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ZON2024-00012_exhibits_18-33
,�01000GG E0 R E S 0 U RCES earth science & geotechnical engineering 4809 Pacific Hwy. E. I Fife, Washington 98424 1 253.896.1011 1 www. georesources.rocks Seton Construction, Inc. 4640 South Discovery Road Port Townsend, Washington 98368 (360) 301-1403 Attn: Bruce Seton brucejr@setonconstruction.com April 4, 2025 Hydrogeologic Report Addendum Proposed Surface Mine Expansion 225 Four Corners Road Jefferson County, Washington PN:001332016 Doc ID: SetonConstruction.FourCorners.L INTRODUCTION This addendum provides additional information and clarification regarding the proposed project, as well as our conclusions regarding the geologic and hydrogeologic conditions at the proposed Four Corners pit located at the above address. Our understanding of the project is based on discussions with Lisa Mahr of NW Mining Solutions, a review of the Geotechnical Assessment prepared by DE -Civil dated February 12, 2025, a review of the review comments prepared by Andrew Gosnell, Associate Planner at Jefferson County, and our previous experience at the site including our March 2, 2018 site reconnaissance, and our March 23, 2018 Aggregate Resource Evaluation. We understand that a licensed professional engineer signed the recent Geotechnical Assessment. Given that the content of the report addresses the hydrogeologic conditions at the site, Jefferson County is requiring it to be signed and sealed by a licensed geologist in Washington State. Based on our review of the above -referenced document, we concur with the characterization of the site and the conclusions contained therein. Additionally, we anticipate thatthe proposed surface mine will comply with the current edition of the Stormwater Management Manual and the relevant components of the National Pollution Discharge Elimination System. These design requirements should provide adequate protection of groundwater resources at the site and the surrounding area. The following additional information is provided in order to address the additional comments from Andrew Gosnell and address components of Jefferson County Code 18.20.240(2)(b)(i-vi). Additional Groundwater Information According to JCC 18.20.240, a hydrogeologic assessment must provide a comprehensive analysis of the site's groundwater conditions and address the potential impacts of mining operations on water resources. While we concur with the findings of the DE -Civil report referenced above, we provide the following information to comply with the requirements of the Jefferson County Code. Site Description The site description provided in the DE -Civil report appears adequate to describe the essential components of the subject site. LOG ITEM Page_ . ®f a SetonConstruction. FourCorners.L April 4, 2025 page 1 2 Ny_drageolagic Characteristics. Expanding on the contents of the DE -Civil report, groundwater in the area was noted at a shallowest depth of approximately 68 feet below existing grade. Based on our review of the available water well reports, it appears that groundwater levels are recorded in four of the water well reports: Port of Port Townsend (PoPT) wells located in the vicinity of the airport, the Ken Brown well, the PUD wells, and the Ocean Grove well. The PoPT well and the PUD well both note static groundwater levels at approximately 68 feet below the top of the casing. The Ocean Grove and Ken Brown wells both note static groundwater levels at about 93 to 99 feet below the top of the casing. Pumping tests noted the range of withdrawal from these wells as 40+ to 158 gpm. These data appear to indicate the presence of a shallow unconfined aquifer and a deeper confined or semi -confined aquifer, separated by a significant thickness of clay, as noted in the driller's logs. The western portion of the site is located within the 5 year time of travel radius of the Ocean Grove well, the eastern portion of the site is located within the 5 year time of travel radius of the PoPT well, and the central portion of the site is within the combined 10-year time of travel radius of both wells. The approximate locations of the water well reports reviewed, their associated wellhead protection areas, and the site location are depicted on the Well Location Map, attached as Figure 1. Given that only two wells appear to be withdrawing from each aquifer, determining groundwater gradient and flow direction is not feasible, as three elevation data points are necessary. However, we conservatively estimate the flow direction of the shallow, unconfined aquifer is generally to the west, towards Discovery Bay. Given that the shallow aquifer in the vicinity of the site appears unconfined and the surficial geology consists of recessional outwash sand and gravel, surface water likely contributes directly to groundwater recharge. Additionally, hydraulic conductivities within recessional outwash are typically moderate to rapid, and the recharge area likely mimics the extent of these recessional outwash soils. Water Quality []atrr Based on our review of the Department of Ecology's cleanup sites webpage and documents retrieved from the website, there are four cleanup sites located within approximately one -quarter mile of the subject site. We did not recover any groundwater quality data that indicated groundwater in the vicinity of the subject site was contaminated above cleanup action levels for any contaminants of concern. No baseline groundwater quality data was available. Impact Analysis As stated, we generally concur with the DE -Civil report. Extraction of the sand and gravel deposit to a depth of 30 feet below the existing site grades is unlikely to negatively impact groundwater quantity. Conversely, removing the surficial soil and vegetation should increase overall groundwater recharge by decreasing evapotranspiration rates at the site. No dewatering or water usage is expected at the site. Potential contaminant sources include heavy equipment and on -site fueling operations. Mitigation Measures Provided that existing state laws, as outlined in the Jefferson County code, for surface mining, stormwater, and hazardous materials handling, are appropriately incorporated into the design and operation of the proposed surface mine expansion, no impacts to groundwater quality should be G E 0 R E S 0 U R C E S earth science & geotechnical engineering SetonCon struction.FourCorners.L April 4, 2025 page 13 expected. Similarly, the removal of vegetation and topsoil is expected to increase groundwater recharge at the site due to the reduction in evapotranspiration. Accordingly, no mitigation measures for groundwater quantity should be required. Material Types Based on our previous work at the site, the material proposed for extraction is consistent with recessional outwash associated with the Vashon Stade of the Fraser glaciation. Gradation analyses of the outwash indicate that the material, on average, is composed of approximately 58 percent gravel (material retained on the US #4 sieve) and 39 percent sand (material passing the US #4 sieve). The fines content (material passing the US #200 sieve) averaged about 2 percent. The USCS classification of the material sampled from the site would be poorly to well -graded gravel with sand, broadly consistent with expectations for typical recessional outwash deposits. Material Quantity and Quality Our previous work at the site estimated that a total quantity of 1.7 million tons of aggregate was available for extraction. This estimate was made for the extraction of aggregate resources across the entire property and assumes maximizing the extraction depth and temporary slopes while minimizing buffers and setbacks. Lateral Extent of Deposit The published geologic map for the site and surrounding area indicates the recessional outwash deposit spans the level to gently sloping area along the west side of Highway 19 between Chimacum and Four Corners and becomes intermittent east of the highway. Depth of Deposit According to the water well reports reviewed as part of our site work and the recent work prepared by DE -Civil, the recessional outwash deposit appears to extend to a depth of approximately 40 to 60 feet below the existing surface grades. A map showing the approximate location of the water well reports reviewed for both studies is attached as Figure 1 to this addendum. Depth of Overburden During our March 2023 site reconnaissance, a portion of the site had been disturbed by prior extraction operations, resulting in site conditions that included an exposed temporary cut slope in the northwest portion of the site. Based on our observations, we expect that 1 to 3 feet of overburden material is present across most of the site. However, a greater thickness may be encountered in areas of heavy, undisturbed vegetation and topographic depressions. The bulk of the overburden material is likely organic -rich topsoil that could be stockpiled on site and utilized during reclamation of the site. Method of Extraction We anticipate that conventional earth -moving equipment will be utilized to strip the overburden and extract the aggregate resource from the site, keeping with common practice in the Puget Sound area. It does not appear that any conditions exist that would require the use of dredging equipment or other specialty earthmoving equipment to extract and stockpile the aggregate resource. GEORESOURCES earth science & geotechnical engineering SetonConstruction.FourCorners.L April 4, 2025 page 14 LIMITATIONS We prepared this addendum for use by Seton Construction, Inc. and other members of the design team, for use in the design of a portion of this project. The data used in preparing this report and this report should be provided to prospective contractors for their bidding or estimating purposes only. Our report, conclusions and interpretations are based on subsurface explorations by others, data from others and limited site reconnaissance, and should not be construed as a warranty of the subsurface conditions. Variations in subsurface conditions are possible between the explorations and may also occur with time. A contingency for unanticipated conditions should be included in the budget and schedule. Sufficient monitoring, testing and consultation should be provided by our firm during extraction to confirm that the conditions encountered are consistent with those indicated by the explorations, to provide recommendations for design changes should the conditions revealed during the work differ from those anticipated, and to evaluate whether earthwork and foundation installation activities comply with contract plans and specifications. The scope of our services does not include services related to environmental remediation and construction safety precautions. Our recommendations are not intended to direct the contractor's methods, techniques, sequences or procedures, except as specifically described in our report for consideration in design. If there are any changes in the loads, grades, locations, configurations or type of facilities to be constructed, the conclusions and recommendations presented in this report may not be fully applicable. If such changes are made, we should be given the opportunity to review our recommendations and provide written modifications or verifications, as appropriate. ♦ G E 0 R E S 0 U R C E S earth science & geotechnical engineering Seto n Con structi on. Fo u rCorners.L April 4, 2025 page 15 We have appreciated the opportunity to be of service to you on this project. If you have any questions or comments, please do not hesitate to call at your earliest convenience. Respectfully submitted, GeoResources, LLC Gealc��s��� / ,'' •1y I Seth Taylor Mattos 1 Seth Mattos, LEG Associate STM/stm Doc ID: SetonConstruction.FourCorners.L Attachments: Figure 1: Well Location Map GEORESOURCES earth science & geotechnical engineering C O C � C � G X O '- C ® C N > NN c m m O C u 0 3 ® o O N a 0 0 w' e J �y€P e roz 1V O LU .G a� 41— z 75 C C O _ � 7_ E s 0 a C C N L C � O J L O J � > N u > w D_ J 2C N O D_ >v E O] DE -Civil, PLLC February 12, 2025 Bruce Seton Jr. 4640 S Discovery Road Port Townsend, WA 98368 C/o Stacy Willis NW Mining Solutions LOG ITEM 2-d Page-1 .7f 9601 Key Peninsula Hwy. NW Gig Harbor, WA 98329 (253)228-0513 www.de-civil.com Geotechnical Assessment Proposed Gravel Mine 225 Four Corners Road Jefferson County, Washington PN:001332016 Job: 25-017 NW Mining.LHGL INTRODUCTION This report presents the results of our geotechnical investigation and engineering recommendations for the proposed mining activities to be located at 225 Four Corners Road in Port Townsend/Jefferson County, Washington. The general location of the site is shown on the attached Site Vicinity Map, Figure 1. Our understanding of the project is based on our discussions with you, and our January 24, 2025 site visit. We understand that you are in the process of applying for a permit to begin mining activities on the site. The proposed mining activities will occur in the west side of the site to a depth of approximately 30 feet, will remove approximately 333,OOOyds of material and will include a footprint of 9.14 acres. Final proposed side slopes will be setback 50 feet from the property and will be a grades that are 2 horizontal to 1 vertical of flatter. SCOPE The purpose of our services is to evaluate the surface and subsurface conditions at the site as a basis for addressing the requirements of Jefferson County Municipal Code 18.240. Specifically, our scope of services for the project included the following: 1. A visit the site to conduct a geologic reconnaissance to assess the site's slope, soil and ground water conditions. 2. Reviewing the available geologic, hydrogeologic and geotechnical data for the site area. Including the WADNR, Division of Geology and Earth Resources, Geologic Maps of Eastern Jefferson County, the USDA, Soil Conservation Service, Soil Survey for Jefferson County, and the DOE Coastal Zone Atlas for Jefferson County. Subsurface explorations and/or laboratory testing were not completed as part of this assessment. SITE CONDITIONS Surface Conditions The subject parcel is located at 225 Four Corners Road in Jefferson County, Washington. The parcel is rectangular in shape, measures approximately 1330 feet in length (west to east) by approximately 750 feet in width (north to south) and encompasses approximately 23.6 acres. The property has been partially cleared of native vegetation in the area of the proposed mine but otherwise is well vegetated with native forest. The site has generally less than 10 percent slopes throughout with an area in the northwest corner where some excavation has taken place with an overall depth of approximately 10 feet. Side slopes of the excavation are at an approximate 2:1 slope. Access to the site will be from 25-017 NW Mining.LHGL February 12, 2025 Page 2 Hwy 20 through adjacent Port of Port Townsend airport property. The site is bounded by a mix of residential and commercial properties on all sides. A site plan was available for the project and is included showing the proposed area of the mining activities, see Site Plan - Figure 2. No seepage was observed at the time of our site visit. No evidence of deep-seated slope instability was observed at the site or the adjacent areas at the time of our site visit. No erosion, or other soil movement was observed at the time of our site visit. Subsurface Explorations No subsurface excavations were performed on this site. We were able to observe exposed slopes around the existing cut as well as review Well bore logs within the immediate area of the site. Groundwater Conditions No groundwater or seepage was encountered observed during our site visit. Site Soils The Soil Survey of Jefferson County (USDA Soil Conservation Service) indicates that the property is underlain by the AgOlete very new silt loam (AgB). These soils were derived from glacial marine deposits on terraces. A copy of the SCS soils map for the site area is included as Figure 2. We observed no evidence of surficial erosion on the site or within 200 feet of the site at the time of our site visit. Site Geology According to the Geologic map of the Port Townsend South and part of the Port Townsend North 7.5-minute quadrangles, Jefferson County, Washington, by James Schasse, H.W., and Slaughter, S.L., June 2005, the site is on the boundary between Vashon recessional outwash (Qgo) and Everson Interstade Glaciomarine outwash (Qgome). The Vashon soils were deposited during the Vashon Stade of the Freasier glaciation 10 to 15,OOOyrs ago. These soils are well sorted sands and gravels deposited by receding glacial ice. The Everson soils were later deposits that occurred from glacial lakes and can consist of layers of sands and gravels and silt. The types of soils were driven by the velocities of the waters within the lakes and rivers at the time of the deposit. Generally these soils have not been overridden by glacial ice and can be considered normally consolidated exhibiting moderate strength and compressibility characteristics. An excerpt of the above reference geologic maps is included as Figure 3. Well Logs We searched well logs in the project vicinity on the Department of Ecology Well Construction and Licensing map and found a total of 33 well records in the immediate area of the project. 8 of the records were of geotechnical borings done in 2015 and 2018 with an address of 310 Four Corners Rd. These borings were to a depth of 11 to 35 feet and reported sand and gravel to the full depth. 13 wells were Resource wells, 8 of which were done at 20 Four Corners road in 2004 to a depth of 14 feet and 5 others drilled in 2024 at 603 Four Corners Road to a depth of 25 feet. The remaining wells are water well records collected from 1971 to 2007. Water wells were generally drilled to depths of 100 to 180 feet with the shallowest static water level being 68 feet. See attached Well reports. 25-017 NW Mining.LHGL February 12, 2025 Page 3 CONCLUSIONS Based on our site evaluation, it is our opinion that the site is suitable for the proposed mining activities. Available geological mapping and well records indicate that the soils at the site and in the immediate area are consistent nature to depths of at least 100 feet. Also based on those records the static water table is at least 70 feet below existing grade which is more than 30 feet below the anticipated limits of the mining activities. Given the anticipated separation between the mining activities and the static water table we do not expect that extraordinary measures will be required to protect the aquifer from the mining activities. LIMITATIONS We have prepared this report for the Seton's and other members of the design team for use in evaluating a portion of this project. Subsurface conditions described herein are based on our observations of exposed soils on the parcel. This report may be made available to regulatory agencies or others, but this report and conclusions should not be construed as a warranty of subsurface conditions. Subsurface conditions can vary over short distances and can change with time. Within the limitations of scope, schedule and budget, our services have been executed in accordance with generally accepted practices in this area at the time this report was prepared. No warranty, express or implied, should be understood. We trust this is sufficient for your current needs. Should you have any questions, or require additional information, please contact us at your earliest convenience. Respectfully submitted, Development Engineering, PLLC r Glen Coad, PE Owner W GC:wgc Doc ID: 25-017 NW Mining.LHGL Attachments: Figure 1—Vicinity Map Figure 2—Site Plan Figure 3 - SCS Soil Survey Figure 4— USGS Geology Map Well Logs f� COO 4 W,p i I{ �J �JrARa r. Och =qlr m. . N. Not to Scale DE -CIVIL, PLLC 9601 Key Peninsula Hwy NW Gig Harbor, WA 98329 ID Ph (253) 228-0513 www.de-civil.com 004-11% ti,„�, smear Ga.- Z Approximate Location(D Site Vicinity Map Four Corners Gravel Pit 225 Four Corners Rd Jefferson County, Washington Job No: 25-017 February 2025 Figure 1 �ti y f ti "'4 4r��"t-�'� J �,.-% h._� ', �� �'r—�Y � y "' �� � v � _L..•-.�� �-• -�ti� � } i y !�_ _ ! •r �� �. - .tr ram... `•-�� }ly, rh A 4-�fl;c VA Yr'''ti-,�i�•..,ti� ""ti^_.�"`�,�. U •'�[".• ,•,� "1�`�%-~�; 7' r---. :���'''. ii. _�.,-�• � sly=`--��•.�.f�"'-- .�SJ n Cnueat r7 � �••.f--`-1 � � Access Easement + � J 1 f 13 Y` �^ fj IN pe j � f ' U : ':?G � 1]n `.�..