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HomeMy WebLinkAboutWEL2025-00008 - WEL Application, Design, Letter - 2/21/2025 SHELTON,WA MASON COUNTY 415N6THELTON: , 0427-97 ,EXT 404 SHELTON:360<27-9670,EXT 400 eELFAIR:360-275-4467,EXT 400 Public Health & Human Services ELMA:360492-5269,EXT 400 FAX:360427-7787 REDOR LLC P O BOX 473 GIG HARBOR, WA 98335 RE: WATER SYSTEM PERMIT. TWO-PARTY WEL2025-00008 )OOO(E State Route 302 122214390061 The 2-party water system, Redor LLC (122214390061/122214390060), 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 Sincer� David Anderson Environmental Health Specialist Mason County Environmental Health 3171202S so MASON COUNTY 0�. 27- 2� COMMUNITY SERVICES a6. 415 N.6^Strat(Bldg S)-Shelmn,WA965a9 WEL E 25 - 6000C Shelton: 360427-96W%400 aelfa.3W-295Je61 x" Elms:360482-5M9 R400 _ — 1 TWO-PARTY PRIVATE WATER SYSTEM APPLICATION MGLCRM FlX)XE 2-7 7 � a anykj oaEss_ ,cm,sraTEav G� b Y 611E EA- .Cm'.arl,Tai. sEcaxoulr2uu6 IYEL-1'2, "TERSCUout aWaCETYYE eY1LlLI Lm BaE F/JICElatm 6� )fjNew O Existing "�Well O Spring 2 2 ry0pe6Fa WATER6r6TEN IREe11Pe01 L motEm osscsvnox we r1 house ar wAXk owemroxs Ta sou eoxom � lD �+� Site Plan: (may also be attached) (property bouma6oa,sWdures,well site whW'radius,ddveways,mods,septic/sower component and lines,easement,etc...) 1 ' 1 a 1 M 1 1 Submittals Checklist: (these additional items will be required for approval) I,y Satisfactory Bacteriological sample(this may be deferred if well is not yet drilled) t/pm��11'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) 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 public view on Me Mason County Web site. Revised. 10/13/2021 Page 1 of 2 _— -- Staff Use Only --- — Review Step 1: Well Site Inspection: -sq«r trrlts �s' may.. YES NO NA ❑ ❑ Evidence of existing sources of contamination within a 100-foot radius of the water source? (drain0elds,tanks, buildings; indicate distance on plot plan) P F ❑ ❑ Are there roads within a 100-foot radius of the water source? (� L Is the road iv , County, or State? (circle one) Distance to the road(s) -I U ❑ ❑ Does the ground slope away from the water source site? ❑ ❑ Satisfactory well cap? ❑ ❑ Well cap screened and vented?❑ The well casing extends If above level ground/concrete slab? (circle one) ❑ ❑ Evidence of a surface seal? Lat: 41.1760? ❑ ❑ Adequate surface seal? Lon: -lit.707 ❑ Y" ❑ Variance necessary for well site approval? Tag: gat.'" Comments: pE Pass ❑ Fail Inspector Date yr VV �— Review Step 2: Two-Party Review: YES NO NA ❑ ❑ Water well report(well log)with a concurrent capacity test? AW klyh� oq 11 RMl wy W Zoom(d1,�w1(, ❑ ❑ Nonconcurrent/separate capacity test? Capacity test information: Date II agklY Driller 41,11 ON�; ( (/ yyy��t GPM Z� ('0 _Duration (minutes) 2 GPD )�Q_ Itl ❑ ❑ Satisfactory bacteriological analysis? Date of test 12// !