Loading...
HomeMy WebLinkAboutWEL2025-00114 - WEL Application, Design, Letter - 3/24/2026 MASON COUNTY 415 N 6TH STREET,SHELT967 ,E 98584 • SHELTON:360-427-9670,EXT 400 BELFAIR:360-275-4467,EXT 400 Public Health & Human Services ELMA:360-482-5269,EXT 400 FAX:360-427-7787 03/24/2026 STANDLEY ET UX SCOTT T KAREN P BOVINICH LILLIWAUP, WA 98555 RE: WATER SYSTEM PERMIT: TWO-PARTY WEL2025-00114 30 N Shar Ln 323165000001 The 2-party water system, Two-Party Well (SFR+ SFR): Standley Hall (323165000001/323165000002), 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 I MASON COUNTY Date Received: COMMUNITY SERVICES Amount Received V Received Br: e' Building,Planning,Environmental Health,Community Health V 415 N.6"'Street,(Bldg 8)—Shelton,WA 98584 WEL L a 5)- (JCJ) 1 I LA Shelton: 360-427-9670 x400 Belfair.360-275-4467 x400 Elma:360-482-5269 x400 TWO-PARTY PRIVATE WATER SYSTEM APPLICATION APPLICANT PHONE 6c01t ctot-1vI'1A I (si ) n- '1 MAILING ADDRESS-STREET,CITY,STATE,ZIP SITE ADDRESS—STREET,CITY,STATE,ZIP LI �I � � V�/ �� � 3 0 N5_h q-r L-lt ` ` -�I PRIMARY PARCEL NUMBER(WELL SITE) 6-5 )- QOCC SECONDARY PARCEL NUMBER(SAME AS PRIMARY IF LOCATED ON SAME PARCEL) -3 J-°3i - 50 DD00D, WATER SOURCE SOURCE TYPE PARCEL 1 LOT SIZE(no minimum) PARCEL 2 LOT SIZE(no minimum) New ❑Existing Well ❑ Spring D,. drr,eS o..s, dL-i-- S PROPOSED WATER SYSTEM NAME(REQUIRED). st -'l- -t PROJECT DESCRIPTION(e.g.,detached ADU,new nnngle family residence,existing connection,ere.) t ew well fy ance�s DIRECTIONS TO SITE I CONDITIONS/GATE CODE/KEY LOCATION/ETC. 4 %/t 4i 4 30 1JSti or Lr Site Plan: (may also be attached) (property boundaries,structures,well site w/100'radius,driveways,roads,septic/sewer components and lines,water lines,property easements,etc.) Required Submittals Checklist:(additional information located on the first page of this packet) E(Satisfactory bacteriological test from within the last year Well report with well tag number,well tag secured to well casing,and capacity test showing 800 gal per day Notice to Future Property Owners of Private Two-Party Water System recorded with Mason County Auditor's Office VeSeptic Records(additional locating requirements may apply if there are no septic records on file) --------------------------------------------------------------------- Staff Use Only -------------------------------------------------------------------- Review Step 1: Well Site Inspection: U 6" arrW- YES NO N/O 3S" f" VI i l cc t ❑ ❑ Evidence of existing sources of contamination within a 100-foot radius of the water source?(drainfields, tanks,buildings; indicate distance on plot plan) ❑ El Are there roa ithin a 100-foot radius of the water source? u Is the ro rivat County,or State?(circle one) Distance to the road(s) 1L ❑ ❑ Does the group slope away from the water source site? ❑ ❑ Satisfactory well cap? ❑ ❑ Well cap screened and vented? << ❑ The well casing extends 70 above leve grow /concrete slab?