Yes
Number of restrooms provided: Number of fixtures in each Parkin : Yes No
Is structure handicap accessible? Circle one Yes No 2 '
Is the structure equipped with afire sprinkler system? Yes No Fire alarm system? Yes No Monitoring Station Name:
Phone number:
1. Floor Plan(5 sets): Use of rooms
• Draw the floor plan to scale •
• Room Dimensions • Location of all exits and windows(include dimensions)
• Location of plumbingand mechanical fixtures ' interior doors with swing radius
2. Site
Plan(5 sets): Note scale used Location of all existing structures&dimensions
• Property lines,easements,&right of ways •
• Distance,in feet,from property line&structures Landscape buffer yards
• On-site sewage tanks and drain fields,&reserve 0 Well location
• Surface&storm water run-off routes Parking areas(number&arrangement)
• Location of fire hydrants&vehicle access roads
3. Septic records,pumpees report or O&M rQport.
4. Fees will bs collected at t/me of sub
Acce ted b Dated ZCr- Submittal Amount $ �v
Receipt number
De artm t view Initials Date
Building Comments
Environmental Health.
Fire Marshal _
Planning
Public Works
Pre Application required? (circle one) Yes No Building Permit required? (circle one) Yes No
Engineering Required?(circle one) Yes No
Occupancy Change? (circle one) Yes No Occupancy Classification:
Type of construction Occupancy classification change from to
Existing occupant load.design persons. Occupant load calculated: persons
DRAGON ANALYTICAL LABORATORY
2818 Madrona Beach Road NW Olympia,Washington 98502
Phone:(360)866-0543 Fax:(360)866-0556
\ Email:dragonlaa comcast.net E
Web Page: dragonlabomto y.com
December 7, 2007
Mr. Bob Harris
140 NEE Rainier Place
Belfair, WA 98528
Dear Mr. Harris,
Please find enclosed the analytical data report for the Bob's General Store
Project, (COC dated 11-26-07).
The sample(s) was/were prepared and analyzed as enumerated in the attached
data report for TSS, BOD and Oil & Grease.
Dragon Analytical Laboratory appreciates the opportunity to provide you with
analytical services. Please call if you have any questions regarding the data
report. We are looking forward to working with you again if you have further
needs.
Thank you for your business. Your referral of our services to others will be
appreciated.
Since I
Robert F. Lewis
Manager of Administration
Specializing in GCMS,organics,wet chemistry,and radiometric chemistry
Dragon Analytical Laboratory
Invoice
2818 Madrona Beach Rd NW
Olympa, WA 98502 Date Invoice#
11/26/2007 071126-860
Bill To
Robert Harris
140 NE Ranier PL N.
Belfair,WA 98528
P.O. No. Terms Project
Service Date Quantity Description Rate Amount
1 Biological Oxygen Demand 40.00 40.00
1 TSS 18.00 18.00
1 Oil&Grease(FOG)HEM 60.00 60.00
Thank you for your order we appreciate your business Total
$118.00
C
n a n
�j
.. Cc.
�h °
o v `v Sample Matrix
tam
g
Date Sampled b ,�
g g 8 Time Sampled
y Jf
w
Container Type °p
m
Color(EPA 110.2)
2 C
3 Specific Conductance(EPA 120.1)
o v
•o Hardness,Total(EPA 130.2) Q,
F 3 3
a
pH(EPA 150.1) `` pNp (�
v N 0
TSS T TDS S,TVS,SS (EPA 160 Series) N 3
Turbidity(EPA 180.1) L w
❑ ❑O13❑ O Y
Metals''(EPA 200 Series) 1�
e Y Alkalinity(EPA 310.1) n
a Nitrogen,Ammonia(EPA 350.3) c C C trA p••
� r w ' n
Nitrogen,Total Kjeldahl(EPA 351.4) Or
CA
o � ry
Nitrogen,Nitrate-Nitrite(EPA 353.3) x 0 O
aq
y Dissolved Oxygen(EPA 360.1)
m p y W
H Phosphorus',total,ortho,hyd(EPA 365.3)
�J 1� � aC
BOD or cBOD(SM 5210) to vp
n
y co COD(EPA 410.4) O
n Er
C1. �
C] PCBs(EPA 608)
Y
p. Pesticides(EPA 608)
d
Volatile Organic Compounds(EPA 624) F
Semi-Volatile Compounds(EPA 625)
TQ Oil and Grease(EPA 1664 HEM)
w
Chloride(SM 4500B) �a-
3 e otal Colifom(SM 9222B) p 0 O d
O
e a Fecal Colifom(SM 9222D) O c n
0
n
z f
y O G
Q'
� I
ro
i
DRAGON ANALYTICAL LABORATORY
Bob Harris
Project: Bob's General Store
DAL Project No.: 071126-860
ANALYTICAL RESULTS FOR THE ANALYSIS OF SOLIDS IN NON-POTABLE WATER
Residue,
Analysis Non-Filterable
JSS)
Chemical Abstract Number(CAS) E-10162
Analytical Method SM 2540 D
Units (mg/L)
Data
Sample Identification Date Analyzed Flags
Method Blank 11/27/2007 nd
Poop Water 11/27/2007 264
Method Reporting Limits(MRL) 4.0
WA-DOE-Laboratory Certification No.: C2013
"nd"indicates the analyte was not detected at or above the listed Method Reporting Limit.
'Wa"indicates not applicable
Comments and Explanations: None
Analyst: P.Lewis
Data reviewed by-4 Lewis
page 1 of 1
i
I ,
DRAGON ANALYTICAL LABORATORY
Bob Harris
Project: Bob's General Store
DAL Project No.: 071126-860
ANALYTICAL RESULTS FOR FIVE DAY BIOCHEMICAL OXYGEN
DEMAND
Analysis BOD5
Chemical Abstract Number(CAS) E-10106
Analytical Method SM 5210 B
Units (mg/L)
Sample Identification Date Data
Analyzed Flags
Method Blank 11/27/2007 nd
Poop Water 11/27/2007 89.0
Method Reporting Limits. 2.0
WA-DOE-Laboratory Certification No.: C2013
"nd" indicates the analyte was not detected at or above the listed Method Reporting Limit.
'n/a" indicates not applicable
Comments and Explanations: None
Analyst: P. Lewis
Data reviEwed by: . Lewis
page 1 of 1
DRAGON ANALYTICAL LABORATORY
Bob Harris
Project: Bob's General Store
DAL Project No.: 071126-860
ANALYTICAL RESULTS FOR THE ANALYIS OF OIL AND GREASE (HEM) IN
NON-POTABLE WATER
Analysis HEM
Chemical Abstract Number(CAS) E-10140
Analytical Method EPA 1664
Units (mg/L)
Sample Identification Date Analyzed Data
Flags
Method Blank 11/29/2007 nd
Poop Water 11/29/2007 17.2
Method Detection Limits(MDL) 1.4
Method Reporting Limits (MRL) 5.0
WA-DOE-Laboratory Certification No.: C2013
"nd"indicates the analyte was not detected at or above the listed Method Reporting Limit.
"n/a"indicates not applicable
Comments and Explanations: None
Analyst: T. McCall/-,,,
Data reviewed by* R. Lewis
page 1 of 1