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Home My WebLink AboutWEL2024-00025 - WEL Application, Design, Letter - 5/24/2024 WA 584 MASON COUNTY 415 N6THELTONSTREET, 0127-9N ,EXT 400 SHELFAIR 360-2754470,EXT400 eELFAIR.360-2]S<46],EXT 400 Public Health & Human Services ELMA:360A82-5269,EXT 400 4 FM 360427-7787 PYLE JAMES MATTHEW 3441 E RASOR RD W BELFAIR, WA 98528 RE: WATER SYSTEM PERMIT: TWO-PARTY WEL2024-00025 140 E Elin Ln 220247590043 The 2-party water system, 140-160 E Elin Ln Water System (2202475900431220247590044), has been reviewed and is hereby APPROVED for 2 connections. Please continue to follow best management practices with maintaining your water system including regular water analysis, landscaping, keeping wellhead area free of contaminants, and stormwater management around the water source. If you have any questions, please contact me at 360-427-9670 Ext.353 or email at danderson@masoncountywa.gov Sincerely, e David Anderson Environmental Health Specialist Mason County Environmental Health Pfl" r/?aeC, MASON COUNTY .. COMMUNITY SERVICES nJR® aJbyPlmgfmimmemJ xJ,M1[unn..xrxwl,M1 615N.6'Sajuldg S) Slclton.WA9S5W WEL Y _ SM.: 3W4r. 6'IOxJ Birsir360-275JR67xGCEI.36 2-5261) JW TWO-PARTY PRIVATE WATER SYSTEM APPLICATION APKIOrWi P - James Pyle 360-801-1263 MLM ADOm-' m .cm,WAl zF 3441 E Rasor Rd W Beffair, WA 98528 SRa 140 E Elin Ln}f n Ln Shelton, WA 98584 PRI400.V PARC6 NIl1l91 rN6181rE1 22024-75-90043 9 NMx PARCB HmlffllFnPPrlWLE1 22024-75-90044 WAhR eOulleE aOMCa,YA ARC9.i LOa PAR .,nr 8� New O Existing 0 Well 0 Spring P 1.27 aCrea 1.27 aG25 oP0]m m1MINKIRml,xlml 140- 160 E Elin Ln Water System owaoaoxs ro ara axomuxs Hwy 3 east, turn right on E Pickering Rd. Cross Harstine Island Bridge, turn right onto E Island Rd S at stop sign turn right onto E Harstine Island Rd S, 1.5 miles turn right onto E Elin Ln. Site Plan: (may also be attached) (property Wundalim,structure,wall alto W100 radius,dnvevavys,roads,sepfiwmei r compaerm and lines,am mel ,etc...) See Attached Submittals Checlillst: (these additional items will be required for approval) Ea Satisfactory Bactenological sample(this may be defamed if well is not yet drilled) 8 Well Log with pump test or 4hour capacity test performed by driller(this may be defamed g well is not yet drilled) e Notice to Future Property Owners recording(record with Mason Co. Auditor, supply copy of recorded document) 0 Septic Records(additional locafing requirements may apply If mere is a lack of septic records on file) y is farm my be eamW and avallable for public view on the M county We1rb�=srte. m Revised: 10/13/2021 pa9e1 of3 Illulllr[ull MAY 2 4 2U24 By —'---------' --Staff Use Only- --- --"— Review Step 1: Well Site Inspection: YES NO NA ❑ ❑ Evidence of existing sources of contamination within 100 foot radius of water source? (drainfields,tanks, buildings; indicate distance on plot plan) ❑ ❑ Are there reads within the 100 foot radius of the water source?If so, is mad ovate County or State. What is distance to ROW? 70 5" ❑ ❑ Does the ground slope away from the water source site?