HomeMy WebLinkAboutSWG Letters / Memos - 4/12/1982 FOR DEPARTMEn
1NTlr TH DEPARTMENT ATE BASIS FOR FEE
ONMENTAL HEALTH SECTION D
?CH STREET • SHELTON, WA. 98584
PHONE (206) 426-5561
NOT
C HONE SITE: PPRO ED A PROVED
BY:
RuPERTY OWNeR /
PHONE DESIGNED SYSTEM REQUIRED
ADDRESS C �N NOT
/ SEWAGE SEWAGE: ❑ APPROVED ❑ APPROVED
SE AGE I ER �
CONTRACTOR BY:
LEGAL DESCRIPTION / /
f- a
G `fir SOIL TYPE
• - OF LOT DEPTH TO ATER TABLE PERC. RATE__.---
TYPE OF A� / .` e BEDROOMS SIZE
BUILDING ' GAL.
SINGLE RESIDENCE PUBLIC WATER NAME SEPTIC TAN (S) /0yc PUMP REQ.
WATER SYSTEM SYSTEM FEET
COMMERCIAL ONLY DISTRIBUTION TILE TOTAL
LIQUID WASTE G.P.D. A SQ. FEEL,
FILTRATION AREA-
DIRECTIONS TO SITE: QUANTITY OF CU. YD.
L �N ` �,� APPROVED STONE-
0CU. YD. SAND---
FILL REQUIRED CU. YDS.
FINAL INSPECTION REQUIRED BEFORE BACKFILLING
DEPTH OF
BACKFILL
Ci 2"STRAW OR PAPER
STONE
O OVER TILE
PIPE SIZE
STONE
DER TILE
SITE PLAN AND SPECIAL STIPULATIONS I ROSS SECTION OF TRENCH
(INDICATE DIRECTION OF DRAINAGE)
r
s
r.
COMMENTS:
THIS SITr-
SITE INSPECTION CHECK LIST NO
Chect_ every acceptable feature. Leave every questionable or unacceptable
feature blank. Explain every blank in the space for remarks.
/ Item Ap lica le Regulations
�. Soil in holes-describe layers & depth Art. VI Sec. 3.5 (a) VII 3.3, 3.7, 10.2
r2: Existing sewage systems
Existing structures - check use VI 3.5 VII. 4.1, 4.2
4. Existing wells - check construction VI 2.1 (b) VII 4.1
,�3'.� rnsencc of-fill VI 1.8 VII 3.6
Lb: 1Ias soil been removed VI 2.1 (c) , 2.4, 3.5(f) VII4.1
q Salt water it
cB Lake
9. River
10. Creek °Y
Y1',, Stream
12. Pond 1P
13.. .vamp S '
14. Misc. Surface water l `°
1�y-Property VI 3.5 (f) VII 4.1
16 -Banks or cuts VI 3.5 VII 4.1, 3.7
17. Distance to public scuer VI 3.5 (g), 9.2, 10.2, 10.3
10.4
�,.--Water table - Record depth VI 3.5 (d) VII 1.4
1 . opes VI 3.5 (e) VII 3.7,4.1
2iveways and roads VII 4.2
2,1,.���train ago patterns VI 3.5 (e) VII 4.1
22,E interceptor drains VII 3.8
�3':, Gulvnrts
24': Water lines VII 2.6, 4.1
Flood control zones VII 4.4
2Cy.`Roof drains VII 3.2
27. Vegetation VII 3.2
RE^IAPKKS
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BY -� DATE