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HomeMy WebLinkAboutWEL2026-00026 - WEL Application MASON COUNTY 415N6IsjS 0427-970,EXT 400 SH STREE 360-4TTON, EXT 584 6ELFAIR:360-275-4467, EXT 400 Public Health & Human Services ELMA:360-482-5269 EXT 400 FAX'.360-427-7787 10/12/2026 ENGER MELVIN D & CATHY A 8391 E STATE ROUTE 3 SHELTON, WA 98584 RE: WA TER SYSTEM PERMIT: TWO-PARTY WEL2026-00026 8391 E State Route 3 221292450020 The 2-party water system, Two-Party Well (SFR+ SFR): Enger Shared Water System (221292450020/221292450030), 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, D id Anderson Environmental Health Specialist Mason County Environmental Health MASON COUNTY Dale Rece1°ed COMMUNITY SERVICES Ln,R t at°n M Pin in �5"__C�� 415 N.6"6::Street.Bldg 2)-Shelt. ."A98584 WEL aoa `_Y - &Eod� She'ton:360-427-9670 Bel fair i60475J16]x40r11I W lD, i -O82-i269 x4IXl TWO—PARTY PRIVATE WATER SYSTEM APPLICATION PI'Dell PIJOM. Melvin Enger -STREET(Hi.STATF ZIP c/o 1161 E Bertlesen Road srtLm.Rlss-SIRFF1.(rn.STcrr.Lm 8391 E State Route 3, Shelton,WA 98584 ER mt II.rrru, 22129-24-50020 SF(VRDART PARCEL NI Mu,R I.SA M:AS PRIM RV IF I0USTFD D\S\M PART Fl.I 22129-24-50030 4FvRflI RUF SDoko--,APr PAKflhlIDrxlrmn nnnonm,n P.RC ELZ LOTSIZF.t minh,] t New O Existing O Well 9 Spring 10 Acres 10 Acres nIIR srsrIM N1MF,1REQI IRFI). Enger Shared Water System PRaerr 0DSCRIPTI0S t.e., fri sdd ADr,,,,.,e'.ear.mrb relth1Kt,e tnL.•" ,.a..Rw Existing home and a future hookup for a new home on neighboring property DIRECTIONS m MIE(,RT mnuxS,care C ORE 1 eat LOC I IO\.Ere Out SR#3 past Pickering Park and Ride, driveway on the left, stay left then right to home and pumphouse is to the right Required Submittals/Requirements Checklist: E] Original water we]I report I well log)or DoE water SeelI report for an existing well. Well tag secured to the sell casing. 0 Capacity test showing 900 GPD with drawdown and recovery to static level information, as described on page one of this packet- Bacteriological test(Bac-t)results current(within 12 months)and satisfactory. S Septic Records(additional locating requirements may apply if no septic records are on rile). E Applicable aril it easement documents. 4 Filing requirements.as described oil page I of this packet*Vote: May be recorded after the permit has been preapprovcd. I own the proposed two-party water well and have the right to grant access for a second connection. I attest that the well currently has no more than one connection. Pnnl' Melvin Enger Sign: n2�Cl Date: 9/17/2026 This form may be scanned and made available for public viewing on the Mason County website Pg 2 Last Updated: 6/30/2026 Please include the following site features for each parcel served by the proposed two-party well: 0 Parcel numbers(s) 0 Property lines/boundaries 0 Applicable easements with the Auditor's File Number(AFN) 0 Roads and driveways 0 Well location with a 100 ft radius around it 0 Structures *water wells shall not be located in garages, barns, storage buildings,or dwellings(WAC 173-160-171) 0 Water lines for existing and proposed connections 0 Septic and sewer components(tanks.primary and reserve drainfields,transport lines) Cl Barns,chicken coops, barns, manure piles, dog kennels,commercial gardens,compost piles ❑ Chemical Storage within 100 0 ❑ Landfills(existing or former)within 1000 ft Site Drawing T i form may be scanned and made available for public viewing on the Mason County we site Pg 3 Last Updated:6/30/2026 PIONEER DIGGING.INC. PARCEL#: 22129-2400000 SOIL LOGS: PIONEER F CUSTOMER: MEL ENGER 5LP22"GLG 5L&O24"GLS SL3O24"Gl5 22"h G.T. 24"+G.T. 244 OT. DobPee(De, Rts igrcr) DRAWING: PLOT PLAN rsooi 22" o T°24" Rom it Nn 7o��x rd/o) SCALE: 1 '-100' I � I I I I I I •,��Y��' f"fix..,+ I Qllrj I I nivlhh I 4�f�QC��-� I tPPfZCF� � I7a129 _�_ *�020 122124 -v1-� I I r bRAI l 1V: 3-5O'x3' (45OX) W/50' Af1N,ZC!' I / EXI51, , L _. 68'-4" P059�,E fA'J'.I.OGAtiON ILIILPING" J- SWAY c � I' 0' rxr. c 200' ■ a 111 0 ■ ■ ■ t. ` sG. i P'r aK4 '� _• am 11 -- -- Staff Use Only -- Review Step 1: Well Site Inspection: YES NO r� NiO ❑ 4 ❑ Sources of contamination within 100 ft of the well?(septic components,chemicals, livestock,etc.) ❑ ❑ Roads located within 100 ft of the water source? Private/County/State Distance to road(s) ry ❑ ❑ Ground slopes away from the well? ❑ ❑ Well located outside ofgarages,barns,storage buildings,and dwellings,with at least 5 ft of separation'? ❑ ❑ Satisfactory metal or plastic well cap that is mechanically secured or welded to the casing? ® ❑ ❑ Access ports and openings sealed/screened to prevent contamination,pressure gauge installed for artesian wells? T ❑ ❑ Adequate surface seal,filled to land surface level?*Leaving vot - future installation of equipment is prohibited. t• ❑ ❑ The well casing extends IZ above level groundi onerete slab. Lat 4�2P146 ❑ ❑ DoE well tag attached to thewcll casing? Lon: 1. ❑ ❑ Variance necessary forwcl site up oval? Tag: 4c4 JO; - Aimwruwns ya �I'rfth_I0 oftof 1,611 Co "Is: /0(7/1076 = W 773 'g00c'1 psv fo cefle S 66(ft- LG as,s tji Fail Inspector Date /l7( (za Review Step 2: Two Party Review: V S VO NA t}Irgq�f5l ❑ ❑ Water well report(well log): Date CompletedSi'W _Driller fq?or t2(* Q/'/fly' ❑ ❑ � Satisfactory capacity test showing a minimum of R00 GPD with full recovery to static level within 24 hours? Capacity test infortnaoon. Date _ DrillerrVump Installer W VQI'I S �vnp p LLffjj((�� �J ��—C._ GPM uzc Duration(minutes) rte Total Gal 2000 Recovery Time((minutes)to Statie / L{I ❑ ❑ Water system capable of supplying at least 30 PSI to each connection?PSI _3 p ❑ ❑ Satisfactory bacteriological analysis? Date /g/1O Tes ting Tting Tab 7kk15 uOD4& 9 l[P ❑ ❑ Signed_notarized,and recorded notice to future property owners?AFN__Z LI(g 53 ❑ ❑ Signed,notarized,and recorded water use agreement?AFN 2 Z ClO $9) ❑ ❑ Signed,notarized,and recorded access easement(s)?AFN Z 7 31 ❑ ❑ The system appears adequate to serve two connections based on lb information provided? l0O(m i6 : A(,Ca'yr Vafer vim 4a_WA ___ Comments: 1 Approved ❑ Denied Reviewer Date hind! t in thicry iew refl a of veined con dinuna as the' - .vcdor de day /the.it. inspect - nooloi,n iv nude impress or impl,d of the lrtury success or/oilers 0/this Si etera J ?rll site nppr ovaldocs nor cmrs Iii ute'eater system app boral Ally /i Wd(01Sf!ecl,o,J to've rrclLc u C S&//cCho L'a Icy a d q ía c-v equ/5(fflev iii Cnre'%building pe- rit per MCC 6.63. PaIc rvi -+orictions and additional tees'na),apply to all new rrredh drilled J1er January I9h 20/S per ESSB 6091. This form may be scanned and made available for public viewing on the Mason County website Pg 4 Last Updated: 6/30/2026 ; Cf J;«3 « 3 a a; !J: \ \ \ ) ` ~ \ _ � G \ \ / � _ ; d $ lo / % � { » ) / : § ) {$ @ ' \ _, _ / / 7 § 11811' < \` m % ! 2 = I | _ , ` . : \ \_ - - - - . -IF ! 