- L'� : t- r V • o � p r o ,/'S r � Cs FQ i.f % i �,o c±, �C��'. L' _ t • .. I - ry .r' _ ti] it - •� �f - _$ L a^� _ -• �4 'i�'-. • -4• 5U-it:Sf.-Mmik 140 DE -CIVIL, PLLC 9601 Key Peninsula Hwy NW Gig Harbor, WA 98329 Ph (253) 228-0513 www.de-civil.com fir Site Plan Four Corners Gravel Pit 225 Four Corners Rd Jefferson County, Washington Job No: 25-017 February 2025 11 Figure 2 Sod Map--Jeftrson County Area, Washington r svn r zsve STlm 51M 5V= Sl= 5T= 513KO 5um0 SMIID SI= 51® 51� sum 3 1. � IRsp5�:15,a5Dipi4dmAer�(11'za5'9uR N a m "0 M, 3 s 0 25D ® lao0 ISO M.PPojKW=WFb Me1a0W ml—.M i�WGW F4fe¢UrMZnc101WC I ::. Natural Rcsourca5 Web Soil Survey • corwrvauon Service National Cooperative Soil Survey ®a>ivx A. N Not to Scale DE -CIVIL, PLLC 9601 Key Peninsula Hwy NW Gig Harbor, WA 98329 Ph (253) 228-0513 www.de-civil.com 2/12/2025 Page 1 of 3 Approximate Location USDA Soils Map Four Corners Gravel Pit 225 Four Corners Rd Jefferson County, Washington Job No: 25-017 February 2025 Figure 3 Ti*aft r1�� -a ' SA'Ution f i, i Tpllr P,ck P. ' Issil oc_ 2) ti Not to Scale DE -CIVIL, PLLC 9101 Key Peninsula Hwy NW Gig Harbor, WA 98329 Ph (253) 228-0513 www.de-civil.com Qgo��� �- Approximate Location <Z> Geological Map Four Corners Gravel Pit 225 Four Corners Rd Jefferson County, Washington Job No: 25-017 February 2025 WELL REPORTS RESOURCE PROTECTION WELL REPORT L O tU rn L O C O L O C O L O C M M tU t A «S L L F— O Z N N O O O U W 4- 0 C O E L tU ❑ This is a report of the activities of a licensed Washington well driller and serves as the official record of work done within the borehole and casing and describes the amount of water encountered. DEPARTMENT OF ECOLOGY Staff of Washngto, Decommissioning Type of Well: Geotech Soil Boring Number of Wells in Group 3: 1 well Type of Work: New Method: Auger Drilling Start Date: 6/22/2018 Drilling Completion Date: 6/22/2018 Received by Ecology: 6/26/2018 8:46 AM Dimensions: Diameter of borehole before decommissioning: 8 in Well depth before decommissiong: I 1 ft 6 in Well Group 3 of 3 for Decommissioning Construction Notice of Intent Number: SE66578 Decommissioning Notice of Intent Number: AE49692 Unique Ecology Well ID Tag Number: N/A Property Owner Name: Jefferson PUD Property Owner Address: 310 Four Corners Road, Port Townsend, WA 98368 Well Location: Well Street Address: City, State, Zip: WA County: Jefferson Township: 30N Range: 1 W Section: 33 in the NE 1/4 of the SW 1i4 Construction Details Casings: Well Head Elevation: From Depth To Depth Type Diameter Stickup Elevation Datum: N/A Elevation Method: Latitude (DD): Longitude (DD): Perforations: Datum: Type Size Total From To Horizontal Coordinate Collection Method: Perforations Depth Depth N/A Tax parcel No.: Screens: Lithology Manufacturer Type Dia- Slot From To Layer: Describe by color, character, size of material and structure, and meter Size Depth Depth the kind and nature of the material in each layer penetrated, with at N/A least one entry for each change of information. From To Material Sand/Gravel Packings: 0 ft 0 in 11 ft 6 in Sand and Gravel Material From To Depth Depth N/A Individual Well Details (Group 3 of 3) Well Driller's Identifier Decom Sealing Materials l B-3 Bentonite Additional Well Decommissioning Information None Well Construction Certification: I constructed and/or accept responsibility for construction of this well and its compliance with all Washington well construction standards. Material used and information reported above are true to the best of my knowledge and belief. Driller/Engineer/Trainee Printed Name: KEVEN DOYLE Drilling Company: Holocene Drilling Co Driller or trainee License Number: 3146 Address: 11412 62nd Ave E If trainee, Driller's License Number: City, State, Zip: Puyallup, WA, 98373 i O IZ O O N L 3= O C O M E L O C d t O s= O L L L M O Z (n O O 9, O O U O a-+ i= O E L M CL a) RESOURCE PROTECTION WELL REPORT This is a report of the activities of a licensed Washington well driller and serves as the official record of work done within the DEPARTMENT OF borehole and casing and describes the amount of water encountered. ECOLOGY state o1 w Wgm Construction Well Group 3 of Type of Well: Geotech Soil Boring Construction Notice of Intent Number: SE66578 Number of Wells in Group 3: 1 well Decommissioning Notice of Intent Number: AE49692 Type of Work: New Unique Ecology Well ID Tag Number: N/A Method: Auger Property Owner Name: Jefferson PUD Drilling Start Date: 6/22/2018 Property Owner Address: 310 Four Comers Road, Port Townsend, WA Drilling Completion Date: 6/22/2018 98368 Received by Ecology: 6/26/2018 8:46 AM Well Location: Dimensions: Well Street Address: Borehole Diameter: 8 in City, State, Zip: WA Depth of completed well: 11 ft 6 in County: Jefferson Township: 30N Range: 1 W Section: 33 in the NE 1i4 of the SW 1/4 Construction Details Casings: Well Head Elevation: From Depth To Depth Type Diameter Stickup Elevation Datum: N/A Elevation Method: Latitude (DD): Longitude (DD): Perforations: Datum: Type Size Total From To Horizontal Coordinate Collection Method: Perforations Depth Depth N/A Tax parcel No.: Screens: Lithology Manufacturer Type Dia- Slot From To Layer: Describe by color, character, size of material and structure, and meter Size Depth Depth the kind and nature of the material in each layer penetrated, with at N/A least one entry for each change of information. From To Material Sand/Gravel Packings: 0 ft 0 in 11 ft 6 in Sand and Gravel Material From To Depth Depth N/A Individual Well Details (Group 3 of 3) Well Driller's Identifier Water Level 1 B-3 Dry Hole Additional Well Construction Information None Well Construction Certification: I constructed and/or accept responsibility for construction of this well and its compliance with all Washington well construction standards. Material used and information reported above are true to the best of my knowledge and belief. Driller/Engineer/Trainee Printed Name: KEVEN DOYLE Drilling Company: Holocene Drilling Co Driller or trainee License Number: 3146 Address: 11412 62nd Ave E If trainee, Driller's License Number: City, State, Zip: Puyallup, WA, 98373 RESOURCE PROTECTION WELL REPORT This is a report of the activities of a licensed Washington well driller and serves as the official record of work done within the borehole and casing and describes the amount of water encountered. DEPARTMENT OF ECOLOGY 51M 0f Wa hhgt0n Decommissioning Type of Well: Geotech Soil Boring Number of Wells in Group 2: 1 well Type of Work: New Method: Auger Drilling Start Date: 6/22/2018 Drilling Completion Date: 6/22/2018 Received by Ecology: 6/26/2018 8:45 AM Dimensions: Diameter of borehole before decommissioning: 8 in Well depth before decommissiong: 21 ft 6 in Construction Details Casings: From Depth To Depth Type N/A Perforations: Type Size Total Perforations N/A Diameter Stickup From To Depth Depth Well Group 2 of 3 for Decommissioning Construction Notice of Intent Number: SE66578 Decommissioning Notice of Intent Number: AE49692 Unique Ecology Well ID Tag Number: N/A Property Owner Name: Jefferson PUD Property Owner Address: 310 Four Comers Road, Port Townsend, WA 98368 Well Location: Well Street Address: City, State, Zip: WA County: Jefferson Township: 30N Range: 1 W Section: 33 in the NE 1i4 of the SW u4 Well Head Elevation: Elevation Datum: Elevation Method: Latitude (DD): Longitude (DD): Datum: Horizontal Coordinate Collection Method: Tax parcel No.: Screens: Lithology Manufacturer Type Dia- Slot From To Layer: Describe by color, character, size of material and structure, and meter Size Depth Depth the kind and nature of the material in each layer penetrated, with at N/A least one entry For each change of information, From To Material Sand/Gravel Packings: 0 ft 0 in 21 ft 6 in Sand and Gravel Material From To Depth Depth N/A Individual Well Details (Group 2 of 3) Well Driller's Identifier Decom Sealing Materials 1 B-2 Bentonite Additional Well Decommissioning Information None Well Construction Certification: I constructed and/or accept responsibility for construction of this well and its compliance with all Washington well construction standards. Material used and information reported above are true to the best of my knowledge and belief. Driller/Engineer/Trainee Printed Name: KEVEN DOYLE Drilling Company: Holocene Drilling Co Driller or trainee License Number: 3146 Address: 11412 62nd Ave E If trainee, Driller's License Number: City, State, Zip: Puyallup, WA, 98373 RESOURCE PROTECTION WELL REPORT L O CL O v to t C O C O m E Sa O C N t O tB C) iv t a L L 1- 0 Z V) v O A O O v LL.I w- O a-+ C O E L CL a) Q� 1— This is a report of the activities of a licensed Washington well driller and serves as the official record of work done within the borehole and casing and describes the amount of water encountered. DEPARTMENT OF ECOLOGY State 01 WUNINgt Construction Type of Well: Geotech Soil Boring Number of Wells in Group 2: 1 well Type of Work: New Method: Auger Drilling Start Date: 6/22/2018 Drilling Completion Date: 6/22/2018 Received by Ecology: 6/26/2018 8:45 AM Dimensions: Borehole Diameter: 8 in Depth of completed well: 21 ft 6 in Construction Details Casings: From Depth To Depth Type N/A Perforations: Type Size Total Perforations N/A Diameter Stickup From To Depth Depth Well Group 2 of 3 Construction Notice of Intent Number: SE66578 Decommissioning Notice of Intent Number: AE49692 Unique Ecology Well ID Tag Number: N/A Property Owner Name: Jefferson PUD Property Owner Address: 310 Four Comers Road, Port Townsend, WA 98368 Well Location: Well Street Address: City, State, Zip: WA County: Jefferson Township: 30N Range: 1 W Section: 33 in the NE 1/4 of the SW 1/4 Well Head Elevation: Elevation Datum: Elevation Method: Latitude (DD): Longitude (DD): Datum: Horizontal Coordinate Collection Method: Tax parcel No.: Screens: Lithology Manufacturer Type Dia- Slot From To Layer: Describe by color, character, size of material and structure, and meter Size Depth Depth the kind and nature of the material in each layer penetrated, with at N/A least one entry for each change of information. From To Material Sand/Gravel Packings: 0 ft 0 in 21 ft 6 in Sand and Gravel Material From To Depth Depth N/A Individual Well Details (Group 2 of 3) Well Driller's Identifier Water Level 1 B-2 Dry Hole Additional Well Construction Information None Well Construction Certification: I constructed and/or accept responsibility for construction of this well and its compliance with all Washington well construction standards. Material used and information reported above are true to the best of my knowledge and belief. Driller/Engineer/Trainee Printed Name: KEVEN DOYLE Drilling Company: Holocene Drilling Co Driller or trainee License Number: 3146 Address: 11412 62nd Ave E If trainee, Driller's License Number: City, State, Zip: Puyallup, WA, 98373 RESOURCE PROTECTION WELL REPORT L O CL N lY CD N r C O C O E L O 4-1 L O C tSS c4 O L A M L L i- 0 Z N O O a O O U 1L 4- 0 C N E L CL a) This is a report of the activities of a licensed Washington well driller and serves as the official record of work done within the borehole and casing and describes the amount of water encountered. DEPARTMENT OF ECOLOGY State al Wa hington Decommissioning Type of Well: Geotech Soil Boring Number of Wells in Group 1: 1 well Type of Work: New Method: Auger Drilling Start Date: 6/22/2018 Drilling Completion Date: 6/22/2018 Received by Ecology: 6/26/2018 8:44 AM Dimensions: Diameter of borehole before decommissioning: 8 in Well depth before decommissiong: 16 ft 6 in Construction Details Casings: From Depth To Depth Type N/A Perforations: Type Size Total Perforations N/A Diameter Stickup From To Depth Depth Well Group 1 of 3 for Decommissioning Construction Notice of Intent Number: SE66578 Decommissioning Notice of Intent Number: AE49692 Unique Ecology Well ID Tag Number: N/A Property Owner Name: Jefferson PUD Property Owner Address: 310 Four Comers Road, Port Townsend, WA 98368 Well Location: Well Street Address: City, State, Zip: WA County: Jefferson Township: 30N Range: I W Section: 33 in the NE 1/4 of the SW 1/4 Well Head Elevation: Elevation Datum: Elevation Method: Latitude (DD): Longitude (DD): Datum: Horizontal Coordinate Collection Method: Tax parcel No.: Screens: Lithology Manufacturer Type Dia- Slot From To Layer: Describe by color, character, size of material and structure, and meter Size Depth Depth the kind and nature of the material in each layer penetrated, with at N/A least one entry for each change of information. From To Material Sand/Gravel Packings: 0 ft 0 in 16 ft 6 in Sand and Gravel Material From To Depth Depth N/A Individual Well Details (Group 1 of 3) Well Driller's Identifier Decom Sealing Materials 1 B-1 Bentonite Additional Well Decommissioning Information None Well Construction Certification: I constructed and/or accept responsibility for construction of this well and its compliance with all Washington well construction standards. Material used and information reported above are true to the best of my knowledge and belief. Driller/Engineer/Trainee Printed Name: KEVEN DOYLE Drilling Company: Holocene Drilling Co Driller or trainee License Number: 3146 Address: 11412 62nd Ave E If trainee, Driller's License Number: City, State, Zip: Puyallup, WA, 98373 L O O N In C O O E L O 4— C O t O C 1a L C L L 9— Z N N O i� _O O U LLI O C tv E L CL ^m Lel RESOURCE PROTECTION WELL REPORT This is a report of the activities of a licensed Washington well driller and serves as the official record of work done within the borehole and casing and describes the amount of water encountered. DEPARTMENT OF ECOLOGY sinew wmhM _ Construction Well Group I of 3 Type of Well: Geotech Soil Boring Construction Notice of Intent Number: SE66578 Number of Wells in Group 1: 1 well Decommissioning Notice of Intent Number: AE49692 Type of Work: New Unique Ecology Well ID Tag Number: N/A Method: Auger Property Owner Name: Jefferson PUD Drilling Start Date: 6/22/2018 Property Owner Address: 310 Four Corners Road, Port Townsend, WA Drilling Completion Date: 6/22/2018 98368 Received by Ecology: 6/26/2018 8:44 AM Well Location: Dimensions: Well Street Address: Borehole Diameter: 8 in City, State, Zip: WA Depth of completed well: 16 ft 6 in County: Jefferson Township: 30N Range: 1 W Section: 33 in the NE 1/4 of the SW 1/4 Construction Details Casings: Well Head Elevation: From Depth To Depth Type Diameter Stickup Elevation Datum: N/A Elevation Method: Latitude (DD): Longitude (DD): Perforations: Datum: Type Size Total From To Horizontal Coordinate Collection Method: Perforations Depth Depth N/A Tax parcel No.: Screens: Lithology Manufacturer Type Dia- Slot From To Layer: Describe by color, character, size of material and structure, and meter Size Depth Depth the kind and nature of the material in each layer penetrated, with at N/A least one entry for each change of information. From To Material Sand/Gravel Packings: 0 ft 0 in 16 ft 6 in Sand and Gravel Material From To Depth Depth N/A Individual Well Details (Group 1 of 3) Well Driller's Identifier Water Level l B-1 Dry Hole Additional Well Construction Information None Well Construction Certification: I constructed and/or accept responsibility for construction of this well and its compliance with all Washington well construction standards. Material used and information reported above are true to the best of my knowledge and belief. Driller/Engineer/Trainee Printed Name: KEVEN DOYLE Drilling Company: Holocene Drilling Co Driller or trainee License Number: 3146 Address: 11412 62nd Ave E If trainee, Driller's License Number: City, State, Zip: Puyallup, WA, 98373 RESOURCE PROTECTION WELL REPORT This is a report of the activities of a licensed Washington well driller and serves as the official record of work done within the borehole and casing and describes the amount of water encountered. P[PAPkTM[xT er ECOLOGY Slate of washkngw Decommissioning Type of Well: Geotech Soil Boring Number of Wells: 4 Type of Work: New Method: Auger Drilling Start Date: 8/27/2015 Drilling Completion Date: 8/27/2015 Received by Ecology: 9/23/2015 1:32 PM Dimensions: Diameter of borehole before decommissioning: 8 in Well depth before decommissiong: 35 ft 0 in Construction Notice of Intent Number: SE55804 Decommissioning Notice of Intent Number: AE33596 Unique Ecology Well ID Tag Number: N/A Property Owner Name: Jefferson County PUD Property Owner Address: 310 Four Comers Rd, Port Townsend, WA 98368 Well Location: Well Street Address: 310 Four Comers Rd City, State, Zip: Port Townsend, WA County: Jefferson Township: 30N Range: 1 W Section: 33 in the NE 1/4 of the SW 1/4 Construction Details Well Head Elevation: Casings: Elevation Datum: From Depth To Depth Type Diameter Stickup Elevation Method: N/A Latitude (DD): Longitude (DD): Datum: Perforations: Horizontal Coordinate Collection Method: Type Size Total From To Tax parcel No.: Perforations Depth Depth N/A Lithology Screens: Layer: Describe by color, character, size of material and structure, and Manufacturer Type Dia- Slot From To the kind and nature of the material in each layer penetrated, with at meter Size Depth Depth least one entry for each change of information. N/A From To Material 0 ft 0 in 35 It 0 in Sand and Gravel Sand/Gravel Packings: Material From To Depth Depth N/A Individual Well Details Well Driller's Identifier Decom Sealing Materials 1 Bentonite 2 Bentonite 3 Bentonite 4 Bentonite Additional Well Decommissioning Information None Well Construction Certification: I constructed and/or accept responsibility for construction of this well and its compliance with all Washington well construction standards. Material used and information reported above are true to the best of my knowledge and belief. Driller/Engineer/Trainee Printed Name: Aren Hansen Drilling Company: GEOLOGIC DRILL EXPLORATIONS INC Driller or trainee License Number: 3123 Address: 14811 W COULEE HITE RD If trainee, Driller's License Number: City, State, Zip: SPOKANE, WA, 99224 RESOURCE PROTECTION WELL REPORT IMThis is a report of the activities of a licensed Washington well driller and serves as the official record of work done within the borehole and casing and describes the amount of water encountered. Vk#A%l Mt" O� ECOLOGY Stale od Mshing— Construction Construction Notice of Intent Number: SE55804 Type of Well: Geotech Soil Boring Decommissioning Notice of Intent Number: AE33596 Number of Wells: 4 Unique Ecology Well ID Tag Number: N/A Type of Work: New Property Owner Name: Jefferson County PUD Method: Auger Property Owner Address: 310 Four Comers Rd, Port Townsend, WA Drilling Start Date: 8/27/2015 98368 Drilling Completion Date: 8/27/2015 Received by Ecology: 9/23/2015 1:32 PM Well Location: Well Street Address: 310 Four Comers Rd Dimensions: City, State, Zip: Port Townsend, WA Borehole Diameter: 8 in County: Jefferson Depth of completed well: 35 ft 0 in Township: 30N Range: 1 W Section: 33 in the NE 1/4 of the SW 1/4 Construction Details Well Head Elevation: Casings: Elevation Datum: From Depth To Depth Type Diameter Stickup Elevation Method: N/A Latitude (DD): Longitude (DD): Datum: Perforations: Horizontal Coordinate Collection Method: Type Size Total From To Tax parcel No.: Perforations Depth Depth N/A Lithology Screens: Layer: Describe by color, character, size of material and structure, and Manufacturer Type Dia- Slot From To the kind and nature of the material in each layer penetrated, with at meter Size Depth Depth Ieast one entry for each change of information. N/A From To Material 0 ft 0 in 35 ft 0 in Sand and Gravel Sand/Gravel Packings: Material From To Depth Depth N/A Individual Well Details Well Driller's Identifier Water Level I Dry Hole 2 Dry Hole 3 Dry Hole 4 Dry Hole Additional Well Construction Information None Well Construction Certification: I constructed and/or accept responsibility for construction of this well and its compliance with all Washington well construction standards. Material used and information reported above are true to the best of my knowledge and belief. Driller/Engineer/Trainee Printed Name: Aren Hansen Drilling Company: GEOLOGIC DRILL EXPLORATIONS INC Driller or trainee License Number: 3123 Address: 14811 W COULEE HITE RD If trainee, Driller's License Number: City, State, Zip: SPOKANE, WA, 99224 ECOLOGY State r:f wachmgton Resource Protectlori Well Report Submit one well report per well installed. See page two for instructions - Type of Work: 05 0 In to s I0 i L O 3 z15 d 0 M 7- rn 0 is.l u 4- 0 c 95 t a d M Construction Decommission b Original NOI No. Ecology Well ID Tag No. $ Site Well Name Consulting Firm A Was a variance approved for this welUboring? p Yes PLNo If yes, what was the variance for? WELL CONSTRUCTION CERTIFICATION: t constructed and/or accept responsibility for corsstrurtion of this well, and its compliance with all Washington well ccwmicdon standards. Matetlals used and the information reported are true to my best knowledge and belief. ',XDriller p Trainee p Engineer Name (Print Last, First Name) Driller/F,rigineer/Trainee Signature 0)py L License No. '251 3 Company Name t71�-_e-P— =(— I t1 C . It trainee box is checked,•sponwes license number. Sponsor's signature Notice of intent No. 2- Type of Well: KResource protection Well ❑injection Point Retnediation Well Grounding Well ❑ Geotechnieal Soil Boring ❑ Ground source Heat Pump ❑ Environmental Boring ❑ Other p Soll- Cl Vapor p Water -sampling Property Owner D Well Street Address L� - City 7 CW1+161= County JEFFE�Sct� Tax Parcel NO-0—C2_03-0 Location (see instructions): WWM ❑ or EWM)Q SW V,-yy RE. ►/a, Section ; �i_ Town 39]A_ Range w Latitude (Example: 47.12345) �• �'sa� Longitude (Example:-120.12345) " ► L O1. (WGS 84 Coordinate System) Borehole diameter _JL inches Casing diameter 2 inches Static water level IA P► €t below top of casing Date il�q ❑ Above -ground completion with bollards Igl,Flush monument * Sack -up of top of well casing ft above ground surface Start Date `1 Completed Date l l (y Z Ca n l] SE.P"LF-D V,1 iTIA r-LWell USWata �AotaUMF►AT t CUMCZE'TE Driller's Log TOPS() I L-- �* ING Q1SE1G SCOF-oULg 40 Wm" BENTvN ITE C*19S S `IbP of SILte-A SRND 11x2-7 `Tbf, OF Z" PVC. SGREEN • - Scti-EDULE t-lo $I_vr .DIO W mA CC,az LES �'�uR.EFFoI� F3A qLF Iu.En w ITN gENToNI'TE C-WIPS Received Department of Ecology DEC 0 5 M4 Water Resources Program NWRO ECYOSO•12 (0W2078) To nquase ADA accotlnmadalion ixehI&Og inarlerish is a fbnaatjorsba rknally iwpaJnd, "U Reology WaterRssouncQs Program 360-407-6872. Porto= with imptu vd hsaring may call Washingran Rdsy Sarvke of 711, Pemons wi i spew* ddrabiMy NW asll7TY at 877-83,74347. M `R.. -30 4* 10 3 H Z15 9 U w 0 a- c E 25 0 a d a F 3� DEPARTMENT OF ECOLOGY State r,d waatungton Resource Protection Well Report Submit one wall report per well WWled. See pegs two for immwtions. - Type of Work: - - Construction Decommission =� Original NOI No. Ecology Well ID Tag No. Site Well Name Consulting Firm Was a variance approved for this well/boring? ❑ Yes JkNo If Yes, what was the varialm for? _ WELL CONSTRUCTION CERTIFICATION: I constructed aradlor accept responsibility for comrnscrion of thir well, and its compliance with all Washington well construe m sonderds. hfaterlele used and the infmnation reported are true to my best lmoarletip and belief. X Driller ❑ Trainee p Engineer Name (Print Lest, First Name) t Driller/EngineerfTrainee Signature ►f.