(/l?0 L Y 7 El El Signed, notarized,and recorded notice to future property owners?AFN Z Z I k39j?j " ❑ ❑ The system appears adequate to serve two connections based on the information provi7TA Comments: _ , aJSa( eqd eC w(woG O *97 � k 4�"j ® Approved El Denied Reviewer Date 1O1S Findings in this review reflect observed conditions as they existed on the day ofthe site inspection. No claim is made,express 9 or implied ofthefuture success orfailure ofthis system. Well site approval does not constitute water system approval �rA All proposed connections to new wells are subject to water adequacy requirements at time of building permit per MCC 6,68. Water usage restrictions and additional fees may apply to all new wells drilled after January 10, 1018 per ESSB 6091. Revised:O1/10/2025 This form may be aranned and made available for public viewing on the Mason County website. Page 2 of 2 WATER WELL REPORT a DEPARTMENT OF Nodceofrmmt Na. WE51382 ECOLOGY Unigae Bcolpgy Wdlm TaSN.. SOC499 rya a wnra: stare prwashiylon ❑e Cmemmnon Site Well Name(ifmore they one wd0: ❑ Dnnnmi.®on b Original ivulbrion NO[No, Wets Ri 1upnnnit/Cutifi..No. Pmpmed Dee: O D.. ❑Induwl ❑M.,[ Pmpelty O nr Name Redor LLC ❑Dc-.tang O bnpdon ❑Tml Well ❑ONn Well Sheet Address 4333 E S1ela Rode 902 Comnmdo.Type: mmra:m rvew weu ❑Alulmim Dann O Jelld ■Ghk Tool City BeBair Cmmry NYDn ❑Deepening D Doe ❑D" ❑Air- ❑M Rmeay T.Pored No. 12221-439 MI Dimenelopr: D'cnarrofborag B m.,m 230 R Dcmb olw:lekkdwe11224 g Wmevedmaeppe4ved fmtlde well? ❑Yap ❑No . , Cmuboegao Dilar: WWI Dyw'whetwv�YVlmufWy Cmiug Liner DaamW From To fiat &al WC WeIdcd ILead ❑. I ❑ 8 in. ♦1 21v 114 in. ❑. 1 ❑ I9 ❑ I.4ca5m(see inssucdonsm W8e 2): ❑WWM or❑EWM ❑ ❑ =m"— —m. ❑ I ❑ ❑ ❑ SE Y.-Y.ofthe SW /;Seclim 21 Tnen 22N 1W ❑ ❑ _ _ m. ❑ I ❑ ❑ ❑ .hlv—Rmge_ ❑ ❑ _ . ❑ ❑ ❑ ❑ VSnlde(Enenlple:47.12345) 47.371 LSp®fade(Example:-120.12345) -122.81302 PUlmpewr: OYm ON. Snaofpmmatims Drmm•e Coartrutlov or DeeomWeelon lhmedvn No. reed olaiove_ 3ve ofpabutiom_m.M_a. ion:Dmc Te Ml .nlwmelm,elmofvmmi.l mtlmuenee,udrb Had®d Pn6nmtl from_Rm_flhebwpomdeurvice mtumprthc mndtalitt exlu—mieneunvu wphakuta.e envy finemh chmgeaf 9mem: �Ym ❑No ®K-P 2c b Dryth 2DR d infnrmelion. Dse eddirionelatreu ifeueeegy Mmmfictumr'e N. JulI. Maledel .From T. Type Winlew Mehl No. On.5 In. Skrr'ue in form 2 flmT� wpsoll 0 2 Einmxr_ in. Samoa_ is lFom_flm_R yelbv brown sand 8 gravel 2 120 s.dmlt«p.aH OYm ONo sittofpmg omvisl_in wet reddish brown sand A some gravel 12D 230 Mmen.a vlacetl som ft m_R. wet reddish brain send g gavel wilti light brown cone.sere: ©Ym ❑No Towlut atltl blue day bells 230 231 S @p h? 1a g M.ialusWwual Bemmnim Ded n evae wmafit u bk w . O Yes ❑No , T,cdealcO RPN dnedY Metl dsealwgevanoff hon, MmmBttmer'r Nene WW- Type: nub FLP. 1.5 Nlmpi.MEcdaplh:1 SO R Dmipnn,,%nnue: 15 gpm W.kr l.ml: lenbnns4ce ekvedonabove munvkvel fl S(vt-apoftapofwelluei::g_ fta vo:mdrurhu Smlkwetmkvei 117 aEemwtop ofwdlswn:ng One Anesunpre —Nr.perrquueiuh D. A:usanwnauwolugd by (up.valve.arJ Wm Teem: Wuapmopioguatpmtonoedl ONo MYee b bywhoml Emily YkM 20 ,en whh 5a ftdrewdowo sec 2 hn. YaM _gp ewM_D Aewdwm.M_M. V.Iu_,W:h_A tlnwtlwneMr_M. Ile-,dare Inure-xro when pomp ad off-.kwlvwremed apm well cop m wM Icrel) 1. wumlevel Time '42 tesel rime w17 t<.el tm 10 4m 37 Sam 19 2m 155 Sm 137 — 3m 1♦B 1An 13e DemofP::mPingdrt BHI>ta120 gpn whh 50 B.dmwtlown.frm�hn.