2 !! of . mb } $ ! «, u. / §[ II1II . � \ \: ; mo o^^ WATER WELL REPORT Ndke Pt lnlNn DepardtenaELdoq UNIQUE WELL(.0.N � 5t Sepona Coq-Cwne?s Coq STATE OF WASHINGTON TNrd Copy'Drllers Copy {5503 Water Rghl Penn No. - Aaless U y (1) OWNER: Name ����''""�� a 5 114 AI etlI4 Sec_7 T�LN.R.X WM (2) LOCATION 01'"Ll County (L) STREET ADDRESS OF VIEW(of ured edrese) LaY TAEPARCELNO.: 32/19 4LGDnn (3) PROPOSED USE; fl Dotnastic DURE DESCRIPI1ON Q (10) Tut Wdl O Oiler Formation:Denote by�lor,dlanmr,slu a motenEit arid uuctur*and N ❑ DeWeter the kind and nature athe meWdam eachareow p oldeverewithal Iead one entry or sae change d bbrmation.Ieiele d wee ercw,ered L NI TYPE OF WORK: IJMIew numbei d well(d more thin one) FROM TO •' yy New Well Method: MATERIAL C "O Deepened ❑ Dug ❑ Soren O ❑ Recoeindle ❑ Cede ❑Driven C ❑ Decommisdcn ❑ Rotary ❑ Jew y (S) D 1EN510N5: Dimneer d well / inches �� sa Drb .�Yll [ M'=N Dept of almPlabd well /90 n E (Q COHSTRUCRON OE ANS 0 ppInsINMd: b gem.from a n.to n. Weelded CO liner reads installed Dam,from—h.to h. G/ - ❑ Thistle _— Diem.Ironn.to_ . - - - y Arloretlpne: ❑Yu .m No .nril7F Type of perloralar used GSIZE of perbntime in.by In. A mrhrellorrs from n.to n. 1r� Y ILl/ OR smears: 4% o t : J,'K-Pec Location /'�9 u� li.r --,r ^ 1`, - fl Menutamurele Narro oia f�S Modd No. N as-r Diem Sbt Sire from/ 30 iL io C Diem 6la size 20_from to �$/(2—__n. ;lahL ll nl �.- a C ` GmeVflNn packed: OYu �No ❑SlzeapmeVue P Jflne .., Mebrelpmcedhom h-to n. Lo t o). Su,Mre week: %\ S O No To what /�'Iry /Q h. Materiel used In Mal RWMat l^ )O3 ODmeny arale¢otain unable water? ❑Yu N� Z Types onddof _. Dept a nved Method of suNq mare oh H S O (7) PUMP: MmMxnureys Nerve I T,A,e. _M.P. .Z (a) WATER LEVELS: lend-aurtsce ekc'aucn edge mean wee level IttOn d y w}3,�. Swc te,i n.below tap of well Date wan sen _r � se .— Gomaets 0 - Anesim pressure .__IW.per square inch Oate O Artesian waters controlled by WELL CONSTRUCTION GEXTIFICATION: Lg (Gap, W uhe.sic) W I condreatl and/or accept reapouiMlly huamslmchon of min soap,erg Vb O (pl woo l en o made?n i amount water feel is losers below dent level compliance with all Washington we ors action standards Merenals used C Was:pump re main? O Yes �i No 12 Ey .d w and he Nbmledon reported oboe are low to my beat knowledge and belief. C Vleb: Mlmin.wM A2 h.drawdownanar hrs. 044'_yl.lln >wU YNN: w1min.onn X.drewtlman ehar___hn. Type or Pnm Name / / U�lu P/1 __________ E Yield: __�a11,with X.dmwalawn after Mrs. (Licensed OrllterlEnglnem) V Recovery dale(Erne taken as zero when pump tamed off)(water Iool measured ham Trainee Name LloTnu Na a wall lop b waterebroil /, r CLe nine Ware,Level Time Water Level Time Water Level Drilling C____ Lc N / (Sidne) - --- -- (lie m /Enpkr J)/J ' / p� — t - - Address R D r rs _ rd>�� Date a testa teat G1301015 �C� Sher test2 gal,ynm.with drawe.n oner_�—nre. Redae:mn No./�ALa2�/1b�2 �am L.. SU Anent oelmlbt with ft.dmwdovn after_____US. Artesian flow a.Pm. Date_ (USE ADDITIONAL SHEETS IF NECESSARY) Temperature of water-Was:,,Minkel analysis model O Yin'f No Ecology Is an Equal Opponunity and AMrmanve Amon employer.For spedal eawnomda n needs coned the Wider Resources Program et(960)107- EGY 0561.20(11N6) 6600,The TOD numbers(3811100)-0006. F. % . 1%. 1 I , < w , . I .\ d � , Pump Test Data Collection Form System ID: Pending Well Tag N_JQSc DOH source ID: Date: 12/11/2023, Northwest Water Systems Type of test: County: Mason Owner: Well Elevation (ft) System Name: Sunset Ridge Events Static Water Level (ft) 103 Well Depth (ft) 140 Time since Depth to pumping water leWd,awdown Pumping Time began(min) (ft) rate (gpm) comments -2.0 0 -1.5 0 13 gpm -1.0 00.5 00.0 00.5 .7 1.0 108.1 5.1 1.5 108.8 5.8 2.0 108.9 5.9 2.5 109.0 6.0 3.0 109.0 6.0 3.5 109.0 6.0 4.0 109.0 6.0 4.5 109.0 6.0 5.0 109.1 6.1 5.5 109.1 6.1 6.0 109.1 6.1 6.5 109.1 6.1 7.0 109.0 6.0 7.5 109.1 6.1 8.0 109.1 6.1 8.5 109.1 6.1 9.0 109.1 6.1 9.5 109.1 6.1 10.0 109.1 6.1 11.0 109.1 6.1 12.0 109.1 6.1 13.0 109.1 6.1 14.0 109.1 6.1 15.0 109.1 6.1 16.0 109.1 6.1 18.0 109.1 6.1 20.0 109.1 6.1 22.0 109.1 6.1 24.0 109.1 6.1 26.0 109.1 6.1 28.0 109.1 6.1 30.0 109.1 6.1 35.0 109.1 6.1 40.0 109.1 6.1 45.0 109.1 6.1 50.0 109.1 6.1 55.0 109.1 6.1 60.0 109.1 6.1 65.0 109.1 6.1 65.5 109.1 6.1 17 gpm 66.0 110.0 7.0 66.5 110.5 7.5 67.0 110.6 7.6 67.5 110.6 7.6 68.0 110.6 7.6 68.5 110.6 7.6 69.0 110.6 7.6 69.5 110.6 7.6 70.0 110.6 7.6 70.5 110.6 7.6 71.0 110.6 7.6 71.5 110.6 7.6 72.0 110.6 7.6 72.5 110.6 7.6 73.0 110.6 7.6 73.5 110.6 7.6 74.0 110.6 7.6 74.5 110.6 7.6 75.0 110.6 7.6 76.0 110.6 7.6 77.0 110.6 7.6 78.0 110.6 7.6 79.0 110.6 7.6 80.0 110.6 7.6 82.0 110.6 7.6 84.0 110.6 7.6 86.0 110.6 7.6 88.0 110.6 7.6 90.0 110.6 7.6 92.0 110.6 7.6 94.0 110.6 7.6 96.0 110.6 7.6 101.0 110.6 7.6 106.0 110.6 7.6 111.0 110.6 7.6 116.0 110.6 7.6 121.0 110.6 7.6 126.0 110.6 7.6 126.5 112.4 9.4 24 gpm 127.0 112.6 9.6 127.5 113.0 10.0 128.0 113.1 10.1 128.5 113.2 10.2 129.0 113.3 10.3 129.5 113.3 10.3 130.0 113.3 10.3 130.5 113.3 10.3 131.0 113.3 10.3 131.5 113.3 10.3 132.0 113.3 10.3 132.5 113.3 10.3 133.0 113.3 10.3 133.5 113.3 10.3 134.0 113.3 10.3 134.5 113.3 10.3 135.0 113.3 10.3 135.5 113.3 10.3 136.0 113.3 10.3 136.5 113.3 10.3 137.0 113.3 10.3 138.0 113.3 10.3 139.0 113.3 10.3 140.0 113.3 10.3 141.0 113.3 10.3 142.0 113.3 10.3 144.0 113.3 10.3 146.0 113.3 10.3 148.0 113.3 10.3 150.0 113.3 10.3 152.0 113.3 10.3 154.0 113.3 10.3 156.0 113.3 10.3 158.0 113.3 10.3 163.0 113.3 10.3 168.0 113.3 10.3 173.0 113.3 10.3 178.0 113.3 10.3 182.0 113.3 10.3 187.0 113.3 10.3 192.0 113.3 10.3 192.5 113.4 10.4 193.0 113.5 10.5 25 gpm 193.5 113.7 10.7 194.0 113.9 10.9 194.5 113.9 10.9 195.0 113.9 10.9 195.5 113.9 10.9 196.0 113.9 10.9 196.5 113.9 10.9 197.0 113.9 10.9 197.5 113.9 10.9 198.0 114.0 11.0 198.5 114.0 11.0 199.0 114.0 11.0 199.5 114.0 11.0 200.0 114.0 11.0 200.5 114.0 11.0 201.0 114.0 11.0 201.5 114.0 11.0 202.0 114.0 11.0 202.5 114.0 11.0 203.0 114.0 11.0 204.0 114.0 11.0 205.0 114.0 11.0 206.0 114.0 11.0 207.0 114.0 11.0 208.0 114.0 11.0 210.0 114.0 11.0 212.0 114.0 11.0 214.0 114.0 11.0 216.0 114.0 11.0 218.0 114.0 11.0 220.0 114.0 11.0 224.0 114.0 11.0 229.0 114.0 11.0 234.0 114.0 11.0 239.0 114.0 11.0 244.0 114.0 11.0 249.0 114.0 11.0 254.0 114.0 11.0 284.0 114.0 11.0 314.0 114.0 11.0 344.0 114.1 11.1 374.0 114.1 11.1 404.0 114.1 11.1 434.0 114.1 11.1 II Sunset Ridge Events Group B Step Test and Constant Rate Drawdown 12.0 .. ■ 25 gpm ■ 24 gpm ■ 90 ._.. _ _.. . _. ._. F 80 __. _. 