HomeMy WebLinkAboutWEL2024-00009 - WEL Application, Design, Letter - 2/13/2024 84
MASON COUNTY 415 N6THELTON: 6'4'7-O70,EXT5
SHELTON:3804274870,EXT 400
BELFAIR:360-2754487,EM 400
Public Health & Human Services ELMA:3604825269,EXT 400
FAX 360427-7787
WATTERS JR RONALD D
261 SE HARRIER RD
SHELTON, WA 98584
RE: WATER SYSTEM PERMIT: TWO-PARTY
WEL2024-00009
261 SE Harrier Rd
320334150020
The 2-party water system, Watter-Wafters Water System (320334150020/320334150010), 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
(dflol?o1`(
MASON COUN M
COMMUNITY ER �Sp 6 AmuM a� R s der:
ena9Pr.,:yE ...uN.Ne.c B/VF
415 N.6°Svaa(Bldg 8)-ShE1Uxa,A 98584
° wEL a01;U- 0000
Shahan: 360427-9670 x400 aelfur:360-2V54 7xa00 Cleo:3MA82-5269 x
,1
TWO-PARTY PRIVATE WATER SYSTEM APPLICATION
T
APPLICANT i/10 HACA, AlD vxoxE
MAEnp AOOR,EBB-BTIIEET.CST,FTATE Ii
2fvl SP ffRevlE2 Rb 54F LTceJ 1 WA A
SITE MORENE-STREET,CRY,"ATE,el'
21PI RAWMe 2P Si Wh "I Lf
PRIMARY PARCEL NUMBER(WELL Sire
32033-ti-94020
SECONDARY PARCEL NUMBER iF APPLICABLe
32033-'il -50010
WATER SOURCE BgpCETYR PARCEL LOT SRE PARCELi LOTSYE
❑ New EkFxis[iug Well D Spring 11.2 AUCS S�DO ApKES
PROPOSED WATER SYSTEM NNIE URECUIREIR
WATme,_-WADS WKr1:.2 S S'fEVvI
PROJECT OESCNPTpN
paovibaWA-MP- T-c 32o33-Hl-sooi6
DNIECTONSTOSRPICMIOnpxs LFfT
f9om LOLE eo -rAr.- LF. TO 030r PIAMT -r^OM 90, �-ofi—wNSHT To I-V1P.fdiu e -
Tdc`sfWktloLl IS 0',L11 A41 YIP,d1 HAepup
Site Plan: (may also be attached)
(Dra,edy bounoalies,svuGurse,WBII site WnW Tedus,cidve+2ys,roads,septidsew r components and lines, easements etc.-)
roc DF_' c i AQQ NOD ( � RvCW f�+ *z
Submittals Checklist: (these additional items will be required for approval)
'9 Satisfactory Bacteriological sample(this may be deferred if well is not yet drilled)
�9 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)
�i Septic Records(additional locating requirements may apply if there is a lack of septic records on file)
This form may be scanned and available for pudic view on the Mason County Web site. Revised: 10/13/2021
Page 1 of 2
—Staff Use Only ---
Review Step 1: Well Site Inspectlon:
— Ho✓4 `60
YES NO NA
❑ ❑ Evidence of existing sources of contamination within 100 foot radius of water source?
(drainfields, tanks, buildings; indicate distance on plot plan)
❑ 'P ❑ Are there roads within the 100 foot radius of the water source? If so, is road private, County or State.
What is distance to ROW?
;f ❑ ❑ Does the ground slope away from the water source site? (show slope on plot plan)
1J ❑ ❑ Is the well cap satisfactory?
1 ❑ ❑ Screened and vented?
❑ The well casing extends Z., above level ground/concrete slab? (circle one)
I] ❑ ❑ Is there evidence of a surface seal? (,Qf:1;,1166S14
❑ ❑ Does the seal appear adequate? ((jw: -125 .058546E
❑ EP ❑ Is a variance necessary for well site approval?
Comments
Pass ❑ Fail Inspector Date
Review Stop 2: Two-Party Review:
YES ,NO NA
❑ IAf ❑ Water Well Report with adequate pump test on file? �I
If NO,date of Capacity Test (Z ho/zo;3 Driller % �r 9{ GPM
❑ ❑ Received Satisfactory Bacteriological Analysis? Date of test��r Z
❑ ❑ Received Signed, Notarized,and Recorded Notice? AFN Zza" j6
❑ ❑ System appears adequate to serve 2 single-family residences based on information DrUvjQad?