(circle one)El ❑ Well tag attached to well casing? Lat: t77• (?Ut6 ❑ ❑ Evidence of an adequate surface seal? Lon: —tj1, 07 f Z/ ❑ ❑ Variance necessary for well site approval? WAz ZO"js�(JQ®FL Tag: (� EE77 Comments: /?v cc Inc 3 S f( L U- Z ' l Sc Ir( 3(! ZUl&= ' 66 li wot oz5-oo o r8 fir' c Pass Fail Inspector Date 1 Z/C 11 7 s Review Step 2: Two-Party Review: YES NO NA ) /; ❑ El Water well report(well log):Date Completed (O ZI/ZDriller 1 „ /El El❑ Satisfactory capacity test showing a minimum of 800 GPD with full recovery to static level within hours? Capacity test information: Date I` IL LUl Driller/Pump Installer CQ 1 t i GPN�J_IV Duration(minutes) Total Gal Recovery Time(minutes)to Static ❑ ❑ Satisfactory bacteriological analysis? Date j/ 2.5esting Lab _t m6 t /`ems, ❑ ❑ Signed,notarized,and recorded notice to future property owners?AFN o i4 ❑ El The system appears adequate to serve two connections based on the information provided? �' f Comments: ` M A 4,Q ) fle.c-e u€ (. r r ur z- n ASoNc 2© Approved ❑ Denied Reviewer Date 5/ Z Y�t?o� NNi 6i 4 Findings in this review reflect observed conditions as they existed on the day of the site inspection. No claim is made, express or implied of the fixture success or failure of this system. Well site approval does not constitute water system approval 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 19", 2018 per ESSB 6091. Revised:07/23/2025 This form may be scanned and made available for public viewing on the Mason County wcbsite. Page 2 of 2 WATER WELL REPORT _�,�_' _�` DEPAST�M,E"T or Notice of Intent No. WE60309 ECOLOGY Unique Ecology Well ID Tag No. BQC129 Type of Wort:: Sate of twist-ington Construction Site Well Name(if more than one well): Decommission Original installation NOt No. Water Right Permit/Certificate No. Proposed Use: IK Domestic ❑Industrial ❑Municipal Property Owner Name Scott Standley ❑Dewatering ❑Irrigation ❑Test Well ❑Other Well Street Address 30 N Shar Ln Construction Type: Method: E New well ❑Alteration ❑Driven 0 Jetted ❑Cable Tool City Lilliwaup County Mason Cl Deepening ❑Other ❑Dug ❑a Air- ❑Mud-Rotary Tax Parcel No. 32316-50-00001 Dimensions: Diameter of boring 6 in.,to 198 ft. Was a variance approved for this well? ❑Yes ❑No Depth of completed well 197.5 ft. Construction Details: Wall If yes,what was the variance for? Setback reduction Casing Liner Diameter From To Thickness Steel PVC Welded Thread O I ❑ 6 in. 0 192.5 .25 in. I 0 K I ❑ Location(see instructions on page 2): C WVIM or❑EWM ❑ 1 ❑ in. in. ❑ ID UI ❑ NE '/,-'/,of the NW 'A;Section 16 Township 23N.. L Range 3W ❑ I ❑ _ in. _ in. DID ❑ I ❑ ❑ 1 ❑ in. - in. ❑ I ❑ ❑ I ❑ Latitude(Example:47.12345) 47.49049 N Longitude(Example:-120.12345) -123.07519W Perforations: ❑Yes ❑9 No Type of perforator used No.ofperforations_ Size ofperforations_in.by_in. Driller's Log/Construction or Decommission Procedure Perforated from_ft.to_ft.below ground surface Formation:Describe by color,character,size of material and structure,and the kind and nature of the material in each layer penetrated with at least one entry for each change of Screens: ii Yes 0 No R K-Packer ' Depth 190 ft. information. Use additional sheets if necessary. Manufacturer's Name Alloy Machine Works Material From To Type Wire-wrapped Model No. Diameter 5" Slot size.014 in.from 192.5 ft.to 197.5 ft. Reddish brown,hard pan,cobbles 0 5 Diameter Slot size in.from ft.to ft. Gray fine sandy silt,dry 5 10 Brown silty fine sand and gravel,weeps 10 17 Sand/Filter pack:❑Yes No Size of pack material in. Materials placed front ft.to ft. Gray clayey silt,dense,dry 17 45 Fine to medium multicolored sharp ravel,fine 45 Surface Seal: SiJ Yes ❑No To what depth? 