13 gpm I 3O . ___ — _ 0a son 1000 1500 2000 xsoa 300O 350O 400.0 4500 rime(mm) Recovery Data Collection Form System ID: Pending Well Tag No: DOH source ID: 0 Date: 12/11/2023, Northwest Water Systems Type of test: Recovery County: Mason Owner: 0 Well Elevation (ft) 0 System Name: Sunset Ridge Events Static Water Level(ft) 103 Time since Time since Depth to pumping pumping water drawdown Time began (min) stopped (min) level(ft) (ft) comments 438.0 0.0 114.1 11.1 438.5 0.5 107.9 4.9 439.0 1.0 105.4 2.4 439.5 1.5 104.1 1.1 440.0 2.0 103.8 0.8 440.5 2.5 103.6 0.6 441.0 3.0 103.5 0.5 441.5 3.5 103.4 0A 442.0 4.0 103.4 0.4 442.5 4.5 103.3 0.3 443.0 5.0 103.3 0.3 443.5 5.5 103.3 0.3 444.0 6.0 103.3 0.3 444.5 6.5 103.3 0.3 445.0 7.0 103.3 0.3 445.5 7.5 103.3 0.3 446.0 8.0 103.2 0.2 446.5 8.5 103.2 0.2 447.0 9.0 103.2 0.2 447.5 9.5 103.2 0.2 448.0 10.0 103.2 02 449.0 11.0 103.2 0.2 450.0 12.0 103.2 0.2 451.0 13.0 103.2 0.2 452.0 14.0 103.2 0.2 '... Sunset Ridge Events Group B Recovery '..... ]d li 4 zo i s • om_._ ♦ a --__— -_ —_._ __. . oa to z.o r.o 40 so 60 to s.o 9O goo uo 'I,,, rime(min) Thurston County Environmental Health 412 Lilly Rd NE 0 Olympia,WA 98506 I 360 867-2631 TUURSTO COUNTY COLIFORM BACTERIA ANALYSIS Dale Sample Colkcled Time Sample County Cbracled / /y7/ �O �1•u room C, J ._Ovr A4 Type of Water System(check only one box) ❑ Prwate Household ❑Group A ❑Group B O Other_ Group A and /Group p.B�Syslems—peniidee from Water Facilities Inventory(WFT. System Narre. � '�� — Conlad Person Day Phone t7.) Cell Prone( ) E-mail: - Eve Phone ( ) Send results I¢ slim,address enc zip ccde or ail address) PO tvo/ 724 N AJ SAMPLE INFORMATION Sample collected by(name): ng) l Specific location or address where sample collected. Special Instructions or comments'. Pomp hbL2 Type of Sample(must check only one roe of N1 through N4 listed below) i Routine Distribution Sample 2.Repeat Sample(after great.rouane) Chlorinated-Yes_NoX_. ❑Distibutlon System Chlorine Residual.Total_Free Chlorinated'.Yes_No_ 3.Raw Water Source Sample Chlorine Residual'.Total_Free ❑E co —GWR(AIP) ❑Fecal—scow.Ow'svr,uss(n„seaew; Unsatisfactory routine lab number: Fillered.Yes_._No ❑Assessment Monlitodng(Al?) Unsatisfactory routine collect date_ ❑Other I I S 4.❑Sample Collected for Information Only Investigative ConsWcfidnl Repairs Omer _ LAB USE ONLY DRINKING WATER RESULTS LAB USE ONLY O Unsatisfactory Total Coliform Present and ®Satisfactory O E coil present O E absent No Loit000 detested Replacement Sample Required.' ❑Sample too old >30 hours) ❑TNTC ❑ Bacterial Density Results'.Total Colibrm___ fl0pml. E.coli._ _./ID0mI. Fecal Cobform /100ml Enterococci 1100 m1. Method Code:0 SM 9223B ❑SM 92220 Dale and Time Received. ❑SM 92156 ❑IEntermen® 9/10/2026 Dale and Tine Analyzed'. Date Reported' sxmpkrumberlr'J1 numMr$is fr nd tsi Lab Use 0ny. 2 80 8 5 0 9 1 0 5 WX RormAlll-3i9(rense4Nlll c 2246833 ifi MASONCO WA ENCER 0226948 Pee Fee $610 00 P49es 4 111 Il 111111 III IIII IIII I I 111111111111IIIII VIII IIIII III VIII VIII IIII BII W: R.FCT i o9 202E TAX r r �� dti} AFFIDAVIT ...... .. LL,;.�) C i II OCT 0 9 202E _J Return Address: Melvin&Cathy Enger EXEMPT 1 Y. 8391 E State Route 3 AASON COUNTY TREASURER _— Shelton,WA 98584 DOCUMENT TITLE: Shared Well Agreement REFERENCE NUMBERS OF RELATED DOCUMENTS: GRANTORS: ENGER,Melvin D.&Cathy A.,a married couple GRANTEE: ENGER,RONALD,a married individual as his separate property LEGAL DESCRIPTION LOT 2 OF LLS#06-065 15/565 32/232 LOT 3 OF LLS#06-06 S 15/565 32/232 ASSESSOR'S PROPERTY TAX PARCEL NOS. 22129.24-50020; 22129-24-50030 Shared Well Agreement and Grant of Easement PARTIES&RECITALS WHEREAS,MELVIN D. ENGER&CATHY A. ENGER,a married couple,hold record title in and to certain real property located in the County of Mason, State of Washington, which property is referred to herein as the"MELVIN ENGER Parcel- Lot 2" and is more fully described as: Lot two (2) of Large Lot Family Exemption No. 06-06, recorded November 29, 2006,in Volume 32 of Surveys, page 232,Auditor's File No. 1883666,and being a portion of the Southeast quarter (SE 1/4)of the Northwest quarter(NW¼) of Section 29,Township 21 North,Range 2 West,W.M., in Mason County,Washington. Tax Parcel No. 22129-24-50020 And WHEREAS, RONALD D, ENGER, a married individual as his separate property, hold record title in and to certain real property located in the County of Mason,State of Washington,which property is hereinafter referred to as the"RONALD ENGER Parcel-Lot 3"and is more fully described as: Lot three (3)of Large Lot Family Exemption No. 06-06, recorded November 29,2006, in Volume 32 of Surveys,page 232,Auditor's File No. 1883866,and being a portion of the Southeast quarter(SE Y4) of the Northwest quarter(NW 1/a) of Section 29,Township 21 North, Range 2 West,W.M.,in Mason County,Washington. Well Agreement- i Tax Parcel No.22129-24-50030 And WHEREAS, there is an existing well, pump, and well house located in & on the southeasterly corner of the MELVIN ENGER Parcel - Lot 2 described above,which well is approved to supply water to both parcels described herein, and which well is referenced in Notice to Future Property Owners of Private Two-Party Water System recorded October 8,2026 under Mason County Auditor's File No.2246759 and shown on the Large Lot Family Exemption Survey referenced herein; And WHEREAS,the parties hereto desire to enter this Agreement for the purpose of reducing to writing their respective rights and obligations pertaining to said well and future water distribution system. GRANT OF EASEMENT FOR WATER LINE MELVIN D. ENGER & CATHY A. ENGER, a married couple, hereby convey a perpetual, non- exclusive easement to RONALD D, ENGER, a married individual as his separate property, said easement to run with the land as follows: An easement for use &maintenance of an existing water line, running under, over and across a portion of the MELVIN ENGER Parcel - Lot 2 property described herein, extending in a easterly direction from the existing well to the common line with the RONALD ENGER Parcel - Lot 3; said easement being ten (10) feet in width, extending along the length of the water line,with the centerline orthe easement being the waterline itself The purpose of said easement is to provide RONALD ENGER Parcel - Lot 3 with access to that portion of the MELVIN ENGER Parcel- Lot 2 parcel,as reasonably necessary to maintain a waterline originating at the well and serving the RONALD ENGER parcel. TERMS OF AGREEMENT NOW THEREFORE, in consideration of the promises and covenants herein contained, it is agreed that that the water distribution system shall be used by the parties to this Agreement,as well as by all future owners and occupants,upon the following terms and conditions: 1. OWNERSHIP. The Parties to this Agreement shall share ownership in the well and its components 50/50. 2, MAINTENANCE/REPAIRS. Once the RONALD ENGER Parcel - Lot 3 connects to the well, the costs for improvements and repairs necessary for the continued operation of the well shall be split equally among the two parties to this Agreement. Major improvements and repairs may include (but not be limited to) pump replacement, pump house repairs, etc. This provision shall not apply to each party's underground water distribution lines as the parties are responsible for their own lines. The parties shall work promptly in cooperation in the event repairs and maintenance are Well Agreement- 2 necessary and payment shall be made promptly to reimburse the other party or pay the contractor directly. The parties agree to annually test the water for bacterial contamination and any additional testing that may be required to maintain the water quality of the system. 