HomeMy WebLinkAboutWQS Sanitary Survey - 2/2/1996 MASON COUNTY
DEPARTMENT of HEALTH SERVICES
Shelton.Washington 98584
(360)427-9670• Belfaic 275-4467
ENVIRONMENTAL HEALTH PERSONAL HEALTH WATER QUALITY
P.O. BOX 1666 303 N. FOURTH P.O.BOX 1666
February 2, 1996
Ricky Hastings
NE 1351 Larson Lake Lane
Belfair, WA 98528
-66Ak05 coJE LoY Vo
RE: Parcel Number: 12330-52-00080
Site Address: NE 1351 Larson Lake Lane
Dear Mr. Hastings,
We want to thank you for your cooperation with the Mason
County Department of Health Services, office of Water Quali-
ty, sanitary survey of your on-site septic system.
Your septic system was not found to be failing. If problems
were observed during the survey that had the potential to
shorten the life of your septic system, they were noted by
field staff. The purpose of this letter is to inform you of
the non-failing status of your system, and to advise you of
any such problems.
The following are observations our staff made on 1/24/96
while surveying your property:
The septic system appeared to be functioning at
the time of the inspection; no obvious problems
were observed.
Attached are some general comments about on-site sewage
treatment/disposal systems. If you have any further ques-
tions, please do not hesitate to contact me at (360) 275-
8733.
Sincerely,
6Ro
Grant A. Holdcroft, R.S.
Lower Hood Canal Lead
®Recycled
ON-SITE SEWAGE SYSTEM SURVEY
LOWER HOOD CANAL CLEAN WATER DISTRICT
Project: LAC Area: Date:
OWNER INFORMATION :
R;chy d-_%�a,, /40srj,ys za p
NE 1351 {,,so, l..h, R6J
uasr 13el�tur !lam 9d528 p
boao aM NFORM rION: J 71..J�,_ RvAY l S &JAC 11W S Cof SO
Puod i :/2330 -S Z - 00680 Owner's Phone:
AddrM!Ne 1361 LA,r-M 41'_ & City; State: AKA— Zip:
Building Type:F (F-Pon T.R..k.; S - Se.. .W Reci&.; C -Coro--W;
M - Multi-family Residence; V - Vacant )
Septic System Type: _ (S - Staodand tank and d-il&ld: P- Pros u Diq b tien;
F - s.nd Filter; M - mound; T - Deep Trench; H - art House;
O - Other; U - unknown)
Installation Date: I c,q I Year Last Pumped:
System Location: ? (F -Front Y"; B - Back Yard; S -side Yard; A- Adjacent Let;
U- Unknown)
Number of Residents: I Shoreline(Y/N):
OCCUPANT INFORMA77ON(complete only if different then owner):
Occupant's Title: _(ram, a , ars) First Name: Iast Name:
Occupant's Phone:
Would you like Information on Water Conservation? (YIN)
Would you be interested in a Community Workshop? (Y/N)
PERMISSION FOR ACCESS TO INSPECT THE SEPTIC SYSTEM: (YIN)
SIGNA'Tm i n� M A Date:
Comments:
�vp5a.
y� y
11
W S 3
LU
cn
22'
as
g r-
•
OD
3
X
f
• r t '
1 1
North
Bob Soltis, Inc.
h'.
Beards : 1
47<
y
Scale: 11344R- HA�
R't iy
1 .
FJ
d
LOWER HOOD CANAL FIELD INSPECTION FORM
;S co�6 *k5 TV' gC-'
Initial Information:
Area: 4 Added to database(Y/N)
Owner Name: (Zr,ac,. {}n 5 rr s Permission to Inspect T: _
Site Address: Appointment Required 7: NJ _
Parcel#: i,�,-3 s-a - nn9Rn Appointment Date: L
Occupant Name:
Inspections:
Level 1: ,4 Level 1C: t a 4 4 6 Level 2:
Inspection Team: L_HCg Updateddatabase(Y/N):
Inspection Results:
Distance between septic tank and surface water:
Distance between septic tank and well: n 1 A- ($) darn m S y's-k m
Distance between drainfield and surface water: /(jad (8)
Distance between drainfield and well: nl A- (ft)
Occupancy(occupants/bedrooms): 1
Other(Larger on-site, business..etc...): h .lnwt d .
�L The septic system appeared to be functioning at the time of the inspection; no obvious
problems were observed.
_ The drainfield area may be compromised due to vehicular traffic. (i.e.: parking, driving)
There are indications of poor system maintenance. (Le.: lack of regular pumping, leaky
plumbing, slow drains, excessive chemical dumping, high water usage)
Construction was noted in the drainfield area.
Sewage was observed entering surface water, confirmed by visual dye and fecal colifotm
count of>200fc/100m1.
_ An unpemdtted outhouse was observed.
Other:
Additional Comments:
�r.: rnissi.-n {a-r tnS-/xe�rm� l v�¢.n b+� room mak t�s4/g 6
System Classification:
Pass: Fail: Suspect:
Failure Priority:
l: aw NaY : My me wMc mv.. m ,<]fl vvl Sp.rm
SW.] Sc4, �,pin4 efm matcrzKm4: M , dkmivmrM.* ui mivvn,
® wR.cc vYa.5:R®.�aY rd.cuc.(oEor)
SITE DIAGRAM
�l
DYE PACKET RESULTS
Soria 1 RA.114 Soria I Rmirnl Soria 3 Rctrirnl
Silo
Number D@ Die ReudW DJe DRe RwW Die DJ RraW Dec Dtic R—h
Pl.sd Revieve Pl+md Rwieuc Plamd RNrvc P4cN Rwieve
BACTERIOLOGICAL RESULTS
Site Date Results
Number