HomeMy WebLinkAboutGEO2024-00065 Storage Facility - GEO Geological Review - 10/23/2023 PLANNING RECEIVED
JUN 12 2024
615 W. Alder Street
Geological/ Geotechnical Assessment
Self Storage Facility
23240 NE State Route 3, Belfair
Parcel No. 12332-50-00021
Mason County, Washington
October 23, 2023
Project#23208
Prepared For:
JH Rigger Enterprises, LLC
PO Box 985
Belfair, Washington 98528
Prepared By:
Envirotech Engineering
PO Box 984
Belfair, Washington 98528
Phone: 360-275-9374
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MASON COUNTY Submittal Checklist
COMMUNITY SERVICES Geological Assessment
Building,Planning,Environmental Health,Community Health
Instructions:
This checklist must be submitted with a Geolooical Assessment and completed, signed, and stamped by the licensed
professional(s) who prepared the Geological Assessment for review by Mason County pursuant to the Mason County
Resource Ordinance. If an item is found not applicable,the report should explain the basis for the conclusion.
Note:Unless specifically documented, this report does not provide compliance to the International Residential Code
Sections R403.1.7 for foundations on or adjacent to slopes, Section R403.1.8 for expansive soils or section 1808.7.1
of the International Building Code Section for Foundations on or adjacent to slopes.
Applicant/Owner JH Rigger Enterprises Parcel# 12332-50-00021
Site Address 23240 NE State Route 3
(1) A discussion of the geologic conditions in the general vicinity of the proposed development,with geologic unit
designation based on referenced maps.
Located on page(s) 5
(2) (a) A discussion of ground water conditions,
Located on page(s) 6
(b) A discussion of the estimated depth to water,
Located on page(s) 6
(c) A discussion of the quantity of surface seepage,
Located on page(s) 6
(d) A discussion of the upslope geomorphology,
Located on page(s) 3
(e) A discussion of location of upland waterbodies and wetlands.
Located on page(s) 3
(3) The approximate depth to hard or dense,competent soil, e.g.glacial till or outwash sand.
Located on page(s) 5
(4) A discussion of any geomorphic expression of past slope instability (presence of hummocky ground
or ground cracks,terraced topography indicative of landslide block movement, bowed or arched trees
indicating downslope movement,etc.).
Located on page(s) 4
(5) A discussion of the history of landslide activity in the vicinity, as available in the referenced maps and .
records.
Located on page(s) 7
(6) An opinion on whether the proposed development is within the landslide hazard area or its associated buffer or
setback and the potential for landslide activity at the site in light of the proposed development.
Located on page(s) 7
(7) A recommendation by the preparer whether a Geotechnical Report should be required to further evaluate site
conditions and the proposed development of the subject property.
Located on page(s) 11
(8) If the presence of a hazard is located within 300 feet of the proposed development,then the following are
delineated on a geologic map/site map:
(a) The area of proposed development,
Located on map(s) n/a
(b) The boundaries of the landslide hazard area(top, both sides,and toe),
Located on map(s) n/a
(c) The associated buffers(top, both sides, and toe),
Located on map(s) n/a
(d) Building or other setbacks (top, both sides, and toe),
Located on map(s) n/a
(9) A site map drawn to scale showing the property boundaries,scale, north arrow, and the location and nature of
existing and proposed development on the site.
Located on Map(s) Site Plan (Appendix A)
I, Michael Staten, hereby certify under penalty of perjury that I am a civil engineer licensed in the State of Washington
with specialized knowledge of geotechnical/geological engineering or a geologist or engineering geologist licensed in
the State of Washington with special knowledge of the local conditions. I also certify that the Geological Assessment
dated 10/23/2023 , and entitled Self Storage Facility , meets all the requirements of the Mason
County Resource Ordinance, Geologically Hazardous Areas Section, is complete and true,that the assessment
demonstrates conclusively that the risks posed by the landslide hazard can be mitigated through the included
geotechnical design recommendations, and that all hazards are mitigated in such a manner as to prevent harm to
property and public health and safety.
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Disclaimer:Mason County does not certify the quality of
the work done in this Geological Assessment.
Page 2 of 2
TABLE OF CONTENTS
1.0 INTRODUCTION................................................................................................................................. 1
1.1 PROJECT INFORMATION.................................................................................................................... 1
1.2 PURPOSE OF INVESTIGATION AND SCOPE OF WORK........................................................................ 1
2.0 SURFACE CONDITIONS....................................................................................................................3
2.1 GENERAL OBSERVATIONS.................................................................................................................. 3
2.2 TOPOGRAPHY..................................................................................................................................... 3
2.2.1 Upslope Geomorphology............................................................................................................ 3
2.3 SURFACE DRAINAGE.......................................................................................................................... 3
2.3.1 Upland Water Bodies................................................................................................................. 3
2.4 SLOPE AND EROSION OBSERVATIONS...............................................................................................4
3.0 SUBSURFACE INVESTIGATION.....................................................................................................5
3.1 FIELD METHODS,SAMPLING AND FIELD TESTING........................................................................... 5
3.2 GEOLOGIC CONDITIONS.................................................................................................................... 5
3.3 SPECIFIC SUBSURFACE CONDITIONS................................................................................................. 5
3.3.1 Groundwater............................................................................................................................... 6
4.0 ENGINEERING CONCLUSIONS AND RECOMMENDATIONS................................................. 7
4.1 LANDSLIDE HAZARDS.........................................................................................................................7
4.1.1 Landslides and Slope Stability Analysis.................................................................................... 9
4.1.2 Surface and Subsurface Drainage............................................................................................ 9
4.2 EROSION HAZARDS............................................................................................................................9
4.3 SEISMIC HAZARDS.............................................................................................................................10
4.4 BUILDING FOUNDATION RECOMMENDATIONS.................................................................................10
4.4.1 Settlement..................................................................................................................................11
4.4.2 Concrete Slabs-on-Grade..........................................................................................................11
4.5 EARTHWORK CONSTRUCTION RECOMMENDATIONS.......................................................................12
4.5.1 Excavation.................................................................................................................................12
4.5.2 Placement and Compaction of Native Soils and Engineered Fill...........................................12
4.6 RETAINING WALLS AND LATERAL EARTH PRESSURES...................................................................13
4.7 SURFACE AND SUBSURFACE DRAINAGE...........................................................................................14
4.8 PARKING AND PAVEMENT ANALYSIS.............................:.................................................................14
5.0 CLOSURE.............................................................................................................................................16
Appendix A-Site Plan
Appendix B-Soil Information
1.0 INTRODUCTION
Envirotech Engineering, PLLC. (Envirotech) has completed this geological/ geotechnical
assessment for a commercial property located at 23240 NE State Route 3, identified as parcel
number 12332-50-00021 in Mason County, Washington. As presented herein, this assessment
includes information pertaining to the Project in this Introduction Section; observations of the
property and surrounding terrain in the Surface Conditions Section; field methods and soils
descriptions in the Subsurface Investigation Section; and assessments for landslides, erosion,
seismic hazards, and supporting documentation with relation to the pertinent IBC sections in the
Conclusions and Recommendations Section.
