HomeMy WebLinkAboutSPH93-0113 - SPL Application - 7/27/1993 KAS JN COUNTY DEPARTMENT OF HEALTH SERVICES
8'
POST OFFICE BOX 1666
$ L'=" , SHELTON, WA 98584
_:.. (206) 427-9670
p� FAX 427-8425
APPLICATION FOR SHORT Ph� IVA�Q PTION
INSTRUCTIONS ,baktd of Payment: 9 7j
1. An application is considered complete when the fss is paid and the following elements have been addressed:
• Parts 1 and 2 of the application form must be completed. -
• One properly excavated backhoe pit per proposed parcel must be ready for inspctlen. properly excavated pits
are 6 It deep with a d ft deep shelf on one end of the pit. The d ft deep shelf moat elope up to the ground
surface for "my ingress and egress.
• A scaled plot plan meat be attached to the application. The scaled plot plan must show the precise location
of the test holes, dimensions of the property, and location of any existing or proposed wells, roads, or
buildings within 100 It of the property boundaries. - - -
2. After a completed application is rscelvf_d, staff will inspect the property and provide the applicant with a - -
written report. If the project requires more assistance than the evaluation of four test holes and completion
of this report, an hourly rate of }37/hour as not forth by the Mason County Board of Bealth may be charged to -
the applicant. ?Wisad 09/01/92
PART 1: APPLICANT/PARCEL IDENTIFICATION
aii
• -NAME OF APPLICANT- ED'SM IITH • TELEPHONE ($66 ) 352-4139
.j• MAILING ADDRESS ZJZ��KUSOM AI.W•
OLYMnfA WA. lfr5oz
aicr ....Z esv
• ASSESSOR'S PARCEL NUMBER 3 2 13 Af - 1 3 - 3 0 1 I o _
• LEGAL PROPERTY DESCRIPTION A
• LOT SIZES (ACRES OR SQ PT) O•/OZ AC• 0.4fn Ac• 0.40 AC• 0.VAG•
LOC 1 LOG 9 Lei d 9 iet �1
• DIRECTIONS FOR LOCATING SITE ^J 5 MI NOOF SNsywj ON SR3 I-* MASOAI LK• b. ;
TA,_ --- I hi NW ALONG MASOM LK• Qown TO MIKKIBSaJ Qtl:
Tar. --I A M( WE Ayoub hi IKKLESoM )2b To SIT&' - Sf76' is oaa TH6 RI6NT .
PART 2: INTENDED USE OF PARCEL
• INTENDED USE OF PROPERTY (Check One) :
Single family residence Multi-family residence
Other, specify:
• WATER SOURCE FOR PARCELS (Check One) : .
Individual wells Community well
/ short Plat Evaluation
PART 3: HEALTH DEPARTMENT REVIEW (OFFICIAL USE ONLY)
............ .................. ...... ............................................................................................................--
.�-�-:. ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::Visas::::::::a::a::::[:ass:::(:::::¢:a:::::::c::::(t::::(::::aatt:::as:(s::::::::::::::a::(a:a:(a:(
SOIL LOGS W SITE ( aczERisTICS
LOT • 2 LOT -a, l0f s
- Tut Pit ( Tat Pit�r a1 - Tost Pit+:{ nTest�/piit yf t-�,�,,
� v—vf M- l� u'�1
-srrn LAM c-f t� u,
h �Qa
i u pN W Depth of Loot pan /�e: - Depth of root pan.: Depth o[ soot pan.; �6 psptII of root Pan.:
Depth of nttlin T Depth of mottling: mil/} Depth of null 7.Q=. Depth of mottling: �qO
P g: P 9: �m P ling- P
Depth m rut. layer: Depth m rut. layer: Depth m rat. layer: Depth m rut. Lys?:
Sail USDA Soil U= "
type (USDA): : � sou t7Pe� — tYPa ( )' Soil type (USDA):
Tat Pit 9_ Test Pit Tat Pit VI- Tat Pit
4 - 3%�77 t �'Dl� wu� or
si��lH Con,.
SFr-fir ` /ib`t .�►m
Depth of root pan.: O Depth of root pa.: ---v-///--- Depth of soot pan.: a Depth of root pm.s `Gl/
Depth of mottling. Depth of mottling: Depth of mottling: a/0/ Depth of mottling:
DepthtoCute layer.