(show slope on plot plan) JK ❑ ❑ Is the"it cap satisfactory? �CJ ❑ ❑ Screened and vented? �+ ❑ The well casing extends { > above level ground/concrete slab?(circle one) ❑ ❑ ❑ Is there evidence of a surface seal? Cot: q;jIV IZ ❑ ❑ Does the seal appear adequate? LOo: -lLi.$f4s6 Tq' $uM 83t ❑ � ❑ Is a variance necessary for well site approval? nry��((�� 1n y Comments necko/ ,Wt� VO V? l�(Y"l, 0t w �i (41 it � nit/ '10,WW Pass ❑ Fail Inspector Date Rattiest Step 2: Two-Party Review: YES NO NA ❑ ❑ Water Well Report with adequate pump test on file? Z3 4m {br 21(0 MM (;,;Zola I {s yal) If NO,date of Capacity Test Driller GPM �J ❑ ❑ Received Satisfactory Bacteriological Analysis? Date of test ❑ ❑ Received Signed, Notarized,and Recorded Notice? AFN ❑ ❑ System appears adequate to serve 2 single-family residences based on information provided? Comments ` Z leApproved ❑ Denied Reviewer Date S�// 2O 2,Y. Findings in this review reflect observed conditions as they existed on the day ofthe site inspection. No claim is made,express or implied af/he fwure success or failure ofthis system. Well site approval does nor constitute water system approval. Water System approval is a two-part process. All proposed connections to new wells are subject to water adequacy requirements at time ofbuilding permit perMCC 6.68. Water usage resMe6ons andaddldonal fees may apply to all new wells drilled i ferJanuary l9e" 2018 per ESSB 6091, This form met be sonree and availablefor public view on tiro Moon Coney Web alb. Revised: 10/13/2021 Page 2 0 2 WATER WELL REPORT wDfPARTW.Tor No eofbpmtNo WE53747 ECOLOGY 7paWa uD yn E dag w u DragNn BNMaSz p cermmooe Site Web Name(if.Ihm ace weU): f2 ❑ Dsm� ODrVmlbmWlim Np Nm Weer Right PerrmVLati eNo. pmpo um a Itoeotic ❑Imam ❑Mm ,l Property Owner Name JAMES PYLE ❑DaHbbriug ❑hsi®tim ❑Twwal C DM1sr_ Wdl SUM Mdta 130 E ELIN LN&140E EL1N LN f,mba Typ: MmM: ®Newval DAMmipo Cdivea ❑ymW ❑,"eNatml Ciry SNELTON Cwmy MASON C Dcpmi:p C a ❑nay S Ah- ❑M"Ra Tu f No. 22024759OD43&220247590044 Dlmeai.w: Dbmacofhwbg n u,m Oat n Wazavaaasae aPTovm fm ftusvell? I]Ya Ta1No Dl&ufaomkkdwe0%1 ft CaMmxWO Derr Wall HYes.what weer the variavcc folP Cmmy Lbw Dmmter Fmm To Tlddmm Shsl PVCwH Tb ® I ❑ S in. H SIB 250 in. p I ❑ ® I ❑ laetim(sa mmrmaona m page 2): 1i WWMm❑EWM ❑ ❑ —iM — ❑ I ❑ ❑ 1 ❑ NW /.Y.ofthe NE ❑ ❑ m a ❑ I ❑ ❑ 1 ❑ Y'Secfim 24 Tos,mahip 20N Rmgp 2 ❑ 1 ❑ _ _i% ❑ 1 ❑ ❑ I ❑ Labmdn(Ex.VII:47.12345)47211018 faamfmaa- cly- am 71pe WpmYabr®d Lm®nde lExampk:-120.12345) -122.&74159 Nopfpaama- S ofpmn,atm_iaby�s Driger'a1�/CoeetraeWbm DMam•issW paeudmm Pe,fma,W fiom_nm_ftbalewy,�Qnn Finau,bn:I>aoitr by mbr,,imsmrw,am:ofvshrulmCramaae,mtlpe tlelaM mere ofthe,pMid b ench hynpmammgxmh 0 kw ens aty W cba of S : By. ❑W MK� DW®_L w ia,. Uu MJYaWa Jvecevy. Mbabetmw'sNme__ Malmal From T. Tym STANLM Hoch No. Dkmwerb n. Slmsve 12 is gem_Rba+� SMtg CLAYS GRAVELSNID BROWN 0 180 I>snwu+_ b. sk,sim boom_fla_R PEAT BROWN 1B0 190 S.ffg was C Ym ON. R of CLAY& SAND SLUE 190 220 Mamia4 plwcd fiom_A b_R —®' CLAY&GRAVEL BLUE 220 245 CLAY SAND&GRAVEL BROWN 25 5 S,wfm snb p Ym ❑Na Toshu4eph?20 n CLAY 8 SAND BLUE 27 35 5 385 Maaial,eee bsW BFMOMTE DW m,y rtram.nmab ummbk aamrt CYm amGRAVEL H2O GREEN 385 381 Typeotwa,w? DepW Ra+w Mellvtl a f srvlin&swam off 'Pomp: Mmul'acawr's Nmw GOUlAS TSye: Bus HP. 3 Ppna iaake,lep0:3Q0 ft D.