HomeMy WebLinkAboutCRT94-0022 - CRT Application - 2/8/1994 MASON COUNTY DEPARTMENT OF HEALTH SERVICES
POST OFFICE BOX 1666
SHELTON WA 98584
(20 ) 427-9670
FAX 427-7798
APPLICATION FOR ENVIRONMENTAL HEALTH REVIEW
RECEIVED
Receipt No: C
Date of Payment: _ FEB 19941
Septic Review: iEALTH ERVICEF
Water Review:
Property Evaluation: 1. Apc�
INSTRUCTIONS ��- tq —( � Z
1. An application is considered complete when the fee is paid, Parts 1-4 of the application form are c plated.
- (,assistance will be provided upon request for completing Part Two), the necessary paperwork is attached, and
required soil evaluation holes have been excavated.
2. After a completed application is received, staff will inspect the property and provide the applicant with a
written report.
3. If the project requires the excavation of more than 3 test holes, the department may charge the applicant an
hourly rate of $37/hour as set forth by the Mason County Board of Health.
PART 1: APPLICANT/PARCEL IDENTIFICATION
..................... ,�7
NAME OF APPLICANT m� m" $A la= TELEPHONE
SITE/HOUSE ADDRESS 1557 Ef DSYvIYYI(d N.)I -ICJrLL.I Ig IZI�,
MAILING ADDRESS
ACREAGE
C1CY 11 atete. - 'aiP
ASSESSOR'S PARCEL NUMBER �L. 2 D Q - - Q 2
LEGAL PROPERTY DESCRIPTION
SUBDIVISION (If Applicable) DIV BLK LOT
DIRECTIONS FOR LOCATING SITE I
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Sketch location of property in this space.
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No. S1 Revised 12/28/93
PART 2: PURPOSE OF APPLICATION ,
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.......... ..................................... ...................................... ......................................................
2A. OPTION ONE
I am applying for a bank loan and the bank 9 asked for an evaluation oE the
following:
d th bank 3 a
VS (Fee: $50)
Septic S:.
•
Age of Syst
• Age of House
• Number of Bedrooms
• Name of Last owner
• Is house currently occ ad?
• Attach p:7:er'o port, dated within last 2 years, stating whethe a system was pumped, th size and
condition
.n:c iti. a tank, and the condition of the baffles.
Water XSyst Fee: $40)
• N r of service connections on water system
• f public water system:
Both (Fee: $68)
. Provide information shown above for both septic and water systems
2B. OPTION TWO
�KI am applying for a building permit, and environmental health has requirad an
eval ation of the following:
isting septic system (Fee: $50)
• Age Of System
• Number of Bsdrocsu�
• Name of Last Owner KAEL Md-L I-
• Is house currently Occupied?
• Attach pumper's report, dated within last 3 years, stating whether the system was pumped, th size and
condition of the tank, and the condition of the baffles.
• If the original septic permit cannot be located and system less than 5 years old, apply for iew On-Site
Swags Disposal Permit.
• If the original septic permit cannot be located and system more than 5 years old, submit signed as-built
drawing from certified designer or professional engineer.
Reserve Area for Future system Repair (Fee: $40)
, Two properly excavated pits are 4 ft deep must be ready for inspection by the department.
Bath (Fee: $50)
. Provide information shown above for both septic system and reserve area
2C. OPTION THREE
I am interested in kno>* g in general terms the suitability of a parcel for septic
system placement. (Fee: + $37/hour)
r. us
Describe the intended use of the propert reason for requesting the review:
No. S1 . Revised 12/28/93
PART 3: PLOT PLAN
...........................................................................................................
.Use this space to draw a d4tailed plot plan, or attach one to this application. A detailed plot plan is c no that
shows the precise location of the test holes, existing septic systems, dimensions of the property, and location of any
wells, roads, or other buildings on the property.
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PART FOUR: AUTHORIZATION
........................................................................................................................................................ .....................
APPLICANT DATE
No. Sl . Revised 12/28/93
PART 5: HEALTH DEPARTMENT FINDINGS - OFFICIAL USE ONLY
:........................
..........................................I...........................................................................................
5A. DETERMINATION OF APPLICABLE STANDARDS
The prima
Z pri drainfield area
must met the following standards:
t curre
nt standards El Standard marine system
'
ElNo overt failure F1 Not applicable.
The reserve drainfield at. ..at have site characteristics that could support a septic system that uld met the
following standards:
Meet current standards. \CV4 fleet marine repair standards.
F1Meet marine expansion standards. El Not applicable.
5B. WATER SYSTEM
YES NO INDIVIDUAL WATER SYSTEM
nEl A water sample was taken by health department staff and analyzed. Total colifom bacteria were
determined to be absent. Laboratory results are attached to this report.
0 El The well cap was inspected. The sanitary seal appears satisfactory.
ElEl The well casing was inspected. The casing projected above ground and ground was sloped away from the
casing.
F] The well site was inspected. No septic systems, chemical storage facilities, manure piles, animal feed
lots, or other obvious sources of contamination were located within a 100 foot radius of the well.
