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Home My WebLink AboutWAT2026-00152 - WAT Application - 8/10/2026 WAT 2026-00-152 MASON COUNTY t5S G°arcs Shelon_Wn 98584 Shelton:360-427-9610. 1>et.400 Public Health & Human Services nc0elr,60-295-4467.Ls t.400 Application for Determination of Water Adequacy Instructions 1, Complete Part 1. No determination can be made until Part 1 is fully completed. 2. Complete only the portion of Part 2 applying to the type of water connection utilized. 3. Submit completed application with any required attachments for review. 4. An approved building site plan must accompany this application. Part 1: Applicant/ Parcel Identification Name of Applicant Shannon Alatalo Date. 7/15/26 Mailing Address. PO Box 524 Phone: 3604342134 Parcel Number. 12330-76-00010 Type of Water System Reason for Application ❑ Public/Community Water System(2 or more fy; Building permit connections) O Division of land'. [X Individual water source (one connection), #of Parcels? SPL fB Well O Boundary line adjustment O Spring/surface water ❑ Other(explain) ❑ Other(explain) ❑ Replacement or Remodel (please indicate name If you have more than one residence connected of water system below if applicable— no to this well, check the Public/Community Water signature required) System box. Part 2: Water Connection Information Complete the section appropriate for the type of water connection being evaluated: Public Water System Name of Water System: Water Facility Inventory (WFI) Number: (write"none" for two-party) O 1 am the manager of this water system. The water system has been approved for services. There are presently connection(s) in use. This will be the connection. ❑ lam the manager of this system. This connection will be to upgrade or change the use of an existing connection on this system (i.e.: recreational to full time). Please indicate on the following line the nature of this change. This water system is able and willing to provide water to this (these) connection(s)without exceeding the limits of the water system or any limits set by state and local regulation. Print Name of Water System Manager Phone Signature of Water System Manager Date This form may be scanned and available for public view at www.masoncountywa.gov J IIIt Iomm' nrinki pig weer Revised 05/o8.2uz4 Page I aft Group B Water Systems ❑ Satisfactory bacteriological test within last year(attach to application). Individual Water Well d( Water well report(attached to application). Depth 312 ft IX Well capacity Test(attached to application) 15.00 gpm >400 gpd. The well driller often performs well capacity tests at the time the well is constructed. Results from these tests are noted on the water well report. Results from these tests will be accepted. If the water well report cannot be located by the applicant or if the water well report does not have a capacity test, a well capacity test, which provides stabilization of draw-down and recovery data, must be performed by a licensed contractor. R Satisfactory bacteriological test within last year(attach to application). Individual Spring/Surface Water ❑ WDOE permit(attach to application) ❑ Method of disinfection ❑ I have reason to believe that this water source can provide at least 800 gallons per day; and/or provides water at a rate of 2 gallons per minute based on the following observations. Author of Statement Date Relationship to Applicant Part 3: Mason County Community Services Evaluation (staff use only) x Satisfactory Determination: This determination does not address adequacy of the distribution system, guarantee an adequate supply of water indefinitely in the future,or guarantee compliance with all applicable WDOE water resource regulations. Recommended approval indicates requirements of Sanitary Code,Title 6, Chapter 6.68.040-Determination of Adequacy for Building Permits are satisfied. Additional Growth Management requirements may apply. Chapter 36.70A RCW. Cl Unsatisfactory Determination: Applicant's water supply does not appear adequate to meet the needs of its intended use for the following reason(s). LI^ S Reviewer's Signatures: 8/10/26 Environ. Health. Date This form may be scanned and available for public view at www.masoncountywa.gov