3. POWER COSTS. Beginning on the date that the owners of the RONALD ENGER Parcel - Lot 3 connect any structure (permanent or otherwise) to the water system, the owners of the RONALD ENGER Parcel - Lot 3 shall reimburse the owners of the MELVIN ENGER Parcel - Lot 2 an amount of $500.00 annually, for power costs associated with operation of the well. This reimbursement payment shall be due on or before January 30th of each year.The parties agree to work together in good faith to agree on increase(s) or decrease(s) from time to time as utility costs change, but any increases shall not exceed 3% annually 4. WATER USAGE. The Parties agree that the water system shall be used for normal domestic supply for homes on each parcel. If a dispute arises concerning normal water usage, the party having complaints shall have the right to meter the water. The expenses of the meter and installment,thereof,shall be borne by both parties equally. S. WATER SUPPLY. If the water system shall ever fail to supply adequate domestic supply of water pressure to the Grantees properties, these parties shall act together in a diligent manner to cure the problem and to maintain the water system in good and orderly repair according to applicable laws and regulations. 6. The Parties understand that the well has been approved for single family residential use only in accordance with Mason County Public Health approval issued under Water System Permit WEL2026-00026 and the Parties agree that use of the well will not be expanded to serve any other users without mutual agreement and approval by Mason County. 7. To the extent that this Agreement adds to, amends, or conflicts with the Notice to Future Property Owners referenced above, the terms of this Agreement shall supersede. 8. The parties agree that the benefits and burdens of this Agreement shall constitute a covenant running with the parcels of land herein described and shall be binding upon the heirs,successors in title and assigns of the parties hereto. IN WITNESS WHEREOF,the parties have hereunto set their hands and seal the day and year set forth below. y t MELVIN D. ENGER CATHY A. ER Well Agreement-3 RONALD ENGER STATE OF 11�ftiSh\YYJ�U✓I ) COUNTY OF fl On On this day personally appeared before me MELVIN D.ENGER&CATHY A.ENGER to me known to he the individuals described herein and who executed the within and foregoing instrument and acknowledged that they signed the same as their free and voluntary act and deed for the uses and purposes therein mentioned. nd and official seal thip KL day ofy!Clk'T�,,y1' .2026. it0.k, Notary Public in nd fortheSta e of 4�4p %Of, C Print Name rr. q��tliyr S Residing at Commission expires STATE OF ss. COUNTYOFV�ACT) ) On this day personally appeared before me RONALD ENGER to me known to be the individual described in and who executed the within and foregoing instrument and acknowledged that he signed the same as his free and voluntary act and deed for the uses and purposes therein mentioned. Given under my hand and official seal this day of D(A i" .2026. Øto Notary Public in ynd for th State of Washington Print Namc CI lm �0TA9 iiil Residing at Commission expires ?� f+atau,G 2 ��''ip��WASM�„��``�� Well Agreement- ti :-'{IN811$l Y1fAF�IM. M-NOEC�iFFAPPt]Cyl (QN ,MASON COUNTY DEPARTMENT C 77 o Official use only OF HEALTH SERVICES PERMIT NUMBER. SWG 2CCG- '- CC 416 CEDAPO BOX R16 6REET DATE RECEIVED. Z - Il CJ 'VC SHELTON,WA 98589 0 a (360)427-9670, Ext.352 RECEIPT NUMBER: 2 - - S APPLICANT DATE CHECK APPLICABLE ITEMS p a �,��(�-� O NEW SYSTEM G C MAILING ADDRESS �;DAYTIME PHONE O REPAIR SYSTEM i P.Q soK - VL,P_ yftpg O TABLE 6 REPAIR CITY STATE ZIP 0 SINGLE FAMILY O OTHER Please describe 2 SITE ADDRESS DRINKING WATER SOURCE C 0 PRIVATE INDIVIDUAL WELL NAME OF DESIGNER PHONE NUMBER • O PRIVATE TWO-PARTY WELL D Tc � ` ' O COMMUNITYIPUBLIC WATER NAME OF INSTALLER SYSTEM p SYSTEMWFIN. NUMBER OF LOT SIZE: ACRES FT X FT SYSTEM NAME: BEDROOMS SPECIFIC DIRECTIONS FOR LOCATING SITE Al. )s-ç 3 , Le'T o4 V'e .sE t1#.- ( V?EFD WCo(xial. t?sSC-cj. PDL S Dl e sr This application is for design approval only. "Lallation permit will be required to install the system. Nag Operation en All s ms d Maintenance as specffietl in Meson County Onehe Standards. • All AN systems must be designed by a Licensed Onsea Wastewater Designer or Professional Erpureer.wants prior r a is granted. 0 • A Mason County Certified Installer must Install all onsre sewage systems,unless prior approval is granted • Onstte sewage system design approval does not imp 'other building site approvals • Any change from the specified use of the property or any site alteration affecting the system design may invalidate this parrot. ` This permit expires 3 years from the date of site review.Denial of this permit may he appealed to tiro Health Officer wdMn fO tleys of denial date. Official use only below this line SOIL LOGS COMMENTS/CONDITIONS O - 2-C, CTS i S 2Cg 4- 2°' +-111 SOIL TEXTURE CODES: V =very G=gravelly 5=sand L-loam $1=sII C=Gay E=exlermly ECTOR IGNATU DA 7 GN DATFI DESIGN EXPIRATION DATE ZS D "PRO D 9A1761 3TL 2 Z�c1 eared 2,23/2005 White Copy-Health Department Yellow Copy-Designer Pink Copy-Applicant ONSITE SEWAGE SYSTEM APPLICATION MASON COUNTY PUBLIC HEALTH W Official use only � P • 426 PO BOX 1666 1666 u STREET PERMIT NUMBER: g_ / J SHELTON,WA 98584 DATE RECEIVED: AMOUNT RECEIVED:$ a (360)427-9670,Ext. 352 p s APPLICANT DATE CHECK APPLICABLE ITEMS = a 67 a NEW SYSTEM S MAILING ADDRESS DAEqçer ME PHONE rfle O REPAIR SYSTEM O O TABLE 6 REPAIR 0 TANK REPLACEMENT CITY STATE ZIP O RV HOLDING TANK ONLY (requires waiver) • INSTALLATION PERMIT ONLY 0 SITE ADDRESS O O SINGLE FAMILY — 2J f ^ WA a OTHER c vU� Jh a describe: C NAME OF DESIGNER PHONE NUMBER Note: Asbullb required for all Insudlatbns. Z NAME OF INSTALL DRINKING WATER SOURCE E, I� 0 PRIVATE INDIVIDUAL WELL p h NUMBER OF BEDROOMS LO SIZE: - 0 PRIVATE TWO-PARTY WELL ACRES FTxFT O COMMUNITYIPUBLIC WATER SYSTEM SYSTEM WFI#: I� SYSTEM NAME: SPECIFIC DIRECTIONS FOR LOCATING SITE, UI n F N` Site must be fla ed from main road and test holes must be flagged with test hole numbers L a Official use only below this line SOIL LOGS COMMENTS/CONDITIONS CJ RE�E1v�� A16`N'��Sh SOIL TEXTURE CODES: V =very G=gravelly S=eend L—bam SIa sift Cday E=extreme) INSPECTOR SIGNATURE DATE DESIGN EXPIRATION DATE DESIGN APPROVED BY DATE DATE INSTALLATION FP.E PAD) INSTALLATION EXPIRATION DATE IN TALLATIqON APPROVEDBY DATE eda �� 7r9t07 Revised 4N Ml MASON COUNTY DEPARTMENT OF HEALTH SERVICES _____August 04,04, 2006 PO BOX 1666 SHELTON, WA 98584 SHELTON (360)427-9670 FAX (360) 427-7798 Pioneer Digging ELMA (360)482-5269 3083 E Mason Benson Rd BELFAIR (360) 275-4467 SEATTLE (206)464-6968 Grapeview WA 98546 