�{�ER License No. l �( 3 _ Company Name 3o ri-_� ---A— [ n C If trainee boa is checked, sponsor's license number. I Sponsor's signature Notice of intent No. �- Type of well: . Resource protection well ❑ 1piwion Point Rernediation Well ❑ Grounding Well Geotechnical Soil Boring ❑ Ground Source Heat PuraP Environmental Boring ❑ Other 13 Soil- E3 Vapor- [3 Water -sampling Property Owner P09d DE P Well Strcet Address D E City, Qp_-T _Tovjh&.t 4Caunty J EFF�1ZSc 1�I Tax Parcel No. 001330055 Location (see instructions): WWM ❑ or EWMX, S_ 14-W _&L 14, Section _&3_ Town s&:g- age .W Latitude (Example:47.12345) Longitude (Example:-120.12345) ' I1 Z. O11 L _ f WGS 84 Coordinate System) Borehole diameter VS- inches Casing diameter 2- inches Static water level ! Pt ft below too of casing Bate �� i 2�q p Above -ground completion with bollards WLFiush monument Stick-up of top of well casing ft above ground surface Start Hate 2. 1 Completed Date l 1 Iy Z Co In 'Well Data S�At E� W ►TN r_L1,S1-1 tnoNU �ACalT + czucZEYE �." PVr✓ R1SE1� SC.ttEout.E W o $FJtLED W vr" SE1ATOTAME C*19S `TbP O 511.-I4.A G&RD 11-x ZiS -CDP OF L" PVC. SCREEN SCA+EDULE WO 5LOT .010 BOPE 14t71.i: BAULF l"ED pil"fH 5E4TONITE C-WIFS Drlller's Log i Tbp�501 t- sl L-T - St L? y Sr t-I oS �v ►TN CnF38 L.ES - i i Received Department of Eulogy DEC 0 5 2024 Water Resources i'rUr3`:,tri NW RO ECYOSO.12 (0772018) To regarast Aral docomsraalpn irtclud[ag matarlels In 4 fo" wl far mo visually iaspai-a, wHE~ WahrAnoerces Progrtras 360407-072. Perron wdh hn-m6wd healing may sail WasUxgtm Re4V Service a[ 711. Perrv- with apWh dhwb t1 xW call77T at 8774U363I1. •3 i 19 _7- I .3 tC 0 L i O 3 z IS En d 0 0 Z0 0 u 11J 4- 0 _ '�5 t 0 a d 0 DEMRTMENT OF ECOLOGY $tatc •:t wasrungton Resource protec#iorii Well Report Submit one well report per well iWalled• See page two for ins=tiong. Type of Work: Construction Decommission t=�- Original NOT No. Ecology Well ID'Tag No. 1 • Site Well Name Consulting Firm Was a variance approved for this well/boring? M Yes P'No If Yes, what was the variance foe. WELL CONSTRUCTION CERTIFICATION: t cottamacd and/or accept reeporoibllityfor conatuctioa of this well. and its eomplf anco with an waahinStm well corsbuction smndalda• Matetmis used aW the Infortttation reported are mn to my best limowledge and belief. )� Driller p Trainee p Engineer Name (Print Last, First Name) D iller/Engineer/Trainee Signature *"--A' License No. 3 1 3 Company Name . _ e,-- --I— I rl C , If trainee box is checked, Sponsor's license number. Sponsor's signature Notice of Intent No. E- Z. -7 D ^ Type of well: in ection Point aktesource Protection We11 ❑ � ❑ Remediation Well ❑ Grounding Well ❑ Gc Wlmical Soil Boring Ground Source Heat Pump Environmental Boring Other p Soli- Cl Vapor- 13 Water -sampling pro" Owner aR F �- Well Stroet Aftess 0 CityBag, :j0VjQEgp County Tax Parcel No. • al 33Qn� Location (see instructions): WWM ❑ or EAVy,s}�� V/ . Section _ZL3 _ Town 3¢11- age Latitude (Example: 47.12345) Longitude (Example:-120.12345) ._. I Z l D -1 (WGS 84 Coorcdinate System) Borehole diameter $_ inches Casing diameter 2_ inches Static water level P1 A ft below top of casing Date 11113 Z O Above -ground completion with bollards MLFlush monument Q* Stick up of top of wall casing ft above ground surface Start Date I ZL-I Completed Date I l I 14 Ce' ' 011 n Ded0a Well Data under' 5> PAX-D W MA FLUSH M01tauM51AT Cr,1iCli ETE TuPSo 1 �. 2" 4VG VSEIL k0ec"iI.b 4a . sENrt-E-o W �t�+ BENToN ITE c.11-tP5 sit.-T MOP OF 51t ii-A SWD IL9 7-0 r `roP OF 70 PVC. SCREEN SCA+EDULe WO $LOT .010 i I s I L-T sA,r4 os 0" l2QP-ENotZ 13AULF IU ED WITH 5ENTONITE Cot-IPS Iry ITH CAe16 LES Received Department of Ecology DEC 0 5 2024 Water Resources Prggro-M NW RO EC•Ya5&12 {0772o181 To rrgmW ADA de�#ore ireehdding ruat`Qriab in a formal farrhe vouatly iaepalrsd, wUEwl V WahrRasowces P -amm 760407-6872. Perron with inpaWd i4amixg may can Warhingran Relay Service at 711. Persons wM V&Mh AMWAV aray eau ny at 877-8334341. ,- 0 rL L. a H s 4- c 0 c t 0 E 0 w- C 0 -o c a } S 0 d s t _ iJ L O 3 I- zz 15 X1 0 v g 2-o 0 u W 4- 0 4- c E 25 t d a d a 47 DEPORTMENT OF ECOLOGY state f:c walrnngton Resource Protection WeIV Report Submit one well report per well insl allaL See pyre two for instructions. Type of Work. �Construction Decommission =:� Original NOI No. Ecology Well ID Tag No. B Site Well Name Consulting Firm Was a variance approved for this welitboring? O Yes Po If yes, what was the variance for? WELL CONSTRUCTION CERTIRCATION: I emmucad andlor accept reepwolbilltyfor eonaML41on ofthis well.ndita cacnpllaneo with dl Waabing m well Boa smnduda. Mabulds ImW nd the irdmutim rq)mW are true to my but Imo Aselp and belief. ji� Driller p Trainee C] Prigineer Name (Print Last. First Name) ❑filierlEngineerffrainetr Signature ►F License No. 3) 3 Company Name If trainee box is checked-, sponsor's Heense-number. Sponsor's signature i Notice of Intent No. 2 -7 0 t Type of well: ,Resource PMtMdOn Well ❑ lnyccUOn Paint Rernediation Well ❑ Grounding Well GeotecWcal Soil Boring ❑ Ground Source Heat Pump ❑ Envirunmental Boring ❑ Other t O Soil- 0 Vapor- c3 Water -sampling property owner C i=Roz Well Street Address Ao City a12T I O�VL�i�F�l? County , ►�rFEI�`3C t�i Tax Parcel No. 001 33OnS Location (see instructions): WWM © or EWMK S ,) /,-V, _�A F__", Section Town Range l �V Latitude (Example: 47.123,45) 1-4?5D � Longitude (Example: -120.12345) i�-Z• D1-1 Z (WGS84 Coordinate System) Borehole diameter -A— inches Casing diameter �- inches Static water level KA ft below top of casing Date l 1 p Above -ground completion with bollards I,LFlush monument Stick-up4topof well casing ft above ground surface Start Date 11 34 Completed Date I 1 14 Z Cowhn 11*01 Dea F1 Well Data SEALED W lr" FLVSI-L MOtSVM �1T + cc,�cittzE Driller's Log T�PSo1c— �` PVC. ME:V- SC*eDULF_ 40 SERt.En W tTli g�ToN lTE C.kl'1P$ Si L-r `MP ol= SILtGA SkRD IL-oZo or, V, PVC, 5C,(tEEr1 Su+EDUL_E '40 5wr ,DID S1 L?y SAV4DS Uv tTN C0(38 LES + �'SORE Hdt,E BACt-F ILLED WITH $ENToNITE CIMPS Received Department of Ecology DEC 0 5 4V4 Water Resources Program NWRO ECYOLSO-12 (0777018) 7'o rsqueas ADA awau reeadWan ischeding a&jrials ui a fare w jar the vivwVy iapadrrd, calf Ecology Wale -Resources P-9-M 340.4(174872. Perronr raith ImpoWd hearing mq caU Washtxglon Hersy 5eMee al 7II. Parton wrap speach dlra5i1lty may cult 7TY at 877-833-6341. 3 -L 2 rq 2 3L, TMENT Or ECOLOGY Srat: ••rw+af�«ngeoi� Resource Prote:ctici� Well Report Submit one well report per well installed. See page two far insmscaans.. . -1-ype of Work: Construction Decommission =� Original NO] No. Ecology Well ID Tag No. BQ U Q 1 -1 Site Well Name Consulting Firm A Was a variance approved for this well/boring? ❑ Yes ;kNo If yes, what was the variance foie! WELL CONSTRUCTION CERTIFICATION: I eoruwcted and/or accept rmpondbilityfor cwntnxdon of this Wall. and its compliance with ell Waabingtm well won smmlwde. Mal tials used and the information reported are true to my bat imosvledp and belief. )4 Driller 1] Trainee l7 Engineer Name (Print Last, First Name) Driller/EngincerlTrainee Signatnrt +f ►f40WA- License No. _ �� q 3 Company Name k3o reA e-. —d— 10 C If trainee box is checked, sponsor's license number. Spansor's signature Nodce'of Intent No. Z- Type of well: Rcsaurc:e Prd�on Well Injection Point Remediation Well ❑ Cstounding Weli Geotechnic3i Soil Boring ❑ Ground Source Heat Fume Environmental Boring ❑ Other p Soil- D Vapor- O Water -sampling Pro" owner DR Well Street Address (o C' R City P l �v County J r.FF Eta •1`l Tax Parcel No. n01 120005 i ocatlon (see instructions): WWI ©ar'Aqx ,]6j V/ , Section Town , 01A Range Latitude (Example: 47.12345) i-i n 5Ct Longitude (Example:-120,12345) (WGS 84 Coordinate System) Borehole diameter _ inches Casing diameter �- i ntltes 5lxlic water level 1A k ft below tap of casing Date p Aboveground completion with bollards M,Flush monument ILA Stick-up:of top of well casing ft above ground surface StarMate �`1 Completed Date l t I y Weil Data )[MI1er's Log SSfkLSD W IYN r-LVStt K0tAQIMr1,T: { .CcNCtZETE TOPSCl1.. -2` PVc, RISEN SC.ttEcUr.E Vo - SERI..ED W ►Tli 6ENToN tTE C.kl-tP5 S 1 L- T- -'TbP o F SILICA Shalt) 12-1C M -Top OF V, pvc SCREEN Sc.t+EDUL�E y0 SwT .DID S 1 L-T Y SM4 DS , W mA COBS LES INME Not.E 13AC.{LFIt.b-ED WITH B;=NToN17E Lt+IpS Received Department of Ecology DEC 0 5 2024 Water Resources Program NW RO ECYaSa-I2 (0712018) To r1gwnr ADA .ecommardatio,v bWud&g pairialr in o jbnnarforNu vJMefiy iwperired, eag,96010gy WUMr HeanBrcar Pmg►om 360407-M72. Perrva wish in-pa&M keeQing may tad! Warhingtan Jt#gV Semite at 711. Far MM wia speseh ddsahitlty may sou M at 87R0343I1. 13 RESOURCE PROTECTION WELL REPORT cvmuw a 4-4I 0 (SUBMIT ONE WELL REPORT PER WELL INSTALLED) Notice of Intent No, Construction/Decommission CY' in circle) 'Type of Well (Y' in circle) XConstruction 0, Resource Protection 0 Decommission ORIGINAL INSTALLATION Notice Geotech Soil Boring of Intent Number Property Owner �5� OCo ,, n � pL" Irv+� Site Address Qi O Tow, cb r vet.+, S JL Consulting Firm Unique Ecology Well ID City Ro 4 T0L h%t 1-County: Tag No: �.3 l�i�1 Location �14 �J/4 Scb— Twc5 - R- circle WELL CONSTRUCTION CERTIFICATION: I constructed and/or accept � one responsibility for construction of this well, and its compliance with all Washington LatlLong (5, 4 i Lat Deg Lat MinlSec well construction standards. Materials used and the information reported above are true to my best knowledge and belief. still REQUIRED) Long De g Long Min/Sec ' 07mer ❑Eogioeer Traiate Name (Prim . — Tax Parcel No Driller/Engineer/Trainee Signature 11 Driller or Trainee License No. �rj Cased or ncased D eter Static Level b�r �b� Work/Decomtnission StartDate 1��3-� 04 _ If trainee, licensed driller's I. D 3 O+ Signature and License no. . r Work/Decommission Completed Date Construction/Design Well Data M 3cp Formation Description CONCRETE SURFACE SEAL EiACKFIiLL ]? r Jimhitl Q,ki (t5 DEPTH OF BORING I t `1 0 -- /�? ft. 940-jN .s44as "< ft. ft. IRIECEIVED JAN 0 7 2005 I L Washlnizton State Department of Ecolo-y Scale 1"= Page b of S ECY 050-12 (Rev 2101) 1"tE OURCE PROTECTION WELL REPORT Cl R-ENT S a 4-4i o (SUBMT ONE WELL REPORT PER WELL INSTALLER) Notice of Intent No, CnrsstructionlDecon»ission ( ' in circle) Type of Well ('V' in circle) Construction Resource Protection 0� �' 0 Decommission ORIGINALINSTALL477ON Notice Geotech Soil Boring I ^�� of Intent Number Pro erty Owner Consulting Firm pL� �hVif Unique Ecology Well ED Tag No: P Site Address T-7p"q- CpY V-wr S City'PO,,+ SUN&L-County: Location J 14 t�W—J14 Se-3 TZ—W 1L ENM code WELL CONSTRUCTION CERTIFICATION: I constructed and/or accept one responsibility for construction of this well, and its compliance with all Washington Lat/Long (S, t, r Lat Deg L.a[ Min/Sec well construction standards. Materials used and the information reported above are true to my best knowledge and belief. still REQUIRED) Lon De �'Q g g Long Min/Sec ' i7tiller ❑Engiae'Arl-Iinee Name (Prin -- Tax Parcel No1— 'UrjllerlF,gin=17rainee Signature u Driller or Trainee License No. �� �S Cased or n a,zd D eter Static Level Work/Dccojnmission Start Date If trainee, licensed driller's b� ° jai 3 d Signature and License no. F Work/Decommission Completed Date Construction/Design Well Data A i 31y ' ( Co Formation Description -e:: CONCRETE SURFACE SEAL y • BACKFILL L-1 DEPTH OF BORING I 0 - /,2 ft. J — G4 4 ul J I ft. ft L IIZECEIVED JAN 0 7 2005 Washin'ton State 1 Department of Ecologly I I I Scale 1 '= Page -!�"of ECY 050-12 (Rev 2/01) RESOURCE PROTECTION WELL REPORT cum?fT I S 0 4-4i o (SUBAHT ONE WELL REPORT PER WELL INSTALLED) Notice of Intent No._ Con.5trtictiowDecommission (Y'in cire:e) Type of Well (Y' in circle) XCo>astruction 0, Resource Protection � 0 Decommission ORIGINAL INSTALLATION Notice Geotech Soil Boring V� �� of Intent Number Property Owner 5%Lm O Irr Rsulting Firm pL-L-� ��Y►t ,,, n Site Address _ o20 ZFD�+( _(.OV!n '6 ?,-- Unique Ecology WellID City PO4 TOL%k\%t County: Tag No: .��, 't Location �ia ��ta SZC L -r., - R < EW06"ne WELL CONSTRUCTION CERTiF[CATION: I constructed and/or accept oje nr responsibility for construction of this well, and its compliance with all Washington Latdzng (s, t, r Lat Deg L•at �rtj$ec well construction standards. Materials used and the infatuation reported above we still REQUIRED) true to my hest knowledge and belief. If � �.OIIJ.R.l� Long Deg Lon Min/Sec g L"I�..cr� uruler ❑EngioC-?(T zPce Name (Frio Tax Parcel No�� f'Dt;Rer Enaitleer/Ttainee Signatze License No. ���j -- r 1 Cased or ncased D eter Static Level r" Driller or Trainee Work/Decommission Start Date Ntrainee, licensed driDer's o ` r Completed Date Signature and License no. Work/Decommission Construction/Design Well Data ` -i F b — too Formation Description `�:! r j�I f T! • CONCRETE SURFACE SEAL 0 ft. •-,, �• - �� �� 1 I N somas f I -j— j BACKFILL �h��Ca I — ft. i I p-e> I I i I 1 j I 1 I I ft. I I I I � I I L i 1 I i RECEIVE ' 1 JAN 0 7 2005 Washill,tOn Stine 1 BORING !a-t Department of Ecolukyy DEPTH OF I I Scale P= Page �D -of I � ECY 050-12 (Rev 2101) RESOURCE PROTECTION WELL REPORT I S a 4�� o (SUBAHT ONE WELL REPORT PER WELL INSTALLED) �c�� tent No, Construction/Decommission (x" in circle) Type of Well ('x" in circle) Construction Resource Protection 70 O Decommission ORIGINAL INSTALLATION Notice Geatech Sail Baring jq3C)93 of Intent Number property owner 4 ► S Consulting Firm '01" Site Address 00Eoue C zy mys Unique Ecology Well ID city PC, 4 11,County: Tag No: �� Location �44 tLW-J/4 Sa6__ Tw� R I Lj EWM"le WELL CONSTRUMDN CERTIFICATION: I constructed and/or accept one responsibility for construction of this well, and its compliance with all Washington (E) Lat/Long (s, t, r Lat Deg Lat Min/SeC well construction standards. Materials used and the information reported above are still REQUIRED) true to my best knowledge and belief. -�a �2 �� Lon De g g LongMin/Sec ' ihigrr �]Leagioerx Iraiaee Name {Prim . Tax Parcel No f�-- 1D, Ua/Enginem/Trainee Signature �rj u ' Cased or Q ncased eter 22Static Level ~' Driller or Trainee Incense No. Start Date tip' If trainee, licensed driller's Work/Decommission Completed Data Iqj jj d,� Signature and License no. Work/Decommission Construction/Design Well Data ki 3u ' t Formation Description r • �{�� r;J I� �Ct4C `ti ' r ■�� �`� F; I CONCRETE SURFACE SEAL ■ 1I1 LBACKFILL +�► I - I I I I 1 I I I I I _ I DEPTH OF BORING I � I I Scale 1"= Page of O — j_ ft. 940-JAI 5'1116S — GA4 cat f ft. ft. RECEI d EIT) JAN 0 7 2005 Washinvton Slate Department ol' Ecolooy 1 I I 1 I ! ! 1 I f I I I L I I I I ! I I I ECY 050-12 (Rev 2/01) t.-F-S0 SCE PROTECTION WELL REPORT CURRENT S o? 4-4i o (SUBART ONE WELL REPORT PER WELL INSTALLED) Notice of Intent No._ Coiwniction/Decon3s Lssion ('x"in circle) Type of Well ('x" in circle) Construction Resource Protection ( D� 1� O Decommission ORIGINAL INSTALLATION Notice Geatec3r Soil Boxing 1 r n 2cll of Intent Nurn6cr Pr Owner L�. Consulting Firm Unique Ecology Well ED Tag No: operiy Site Address _�0"" 1-7eDy,V COYY-U_rS 1/ ^- City �o TOkhL ounty: �e+T Sb''� Location 6!�i4 t W/4 Se-✓ Tw R-'=0 EWM c'["I` WELL CONSTRUCTION CERTIFICATION: I constructed and/or accept one responsibility for construction of this well, and its compliance with all Washington LauLong (s, t, r Lat Deg I.at 1V WSeC well construction standards. Materials used and the information reported above are true to my best tmowiedge and beliei fQ still REQUIRED) Long De (—a"r g Long Min/Sec ' inurr ❑ Eugine'ATrsinee Name (Fein . — Tax Parcel Na.—� 4Dr&rlE1gioeer/Trainee Signature Driller or Trainee License No. o�,�'�� � Cased or • ncased D eter a Static Level ~' Work/Decommission StartDate 1� 3 If trainee, licensed driller's 6 .g- Signature and License no. Work/Decommission Completed Date Consiruction/Design Well Data A-i3u Formation Description I f I i I I I I T I f f I 1 I I I I I I I I 1 I CONCRETE SURFACE SEAL BACKFILL �_+r.►�p Cki F6 DEPTH OF BORING !a2 r IF 0 ft. GR.4 uL N S'iWDs i ft. i ft. JAN 0 7 2005 Wa;hinRtoll Stile Depariment ul' Ecolk,,y 1 1 I I I I 1 I I I I I Scale V= Page - of 15 ECY 050-12 (Rev 2/01) PLESOIRCE PROTECTION WELL REPORT NoaRceRo�flatentNo._ S 0 4-4► ri (SUBMIT ONE WELL REPORT PER WELL INSTALLED) Construction/Decommission ("x" in circle) Type of Well ('x" in circle) Construction Resource Protection 70 0 Decommission ORIGINAL INSTALLATION Notice GeoteCh Soil Boring Ir n �v� of Intent Number . _ Properly Owner -.,x O Consulting Firm, p�`�rnvit Unique Ecology Well ID Tag No: Site Address jo T7,,s r YCym . S City Tv' Tp►hhSe6&County:EWM Location 6!�14 tLLJJ/4 SZ—S— Two5—"' ' R'—Lj - cira[e WELL CONSTRUCTION CERTIFICATION: I constructed and/or accept " onr responsibility for construction of this well, and its compliance with all Washington Latli ong (s, t, r Lat Deg Lat MirdSeC well construction standards. Materials used and the information reported above are still REQUIRED) true ro my best Imowledge and belief. �Q Cat es Long Deg Long Min/Sec in;Ilcr ❑Fngiaeex T ce Name (Fein — Tax Parcel No %`� 'Dliller/Engin,m(trainee Signature L- ►1 ' Duller or Trainee License No. Cased or nCased eter Static Level `� r" S-C 1 Work/Decommission Start Date i � 04 [Iffftrainee, licensed dither's ' j4. a3 p s - gnatare and License no. f Work(Decommission Completed Date ConstructiowDesign Well Data A13U J IS Formation Description CONCRETE SURFACE SEAL BACKFILLaer.Awt,' &;F6 DEPTH OF BORING IrL t � I 0 - 12 ft. j I &4CLVN 54Vh-S _ GA4 -- ft. ft. JAN 0 7 2005 Washington State Department of Ecoloj y Scale V= . , Page—IL of ECY 050-12 (Rev 2/01) RESOURCE PROTECTION WELL REPORT CEMI-R-ENT � Q 4 -4 10 (SUBMIT ONE WELL REPORT PER WELL INSTALLER) roticc of Intent No._ CortstructiowDecoimnission ('z" in circle) Type of Well ('z" in circle) X 0, �' Construction Resource Protection 0 Decommission ORIGINAL INSTALLATION Notice Geotech Soil Boring of Intent Number Pro a Owner Consulting Firm �L`Hr.Y1C Unique Ecology Well ID Tag No: P rtY .,, (� Site Address '2O �Ov.