HomeMy WebLinkAboutWEL2025-00008 - WEL Application, Design, Letter - 2/21/2025 415 N 6TH STREET,SHELTON,WA 985M
MASONCOUNTY SHELTON:360427-9670,EXT 400
BELFAIR:360-275-4467,EXT 400
Public Health & Human Services ELMA:360482-5269,EXT 400
FAX 360427-7787
REDOR LLC
P O BOX 473
GIG HARBOR, WA 96335
RE: WATER SYSTEM PERMIT. TWO-PARTY
WEL2025-00008
XXXX 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
31712 S
all
MASON COUNTY pANRoxese 01. 27 2C45 In
COMMUNITY SERVICES �t O Bea
415 N.01sencep(Bldg 8)—Shelter,WA 985M WEL 20 25 - Oo00S
Shelton: 3W427-95M x400 Belfur:30-2754469 x400 Eima:3604 2-5269 x40a
TWO-PARTY PRIVATE WATER SYSTEM APPLICATION
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Site Plan: (may also be attached)
(property boundaries,structures,well site w1IN'redius,drieeuaW,roads,septictsewer components and lines,easements,etc.,.)
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Submittals Checklist: (these additional items will be required for approval)
Satisfactory Bacteriological sample(this may be deferred if well is not yet drilled)
Well Log with pump test or 4-hour capacity test performed by driller(this may be defamed 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 learned and available for public vlew on the Mason County Web site. Revised: 10/13/2021
Page 1 of 2
------------------------------------------------------------ Staff Use Only ..-
Review Step 1: Well Site Inspection:
YES NO NA
❑ ❑ Evidence of existing sources of contamination within a 100-foot radius of the water source?
(drainfields, tanks, buildings; indicate distance on plot plan)
PT ❑ ❑ Are there roads within a 100-foot radius of the water source?
Is the road dv , County, or State? (circle one) Distance to the mad(s) -I V
❑ ❑ Does the ground slope away from the water source site?
❑ ❑ Satisfactory well cap?
❑ ❑ Well cap screened and vented The well casing extends � above level ground/concrete slab? (circle one)
❑ ❑ Evidence of a surface seal? Lat: 41.17609
❑ ❑ Adequate surface seal? Lon: -IZL-71Zp7
❑ 0 ❑ Variance necessary for well site approval? Tag:garlylik
Comments:
pG Pass ❑ Fail Inspector Date
/Review Step 2: Two-Party Review:
YES NO NA
❑ ❑ Waterwell report(well log)with a concurrent capacity test? *011 04171111kavW 100jor&IJIiiii
❑ ❑ Nonconcurrent/separate capacity test?
Capacity test information: Date U115 011 Driller � r4
GPM 26 Duration (minutes) 2 VO GPD Y eO
IZ,I El /❑ Satisfactory bacteriological analysis? Date of test R ?N Y 7
❑ ❑ Signed, notarized,and recorded notice to future property,owners?AFN Z
El ElThe sy/ G(.sttemm Q NK appears adequate to servne two cconneectioonns baased on the information prove A
,Comments: tr^ S 1'G✓1 1LlC(� 0Gd � o
/1 Approved ❑ Denied Reviewer Data 1plf
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Findings in this review reflect observed conditions as they existed on the day ofthe site inspection. No claim is made,express H
or implied ofthefuture success orfailure ofthis system. Well site approval does not constitute water system approval rF'
All proposed connections to new wells are subject to water adequacy requirements at time ofbuilding permit perMCC 6.68.
Water wage restrictions and addition!fees may apply to all new wells drilled after January l9s% 2018 per ESSB 6091.
This form may be scanned and made available for public viewing on the Mason County website. Revised.01/10/2025
Page 2 of 2
WATER WELL REPORT 0DEPARTMENT OF Nofimoflme,&No. WE54382
ECOLOGY Unique aniou wen m Tag No. mIc MM,
Type a Wa.k: Slate of Waitingtpn
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peapmed Use: B Dou ❑lv0mial ❑Msmcgal Prop"Owper Name Redor LLC
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Well Sfica Mdr®s 4393 E Bleb Rout,302 coasft.