RE: Design for ENGER Case No: SWG2006-00562 Parcel No: 221292400000 Your design for the above referenced parcel has been review and is APPROVED. Please refer to the comments section of this letter for any additional information. Please call me at (360)427-9670, ext. 279 if you have any questions. Sincerely, Amanda� Reynolds Environmental Health Mason County Health Services COMMENTS: 81412006 1 of I SWG2006-00562 On-Site Sewage Systems (Chapter 246-272 WAC) Request for Waiver From State Regulations j (complaedby applkant) Name: (I) Address: 6;. Ywt. x t .5f ` y Telephone: !rt Sisnswn: Property Identification: p) ` t? e YS ten O u (completed byapplkam) WAC Number. (4) WAC Requhement (5) Waiver Sought (6) 216.272— t Subsets: Justification(mingatlon nranm to be provlled): (7/ Z© F Douils rgPc ctc (canplaedby health officer) Review Ctiterit (g) Mitigation Mess,,(in addUkn to those proposed): (9) ..ce&& (t5 . Commas/Conditions: po) Type of Waiver. ( l) 3 Class A 4CC3 D ]Class C—Request DOH roview¢gfgn griming? Yes_ No J- NeighborNWficatlon: (12) Requued? Yes_ No y nreded are agreement.easements,etc.PropnNJtied? Yes — No— (completed by officer))d This Request For Waiver From State Regulations has been reviewed aaording to the provisions of Chapter 246-272 WAC OnSite Sewage Systems. The review criteria applied,and the mitigation manor proposed and/or required,have been evaluated for their ability to provide public heahb protection at least equal to that provided by this chapter WAC. l Dealed 4 Approv /Granted—Sub' to all comments,andidom and requirements noted n Sections ll and Ill. Loal Health Offcer (13) d-Lt eet Date: Instructions for Completion Sections I and Ii are to be completed by the Applicant. Sections III and Ware to be completed by the Local Health Officer or his/her authorized representative. Most items in each Section are followed by a number in(). The instructions below art listed by these numbers: (1), Individual requesting waiver. (Presumed to be property owner...,indicate if not.) Be sure to include mailing address and phone number. (2) Local Health Department Usually this will be"hikd in"by the local health agency office. (3) Property ldatifiatiwt: Provide the address,parcel number,pesmit_applcanon member or other identifying description of the property forwhich a waiver is being requested. Afult legal description u not required (4) WAC Number Specify the particular WAC number from Queer 246-272 WAC for which a waiver is being sought,each as WAC 246-272-140(1)". (5) WAC Requitement State the requirement in the specified WAC for which a waiver is being sought,such u"100 foot setback from SSAS to a watt". (6) Waiver Sought Briefly describe the waiver sought,suds as"Reduction of setback 1o70 feet". (7) Jatifwadion. Provide the rationale for the waiver request What site coeditions system design charadaivtia,etc.mitigate the concerns that resukcd io the requhemenb in the WAC? Technical justification should include supporting data,plat plan.,device or treatment methodology proposed,possible mitigating site characteristics,gross bud area,other options explored,and any other pertinent data. Possible mitigation meson may include system design,site requirements,or administrative approaches. Much additions]page,if necessary to provide the local health officer adequate information upon which to make an informed decision. (8) Review Criteria Indicate when specific criteria were used in die review of the proposed waiver and mitigation measures. (9) Mitigation Measures.Indicate my mitigation measures required in addition to those proposed by the applicant (10) Comments/Conditions. Briefly describe my concnm or issues regarding the waiver request,mitigation masmn,correlated issues. (11) Typo of Waiver hrdicau which category of waivers this particular request is in. For Class C Waivem,indicate if DOH review is to be requested before a decision is made to gnat the request (12) Neighbor Notification. Am there my aspects of this waiver request for which notification to and/or permission by,adjoining or nearby property owners/dwellers would be appropriate? (13) Local Health Officer. This is where the Local Health Officer,or his/her authorised representative,by checking the appropriate box and signing,grants or denies the requested waiver. Assistance for applicants requesting a"Waiver From Local Health Depunnent I District Health Offices may obtain assistance State Regulation"may be obtained from the Local from the Washington State Department of Health in their review of Health Deputment or District proposed"Waive From State Regulation": (360)236-304]/John fission 2 /,` MASON COUNTY OF HEALTH SERVICES PPi��i FfeauA IMPARTMENT water tb aat7 14eairorvaeaol Health LOCAL(360)427 9650 BBLPABt(360)2754467&4468 Application for Waiver/Appeal TOLL PRA (36O 42�7798 Amount Paid: J1�Ii �'�C�J'�� Receipt Numbu: Instructions PART 1: Applicant/Parcel Identification N1rt t(�E2 Date Name of Applicant Telephon Mailing Address flAssessor's Parcel Number 11 12 Y 2 a o0 oa CCt� Subdivision Name and Lot vr, CEDAR STt pAR 2: Nature of Waiver/Appeal 0 Food Sanitation ttwaiTu"uns ❑ Sood Waste Requirtmeau ❑ On-Sift Sewage RegFialf It ❑ Groap B We9e System Re l"a"'i nts o Laeun n WA(t 24 2462724950! 2724 9 50s nemmu o Holding rank AC 24 272 l2 ❑ Water Adequacy 10411 o o -Sing WAC 246-272-12501 ❑ Enforcement 15melines ❑ oasttestandords ❑ Depertmenml Detuminations n Certlflcatlon contractor(Pumper. ❑ other dulgno, installa.O&Adspecl requirments ption of WaivaIApP"l(includ'JUSu Ic* on,additional matuiel may be attached) Il Date: ApPIIII Sieaarnm: /IIWOATAIRRCHIYEIWA/YFJt NP UPaPa:APd13a.199'! ' PARTS: Health Department Evaluation(Staff Use Only) / IA.Type ofDeteanimaon Required: ID. Type ofOnsi�te/waiver(if.ppliabte): / Gass A faictan a a Qua C O Appal �VV.iver ❑None requhe ❑d 2. Identificaton of Specific Code/Standard(Deterrnination(include date of determinatlan or latest code/standard revision): WArc- 211(m 2`1Z \\50\3. yve=: `` fir,-, 711 ko 1Z tçLr 4. Hearing Official: 13 Board of Health Health Officer O Pollution Control Hearing Board _fJfealth Services Director ❑ Certified Contractor Review Board Ertvirorrmenfal Health Manager 5 Mãgitio8F dots: `(`b. 6. 1 have reviewed this waiver/variance request ft it complete,and mitigation required by state and local policy hash en submirrm,y/ Date ______Z rJ�O Staff: f PART 4: Determination of the Hearing Official YX The hearing official has determined that approval of this request will not adversely affect public health and is herby granted. This decision Is based on the following findings and conditions: O The hearing official has determined that approval of this request could potentially have an adverselY affect public health and Is hereby denied. This declslon Is based an the following findings: Date: 3 0 Hearing oificinl , 6�ri N:IWD.fr4WRCHJVE1W.r1YER wf Upddt Malt u•rep] A • APPENDIX A • CLASS B WAIVER OF ON-SITE SEWAGE REGULATIONS WAC 246-272 AND WORKSHEET FOR DETERMINING A REDUCTION IN VERTICAL SEPERATION This worksheet is used to determine if a site qualifies for a reduction in vaunl sepaation under the Class B Waiver. Please fill out the worksheet in its entirety. Inuornpkte worksheets are returned m you end will cease delays b yon pemdt appfiutima Part 1:Applicant Information Name of Appl am M s/jhf=F Due siteAmress: °O391 C Sly - i0k S cIt , wee 48SP.