34 ft. Sand,silty,tight 83 Material used in seal Bentonite chips Did any strata contain unusable slater? ❑Yes ED No Gray fine to medium gravel,silt binder,tight 83 95 Type of water? Depth of strata Gray silt,dense,dry 95 113 Method of sealing strata off Gray silty clay,soft 113 148 Brownish gray silty clay,soft 148 155 Pump: Manufacturer's Name Type: Brownish gray silty clay,some gravel 155 181 H.P. Pump intake depth:_ft. Designed flow rate:_gpm Brown fine silty sand,fine to large gravel,heavinq 181 Water Levels: Land-surface elevation above mean sea level 100 ft. water bearing 198 Stick-up of top of well casing 1_5 ft.above ground surface Static water level 53 ft.below top of well casing Date 10/23/25 Artesian pressure_lbs.per square inch Date Artesian water is controlled by (cap,valve.etc.) Well Tests: Was a pumping test performed? 0 No ❑Yes b by whom? Yield gpm with—ft.drawdown after hrs. Yield_gpm with—ft.drawdown after hrs. Yield gpm with_ft.drawdown after_hrs. Recovery data(time-zero when pump is turned off—water level measured from well top to water level) Time Water Level Time Water Level Time Water Level Date of pumping test Bailer test_gpm with_ft.drawdown after_hrs. Air test 25 gpm with stem set at 140 ft.for I hrs. Date 10/23/25 Artesian flow_gpm Temperature of water 51 °F Was a chemical analysis made? ❑Yes No Start Date 10/22/25 Completed Date 10/23/25 WELL CONSTRUCTION CERTIFICATION: I constructed and/or accept responsibility for construction of this well,and its compliance with all Washington well construction standards.Materials used and the information reported above are true to my best knowledge and belief. 7 Driller❑Trainee❑PE—Pri , ame Cory Johnson Drilling Company Arcadia Drilling Inc. Signature Address PO Box 1790 License No. 3441 City,State,Zip Shelton,WA 98584 IF TRAINEE:Sponsor's License No. Contractor's Sponsor's Signature Registration No.ARCADDI098K1 Date 10/23/25 ECY 050-1-20(Rev 09/13) Jfyou need this document in an alt entaie fora!,please call the IValer Resources Program at 360-407-6872. Persons with hearing loss can call 71/for Washington Relay Service. Persons with a speech disability can call 877-833-6341. Arcadia Drilling Inc. P.O. Box 1790 Shelton,WA.98584 Customer: Scott Standley Well Tag#: BQC129 Site Address: 30 N Shar Ln,Lilliwaup Depth: 197.5' Date of Test: 11/4/25 Static: 53' Pump Set: 180' TIME GPM LEVEL RECOVERY 1 Min 3.5 53 TIME LEVEL 2 Min 3.5 53 1 Min 52.1 3 Min 3.5 53 2 Min 51.2 4 Min 3.5 53 3 Min 51 5 Min 10.5 53 4 Min 51 6 Min 10.5 54.5 5 Min 51 7 Min 10.5 55 8 Min 10.5 55.2 9 Min 10.5 55.2 10 Min 20 55.2 15 Min 20 60.6 20 Min 20 60 25 Min 20 60 30 Min 20 60.1 35 Min 20 60.1 40 Min 20 60.1 45 Min 20 60.1 50 Min 20 60.1 55 Min 20 60.1 1 Hr 20 60.1 1 Hr 10 Min 20 60.1 1 Hr 20 Min 20 60.1 Vanguard Laboratory 2635 Parkmont Lane SW, Suite A Olympia WA 98502 '.Jx21nIIS.? 360-967-7010 COLIFORM BACTERIA ANALYSIS FORM Date Sample Collected Time Sample County Collected Mason 11/04/2025 3 4 5 DAM Month Day Year :__®PM