An initial geological/geotechnical evaluation of the project was conducted by Envirotech on June
12,2023.It was determined that natural slopes between 15%and 40%were present within 300 feet
of the project. Due to these slope grades, a geological assessment is required pursuant to landslide
hazard areas of the Mason County Resource Ordinance(MCRO). In addition,this report conforms
to the requirements outlined in the International Building Code(IBC)Sections 1603.1.6 and 1803.6
for commercial developments.
During the evaluation and site visit by Envirotech,surface and subsurface conditions were assessed
in order to determine if further geotechnical studies are required.After completion of the field work
and applicable Project research,Envirotech prepared this geological assessment.
1.1 Project Information
Information pertaining to the project was provided by the proponent of the property, and
observations from a field visit by Envirotech. The proposed development is expected to consist of
a building and driveway/parking for a self storage facility, and other ancillary features typical of
this type of development.Approximate site development with relation to existing site features are
illustrated in the Site Plan in Appendix A of this report.
1.2 Purpose of Investigation and Scope of Work
The purpose of this geological assessment was to evaluate the project in order to confirm that the
proposed development is outside of any landslide hazard area and its associated buffers and
setbacks as determined in the MCRO. In addition, this assessment addresses the reporting
requirements outlined in the IBC.
The investigation included characterizing the general project surface and subsurface conditions,
and evaluating the suitability of the soils to support the planned site development. In order to fulfill
the purpose of investigation, the geological/ geotechnical program completed for the proposed
improvements of the project include:
• Review project information provided by the proponent of the project;
• Conduct a site visit to document the site conditions that may influence the construction and
performance of the proposed improvements;
• Define general subsurface conditions of the site by observing soils within test pit
excavations,review well logs from existing wells near the project,and evaluate geological
and hazard maps depicting the site geology for the vicinity of the project;
Envirotech Engineering Geological Assessment
PO Box 984 page 1 Parcel 12332-50-00021
Belfair,Washington 98528 Mason County,Washington
Ph. 360-275-9374 October 23,2023
• Perform soils testing, such as visual classifications,to determine selected index properties
of the soils;
• Complete an engineering assessment supported by planned site alterations and the surface
and subsurface conditions that were identified by the field investigation, soil testing, and
applicable project research;and,
• Establish engineering conclusions based on findings and anticipated development.
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Envirotech Engineering Geological Assessment
PO Box 984 page 2 Parcel 12332-50-00021
Belfair,Washington 98528 Mason County,Washington
Ph. 360-275-9374 October 23,2023
2.0 SURFACE CONDITIONS
Information pertaining to the existing surface conditions for the project was gathered on June 12,
2023 by a representative with Envirotech. During the site visit, site features were documented that
may influence construction or reveal potential geological hazards.This Surface Conditions Section
provides information on general observations,vegetation,topography,drainage and slope/erosion
conditions for the project and surrounding areas.
2.1 General Observations
The property is developed with an existing professional services building currently used for
dentistry practice,paved parking lot, and other ancillary features. NE State Route 3 extends along
the west side of the property.Vegetation on and near the property consists primarily of firs,maples
and other trees and shrubbery common to this area of the Pacific Northwest. Where development
is planned to be located,the land has been cleared and graded to a relatively flat to slightly sloping
condition.An aerial photo of the project and immediate vicinity is provided on the following page.
2.2 Topography
The topographic information provided in this section was extrapolated from a public lidar source,
and incorporated observations and field measurements. Where necessary, slope verification
included measuring slope lengths and inclinations with a cloth tape and inclinometer. See the Site
Plan in Appendix A for an illustration of the general slope indicators with respect to the planned
development.
Descending grades are generally located to the west of the planned development. This slope is
relatively minor within 300 feet of the project, with no apparent slope grades of at least 15%.
2.2.1 Upslope Geomorphology
Ascending slopes exceeding 15% are located on and beyond the property. Average slope
grades are approximately 16% with a vertical relief of approximately 65 feet. The upland
area of the property is situated on a hillside and crest. Landforms are primarily of glacial
origin with centuries of weathering overburden. Additional geomorphology that is
pertinent to both upslope and downslope areas are provided in the Subsurface Investigation
Section of this report.
2.3 Surface Drainage
The majority of the stormwater runoff originating upslope from the anticipated development is
expected to be minimal to moderate. Significant scour, erosion and sediment transport was not
apparent near the project.
2.3.1 Upland Water Bodies
There are no apparent water bodies or wetlands located upslope from the planned
development that would significantly influence the project.
Envirotech Engineering Geological Assessment
PO Box 984 page 3 Parcel 12332-50-00021
Belfair,Washington 98528 Mason County,Washington
Ph. 360-275-9374 October 23,2023
2.4 Slope and Erosion Observations
The existing moderate slopes near the project signal a potential landslide or erosion hazard area.
Some indicators that may suggest past slope movements include:
• Outwash of sediments near the bottom of the slope,
• Fissures, tension cracks or naturally stepped land masses on the face or top of the slope,
and parallel to the slope,
• Fine,saturated subsurface soils,
• Old landslide debris,
• Significant bowing or leaning trees,or,
• Slope sloughing or calving.
The above mentioned indicators, or other signs of significant mass wasting on the property or
within the general vicinity of the project were not observed or discovered during research.
Indications of past landslides, current unstable slopes, deep-seated slope problems, or surficial
slope failures were not observed during the site visit.
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Envirotech Engineering Geological Assessment
PO Box 984 page 4 Parcel 12332-50-00021
Belfair,Washington 98528 Mason County,Washington
Ph. 360-275-9374 October 23,2023
3.0 SUBSURFACE INVESTIGATION
Information on subsurface conditions pertaining to the project was gathered during research and a
site reconnaissance. The site visit was accomplished on June 12, 2023 by a representative with
Envirotech. Specific information on field methods, sampling, field testing, subsurface conditions,
and results from soil testing are presented in this section of the report. Appendix B has pertinent
information on subsurface conditions for the Project,including test pit log(s)representative of the
site soils, and water well report(s)originating from the subject property and/or nearby properties.
