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Home My WebLink AboutWEL2024-00031 - WEL Application, Design, Letter - 6/6/2024 ® MASON COUNTY 015 NB SHETREET 6HELT07 ,EXT 56 SH STREET, ,SHEL ON, EXT BELFAIR:360-275d 67,EXT A00 Public Health & Human Services ELMA:360482-5269,EXT 400 FAX:380427-7787 08/09/2024 SPEAR ET AL LOGAN & BRENNA ANDREW & MARCY SPEAR SHELTON, WA 98584 RE: WATER SYSTEM PERMIT., TWO-PARTY WEL2024-00031 )OOO(SE Lynch Rd 319024190002 The 2-party water system, Lynch Rd Lot B(31902419DD02/319024190001), 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, / David Anderson Environmental Health Specialist Mason County Environmental Health ASS I tl MASON COUNTY DANNA wei COMMUNITY SERVICES u mama Pumma E�m�a,me„w x..¢nmmm.nNxe.lm 415 N.61 !luect.(Bldg 8)—Shelton.WA 985M WEL Shelton 366427-9690 x400 Belfsir:3642154467 x400 Elme.360A82-5269 x w TWO-PARTY PRIVATE WATER SYSTEM APPLICATION pryLIpLNT PHONE Logan Spear 360-239-1541 uld" O....-SIB ,cm.STNTE,nP 1661 W Shelton Valley Rd Shelton, Wa 98584 WE ADDRESS-STREET,CRY.5TATE,MP xxx SE Lynch Rd Shelton, We 98584 Pe"ARY PARCEL NUMBER(wELL SITE) 319024190002 ECONOARY PARCEL NUMBER NF APPI1 ABLEt 319024190001 WATER souRCE BNew ❑Existing SOURCE nPF Well ❑Spring 191LOT slLE Pi 2LOT SUE PROPoSBD WATER SYSTEM NAME(REOUIREO) (l' Lynch Rd Lot B P.ECT OEscwPnoN Install two party well to service a single family residence on lots A and B gRENO W NS TO We CoNOIMAS US HWY101 South from Shelton to SE Lynch Rd. app. 4.2 miles out Lynch to site on left side of Lynch Rd Site Plan: (may also be attached) (property boundaries,structures,well site w1100'radius,driveway%roads,septidse,Mer components and lines,easemeMa,etc... See Attached �THOTEN JUN//06 2024 ey 1� Submittals Checklist: (these additional items will be required for approval) Satisfactory Bacteriological sample(this may be defamed if well is not yet drilled) Well Log with pump test or 4-hour capacity test performed by driller(this may be deferred if well is not yet drilled) Notice to Future Property Owners recording (record with Mason Co.Auditor, supply copy of recorded document) Septic Records(additional locating requirements may apply if there is a lack of septic records on file) Thia form may be scanned and available for public view on the Mason County Web site. Revised: 10/13/2021 Page 1 of 2 r .-------------------------------------.......---------.------------- 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? T (drainfields,tanks, buildings; indicate distance on plot plan) ❑ ❑ Are there roads within the 100 fee dius of It water gpgrce?If so, is road private, un r State. What is distance to ROW? ge M. ❑ ❑ Does the ground slope away from the water source site?(show slope on plot plan) �y ❑ ❑ Is the well cap satisfactory? ❑ ❑ Screened and vented? . ❑ The well casing extends 7 7 above level ground/concrete slab? (circle one) ❑ ❑ Is there evidence of a surface seal? Ldf: HF 1607 y ❑ ❑ Does the seal appear adequate? V/4 : - I1;01681 ❑ ❑ Is a variance necessary for well site approval? �: VFW Commends _ Pass ❑ Fail Inspector Date 1)6 Review Step 2: Two-Party Review: YES NO NA �A W ❑ ❑ Water Well Report with adequate pump test on file?#IYad+w 101116 c7I 6Rr�76tY r✓� 20y+sb,4W 60,hh�jea�el If NO,date of Capacity Test Y'V AiZ4 Driller r r l /Opt I} GPM 2' ❑ ❑ ❑ Received Satisfactory Bacteriological Analysis? Date of test t ❑ ❑ Received Signed, Notarized,and Recorded Notice? AFN Z ❑ ❑ System appears adequate to serve 2 single-family residences based on information provided? ,,,C...,,,,,orrr��lmments J� pr7 Approved El Denied Reviewer Date /N Findings in this review reflect observed conditions as they existed on the day of the site inspection. No claim is made,express or implied ofthe future success or failure ofthis system. Well site approval does not 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 of building permit per MCC 6.68. Water usage restrictions and additional fees mae apply to all new wells drilled after January 19a, 2018 per FSSB 6091. Revised: 10/13/2021 This form may be scanned and available for public view on the Mason County web site. Page 2 of 2 « # �� .