Comments ARC,
C�C���O
ICJ Approved ❑ Denied Reviewer Date
/, 1 HFgiTH
Findings in this review reflect observed conditions as duty existed on the day of the site inspection. No claim is made, express
or implied ofthefuture success orfailure ofthis system. Well site approval does not constitute water system approval. Water
System approval is a twopori process.
All proposed connections to new wells are subject to water adequacy requirements at time ofbuilding permu perMCC 6.68.
Water usage restrictions and additional fees may apply wall new wells drilled after January 19m,2018 perESSB 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
%via ftn" 91c.
340WE DauieTwm 71d
ftq/ak'w o Man
(360)301-6107
Project 261 SE
Harrier RD TAG: NA
Capacity Test
Date 12/20/23
Pump 1.5HP
Well Depth 140ft
Static Water Level 77.5ft
Draw Down Recovery
Time Water Level GPM 0 83.9ft
0 min 77.5ft 0 1min 79.411
5 min 84.5ft 13.0 2 78.4ft
10 min 83.7ft 13.0 3 78211
15 min 83.811 13.0 4 78.1ft
30 min 84.Oft 13.0 5 78.Oft
1 hr 83.8ft 13.0 10 77.8ft
2 hr 84.1ft 13.0 20 77.7ft
3 hr 83.9ft 13.0 30 77.6ft
4 hr 83.9 13.0 40 77.5ft
45
Capacity Notes:
Over the course of the 4hr capacity test, the well at 261 SE Harrier Rd. Shelton,WA 98594
produced at a consistent 13GPM, for a total of approximately 3,120 gal.
26376 Twave '
sac SPECTRA Laboratories -Kitwp
Pwbba WA .__... —.-
98370
360 msui COLIFORM BACTERIA ANALYSM FORM
Oaa Saroa CcacbO 7 d CauM
11120� 2� 2� 1✓(�0t'-1
rww a« w.
TWeoi Wear Sr3W 0a*orhWba)
❑GMpA ❑GmFs _
Ca AsWGaVBSFWM-RewelmeWtlr Immnwr'IWR
8gam"M`2/YI
rxeakFinac
pq{yaa Od Rmia
Emmt: Eva Pkea
Bwf ravmb:prm..�.r...+q«w.rsw.rrr.p+ra
SAMPLE RUam om
Smpa mtecb6 by Ommy
Specacbm6mamas�.-.��aaammma
I I �1hY
Type a soma(a+a mdr a+mq
f.❑ROWmabMWtlon smaa W% x❑Nw+areal NA
auomme:rm ❑ Ro❑ mmam amMa
IbeaMYWrynvbr mlmwb W
Cbbme RaMuk TaW_Fwe_
3.amuMMavlbrab &Wle ---
i i 1 Uaesae1mF10YYRo411kaVe
CMaakra Yae_RL_
OumA M CAWWWIOATebL_Fm
' ❑elvmmMl PwP)
l 8aamaOWl Remswea Ylmarseepe�mmma6oa) ) a �
❑ E cab ❑Facel mna r«_re_ L.�--Li
� 5. CaeamrinfwemrrOM/.
LABusEOPLY ORMMWATERRESULTS LAB my
❑UMIO%CWV Ta Catbrm Pmsmem+
❑E.mbpemit ❑Ealffiarl
BM "Dw"Rper:Ta Ctllbm___jpWIOOmL Ec*--MOMlOW
Fa Co6bm__aW10 I --CWW
Rpacmma AmpeRqubek ❑WC ❑3mpleaooll
❑ smaWvwm ❑Bamt.acvakm ❑ .. ___---
oe ammr a.ma
o -ni
�, Yams 3tai1r31 LOIMf16asYA
Ola M rvr+rw«r�.
grw��M�im�wXw�
maMW-empe Wr««e«M
w�eerllrM.li.�1YlY!«��V
mo. 34ZoL-- •r...m..�r.....a..,....
areamiw.rrrm
2207536 MASON CO WA
02/1312024 le:07 #n DEQ
IIAVIS "PS INC
1ImN Fisis ffillse P.O.,
Retum To:
Davis Pumps Inc.