3.1 Field Methods,Sampling and Field Testing
Information on subsurface conditions for the project was accomplished by probing anticipated
foundation areas with hand tools,and observing soils within test pit excavations and/or earth cuts.
Information on subsurface conditions also included reviewing geological maps within the project
vicinity,and water well reports originating from nearby properties. No soil samples were collected
for this project. Envirotech measured the relative density of the in-situ soils by gauging the
resistance of hand tools.
3.2 Geologic Conditions
In general, soils at the project are composed of materials from glacial advances. The geologic
conditions as presented in the"Geologic Map of Washington,"compiled by J.Eric Schuster,2002
indicates Quaternary sediments, Qg. Quaternary sediments are generally unconsolidated deposits,
and dominantly deposited from glacial drift, including alluvium deposits. This project is located
within the Puget Lowland.Typically,"lower tertiary sedimentary rocks unconformably overlie the
Crescent Formation."as revealed in the Geologic Map.Initial sedimentary rocks were formed from
shales,sandstones and coal deposits from rivers.During the Quaternary period,the Puget Lowland
was covered by numerous ice sheets, with the most recent being the Fraser glacier with a peak of
approximately 14,000 years ago. Upon the glacial retreat, the landscape was formed by glacial
erosion glacial drift deposits.
The "Geologic Map of the Belfair 7.5-minute Quadrangle, Mason, Kitsap and Pierce Counties,
Washington" by Michael Polenz, Katelin Alldritt, Nicholas J. Heheman, Isablle Y. Sarikhan, and
Robert L.Logan,July 2009,provides the following caption(s)for the project area:
Unit Description
Qaf Silt, sand, gravel, and boulders; typically poorly sorted and stratified; forms concentric
lobes where streams emerge from confining valleys and reduced gradients cause sediment
load to be deposited
3.3 Specific Subsurface Conditions
The following subsurface conditions are estimated descriptions of the project subgrade utilizing
information from the depth of penetration at all testing, sampling, observed and investigated
locations. Soils for this project were described utilizing the Unified Soil Classification System
(USCS). Using the USCS in conjunction with estimated relative densities and other anticipated
engineering properties of the soil, susceptibility for potential landslides, erosion and seismic
Envirotech Engineering Geological Assessment
PO Box 984 page 5 Parcel 12332-50-00021
Belfair,Washington 98528 Mason County,Washington
Ph. 360-275-9374 October 23,2023
hazards may be assessed.
The project is primarily composed of undisturbed, native soils, without indications of substantial
fill. However,some fill was present on the downslope side of the building pad. Competent bearing
soils were encountered at 12 inches below the existing native ground surface in locations where the
ground was probed. For engineering purposes,these native soils consist of distinguishable layers,
as presented below.
In one location, soils within the upper 3 feet of natural ground were observed to be moist,brown
silty sand with gravel (SM). Another location exhibited 8 feet of poorly graded sand with gravel
(SP). Expanded and specific subsurface descriptions, other than what is provided in this section,
are provided in the soil logs located in Appendix B of this report.
According to the"Soil Survey of Mason County,"by the United States Department of Agriculture,
Soil Conservation Service(SCS), the site soils are described as Everett very gravelly sandy loam,
Eh, with 8% to 15% slopes. See the soil map below, and the applicable SCS soil profile(s) in
Appendix B of this report.
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3.3.1 Groundwater
From the water well report(s) and knowledge of the general area, permanent groundwater
is at least 50 feet below the current ground surface. Surface seepage or perched
groundwater at shallow depths was not observed on-site,nor indicated on the well reports.
However, some seasonal groundwater is expected to flow directly above the hardpan on
occasion.
Envirotech Engineering Geological Assessment
PO Box 984 page 6 Parcel 12332-50-00021
Belfair,Washington 98528 Mason County,Washington
Ph. 360-275-9374 October 23,2023
4.0 ENGINEERING CONCLUSIONS AND RECOMMENDATIONS
The following sections present engineering assessments and conclusions concerning the project.
These conclusions have been made available based on the planned construction activities as
outlined in the Introduction Section of this report;general observations of drainage and topography
as summarized in the Surface Conditions Section; and soil conditions that were identified by the
field investigation and soils testing as outlined in the Subsurface Investigation Section.Conclusions
for the project that is provided herein, includes pertinent information for landslide, erosion and
seismic hazards.
4.1 Landslide Hazards
For the planned development, as provided in the Introduction Section of this report, it is
Envirotech's opinion that the proposed development is not subjected to or cause adverse impacts
to a landslide hazard area, or its associated buffer or setback as defined in the MCRO. This
conclusion is based on the contents provided in this report.
Landslides are natural geologic processes, and structures near slopes possess an inherent risk of
adverse settlement, sliding or structural damage due to these processes. Geotechnical engineering
cannot eliminate these risks for any site with sloping grades because gravity is constantly inducing
strain on the sloping soil mass. Excessive wet weather and/ or earthquakes will exacerbate these
strains. Geotechnical engineering considers excessive wet weather and `design' earthquakes in
order to provide an acceptable factor of safety for developing on or near sloping terrain. These
factors of safeties are based on engineering standards such as defining engineering properties of
the soil,topography,water conditions, seismic acceleration and surcharges.
Surface sloughing or other types of surficial slope movements usually do not affect the deep-seated
structural capability of the slope. However, excessive and/or repeated surficial slope movements,
if not repaired, may represent a threat to the structural integrity of the slope. Maintenance of the
slope should be completed if the situation does arise in order to prevent the possibility of further
surficial or deep seated slope movements that may be damaging to life or property.
According to the Coastal Zone Atlas of Mason County,Washington,the project is within and near
terrain labeled `Stable' and `Intermediate' regarding potential landslide activity. Stable slopes are
generally not prone to landslides due to small grades and accommodating geology. Historically,
intermediate terrains have no known landslides. A site specific analyses and conclusions
concerning the slopes are presented herein. A Stability Map from the Coastal Zone Atlas for the
general area of this Project may be found below.