Depth to rest. layer: Depth toroot. layer: "- GG Depth torust. lope?:
Soli type (UsDs): soil type (Des): sou type cams): '. 3 soil type (mm):
Curtain drain needed? curtain drain aaded? tvrtain drain needed? Certain drain needed? 1 l
slop. slope (a): �� .sing. (s)= L slope M2
sMrellme? (yn): emraline? (xnp: 2± Shoreline? (:n): -�I— moraine? Cris):
�..::. lot size:- �(J�D Miriam lot sizei (L� rinimum lot size:" Nlniane lot aim:' &WA
- minimum lot miss applies to new subdivision* and is defined as the minimum allowable land area per residence or residu-
tial «(niva t caso salon. �I• �5 �3--OR8d S�f',rt3—oR , Sc,w�4, t8br) �?—oq�R
�� (X �2
t 7s -
, 10 i c� LI�I a-o
Revised 09/01/92
Short Plat Evaluation
PART 4: HEALTH DEPARTMENT REVIEW SUMMARY (COMMUNITY DEVELOPMENT USE)
.................................................................................................................. ...........................................................
"PROVE
After "examining lot oi3*, proposed water source, and soil type, it is the de-
termination of Mason Coviky Department of Health Services that each proposed
parcel can support- an -on--pite sewage disposal system meeting the requirements
of state and local regulations.
DR"
After examining lot size, proposed water source, and soil type, it is the de-
termination of Mason County Department of Health Services that each proposed
parcel cannot support an on-site sewage disposal system meeting the require-
ments of state and local regulations.
This determ consideration of the following factor(a) :
�(HKXM APPROVAL UNTIL FURTHER ACTIONS ARE TAKEN Sr APPLICANT
After examining lot size, proposed water source, and soil type, it is the de-
termination of Mason County Department of Health Services that each proposed
parcel cannot support an on-site sewage disposal system meeting the require-
ments of state and local regulations until the following conditions are met:
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'r 41�f A64k_ j1d J9-1;./ 4-SCIAJ
44-1di-Af? OrLff-7 &W
NAX M H6UyjLW ! `t4AJ CA)WA*J'XA-
Cmditi=(*) required prior to apprwal have by the awlnant.
kil i4) 01 Realth Official Date
PART 5:_*RPRZ;W E
......................................... ....................... .......................................................................................
-Realth Official Date
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MASON COUNTY
DEPARTMENT of HEALTH SERVICES
Mason County Bldg. III 426 W.Cedar
P.O. Box 1666 Shelton,Washington 98584
(206)427-9670• Belfair:275-4467
ENVIRONMENTAL HEALTH PERSONAL HEALTH WATER QUALITY
DATE: 02 AUGUST 1993
TO: MR. ED SMITH
P7 ',n��
2122 DICKINSON N.W.
OLYMPIA, WASHINGTON 98502
(206) 352-4439
FROM: GUY GRAYSON
ENVIRONMENTAL HEALTH SPECIALIST
SUBJECT: POOR TEST HOLE IDENTIFICATION:
PARCEL #: 32134-13-90110
THE ABOVE REFERENCED PLAT HAS BEEN RECENTLY SUBMITTED BY YOU,
ALONG WITH FOUR SITE APPLICATIONS. I ATTEMPTED TO DO THE
EVALUATIONS TODAY, BUT COULD ONLY FIND A FEW TEST HOLES . THE
REQUIRED TEST HOLES HAVE NOT BEEN MARKED, EITHER BY NAME OR
LOT NUMBER DESIGNATION.
THE LACK OF TEST HOLE MARKINGS CREATES AN ADDITIONAL BURDEN ON
INSPECTORS BECAUSE VALUABLE TIME IS EXPENDED IN SEARCHING AND
CORRELATING INFORMATION ON SITE TO IDENTIFY THE CORRECT HOLES
FOR THE APPROPRIATE LOT.
PLEASE NOTE THAT A SUCCESSFUL PARTNERSHIP BETWEEN APPLICANTS.
OWNERS, SURVEYORS, DESIGNERS, INSTALLERS, AND THE HEALTH .
DEPARTMENT REQUIRES MUTUAL COMMUNICATION AND COOPERATION.
THE CIRCUMSTANCES RELATED ABOVE ARE NOT ISOLATED TO JUST YOUR
CASE, THIS SITUATION HAS BEEN DISCUSSED AT OUR STAFF MEETING
WITH THE RESOLUTION THAT:
-- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - --
THIS DEPARTMENT WILL NOT EVALUATE SITES THAT DO NOT HAVE
CLEAR SPECIFIC TEST HOLE MARKINGS THAT LEAD THE INSPECTORS
TO THE HOLES AND THEN INDICATE EXACTLY WHICH HOLE THEY ARE
LOOKING AT.
-- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Page 1 of 2
go ,a let;
FOR YOUR INFORMATION THE FOLLOWING GUIDELINES ARE PRESENTED AS
CLARIFICATION:
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 sidewall . "
Safetv is a legitimate concern of both backhoe operators and
health department staff. Holes should be excavated with a 6
foot deep end and a 4 foot deep shelf. The end of the shelf
should then be ramped up to the ground surface. This allows
staff to enter and exit the hole via the ramp, and to examine
the 6 foot sidewall without going deeper than 4 feet by
standing on the shelf.
