HomeMy WebLinkAboutSWG Letters / Memos - 5/22/1998 MASON COUNTY DEPARTMENT OF HEALTH SERVICES
POST OFFICE BOX 1666
SHELTON, WA 98584
(206) 427-9670
FAX 427-7798
May 22 , 1998
Dorothy Ethridge
PO Box 40531
Bellvue, Wa. 98015
RE: Parcel Number: 12330-51-00017
Site Address: NE 140 Galley Way
We want to thank you for your participation with the Mason County
Department of Health Services in the Lower Hood Canal sanitary
survey.
Your system was surveyed on 5/18/98. At the time of the
inspection, your septic system appeared to be functioning and has
been given a non-failing status.
For your information, operation and maintenance guidelines for
you septic system have been enclosed.
If you have any further questions, please call me at 360-427-9670
ext.353.
Sincerely;
Cindy E. Bingham
Water Quality Technician
ON-SITE SEWAGE SYSTEM SURVEY
_ PERMISSION TO INSPECT FORM
w Project: Ilic �Cfl I� �
OWNER INFORMATION
JAN 2 1 1998
Name: �(�.� �TM(cED6E,
Address: HEALTH SERVICES
II v tie intro 4801 S
SFFE INFORMATION :
Parcel k : P 33a- 5I-0oQ o Owner's Phone: a)(p �o4�-3(o-la
Address: NC ILn GN11e s (Lq City: State: WA_ zip: 9
Building Type: F (F-Fun Time Reside ; S - Smsoml Residence; C Commercial;
M - Multi-family Rmldonco; V - Vwc )
Septic System Type: (S - Srmdara sank and dminfield; P-Prwsuro Distd%ution;
F - Seed Finer, M -Mound; T - Deep Trench; H- out House;
GO - Other; U - unmewa'))
Installation Date: U Year Last Pumped: 19 91.E (Freer Year or U- Utdmur�)
System Location: (F-Front Yard; B - Back Yard; S -side Yard; A - Adjacent Lot;
U - Unknown)
Number of Residents: U Shoreline (Y/N): ,
OCCUPANT INFORMATION(complete only Udlderent tkan owner):
Occupant's Title: (nut, t , ms) First Name: Last Name:
Occupant's Phone: -
PERMISSION
PERMISSION FOR ACCESS TO INSPECT THE SEPTTC SYSTEM(( i(YIN)
SIGNATURE. P Date: (- h::qz--
Comments: U r�k ray VJ -