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HomeMy WebLinkAboutWQS Sanitary Survey - 9/22/1995 MASON COUNTY DEPARTMENT of HEALTH SERVICES Shelton,Washington 9B584 (360)427-9670• Betlair.275-4467 ENVIRONMENTAL HEALTH PERSONAL HEALTH WATER QUALITY P.O.BOX 1666 303 N. FOURTH P.O.BOX 1666 September 22, 1995 Max Walker 1091 NE LARSON LAKE RD BELFAIR, WA 98528 111131 RE: Parcel Number: 12330-53-00031 Site Address: 1091 NE Larson Lk. Rd. Dear Mr. Walker, 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 9/22/95 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. S incerely� Grant A. Holdcroft, R.S. Lower Hood Canal Lead (D Rxycled ON-SITE SEWAGE SYSTEM SURVEY LOWER HOOD CANAL CLEAN WATER DISTRICT Project: LHC Area. e(Yu,'R " Date: OWNER INFO��RNATION: /✓l�,rd�a;.lt. Owner's Phone: Itl9t NE 1�s� LJC . /(d, 0., 985Z� SITE INFORMATION : �`H�S CodE LoT o 3 / Parcel# : IZ330 — 53 - Ot�031 Well Depth: ra. m. Address: 10AI NE L.u, 5s = 1K City: &/hr State: WA— 7-ip:—q!§-2-9 Building Type: F (F-wu Time xeddeme; S -se..on.r, C i.w; M-nmw-nnutr; V-v.uM) Septic System Type: M- m.m; T - vee9 T..ee; H -om neo.e; O -m-; U -u�) installation Date: Year Last Pumped: 19001 (m Ya.a U - u. ) System Location:F (F-P Y.,d; B - R.et Y.M; S -sue Y..a; A - mj.e w; U- u.mw.) Number.of Residents: Shoreline (YIN) OCCUPANT INFORMATION(complete ody if different Me owmr): Occupant's Title: _ (tut, mn. ms) First Name: Last Name: Occupant's Phone: Would you lilte Information on Water Conservation? (Y/NJ Would you be interested in a Community Workshop? (Y/N) PERMISSION FOR ACCESS TO INSPECT THE SEPTIC SYSTEM: (YIN) SIGNATURE: , Date: 9 v Comments: gv le O� ssio �, Owner✓ R"isd rune 29, 1994 / @ o _ _ ; ! � . G ! � | , _ ■ | § � § ° § no k d E § � % j � § | | u & , e _ / 2 § §. - � B - ! e § § f | § 6 § � § � a I § §| z ° § � 0 t , 2 | ° d t d § § " \ f Z 2 . — z !! 1=z « § � LU � 9 § § \ ) © v ® ut . } 0 \ \ | / m |■ % » , �2 wo tl !3-3: \ g00z E |� o � \ 0 / } wq \ " e } rL ^ ' .i } / / ) / \ \ / \ ) oil i.. 7 /a � , LOWER HOOD CANAL FIELD INSPECTION FORM Initial Information:,,n Area: +'t' l�td��,� Added to databwe(Y/I): I, Owner Name: IM"r I W-C t J o- 6—r Permission to Inspect T: Site Address: F a I la. I at!r- l" Appointment Required?: Parcel#: 1 Z'33 O - St - DOO 3l Appointment Date: Occupant Name: VW c�-,u(� Inspections: Level 1: 21 5 5 Levi le 9111 '5 Level 2: Inspection Team: C3 Updated databwe(Y/N): Inspection Results: Distance between septic tank and surface water: I o�} (ft) Distance between septic tank and well: I o o-, (ft) - Distance between drainfield and surface water: --Lap 1- (ft) Distance between drainfield and well: I flo (ft) Occupancy(occupants/bedrooms): y Other(Larger on-site,business-etc... /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. (i.e.: 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 coliform count of>200fd100ml. _ An unpemutted outhouse was observed. Other: Additional Comments: System Classification: Pass: Fail: Suspect: Failure Priority: Pam rvefc rY«,N bou,o«n.god.vgy<3a v n.Sip.f� l: al W Nml.1: ViwJ mn.�^�a'rrK c*' eslcmr SIIW.3: 3«rrs[MPK 4:o16�m1 sot ai«oK m,(rc vs«.�:(Fh«�r on�Wtim,;Nammmb uamr d�oat m«'v¢ .u. r .r:rrkwity m z tow STYE DIAGRAM i VJ DYE PACKET RESULTS Sales 1 Rarieval Soria]Fstricval Seri=J Rc4icvil SW N_. . Datc DJe RmMa D.tc Date RmW Atc D.4 Rmtla Datc Dstc Res�lla Plate Rctrieae P4oeE RNic.e P4oed Rarieac Plamd Retricc BACTERIOLOGICAL RESULTS Site Date Results Number