Type of Water System(check only one box) ❑Group A ❑Group B L Other Group A and Group B Systems—Provide from Water Facilities Inventory(WFI): ID# System Name: Scott Standley Contact Person:Arcadia Drilling,Inc Day Phone:(360 )426-3395 Cell Phone:( ) Email: Eve.Phone:( ) Send results to:(Print full name,address and zip code or email) adeta@arcadiadritting.comAND jenn@arcadiadrilling.com SAMPLE INFORMATION Sample collected by(name):Shad Specific location where sample collected: Special instructions or comments: 30 N Shar Ln, Liulwaup Counts please Type of Sample(select only one type of sample from types 1 through 5 below) 1.0 Routine Distribution Sample(AIP) 2.❑ Repeat Sample(AIP) Chlorinated:Yes•.._.........No (from distribution system after unsat routine) Unsatisfactory routine lab number. Chlorine Residual:Total_Free_ 3.Ground Water Rule Source Sample Unsatisfactory routine collect date: S / 1 Chlorinated:Yes No ❑Triggered(NP) Chlorine Residual:Total—Free— ❑Assessment(A/P) 4. Surface or GWI Raw Source Water Sample(Enumeration) Cl E.coli ❑Fecal Filtered Yes_No_ 5.I]Sample Collected for Information Only: -LAB USE ONLY DRINKING WATER RESULTS LAB USE ONLY ❑Unsatisfactory Total Coliform Present and I Satisfactory ❑E.coli present O E.coli absent Bacterial Density Results:Total Coliform _<1.0 1100ml. E.coli : 1.0/100ml. Fecal Coliform /100ml. HPC /1 ml. Replacement Sample Required: ❑TNTC ❑Sample too old ❑ Sample Volume ❑Damaged Container ❑ Date i ec ed: Lab Reference Number — Receipt mp C': I Method Code: SM9223B Date Reported to DOH Lab Use Only: DOH LabSample# 285- [O$ Z ,� 0CH ram 43313 t9(dbnn,a 5et7).n you rand Na p,bBeadan In en Ntn,mean te,r et ca48U;nra urn 7(rolY r Y tat till TNa and near pbruetane ae avavable at wrw dad we gwlddnksadyeter • 2 ado, S. Q yak O131 NIVilO JO 3003 WONJ'U Ot-3NIl 33JVM 711f 3Hf im 03SOdONd fin} 'ld OS� r V � / LJ �e �a1 Ca THURSTON-MASON HEALTH DISTRICT j �f 5th l� Birch, P.O. Box 746 No. Shelton, Wash. 9. 8584 DIVISION OF INYIIONMUNTALBIALTM Courthouse knnex Phone 426-4407 Olympia, W h 98501 Phone: 35 =4851 EXT`'84 OWNER '. . HONE 7 ,., I/ S S"5 O1�//.�/� STATE ?7Qo OWNER'S ADDRESS CITY T SEND REPORT TO CITY STATE . Q' SEWAGE CONTRACTOR '6N a At D N ADDRESS (If self, confer with E.H.S.) LEGAL DESCRIPTION •. d e val. 0 PlAr^ 31 PARCEL NO. O ' LOT SIZE/IC )' / Z O INTENDED'USE OF EL G.________ NO. OF. BEDROOMS N0. OF BATHROOMS BASEMENT PLUMBING: YES NO . ^ NAME OF'WATER SYSTEM INDIVIDUAL PUBLIC C MMUNITY DIRECTIONS TO -PROPERTY: (Be -Specific) IVY DRAW A'°SKETCH SHOWING; , 1. Property lines, location of hruae on.t a lot, and dimensi ns of the lot. 2. Location of the'house and.sewage disposal system in relation to streams, 'l as, wells, soil g holes, patio. driveways, Undo ground tanks, water supply lines and easement . � � o r 60 fe The septic system -is an approved temporary method of sewage disposal until sanitary sewers are available. DO NOT WRITE IN THIS SPACE. MINIMUMS �r*�i l-7- 7 Septic Tank Drainfield ____�_ L' SITE APPLICATION DATE APPLICANT'S 6IGNAT IPT NO. DSO 8Y SITE INSPEC IAN FE APP,RO�►ED T :APPRO HY = Date Dane, Inspector ALT I Q. F-7 SEWAGE APPLICATION �7 DATE APPLI o9 SIGNATURE_ BY —' FEE lRECEIPT NO: ; PERM