� Av km_Qpmwimeumemu_flNr_M. DM Artesian Mw_gpm Tempmmm�olweW °F wu.e Jen lyms ? Dyer ON. Spd Dqp Ql2g/2n1 CoupletdDYC 11/15/24 WNLL CONMUCf10N CERT)FICATION: I coselmctod eoNmacmpt responsibility fmconstmation oftlds well,and its compliance with All Washington well construction standatde.MatennIn usd mM the infomw5mrepodd above to my best Imowledge end belief. ❑. Driilm❑'Dainee❑EE/-P�rim Name EOd1y Davis n Ailling C�my Davis Drilling 3igmhue (� 4 _/ y"ee Address 340 NE Davis Farm Rd Wcepx No. City,Stat,Tan Beffair,WA 98528 IF TRAINEE:Sp nnoe ❑curse No. Contreat"'s Sporn e s Sippmrze Regiatn m No.DAVISDH 100A Due NOV 2024 ECY 05LL 1.20(Rev 08/19)1fyaa needthis document in an aliernatefomat,please call the Walllfif ¢m1 Program 41 3 60.40 7-68 72 Peuonn wOh Fearing lass can ca071/for B'aa8mgmn Relay Se+rree. Persons w ha�h di MiLy cop m1I877-833-6341. Davis Drilling 340 NE Davis Farm Rd Belfair, WA 98528 Test Pump for: Redor LLC Address:4333 E State Route 302 Well depth:224 Well tag: BQC 499 Pump size: 1.5 hp Static water level: 117' Date: 11/15/24 TIME WATER LEVEL GPM 5m 159.5' 20 lom 170' 20 30m 176' 20 lh 176' 20 2h 176' 20 3h 176' 20 4h 176' 20 RECOVERY 1m 164' 2m 255' 3m 148' 4m 142' 5m 137' 15m 120' 30m 117'p 'nes sE,wie hwd WA Oec98M WA 9a46 (3fi0)44}7845 Dab Sampb Cobtletl TIId5Rfa1 'Cmny LZ �w �YIQ�I typedwatrELabm(a.a myaesmc, ❑GmupA ❑G p8 DRa Cm AaW Gm BSOwn-P ftfipn WMm Fm tid lm wy(MI): C. Nema:, Paul Cmbp Pnm: 302, DryF CAW : Emak Ed Flwnc $eel�dh b:aMaNrr..Wle Ntlpogl4(aiRO*.M�IeimkagM�NOI hD �v SpedE ft Mggw*w Bptt iNedWdprKd t wa( -, bra 1.0ReW 04b& oe Ba*b") 2.[1Rp &Rp VP) ch ,yaso WD atPNdwe ad.w.mm, Cahme RdtlNt ToW Free Draeb�iouBie�nuada 49 3.GrouaEWank Rub Bourn Angle --- ----- e lbeesafecbrynxNnemY%Qdb'. ❑AseessmeM(API (Tbfine Reepue[TCYI_Frea_ FC t Fib J a.soma wOMR S =WderbmpW(Enumwe) ❑ E WO [3 Poll 5. ob CdbuNWbRm�Nm anM ❑ .. Yobl Ctlbm P1denl N! 7r, - ❑Ewp . 13,0 t BMa4lDdepy Rdub'TaWCoSbm_mpuYQpmLEmf npYf00m1. Fecal CWNam__.iJiDpni 1PC_tWIH. MWb MBempb Req~ ❑TM ❑swkemb ❑ $O'IpC Volum¢ ❑DgmaJ Id CGId4KK In ttl xuMr remoC'- ban,ur , mlwnsunm GEC 4 4ie Spectra Labs - Kitsap, LLC (Poulsbo) SPECTRA Laboratories-Kftsap 26276 Twelve Trees Ln NW Ste.C Poulsbo,WA 98370 Phone: (360)779-5141 www.spectra-lab.com Spectra Labs- Kitsap,L.L.0(Poulsbo)received samples for Hood Canal Water on Tuesday,December 3, 2024 at 11:40 am. Unless otherwise noted,all samples were received in good condition and were tested in accordance with the laboratory's quality control procedures.A summary of the samples received are outlined below. Sample No. Description Location Sampled 246622-01 Paul Re"Hwy 302 Well Head 12/=024 15:30 246622-02 Penny PH 12/072024 14:00 246622-03 Tom PH 12/0=02414:05 246622-04 John Arwine Well Head 12/02/2024 15:00 This report package contains laboratory sample results and any attachments listed below. If you have any questions please call(360)779-5141 or email us at www.spectm-lab.com. Attachments 01) �F�F�1pZs 0 This report is issued solely for the use of the person or company to whom it is addressed.Any use,copying or disclosure other than by the intended recipient is unauthorized.If you have received this report in error,please notify the sender immediately at 360443-7845 and destroy this report promptly. These results relate only to the items tested and the sample(s)as received by the laboratory. This repon shall not be reproduced except in full,without prior