��. . . . . ... . . . � � men, _ ' ; ( - ! ) » . $| , | ! � \ ` ■ � ) � 2� ! � / a E` | • | ] !]JAI, h , . •°: _ , � ] § - ! | Rui | # $] y m ` ! � % � ( | � ■ ! I � l i • • m� | nmlmgmll ] : Arcadia Drilling Inc. P.O. Box 1790 Shelton,WA.98584 Customer: Logan Spear Well Tag#: BPF197 Site Address: SE Lynch Road Depth: 202' Date of Test: 7/31/2024 Static: 95, PUMPS t' um Set: 140' TIME GPM LEVEL RECOVERY 1 Min 3.5 96 TIME LEVEL 2 Min 3.5 96 mMin96 3 Min 3.5 96.1 4 Min 3.5 96.1 5 Min 12 96.1 6 Min 12 98.7 7 Min 12 98 8 Min 12 99 9 Min 12 99 10 Min 23 99.1 15 Min 23 103 20 Min 23 103A r� 25 Min 23 103-6 4 30 Min 23 103.9 pUG p 9101 35 Min 23 103.952 40 Min 23 1 104 RECE\VET 45 Min 23 104 50 Min 23 104.1 55 Min 23 104.1 1 Hr 23 104.2 1 Hr 10 Min 23 104.3 vanguam"Donor}' 2635 Parkmont Lane SW,Suite A Olympia WA 98502 �9�1k V"tTAfD 3W967.7010 CMFoMat BACTMMAKALYWEM R�GF1 � ar S.,ow Cotlec@a Tire`serot any W07/2024 a o+ MASON Trye d Wm.SF�.m`Id+m amT an taI ❑CH WA ❑0"s momm Cemm A W tulle 8 SnAam-PoblisW n WW FKWM Mbf(FIFA: 0F .— _ _ — - - sy—N— LOGAN SPEAR Ca inorl.Am.me 0,06%W )*v (WC )4253395 crwmrl 1 Em Ew Pta.. l aN.Fr.Y IPWe M imn,eaAwl ne w anY a ewa5 wepsrYlgmn A/O Me�C.a.enln0 vm SAMPLE/MFOWATpM ._... s.rormmxa"la.ael SHAD sobk maaton vfem remle aXeckO^_5oec¢i nwceae.canm.m MBPF19T SE Lynch Rd.Shelton TEpMamelbwwa*mvpol Sao tamvan t ho*s aennl t.paeeWNwwavoeaeepom zOaeremaselabonq ChMemW Ym_!+a____ NP.r"aeroir.r:m��n.wa were; CILw.aW/TM—Fme_ �ml�M.dry muYe W narMr. 361'm' reell lWIrRt lYI Bwae SmWtt mmiemb[tdw.. �I CTW+ra6a.yei No ❑TIW4d(AR) ClMine ReeeW'ima_Fm_ ❑Ana.n.rrt jAP) A amlrt WOMPNSana1`n SW4*(Enulenlim) 8 a QE rok ❑Peal 51111 Fdmfebemmow LABUSE0IAY 00MUpWATNI MILTS IABUSEOMY ❑WnNWWyTad Caaam Pn.ealena ®tW�Y ❑EaFpw>+I ❑Eca+dme tWWWae kj R*@ b:TMCdAvn room E.ai MOW Fad LoYlam Merl. INC It PI hallo .41I.IWORWAIe5: ❑TWC ❑sw*wom ❑ S.p4vdaae ❑nemepM Conaw ❑ R0 O YZf V q.ioT c' 1tl°°`"" SM9223B (m PapmclXiH lm.ft pONUbSA.DYI 2W wnr�••nrr. - � .0 22137550TMASON CO WA Return To uuiiiiiuii /$h. P./ Fen dLy R✓F �y 20l . Y 4Q s Grantor(s): (1) �no..✓ R✓nnAe 1Pea✓ , (2) - ✓o r S&dtl �a✓ V liOAav Grantee(s): (1) PIJBLIC -� Legal Description (1) r7 b / dFl ?tot�lb,lock11,plai or secron, mw�Lr��N, range) Assessor's Tax Parcel: (1),��_Z--1+-��.Q 12-2. 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, State of Washington, has been designated to serve a source of water to the following parcels situated in Mason County, State of Washington; +herein described: �_L Q Tax Parcel: (Connection 1) 3- 2--�L'-1O QD Tax Parcel: (Connection 2) 3 L Z -_q-_L'_- 0 Q- 0 The system owner is responsible for keeping Rthissysttem in compliance. The name of the water system is: �rt rh d L n+ f3 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. This system (has/ has not) been granted one or more waivers from specific provisions of the regulations. n , Dated on this�{Ik day of Ilul�, 2g�- Signature of Grantor(s): �T"�, (1) (2) J Page 1 of 2 State of Washington ) County of Mason ) I, the undersigned, a No ry Public in an or the above named County and State, do hereby certify that on this ay of . 20, 1, J` Azf .�. CPJI1tC� pets nally appeared befo7d me,Who is known to be si ner of the above instrument,bnd acknowledged that he(she) ey) igned it. GIVEN under my hand and official seal the day and year last above e/^c! J � f �p°.�......,,,, Notary Public in aryd for the late of W[s<Zington, AE'R c, q +,y residing at D O }( { , My commission expires: Ll .."!701:... ,ua �w FWASHyH.�' �wuuuun+w"`_ Page 2 of 2 E$ I 264'a/. RA HI / i I g I I >A I I I I I I I I - I I �� I I e I I k I I 6 M.Halverson Design LLC Logan Spear sunlxo: - Pamelk 3190241-90002 PO eox 1519 S�elbn Wa 9a584 a Mail,Pooh w SMI-n vamy as I OT�R OF SP xlma '' Halvemandesi nll outlopk.wm snap,w:ease, 1 I g N Rg 15T r/. && `-�ay I I mm933#ns`� FEri as@l a' 'SAS' 8 UF? -��a3 3 ggnmQ p_ 3'4 I ms I I ¢ > ` "-------- L I I I r) V I I tl IOU I I M.Halverson Design LLC Logan Spear sumon Parcel#3190241-90001 PO Box 1519 Shelton We 98584 a ft^a 200O W 5nerton valley ae LOT A OF SP#1 ma 1 Halt' mndoe nllc utlook.com Snellon,Wa ae5ea