PUBLIC WATER SYSTEM
DFJ Records indicate water sampling requirements are being satisfied.
El0 Records indicate the Water Facility Inventory form is current.
Department files contain no information indicating the system is out of compliance with state or local
water system requirements.
5C. SEPTIC SYSTEM
YES NO
El * Tn - a certified. -Nlanhwas inspected by septic tank pumper within the past 2 years and found to be
in satisfactory condition. A pumper's evaluation is attached to this report.
Ctords for this property contain &,Mptic permit, design (if required), final inspection a)proval, and
as-built approval. n-a
The drainfield site was inspected, and appears consistent with recorded documents.
The drainfield area appears to be maintained in an acceptable manner.
F1The drainfield area (the area where the drainfield is assumed to be located based on office records
and/or observed site conditons) appears to be maintained in an acceptable ==at.
The -D )
Th r.�n . dUa'rea (the area where the drainfield is assumed to be located based on office records
and/or observed site conditons) show no indication of overt failure at the time of inspecti)n.
No. S1 • Revised 12/28/93
5D. SOIL CONDITIONS
TEST HOLE #1 TEST HOLE #2 HBE. —�
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Depth of root pen. : /C Depth of root pen. : Depth of root pen. :
,/ U N
- Depth to restr. layer l Depth to restr. layer ItL� Depth to restr. layer
Soil Type: Lf Soil Type: T Soil Type:
Vertical Separation:" Vertical Separation:" Vertical Separa ion:'°'
Curtain drainable? (Y/N/NA) :
Slope (%) :
Shoreline? (YIN) :
Minimum lot size:'
Designer level:
' vertical separation is the depth of unsaturated, original, undisturbed soil of Types 2-6 that exi to between
the bottom of the subsurface absorption system and a restrictive layer or the watertable. Vertici 1 separation
for purposes of designating designer level will be calculated by the health department based on a 12-inch deep
5 ,t60 TH R NOTES AND COMMENTS
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No. Sl Revised 12/28/93
PART 6: HEALTH DEPARTMENT DETERMINATION OFFICIAL USE ONLY
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6A. PRIMARY bRAINFIELD SYSTEM
The primary drainfield area was inspected by staff and pertinent records were
reviewed. The following determination has been made:
The system appeared to be functioning adequately at the time of inspection and
and meets current design standards.
The system appeared to be functioning adequately at the time of inspection.
V�Vot applicable.
C it ixlk'�� �I�AA(24 &*1-15- d4fq AE-11404 114 1, 211
; I � A 1" 61 4-
&XIMAA F-1 MAA WEE 602
6B. RESERVE DRAINFIELD AREA
The reserve drainfield area was inspected by staff and the soil was evaluated.
Site characteristics indicated an area exists that could support a septi- system
that would meet the following standards:
V-1--urrent standards.
ElMarine expansion standards.
1:1 marine repair standards, Treatment Standard
ElNot a licable.
Comments: X kg�" wuLo cum LA-) jowara�f
6C. WATER SYSTEM
The water system was evaluated by staff the fo g determination has been made:
WAT
ER ter valuated by
SYSTEM
system
was e a Ell staff
the fo g determination has
The water source consists of individual well that appears to be a
consists
f
actory source of able water for a single family residence. The water
13 was sampled, an ria were found to be absent.
3
The wate ource is a public water system that appears to be I antial
com ance with applicable regulations.
ents:
..............................................................................................................................................................................
Findings and determinations of this review reflect observed conditions as they existed on the day the evaluatJon was
performed. Absolutely no claim is made by this office, either expressed or implied, concerning future success or failure
of the systems and sites evaluated.
Resource land and critical area 0: aired by Department of Community Development prior to issuance of
developmental permit
.
-7*" 7:7
INSPECTOR .......... DATE No. Sl . Revised 12/28/93
7 ERHUNE HOMES, INC.
HOWARD & NANCY BAUER
Legal Description
PARCEL 1:
LOT 3 OF SHORT PLAT NO. 324, AS RECORDED AUGUST 19, 1977, UNDER
AUDITOR' S FILE NO. 332768 AND BEING A PORTION OF THE NORTHEAST QUARTER
OF THE NORTHEAST QUARTER OF SECTION 3 AND OF GOVERNMENT LOT 1 OF
SECTION 3; ALL IN TOWNSHIP 20 NORTH, RANGE 2 WEST W.M., IN MASON
COUNTY, WASHINGTON;
TOGETHER WITH TIDELANDS OF THE SECOND-CLASS FORMERLY OWNED BY THE STATE
OF WASHINGTON, LYING IN FRONT OF, ADJACENT TO OR ABUTTING UPON SAID y
UPLANDS. TO
PARCEL 2:
TOGETHER WITH THOSE EASEMENTS AS SET FORTH IN SHORT PLAT 1324 AS
RECORDED AUGUST 19, 1977 UNDER AUDITOR'S FILE NO. 332768;
TOGETHER WITH AN EASEMENT FOR INGRESS, EGRESS AND UITILITIES OVER,
UNDER AND ACROSS THE NORTH 20 FEET OF LOT 1 OF SHORT PLAT NO. 1243,
RECORDED MARCH 8, 1983, UNDER AUDITOR'S FILE NO. 412707, SAID EASEMENT
BEING GRANTED UNDER INSTRUMENT RECORDED JUNE 21, 1985 UNDER AUDITOR'S
FILE NO. 441489.