Envirotech Engineering Geological Assessment
PO Box 984 page 7 Parcel 12332-50-00021
Belfair,Washington 98528 Mason County,Washington
Ph. 360-275-9374 October 23,2023
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According to the Department of Natural Resources (DNR) "LHZ — Final A-1 Map — Landslide
Inventory—Mason Watershed, by Sarikhan, et. al., May 2007," previous landslide activity is not
recorded near the project.Per the Resource Map from DNR,the Project is not within terrain labeled
`highly unstable' or `highly erodible' relating to soils. DNR labeled portions of this project as
medium to high slope instability with relation to slopes. This delineation is primarily dependent
upon slopes and convergence. Secondly, lithology and precipitation are modeled within this
delineation. In summary, this designation is based on mapping without field observations or
knowledge of the specific site geology or soils. A resource map from DNR is provided below:
Envirotech Engineering Geological Assessment
PO Box 984 page 8 Parcel 12332-50-00021
Belfair,Washington 98528 Mason County,Washington
Ph. 360-275-9374 October 23,2023
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4.1.1 Landslides and Slope Stability Analysis
Past landslide activity or high slope instability indicators near the proposed development
was not revealed during the project research. However, the eastern half of the parcel is
within the boundaries of a mapped historic landslide. Detrimental landslide activity or
potential high landslide indicators were not observed during the site visit as outlined in the
Surface and Subsurface Conditions Sections of this report. Due to these factors, and
existing/proposed conditions, a slope stability analysis was not deemed necessary for this
project. Considering the planned construction as summarized in the Introduction Section
of this report; the aforementioned surface and subsurface conditions for the project; the
slope stability assessment provided herein;and the Engineering Conclusions provided later
in this report,it is our opinion that the project is not within a landslide hazard area,and that
the proposed site alterations will not encourage a landslide hazard.
4.1.2 Surface and Subsurface Drainage
This project does not appear to experience significant subsurface drainage or surface
runoff. It is our opinion that groundwater or surface drainage is not a limiting factor for
this project.
4.2 Erosion Hazards
Based on the USCS description of the Project soils, the surface soils are considered moderately
erodible. According to the Resource Map from the Washington State DNR,as provided above,the
Project is not within terrain labeled `highly erodible.' This Project is not within an erosion hazard
area as defined by the MCRO. Erosion hazard areas are those with USDA SCS designations of
River Wash (Ra), Coastal Beaches (Cg), Alderwood Gravelly Sandy Loam on slopes 15% or
Envirotech Engineering Geological Assessment
PO Box 984 page 9 Parcel 12332-50-00021
Belfair,Washington 98528 Mason County,Washington
Ph. 360-275-9374 October 23,2023
greater(Ac and Ad),Cloquallum Silt Loam on slopes 15%or greater(Cd),Harstine Gravelly Sandy
Loam on slopes 15%or greater(Hb), and Kitsap Silt Loam on slopes 15% or greater(Kc).
Temporary and/ or permanent erosion control measures may be required for any site when land
disturbance is involved. Erosion control will mostly depend on the timeliness of construction,
moisture content of the soil, and amount of rainfall during construction. Soil erosion typical to the
existing conditions and planned disturbance of this project include wind-borne silts during dry
weather, and sediment transport during prolonged wet weather. Sediment transport of disturbed
soils could be from stormwater runoff or tracking off-site with construction equipment. Although
an engineered erosion control plan is not warranted for this project, Best Management Practices
(BMP's)should be employed during and after construction. Ordinary BMP's includes silt fencing,
protection of drainage outlets and vegetating denuded areas.
Erosion control information and specifications may be found in the applicable "Stormwater
Management Manual for Western Washington,"prepared by the Washington State Department of
Ecology Water Quality Program.
4.3 Seismic Hazards
Soils immediately below the expected foundation depth for this Project are generally Type D,
corresponding to the International Building Code (IBC) soil profiles. According to the IBC, the
regional seismic zone is 3 for this Project. The estimated peak ground acceleration ranges from
0.50g to 0.60g. This estimation is based on the United States Geological Survey(USGS)National
Seismic Hazard Project in which there is an estimated 2%probability of exceedance within the next
50 years.
There are no known faults beneath this project. The nearest Class `A' or 'B' fault to this property
is the Tacoma fault. This fault is Class `B', and is located approximately 1 mile to the north of the
Project. This information is supported by the USGS Quaternary Fault and Fold Database for the
United States.
The potential for liquefaction and other earthquake induced hazards are believed to be low for this
project. This is based on subsurface conditions such as soil characteristics and the lack of a
permanent and substantial shallow water table.Subgrade characteristics that particularly contribute
to problems caused by seismic events include submerged and confined, poorly graded granular
soils.Although gravel-and silt-sized soil particles could be problematic,fine and medium grained
sands are typically subjected to these types of seismic hazards.
4.4 Building Foundation Recommendations
Future buildings or carports may be an element of this project. Recommendations provided in this
section account for the site development of a typical commercial facility. The recommended
allowable bearing capacities and settlements as presented below, consider the probable type of
construction as well as the field investigation results by implementing practical engineering
judgment within published engineering standards. Evaluations include classifying site soils based
on observed field conditions and soil testing for this project. After deriving conservative relative
densities, unit weights and angles of internal friction of the in-situ soils, the Terzhagi ultimate
bearing capacity equation was utilized for determining foundation width and depth. Foundation
Envirotech Engineering Geological Assessment
PO Box 984 page 10 Parcel 12332-50-00021
Belfair,Washington 98528 Mason County,Washington
Ph. 360-275-9374 October 23,2023
parameters provided herein account for typical structural pressures due to the planned type of
development. A structural analysis is beyond the scope of a geotechnical report, and a structural
engineer may be required to design specific foundations and other structural elements based on the
soil investigation.
Stepped foundations are acceptable,if warranted for this project. Continuous,isolated, or stepped
foundations shall be horizontally level between the bottom of the foundation and the top of the
bearing strata. The frost penetration depth is not expected to extend beyond 12 inches below the
ground surface for this project under normal circumstances and anticipated design features.
A modulus of subgrade reaction of no more than 150 pci should be used for the foundation system.
Friction between the bottom of the foundation and soil may be utilized to resist lateral loads. A
coefficient of friction of 0.45 may be used for this application, and should account for the vertical
dead loads only.
Existing in-situ soils for this project indicates that the structure can be established on shallow,
continuous or isolated footings. Foundations shall be established on relatively undisturbed native
soil that is competent and unyielding. Alternatively, foundations may be constructed on selective
re-compacted native soil or compacted engineered fill as described in the Earthwork Construction
Recommendations Section of this report.