� Y rVU(5 !� City �ar T6w�`..JLcounty: —3,, Location J 14 J/4 Sa6-- TwZT �J^ ]EWM —i° WELL CONSTRUCTION CERTIFICATION: I constructed and/or accept j °ne responsibility for construction of this well, and its compliance with all Washington Lat/Long (s, t, r Lat Deg Lat Min/Set `� well construction standards. Materials used and the information reported above are true to nay best knowledge and belief, still REQUIRED) Lon, De a` `fir G g Long lvlin/Sec tiriller DEnpjueaATraince Name [Prig , Tax Parcel No./�--• "D ii mfEngineer(ftaivee SigttaWre ►► Driller or Trainee License No. eZs T Cased or ncased D eter Static Level ~' s e� Work/Decommission Start Date 1: - s / c' Fl�fainee, licensed driHer s i3 a 3 ��ature and License no. . Work/Decommission Completed Date ConsmrctiowDesign Well Data A-i3u — 061 Formation Description i I I I I I I I I T I I I I i T I I 1 I I I 1 I ,Jltii;�.��,, f' * ` • CONCRETE SURFACE SEAL BACKFILL �►� tk►F6 DEPTH OF BORING lcl it 0 — 42 ft. 940-V,►I 54 4h, S -- GM UC ( ft. ft. 'DECEIVED JAN 0 7 2005 Washing(on Stalte i Department cat Ecolilsv ! Scale V= Page � r` u ECY 050-12 (Rev 2/01) O CL to t O C E w C O t a.+ rr O c� co Ama cc 0 s A C L L tv F_ 0 z H d) O a a� O 6 U W 0 C al' E L cc CL 0 n RESOURCE PROTECTION ION WELL REPORT CURRENT � � ��� 0 (SUBMIT ONE WELL REPORT PER WELL INSTALLED) Notice of Intent No._ Coust[vetiowDecommission ( ' in circle) 'type of Well ('V' in circle) Construction Resource Protection 70 1� O Decommission ORIGINAL INSTALLATION Notice Gevtech Soil Boring of Intent Number -- I Con Firm DLt} Unique Ecology Well ID Tag No: operty vrn Site Address 0O To', C.,M1(S d- _ City p°• Oc•xs—WA-County: _�. Z5�yy ,`ice�►-` Location J 414 ��/4 Se� Twn-�"' - R ! L3 rirrrc WELL CONSTRUCTION CERTIFICATION: I constructed and/or accept � one responsibility for construction of this well, and its compliance with all Washington well construction standards. Materials used and the information reported above are LatlLvntz g (5, t, r Lat Deg La[ MirtlSec true tom hest lmowled a and belief. still REQUIRED) y g Long Deg Long Min/Sec uriller 01 ngiar.-Arraiaeo Name (Prin ,2 — Tax Parcel No.1'— 'Dr&r/EllgineerfFrainee Sia atwc �t Driller or Trainee License No. �� �rj T Cased or • neased eter Static Level �,�� S6! WOrk/DecommiSSlOn Start Date �a�3 If trainee, licensed drzller's 4- Signature Signature and License no. Work/Decommission Completed Date Construction/Design Well Data ki 3ko - I'b Formation Description CONCRETE SURFACE SEAL 0 - /_2 f t . I II &26-.,N Somas - Gt- �� I I � BACKFILL — f t . I I I f � I ft. I I I 1 1 I I � I i 1 DECEIVED I JAN 0 7 2005 { DEPTH OF BORING 9a I Washin�1011 State Departilient of Ecolo�_Tv I Scale V= Page of $ ECY 050-12 (Rev 2/01) File GtivInal and First copy with Application No.�.�.-�. a 7 depart tea+►•ef•17Cr�bgY WATER WELL REPORT tI /I C Sec'Ond Coop— 4'a mer's Copy Third. �:r '�—1]riifex's LapY STATE OF WASEaNGTON Permit No_ . r _ (1) OWNE1;�'. (2) LOCATION OF WELL: county.---_J e f f e,rs o� %i..j�._!, sec__3a T_3.Q._N.. and distance from section or subdivision corner (3) PROPOSED USE: Domestic EX Industrial ❑ municipal ❑ Irrigation ❑ Test Well ❑ Other ❑ (4) 'TYPE OF WORK: Owner's number of wen fif more than one).... .._---- ...-..-_,._2 New well Z Method: Dug ❑ Bored ❑ Deepened ❑ Finish cable (g Driven ❑ Reconditioned ❑ S to rt Rotary m jetted ❑ (5) DEVIENSIONS: Diameter of Well g inches. D1 1- 3 —ft. Depth of completed weiL.__L7-3it (6) CONSTRUCTION DETAILS: Casing in3talled:.___8_" Diam. from _ .Q_ ft. to -L58- ft. Threaded ❑ _.1 2_" Diam. from ft. to _V5B_ ft. Welded .4• • " Diam. from —__— ft. to ft. Perforations: Yee ❑ No 12 Type of perforator used' -- SIZE of perforations in. by in. perforations from — ft. to _ ft. perforations from ft. to ft perforations from ft. to _ ft. Screens: yea M No ❑ is mufacturer=a Name __J7obl sn�n Model No o Dlam. �2� Slot sire Ja22 from 8..._ ft. to -IA5 - ft. Diem 7 a Slot size r.Q from 8 ft. to_�} !t Gravel packed: yes 0 No Q Size of gravel: _ Gravel placed from ft. to Surface Seal: yea I& No ❑ To What depth?^ ft Material used In seaLliQI�G �w,� Did any strata contain Unusable water7 : Yes ❑ , Ni) M Type of water? Depth of strata Method of sealing strata off. (7) PUMP: Msautactuxees N +++e Type: 13p.. — (9) WATER .LEPERS: Land.sysfacc. etevatiort p rp g o above mean sea level...... Static brad _ �q t (t �_it below top of Well .I1ate_ Arty pressure tin, per square inch DAte Artesian water is controlled try (Cap, valve, etc.) (9) WELL TESTS: lowered w =stau tlwatler level is �ril.e Was a pumptest made? Yes 2 No Ii Yes. by Whom?....................._...�... yield: 158 gal./msa. with 27 l71I ft, drawdown after 5hrs. Recovery data (time taken as zero when pump turned off) (water level measured from Wen top to water level) Time Water Level Time Water Level Time Water Level Q5'. --...3.0.0...I.Q.t.� ( .-.a-LO-O K-99•---gu Date of test r.__... 2/2Y U— Bailer test___ gal./min with—-._--ft. drawdown after_—_.-Jrs. Artesian flow—_—.g.psn. Date___ —- Temperature Temperature of :rater_..49.._. Was a chemical analysis made? Yea ® No ❑ w (AO) WELL LOG: .M. Formation: Describe by cotor, character, sue of material and structure, cmd. Show thickness of aquifers and the kind and •nature of the material ir► ear ft stratum penetrated, wit[t at least one entry for each change of formation. .e■ se ' a - . ■ • 'IrDw.-loos-e—sand. ; �■ • • er r _ae _ t- •• �i � a a r ■ : - + - i i • i .ar _ ■ . f�• Work .111l . complet-A2 WELL DRILLER'S STATEMENT: This well was drilled under my jurisdiction and this report is true to the best of my knowledge and belief. (Person, firm, or corporation) (Type or print) Address..-R..0..._—.B-OZ._LE1----ae,ClUim,35h-1. YJ x'1 Hancock 0204 (Weil iaril(er) License 1Ya..s� 0 � .ki'_.0��.1.. Date__2/7_.- ----- 19 ZB- Harold Miller 0343 I� f � (USE ADDrl'IONAL SSZEZS IF NECESSARY) ECY t•Za *,Ism; A . ar• z 1L11 78 . J'J J •�o 0 ! F CL k I } t PUMPING LOG 'No ............ For -...Ken ... Brai,rn :gin t e m r'ise_s ico t TO_ -=- By S3'OICAN DRi=G COMM, ANY. Contract 1*, 0............... P.O. Box 161, Sequim, Wash- - Phone 683-5580 Rt 3, Box 175, Port Orchard, Wash -Phone TI- 6-2057 : •fe11 No. 2 � ]1 7411 12=y:11r 12 '� 8 rt 1251511 1"1911 1251 125 22 L " 1011 1 L� �2511 s1 1• f7 t c_ 127' 1 11 � 27" 1 n i27'," 12 7 : 1.11 k 991911 D.-:?,r�O��iI '.`/.c`e- Ten 21 110" 24t711 �5s2u 25' 1 1 " 261311 26'6" 2618" 26111 25en1► �71511 271711 �717" 271711 27:71' 27l711 PTO^�: Thb above st atld corrlrebt to the Signed: lJ'�a��F�A7 stoican B P.O. Box Sequi m, Y; UY I n� rly l �? gar It H tt k • n " u S , w) Farm f - ' 3 - F atsaent is. t�-�e best- of my) �L2* er hzoi cp, 2rasiarmt, D413 !lip-- Cell. , Ind. 61 sh. 98382 .ti: OF EOULUi3y SOUTHVIIST REGIONAL OFFICE i File originalmod first copy with WATER WELL REPORT Start Card No. ' AE02746 rrl ocpwtrseof Ecology UNIQUE WELL I.D. # ACM501 second Copy - Owner'sCopy STATE OF WASHINGTON rntrdCopy- Driller'sCopy a?0t� ';?o Water Rights Permit No. (1) OWNER: Name: PUD #1 of Jefferson County Address: PO Box 929, Port Hadlock, WA 98339 (2) LOCATION OF WELL: County: JEFFERSON SE 114 of the NE 1/4, Sec 33, Twnsp 30 N, R. 1 W W.M. (2a)STREET ADDRESS OF WELL or nearest address Old 6" Airport Well, PARCEL # 001331011, Port Townsend, WA 98368 (3) PROPOSED USE: r Domestic r Test well r Irrigation r Municipal r Industrial r Dewater r Other (4) TYPE OF WORK: Owner's number of well(if more than one): r Abandoned r New well Method: r Dug r Bored r Deepened r Cable r Driven r Reconditioned r Rotary r Jetted (5) DIMENSIONS: Diameter of well: inches Drilled feet Depth of completed well 0 feet (6) CONSTRUCTION DETAILS: Casing Installed: in. diam. from ft. to ft r Welded in. diam. from ft. to ft. r Liner installed in. diam. from ft. to ft. r Threaded in. diam. from ft. to ft. Perforations: Were perforations made?: r Yes Perforator type: Size of perforation: in. by: irr. Perforations from: ft. to ft Perforations from: ft. to ft. Screens: F Screens installed Manufacturer's name: Type: Diam. in. slot size from ft. to ft. Diam. in. slot size from ft_ to ft. Gravel: r Yes Size of gravel: in. Gravel Placed from: ft. to ft. Surface seal: Yes To what depth7: ft. Material used in seal: Did any strata contain unusable water r Yes Type of water: Depth of strata: ft. Method of sealing strata: (7) PUMP: Manufacturer's name: Type: HP (8) WATER LEVELS Land -surface elevation above mean sea -level: ft. Static level: ft. below top of well Date: Artestian pressure: PSI Date: Artesian water is controlled by (9) WELL TESTS Drawdown is amount water level is lowered below static level Was a pump test made? r Yes, by: Yield: GPM with ft. drawdown after hrs Yield: GPM with ft. drawdown after hrs Recovery data (time taken as zero when pump turned off) (water level measured from well too to water levell Water Time level Water Time level Water Time level Date of test: Bailer test: GPM with ft. drawdown after hrs Air test: GPM with stem set at ft. for hrs. Artesian flow: GPM Date: Temp. of water. deg. Was a chemical analysis made? r Yes (10) WELL LOG or ABANDONMENT PROCEDURE DESCRIPTION Formation: Describe by color, character, size of material and structure, and show thickness of aquifers and the kind and nature of the material in each stratum penetrated, with at least on entry for each change of formation. MATERIAL FROM TO 6" casing was pulled while I i hole was being filled with 3/8 bentonite chips to within 2' i ground surface. . iI I 2007 coil S DEl�rfrtl��f[ ale C,! Lctala gy Work started: 5/21 /2007 Work completed: 5/21 /2007 WELL CONSTRUCTOR CERTIFICATION: I constructed and / or accept responsibility for construction of this well, and to the compliance with all Washington well construction standards. Materials used and the information reported above are true to my best knowledge and belief. Contractor: LOFALL WELL DRILLING Address: 180 NW Lofall Rd, Poulsbo, WA 98370 Signed: icense # 1029 (Well Driller) Contractor's Registration No: LOFALWD124C5 Date: 6/19/2007 _ PUMPING LOG No:.._------ Page No- -------•------ b No.. I �.- r 31 Contract No._-2......... L Date ...---...... By STOICAN DRU LING COMPANY aStatic Water ievel_� .yj P.O. Box 161, Sequim, Wash. - Phone 663-5580 . O Rt 3, Box 175, Port Orchard, Wash - Phone TR6-2057 c/o & o rml 1}wishaoh a 2W� s � 1` ' g•' DATE_ Rb.I Box effo oa COM't S� i Port d10VIo Us 9 5 _ #9 Pumping H TIME G.P.M: Level DRAWDOWN Water Temp. Pump. RPM.' Remarks . s •ilanal'ks .. 11 : 00 A,. X SU Tt P1 V , . tt w ' � - 1 e 14 Tsar `r ; 0 7 l. a5 �} 60. - 0- 7 d 11:15 " 172°.'rf.1'� 1�r _ c t2s0oadaQa. " .t1� 22G'" -� r" rg r. n 12a=Q +.+�t. 4t�s2�5" . ,K L.1 S0-23 0 n ,+ K - t16�8n:. 2+ " *' �:0c1 �� a s .•; t-Z6t4'' 23�6 � .� V 4 i- C2 " ' * ' � - 115 � 23 11618 25'5 " M !1 R= 2515 a 6:Ga �.6 € '7 sig 9. Clear A a M., 06r 8". 23j . „� . 7100 f N R Atop 'r '� �' �f��8" 23i�n � 9-too t �6 S 23� N to too of 4 to 11:00 � � " F w NJE Of EV 12100 P�irk =a 1r6110 23471t 1 3 00 A.R. 11 02200 '' " 116' 10" 23#7n w MAY 15 1981 z 116 9 1 H �#:00 n r► 117" 3i0 " 0 � 5 i00 " M.. R 116 10" 23r7�Ng�G1DNA&4�Fl � o n n ' " 116' 11 " 2318 gpUT 7:00 ,: 116' 10r" 231711 '" " OGY $ 200 It it d 1 16' 2" 22' 9"T :00 n " t 16' 2't 22' 9" " v n u " 116'3" 23' a w o 100 t! n n 1 16' 1" 22" B n o t : 8 A.S. 60 116R1" 22'8" dear }' 1:25 -to "I StoP1?ed 1p � '1`tlsalr X�aovery- a�i 1 :28 A.�. t�aoave rod to-144' 6" E 1 s30 k4.i-3f "s "nn�102r5au11 9906� � L 1:0A.M. Runs"ann"ea Q 9 "$#"It is wi {" 1"sr N at ►r1 3"" fitaia3n D 11iD$ %Q Inc a 2;20 .-*u* 96r7n 2:00 2,'Aw n1"n1"rennn ""z.9513""' �etluim� � sh. g$382 #0 93' 3" 'u1i tea❑ a ry Motet abcoare true rrec ttoethety stof my tad axledge, $r 6, fo Qan#j,Me .Z a 7 ;_Page No . ............... Date,A�!$�.$,� L t _Static Nate± Levan 0 r a [0Y DATE:Obearmtiol M PUMPING LOG No ............. For- ..._........_.._.... By STQICAN�DRIiI.MGYCCMPANY� P.Q. Box 161, Sequirn, Wash. - Phone 683-558fl Rt 3, Box 17S, Port Orchard, Wash - Phone TR64057 Ran BIM IntsrPrise W011 S* NW-1 SW� Sev lob No_______________ Contract No ........ ng �MF fir.- lies* oa 00u9�Qra a Lo.Z 0w rS Aeon. 11, 8■ ■•� SN' NA SRC, Sao TIME G.P.M. Level DRAWDOWfV tiVater Temp. pum vs p 9-P-M. Remarks T.30x Rt T3T�3,0ff s 10:50 A. start 11335 " np 10201'� 0 12335 iF.Iff .10211" =35 M M 1021$ �% N 1 J1 3/ 0 M E 3140I w 4; 35 10214AW " 25 335 ," " W1 5 7so0 8100 in q togOr :l3{ �C 5n � � ii t7 42 i� o c 10100 1,1300 102:!w 1Q2!$" �a * 12:00 0 . t'02'8 " 7" 91 r 00 02111A IQ as1G IV#02�11 _ a 9305 f03'3 " 11 3 4" 10 SQ0 Xf 03f 1 1 i Agaova rr 0 z 1 f S25 A.M «�_.. � 11 s45 A.g �-�,..._..� —103'2sn -1Q3#2Ilr' a 11:38 �.Yf Boa-_—.. 12 -10312; " 0 s3E3. r� ..�..�.. -103' 1 f 0 9130 Al. N 102' 0 0 W 0 HOUS The above sta aments a true and c�t to 'th beat of knAWled. e. E Signed: . C er stoi an,Pres. c. 73 s Sto can Drill as Co. Ina. F.0 Box 161 F- _ Seq Imp gash. 98382 L O iz rue 4r4rinai and First copy with Application �(o, _: _!..d 4 Ocvawt e-_, i"egtt gy WATER WELL REPORT - seclaiLiS'wnes.s Copy Third C^.!.i — L7r171eYs CaPY STATE OF WASHINGTON Permit No_ .0 a t (1) owNTER: (2) LOCATION OF WELL: County.__) of f e r4,9A -- W It.WU.....,, Sec__U T_30.-N.. from section or subdiv%slon corner (3) PROPOSED USE: Domestic: a Industrial ❑ Munlelpal ❑ irrigation [3 Test Well ❑ Other 11 (4) TYPE OF WORE' (if niore number than one) - New well ]] Method: Dug 0 Bored .❑ Deepened a Fini Sh Cable (g Driven p Reconditioned p Start lfotary M Jetted ❑ (5) DMENSIO+77N�S: Diameter'of wen _ S ... inches. Drilled. L1 �+�it. Depth of completed (6) CONSTRUCTION DETAILS: Casing iinstdlled: — 8 ^ Diam. tram {L: ft. to _15._ ft. ❑ .�� Threaded � - Diam. from 1 55 tt. to . L5& it. Welded i�R' ' Diam. from — ft. to ft. Perforations: Yes Cl No Ct' Type of perforator used:...... -- SIZE of perforation ----- in. by — -- In. perforations from _ fL to ft. perioratios+s from Y_ _ _ ft. to eL perforations from ft. to Screens: Yes a No ❑ . Manufachwees Name. TnhnSa-_ei — Typeya:-", Model No �p D1am. Slot size -0.0a) from LL2C]._.. it, to ..L•_.;^ ft. Divert Slot size _.Q.L8 from ft. to -L73- tt, Gravel packed: yes ❑ Na cz size of gmvei: Gravel placed from it. to Surface sent Yes M. No © To wheat derth? _. tt. Watnial rued in Did any strata contain unusable water? Yes [3. No M Type of water Depth of strata Method of sealing strata o$ -- (7) PUMP: maanfacttser's Name_ Type: (S) WATER LEVELS. Lana -surface. elevation ro g above at sea e.... Static level. �..r�� tt----....it. betow tapop well of l[ '1?ata.. L� Artesian pressam _ ]h+. per square inch Ddt• Artesian water is contmued . 7 (C&P. valve, etc.) (S) WELL TESTS: ow�ereddbbelow ssttati ticwva l level is Was a Pump test made? Yes We Q Tf yes, by whom?- .--- l e r x[e]d_ 158 gai imin. with 27 t? 11 it. drawdown atter9 2 hrs. Recovery data' (time taken as zero wben pump turned off) (water level rnea�ured from well top to water Ievel) Time Water Level Time Water Level Time Water L•u■i 214 .. _ i et 3 : o _ _� o T— -3... 1.QQ_ -� - Date of test `�/2 Z78 Heiler test gal/min, witt>_ _ _ ft. dmwdown after._..- _.-_hzs. Artesian 43eWDate- Ternpemtere of water_.4 — Was a chemical analy3 made? Yes ® No 0. .M. (10) WELL LOG: - Formation: Describe by color, character, stxe at materta[ and atrusture, and show thickness of aquifers and the kind and nature of the marertat in each strammc neretrated, with at teost one entr+j for each change of formation. ■■ 1■ t+ ' / • ■/ WPM • r a � _ +- r i - a a ■ t _ i � 0 Work started. Li 1 On_ Completed ` 2 3 1Z-. NYELL DRILLSTATEMENT: This well was drilled under my jurisdiction and this report is true to the best of my imowledge and belief. rrA Scicatl.x•�,],Z-n--°. �J��...._ ...._. (Person, firm, or corporation) (Type or pritrt) Address...«P [Signed].L41-_..._ ..... ; �x� s deza ...Li47.3. MVrl Hancock 0204 .""en Driller) License No.s1.U-'Q_n!1Ce _Q391.. 197B. Herold Miller 0343 � f f (USE ADDITIONAL a== W NECESSARY) �� i a CL /7 (A 0. _� 0 i �� r- r.3 i,.3 L7.5 27 Ca co 0 z 41 'A 0 LU 46 16. m CL PLF;%-1?1N%G UK." Xiaes ........ .. By STOICAN DRUJIMc; _=,V AMY P.O. DOx 161. SeqWrn, Nash - Pbone E63.556-3 Contract1�;a ...... ..... . . Rt 3. Box 175, Port Orchard, Wa,n' -.Phz.-ic TR&w-2357 ITO. 2 I D Via,e:, Temrz lall 1 2 1 o:I 21 124',111 24?7" 12 4 8:: 2-12" 1 25; 511 25t11t' 9 261311 126' 261611 2 1 1 1251.t ; 261811 I 5.,l I 26111 It ,I - i c-_;� loll271411 1 271511 14 27 271 ti 7 27t7111 2V711 27 :7 '1 127:111J 2-IT711 M51411 102 211 101`101, ' colgi) , 100 '-5:1 1 991911 110 Tt I and c o rza b -U to the Signed: Va �e 1, ST,01L Stoican I P.O. Box seaulm, 17 1113ty Cloudy clear f1 it ri Jt It 'S'VOT) Pam Cement isf 4-1 nis ast of my rag- Cc �sh- 98382 OF Eck OUTMAST REGIONAL 047 3 L 0 a <v N t 0 a 0 M E O a, s- o a c R ca to a s c c� L L F- 0 z H a� 0 -o a a� 0 0 v w 0 4w c a E L a w ❑ s H . „ T r UNIQUE WELL I.D. NUMBER L O t R Y Z 1 2 3 Ik3N1*91Vl-'iVAIt 0EIAI10 E I 1 01- E C 0 L 0 C Y WELL TAGGING FORM Date of Field Visit _ 6Xj319- By RECORD VERIFICATION Well Report available (please wrack) l ❑ Well Report not available �r,, ❑ Verification inconclusive WELL OWNERSHIP;IF DIFFERENT -FROM- WELL 'REPORT Title A First Name ,J p Street address Ge ?3 4" 20 Last Name EC E I V ED �iii',1 6 ZO10 city _ /rt Tw►yA� D __ State _ a i E_.i 1iNi F '.LOCATION• ,OF WELL;: IF. DIFFERENT FROM WELL REPORT Well Address 4V City _ �wY./ P� % - County,_ T. -?O N. R. 0/ w.M. Sec. -/-�NOW 'A of the � 'A .............................................................................. Latitude `�� 0a y6 ❑ GPS 1B Topographic Map Longitude ❑ Suivey ❑ Computer generated ................................ . ❑ Digital Altimeter Elevation at land surface f 136 fee meters (circle one) ❑ Topographic Map,jL.' .. � r;.. • �� Gther�' fy'1r'1�� � 'VR11i°`Mr Additional information, if available: Location marked on topographic map (please attach) 1 s/ ° ° 4g— �s� y� ° ° ❑ Location marked on air photo (please attach) y 7 ° ` ° ��"° �8 Jd o 0 Please attach this form to the Weft Report and submit it to the Depardaeni of Ecology Water Resources Program Headquarters. i WELL CHARACTERISTICS Physical Description of Well (size of casing, type of well, housing, eto;): 11i1p;�r_>.►t�r�I _ Location of Well Identification Tag: Was Supplemental Tag needed for ease of identifying well? \jP NO O YES If yes, where was tag placed?, M1 Scale 1:24,000 (1'=2,0001) Indicate the location of the well within the Section by � drawing a dot at that point. ' SECTION --?J FOR ECOLOGY WATER RESOURCES PROGRAM USE ONLY Water Right N Gi_ Zti Date Issued Circle one: Application Permit Certificate Claim Exempt ' o�' /��, •�foWv1 4i �l ' C G Itractors E L C. n - `�MA c MIS421, elm 117 y u n M tO4 6X Jefferson County s V-0y Y aroN tionaI Airport \ e P metl 1ng$,' 3 ' Ima A p •6M 134; p eFour arners 33 M 136 .•ate b_ A •+-.raa l: .. Substation i f V u V--A Trailer qk n C ApyO ks I � n , r :, r N � ,t �, r 4 I g$y p u 16 )odm ' 6'r A {� a n i !f n aJLF { Y 4g I {b DER DN STA P _ 2}a r � 43 ek 513 (CENTER) rccJ.:' L O a 4) no _ (3) PROPOSED USE: Domestic ❑ Industrial ❑ Municipal ❑ C ^, ��� �ir� lion ❑ Test Well ❑ Other H (4) TYPE OF WORK: Owner's number t more than of well ` ' (Ione)•••. i New well Method: Dug r❑ „ Bored ❑ �+ Deepened ❑ Cable Driven ❑ C Reconditioned ❑ &A Rotary j@ Jetted Q O _ C (5) DIM&SIONS: Diameter of well I-, ............. inches. ................ft. Depth of completed well _-_-_- a.+ t� E C s L O C r.+ R s C L L M H 0 Z y O A O O 0 W 4- 0 4.+ C W E a� L cc a W t (6) CON�TRUCTXON DETAILS: R&J Casing installed:...- �`_ ., Dlam. from ,O._ nr io l'._ it. Threaded ❑ r7'( Dlam. fr. It. to AY-f it. NVelded jj3 - " '.--" Diam. from ._...-._...— ft. to it. Perforations: Yea ❑ Nov Typeof perforator L3ld..-.,r-._,.......,.._».-_,�..�....»_.........».......... SIZE of perforations _.... —............... in. by ........... ••••••- in. .... ....... . perforations from . .................. ft. to ._-....-.__.__.__ ft, -_--------• perforations from -•-------- -... ft. to -..-_._.-._ ------- it. _....._._.___-_.. perforations from .............. ..... ft. to ... ........... ....... ft. Screens: ye, X No ❑ bianufa,4urer'sName. Model yNo..S..sLQr.,,... Diam. F• f _ Slot size from ..IV4... ft. to-d--yX _ ft. 1�(am................ Slot size aZ. ._ from It. to 1.a-.3 _ It - Gravel packed: Yes ❑ No U' Size of gravel: ..................... _....... gravel placed from .... ....