*W gowmt 18 p Sa Laobmekvmwn ab.e,m ru bKl n S,kF,p.fw orapWx9rasw,by t ft.bove pou,W rarlaze Sm,ic wax L+el 212 ftmlow mpor Jl wsbg Due 4T2vt1 Arkawprtaure__WC TraamrsvN IAh A,xs®wmwncmvclktlM (mp.Wstae) wA Tmm: wma�pwt . ❑m 4Ll Ym b byw YbW 23 pavh2 a.traxJoxna&r4 b,s. YkW_pviN_ftMwroanabn M. YiW_6Po,vW,_(L baWoum aRer_hie. Rawgy Nm(lien[=ana vMo puoq u Om[A OR-eabinel,mrmW fim„well TaTi mw...kucn le Wa:v lercl Tim Wv,u Lm[I T. WYalt,wl GrootpimP,B4u__ BUTeraen_pwhh_Rdmvdowna� h,v� Avm_ga,wbhvmWrt_RRr_hn 0.a Ar,®Ibw_p Tempmmmofv _•P Wmecbmimlamlyshsmde? GYea am S�Dft±1-24 Co pkwdDaM 4-1624 WELL CONSTRUCTION CUITTWCATION: ImosbucwdmNmacceptrmpomib8iryfmmmNxtimoftWsww14MMincoogliavaewnhaUWv ngtmweD cmbtrucnw smvdmds.Materials,vW aM tlm inf vim reportW above meouemnry botkeowWdge avd be5ef. R DUBw❑Ti..❑PE-flit Name CLAYTON P1TTS Drillibg Comwy COOLWATER DRILLING,INC. si®m Address 10921 NW HOLLY RD License No.M16 City,swg Zip BREMERTON WA 98312 W TRAINEE:Stmosor'a LJcesue Nm Cmhxlar's Sponsm's sieoahac Rcgiananmm,COOLWD1941QM Dve 5.7-24 ECY050-1-M 11/18) Nlvm nreJthie&numrnt in an altrrnar�Iormar.➢lease cull the Rfrrm Res,.unrx ProA at Wk:903-&17}. hYMM@9NR}1#A4i i55N tNIF^1I IPn NLtiMbpSIg RYA1"YlwiiT fRVMwswM x,ynvt•h.4twMl4r.asr mrl 4^.ca3-BNI. 26276 Terdw i Twee Le NW i Sete " SPECTRA Laboratories Kitwp Poui.bo,WA 060p7Astat FoOLIFORM BACTERIA ANALYSIS FORM oak Semple Collette Tme Sarpk cmAR• 641 I'ii 12x/ cdkw plea lee% oer Ye 3 :tjLo+a .K ors Type of Wake Syskm(dmrk o*are bm) ❑GFwpA ❑GreupB Gnmp Aard GmupBGysaiw-Pmupebmn WaMFadftiee lmRnbry(WFI): _— Sysem Nanm: DyRapa 3co _ 'Foot CdFh c BUL [x PSac Smdmoa ax dwr.re,rew.r;mmarmw.rarmkemYreeree <e.olt✓.f.vEL'A3tttl+Cr lkTnn?t_cnt.. SAMPLE INFORMATION ampleuakple'by(emna): coal+. A4V SpxNebWmWwea®Okmbcktl: Spsial kadacdora mmaaew /_ //.aR fl Tr'6 YftfrJ TYpeot Sample,dre Mlymmbox) 1.❑Rmetme Dim leden Sample(RIPI Z O Reper Baople(AIP) ChbMiated:Yes ❑ No❑ Bp1" 01` "�1°Y°t'101�1 Uroahhrby muam kDmeMv. •Chbme Residual:TokL—Fme_ �3.GrouMWakr Rua 3emw Smrple Wm*b*,ymdimc*ddWM G I I I l 1. 1 chimin kO:Yes_No_ ❑Trgrex!per) C Me Re dwt Tokl_Fina_ ❑Anewment(AM a SuelewmON f.sewme WAK Semple(Enumaafun) 8 ❑ Ema [I Feed nwa xr_w_ 5. Smge Wueadie, I tm NY.. LAB USE ONLY DRINKING WATER RESULTS LA4 USE ONLY ❑unsadsremy Tom caBmm Fmemand �S ftcicy ❑Emapraaf ❑EwdaWem BacterialD.*Rauch:Tool W&w---rpn1lDNp E.at—nwi mnl. FeratCdifam dr100nY. WC.___duMM. Replaeemem Sample Rapkol: ❑TNTC ❑Sespleleeeld ❑ SammplleekVpodlma ❑DNMWCwiww 0 —C7,-\ B..plTwp r. W1ptl m�mwrrswrr� q,I APR 23 202{ �0" w+ww:eAau.rrrr+e+Y APR 2d 2024 Op114Smgae ,u reYr.r.eerr.rrarYWaY V II.� �.\ Y�eIYYTrrP�4iY��p 1 ooxrYauepwmm r Name and Return Address: 2211204 MASON CO WA JBmCB'] 05124/2024 11 to PM NOTCE 3441 L1 Ra8Or Rd W I IYLE #199814 Rec Fee'. $305 50 Pages 3 Belfair.WA 98528 II��II III�II III IIII IIIIIII�II�II IIII III I�II�IIII II�IIIf III�III�IIII IIII Document Title(s) 1. Notice to Future Property OwnersofPrinte TwoPaelyWatarSnt® 2, Reference Number(s)of Documents Assigned or Released ADOmONAL REFERENCE YS ON PAGE GrarLtor(s) Litmus e 2 ADORWNAr.