For a bearing capacity requirement of no more than 1500 psf,a minimum continuous footing width
of 15 inches shall be placed at a minimum of 12 inches below the existing ground surface atop
prepared subgrade and unyielding soils outside of existing fill areas unless the fill is reconditioned
per the earthwork requirements of this report.For a columnar load of no more than 3 tons,a circular
or square isolated foundation diameter or width shall be at least 24 inches. Foundation
recommendations are made available based on adherence to the remaining recommendations that
are provided in this report.Alterations to the aforementioned foundation recommendations may be
completed upon a site inspection by a geotechnical engineer after the foundation excavation is
completed.
4.4.1 Settlement
Total and differential settlement that a structure will undergo depends primarily on the
subsurface condition`s, type of structure, amount and duration of pressure exerted by the
structure, reduction of pore water pressure, and in some instances, the infiltration of free
moisture. Based on the expected native soil conditions, anticipated development, and
construction abides by the recommendations in this report,the assumed foundation system
may undergo a maximum of 1.0 inch total settlement, and a maximum differential
settlement of 0.75 inch.
4.4.2 Concrete Slabs-on-Grade
Interior slabs, if utilized, should be supported on a minimum of 4 inches of compacted
coarse, granular material (Retained on U.S. Sieve #10 or greater) that is placed over
undisturbed, competent native subgrade or engineered fill per the Earthwork
Recommendations Section below.
Envirotech Engineering Geological Assessment
PO Box 984 page 11 Parcel 12332-50-00021
Belfair,Washington 98528 Mason County,Washington
Ph. 360-275-9374 October 23,2023
The recommendations for interior concrete slabs-on-grade as presented herein are only
relevant for the geotechnical application of this project.Although beyond the scope of this
report, concrete slabs should also be designed for structural integrity and environmental
reliability. This includes vapor barriers or moisture control for mitigating excessive
moisture in the building.
4.5 Earthwork Construction Recommendations
Founding material for building foundations shall consist of undisturbed native soils to the specified
foundation depths. Compacted engineered fill,or selective re-compacted native soils may be used
to the extents provided in this Earthwork Construction Recommendations Section. The following
recommendations include excavations, subgrade preparation,type of fill,and placement of fill for
building foundations.
4.5.1 Excavation
Excavation is recommended to remove any excessive organic content or other deleterious
material, if present, beneath foundations and to achieve appropriate foundation depth.
Additional sub-excavation will be required for this project if the soils below the required
foundation depth are loose, saturated, not as described in this report, or otherwise
incompetent due to inappropriate land disturbing, or excessive water trapped within
foundation excavations prior to foundation construction. All soils below the bottom of the
excavation shall be competent, and relatively undisturbed or properly compacted fill. If
these soils are disturbed or deemed incompetent, re-compaction of these soils below the
anticipated footing depth is necessary. Excavations shall be completely dewatered,
compacted, and suitable before placement of additional native soil, engineered fill or
structural concrete.Subgrades shall be prepared for ensuing foundations and slabs by proof
rolling with a steel drum roller or a hand-held jumping jack.
4.5.2 Placement and Compaction of Native Soils and Engineered Fill
For engineered fill or disturbed native soils that will be utilized as fill material directly
beneath foundations, observation and/ or geotechnical testing is required prior to
foundation construction. The following placement and compaction requirements are
necessary.
For disturbed native soils or engineered fill beneath foundations, limits of compacted or
re-compacted fill shall extend laterally from the bottom edge of the foundation at a rate of
one horizontal foot for each foot of compacted or re-compacted fill depth beneath the
foundation. See the illustration below.
Envirotech Engineering Geological Assessment
PO Box 984 page 12 Parcel 12332-50-00021
Belfair,Washington 98528 Mason County,Washington
Ph. 360-275-9374 October 23,2023
FOOTING
COMPACTED
NATIVE SOILS
OR ENGINEERED 1
FILL
1
I I—I I '
UNDISTURBED SUBGRADE
Both engineered fill and native soils used as compacted fill should be free of roots and
other organics, rocks over 6 inches in size, or any other deleterious matter. If import
material is utilized as structural fill material for placement in building pad areas, we
recommend that it meets the current Washington State Department of Transportation
Standard Specification for Road, Bridge and Municipal Construction (WSDOT), Section
9-03(14), for Gravel Borrow. The material should be placed per the recommendation in
section 2-06 of WSDOT for sub-grade. Material should be placed in 12 inch vertical lifts
and compacted with a vibratory smooth drum roller to achieve 95%of the(ASTM D1557)
modified proctor.Each lift surface should be adequately maintained during construction in
order to achieve acceptable compaction and inter-lift bonding. Alternative materials may
be imported for this project and used for foundation support per the geotechnical engineer.
Temporary earth cuts and temporary fill slopes exceeding 4 feet in height should be limited
to a slope of 2:1 (horizontal:vertical). Utility trenches or other confined excavations
exceeding 4 feet should conform to OSHA safety regulations.Permanent cut and fill slopes
shall be limited to a slope of 2:1,unless otherwise approved by an engineer.
4.6 Retaining Walls and Lateral Earth Pressures
Retaining walls may be utilized for this project. The lateral earth pressures exerted through the
backfill of a retaining wall are dependent upon several factors including height of retained soil
behind the wall, type of soil that is retained, degree of backfill compaction, slope of backfill,
surcharges,hydrostatic pressures,earthquake pressures,and the direction and distance that the top
of the wall moves.A structural or geotechnical professional should design retaining walls based on
specific conditions.
Soil parameters for the structural design of retaining walls may be estimated as 134 pounds per
cubic foot(pcf)and 130 pcf for engineered fill and native soils,respectively. The angle of internal
friction may be estimated as 36 degrees and 34 degrees for engineered fill and native soils,
respectively. These soil parameters are based on soil type and placement conforming to the
Earthwork Construction Recommendations Section in this report.
Native soils may be used as retaining wall backfill for this project if the total wall height is 4 feet
or less and the recommendations below are followed. Native soils for retaining walls exceeding 4
feet in height must be approved by the local authority or evaluated by an engineer. Backfill may
consist of engineered fill,as presented in this report,or borrow material approved by a geotechnical
engineer. Compaction of these materials shall be achieved in compacted lifts of about 12 inches.