express written approval by Spectre laboratories. IM5/2024 Page 1 of 1 2219303 MASON CO WA HEB- L'LC 2124 #20435 06 6 AGREE $307 50 Pa5¢s 5 II'll iIIIIiIIIIIIIN�IIII!IllllillllllllllllllllllllllllllllllllllllVIIII Return to: Redor LLC PO Box 473 Gig Harbor, WA 98335 DECLARATION OF WATER USE AGREEMENT Redor, LLC Water System This declaration made and entered into by property owner: GRANTOR: Redor, LLC GRANTEE: Public Parcel # 12221-43-90061 Township 22N, Section 21, Range 1 W, SE Y; of the SW '/< The property owner holds title to certain properties situated in Mason County, Washington described as follows: Parcel# 12221-43-90061 LOT 2 OF SHORT PLAT NO. 1595, RECORDED JL;AE 9, 1986 U U NDER A )l I OR'S FII. NO. 453443, BEING A PORTION OF GOVERNMENT I.O"F 4 OF SEC I ION 21. 1"OWNSnIP 22 NORTH. RANGE I WEST, W.M., IN MASON COUNTY. WASHINGTON. Parcels! 12221-43-90060 LOT 1 OF SHORT PLAT NO. 1595, RECORDED JLNE 9, 1986 UNDER AUDITOR'S F:L6 NO. 453443. BEING A PORTION OF GOVERNMENT LO"I 4 OF SECTION 21. TOWNSHIP 22 NORTH, RANGE 1 WEST. W.M., IN MASON COUNTY. WASHINGTON. The owner desires to provide a water system to supply water for the above parcels. LEGAL DESCRIPTION OF WATER SYSTEM The owner hereby dedicates an easement for a well,pump house and facilities which are necessary to produce and distribute water to said properties described as follows: Existing well is located at coordinates 47.37608, -122.81302 on Parcel# 12221-43-90061. A 30 foot radius around the well is reserved for a utility easement. TOGETHER WITH and Subject to an easement for ingress, egress.. and utilities a 20' wide section along the South property line. OWNERSHIP OF THE WELL AND WATERWORKS The water system is owned by Redor, LLC, hereinafter known as"Owner". COST OF WATER SYSTEM MAINTENANCE The incurred cost of maintaining the water system shall be the responsibility of the Owner. The Owner shall establish a water rate solely at the owner's discretion sufficient to cover system operating expenses, regulatory costs, maintenance costs, establish a reserve fund for equipment repairs, replacement and a return on investment. MAINTENANCE AND REPAIR OF PIPELINES 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. Pipe material used in repairs shall meet approval of the Health Officer. Cost of repairing or maintaining common distribution pipelines shall be born by Owner. Each party in this agreement shall be responsible for the maintenance, repair and replacement of pipe supplying water from the common water distribution piping.commencing at the individual service meter. to their own particular dwelling and property. Water pipelines shall not be installed within 10 feet of a septic tank or within 10 feet of a sewage disposal drain field Imes. PROHIBITED PRACTICES The parties herein. their heirs, successors and/or assigns. will not construct. maintain, or suffer to be constructed or maintained upon the said land and within 100 feet of the well herein described, so long the same is operated to fumish water for the public consumption, any of the following: septic tanks and drain fields. underground storage tanks. state roads. railroad tracks. vehicles, barns. feeding stations. grazing animals. enclosures for maintaining