-........... ._ it. to ...._ .............._.._.......... ft. Surfape seal: Yes gy 1q. ❑ To what de P♦tht -. tr�..... it. Material used In sc ►ICL!11J�C .Ld.irf Did any strata contain unusable' water? Yes ❑ No ❑ Type of water?._.__._..._.-._...___...... Depth of strata .... .._.... ....... _..... __, Method of sealing strata oB__......_ . ...,......._..- ....__...-----------•------- (7) PUMP: Manufacturer's Type• (S WATtR LEVELS. Land -surface elevation //�//�� ) above mean sea level. J..7,t J,.- „.__.__ft. Static level ....7. .rl�..lr „..__.St. below top of well Date.._S.'_-y='W/_ Artesian pressure _....................... .]bs. per square inch Elate ........................... Artesian water is controlled by .... ............................. ....„ _.__..._... (Cap, valve, etc.) (9) WELL TESTS' Drawdown is amount water level is lowered below static level Was a pump test made? Yes P No ❑ U yes, by whom((��?...? rl*,i........ Yield: Ral.fmin. with it. drawdown after hrs. Recovery d to (time taken as zero when pump turned off) (water level measure from well top to water level) Time Water Level I Time Water Level Time Water Level 41..AM..>)m�ecill��ra� .................._ �?P..�1:. y"" � .�'..... ...��;3 v....._..I.ti �':s'-'!....[ai.iS�---..Sratt�..��►..... �..9.-!���ri.-....:�--�----... Date of lest Baller test ..-.t......_.....gal./min. with--._.-_.-_-_-._-tt, drawdown after....................hrs. Artesianflow ................... ......R.................. .g.pxn' Date ._. ......................................... L Temperature of water...-.)/-7...- Was a chemicol analysis made? Yes ;ff No Cl Jminal IFi rst lrgt CaPY with WATER WELL REPORT Application No ........................... u..... ep trignt rt Ecsy Setond Copy -� owner'z copy Third Copy —lDr! 11 er's Copy STATE OF WASffiNGTON Permit No . .... .. ...................... .. (x) OWNER: '�'!?..G�V�-3d e).vTes Re'/i (2) LOC. iTXON OF WELL: countyJq-6f.,v�' 1,0t -.... ...... ;.:2 ?. �, Sec,.,3..x.... T 7ra.-N.. W.M. Bearing and distance from section or subdivision corner WELL LOG: Formation: Deacribe bV cOlor, character, size of metcridl and Structure, and show thickness of agiei�ars rind the kind and nature Of the material in each Stratum penettutod w{tlt at least one entry for each change of formation. MATERIAL FROM TO I ' �CiL ,� •' llLcr� - �i�7'1d1s �,ijl�ii � � ��i["L Ertl - ,. sz 21e d f d 2. ltJ. ii' Jt r ➢ / 4 At 33 "wA lejw 133 3 i _ r , "''A ' •, Sd%!L9 01- Av/t: %" I Lv r L ' Q {Zfl C i li ' . V ..ernT �rr•]f1AlAl nFti:ir' Work startetl ..�—. .-.-.____, 19.�I_.. Cample[ed V....'....fCr .......__., l8 _ WELL DRILLER'S STATEMENT: This well was drilled under my jurisdiction and this report is true to the best of my knowledge and belief. NAME.._QJ.l..dlc'f%.._/L+!ir7 ..' C'r-f_uG.................................. (Person, firm, or co ration; (Type or print) � Address...„'ldl,► i?%.� �..-.-..-Fla?!-.s...�`-3�4-.-...- [Signed] _....lJ>< t L+�--'GEt!h.a...�es 7 :. 4g t �J7 /!✓�' f 2t'r! O (Well Driller) j License No...-..G.Z /1r ....... Date...�........... ............... 19..'F Toe C' 6317/• (USE ADDITIONAL SBXWS IF NECESSARY) ECY 050.5-20 c7 File rOriginaland First Copy with WATER WELL REPORT Stall Card No, d 23 Department of Ecology Second Copy —Owner's Copy `p Third Copy--Driller's Copy STATE OF WASHINGTON -r' -�- WLtter Right Permit No. (1) OWNER: Car I_Ray - Addroes4a4e CK� y —BOX 229 f>�I�eetiCrLt�' (2) LOCATION OF WELL: county ME;ar-- meE.Ad Sac T. N.. Ri W.M. (2a) STREET ADDDAESS OF WELL (or nearest address) TF-F C FJLS _tj C1yC YJ !V 7-V ;0 � Aek.T7_1 — (3) PROPOSED USE: X Domestic Industrial ❑ Municipal ❑ Cl Irrigation ❑ DeWaler Test Well ❑ Other ❑ (4) TYPE OF WORK' Owaer'e number of well (if moro then one) Abandoned ❑ Newwall & Method: Dug ❑ Bored ❑ Deepened ❑ Cable Driven ❑ Reconditioned ❑ Rotary t .fatted ❑ (5) DIMENSIONS: Diameterolwall inches. Drilled O feet. Depth of completed well Z2 fl. (6) CONSTRUCTION DETAILS: A'ARVWi,9,&WjT Casing Installed: ko Diem. frem— _V/ if. to / / t? it, Welded Diam.from II-fo ft. Liner installed Threaded ❑ ' Diam. Irom It. to ft. Perforattans: Yas No�g, Type of perforator used SIZE o1 perforations _. _ _ in. by In. perforations from it. to if. parforalfansfrom It. to ft. perforations from ft. to It. Screens. Ye No Manufacturer's lN" Name{ t'.�" Type I;� -S- Model No Diem. /6 ( Slot aizo �from//0- N.J.&.1-1-- ft. Dlam. z r slot sire - b 0 from%f199:: tL to /2 o _". Gravet packed: Yes No10- Size of gravel Gravel placed from ft, to ft. Surtaceseal: Yes6- NoC❑. rTowhialldeuth? a- ft. Me l erla) a9 a rl ln9 a al S A_:1A TVt` a=9, Did any strata contain unusable water? Yea ❑ No Typo of water? Depth of strata Method of sealing strata all (7) PUMP: Manufacturer's Name Type. H.P (8) WATER LEVEL f ion bogo Moen ea t a el [. rtbavo mean sea valet it. Static level G ft-belowtopolwell Date Artesian pressure lbs. per square Inch Dale Artesian water Is controlled by f p,aaNe,elo. (9) WELL TESTS: DrawdownisetflvalIslowered below static level Was a pump test made? Yesmn woere ❑ No Ryes, by"am7 Yield: g41.1min, with it. drawdovm after — Recovery data (time taken a9 zero when pump turned off) (water level measured from well top to water level) Time Water Laval Time Water Loyal Time W.1er Laval Date of Batlertast gni.lmin. with M. drawddewn after hrs. Airtest ` 0313 min. with stem eel at _ZQ& fl. for Z hrs. Artesian flow g.p.m. Date �r( Temperature of water Was a chemical analysis made? Yea ❑ No sC; (10) WELL LOG or ABANDONMENT PROCEDURE DESCRIPTION Formation: Describe by color, character, size of material and structure, and show thickness at aquifers and the kind and nature of the material in each stratum penetrated, with at least one enlry foreech chengoof_Informatioa. �• MATERIAL - FROM I TO 19. WELL CONSTRUCTOR CERTIFICATION: 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 belie(. NAME �I7%r�i9�i 1��t!CG�N_q &. p (PERSON. FIRM, OR CORPORATION) [TYPE OR PAiND Address `�� U/ d (Signs License Nolsu , Contractor's (WELL DRILLER) Registration 7— �j� No. Date 19J- u (USE ADOITIO AL SHEETS IF NECESSARY) ECYOSO-1-20 (101137) -1329- °1ISPI.s 0 NORTHWEST MINING SOLUTIONS August 6, 2025 RE: Response to Edward Johnson/Comments Regarding SEPA Determination ZON2024-00012 Dear Mr. Johnson, Thank you for taking the time to voice your concerns in regard to the SEPA Determination ZON2024-00012, for the proposed Four Comers Sand & Gravel Pit located in Jefferson County, WA. I am responding to your concerns as the authorized agent and Mining Consultant for Bruce Seton Jr. & Seton Construction, Inc. Environmental Impact Statement We understand that you have requested that an Environmental Impact Statement (EIS) be performed on the proposed Four Corners Sand & Gravel Pit. It is the understanding that you believe this is a feasible request based on the belief that this project may have extensive impacts on vegetation, wildlife, and local air quality. Stating that the sites earthwork activities will cause "great disturbances" to the area impacting wildlife, traffic, and air, and that an EIS would "certify the environment will not be damaged to the extent it may cause long- lasting and permanent damage." Response: Washington State Law WAC 197-11-330 outlines the threshold determination process under Washington's State Environmental Policy Act (SEPA) rules. These guidelines help agencies understand the proposed project and the potential impacts that the project would impose on the environment. As a mining project, the proposed Four Corners Sand & Gravel Pit has been evaluated under these laws and must adhere to not only Jefferson County regulations, but also additional regulations set forth by the Washington State Department of Natural Resources, Washington State Department of Ecology, and the Olympic Region Clean Air Agency. All of these agency's issue permits with strict guidelines. Each lead agency performs their own annual site visits to ensure that the site stays within compliance to all regulations throughout the year. Jefferson County has performed an extensive review into our application and is expecting to give a SEPA determination to the project of "Non - Significance". This determination is based on the size of the project, studies done for the project, and an evaluation completed by experts in their field. Typically, an Environmental Impact Statement (EIS) is required for large-scale projects involving thousands of acres, significant financial investment, and multi -year study efforts. Given the limited scope of this project, the County has determined that an EIS is neither necessary nor appropriate in this instance. In your letter, you express concerns regarding potential habitat and wildlife disruption associated with the proposed operation. Specifically, you cite issues such as noise pollution, air quality impacts, and deforestation resulting from excavation activities. Additionally, you raise concerns about increased use of heavy-duty transportation vehicles and the potential for permanent damage to local roadways. This project is limited to a total disturbance on 9.14 acres over the life of the mine. The Washington State Department of Natural Resources (DNR) requires all mining operations to be performed in phases. This requirement mandates mining operations to minimize ground disturbing activities to a segment of the approved permit boundary. NORTHWEST MINING SOLUTIONS, LLC As slopes are finalized the operation is required to reclaim the area of disturbance within two years. This operation is split into two phases; 4.5 and 4.64 acres. Upon reclamation, topsoil will be distributed, and 400 trees and shrubs will be planted per acre as required by the DNR. This project will only disturb areas in segments as needed to help preserve a natural noise and visual barrier, as well as help reduce the impacts on the air and surrounding environment. The provided Reclamation Plans detail the sites phasing plan, reclamation plan, and revegetation plan. Site operations will be minimal and driven by local market demand. Annual production is estimated at approximately 10,000 cubic yards, resulting in intermittent activity rather than continuous or daily operations. The site will operate only as needed, with production levels adjusted based on regional demand. At peak market periods, the site is expected to generate a maximum of 3 to 4 large dump truck trips per day, Monday through Saturday. These projections are outlined in the accompanying "Site Generated Traffic Volumes Memo." The occasional addition of 3 to 4 truck trips per day on State Route 20 is not anticipated to result in significant impacts to nearby residents. All operations will comply with applicable local and state regulations, including load weight limits, load securing requirements, access road maintenance, and dust suppression measures such as water truck usage. Noise and air quality are common concerns associated with mining operations. To mitigate these impacts, the site will implement dust suppression measures using a water truck as needed and maintain a 50-foot setback from the property boundary. This setback will remain in its natural forested condition to serve as a buffer, helping to reduce noise and airborne particulates affecting the surrounding community. Crushing activities will occur only as necessary and are not expected to produce continuous impacts. While operational hours are provided to indicate when activities may take place, they do not reflect constant or daily operations. As previously noted, the site will operate on an as -needed basis, aligned with market demand. Requests: It is understood that Edward Johnson would appreciate Seton Construction, Inc. meet the following minimum requests: 1. Increase the buffer from 50-ft to 100-ft, claiming the airport produces a large amount of noise and light pollution. Increasing this buffer will help reduce the impact of these elements. 2. Change the proposed slope configuration of 2H:1V to 4H:1V. Claiming 2H:1V slope is substandard and is a danger to the surrounding properties. 3. Construct a 10-foot or higher earthen berm around the perimeter of the project to help aid in noise, safety, and visibility into the projects operations. 4. Not allow the construction of a second access road to the site which will increase the risk of air and noise pollution to the area. 5. Require a signed agreement of intent regarding the following: a) Promise to not start on a phase before the previous phase has been completed. b) The intended use for the eastern part of the parcel. c) State the longevity of the project. NORTHWEST MINING SOLUTIONS, LLC 6. Have the airport light beacon re -located. Response to Edward Johnson requests: 1: The 50-foot setback exceeds the standard safety and regulatory requirements for a project of this scale. Given the phased nature of the operation, it is anticipated that several years will pass before any activity approaches the vicinity of Mr. Johnson's parcel, and no immediate impact to existing trees is expected. As such, we do not believe an expanded setback is warranted. 2. A Licensed Civil Engineer and a Licensed Engineering Geologist have conducted Hydrogeologic and Geotechnical analysis of the site. Based on their analyses, excavation at slopes of 2H:1V or flatter is considered safe. See reports conducted that were submitted with this proposal to the County for further details. 3. Seton Construction, Inc. is willing to construct an earthen berm at least 10 feet in height around the project perimeter to help mitigate noise, enhance safety, and reduce visibility into the operational area. Additionally, the site will install perimeter signage as required, warning of potential hazards associated with mining activities to discourage unauthorized access. 4. Seton Construction, Inc. is willing to maintain a single access road to State Route 20, and will not seek a secondary access at this time. 5. Require a signed agreement of intent regarding the following: a) The Washington State Department of Natural Resources (DNR) requires phased mining and reclamation for ongoing operations. To comply with these regulations, the site must complete mining and reclamation within each phase before advancing to the next. This requirement is incorporated into the site's approved Reclamation Plans and will be enforced by the DNR's Mining and Reclamation Division. b) The remainder of the parcel is intended to remain designated for forestry use, with no plans for future mining outside the approved permit boundary. Any activity beyond the permitted area would be subject to strict enforcement by the Department of Natural Resources (DNR) and would require corrective actions involving significant time and cost. Seton Construction, Inc. has no interest in expanding operations into that portion of the property. c) The duration of the mining operation will be determined by market demand. With an estimated annual output of approximately 10,000 cubic yards, the site could potentially remain active for up to 33 years. However, operations will occur on an as -needed, job -by -job basis. As such, the exact lifespan of the mine cannot be definitively projected or committed to at this time. 6. The airport light beacon is a matter governed by the Federal Aviation Administration (FAA) and falls outside our jurisdiction. It is a federally mandated safety feature intended to support pilot navigation and cannot be modified through local project decisions. NORTHWEST MINING SOLUTIONS, LLC We sincerely appreciate your engagement in the SEPA review process and your thoughtful consideration of the proposed Four Corners Sand & Gravel Pit. Community input is a vital part of responsible land use planning, and your comments have helped inform a more thorough and transparent evaluation of the project. Seton Construction, Inc. remains committed to operating in accordance with all applicable local, state, and federal regulations, and to minimizing environmental and community impacts through careful planning, phased operations, and ongoing reclamation efforts. We hope this response has addressed your concerns and appreciate the opportunity to discuss these issues with you. Should you require any additional information or clarification, please do not hesitate to contact me. Sincerely, Lisa Mahr President, Project Engineer Northwest Mining Solutions, LLC 619-328-7917 NORTHWEST MINING SOLUTIONS, LLC 4 LOG ITEM TO: Greg Ballard, UDC Administrator gage, L r FROM: Andy Gosnell, Associate Plannerot 1 DATE: August 7, 2025 RE: Site Evaluation Report Waiver Request — Staff Recommendation Bruce Seton — Parcel 001332016 — 225 Four Corners Road, Port Townsend, WA 98368 A request for a waiver from special reports has been submitted to DCD by Ms. Lisa Mahr on July 31, 2025. This request is related to an additional information request that was made during the course of project review for Conditional Use Permit ZON2024-00012. The performance standards for "mineral extraction within a designated critical aquifer recharge area" outlined in 18.20.240(2)(h)(i) JCC specify that a Site Evaluation Report be submitted for DCD review and approval. This report is required to quantify the types of material present on -site, hydrogeologic conditions and potential impacts to surrounding wells. The elements to be addressed in the Site Evaluation Report per 18.20.240(2)(h)(ii) have all been provided to DCD through the geotechnical report and two hydrogeological addendums. I have reviewed the applicant's project narrative, reclamation plans and the submitted reports. Based on my analysis of the above documents, I recommend granting a waiver to the requirement for a Site Evaluation Report. `. APPROVED DENIED Greg Ballard, DC Administrator MDK I Law Wdih,gem'z BUWnaes Law R r Mark D. Kimball, J.D., U-M, LLM United States Supreme Court Un Red States Tax Court New York; Texas Mark G. Niehoff, B.A.B.A Corporate Paralegal Karel Kant Real Estate Paralegal Sabrina Sabour-Mohajer Litigation Paralegal Samuel Aryevich Paralegal May 22, 2025 LOG ITEM 2-2 Page - -L Qf--±_. Jefferson County Community Development Jefferson County Department of Community Development, Development Review Division 621 Sheridan Street, Port Townsend, WA 98368 AlexT. Larkin, ID, RE Nahal Nabavinejad, J.D. Dennis Kasimov, J.D. Unsa Manzoor, LLB., U-M. England & Wales Benjamin Phillips, JD New York Washington D.C. Octavian Pop, JD. AGosnell@co jefferson.wa.us Via Email and US Certified Mail Re: Edward Johnson/ Comments Regarding SEPA Determination ZON2024-00012. Dear Jefferson County Department of Community Development, We are legal counsel for Edward Johnson, who resides at 321 Four Corners Road in Port Townsend. Mr. Johnson's home directly borders the property under consideration. Mr. Johnson has several objections regarding the development of a sand and gravel pit ("project"). The objections pertain to the need for an Environmental Impact Statement (EIS), and the effect the Sand and Gravel pit will have on Mr. Johnson and the other locals Environmental Impact Statement Under provisions of WAC 197-11-330, whenever a proposal is made for major actions that may significantly impact the quality of the environment, the lead agency may decide whether an EIS is required. Under current circumstances, an EIS would need to be created and taken into consideration. This is because the project may have extensive impacts on vegetation, wildlife, and local air quality. Whenever any excavation is taking place, many intrinsic factors of MDK Law 777 108th Avenue Northeast, Suite 2000 1 Bellevue, Washington 98004 (425) 455-9610 1 f142S)4S5-1170Imklmball@mdklawcam I www•mdklawcom COMMENTS REGARDING SEPA DETERMINATION May 22, 2025 Page 12 earthwork, crushing, and moving sand and gravel cause great disturbances. Three areas of the environment may be affected due to the project, Wildlife, Traffic, and Air. That EIS should be done to certify the environment will not be damaged to the extent it may cause long-lasting and permanent damage. Habitat or Wildlife DisruQtion The excavation will influence the habitat and wildlife, which are an environmental category under WAC 197-11-444(d). The process of excavating causes noise pollution, air quality issues, and deforestation. These disturbances negatively affect wildlife. These issues are exacerbated due to the increase in heavy vehicle traffic. These negative circumstances would most likely have a great negative impact on the wildlife that lives in the project area. Traffic and SafpV Concerns The excavation site will have an influence on traffic and raise safety concerns, which are an environmental category under WAC 