Each lift should be uniformly compacted to at least 85%, and no more than 90% of the modified
Proctor maximum dry density (ASTM D 1557). If pavement or building loads are planned to be
Envirotech Engineering Geological Assessment
PO Box 984 page 13 Parcel 12332-50-00021
Belfair,Washington 98528 Mason County,Washington
Ph. 360-275-9374 October 23,2023
located within retaining wall backfill, then 90% compaction is required. In addition, heavy
construction equipment should be at a distance of at least'/z the wall height. Over-compaction and
limiting heavy construction equipment should be prevented to minimize the risk of excess lateral
earth pressure on the retaining structure. Envirotech recommends that retaining wall backfill is
compacted with light equipment such as a hand-held power tamper.If clean,coarse gravel soils are
utilized as engineered fill,and surcharges will not influence the retaining wall,compaction may be
achieved by reasonably densifying granular soils with construction equipment.
4.7 Surface and Subsurface Drainage
Positive drainage should be provided in the final design for all planned buildings. Drainage shall
include sloping the ground surface,driveways and sidewalks away from the project structures.All
constructed surface and subsurface drains should be adequately maintained during the life of the
structure. If drainage problems occur during or after construction, additional engineered water
mitigation will be required immediately. This may include a combination of swales, berms, drain
pipes,infiltration facilities,or outlet protection in order to divert water away from the structures to
an appropriate protected discharge area. Leakage of water pipes, both drainage and supply lines,
shall be prevented at all times.
Drainage control is not restricted for this project from a geotechnical standpoint,except infiltration
should be avoided within 20 feet from the top of fill slopes.
4.8 Parking and Pavement Analysis
The pavement section design analysis was completed using AASHTO's Guide for Design of
Pavement Structures. The AASHTO procedure utilizes a Structural Number(SN)which is used to
determine thicknesses of pavement structural sections based on their corresponding structural
coefficients. The structural number is determined from a nomograph utilizing Equivalent Single-
Axle Loads (ESALs), Reliability (R%), Serviceability Loss (OPSI), Standard Deviation (S.), and
Soil Resilient Modulus(MR)of the subgrade soil.
ESALs =(ADT)(365 days/yr)(N)(DDF)(DLDF)(GR)(PT)(TF)
ADT =2-way Average Daily Traffic Count
=20(assumed)
N =Pavement Design Life
=20 years
DDF =Direction Distribution Factor
=50% (50-50 split each direction)
DLDF =Design Lane Distribution Factor
= 100%(one lane in one direction)
G R =Growth Rate
=0%
PT =Percent Trucks
=50%
TF =Truck Factor
= 1.7(common default value)
Envirotech Engineering Geological Assessment
PO Box 984 page 14 Parcel 12332-50-00021
Belfair,Washington 98528 Mason County,Washington
Ph. 360-275-9374 October 23,2023
ESALs=(20)(365)(20)(0.5)(1.0)(0.5)(1.7)=62,050
R% =80% (Reliability value for local access)
OPSI =2.0 (Serviceability Loss for local access)
So =0.45 (Standard Deviation)
MR = 1155+555(R Value)= 1155+555(30)= 17,805 psf
where R-Value is interpolated from soil results
The flexible pavement nomograph presented in the AASHTO Guide, was used to calculate the
structural number of 1.6.In conjunction with known or assumed pavement layer depths(di,etc...),
typical published structural coefficients (al, etc...), and drainage coefficients (ml, etc...), as
needed,the following formula was used to determine the pavement structural section.
SN<aid, +a2d2m2+ ....+aidimi+ ...
1.6<_(0.42x2 in)+(0.14x2 in)+(0.14x5.0in)
where a=0.42 for asphalt concrete(class B)
a=0.14 for CSTS
a=0.14 for CSBC
Based on the result of the analysis provided above, Envirotech recommends that the following
pavement elements be utilized at a minimum:
Asphalt concrete 2.0 inches
CSTC 2.0 inches
CSBC 4.0 inches
Envirotech recommends construction to occur during the dry season(May 1"to October 31s`)if at
all possible. The upper organic laden soils should be removed beneath proposed roadway sections
to a depth so that the necessary fill and/or pavement structural section is atop the underlying sand
and gravel layer. Upon excavation, the native subgrade should be proof rolled with construction
equipment to a firm,unyielding condition. If necessary,engineered fill soils should be placed and
compacted in order to achieve proper grade. Engineered fill soils should be approved by the
geotechnical engineer,and compacted to at least 95%of the modified Proctor.
Upon satisfactory completion of the subgrade preparation and necessary fill, the overlying 4.0
inches Crushed Surfacing Base Course (CSBC), 2.0 inches of Crushed Surfacing Top Course
(CSTC) and 2.0 inches asphalt concrete layers may be constructed. New CSB/TC should meet the
requirements of Class B foundation material from the Washington State Department of
Transportation Standard Specifications for Road,Bridge and Municipal Construction.Furthermore,
the base materials shall be compacted per the (ASTM D1557)modified Proctor. Each lift surface
throughout the project should be adequately maintained during construction in order to achieve
acceptable compaction and inter-lift bonding.
Envirotech Engineering Geological Assessment
PO Box 984 page 15 Parcel 12332-50-00021
Belfair,Washington 98528 Mason County,Washington
Ph. 360-275-9374 October 23,2023
5.0 CLOSURE
Based on the project information and site conditions as presented in this report, it is Envirotech's
opinion that additional geotechnical studies are not required to further evaluate this project.
Due to the inherent natural variations of the soil stratification and the nature of the geotechnical
subsurface exploration, there is always a possibility that soil conditions encountered during
construction are different than those described in this report. Therefore, it is recommended that
Envirotech is promptly notified if project and subsurface conditions found on-site are not as
presented in this report so that we can re-evaluate our recommendations.
This report presents a geological/geotechnical assessment, and is intended only for the owner, or
owners' representative. Furthermore, this report is only valid for the project information and
location described herein.
The services described in this report were prepared under the responsible charge of Michael Staten,
a professional engineer with Envirotech.Michael Staten has appropriate education and experience
in the field of geotechnical engineering in order to assess landslide hazards, earthquake hazards,
and general soil mechanics.
Please contact Michael Staten at 360-275-9374 if you have any questions, comments, or require
additional information.
Sincerely,
Envirotech Engineering
Jessica Smith,M.S. Michael Staten,P.E.