`j Mailing Address: P.O . SOX !(IS car 13£-Fate Chy CJr1 Zip:________ Aawsurs P.d a: 99- 127 as ( wn(-1 SWG#: Part 2: Checklist 1) Sal Series 3) Check the soil structure The soil series must be Alderwood,Huserc, Smscmre must be single grained or wale Hoodsport,Shehm,or Sinclair Gravelly Sandy Loam Chad the soil series at the site u Indicated in the Sal Survey,Meant County,Washiogmn(USDA 1960) Single Grained or Weak............................................................ WellStrutmred...................................._..............................._......❑ ❑ Aldawood Gravelly Sady bun..............................................❑ Other .............................I............._❑ O Harstine Gravelly Sandy loam....................................................O ❑ ❑ Hoodsport Gravelly Sandy loam..............................................❑ 4- 3) '© percent slope of Prioury/regime 3urdeW ass ...❑ �:.. Slopes must be from 3-30 percent Gravity is allowed Shah..Gravell ..................................................... y Sn _. only on slopes from 3-15 puma. Pressure only is Sinclair crave0y Sandy loam.....................................................C❑ .❑ allowed on slope from 16-30 peacenn. Other ......... ... ...... . . . ..❑ ❑.. .S Less dun 3 percem .... ..._❑ ❑ X 315 percent..... .__.... .. S 2) CAsed the soil type .R5q 16-30 prcnc. ... . ... . ... ..... ....❑ ❑ Soil types must be bur,sandy loath,or loamy sand d Greeter than 30 pecen ... .... .... . . ...❑ ❑ Gravel and course fragetnents may nut exceed 60 percent. KC' 4) Check the up-slope vertical sep n Up-dope vertical aqfretian must be greeter than 1?. • Loam....._................._..............................................................__.. ❑ ❑ • Gravity it allowed down m 18'and Preuu2 is required from 18 toll LannySand.............................._..................,............................. Lasthan 12°.......,...._.........................................................._....... ❑ ❑ Study Loara..................................................................................❑ • • 12-18"..........................................._......._......_.........................._..... Percent Gravel by Vileness: Less than or equal m 60 pe nant Greater than 18"........_..........................._........,........................... ❑ CI ... ... ..... ...... ❑ Greater than 60 Deunuir d by: Percent.._........ .. ..... ..... ... Depth m Hardpan................................. ...................... y,/ ❑ Depth to Mmelitg.........................................................,th��y(f U Both........_......................._......._................................_.,p 6) Check the drainage of the soil 3) Check Horizontal Atenumon Zane _r Soils most be modestly well drained to well&Scd. A 50 foot horizontal ettenuadan znre is required. down-gsdimt of the sub-mr6a system. Well Drained......................................_............................ Is there less than 50 feet between the down gradient side of the proposed primary/reserve etas and the Moderately Well Drained................................_......_............... Cl O _ property bou dary? Ohe ...............................................❑ ❑ Yes.,.................._....,.......................................................,...._..........❑ ❑'- 7a) Check the water able level If yes,the apphcam wit need to provide a recorded ae If a swsooal wear table exist above 36",then a easement prior to final acctpuI of the on-site curtain drain is required Water teblea shalbwer then sewage appli our l2"are not albwed. - g 10b) Record So foot zone on deed _ Is the water table The So four horizontal attenuation zone is required to .............................................❑ ❑ . he recorded on the deed of the property u Above 36"..........._..........................' unbuildable prior to design opposed The owner Above 24"......................................................................................x must agree that this area wit rube used for the ffi ❑ Q- construction diva dab,palm,puking cam, Above 12".................. _........................................................... _..._ 14..d"traffw,or other sonilu suds sitter. 7b) Is a curtain drain proposed up slope dAx perry "- 1s the owner ewue and in agrtanva with tine dramfield area? I . rr� tenor?(hone owner initial t_) Yes.........................._................................................_.................... ❑ Yw......................................................._..............._.........,...._......- No....... ... .. ...... ... ... ...... .. . . . .... No .. .......... ..... . ... . ..... .. .........❑ ❑• Is the 50 foot zone recorded on der deed? 8) 1a the property on muhse shcaluse? Yw .. .. . .. .. . . .. ...... ... . . ❑ ❑ Sites within 200 feet d nurvse shaelisses must Na............................................... ovt .. . __�' comply with standard regsritmantt et*OSt -T%N1E OP 11) Check proximity to wells Ya.._.............................................................................................. ❑ ❑.,'. . Down-gradlert wills must have a hornonW aeibeck No........................................................................................ .... of 200 feet Up-gradient wets must be acted'100 If yes,Indicate the divorce fipm da slwretna m fee' primary drsinfield areas: AI\fees. Iodine,else amateur distance from mmug oc 9) Is there any fresh water bodies within,or adjacent tot proposed wells to the dte propeybaudaria areas: ) ' VYSLoPE A 200 four hor'votd set-beck must be maintained between the shoreline and the pdmay/serene drianfield arws. Yea....................................................................................._.._.... ❑� ❑ No...,.._.........................................................................._.... .......Jot If yes,Indicate the distinct£rasp the shoreline to porosity dramfield areas: r4 fee. Designer Comments: Health Department Comments. jf/HE)t Dt'br/ LS £ev,e0m, c OCA-'rt&Mr G,WILL- BE4Wezoø0Et "r I part 3: Certification and Approval Applicant Certification: I certfy,to the best of my knowledge,that the above information is inc and wnect. I acknowledge that am solely retponsibk for on i resat mainbinutg the integrity'of the primary and reserve dtainfield areas and that deswnioo ot damage in immediaie rescinding of the ondte sewage permit ,,1���`JJJ blr ��- Dale Designer Dare APPS Health Department Review: Preliminary Review For Design Submission: U Approved ❑Denied Enviromental Health Samimien Date Waiver is ❑ Approved ❑named Dee 5nvitwoamal Huh,Sarriuriaa Comment: Pmeer t7gakq Irc,e DESIGN .FORM-PAGE ONE evism uftWobenee dski3NMN NMeIa WWIMHe I* e Canpleted desgi(am that has been,Wed ad dated Soled laph sketch.Itkthn aY a*able hems m d,edlist steed plat plan,kdudrq all kable hems an ckdJist Goss-sectam sketch.Ircluduq a'1 ç,Ikae items m dedJizt PARCEL IDENTIFICATION perml part 5WW CC, -m SG, 2 aeatia-f Nat ax PAY55E leSt!pkM#t 360-426-1805 *pØkafll ' ME L NC,ER eaWertlMeN. ':O85 E Masai 6emm Rd. P0,1OX 1618 CPPEVIEW WA, 98596 DEVNp WA 98528 AneonR #: 22129-24.00000 DESIGN PARAMETERS ❑ Wm mma o rat tiler ❑ sim ❑ IS lice I'SS ❑ teralk TewMHe/iMeL e5— ❑ FYI Yre/MNeI aw"be(d4y�ie mNrera o am Tr 0 -smeies tares o eraYlu �� fa9i71e aUC 0 3 2008 �— Wes loot CC*T4C T * M,s a �— iNK81a TSa WA 9Q ftcec i NerMtEt yl Trtad/eN Lents —lUR E(ewlioa'Meanrnmenfr ttet•iMe i aaeroa px tap / I'J/A its M LLpYWa fret• 10 —asacw f.ry Ma1NM rN 00 o r eAllal trMe °� eeyaNYelleeltQeeea 24" amide/on 7ranqxrt P3'$-- 5CH.440� eraeeaee OeM1e1t ieShIt ❑ra eta O_- - /--- pMNM era oa P /Spk,„,S #e t om Makr m NMVa4 amIPune c.GamM 6 iWeraoe i McYanea srcea pMySIN r let sfl Ca. ome IaeaMi tmCt 12' erm i o a w e'LM 0�—p�M� �M p'nl fames:mu Nrl IYIM comet G Tetd prM am 50,09 a, a reed: lees w tekallel TOW Repme st* 2.7' ¢ dae� XFIF., Fiara D�eq In:�Rensan DESIGN FORM-PAGE TWO Peru Pelt 5WG AaesssY Pwc #: 22129-24-00000 DESIGN CHECKLISTS Scald PI..EPGn Sca(edAyawt5(ti Cm#-seclions4frt ttw IlNe wr►w YNewlw JeswsNor/IMre 9'erwmaam �irww/Mw N.rwYlwarrl Jrw[e ❑ MEtll wywwJwNYY anffS CreI__q�wNINee1 MNYJ�iwY N �erwwMNNlweaew Nwl,1 ea YNI/e rtl wlrle kc . YNnww S flu.fl Jwew www w- - Nw to • _ - iweeflYsw/wlbwlwMr tl wwtlwwAww firm" rNNww1 ❑ lww&aNBwff Rre____ -wow NRwN)8&w 0 Sand augmentation dorm Nw Rrus r— ,in Mldw is ep d JM wrde1 WS �YYeZ it St YNwff grAENW llw Nw wrmJ 4rMleffwlw MYw.LS Ib'YNerr reN were YnJ w ffNe w �Yeew/mrwY/NINMbVMrer! cwswlw___ 4luYYNewrww:—w �Nerr tlnwxttwNeMewYNlwJw fbw YMwwwlff New 9JeNp•tltlIXJ ttl J1lrNwJe rtttiw: In ❑ WSY,MIMMIIIM0.wwrlbetlNr MYJIIe PIONEER DIGGING, INC. 366426-1803 i6onal9nforrnaG-an bob Fgox(Pegw) Cs�Meo wtlw Na P&ycx(Grdle,) w YlrkJre AIMeeNrJw �YNfedINlWw DESIGN APPROVAL lhwffM.a&doff tied &nw,waft meRwltsel Nw wweM b be NMwff N Off Ywrwww New tl lMrl N___ M Mw flew.Mlfff islwa: L P '11G rNNMaNMwlyd ! fre The werSYwwreNwWft6 ww wrrlrw ewb OWWWWdleMIN eewrer.rYNkrN�YrnwYwNw Nw w41e rtiMYNew YaewENMeew M6ee lit afflict f1eo 11wJw YeMr elYw neLI ewNMrlw / me iu epMlwehlw Mwwwtll4 weNrrwwwl et MIIIreM YerZll ewbl^"nowa TwWa wY[JbaIN�MrYtler.wwpYletlMWMY r b Yw Ye NMoIw Ynweewtlw is a. ...r_ — dmom___ z aE I : o I � _ 1321. 32 868° 4655"E 3563 41. 60 g sz. a � O o 3 N 2 I D,Do p.c. I0.oOci- A� M '1,04 Ac: ° s h 1. 11'1 ¼y 1^ n N M O S Z 58 °021 'p 35:.35 — R — �3 33055 ' wep ' 'IySR 4g .kx (.25N. OF LINO; 1322. 48 586°1649" ( i / / 1 6.01 / 2 1/2" I. P.; Vol. 9 of PIat2, Pg. 82 . 28) ` REBAR C0NCRE TI ( ,SY S. OF LINE) ` / Vol. 9 of Plot., P SHELTON , WA . ( 206) 426 - 4586 LARGE Lot S' c3 DII S1O BASIS OF BEARING : rO (L SURVEY BY D. H0LMAN FOR GE " (j� ttUR rr Ghj . Vol . 6 OF SURVEYS, Pal, A.F. 4 7 "` OWN 2Y DATE J . D. V. JULY 19E CN1(D 6Y SCAt2 H . T. V. I11 = 10( PIONEER DIGGING, INC. PARCEL#: 221 292400000 SOIL LOGS: 360-426-1903 CUSTOMER: MEL ENGER SLI P22"Gt-S SL2-O�24'&S SL3044 Cr "OLS 2poy Pc,, "(Peigrc' DRAWING: PLOT PLAN 70 22' ROOl9T024' ROOISTo24' Na Pq,,(Drdk) SCALE: 1I _2001 '-T- 552 -4" Mr_,. ._is ;•�y^ka i I 406 p 3 Z IT H I sEe PLor I < / e e At R0 E WKLL 0, 200' 400 EM ._ PIONEER DIGGING,INC. PARCEL#: 22129-2400000 SOIL LOGS: 511-022"G� SL -624"GIF SL&624"G�s 64261 603 CUSTOMER: MEL ENGER 22••+G T 24 +G.T. 24"♦G*. bob Payme(Doircd DRAWING: PLOT PLAN rzooTsro 22" Wools To 24" somsm 24" 4e Pop'c(D,dla) SCALE: 1"=100' II I I I I..4//C o TGUL5cPr 1 I '' r7ta I I I I I V?Ar ttn 3 So a (4O) ,J W/90' KIN.ZGth _ i " I i a 68' a" / I'0551�.E r3u�iLnlrlc� / LANK LOCATION 1I J _ I L— P�AU / nRIVEW y d /'7 ePla� 60 i>""+. ., o, ter.:. 200 S. PARCEL#: 22129240000° SOIL LOGS: PIONEER DIGGING, INC. SLI.G22•'GLs SL2-62a•'c�s Su' 626"us 60426-1603 CUSTOMER: MEL ENGER 22,.E G7, 244 Cl. 2a"i GT. bob Payx CDcelgm) DRAWING: DRAINFlELD OCTAL 2" STo22" 24 4 TO 2a'• isT024 Na Poyrc(Drife) SCALE: 1"=10' \ y0 \ cS / / / 0' 10' 2O• 0B IZJATI0N POKf5 PIONEER DIGGING.INC. PARCEL#: 221224 OOO00 SOIL LOGS: SLI-o-z2O15 sl2-oza"G.S aS-G24•'a5 360-426-1803 CUSTOMER:MEL ENGER 22 +GT. 2a^+cr. 24 +c.r Dob F' rx(Dczig ) DRAWING. CROSSSECTION ipOT5T022" FOols T024" pppl5T024'• Na Pc(D,dla) SCALE: N/A OD`�6KVAtION I'OR'i W ICV 60X AU(: o 3 ?000 5nv FLL FIw,to CRW MMOVPDLE CM SPM7Y FILL FLna FPf�'IC bLPJNROCK (,RP1nL �o GRIGINPL a,_ 125" LAnRN I I I I I - - I I I I I 5f21Gt1V>;LA�� a ; �e . II0 '�Mv{Y EMC:GCa PARCEL#: 22129.2400000 DESIGNER'S NOTES: t2&1 DIGGING,INC. INSTALL ALL RLSERS TO FlNISXED GRADE. SEPTIC TANK CUSTOMER: MEL ENGER MUST BE LLPLACED ATPROPERIIEDGRON FOR TIC TAN Pqe e(Denigm) DRAWING:TANK DETAIL DRAINING our OF Xou5E. Pe e(Drd/ed SCALE: N/A GfM q W/X8W QILD T (KR MLP612o 1 M n"PAC cMH� !LE cUVW %1,T TNaro NHCP RNPfNA a we RllfW orRLfs �7d.. "R:'^,: .. r?e. Na 4111, 0 p006 pr 1200 CPL, P11C 1PNK CO fl 4n tWAV*i OfIf NM WMN M1M/*,.n Laf 24 RIXW 9Rf W/5(&WONI� HonmeWiQflL&aaxf TpJr9orI.Efo4IHH➢ & ofavN £HO .n— Iiii w Tht AI@A on LNNItCr O4 £W1 Lf y11rNA.1O q�1 Mn flOK XM—. . 1000 at PUMPIPNK NAW S IXP,R:3 PIONEER DIGGING.INC. PARCEL#: 22129-2400000 DESIGNER'S NOTES 0,426.1803 CUSTOMER: MEL ENGER IasrnuuiRISERS OP MANIFOID COVERSTO ala mGRADE FOR EASY ACCESS Hob Payax(Dvigrer) DRAWING: MANIFOLD Na Pc(Ddlo) SCALE:N/A ASP : _�` �,:iF2 T. aric a 3 2 . ¢ SIDE VIEW OF VPLVE 13OX I25" F3PLL VPLVE(1W.) 1.25" fLEx FM 1.25" Fft LII.ES .25" CtCK VPLVE (1YPJ 1,25" CFECK VPLVE5(flF ) 1.25" 6&L VPLVE (M',) ® 2' %H40 II I TOF'view OF VALVE oox 25" fEEDe Llf�5( P.) E% • EF33E EF 3 SPECIFICATIONS •Capacity to120 GPM -Heads to 90 feet .Discharge size t4. J47 2"female NPT •Power cord 10'or 20' •Solids 3/4"maximum MATERIALS OF MATERIALS OF CONSTRUCTION -"4 CONSTRUCTION •Stainless Steel •Stainless Steel •Engineered Composite •Engineered Composite FEATURES&BENEFITS APPLICATIONS FEATURES& BENEFITS •Eghtweight •Graywater pumping •Lightweight APPLICATIONS •Septic Tanks Effluent •Corrosion resistant •Graywater pumping •Corrosion resistant •Manual or automatic •STEP Systems •Manual or •Septkys Effluent operation •Water transfer automatic operation •STEP System •Field replaceable power •Field replaceable power •watertransfer PUMP MODELS - cords cords EF33.1/3 hp,115 or 230 volt, •Continuous duty when fully SPECIFICATIONS •Continuous duty when fully 1-phase submerged •1/3 hp.115 or 230 volt, submerged 1-phase •Fluid Temp.Range: EFSO.1/2 hp,115 or 230 volt, •Fluid Temp.Range: 1-phase 32•F(0"C)min. Nall •Heads to yto 64 GPM 32"F(0"C)min. Ef75.3/4 hp,230 volt, 104"F(40'C)max. 104"F(40•C)max. •Heads 27 feet 1-phase AGENCY LISTINGS •Discharge size 1-1/2" AGENCY LISTINGS EF10O.1 hp,230 volt, female NM UL Listed 1-phase ® UL Listed •Power Cord 10'or 20' h1 UL Listed to Canadian EF1S0.1-1/2 hp,230 volt, •4 UL Listed to Canadian •Solids 3/4"maximum safety standards 1-phase safety standards sa ID p II p •w19t tfl m. E JJ a II 'l e fl.Y• N l0 1C S !1 a a i1 1r.'AF:a0T. sa Ni Y a a0 :r a so' m sa so s ua1 O p N a a 0aaIeW NNNpMID1aW W a a N a 10 W US WIONSna WNNt qT. R. Y TI WNYa u.iWYO a • PIONEER DIGGING INC. ® 360426.1803 Bob Paysse .. Washington State Onsite Wastewater Designer p a Installation&Maintenance for: Shallow Pressure System 1:This system WilI.. re41Se a.05 Fast ATU.