197-11-444(c). The purpose of digging and removing sand and gravel will produce a large volume of material that will need to be transported. This, in turn, will cause an increase in heavy-duty transportation vehicles coming to the area and using the roads in the area. The increase in vehicles will cause an increase in risks to the locals. That could be due to loose gravel and sand on the road that may blow from the trucks. An increase in damage to locals' cars due to said gravel on the ground. Lastly, the roads that locals use every day to live their lives will be permanently damaged as the increase of fully loaded heavy transportation vehicles will morph and deform the road itself. These factors may have a direct adverse effect on the locals, the roads they use, and how they live their daily lives. Noise, Dust, and Air Pollution WAC 197-11-444(1)(c) and (f) state that elements such as Air and Noise pollution must be taken into consideration when considering approval of a SEPA determination. The applicant has stated in his SEPA Environmental Checklist, there will be dust created due to the project. Additionally, the process of digging, crushing, and transporting sand and gravel will cause a large amount of dust to be blown into the air. This will most likely have a great health impact on residents living near the project site. The process the project will go through to extract and create sand, and gravel will most likely cause a massive and consistent amount of noise pollution. Due to these various pollutions, the locals' daily life will be drastically negatively affected, and the environment will be negatively affected as well. MDK Law 777 108th Avenue Northeast. Suite 2000 1 Bellevue, Washington 98004 (425) 455-9610 1 f(425) 455-1170 I mkimball@mdklaw.com I wwwmdklaw.com COMMENTS REGARDING SEPA DETERMINATION May 22, 2025 Page 13 Impact on Locals Due to the sand and gravel operation, the locals' quality of life, value of their properties, and many other aspects of their lives will be reduced. As noted above, the noise from the excavation, processing, and all the other aspects of operation regarding the project will cause constant noise pollution. As stated by the applicant in the SEPA Environmental Checklist, the operations will run Monday through Friday, 7:00 am through 7:00 pm. Most of these nearby residents are not wealthy. They bought homes to enjoy the peace away from large cities such as Seattle and Tacoma. The project will directly diminish what attracted them to the area and cause a massive negative impact on their daily life and enjoyment of their property. In the area close to the project site and the locals is an airport named "Jefferson County International Airport." The airport causes extensive noise pollution with airplanes landing and taking off. This pollution will increase with the development of the project site, and the deforestation will take away from the trees that absorb sound from the airport. The airport also has a light beacon that planes may use during cloudy conditions. The beacon lights up the entire sky and illuminates the locals' houses at night. The trees that are currently in place block out a significant amount of the light and helps with the light pollution from the beacon. The project would significantly reduce the tree cover and would allow an immense amount of light to shine in Mr. Johnson's and other locals' houses at night. Requests Although our client opposes approval of the project, in the event that it is approved, it should be subject to the following conditions. The first request regards the proposed buffer. Currently, the proposed buffer is 50 feet. Mr. Johnson's request is to increase the buffer to 100 feet. The reasoning is that 50 feet will still allow a massive and unacceptable level of noise pollution to reach the homes. An increased buffer will block out more light pollution coming from the airport's light beacon. Additionally, the airport causes extensive noise pollution due to planes taking off and landing. The second request is to change the proposed backslope. The proposed backslope is a two -to -one length/height slope. This slope is substandard and is a danger to all of the homes surrounding the project. Mr. Johnson's request would be to change the backslope to a 4/1 ratio. This will protect the properties and increase the safety of the homes surrounding the operation. The third request is to construct a 10-foot or higher earthen berm around the perimeter of the project. The reasoning for this perimeter is to alleviate the noise pollution that will come from the project. Additionally, the earthen berm will increase safety and reduce the risks residents may face from the project. MDK Law 777 108th Avenue Northeast, Suite 2000 1 Bellevue, Washington 98004 (425) 455-9610 1 f (4251455-1 170 1 mkimball@mdklaw.com I www.mdklaw.com COMMENTS REGARDING SEPA DETERMINATION May 22, 2025 Page 14 The fourth request pertains to the second access road that is being proposed, which would be extremely close to Mr. Johnson's home. This means that heavy and loud trucks would be traveling close to Mr. Johnson's home when they enter and leave the pit. An access road already exists on the project site. The request is not to allow the construction of the second access road due to the air and noise pollution these trucks would make. The fifth request pertains to the project applicant to have a signed agreement of intent regarding certain aspects of the project. The aspects are listed as follows: + Promise not to start on a phase before the previous phase has been completed. + The intended use for the eastern part of the parcel. • State the longevity of the project. Finally, the sixth request concerns the airport light beacon. The light pollution due to deforestation of the area will increase regardless of the size of the buffer. Mr. Johnson requests the light beacon be moved from its current location to the northeast end of the airport operations. Respectfully, MDK Law, Mark D. Kimball, Octavian C. Pop, Attorneys at Law MDK Law 777 108[h Avenue Northeast, Suite 2000 1 Bellevue, Washington 98004 (425) 455-9610 1 f (425j 455.1 170 1 mkimball@mdklaw.com I ww`+v.mdklaw.com N O R T H W E S T MINING SOLUTIONS August 6, 2025 LOG ITEM Pad e�_ [ofq RE: Response to Edward Johnson/Comments Regarding SEPA Determination ZON2024-00012 Dear Mr. Johnson, Thank you for taking the time to voice your concerns in regard to the SEPA Determination ZON2024-00012, for the proposed Four Corners Sand & Gravel Pit located in Jefferson County, WA. I am responding to your concerns as the authorized agent and Mining Consultant for Bruce Seton Jr. & Seton Construction, Inc. Environmental Impact Statement We understand that you have requested that an Environmental Impact Statement (EIS) be performed on the proposed Four Corners Sand & Gravel Pit. It is the understanding that you believe this is a feasible request based on the belief that this project may have extensive impacts on vegetation, wildlife, and local air quality. Stating that the sites earthwork activities will cause "great disturbances" to the area impacting wildlife, traffic, and air, and that an EIS would "certify the environment will not be damaged to the extent it may cause long- lasting and permanent damage." Response: Washington State Law WAC 197-11-330 outlines the threshold determination process under Washington's State Environmental Policy Act (SEPA) rules. These guidelines help agencies understand the proposed project and the potential impacts that the project would impose on the environment. As a mining project, the proposed Four Corners Sand & Gravel Pit has been evaluated under these laws and must adhere to not only Jefferson County regulations, but also additional regulations set forth by the Washington State Department of Natural Resources, Washington State Department of Ecology, and the Olympic Region Clean Air Agency. All of these agency's issue permits with strict guidelines. Each lead agency performs their own annual site visits to ensure that the site stays within compliance to all regulations throughout the year. Jefferson County has performed an extensive review into our application and is expecting to give a SEPA determination to the project of "Non - Significance". This determination is based on the size of the project, studies done for the project, and an evaluation completed by experts in their field. Typically, an Environmental Impact Statement (EIS) is required for large-scale projects involving thousands of acres, significant financial investment, and multi -year study efforts. Given the limited scope of this project, the County has determined that an EIS is neither necessary not appropriate in this instance. In your letter, you express concerns regarding potential habitat and wildlife disruption associated with the proposed operation. Specifically, you cite issues such as noise pollution, air quality impacts, and deforestation resulting from excavation activities. Additionally, you raise concerns about increased use of heavy-duty transportation vehicles and the potential for permanent damage to local roadways. This project is limited to a total disturbance on 9.14 acres over the life of the mine. The Washington State Department of Natural Resources (DNR) requires all mining operations to be performed in phases. This requirement mandates mining operations to minimize ground disturbing activities to a segment of the approved permit boundary. NORTHWEST MINING SOLUTIONS, LLC As slopes are finalized the operation is required to reclaim the area of disturbance within two years. This operation is split into two phases; 4.5 and 4.64 acres. Upon reclamation, topsoil will be distributed, and 400 trees and shrubs will be planted per acre as required by the DNR. This project will only disturb areas in segments as needed to help preserve a natural noise and visual barrier, as well as help reduce the impacts on the air and surrounding environment. The provided Reclamation Plans detail the sites phasing plan, reclamation plan, and revegetation plan. Site operations will be minimal and driven by local market demand. Annual production is estimated at approximately 10,000 cubic yards, resulting in intermittent activity rather than continuous or daily operations. The site will operate only as needed, with production levels adjusted based on regional demand. At peak market periods, the site is expected to generate a maximum of 3 to 4 large dump truck trips per day, Monday through Saturday. These projections are outlined in the accompanying "Site Generated Traffic Volumes Memo." The occasional addition of 3 to 4 truck trips per day on State Route 20 is not anticipated to result in significant impacts to nearby residents. All operations will comply with applicable local and state regulations, including load weight limits, load securing requirements, access road maintenance, and dust suppression measures such as water truck usage. Noise and air quality are common concerns associated with mining operations. To mitigate these impacts, the site will implement dust suppression measures using a water truck as needed and maintain a 50-foot setback from the property boundary. This setback will remain in its natural forested condition to serve as a buffer, helping to reduce noise and airborne particulates affecting the surrounding community. Crushing activities will occur only as necessary and are not expected to produce continuous impacts. While operational hours are provided to indicate when activities may take place, they do not reflect constant or daily operations. As previously noted, the site will operate on an as -needed basis, aligned with market demand. Requests: It is understood that Edward Johnson would appreciate Seton Construction, Inc. meet the following minimum requests: 1. Increase the buffer from 50-ft to 100-ft, claiming the airport produces a large amount of noise and light pollution. Increasing this buffer will help reduce the impact of these elements. 2. Change the proposed slope configuration of 2H:1V to 4H:1V. Claiming 2H:1V slope is substandard and is a danger to the surrounding properties. 3. Construct a 10-foot or higher earthen berm around the perimeter of the project to help aid in noise, safety, and visibility into the projects operations. 4. Not allow the construction of a second access road to the site which will increase the risk of air and noise pollution to the area. 5. Require a signed agreement of intent regarding the following: a) Promise to not start on a phase before the previous phase has been completed. b) The intended use for the eastern part of the parcel. c) State the longevity of the project. NORTHWESTMINING SOLUTIONS, LLC 6. Have the airport light beacon re -located. Response to Edward Johnson requests: 1. The 50-foot setback exceeds the standard safety and regulatory requirements for a project of this scale. Given the phased nature of the operation, it is anticipated that several years will pass before any activity approaches the vicinity of Mr. Johnson's parcel, and no immediate impact to existing trees is expected. As such, we do not believe an expanded setback is warranted. 2. A Licensed Civil Engineer and a Licensed Engineering Geologist have conducted Hydrogeologic and Geotechnical analysis of the site. Based on their analyses, excavation at slopes of 2H:1V or flatter is considered safe. See reports conducted that were submitted with this proposal to the County for further details. 3. Seton Construction, Inc. is willing to construct an earthen berm at least 10 feet in height around the project perimeter to help mitigate noise, enhance safety, and reduce visibility into the operational area. Additionally, the site will install perimeter signage as required, warning of potential hazards associated with mining activities to discourage unauthorized access. 4. Seton Construction, Inc. is willing to maintain a single access road to State Route 20, and will not seek a secondary access at this time. 5. Require a signed agreement of intent regarding the following: a) The Washington State Department of Natural Resources (DNR) requires phased mining and reclamation for ongoing operations. To comply with these regulations, the site must complete mining and reclamation within each phase before advancing to the next. This requirement is incorporated into the site's approved Reclamation Plans and will be enforced by the DNR's Mining and Reclamation Division. b) The remainder of the parcel is intended to remain designated for forestry use, with no plans for future mining outside the approved permit boundary. Any activity beyond the permitted area would be subject to strict enforcement by the Department of Natural Resources (DNR) and would require corrective actions involving significant time and cost. Seton Construction, Inc. has no interest in expanding operations into that portion of the property. c) The duration of the mining operation will be determined by market demand. With an estimated annual output of approximately 10,000 cubic yards, the site could potentially remain active for up to 33 years. However, operations will occur on an as -needed, job -by -job basis. As such, the exact lifespan of the mine cannot be definitively projected or committed to at this time. 6. The airport light beacon is a matter governed by the Federal Aviation Administration (FAA) and falls outside our jurisdiction. It is a federally mandated safety feature intended to support pilot navigation and cannot be modified through local project decisions. NORTHWEST MINING SOLUTIONS, LLC We sincerely appreciate your engagement in the SEPA review process and your thoughtful consideration of the proposed Four Comers Sand & Gravel Pit. Community input is a vital part of responsible land use planning, and your comments have helped inform a more thorough and transparent evaluation of the project. Seton Construction, Inc. remains committed to operating in accordance with all applicable local, state, and federal regulations, and to minimizing environmental and community impacts through careful planning, phased operations, and ongoing reclamation efforts. We hope this response has addressed your concerns and appreciate the opportunity to discuss these issues with you. Should you require any additional information or clarification, please do not hesitate to contact me. Sincerely, Lisa Mahr President, Project Engineer Northwest Mining Solutions, LLC 619-328-7917 NORTHWEST MINING SOLUTIONS, LLC 4 wP STAT .'4 inn STATE OF WASHINGTON DEPARTMENT OF ECOLOGY Southwest Region Office PO Box 47775, Olympia, WA 98504-7775 • 360-407-6300 May 28, 2025 Andrew Gosnell, SEPA Contact Jefferson County Community Development Department 621 Sheridan Street Port Townsend, WA 98368 Dear Andrew Gosnell: LOG ITEM Page� 0fZ Thank you for the opportunity to comment on the optional determination of non- significance/notice of application for the Four Corners Sand & Gravel Pit Project (ZON2024- 00012) located at 225 Four Corners Road as proposed by Bruce Seton Jr. The Department of Ecology (Ecology) reviewed the environmental checklist and has the following comment(s): SOLID WASTE MANAGEMENT: Derek Rockett (360) 995-3176 All grading and filling of land must utilize only clean fill. All other materials may be considered solid waste and permit approval may be required from your local jurisdictional health department prior to filling. All removed debris resulting from this project must be disposed of at an approved site. Contact the local jurisdictional health department or Department of Ecology for proper management of these materials. TOXICS CLEANUP: Dean Malte (360) 999-9584 One underground storage tank (UST) site (Jefferson County PUD No. 1, FSID 7125893) is located within 750 feet of the project area to the south-southwest. The site has two active USTs containing gasoline and diesel fuel. No releases are associated with the USTs at this site, and it does not appear to be a concern for the proposed work. However, if any contamination is unexpectedly encountered anywhere in the project area, it must be reported to Ecology (per WAC 173-340-300) via the online ERTS at htt s: ecolo .wa. ov Footer Re ort-an-environmental-issue statewide -issue - reporting -form. WATER QUALITY/GENERAL PERMITS UNIT: Eli Newby, Sand & Gravel Permit Manager (360) 763-2633 1 eii.newby@gqy.wa.gov All new facilities and un-permitted existing facilities that intend to obtain coverage, and permitted existing facilities planning a significant process change must submit a complete and accurate Notice of Intent (NOI). The Permittee must submit the NOI no less than one hundred and eighty (180) days before beginning any activity that may result in the discharge Andrew Gosnell May 28, 2025 Page 2 of any pollutant. No discharge is authorized until the effective date of permit coverage. Please include all planned activities and associated wastewater discharges to occur under Sand and Gravel General Permit coverage (Permit Condition S.1, Table 1: Sand & Gravel General Permit - Washington State Department of Ecolo ) in the SEPA checklist and applicable studies to ensure the SEPA decision is appropriate for Ecology permitting without the need for SEPA revision. Please review "Defining the entire proposal" at: Lead agency determination and responsibilities - Washington State Department of.Ecolopy for more information. Ecology's comments are based upon information provided by the lead agency. As such, they may not constitute an exhaustive list of the various authorizations that must be obtained or legal requirements that must be fulfilled in order to carry out the proposed action. If you have any questions or would like to respond to these comments, please contact the appropriate reviewing staff listed above. Department of Ecology Southwest Regional Office (J KT:202502010) cc: Derek Rockett, SWM Dean Malte, TCP Eli Newby, WQ From: SEPA To: Andrew Gosnell Subject: ORCAA Comments on SEPA#202502010 - Four Corners Sand & Gravel Pit Date: Thursday, May 15, 2025 1:35:16 PM Attachments: Outlook -signature .ona Focus ShceL - When is an NQQ R%luined FINAL 11-03-2022pdf Focus Shre1 Camoietinn the NOC Process FINAL 11-03-2022.odF LOG ITEM Page ___L_of ALERT: BE CAUTIOUS This email originated outside the organization. Do not open attachments or click on links if you are not expecting them. Good Afternoon, Olympic Region Clean Air Agency (ORCAA) reviewed the proposal for the Four Corners Sand & Gravel Pit, located at 225 Four Corners Rd in Port Townsend, WA. The Environmental Checklist