Staff Geologist Geotechnical Engineer
Envirotech Engineering Geological Assessment
PO Box 984 page 16 Parcel 12332-50-00021
Belfair,Washington 98528 Mason County,Washington
Ph. 360-275-9374 October 23,2023
APPENDIX A
SITE PLAN
SCALE, I ISCH - :00 FEET
2 !:ca
PROPERTY LINE
ti� 7P
of EXISTING NGRESS/ '91RESS
Q PAVED
PARKING PROPOSED
h PO BUILDING 3C
EXISTING
4r DENTIST'S AREA
OFFI TPI0
2 CE Bit 14%3
PROJECT/ OVNER/ LOCATION,
SINGLE FAMILY PROPERTY
GEOLOGICAL ASSESSMENT
SWIMS
23240 E STATE ROUTE 3
PARCEL 12332-9C-0',gP:
PAS13M ASHIKT13N
LEGEND ENGINEER,
EHVIROTECH ENGINEER[NG
-•a SLOE INDICATOR BOK 904
BELFAIR, VASHINGTON 995PO
PO PROBE 3W-275-9374
TPIe TEST PrT SITE CLAN
APPENDIX B
SOIL INFORMATION
TEST PIT LOG
TEST PIT NUMBER TP-1
PROJECT: SFR Geological Assessment DATE OF LOG: 06/12/2023
PROJECT NO: 23203 LOGGED BY: MCS
CLIENT: Studerus EXCAVATOR: N/A
LOCATION: Parcel 12332-50-00021 DRILL RIG: None
Mason County, Washington ELEVATION: N/A
INITIAL DEPTH OF WATER: NIA FINAL DEPTH OF WATER: N/A
SOILS RATA, STANDARD PENETRATION TEST
DEPTH SAMPLERS USCS DESCRIPTION LL PI CURVE
AND TEST DATA DEPTH N 10 30 50
0
SM Brown,moist,medium dense SILTY
SAND with GRAVEL.Gravel is fine and
subrounded.Sand is primarily coarse.
1j Non plastic.
2
3
Excavation terminated at approximately
3.0 feet
4
5
6
7
8
9
10
I
No Groundwater Encountered ENVIROTECH ENGINEERING
This information pertains only to this boring and should not be Geotechnical Engineering
interpreted as being indioitive of the entire site.
TEST PIT LOG
TEST PIT NUMBER TP-2
PROJECT: SFR Geological Assessment DATE OF LOG: 07l1712023
PROJECT NO: 23203 LOGGED BY: MCS
CLIENT; Studerus EXCAVATOR; N/A
LOCATION: Parcel 12332-50-00021 DRILL RIG; None
Mason County, Washington ELEVATION: NIA
INITIAL DEPTH OF WATER; NSA FINAL DEPTH OF WATER; NIA
STANDARD K NETRATION TES'.
S OIL STRATA,
DWTH SAMPLERS 115L5 DESCRIPTION L_ PI CURVE
AND TEST DATA DEPTH N 10 30 50
...................--................
SP Brown,molst,medium dense POORLY
GRADED SAND with GRAVEL and
traces of silt.Gravel Is fine and
subrounded.Sane Is primarily medium.
Non plastic,
2
T -
Excavatlon terminated at approximately
A,0 feet
o
No Groundwa:e,EncountereG ENVIROT LCH ENGINEERING
rnrs fi ems U,per[arns a.,;ro m s eonry a�dsrtvKt-ores Geotechnlcal Englneering
inrcrprctvC as Laing indr:Kve:ar Gka rnEro s7e
Map Unit Description:Everett very gravelly sandy loam.8 to 15 percent slopes--Mason
County.Washington
Mason County, Washington
Eh—Everett very gravelly sandy loam, 8 to 15 percent slopes
Map Unit Setting
National map unit symbol: 2t62b
Elevation: 30 to 900 feet
Mean annual precipitation: 35 to 91 inches
Mean annual air temperature: 48 to 52 degrees F
Frost-free period: 180 to 240 days
Farmland classification: Farmland of statewide importance
Map Unit Composition
Everett and similar soils:80 percent
Minor components:20 percent
Estimates are based on observations,descriptions,and transects of
the mapunit.
Description of Everett
Setting
Landform:Karnes,eskers,moraines
Landform position(two-dimensional):Shoulder,footslope
Landform position(three-dimensional):Base slope,crest
Down-slope shape:Convex
Across-slope shape:Convex
Parent material:Sandy and gravelly glacial outwash
Typical profile
Oi-0 to 1 inches: slightly decomposed plant material
A-1 to 3 inches: very gravelly sandy loam
Bw-3 to 24 inches: very gravelly sandy loam
C1-24 to 35 inches: very gravelly loamy sand
C2-35 to 60 inches: extremely cobbly coarse sand
Properties and qualities
Slope:8 to 15 percent
Depth to restrictive feature:More than 80 inches
Drainage class:Somewhat excessively drained
Capacity of the most limiting layer to transmit water(Ksat):High
(1.98 to 5.95 in/hr)
Depth to water table.More than 80 inches
Frequency of flooding:None
Frequency of ponding:None
Available water supply,0 to 60 inches: Low(about 3.2 inches)
Interpretive groups
Land capability classification(irrigated): None specified
Land capability classification(nonirrigated): 4s
Hydrologic Soil Group: A
Ecological site: F002XA004WA-Puget Lowlands Forest
L's N Natural Rosources Web Soil Survey 1211712022
Conservadon Service National Cooperative Soll Survey Page 1 of 2
Map Unit Description:Everett very gravelly sandy loam,8 to 15 percent slopes--Mason
County,Washington
Forage suitability group: Droughty Soils(G002XN402WA),
Droughty Soils(G002XS401 WA),Droughty Soils
(G002XF403WA)
Other vegetative classification: Droughty Soils(G002XN402WA),
Droughty Soils(G002XS401 WA),Droughty Soils
(G002XF403WA)
Hydric soil rating: No
Minor Components
Alderwood
Percent of map unit:10 percent
Landform:Ridges,hills
Landform position(two-dimensional):Shoulder
Landform position(three-dimensional):Nose slope,tall
Down-slope shape:Linear,convex
Across-slope shape:Convex
Hydric soil rating: No
Indianola
Percent of map unit:10 percent
Landform:Eskers,kames,terraces
Landform position(three-dimensional):Riser
Down-slope shape:Linear
Across-slope shape:Linear
Hydric soil rating: No
Data Source Information
Soil Survey Area: Mason County,Washington
Survey Area Data: Version 18,Sep 8,2022
u50W Natural Resources Web Soil Survey 12/17/2022
3� Conservation Service National Cooperative Soil Survey Page 2 of 2
File Or,pnai and Fast Copy wnh
DsparlmMt of F.potolry WATER WELL REPORT APPI cation No
Second Copy-owned Copy
•nurd Copy-Driller's copy STATIC Or WAUZNGTON
Parfet No.
as (1) OWNM Nam, .... u..erry Byer!.! .._.. ............. c 23110 'wv ? relfair, .,Ia.. Addre�t r OPC^^
L (2) LOCATION OF WELL;
FL caumr.... z_asori................._........_.... —�.�•t..•` ..� ser.�2. .T.23x.,Rl''l..wM.