Paae 20f2 fl MF. I VI Water Well Report ECOLOGY Page 1 of 2 Project Details Notice of Intent#: WE62908 Well Report ID: 2384097 Owner Name: AUSTIN CASTEEL Project Name: Well Street Address: MAST RD BELFAIR WA 98528 Tax Parcel Number: 12330-76-00010 County: MASON Latitude: 47 45289 QuarterQuarter-Quarter: NE-SW Section/Township/Range: 530/T23N/R1W Longitude: _122,85758 Construction Details Well Type: Water(Cased Well) Well Name: Work Type: New Purpose of Use: Domestic (Single) Drilling Method: Cable Well Tag Number: BQC489 End Date: 7/8/2026 Construction Start Date: ft. Measurement Date: 7/8/2026 Static ot Water ing Level: 282 ft. Completed Depth: 312 ft. Total Boring Depth: 312 ft. Casing Strings tlThth IWT tl Gin. .• • 1ft. 1 Mild Steel 0 ft. 302 ft -------2-------- Welded 25 in. 6 in. Screens Johnson _ NO 302 ft. 312 ft. 1 stainless 5 in. -/a _---- 14n in K-Packer Depth 300 ft. Driller Certification I hereby certify that I am the driller named in this well report. I have constructed, or supervised the construction of this well or boring and I accept full responsibility for the construction and/or decommissioning activities performed. I further certify the activities performed are in compliance with the construction and decommissioning standards set forth by Washington Administrative Code Title 173, Chapter 160 and all other applicable rules, laws, and local ordinances. Driller Name (Lic.#): MICHAEL A DAVIS (0797) Drilling Company: DAVIS DRILLING INC Company Address 340 NE DAVIS FARM RD Driller Signature: J BELFAIR WA 98528 Electronically Signed On: 7/15/2026 6:23:25 PM The Department of Ecology does not warrant the information contained in this well report. L)trAR mrI I > Water Well Report ECOLOGY Notice of Intent.WE62908/Well Report ID: 2384097 Page 2 of 2 Sealing and Backfill Layers 1 Annular Bentonite Chips Oft. 20 ft. Lithology (Driller's Log)1 Topsoil 0 ft. 2 ft. 2 Brown till 2 ft. 38 ft. 3 Light brown clay 38 ft. 45 ft. 4 Brown till 45 ft. 205 ft. 5 Silt, sand &gravel wet 205 ft. 210 ft. 6 Reddish brown conglomerate wet 210 ft. 225 ft. 7 Dry till 225 ft. 295 ft. 8 Brown sand &gravel wb 295 ft. 312 ft. Pump goulds sub 1.50 H.P. 305 ft. 12.00 GPM Well Tests (Air, Bailer, and Flowing) Date of the Test: 7/8/2026 Tested By: Mike Davis Bailer 15 GPM •• 7 ft. ------- 60 min. The Department of Ecology does not warrant the information contained in this well report. 2222_, t i 1706 SE NLIe HIII '. �I • SPECTRA Luboraloric,- Ritcap Pon PUaMWA , W iWexperience-1— 'I. 9Safb 2222 COLIFORM BACTERIA ANALYSIS FORM 111 Date Sample Collected Tme Sample Cojnt Collected anim o War Year 9229. 2299... Type of Water System(check only artebo s n QGvupA QGaLp6 D drt L{0tC ;. -- Group A and Group B Systems-Provide from Water Facilities lnvenlory(WFI)_ ID# �(�— System ( Qvl .�-\' L• `d l �1 2299 9229 Content Person — Deyphwe.l _l _Cell Phone () Rw `J�r V 3Z r, '\D t1 ' ca t !"i'\ -.. Serve resufls to:lPrint lull name.cadre$and im:ode ore-nail 9229. 2222_ 9999 9999 2299 SAMPLE INFORMATION Sample collected y name)- -{ r \ Specific Isoocaa oo wt'crele\ample cd lected • Spend lnsadctons or comments :�Tyya ol8�llpb(aelelYardyorw tYpaaeemlN�_fmn LWeatmmu7hs Gabwl I.0 Rouene Distribution Sample INP) 2 ❑ Repeat Sample(NP) Chodnatedl Yes_No_ from disPLu:o'isystem alter unsat ionenel Unsatisfactory routne lab number Cnlonne Resid+zl'.total .Free ___ O.Ground Water Rule Source Sample I Unsatisfactory routine collect date is _ _I I Chlonnated Yes 9999.No_.. Q Triggered(AIP) Chbnne Rosidlal.Total_ Free ❑Assessment (A'P) ._- '. 4, Surface orGWl Raw Source WabrSample(Enumeration) Q E.colt ❑Focal riireed r.: eo 9999 - 5e, mpie Collected b InramN Only: _ LAB USE ONLY DRINKING WATER RESULTS LAB USE ONLY Q Unudsfactory Total Coldonn Present and _�- Saashclory O Look present ❑E cull absent -- 9229. . .2222_ Bedadel Density Raeulb'Total Colkm /100m1 ECW --/lO nl. Focal Coltorm cN /lOGml. HPC_- _!1ml. - _ 9229__—.2222_ -99.22'j I Replacement Sample Required: ❑iNTC ❑Sample too old ❑ Sample Volume ❑Damaged Container CJontaliner ❑.2222-.. i .!(v 9223B M9- IM pa--t��L-}yy}D�te eaen \s� Reosp11emoc. Me1nLC de 22_ Dale keponed W UGH Lab J.0" DOHL#Sa q9 tazl.rrem.+.w°ar ':wra6!Ii .or..`' Imrs-.IN. .�,n , , ar 2222