indicates rock crushing would occur on site and that permits are needed from ORCAA. ORCAA has the following comments for the applicant: Review and approval of a Notice of Construction by ORCAA is required prior to commencing construction or installation of any stationary source of air pollution, including rock crushing operations. This is accomplished through the approval of a Notice of Construction (NOC) application or a Notice of Intent to Operate (NOI) application. Rock crushers can operate under one of ORCAA's NOI permits, a regular NOC permit, or under ORCAA's General Rock Crusher Approval Order (which is also an NOC permit). The advantage of the General Rock Crusher Approval Order is that it's modular and portable, whereas a normal NOC is site -specific. Rock Crusher NOC and NOI information and permitting forms can be found under the 'Rock Crushers' tab at: h _ /www.orcaa.org/for- b us i n ess/h us i n ess-as s i sta n cel Please contact our office at 360-539-7610 to discuss the permitting options available to you so we can get you the appropriate permitting application that best suits your operation. Attached are two focus sheets which broadly cover when a permit from ORCAA is required, and what the process looks like once ORCAA receives a permit application. Thank you for the opportunity to comment. Best Regards, Abi Roberts, Engineer I ++++++++++++++++++++++++++++++++ Olyrnf)ic Region Clean Air Agency 2940 Limited Lane NW Olympia, WA 98502 40�ORCAA Office — (360) 539-7610 x 106 O RCAA www.orcaa.ora From: Nicole Gauthier To: Andrew Gosnell Subject: Re: ZON2024-00012 Notice of Application Date: Thursday, May 15, 2025 2:36:01 PM Attachments: imaae.ona Outlook-ao4zsxek.pna Outlook-adflwkct.pno Outlook-u5dmz3ho.ona LOG ITEM Page o f� ALERT: BE CAUTIOUS This email originated outside the organization. Do not open attachments or click on links if you are not expecting them. Andrew, Thank you for taking the time to speak with me earlier today. When reviewing this project, I would like to stress the importance of the bus stop that is located on Highway 20. See below for the Google Map. It's important to Jefferson Transit and the community members that use this bus stop that it is not compromised. There are not a lot of places on Highway 20 where a bus stop is feasible. I would appreciate further information if the site for the access road is changed from the original plans. Thank you, Nicole Nicole Gauthier I General Manager Jefferson Transit Authority 63 Four Corners Road, Port Townsend, WA 98368 360-385-3020 x107 I naauthieE@Ieffersontransit.com www.jeffersontransit.corn a rej ■ e mail ccrrespcnderc� [e ono, From ' s cda,e>> +s sub;ect tc Score F�blir Re�:oros /Irr, wr�cr moi resar� ,r, ,r,,,.rori� 9 and archiving, as well as disclosure to third parties upon request, From: Andrew Gosnell <AGosnell@co.jefferson.wa.us> Sent: Wednesday, May 14, 2025 4:44 PM To: sking@cityofpt.us <sking@cityofpt.us>; ebolin@cityofpt.us <ebolin@cityofpt.us>; Larson, Andy <LarsonA@wsdot.wa.gov>; Sherrie Shold <SShold@co.jefferson.wa.us>; Pinky Mingo <PMingo@co.jefferson.wa.us>; Emma Erickson <EErickson@co.jefferson.wa.us>; Laura Pollina <LPollina@co.jefferson.wa.us>; John Fleming <JFleming@co.jefferson.wa.us>; allison.e.satter.civ@us.navy.mil <allison.e.satter.civ@us. navy. mil>; Jillian.Greenwood@dnr.wa.gov <Jillian.Greenwood@dnr.wa.gov>; William. Robinson@dfw.wa.gov <WilIiam.Robinson @dfw.wa.gov>; Noel.Sharp@dnr.wa.gov <Noel.Sharp@dnr.wa.gov>; btracer@ejfr.org <btracer@ejfr.org>; bgraham@jeffpud.org <bgraham@jeffpud.org>; sharper@jeffpud.org <sharper@jeffpud.org>; apapiez@skokomish.org <apapiez@skokomish.org>; mpowers@pgst.nsn. us <mpowers@pgst.nsn.us>; crossi@pnptc.org <crossi@pnptc.org>; ascagliotti@jamestowntribe.org <ascagliotti@jamestowntribe.org>; ataylor@jamestowntribe.org <ataylor@jamestowntribe.org>; Istrong@jamestowntribe.org <Istrong@jamestowntribe.org>; dlewarch@Suquamish.nsn.us <dlewarch@Suquamish.nsn.us>; stephanie.jolivette@dahp.wa.gov <stephanie.jolivette@dahp.wa.gov>; Nicole Gauthier<ngauthier@jeffersontransit.com>; jmcmacken@pensinsuladailynews.com <jmcmacken@pensinsuladailynews.com>; jeffconews@peninsuladailynews.com <jeffconews@peninsuladailynews.com>; eric@portofpt.com <eric@ portofpt.com> Cc: Lisa Mahr<lira@northwestminingsolutions.com>; brucejr@setonconstruction.com <brucejr@setonconstruction.com>; Greg Ballard <GBallard@co.jefferson.wa.us>; Emily Calkins <ECalkins@co.jefferson.wa.us> Subject: ZON2024-00012 Notice of Application IYou don't often get email from agosnell@cojefferson.wa.us. Learn why this is important Good afternoon All, Jefferson County Department of Community Development is noticing a Conditional Use Permit application for the establishment of a new sand & gravel pit at a site between Jefferson County International Airport and State Route 20. Attached is our noticing document and the project site plan. If you would like to comment on this proposal, please send me your comments by May 28, 2025. Please contact me for any additional information on this project. Warm regards, Andy Gosnell (he/his) Associate Planner 360.379.4458 AGosnell@co.jefferson.wa.us NOTE: I work a 4-10 schedule and am typically out of the office on Fridays. For general questions, please contact DCD's front desk at (360) 379-4450. LOG ITEM 27 From: Larson, And Page _of 2 � To: Andrew Gosnell Cc: Ablson. Maha; Loescher. JefF Rae. Connie; Page, Gerald Subject: RE: [EXTERNAL] ZON2024-00012 Notice of Application Date: Thursday, May 15, 2025 7:32:38 AM ALERT: BE CAUTIOUS This email originated outside the organization. Do not open attachments or click on links if you are not expecting them. Hi Andrew, This notice shows an existing access from this parcel to SR 20, but the permit for that access does not include this parcel. If they intend to directly access SR 20, they will need to apply for that access and provide a TIA for their impacts to the highway. Andrew Larson, PE Development Services Engineer (he/him/his) (360) 900-9541 From: Andrew Gosnell <AGosnell@co.jefferson.wa.us> Sent: Wednesday, May 14, 2025 4:45 PM To: sking@cityofpt.us; ebolin@cityofpt.us; Larson, Andy <andrew.larson@wsdot.wa.gov>; Sherrie Shold <SShold@co.jefferson.wa.us>; Pinky Mingo <PMingo@co.jefferson.wa.us>; Emma Erickson <EErickson @co.jefferson.wa.us>; Laura Pollina <LPollina@co.jefferson.wa.us>; John Fleming <JFleming@co.jefferson.wa.us>; allison.e.satter.civ@us.navy.mil; Greenwood, Jillian (DNR) <jillian.greenwood@dnr.wa.gov>; Robinson, William (DFW) <William.Robinson@dfw.wa.gov>; Noel.Sharp@dnr.wa.gov; btracer@ejfr.org; bgraham@jeffpud.org; sharper@jeffpud.org; apapiez@skokomish.org; mpowers@pgst.nsn.us; Rossi, Cynthia <crossi@pnptc.org>; ascagliotti@jamestowntribe.org; ataylor@jamestowntribe.org; Istrong@jamestowntribe.org; dlewarch@Suquamish.nsn.us; Jolivette, Stephanie (DAHP)<stephanie.jolivette@dahp.wa.gov>; ngauthier@jeffersontransit.com; jmcmacken@pensinsuladailynews.com; jeffconews@peninsuladailynews.com; eric@portofpt.com Cc: Lisa Mahr<lisa@northwestminingsolutions.com>; brucejr@setonconstruction.com; Greg Ballard <GBallard@co.jefferson.wa.us>; Emily Calkins <ECalkins@co.jefferson.wa.us> Subject: [EXTERNAL] ZON2024-00012 Notice of Application WARNING: This email originated from outside of WSDOT. Please use caution with links and attachments. Good afternoon All, Jefferson County Department of Community Development is noticing a Conditional Use Permit application for the establishment of a new sand & gravel pit at a site between Jefferson County International Airport and State Route 20. Attached is our noticing document and the project site plan. If you would like to comment on this proposal, please send me your comments by May 28, 2025. Please contact me for any additional information on this project. From: To: Subject: Date: Hi Andy: John Fleming Andrew Gosnell RE: ZON2024-00012 Notice of Application Wednesday, May 14, 2025 4:49:29 PM I think I already commented on this project in EPL. Stormwater design looks good, all will be infiltrated in the hole they are digging. Transportation is off WSDOT SR-20, existing. LOG ITEM Page -off (They could also come out Four Corners Road, if needed, with a road approach under the power lines, if granted an easement.) From: Andrew Gosnell <AGosnell@co.jefferson.wa.us> Sent: Wednesday, May 14, 2025 4:45 PM To: sking@cityofpt.us; ebolin@cityofpt.us; Larson, Andy <LarsonA@wsdot.wa.gov>; Sherrie Shold <SShold@co.jefferson.wa.us>; Pinky Mingo <PMingo@co.jefferson.wa.us>; Emma Erickson <EErickson @co.jefferson.wa.us>; Laura Pollina <LPollina@co.jefferson.wa.us>; John Fleming <JFleming@co.jefferson.wa.us>; aIlison.e.satter.civ@us.navy.mil; Jillian.Greenwood@dnr.wa.gov; William.Robinson@dfw.wa.gov; Noel.Sharp@dnr.wa.gov; btracer@ejfr.org; bgraham@jeffpud.org; sharper@jeffpud.org; apapiez@skokomish.org; mpowers@pgst.nsn.us; crossi@pnptc.org; ascagliotti@jamestowntribe.org; ataylor@jamestowntribe.org; Istrong@jamestowntribe.org; dlewarch@Suquamish.nsn.us; stephanie.jolivette@dahp.wa.gov; ngauthier@jeffersontransit.com; jmcmacken@pensinsuladailynews.com; jeffconews@peninsuladailynews.com; eric@portofpt.com Cc: Lisa Mahr<lisa@northwestminingsolutions.com>; brucejr@setonconstruction.com; Greg Ballard <GBallard @co.jefferson.wa.us>; Emily Calkins <ECalkins@co.jefferson.wa.us> Subject: ZON2024-00012 Notice of Application Good afternoon All, Jefferson County Department of Community Development is noticing a Conditional Use Permit application for the establishment of a new sand & gravel pit at a site between Jefferson County International Airport and State Route 20. Attached is our noticing document and the project site plan. If you would like to comment on this proposal, please send me your comments by May 28, 2025. Please contact me for any additional information on this project. Warm regards, Andy Gosnell (he/his) Associate Planner 360.379.4458 AGosne lI P-co-jeffers-Qnwa. Q5 IV 4� 7 TEIV L Zq ��e O WrWashington State Af Department of Transportation Access Connection Permit Managed Access Highways Only Not for use within an Incorporated City or Town Name and Address of Applicant: Permit Number ACP- 62355 BRUCE SETON JR 4640 S. Discovery Rd. State Route 20 Mile Post 6.510 ❑LeftCRight Port Townsend, WA 98368 Region County I Olympic Jefferson Property Address (If different from above) Joint Use Connection Yes ❑ No Primary Tax Parcel Number: 001332016 225 Four Corners Rd, Port Townsend, WA 98368 Additional Tax Parcel Numbers (if applicable) 001332017,001332004,001332013 Email brucejr@setonconstruction.com Phone 360-301-1403 Project Name (if Applicable) Lot # Govt. Lot # n/a Average Weekday Vehicle Trips Ends not to exceed: 100 AWDVTE Approach width not to exceed 30' feet wide Public Land Survey System 1/4 of the 1/4 of section 33 Township 30 N,Range 1 F_ E F,—,' W Permit Category Permit Type Current Mana ed Access Highway Classification r 1 -Minimum Connection Fv Conforming 1 - 1320' Minimum Approach Spacing Required 2 - Minor Connection ; Non -Conforming .i 2 - 660' Minimum Approach Spacing Required 3 - Major Connection _ F i Variance 3 - 330' Minimum Approach Spacing Required 4 -Temporary Connection 4 - 250' Minimum Approach Spacing Required 5 - 125' Minimum Approach Spacing Required This Access Connection Permit serves: Joint access of existing approach for mining operations. This permit Is assigned to the parcels) listed above, and shall remain assigned to those parcels) regardless of any change In ownership of the parcels). The parcel(s) served by this permit will be referenced to as the "Permit Holder", and the Washington State Department of Transportation hereinafter will be referred to as the "Department". The Department will allow the Permit Holder to construct, upgrade, use, and/or maintain this access connection provided the Penult Holder accepts all the terms, p►ovislona, and Exhibits attached hereto, and listed below, and by this made a part of this permit. xhibit 'A' - GP Specials - 4 pages xhibit `13" - Right -of -Way Plan -I sheet txhibit 'C" - Plan -I sheet Exhibit "D' - TMC Requirements - 1 sheet By signing below the Permit Holder accepts the terms, provisions, and exhibits attached to and made a part of this permit PERMIT HOLDER DEPARTMENT Print Name BRUCE SETON JR Print Name Andrew Larson, PE Print Title: President Print Title: Development Services Engineer Signature Date Signature Date F& DOT Form 224-005 Revised 1012015 Page 1 of 8 General Provisions 1. INDEMNIFICATION The Permit Holder, its heirs, successors and assigns, agrees to indemnify, defend, and hold harmless the State of Washington and its officers, employees, and agents from all claims, demands, damages (both to persons and/or property), expenses, regulatory fines, and/or suits that: (1) arise out of or are incident to any acts or omissions by the Permit Holder, its agents, contractors, tenants, invitees, licensees, and/or employees, in the use of the state highway right-of-way as authorized by the terms of this Permit, and/or (2) are caused by the breach of any of the conditions of this Permit by the Permit Holder, its agents, contractors, tenants, invitees, licensees, and/or employees. The Permit Holder, its heirs successors and assigns, shall not be required to indemnify, defend, or hold harmless the State of Washington and its officers, employees, and/or agents if the claim, suit, or action for damages (both to persons and/or property) is caused by the sole acts or omissions of the State of Washington, its officers, employees, and/or agents; provided that, if such claims, suits, or actions result from the concurrent negligence of (a) the State of Washington, its officers, employees, and/ or agents and (b) the Permit Holder, its agents, contractors, tenants, invitees, licensees, and/or employees, or involves those actions covered by RCW 4.24.115, the indemnity provisions provided herein shall be valid and enforceable only to the extent of the acts or omissions of the Permit Holder, its agents, contractors, tenants, invitees, licensees, and/or employees. The Permit Holder agrees that its obligations under this section extend to any claim, demand and/or cause of action brought by, or on behalf of, any of its employees or agents while performing construction, operation and/or maintenance work authorized by this permit. For this purpose, THE PERMIT HOLDER BY MUTUAL NEGOTIATION HEREBY WAIVES WITH RESPECT TO THE STATE OF WASHINGTON ONLY, ANY IMMUNITY THAT WOULD OTHERWISE BE AVAILABLE TO ITAGAINST SUCH CLAIMS UNDER THE INDUSTRIAL INSURANCE PROVISIONS OF CHAPTER 51.12 RCW. The Permit Holder further agrees that the proper performance, safe conduct, and adequate policing and supervision of the work authorized by this permit shall not be lessened or otherwise affected by the Department's approval of the plans, specifications, or work authorized by this permit, or by the presence at the work site of Department representatives, or by compliance by the Permit Holder with any requests or recommendations made by such representatives. This indemnification and waiver shall survive the termination of this Permit. 2. REQUIRED PROPERTY RIGHTS If the parcel(s) served by this permit does not abut the state highway, the Permit Holder must provide legally recorded. easements or other property rights that grant a continuous right of access between this parcels) and the state highway right-of-way as required by WAC 468-51-030(2). The Permit Holder shall provide copies of these documents to the Department before beginning any work authorized under this permit. 3. PERMIT TYPES There are three types of Access Connection Permits — Conforming, Non -Conforming, and Variance Access Connection Permits. A brief description of each of these three types of permits is as follows: • Conforming Access Connection Permits (WAC 468-51-020(4)) meet current Department location, spacing, and design criteria standards at the time of the permit application submittal. • Nonconforming Access Connection Permits (WAC 468-51-100) do not meet the Department's location and spacing criteria standards at the time of the permit application submittal, but denial would leave the property without reasonable access onto the public road system. Nonconforming Access Connection Permits may continue only until the Department determines that a Conforming Access Connection can be constructed, in such case the Nonconforming Access Connection shall be removed. Variance Access Connection Permits (WAC 468-51-105) are a special nonconforming or additional access connection permit issued for a location not normally permitted by Department standards current at the time of permit application. A Variance Access Connection Permit may be issued only after an engineering study demonstrates to the sole satisfaction of the Department, that the connection will not adversely affect the safety, maintenance, or operation of the state highway in accordance with its assigned classification. A Variance Access Connection Permit may only be issued for Class 2 thru Class 5 highways and may remain unless a new permit is required due to changes in property site use or unless the Department modifies, revokes, or closes the permit pursuant to WAC 468-51-120. Page 2 of 8 4. OTHER PERMITS, FRANCHISE RIGHTS, AND AGREEMENTS This permit shall not be deemed or held to be an exclusive one and shall not prohibit the Department from granting other permits, franchise rights, and/or agreements or from entering into other permits, franchise rights, and/or agreements of like or other nature with other public or private companies or individuals for the use of the state highway right-of-way, nor shall it prevent the Department from using any of its highways, streets, or public places, or affect its right to full supervision and control over all or any part of them, none of which is hereby surrendered. 5. PERMITS FROM OTHER AGENCIES The Permit Holder shall be responsible for obtaining all necessary Federal, State, and Local Permits including, but not limited to, Washington State Department of Ecology, Washington State Department of Fish and Wildlife, Washington State Department of Natural Resources, and U.S. Army Corps of Engineers permits or other approvals required prior to beginning any of the work authorized in this permit. The Permit Holder shall defend and hold harmless the State of Washington, its officers and employees, for any fines, costs, or other amounts should the Permit Holder fail to obtain all required permits. 6. PERMIT HOLDER'S REPRESENTATIVE Should the Permit Holder not be present during any of the work authorized by this permit, the Permit Holder shall designate a representative that has either the legal authority to represent the Permit Holder or the authority to make decisions on behalf of the Permit Holder with respect to the work authorized by this permit. The Permit Holder, at its own expense, shall adequately police and supervise all work authorized by this permit, including but not limited to its contractor, subcontractor, agent, and others, so as not to endanger or injure any person or property. The Permit Holder or the Permit Holder's representative shall be present during any active construction or maintenance work authorized by this permit. Failure to comply with this provision may result in the Department restricting any further work by the Permit Holder within the state highway right-of-way until this requirement is met. 7. PRE -CONSTRUCTION CONFERENCE The Permit Holder shall not start any construction on state highway right-of-way without first having a preconstruction meeting, which shall be attended by the Department, the Permit Holder or its authorized representative, and the Permit Holder's contractor, if applicable. Unless requested otherwise by the Department, the preconstruction conference shall be onsite at the location of the work authorized by this permit. S. DEPARTMENT NOTIFICATION The Permit Holder shall notify the Department a minimum of five (5) working days prior to, including but not limited to: the preconstruction conference; the beginning of any construction work; the implementation of any traffic control plan that closes or restricts a sidewalk, pathway, trail, highway shoulder, or traveled lane of the state highway; submittal of a new or revised traffic control plan; any extension of allowed working hours or days; and the final inspection upon completion of the construction. Working days, for the purposes of notifying the Department of any work or other activity as authorized by this permit, are the weekdays Monday through Friday, excluding legal holidays. 