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Home My WebLink AboutWEC2024-00082 - WEC Application - 6/21/2024 415 N 6-STREET,SHELTON,WA 98584 MASON COUNTY SHELTON:360427-9670,EXT.400 COMMUNITY S'ERVICFS BELFAIR:360-2754467,EKIF.400 w+eorswa�af ux.+arr�.wrx in ELMA:360-482-SM.EM.400 FAX:360-427-7787 NOTICE OF INTENT TO CONSTRUCT A WELL -- Perm*Number Pavmera lMoenatlon Instructions 1�� 11 1. Complete Part t.Incomplete applications will be rejected ^WEC Recapt Numbes—UAZt'l l 2. Attach a plot plan and vicinity map. U ❑ Cash 3. Submit this completed application with appropriate fee a minimum Check of 24 hours in advance of initiating well construction. Refer,to / f2` 1 Mason County Environmental Health fee schedule for cost. Data of Payment b/IXl l�l� 4. Mason County Public must receive notification at least 24 hours ��TTT��`lll"` prior to the drilling of the wag. PART 1: Applicant!Parcel Identification Site Address f_ "6 Start Card Drilling Firtn S L/l/ Phor Z 7 Applicant 4/ L Phone Mailing Address 17 City `Til state Zip d Parcel Number Is the well site Within 100 feet of salt/seawater? JJ.(,1(�� ❑No If yes,a variance from DOE is requi ve yod applied/received (circle one)a variance? es ❑No NOT :AN a wet re subject ro wateradequacy re00imrrrenls at rime douilding pemMason carry Title 6.66. W usage ms ' fees yapply roalr a waft drilledafter January fe^,W18 per ESSB 601. /Agen Ignature PART 2:Health Department Review(Staff Use Only) YES TAG# Called In `113t11-`1 fcR 81 t 1 1`t ❑ Driller on Site? e- ❑ Is the well capped and Vented? ❑ ❑ Is there evidence of a surface seal? 1,,L � D ❑ Is there a 2-annular space on all sides of the casing? ❑ ❑ Has the seal slumped? N J , — t ZL 44 o B4 le ❑ �`�' Is the well flowing or is there evidence of other leakage? ❑ Is there evidence of cascading water? r El is there evidence that the seal is at least 18 feet long? 7f. o 4ACL6 opel,5 vra ostG StID� ❑ "� Do the well site set-backs appear to)be appropriate? C b°V"'f r 'PL .a PcTt.�SS �/ Jxra+L Ar R�- RK o &VLM ❑Fail Inrspecror Date If/2-1 This farm may be scanned!and available for public view on the Hawn County Web site. Revia,12172018 s v V Z � 3 cze ,� qzA ti � of STATE OF WASHINGTON DEPARTMENT OF ECOLOGY Southwest Region Office PO Box 47775,Olympia,WA 98504-7775 • 360-407-6300 Sent via Email June 20,2024 Corey Weick 4907 Main Street Tacoma,WA 98407 cwweick@vahoo.com RE: Variance request from Washington Administrative Code(WAC)173-160-171.The property address is 3961 East Pickering Road in Shelton, in the SE X SW 9 of Section 9,Township 20 North,Range 02 West,W.M.,on Tax Parcel 22004-SO-00902in Mason County. This document will not be sent in the US mail.In order for Ecology to confirm you received this document,please reply to the email this document was attached to with the following:"I have received Ecology's decision via email. This email serves as my response that I am the addressee or their agent,and that the decision has been received and certified mail is not requested." The Department of Ecology(Ecology)received your variance request via email on June 4,2024.The request states strict compliance with WAC 173-160-171(3)(b)(v), which details siting standards for water wells, is impractical because the entire property is within 100 feet of a saltwater body.The well will be placed approximately 40 feet from the high tide line. We have discussed that equal or greater human health and resource protections will be accomplished by a combination of water storage("500-gallon tank is suggested)and low pumping rate to lessen the risk of seawater intrusion. The rate of groundwater withdrawal shall not exceed three gallons per minute, however,a pumping rate of one gallon per minute is recommended. This letter documentsthe varianceyou requested to WAC 173-160-171(3)(b)(v)is granted in accordance with WAC 173-160-106. The variance expires June 21, 2025, and is granted only for construction of the water well in the manner and location referenced in the variance request.The intent of this variance