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Home My WebLink AboutCRT2023-00009 - CRT Loan Cert. / EH Review - 10/2/2023 MASON COUNTY 415N6TH STREET, BHELTON, 98580 SH 967 ,EXT BELFAIR:360-275-4467,EXT 400 Public Health & Human Services ELMA 360-482-5269,EXT400 FAX:360-427-7787 EH REVIEW: PROPERTY/TEST HOLE EVALUATION CRT2023-00009 APPLICANT MURDY CHERYLYNN K Phone: Address: 1181 E MASON LK DR E GRAPEVIEW, WA 98546 OWNER MURDY CHERYLYNN K Phone: Address: 1181 E MASON LK DR E GRAPEVIEW, WA 98546 Site Address: 1170 E Mason Lake Dr E Primary Parcel Number: 221045200050 Date Received: 10/02/2023 Date Inspected: 10/04/2023 Date Issued: Inspected By: David Anderson Fees Paid: $350.00 Inspection Results: TEST HOLE#1 RESTRICTIVE LAYER DONE TEST HOLE#1 SHORELINE SETBACK DONE TEST HOLE#1 SLOPE DONE TEST HOLE#1 SOIL TYPE DONE TEST HOLE#2 RESTRICTIVE LAYER DONE TEST HOLE#2 SHORELINE SETBACK DONE TEST HOLE#2 SLOPE DONE TEST HOLE#2 SOIL TYPE DONE TEST HOLE#3 RESTRICTIVE LAYER N/A TEST HOLE 43 SHORELINE SETBACK N/A TEST HOLE#3 SLOPE N/A TEST HOLE#3 SOIL TYPE N/A Comments/Summary: TH1: 0-8"o-layer 8-36" EGMS Type 1 soil with 80% gravel Restrictive at 36"with mottling and till/hardpan. Pockets of no restriction. TH2: 0-12"o-layer 12-30" EGMS Type 1 soil with 65%gravel Restrictive at 30"with mottling and till/hardpan Both test holes had an organic layer of soil from 8 to 12 inches deep,with extremely gravelly medium sand to 36 inches in test hole one and 30 inches in test hole two.A restrictive layer was found at 36 inches in test hole one and 30 inches in test hole two. The restrictive layer was determined by mottling and a layer of glacial till/hardpan.The soil is Type 1 due to the gravel content ranging from 65%to 80% rock by volume. All extremely gravelly (60%to 80% rock by volume) soils are categorized as soil Type 1, excluding soils Type 5 and 6. lSG° r. 0CT 0 31073 415N8 - - NWA '8584 War a .erm SHELTON- •I- -70.E -400 2 • BCE 360-275-4 T. 400 Public Health & Human Services ELMA 360-482-5269, exT.400 FAX. 360-427-7798 • APPLICATION FOR ENVIRONMENTAL HEALTH REVIEW Permit Number Payment Information Type of Review Seotic and Water $430 CRT Receipt Numbe Seotic $255 rl0 1 1 Cash Water $255 (Individual and Two Party) l/��oG LJa Check q 'y Group B WS$95.00(+$95.00/hour beyond 1 hour) 6000 ( Date ofPaymenja2v23 x Property Evaluation $350 Resample $30 lab fee Instructions: Complete Parts 1, 2, and 3 completely and accurately. With the application form, please submit the appropriate fee and the necessary documents such as a septic system maintenance report. If the application is for a property evaluation for septic, be sure the test holes have been dug and the location is clearly marked at the site 36r.)/g1,,6- PART 1. APPLICANT AND PARCEL IDENTIFICATION Name of Applicant /t02/4/ M //e Y Phone&O6/77 /�p� 63 Mailing Address of Applicant //// F 47,9501V' " /{1-1( DR gip-, a p 1--- _. City Copt ✓i6ld t- State r-f/ Zip /pv 3Z 12-digit Tax Parcel No. 427_2MI.— �1 a 6!2 ci O Site Address //76 /72 /-0_G,'9ST -Brief Leaal Description 410//2/ /j 5 . U/11,42n/ �S�Uf _ _/1110.6-0 Driving Directions n2/9SCi71l/ Lk ,Co �U /l1l 11^/ i--/C /✓2 �� 5/ --- ?age I of 4 This form may be scanned and available for public view on the Mason County Web site. to✓¢ed 12/8/2022 PART 2: TYPE OF REVIEW I Septic System • Age of system • Age of nouse • Number of bedrooms • Name of last owner • Is house currently occupied? 11 YES Li NO • If not occupied, how long has it been vacant? I Water System • Number of service connections on the water system? • If a public water system, name of system • WFI number .q Property Evaluation (soil logs) Property evaluations provide, in general terms, the suitability for a parcel for septic system placement. THIS DOES NOT GUARANTEE FUTURE SEPTIC SYSTEM APPROVAL. • Describe the intended use of the property and the reason for requesting the review. f1��4/p�N✓Id AG PART 3: PLOT PLAN Jse the space below to draw a detailed plot plan,or attach a detailed plot plan to this application. The plot plan should include the followina: North Arrow, Location of Test Holes, Location of Existing Septic System,Dimensions of Properly, Location of any Drinking Water Sources(wells, springs, etc.) Roads, Easements, Surface