340 NE Davis Farm Rd
Belfair, Wa 98528
Declaration of Water Use Agreement
Wafters-Watters Water System
Private 2 Party
ABBREVIATED LEGAL DESCRIPTIONS AND PARCEL NUMBERS OF TRACTS BRING SERVED:
The well and water system being situated on:
Parcel#32033 41-SH20
LOT 2 OF LLS 016-01 AF 020629/7 PTN OF NE SE
261 SE HARRIER RD'HUTON WA 98584
R3W T20N S"33 SE%NE'A
Grantors:WATTERS JR,RONALD D
Ovnerof
Parcel 93203341-50020
LOT 2 OF L1 S#16-01 AF#2062917 PTN OF NE SE
Ram T20N Sm13 SE IA-NE'G
Grantee: WATTLES JR.RONALD D
Ownerof:
Parcel#32033-41-50010
LOT 1 OF LLS#16-01 AF#2062917 FTN OF NE SE
POW T20N See33 SF.Y.-NE'A
Has been designated to serve a source of water to the following Parcels simated in Mason County,State of
Washington:herein described:
Parcel#3203341-50020
LO"1 2 OF LLS#16-01 AF#2062917 PIN OF NE SE
261 SE HARRIER RD SHELTON WA 98594
R3 W T20N Su33 SE'/,NE'A
Parcel#32033i1-50010
LOT I OF LLS#16-01 AF#2062917 PTN OF NE SE
R3W T20N Sec33 SE',NE'A
OWNERSHIP OF WELL AND WATERWORKS
It is agreed by the parties that each of said parties shall be and is hereby granted an undivided one-half interest in
and to the use of the well and water system. Each Party shall be entitled to receive a supply of water for one
residential dwelling and shall famish a reasonable supply of potable and healthful water for domestic purposes.
COST OF MAINTENANCE OF WATER SYSTEM
Each party hereto covenants and agrees that they shall equally share the maintenance and operational costs of the
well and water system.
NOTICE TO FUTURE PROPERTY OWNERS
The water system is designed to provide for two services. Additional planning and design approval most be
obtained from the local health jurisdiction prior to expanding beyond this number of services. Design flow
standards account for domestic use and watering of a typical lawn and/or garden space only. The design assumes
that all residences will be equipped with ultra low flow plumbing fixtures and that all users will keep conservation in
mind whenever the system is used. Additionally,a water right,obtained from the Department of Ecology,is
required if the water system exceeds exemption standards.This system has not applied for or been granted any
waivers from specific provisions of the regulations.
EASEMENT OF WELL SITE AND PUMPHOUSE
There shall be an easement for the purpose of maintaining and repairing the well and components to complete and
maintain a properly functioning water system and appurtenance thereto,within 100 feet of the well site in my
direction of both properties listed. Said easement shall allow the installation,maintenance or repair of the well,
water system,pump house,pumps,water storage reservoirs,pressure tanks,waterline,utility lines and/or anything
necessary to the operation of the water system.
MAINTENANCE AND REPAIR OF DISTRIBUTION LINES
All pipelines in the water system shall be maintained so that there will be no leakage of seepage,or other defects
which may cause contamination of the water,or injury,or damage to persons or property. Cost of repairing or
maintaining common distribution pipelines shall be home equally by both parties. Each party in this agreement
shall be responsible for the installation,maintenance,repair,and replacement of pipe supplying water from the
common water distribution piping to their own particular dwelling and property. Easement shall be granted on both
lots to repair,replace or maintain the waterline as needed for distribution purposes.
PROHIBITED PRACTICES
The parties herein,their heirs,successors and/or ensigns,will tax constntct,maintain or suffer to be constructed or
maintained upon the said land and within 100 feet of the well herein described,so long as the same is operated to
furnish water for public consumption,my of the following:septic tanks and drainfields,sewer fines,underground
storage ranks,county or state roads,railroad trucks,vehicles,structures,barns,feeding stations,Razing animals,
enclosures for maintaining fowl or animal manure,liquid or dry chemical storage,herbicides,insecticides,
hvardous waste or garbage of my kind.