(Circled one applies) 2: Install Aquaworx control panel as per design. 3:Install risers to surface on septic tank(or ATU)and Pump tank as per design. 4:Install check valve&union in transport line within tank lid. 5:Divert all storm water rmoff within 10' of upslope edge of the drainfield or reserve area. 6:No curtain drains allowed within 10' of the upslope edge and 30'of the downslope edge of drainfield or reserve are& 7:All Materials and workmanship must meet County and State Regulations 8: Deviation from this design without prior written approval from the designer and Mason County Health Dept.will make this design null and void. 9:The prepared plot plan is not a survey;it is the owner's responsibility to verify property line locations,all easements,and encroachments prim to installation. Any discrepancies must be reported to the designer immediately. 10:This design is intended to meet State and local health dept.requirements that are related to the system being proposed. Any placement of proposed buildings,or other non related items on these drawings may or may not meet local and or stat requirements. It is the property owner's responsibility to determine what is acceptable to the various departments for non-related items. 11:Install this system in dry weather. 12: Trench bottoms must be level. Follow the contours of the slopes. 13:For protection of the drainfield,no traffic is allowed on top of the proposed drainfield areas. 14:Encroachment of house and/or driveway into drainfield areas may tender this design and site unusable. 15: All roof drains and downspouts shall be directed away from drainfield areas. 16:Drainfield should not be installed into depressed areas where surface water can collect. All grading over drainfield must provide proper surface water run-off. ASBUILT FORM .• 7 b Lod( Mason County Public Health PARCEL IDENTIFICATION Assessor's Parcel a n Q _ 24/- tOaot Permit Number SWG Ql _" CO 51.2 (Twelve-Digit Number) 'VI it P4 ( 3�— _ Subdivision Applicantt 's Name p p I' (Nsrre/DiviaionBlockAat) Applicant Address r8' ,1Lf''1—`'J�vQ .? lnslaller's Nance �t?t) 7YFM Icy Sp/r& City,State.Zip �^--• )"�"J ". Designer's Name INSTALLER CHECKLIST N/A Yes Prior to completion 1. SEPTIC TANK >5 ft.From foundation?............................................................ ❑ ❑ >50ft from wells?......................................................_......... ❑ ,!] ❑ v ..... .......... .._....... .. ❑ >50 ft surface we[er. ............................... ❑ Building stubout to septic tank:cleanout if nm l-2%?................... ❑ fl ❑ Baffles intact and clean?................................................_......... ❑ �@ ❑ Dividing wall intact?................................................_............. ❑ ❑ Risers installed for ?..............................................._..... ❑ �Q1 ❑ Screen basket f luent filte installed?!circle one).t.p Kam, ❑ O Tank size: 1115 gal.; Manufacture:J≤s≥FAS H. D-BOX Leveled with water?............................................... . .21 ❑ ❑ Speedleveler used? ............................................................ Rl ❑ ❑ ID. Drainfield >10ftfromfmmdation?...................................................._. ❑ ;� ❑ >5k tram property lines and easement lines?............................. ❑ O > 100 ft from weds?.............. ❑ >100 ft from surface water?............................................... ❑.. ❑ >I0 ft from potable waterlines' ............................................. ❑ ❑ Laterals level to±1 inch&end ca present if not looped' ❑ O capsPee'. .............. Gmvelless chambers utilized?................................................ ❑ O Gravel clean,properly sized,and proper depth'........................... 0❑ O PRESSURE SYSTEMS Sand quality ASTM C-33?._................._........._....._.._... ❑ O Head height uniform ≥24 inches? Actual head height_ ❑ Cl Xf Clean-outs and observation pons present?......................... ❑ O Mound: Side Slope 3:1?............................................. 0' O O Owner informed electrical connections must be made by O owner or licensed elecaician and inspected by L&1?............_ ❑ IV. PUMP/PUMP ..�. CHAMBER Pump hake 1IW^ - ---4t ; Pump model §Ia,t: EO ❑ ❑ Chamber sin 10QQ gal; Manufacture V..akv PSrt ❑ ❑ Height of pump off bottom of pump chamber i & Jtc4 inches Pump chamber draw-down 4L51.._gallons per inch per minute' pump capacity 33 gallons per minute Pump controls:Timer,Elapsed Time Meter,Count&?(Circle all that ❑ ❑ apply). If timer:Pump On f fcc. Pump OC& fin ,../ Riser installed for acce.Ys?......................................................... ❑ p O Alarm installed'.................................................. .— O O ASBUILT DRAWINGCHECKLIST 7 � Rv 1 77t nmino rii. byi 77, manifoIdM orientation �' pZ &layout Wf.N7 Rai h- s N' $ TrenclWed 5 r dimensions and dtiO critical distances within layout iky. Septic/pump lank placement fQ Location of buildings �.I Observation port& cleanout location Locaton of wells& lA muds jUndisturbed native �f soil between Y¢i trenches North arrow sgaRl ell arienmton made in he field by the insrp7ler are gencrallya-epla eta romise the viabilityo the rysrem 6uromthe instadesign that affect h CAUTION:Minaradpprovaisrosepticr the depddminp deviations u, J both the department ardehe designer,but could in certain cases carp obtain poor wniteny eviaaffmmeit the approved road designnmeust be showng�r orc makmB�J' PSYRF . nY 'anonrfrom WPCRRTIFICATION Check a box from Row"A"and'B",sign and date❑th cceouficauooft deviations from the design stampedcertify that I insta led the system without any 1 certiovna'by MCPH eve shown above.eviation from the design stamped"APPROVED"byCPH certify that I contacted the designer and left the ❑ f did nil contact thetestgne r priu r to final rover becauseystem open for inspection up to 4$hn prior to cover. designer waived the notifiation requirement.rtify that all information contained on Nis form is actuate. I understandtat if the information contained herein is nothere will bejost cause for inunediate suspension of my installer certification.niatre of Instal signed approves this installation on behalf of Mason County Public Health. 1e1 O - /J � 6 O7 Si vi r Si azure of Sanitarian mm Revisal Jma&Y 20al