�ONPSGa_ Grardee(s) 1.Public 2. PDDRIOWIL GRANTERS ON PAGE Legal Description(annreewLee ram:La.W,block PNL or sect ,roerahi,,raop,auane./nearmr) TR 4 OF SURVEY 21123 LOT:3 OF Split 2815 ADDITIONAL LEGAL IS ON PAGE_ Assessors Property Tax Parcel/Account Number(s) 22024-75-90043 22024-75-90044 ADDmONAL PARCEL MS ON PAGE_ THE AU DITOR/RECORDER WILL RELY ON THE INFORMATION PROVIDED ON THIS FORM.THE STAFF WILL NOT READ THE DOCUMENT TO VERIFY THE ACCURACY OR COMPLETENESS OF THE INDEXING INFORMATION PROVIDED HEREIN. 3 Return To James Pyle 3441 E Rasor Rd W Belfair,WA 98528 Grantor(s): (1) James Pyle Grantee(s): (1) PUBLIC Legal Description (1) TR 4 OF SURVEY 21123 LOT: 3 OF SP#2815 (Abbreviated form:i.e.lot,bk ck,plat or section,township,range) Assessor's Tax Parcel: (1) 22024-75-90043 NOTICE TO FUTURE PROPERTY OWNERS OF PRIVATE TWO-PARTY WATER SYSTEM I (We)the undersigned grantor(s), certify that the water source located on the above- described real estate under Legal Description(1)and Assessors Tax Parcel(1) situated in Mason County, Slate of Washington, has been designated to serve a source of water to the following parcels situated in Mason County, State of Washington;herein described: Tax Parcel: (Connection 1) 22024-75-90043 Tax Parcel: (Connection 2) 22024-75-90044 The system owner is responsible for keeping this system in compliance. The name of the water system is: 140- 160 E Elin Ln Water System This system is designed to provide for two service connections. Planning and design approvals must be obtained from the department prior to expanding beyond this number of services.Additionally, a water right, obtained from the Department of Ecology, is required if the water system exceeds exemption standards. Parcel owner 22024-75-90044 agrees to pay parcel owner 22024-7590043$120 annually to cover electrical cost of operating the well. This system has not been granted one or more waivers from specific provisions of the regulations. Dated on this 21 day of MAY . 202r . Signature of Grantor(s) ,(/ (1)� Page 1 of 2 State of Washington ) County of Mason ) I,the undersigned, a Notary Public in and for the above named County and State, do hereby Tcertify that on s day of 20� � iu' rsonally appeared before me,who is known to be signer of the aboW instrument, and acknowledged that he(she) (they)signed it. GIVEN under my hand and official seal the day and year last above written. ENE M,W�c"o Notery Public in nd r the State f n t ylshi ;..y •�.es'o"'F+: S''•� residing at � 110TARY 'Pe: ?_ My commission expires: b bZ 21009497 �,,. ,• PUBLIC 01 ...As..... Page 2 of 2 E Elin Ln 1510 E Harstine Is 30R EbodrICOU James Pyle Road EBOSOWK 3441 E Rasor Rd S 166 Ft Belfair WA 98528 (360) 801-1263 jimmypyle@icloud.com 166 Ft Existing Power Pole 166 Ft 'r700 Ft0 Underground Primary 166 Ft r30 RR 166 Ft ❑ 100 E Elin Ln 22024.7& + ■+ o,,,,,,, y 120 E Elin Ln 166 Ft � 22024-754MM 140 E Elin Ln 166 Ft 2202A-7; sa 2202A- 58OW 160E Elin Ln 166 Ft D,?r, ROW Easwnwd one 330 Ft