The parties herein,their heirs,successors and/or assigns are required to keep the water supplied from said well free
from impurities which might be injurious to the public health.It is the purpose of these grants and covenants to
prevent certain practices hereinafter enumerated in the use of said grmtor(s)land which might contaminate said
water supply.
Exhibit A NOW,THEREFORE,the gmnmr(s)agree(s)and covenmt(s)that said grantor(s),his(her)(their)heirs,
successors and assigns will not construct,maintain,of suffer to be concocted or maintained upon the said land of
the grmtor(s)and within fifty(50)feet of the well herein described,so long as the same is operated to furnish water
for public consumption,ANY POTENTIAL.SOURCE OF CONTAMINATION INCLUDING BUT NOT LIMITED
TO:cesspools,sewers,privies,septic tanks,drainfrelds,manure piles,fenced pasture,garbage of any kind in
description,any enclosure or structures for the keeping or storage of non biodegradable fertilizers,liquid or dry
chemicals,herbicides or insecticides as well as any enclosures or structures for the keeping or maintenance of fowl
or animals such as barns,chicken houses,rabbit botches,pigpens,livestock sheds,and further agme(s)not to use,
apply,dispose or suffer to be used,applied or disposed,non biodegradable fertilizers,any liquid or dry chemicals,
herbicides or insecticides within the above described protective radius.These covenants shall nm with the land and
shall be binding on all parties having or acquiring any right,title,or interest in the land described herein or any part
thereof,and shall insure to the benefit of each owner thereof.
WATRR SYSTEM MANAGER
The owner of Parcel 43203341-50020 LOT 2 OF LLS 016-01 AF 024162917 PTN OF NE SE R3W 720N See33 SE%-NE
Y. is the designated"Manager"of the system.. The manager shall be responsible for arranging submission of all
necessary water samples as required in the Washington Administrative Code,and Mason County Rules and
Regulations and handling emergencies such as system shutdown and repair. The Manager shall provide his/her
name,address and telephone number to the Health Officer and shall serve as a contact person to the Health Officer.
The manager shall organdie and maintain the water system records and notify the Health Officer and all parties,
service connections and lots that are included in this agreement,of the water quality tests that are required by WAC
246.291 and Mason County Rules and Regulation.Water system records shall be available for review and inspection
by all parties in this agreement and the Health Officer.
HRIPS.SUCCESSORS AND ASSIGNS
These covenants and agreements shall tun with the land and shall be binding on all parties having or acquiring any
right,title,or interest in this land described herein or any part hereof,and it shall pass to and be for the benefit of
each owner thereof.
ENFORCEMENT OF AGREEMENT ON NON&ONFORKMG P RTIFS AND PROPERTIES
The parties hereto agree to establish the right to make reasonable regulations for the operation of the system,such as
lennination of services if bills are not paid within 45 days of the due date,additional charges for disconnection,
reconnection,etc. Parties not conforming with the provisions of this agreement shall be subject to interest charges
of Ill%per annurn together with all collection fees.
WATTERS-WATTERS Water System Owner Date
S/�EQ 24
SW ERS Water System Owner Date
WAiTER
State of Washington,
Countyof mGSGn
1,the undersigned,a Notary Public in and for the named above County and State,do hereby certify that
on this G41, day of 2023,personally appeared before me ?fsV.r.1 l t Yi4P1�
to me known to be the individual'described on and who executed the within instrument,and acknowledge
that he(she)(they)signed and sealed the same as free and voluntary act and deed,for the users and
purposes herein mentioned.
GIVEN under my hand and official seal the day and year last above written.
Notary ttP is in�for the State of Washington,
� Ptl9t.1�
residing at
M commission ires: UZ '9••. c
Y exP %1F.'O WA tN`�G`���
Mason County WA GIS Web Map
211 212024, 8:06:44 PM 1:1,537
(& WBL� LO6R'CipN 0 0.01 0,03 0,05 mi
County Boundary Vfgtc- Lochn- oN 0 0.02 0.N o.Nkm
No Filled 90 WAIw f(ELD LOC1aioni
Site Address (Zoom in to 1:3,000) 1
Souu'.EW.Mwr,EaNW Geop,go,a,q tln GIG Gw Cwnmunlly
O Tax Parcels (Zoom in to 1:30,000)
Mmm Caunry wn cls wee nYp lyplmlm
Mva,.MK,o»II