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MASON COUNTY
DEPARTMENT of HEALTH SERVICES
Shelton,Washington 98584
(206)427-9670• Belfair:275-4467
ENVIRONMENTAL HEALTH PERSONAL HEALTH WATER QUALITY
P.O. BOX 1666 303 N. FOURTH P.O. BOX 1666
DATE: 14 FEBRUARY 1994
TO: MR. & MRS. BAUER
1536 MAPLE LANE
KENT, WA 98031
(206) 852-3189
FROM: GUY GRAYSON
ENVIRONMENTAL HEALTH SPECIALIST
SUBJECT: TEST HOLE REQUIREMENTS
PARCEL #: 22004-11-90220
155 E. COMMUNITY CLUB RD.
Attempted an Environmental Health Review on 02/10/94, for the
purpose of evaluating Reserve Area.
There were no test holes evidient on the property for the
inspector to evaluate.
OUR REQUIREMENTS FOR TEST HOLES ARE AS FOLLOWS:
"The test holes need to be a minimum of 6 feet deep,
2 feet wide, and have one end sloped for easy ingress
and egress. The minimum depth of the test hole is set
at 6 feet because allowed drainfield depth can go up
to 3 feet, and the system designs are determined by
the 3 feet of soil under the adsorption bed or trench
bottom. In addition, the sidewalls of backhoe pits
often sluff reducing the depth of observable side all. "
of t iff a legitimate concern of both backhoe o era o s and
heal department staff. Holes should be excavated wit a 6
foot deep end and a 4 foot deep shelf. The end of the helf
should then be ramped up to the ground surface. This a lows
staff to enter and exit the hole via the ramp, and to ine
the 6 foot sidewall without going deeper than 4 feet b
standing on the shelf.
You must apply for a Re-Evaluation when the test holes are
dug, and there will be a $40.00 fee for the re-inspect ion.
IF YOU HAVE QUESTIONS, OR IF I CAN BE OF FURTHER ASSISTANCE,
PLEASE CALL ME AT (206) 427-9670, Ext. 555, BETWEEN THE HOURS
OF 8:00 AND 9 :30 A.M. MONDAY THROUGH FRIDAY.
( Recycled
MASON COUNTY DEPARTMENT OF HEALTH SERVICES ,
POST OFFICE BOX 1666
SHE TON, WA 98584
206) 427-9670
FAX 427-7798
March 14, 1994
Mr. and Mrs . Bauer
1536 Maple Lane
Kent, WA 98031
RE: BLD94-0089
PARCEL NUMBER 22004-11-90220
LOT 3 of SP# 324
Dear Mr. and Mr. Bauer
Your building permit indicates that you are proposing to p ace a
single family residence on a lot with an existing septic system on
a designated shoreline. Policy requires that the septic system be
in compliance with current code. Therefore, the following items
will need to be completed prior to issuing your building permit:
o Have the septic tank pumped and inspected by a certified
pumper. Submit a copy of the pumper' s report to this
office;
O Complete Environmental Health Review (CRT94-0022) - -
$40.00 re-evaluation. . .no test holes dug when sanitarian made
original site visit on 2/10/94
To verify full compliance of the existing system. . .
Dig one test hole in close proximity to the septic
system and expose the ends of the laterals;
To designate a reserve area. . .
dig two test holes and have the site inspected by a
sanitarian. A reserve area will be considered
adequate if it can meet all current state and local
regulations for placement of a new septic system.
If you have any questions, please call me at 427-9670 from 8 : 00 to
10:00 Monday through Friday.
Sincerely
Carolyn Jensen
Environmental Health Specialist
�O Jim Hunter and Associates
O� P.O. Box 162 e Olympia, WA 98507
(206) 493-2484 • FAX (206) 493-2486
J�V SEPTIC SYSTEM DESIGNERS
O v
DATE : July 19 , 1994
TO: Thurston County Environm taA Health
FROM: Dick Yunker , Designert / W✓U
SUBJECT : Bauer ; TP0 220041190220
Attached is 'our design for the upgrade to the existing approved
drainfield . The features that constitute an enhancement are as
follows :
1 . Sand filter pre-treatment has been provided to produce
Treatment Standard 2 effluent for disposal in the
drainfield .
2 . Effluent distribution has been upgraded from serial
gravity to pressure to provide equal distribution over
the entire drainfield .
3 . The number of bedrooms has been reduced from three to
two . Therefore , the effective application rate has been
reduced to 0 .57 GPD/SF .
4 . A reserve area sized at 0 .45 GPD/SF has been clearl
designated .