Water, and 3uildings on the property. (skip Part 3 for Group a water system review) LOT SIZE 56 9cffnro X Acres COMPASS 4 Applicant's Signature: � � i Date ✓0/7/,�0�3 Page 2 of This form may be scanned and available for public view on the Mason County Web site. Revised 12/8/2022 PART 4: HEALTH DEPARTMENT FINDINGS - OFFICIAL USE ONLY Septic System Yes No The septic system was inspected by an appropriate maintenance provider and the submitted report is current. Li _. Records for this property contain a septic permit, design, final approval and as as-built drawing. H 'Li The site was inspected and the system location appears to be consistent with recorded documents_. The area of the on-site system appears to be maintained in an acceptable manner. - - Was Operation and Maintenance a condition of permit approval? _. P i Is a copy of a current Operation and Maintenance report attached? Water System Yes No Individual Water System A water sample was taken by Public Health staff. Total coliform bacteria were determined to be H absent. Laboratory results are attached to this report. ] The well cap was inspected. The sanitary seal appears satisfactory. The well casing was inspected. The casing projected above ground and the ground sloped away from the casing. The well site was inspected. No septic systems, chemical storage facilities, manure pile, animal feedlots or other obvious sources of contamination appeared within a 100-foot radius of the well. Yes No Public Water System - Records indicate water-sampling requirements are being satisfied - Records indicate the Water Facility Inventory form is current. �'. Department files contain water system design and letter of approval. Soil Conditions iD/�./ZO L3 Test Hole #1 Test Hole #2 __l Test Hole #3 0-8" 0-layer C�$%yowl 0- ti" 0-(aya" fo6c'3 rof I 8 36' EA/0 fill 3dr EGA5' 06yroyriwli lv a 2fytflUtye, of 26''rrtwat\ (tca of R '' wMhmo� � 7 Pa S bF moinoli 7 taro a4°� hoiuPal./ Soil Type- Soil Type: 1 Soil Type: h Restrictive layyer: 36 Restrictive layer ____. Restrictive layer p a : Slope. ti 0 '0 /0 Slope O'� Slope u Distance to Shoreline: n— I50 Distance to Shoreline:" IN Distance to Shoreline: Page 1 of 4 This form may be scanned and available for public view on the Mason County Web site. Revised I2 8,2022 PART 5: HEALTH DEPARTMENT OBSERVATIONS — FOR OFFICIAL USE ONLY Primary Drainfield Yes No The system appears to be functioning adequately at the time of the inspection. (Only applicable if I I system has been in use on a regular basis for the last 6 months ) I i I I Sanitary survey? Ll Pass Li Fail i Suspect Not applicable Water System Yes No The water source consists of an individual (or a two-party)well that appears to be a satisfactory _ source of potable water for a single-family (or two single family) residence(s). The water was PI . . sampled and coliform bacteria were absent. The water source is a public water system that appears to be in compliance with applicable LI regulations. I Well Construction Permit Pass L. Fail PART 6: Comments Both fe5t hotel hod on ary oc Faye." of 5ofl from S fo t2 mctes deep twill extremely yrarelly medium sand fo fesfhole one and 30" r' f-Sfhole *0- A- resfrittiivc_ layer was found a/ 364 ?vi 1esithole one- and 3n" ,Yi k8f4o(e af wo . 7lte Ve9fi"t(fft(cr eI' t -a5' dr fe,rmM& byySi/m7 (t', and a 7( Inspector Date Date l0/5/ oZJ Important Notice'. Findings & determinations of this review reflect observed conditions as they exist on the day the evaluation was performed. Absolutely no claim is made by this office, expressed or implied concerning the future success. failure or permit approval of the system and site evaluated. layer of Magi MI /hard pan . The, ion 6 Type 1 due to file, jowl Grt+enF ran my from . 65 qv 30% root by volume. Al! eXfrerheli y raven?, (6o�io to 907e rout by volume) Soils cut caf&yortzed a5 5,i I Type') excluding 5005 'Type S and 6. Page d of A This form may be scanned and available for public view on the Mason County Web site. Rcclscd I2'g2U22 dyv K d P k, vjr . 2 fI " I / 2= `i ; C - -. ../ ' / I ,tj. .. .. . �d° i • I .1 elfr 'ap t l 9 -€., +yam d i r` 'r \may I‘ �� " f 4 a E � r�-�yIDi�7 y 75 � s v Si , til \p ' , i'q oIli ti �t p �7 � � \ s \