fowl or animal manure, liquid of dry chemical storage. herbicides. insecticides. hazardous waste or garbage of any kind. The patties will not cross connect any portion or segment of the water system with any other water source without prior written approval of the Mason County Department of Public Health and/or other appropriate governmental agency. NOTICE TO FUTURE PROPERTY OWNERS OF PUBLIC WATER SYSTEM This water system is designed to provide for 2 services. Additional planning and design approvals must be obtained from the department prior to expanding beNond this number of services. Design flow standards account for domestic use and watering of a typical lawn and 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 ;s used. Additionally, a water right. obtained from the Department of Ecology. is required if the water system exceeds exemption standards. PROVISIONS FOR CONTINUATION OF WATER SERVICE The parties agree to maintain a continuous flow of water from the well and water system. herein described in accordance with public water supply requirements of the State of Washington and Mason County. In the event that the quality or the quantity of the water from the well becomes unsatisfactory as determined by the Health Officer. the parties shall develop a new source of water.the patties shall obtain written approval from the Mason County Department of Health. All fees and necessary equipment associated with the new source shall be born b; owner. RESTRICTIONS ON FL RNISHING WATER TO ADDITIONAL PARTIES It is further agreed by the parties hereto that they shall not furnish water from the well and water system herein above described to any other persons. properties or dwelling without prior written approval from the Mason County Department of Health. HEIRS. SUCCESSORS AND ASSIGNS These covenants and agreements shall run 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-CONFORMING PARTIES AND PROPERTIES The owner reserves the right to make reasonable regulations for the operation of the system. so h as the termination of service if bills are not paid within forty-five days of the due date. additional charges for disconnection. reconnection. etc. Parties not contonning with the provisions of this agreement shall be subject to interest charges of 18% per armum together nvith all collection fees. Owner's Statement Of Responsibility: I, the undersigned, do hereby attest that as the owner of this water system I am responsible for any maintenance cr.[Ppairs involved in the continuing operation of this system. Signature r ;' Date Paul Redal Manager of Rader, LLC State of Washington, Countyof l.the undersigned, a Notary Public in and for the named above County and State.do hereby cetiZfy that on this a4S day of fV o i , 4-M LO$ 6onally appeared before me g2 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 sane 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. Nonm� ftbiic ,,� State of Wasitu gt t� fAll _R"tt 0` to t ri; jNy Public in andfor the State of Washington {y(,OMMI>SJON P XftRESg at --(-7r v� JuNk 1),1021, My commiss; i Tres: On (09 jsc2e ' '' " c. FTo<m � :R r � : r � � m m j z i �I I 9 - � I _ 40 z v a ; I F � mYn c�oe ; R Ox p Z Nssbb 98 j cm OP, a �=N 1. 9