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WELL C'ONSIRUMON CERTIFICATION: 1 consoucted avd/m a«pt rmpwsibi5ty for c wetruRion of this well,and its conpEance with all Washington well
crossleuddon amsu arils.hbtaials usol and the information repoRd abov,&,,Mto eny best knowledge and belief.
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IN Driller O Trainee❑PE—Print Name Emily Davis Drilling Colepan,Davis Dnlling
Sianwte- ♦ /� Add.340 NE 0"Fenn Rd
License No.3T82� City,Stet,Zip Belblr,WA 98528
W TRAINEE:Sponwr's Ue.NO. Cenua:ror'a
Swoeor'n Sigoamn RegMea5w No.DAVISDI1100A Dena NOV 2024
{ ECY 050.1-20(Rev 08/19)Ifyou need thu document in an altemalefarmal,ylme,mil the Water Resourew Program 4,360-407-6872.
J PemonrwUhhearinglavcnn 7(IfoiW higB Relay Senv Perm mlha.q hduaUh'ymnmll877433-6341.
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 GffM
5m 159.5' 20
lom 170' 20
30m 176' 20
lh 176' 20
2h 176' 20
3h 176' 20
4h 176' 20
RECOVERY
lm 164'
2m 155'
3m 148'
4m 142'
Sm 137'
15m 120'
30m 117'p
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Spectra Labs - Mtsap,LLC (Poulsbo)
SPECTRA Laboratories -Kitsap 26276 Twelve Trees Ln NW Ste.C
Poulsbo,WA 98370
Phone: (360)779-5141
www.spectra-lab.com
Spectra Labs-Kitsap,LLC (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 Redal Hwy 302 Well Head 12J(M024 15:30
246622-02 Penny PH 12/02/2024 14:00
246622-03 Tom PH 12IM02414:05
246622-04 John Arwine Well Head 12/022024 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.spectra-lab.com.
Attachments
01)
AF��i� 1pIS
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
360-443-7845 and destroy this report promptly.
These results relate only to the items tested and the sample(s)as received by the laboratory. This report shall not be reproduced
except in full,without prior express written approval by Spectra Laboratories.
12/05/2024 Page 1 of 1
2219303 MASON CO WA
RE60R PLLC pZ00356 RecEFae g30] 60 Pages 5
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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 '/a of the S W '/.
The property owner holds title to certain properties situated in Mason County, Washington
described as follows:
Parcel# 12 22 1-43-90061
LOT 2 OF SHORT PLAT NO. 1595, RECORDED Jt'NE 9. 1980 UNDER AUDITOR'S FIL"3
NO. 453443. BEING A PORTION OF GOVERNMENT LOT 4 OF SECTION 21. TOWNSnIP
22 NORTH. RANGE l WEST, W.M.. IN MASON COUNTY. WASHINGTON.
Parcel# 12221-43-90060
LOT 1 OF SHORT PLAT NO. 1595, RECORDED JU'NE 9, 1986 U\'DER AUDITOR'S F;Lt
NO. 453443, BEING A PORTION OF GOVERNMENT LOI 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 furnish water for the public consumption, an7 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 parties will not cross connect any portion or segment of the water system with any
other water source without prior written approval of the Mason Counts 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 3 services. Additional planning and design
approvals must be obtained from the department prior to expanding beyond 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 parties shall obtain written approval from the Mason County Department of Health.
All fees and necessary equipment associated with the new source shall be born by owner.
RESTRICTIONS ON FURNISHING WATER TO ADDITIONAL PARTIES
It is further agreed by the parties hereto that they shall not furnish water from the well and aat7r
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-NN e 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 annum together with 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 or spp airs involved in the continuing operation of this system.
i
Signature Date i - Z, i
Paul Redal
Manager of Redor, LLC
State of Washington,
County of Proir_
1.the undersigned, a Notary Public in and for the named above County and State.do hereby
cetTify that on this a5'1"day of N +' .�Ht ZO�peisonally appeared before me
-jam / ? 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.
�;. Fietarev i'ebtfc ,
- State of'Washu gt in
GAIL E AY:11) I
LICENSE -a0419
Nq a P{tblic/in�and for the State of Washington My COMMISSION FJ[Y=RES ti
res}d ng at C{,u -t--�-�Y JUN 9,20
My commissi Aires: r e 107
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