Beuln[sad designee trrtm asenon or subdlWHon rnrMr
(3) PROPOSED USE. Domestic Q Industrial ❑ r[umeipal❑ (10) WELL LOG;
41 Irrigation,❑ Test well ❑ Other ❑ Fomstlan:DNeribs by1r rotor,chp,srter sw of the regions,to each
material and seruetun,and
sh thlekneat of aQtMl,n and Mekt.d and nature o/
ow
(4) TYPE OF WORK: Owner's number of well Krolum f reetmeed,with at Issas one entry for at ek ehawpe of loranetton.
N of m than oriel.... ........ ...................... 1tATiRIAL
NOWweu Method:Dw[ ❑ Based ❑ FAWN TO
4-- Deepened ❑ Cebit, Driver,o Arown,sand_gravel _ 0 2
= Reconditioned❑ Rotary❑ reettla ❑ s a fl a ve 1 e 1 a 2 21--
C (5) DIMENSI NS: Diameter of welt. Dr. sand som -rare)_ 21 , 20
••�� ...?.....•.].. .belies.
0 15
Dri11W....SJ:::.........n. Depth of eompMlee wU......53R_..___1t. Br. sa.Lld__-------�------ 2U
Br- aanI --wester-- — - -- K - 6 _
(6) CONSTRUCTION DETAILS: Br. sand water very fine_ __ _._6.. 6
Cast Br. clay --- 6 - -
O
Casing ided 0 ted: ..�........••Diem.from....._0..._n.to.S�b_n. Br.. sand very f isle^ cla wat r , 72. -� ^rnr,.aed❑ .....• Dt.at.?ram............n.to...---...._...n. 3f
Welded$`J .............Dlatn.tram... ...__.R.to................n, Blue clay 2 ?4. _
a► Stray sand Pine, water cla R
Perforations; yN❑ No 16 F�_
�J clay seams mud
i rrae of perforator used............_.....___,_............. ._.__........................_ Blue Clay 16 20
O —stza of perforations .. ............... m.by . . .._..............b. Blue clay seams :?ud 204 200...__..._....petroratton.horn.............._.......n.to_.........._........n. - —
pertoratiooa from_........_... ft.to......----...._....n. Blue clay 20
....................perforations ftoto................... n.to........_......_... n. Blue sandy__clay 2 2 2 4
eo Blue sandy clay seams mud 2 _ 2 9
$CreenlC Yes RI No❑ --
93 Johnag.r......_..................._..._..--.--._... tie and clay -- 8 M_
Type "�';e��H• Blue sandy-p a le and __
Type.......y� I'I.eid.-..�(f�.1,'1..........Y��d�ejI Na.._....-.._____....__...
aL. mam....9.......-.St.,airs a 02.Q from..517.n.to 532..n. clay 4 2 -
Dum.....6...... slat site-Q4.0 from_.532.tL b.... 3.7._:< Gray clay_.lenses f ine_--sand 2 4 0
Lis — S;ray clay --Gra-1 packed: Y 440 0
r- N❑ N.rx sere et[ravel:...._._..-........_..
tp Srav_ 311dy clay 450 460
L Gravel placed tram................. .._-_.._...n.to.............-.__........_._.ft. Gray clay --- 4 Q 4£''-
-- _._ _.
R Surface seal: Yes E x4o To wyat depth,.......1 Q.._...--ft proven clAy seams Fr, sand_,w_ er—.3 °p
Material used in ass,.....pent Onl Se....._..... ....._.._....._.. Br, clay seams sand Zr3v_Q ter�lrf�P tlo�
Did any strata contain unusable water? Yes❑ No 1l BBr, �sa�.ndd L��.�r..3��ye�1 el_}air—♦�_,._,}—+
O Type of water?.... ................. ..Depth of strata................... ... -Br., 3=1iL+—t gravel
HRSS�ELF u-L _ j
Z Method at«aura siren oar......_......................... cemented _ -_-- - __ _501 K 3
.I..................
H
(7) PUMP: tdanuheturera xama................... ..._......... mown sand gravel :eater--
._..._..._............_...... _
,a Type:........_........... ......................... .. ......................HP......................... B.4IDe__�.£ e• S23
>+ (8) WATER LEVELS: Land-aurtaee clevauon ------
r�a, 1�1.1 above een sea level.... ..........fi r...-....rive
1V'r rune level ......_ _. ..........._t[. m ..
below to of well Data.. •Drava.- ''—�—
P �.o.....:._._ —_O Artesian pressure........... .............Ilea.Per square Inch Wte..........._...._........-- •. frE13 -
(� Artesian water is controlled bY._.._._.................._......... ---
..........................
W ICap.valve.etcJ ___—__
_--
EPARTMtNl
Draevdown la amount water level,s ---- D
0 (9) WELL TESTS: lowered below static level {�(.)1� ampletM. "4.y.a
Was■Pump test made? Yes❑ No❑ It yes.by whom,...... weft maned"
[al./min.with ft.dnwdawn after hn 11'_..:3.Id .a._..,
Yield:
tL WELL DRILLER'S STATEMENT:
— This well was drilled under my jurisdiction and this report is
_ true to the best of my knowledge and belief.
R sec nays dsta itime taken as Zero whe m n pup turned on er) (wst level
fl. ,reassured tram wait top to water level) e,
Ol Tim! Water noel Time Water Level Tame water Use, NAME........... 1G21.01S.Qn._Dr.,lling. C.o..
0 I (Aetwa.Ilan,or eorpontton) (Type or print)
0^ pox 123 -ort 0 chard a.
... ........ .... ............r................................_........................_................ Add.........:_r_..----.....:-.........._..........:._..........._......-...............J.....:a..........
H ............... ...............I....._. .................................................................
Date of test .... _...._............. _... (Signed]....... ........
Malter teat_.2.C_._. {al./mina with.--.QO.....n.dnwaown afW.-._,1._.......M. .........
..... ....__ ......
112
w
.fiesta.flow...._...................................__.....[.P.m. Date._................................_.._._._....
Temperature of water............Was a chemical analysis made?Yes❑ No Llceflse NO..........0.51^............ ........Datell..NOV.............,19.°.2
1USE ADDIfTONAL SKCVM IF NZCZSSARY)
fcr 050-1-20 ■fw 3