- - - - - - - - ----- - - - --- - - - - - -- -- - -- - - - - - - - - - - - - - - --- - -- --- - - - - - - --
EACH TEST HOLE SHOULD BE MARKED FROM THE ACCESS ROADWAY EDGE
BY SOME FORM OF MARKER. GENERALLY PLASTIC TAPE IS USED. THE
MARKER SHOULD BE LABELED WITH YOUR NAME. IF THE TEST HOLE IS
OUT OF SIGHT-DISTANCE FROM THE ROADWAY THEN MARKERS SHOULD BE
PROVIDED EVERY FEW FEET TO LEAD THE INSPECTOR TO THE LOCATION.
EACH TEST HOLE NEEDS TO BE MARKED WITH A NUMBER, LETTER OR LOT
DESIGNATION.
THE PROVIDING OF PRECISE MARKINGS WILL ENHANCE THE EVALUATION
PROCESS AND BE TO YOUR BENEFIT AS WELL AS THE INSPECTOR
INVOLVED.
WE TYPICALLY DO NOT MAKE APPOINTMENTS TO DO SITE INSPECTIONS.
PLEASE MARK THE TEST HOLES AS INDICATED ABOVE AND THEN NOTIFY
THIS OFFICE THAT THEY ARE READY SO THAT THE SITE CAN BE
EVALUATED.
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.
Page 2 of 2
MASON QOUNTY DEPARTMENT OF HEALTH SERVICES
POST OFFICE BOX 1666
SHELTON, WA 98584
(206) 427-9670
FAX 427-7798
PROPOSAL: Ed Smith Short Subdivision (4 lots)
COMMENTING DEPARTMENT: Mason County Department of Health
Services
COMMENTING OFFICIAL: Carolyn Jensen, Environmental Health
Specialist
DATE: September 2 , 1994
SPL93-0086
SPH93-0113
WEL94-0048
The plans for the Smith Jr. Water System which is intended serve
drinking water to this proposed subdivision have been approved for
4 connections. In addition, a certificate of inspection and
installation of the community water system as per the approved
plans has been submited.
MASON COUNTY DEPARTMENT OF HEALTH SERVICES
POST OFFICE BOX 1666
SHELTON, WA 98584
(206) 427-9670
FAX 427-7798
September 2, 1994
Ed Smith, Jr.
P.O. Box 633
Olympia, WA 98502
RE: WEL94-0048 - - SMITH JR. WATER SYSTEM
PARCEL NUMBER 32134-13-90110
SPH93-0113 & SPL93-0086
Dear Mr. Smith
The plans for the above referenced water system have been reviewed.
Approval is granted for four connections . This will satisify the
drinking water requirements of the Environmental Health portion of
the review of your proposed short plat provided that the following
is placed on the face of the plat :
The drinking water provided by the water system exceeds
the standards for Manganese. Water treatment can be
provided by each individual connection. Manganese is not
a health threat but excessive amounts of manganese in
drinking water can affect the color and taste of the
water and can stain fixtures and clothing.
The Water Facilities Inventory for has been sent to the Department
of Health (DOH) . DOH will enter this water system into their
computer and assign a unique number to this water system. This
number and the water system name should be put on all
correspondence and water samples so that identification can be
simplified and proper credit can be given to the water system.
This water system will be required to monitor drinking water
quality by the following schedule:
O a bacteriological analysis for coliform annually;
O a chemical analysis for nitrate every three years;
If you have any questions, please call me at 427-9670 from 8 : 00 to
9 :30 Monday through Friday.
Sincerel
Carolyn sen
Environm tal Health Specialist
SPH93-0113
SPL93-0086
Ed Smith
PARCEL NUMBER 32134-13-90110
Please put the following on the face of the plat:
The drinking water provided by the water system exceeds the standards for
Manganese. Water treatment can be provided by each individual
connection. Manganese is not a health threat but excessive amounts of
manganese in drinking water can affect the color and taste of the water and
can stain fixtures and clothing.
Nothing can be constructed, maintained, or suffered to be constructed or
maintained within 100 feet of the water source, so long as the well is
operated to furnish water, any potential source of contamination, such as
septic tanks and drainfields, sewerlines, underground storage tanks, roads,
railroad tracks, vehicles, structures, barns, feed stations, grazing animals,
enclosures for maintaining fowl or animal manure, liquid or dry chemical
storage, herbicides, insecticides, hazardous waste, or garbage of any kind
or description.
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