NO.. APPAAVE v. A 8 PrintedI pct 1-iii lied {'om M son County z)M 3 H' - THURSTON-MASON HEALTH DISTRICT 4TH.PHONE 753-8073 " P.O.BOX 746 -110'W''K' T: PHONE 426-4407 /OLYMPIA;WA 98501 SHELTON,W4 98584 RECORD OF FINAL-INSPECTION;OF YOUR SEWAGE DISPOSAL SYSTEM; PARCEL NO. �' �� ADDRESS '.NSHIP': RANGE SEC. THIS,RECORD IS NOT GUARANTEE OF PERFORMANCE. NAME OF L T A SEPTIC SYSTEM IS NOT A MUNICIPAL SEWER, HOWEVER PLAT oo� Z WITH PROPER MAINTENANCE AND CAREFUL USE OF: SOIL WATER IT CAN.GIVE MANY YEARS OF TROUBLE FREE SER- COMMENTS VICE. MANY PROBLEMS WITH SEPTIC TANKS ARE,CAUSED SITE A RATION- F ELD X BY FLUSHING .EXCESSIVE AMOUNTS OF PAPER, CLOTH NO S E 3 AND PLASTIC'MATERIALS DOWN THE DRAIN OR BY LARGE -DEPTH TO WATER TABLE..- OF YEAR MONTH 5 ND c Fl L'� AMOUNTS OF. WATER FROM LEAKY FAUCETS OR FAULTY �- FIXTURES. INSTALLER THE. SEPTIC TANK ,ITSELF SHOULD BE,CLEANED EVERY 3e,cIó.o a' TWO OR THREE YEARS,DEPENDING ON THE HABITS OF THE SIZE FAMILY,,THE NUMBER OF FIXTURES IN THE VHbUSE,.AND. SEPTIC TANK CSI THE AMOUNT THAT A GARBAGE,;DISPOSAL ,IS. USED. DRAINFIELD TOTAL FEET CLEANING AT THE RIGHT TIME WILL AVOID THE`RISK OF LENGTH : tike O INJURING OR DESTROYING .THE DRAINFIELD DUE. TO ... TRENCH AREA TOTAL SO.FT. SOLIDS.CARRYING OVER INTO THE DRAINFIELD.'CALL THE 'THURSTON-MASON HEALTH DISTRICT FOR A LIST OF LIC TILE [3g CORRUGATED ❑ SOLI ❑CEMENT ENSED;SEPTIC TANK CLEANERS IN YOUR AREA THE CLEAN DEPTH. ER CAN SERVE YOU BEST IF YOU SHOW HIM THIS RECORD ROCK _ V - WHEN HE COMES. CU.YDS. V V DEPT. . " - INCHES. HEAVY TRUCKS ,OR' :EQUIPMENT' SHOULD_. NEVER BE SPACE RESERVED.FOR. DRIVEN OVER THE TANK OR DRAINFIELD. CONSULT THIS REPLACEMENT DISTRIBUTION FIELD:' SCI- FT.' RECORD IN CASE ANY. BUILDINGS,:DRIVEWAYS, SWIM- 4 NORTH MING POOLS, OR EXTENSIVE•GRADING OR. FILLING ARE , LATER:CONTEMPLATED SHRUBS OR TREES SHOULD NOT BE PLANTED CLOSE TO j THE SEPTIC. TANK,AS,. THEY 'WOULD; INTERFERE WITH slepes •CLEANING OF THE TANK-,THEY CAN BE PLANTED IN THE DRAINFIELD AREA PROVIDING.WILLOWS ARE NOT,USED. THE YARD GRADEVIN THE DISPOSAL AREA SHOULD.BE'SUCH ''°' .t°' .. .1 THAT.SURFACE WATER IS NOT POCKETED ON THE DRAIN- V V FIELD;:`ANY SETTLING OF THE GROUND OVER-THE TREK. CHES,SHOULD BE.FILLEDIN WITH SOIL DO NOT EXCES• �mpes SIVELY,-WATER THE LAWN IN THE DRAINFIELD AREA. WATER.EVAPORATION FROM THE DRAINFIELD 'IS.ABOUT J EQUAL TO ONE HALF INCH OF RAIN PER DAY. FOOTING DRAINAGE, DOWNSPOUTS AND WATER . . SOFTENER RECHARGE WATER SHOULD NOT BE CONNECTED >� 1t. INTOTHE SEPTIC SYSTEM OR DISCHARGED INTO THE DRAIN- ��� FIELD AREA. - - THE TYPES OF BACTERIA NEEDED IN A SEPTIC TANK ARE ' ALWAYS.FOUND IN SEWAGE: THERE IS NO NEED TO ADD YEAST OR OTHER STARTERS TO A SYSTEM: THE USE OF RE JUVENATOR5 OR"CHENIICALS TO CLEAN A SEPTIC TANK - V • - -- @ rl uet _ HAVE NOT BEEN PROVEN TO BE.BENEFICIAL AND MAY BE HARMFUL BY FLUSHING SOLIDS OUT OF THE TANK OR BY'CHANGING;THE:CHARACTERISTICS OF„THE-SOIL: THE NORMAL USE OF BOWL''CLEANERS OR CLEANING Q, POUNDS WILL NOT-KILL THE BACTERIAL ACTION V V V V V DOWN THE OPERATION OF THE SEPTIC TANK .•G*' " %sibO v C� PE APPRVE . THIS IS AN IMPORTANT.DOCUMEN gt r- ' �/ 7• P T �. Bz�..� • ` , ' y � � �� CERTIFIED BY. E' FS�SENCP � il. Pt; d 1;or}1 Mon uc�urit1 DM . . pM