is to prevent contamination of the groundwater resource from constructing a well within a setback. This variance is not intended to protect someone from drinking contaminated water.Seek advice from your local department of public health for guidance in determining the water is safe prior to consumption.Any licensed water we]I driller can execute the construction of the well according to the variance request,subject to the provisions listed below: 1. A"Notice of Intent"and fees shall be submitted to Ecology at PO Box 47611,Olympia,WA,98504-7611. Corey Weick June 20,2024 w/Davis Drilling Variance Response Letter 2. All other minimum construction standards found in WAC 173-160 shall be followed to prevent degradation of the groundwater resource. 3. A well report containing the details required by WAC 173-160-141 shall be submitted to Ecology at PO Box 330316, Shoreline, WA 98133, within 30 days of completion of work on the well. Attach a copy of this variance to the well report. 4. With the exception of the specific provisions set forth(above)in this variance,all federal,state,and local requirements shall apply. S. This variance expiresJune 21,2025.Afterthis date,approval ofa new request forvariance or an extension must be requested in writing for the work proposed. Your right to appeal You have a right to appeal this decision to the Pollution Control Hearings Board(PCHB)within 30 days of the date of receipt. The appeal process is governed by RCW 43.21E and WAC 371-08. "Date of receipt" is defined in RCW 43.21B.001(2). To appeal,you must do all of the following within 30 days of the date of receipt of this decision: • File your notice of appeal and a copy of this decision with the PCHB(see filing information below). "Filing" means actual receipt by the PCHB during regular business hours as defined in WAC 371-08-305 and-335. "Notice of appeal"is defined in WAC 371-08-340. • Serve a copy of your notice of appeal and this decision on the Department of Ecology by mail, in person, or by email(see addresses below). You must also comply with other applicable requirements in RCW 43.21E and WAC 371-08. Filing an appeal Filing with the PCHB For the most current information regarding filing with the PCHB,visit: httpe://eluho.wa.gov/or call: 360-664-9160. Service on Ecology Street Address: Mailing Address: Department of Ecology Department of Ecology Attn:Appeals Processing Desk Attn:Appeals Processing Desk 300 Desmond Drive SE PO Box 47608 Lacey,WA 98503 Olympia,WA 98504-7608 E-Mail Address: ecologyappeals@ecy.wa.gov Notice of Intent to Construct a Notice Number Water Well WE56946 This form and required fees MUST BE RECEIVED by the Department ECOLOGY of Ecology 72 HOURS BEFORE you construct a well. 1. Owner Name Corey Weick Mailing Address City State Zip Corte 4907 Main St Unlit 731 Tacoma WA 98407 2.Consulting Firm fd applicable) Business Name Davis Drilling Mailing Address City State Zip Code 340 NE Davis Farm Rd Belfair WA 98528 Emil Address Phone Number (360) 2755367 3.Well Site Location County Name Tax Parcel Number Mason 22004500902 Street Address city State Zip Code 3961 E Pickering Rd Shelton WA 98584 Township 20N Range 2U/ Section 9 '/.(wthin 160 acres) NW 1 '/.-'''/ (within 40 acres) SE Latitude Degrees Longitude Degrees 4.Project Details Estimated Start Date 7/15=24 Project Name Wei(*Well Prgect No.of tomes 1 Well use: Domestic (Single) Work Type: New Water Right Permit- Not Required 5.Driller Details Professional Name[Architect I License Number Engineer I Surveyor](if applicable) Drilling Company Name Phone Number DAVIS DRILLING ING (360) 275 5367 Licensed Driller Name Driller License Number EMILY DAVIS 3142 Comments 6.Fee Summary Total amount due for wells with Casing diameter less than 12":$200.00 -Remit payment to:Department of Ecology CashiedW Uric P.O_Box 47611,Olympia WA 96501-7611 DR Pay online at https:Happswr ecology wa govlweliconstmction/Wells/Notice0fintentPaymentReciumtaspx Notice Status Date Confirmation I Cash Jaumal Number Pending 6121202410:11:57 AM 24062156776142