9. PERMIT DOCUMENTS ON SITE A complete copy of this permit, protected from the elements, shall be readily available any time active construction work is being performed as authorized by this permit. The permit shall be shown, upon request, to any state representative or law enforcement officer. Failure to comply with this provision may result in the Department restricting any further work by the Permit Holder within the state highway right -of --way until said requirement is met. 10. TRAFFIC CONTROL PLANS The Permit Holder shall not implement any traffic control plans (TCP) on state highway right-of-way without the Department's prior written approval. It is the Permit Holder's responsibility to plan, conduct, and safely perform the work authorized by this permit. Should additional TCP's be needed for the construction and/or maintenance of the work authorized by this permit, the Permit Holder shall submit work -speck traffic control plans to the Department for review and written approval. A wide range of pedestrians might be affected by traffic control zones, including the young, elderly, and people with disabilities such as hearing, visual, or mobility. Bicyclists may also be impacted. The Permit Holder shall implement all reasonable means of traffic control necessary to adequately accommodate these needs if they can be reasonably expected to be encountered during the work authorized by this permit. All traffic control plans shall be in compliance with the current editions of the Washington State Department of Transportation (WSDOT) Work Zone Traffic Control Guidelines and Federal Highway Administration -approved Manual on Uniform Traffic Control Devices (MUTCD) for Streets and Highways. Page 3 of 8 Transportation (WSDOT) Work Zone Traffic Control Guidelines and Federal Highway Administration -approved Manual on Uniform Traffic Control Devices (MUTCD) for Streets and Highways. The WSDOT Work Zone Traffic Control Guidelines (M54-44) may be accessed at: http:/twww.wsdot.wa.gov/Publications/Manuals/M54-44.htm The MUTCD, including modifications for Washington State, may be accessed at: hftp://www.wsdot.wa.gov/OperaUonsfTraffic/mutcd.htm 11. CHANGES TO TRAFFIC CONTROL PLANS The Department reserves the right to immediately modify, suspend, or revoke any traffic control plan or work authorized under this permit, including but not limited to lane closures and shoulder closures due to unexpected conditions or other circumstances which the Department determines is in the best interests of the state and/or safety of the traveling public. All costs associated with a modification, suspension, or revocation shall be borne solely by the Permit Holder. The Department shall in no way be held liable for any delays, costs, or other damages to the Permit Holder by reason of any such Department action. 12. TRACKING OF MATERIAL The Permit Holder shall maintain the surface of the access connection to prevent the tracking of material onto any portion of the state highway, including the traveled lanes and shoulders of the highway. Any tracking of material onto the highway, such as mud or debris, shall be immediately cleaned up by the Permit Holder in accordance with RCW 46.61.655. Should the Permit Holder fail to immediately correct or clean up material tracked onto the state highway after receiving written notice from the Department, the Department reserves the right to perform the necessary work to preserve the state highway right -of --way or for the protection of the traveling public or pedestrians. If the Department performs the work as provided herein, the Permit Holder agrees to make payment to the Department within thirty (30) calendar days of the date of the Department's detailed invoice. If the Department chooses not to perform the work, the Department may initiate an action to revoke this permit as provided as provided by WAC 468-51.120. 13. EROSION AND SEDIMENTATION CONTROL The Permit Holder shall comply with the Washington State Department of Transportation Highway Runoff Manual (HRM) and implement Best Management Practices (BMP's) to reduce erosion, trap sediment, and ensure that sediment -laden water does not leave the work site. The HRM establishes minimum requirements and provides uniform technical guidance for avoiding, minimizing, and/or mitigating potential water resource impacts. All water discharges to or from the state highway right-of-way due to the work activities authorized by this permit shall conform to all applicable federal, state, and local water quality regulations. The Washington State Department of Transportation Highway Runoff Manual, M31-16, may be accessed at: hftp://www.wsdot.wa.gov/Publications/Manuals/M31-16.htm 14. CULTURAL RESOURCES If any archaeological or historical resources are revealed due to the work authorized under this permit, the Permit Holder shall immediately stop work and notify the Department's representative and retain a United States Government Secretary of the Interior's qualified archaeologist. Said archaeologist shall evaluate the site and make recommendations to the Department regarding the continuation of the work. 15. UTILITY IMPACTS All manholes, valve covers, catch basins, utility boxes, or other similar utility appurtenances impacted by the work authorized in this permit that do not require a separate Department Utility Permit or Utility Franchise shall be constructed, modified, or repaired to match the highway shoulder slope and if outside the highway shoulder shall match the adjacent terrain as required by the Department. Any Department inspection or concurrence of this work shall be for the sole benefit of the Department and not for the Permit Holder or any third party. The Permit Holder shall make a timely application for any Department -issued Utility Permit, Utility Franchise, or an amendment to an existing utility permit or franchise. Failure to obtain any required Utility Permit, Utility Franchise, or an amendment to an existing utility permit or franchise in a timely manner may result in the Department delaying the work authorize by this permit until such time that the require documents are obtained. The Permit Holder agrees on behalf of itself, its successors, assigns, tenants, invitees, licensees, contractors, agents and/or employees, that the Department shall in no way be held liable for any delays, costs, or other damages to the Permit Holder or its successors, assigns, contractors, tenants, invitees, licensees, employees and/or agents by reason of any action taken by the Department pursuant to this section. Page 4 of 8 Additional guidance in accommodating utilities within state highway right -of --way may be found in the current editions of the Washington State Department of Transportation (WSDOT) Utilities Accommodations Manual M22-86 and WSDOT Utilities Manual M22-87. The WSDOT Utilities Accommodations Manual, M22-86, may be accessed at: http:/Avww.wsdot.wa.govPublications/ Manuals/M22-86.htm. The WSDOT Utilities Manual, M22-87, may be accessed at: hftp://www.wsdot.wa.gov/OperationsfTraffic/Mutcd.htm 16. SURVEY MONUMENTS The Permit Holder shall not disturb, remove, or destroy any existing survey Monument before first obtaining a Washington State Department of Natural Resources (DNR) permit. The Permit Holder further agrees that all Department control and alignment monuments may not be disturbed, removed, or destroyed unless specifically authorized by this permit or pursuant to the Department's prior written approval. Any reset survey Monument shall be set by or under the direct supervision of a Professional Land Surveyor who has an active professional license with the State of Washington. A listing of Survey Monuments may be accessed at the Department's Geographic Services Office Website: http:/Avww.wsdot.wa.gov/monumentisearchBroad.aspx 17. DELAY TO DEPARTMENT WORK All work authorized by this permit shall be done in such a manner by the Permit Holder as will cause the least interference with any of the Department's or it's contractor's work on the state highway. The Permit Holder agrees on behalf of itself, its successors, assigns, tenants, invitees, licensees, contractors, agents and employees, that the Department shall in no way be held liable for any delays, costs, or other claims or damages by the Permit Holder or its successors, assigns, tenants, invitees, licensees, contractors, agents and/or employees occasioned by the Department's or its contractor's work on the state highway right of way. 18. MATERIALS AND WORKMANSHIP All material and workmanship shall conform to the current edition of the Washington State Department of Transportation Standard Specifications for Road, Bridge and Municipal Construction, and amendments thereto, and shall be subject to inspection and concurrence by the Department. Any Department inspection or acceptance shall be for the sole benefit of the Department and not for the Permit Holder or any third party. The Washington State Department of Transportation Standard Specifications for Road, Bridge and Municipal Construction (M41-10) maybe accessed at: http:/Avww.wsdot.wa.gov/Publications/Manuals/M41-10,htm 19. PERMIT MODIFICATIONS, AMENDMENTS, CHANGES AND/OR CORRECTIONS The Department reserves the right to require permit modifications, amendments, changes and/or corrections should the authorized construction not conform with the Department's current Standard Specifications for Road, Bridge, and Municipal Construction, Department's Standard Plans, Department's Design Manual, the permit Special Provisions and/ or if unexpected construction site conditions are encountered prior to or during the performance of the work authorized by this permit. The Permit Holder is required to obtain the Department's prior review and written approval for any proposed changes to the permit. Permit Holder agrees on behalf of itself, its successors, assigns, tenants, invitees, licensees, contractors, agents and employees, that the Department shall in no way be held liable for any delays, costs, or other claims or damages to the Permit Holder or its successors, assigns, tenants, invitees, licensees, contractors, agents and/or employees, should the Department require any modifications, amendments, changes and/or corrections to the permit. 20. STORAGE OF EQUIPMENT AND MATERIALS The Permit Holder shall not place or store any equipment and/or materials within the state highway right-of-way unless specifically authorized by this permit or in writing by the Department, and any placement or storage of any equipment and/ or materials, if allowed, shall only be during the active construction phase of the work authorized by this permit. 21. CONSTRUCTION AND MAINTENANCE WORKING DAYS —SUSPENSION OF WORK The Permit Holder shall not perform work on a Saturday, Sunday or a legal holiday, unless specified elsewhere in this permit or by the Department in writing. RCW 1.16.050 lists the following days as the observed legal holidays and their common names: • First day in January - New Year's Day • Third Monday of January - Martin Luther King Je s Birthday • Third Monday of February - President's Day • Last Monday of May - Memorial Day Page 5 of 8 • Fourth day of July — Fourth of July • First Monday in September - Labor Day • Eleventh day of November - Veterans' Day • Fourth Thursday in November — Thanksgiving Day and the day immediately following • Twenty-fifth day of December - Christmas Day 22. FAILURE TO COMPLETE WORK IN A TIMELY MANNER The Permit Holder agrees to complete the work authorized by this permit within 120 days, unless an extension of time is granted in writing by the Department. Should the Permit Holder fail to complete the work within the approved time limit, the Department shall determine what work must be completed to restore the state highway right-of-way back to a condition and configuration that is safe for public use. Should the Permit Holder fail to immediately finish the work authorized by this permit or to restore the state highway right-of-way back to a condition and configuration that is safe for public use after receiving written notice of the deficiency from the Department, the Department reserves the right to perform the necessary work to preserve the state highway for public use and for the safety of the traveling public. If the Department performs the work, the Permit Holder agrees to make payment to the Department within thirty (30) calendar days of the date of the Department's detailed invoice. If the Department chooses not to perform the work, the Department may initiate an action to revoke this permit as provided as provided by WAC 468-51.120, as well as recover all costs associated with restoring the state highway right -of --way. 23. FINAL INSPECTION AND SURETY RELEASE All work on state highway right-of-way is subject to ongoing monitoring and inspection by the Department solely for the benefit of the Department and not for the Permit Holder or any third party. Upon completion of the work authorized by this permit, including the removal of all construction related rubbish and debris, the Permit Holder shall request a final inspection from the Department's representative. Only upon the Department's inspection and concurrence of the work authorized by this permit will the Department release the surety, if any, that was made a condition of this permit, provided all other conditions related to the surety have been met. 24. ON -GOING MAINTENANCE OF ACCESS CONNECTION The Permit Holder, its successors or assigns, shall be responsible for maintaining the access connection and related appurtenances between the state highway edge of shoulder and the state highway right-of-way line, including but not limited to, pavement surface, culverts, catch basins, earthen embankment slopes above and below the access connection, vegetation growth that impacts traffic and pedestrian sight lines and sight distance, the removal of snow or other material that may be tracked onto the access such as mud and debris, and mail boxes. The Permit Holder shall correct any maintenance deficiency within thirty (30) consecutive calendar days upon discovery or Department written notice, unless the Department authorizes in writing a different time period_ Should the Permit Holder fail to correct a deficiency, after receiving written notice of the deficiency from the Department, the Department reserves the right to perform the necessary maintenance work to preserve the state highway right-of-way or for the protection of the traveling public or pedestrians. If the Department performs maintenance work as provided herein, the Permit Holder agrees to make payment to the Department within thirty (30) calendar days of the date of the Department's detailed invoice. If the Department chooses not to make the repair, the Department may initiate an action to revoke this permit as provided as provided by WAC 468-51,120. 26. STORMWATER AND DRAINAGE MAINTENANCE The Permit Holder shall construct and maintain the access connection such that no stormwater runoff is directed onto the paved surface of the state highway traveled lanes and shoulders. Curbing or other drainage features may be required if the grade beyond the edge of shoulder is flat or slopes toward the state highway pavement such that any stormwater runoff on the access connection would flow onto the traveled lanes and shoulder of the state highway. The Permit Holder shall be responsible to maintain all culverts and catch basins associated with this permit and shall provide all necessary ongoing maintenance to keep those culverts and catch basins free -flowing and clear of all obstructions in accordance with the provisions of Section 24. The Permit Holder shall not interfere with the conveyance and/or treatment of the existing highway stormwater drainage system. If the work performed in any way adversely interferes with existing state highway stormwater drainage, including the treatment and/or conveyance of stormwater, the Permit Holder shall immediately correct its drainage impacts on the state highway at its own expense after receipt of the Department's written notice. Such work as required by the Department shall be inspected and concurred to by the Department. Any Department notice, requirement, inspection and/ or concurrence shall be solely for the benefit of the state and not for the Permit Holder or any other third party. Should the Permit Holder fail to immediately maintain or correct any stormwater conveyance, drainage, or treatment deficiency Page 6 of 8 after receiving written notice of the deficiency from the Department, the Department reserves the right to perform the necessary work to preserve the state highway right -of --way or for the protection of the traveling public or pedestrians. If the Department performs the work as provided herein, the Permit Holder agrees to make payment to the Department within thirty (30) calendar days of the date of the Department's detailed invoice. If the Department chooses not to perform the work, the Department may initiate an action to revoke this permit as provided as provided by WAC 468-51.120. 26. RIGHT-OF-WAY VEGETATION MAINTENANCE The Permit Holder shall not cut, spray, retard, remove, destroy, damage, disfigure or in any way modify the physical condition of any vegetative material located within the state highway right-of-way for any reason, except for the work specifically detailed, shown, and authorized in this permit. If it becomes necessary to increase the sight lines and sight distance at this access connection for safety purposes, the Permit Holder shall contact the Department to obtain prior written approval for any vegetative material modification located on the state highway right-of-way, including obtaining the Department's prior written authorization for vegetative material modification to provide Permit Holder property sign or facility visibility from the state highway. This includes any modifications to the earthen embankment on either side of the access connection. The unauthorized cutting of timber or damage to the vegetative material is prohibited. Criminal penalties may apply under RCW 47.40.080. Civil penalties may apply under RCW 4.24.630. The Permit Holder agrees that it shall perform all restoration work at its sole cost and expense to the satisfaction of the Department. 27. FUTURE ACCESS PERMIT MODIFICATIONS BY THE DEPARTMENT AND RIGHT OF ENTRY In the Department's sole discretion as part of its highway work program, existing permitted access connections may require modification, relocation, or replacement in order to meet current Department design standards. The Department shall be responsible to perform such modifications, relocations, or replacements at the Department's sole cost and expense. The Permit Holder hereby authorizes the Department to enter upon its lands only where necessary to modify, relocate, or replace all or a portion of the permitted access connection and to maintain traffic control devices and appurtenances associated with the Department's work performed on or near the permitted access connection. Should the Permit Holder request that further enhancements or modifications be added to the Department's work, the Department, at its sole option, may allow the further enhancements or modifications be added to its worts program provided all costs to perform the additional enhancements or modifications is at the sole expense of the Permit Holder. The Permit Holder agrees to remit the estimated costs of the work to the Department before the Department will perform the additional enhancement or modification work. The Department agrees to reimburse the Permit Holder for monies paid but not used for the work within thirty (30) calendar days after the work is performed. The Permit Holder agrees to reimburse the Department for all additional costs should they exceed the estimated cost paid within thirty (30) calendar days after receipt of a detailed Department notice. 28. FUTURE ACCESS MODIFICATIONS BY THE PERMIT HOLDER The Permit Holder shall immediately notify the Department of any changes made or proposed in the use, intensity of development, type of traffic, or traffic flow of the property or properties served by this access connection permit. The Department may require further traffic analyses by the Permit Holder if the change is significant that would require a new access connection permit and/or modifications to the access connection. The cost of a modification to this access connection shall be the sole responsibility of the Permit Holder, including the cost of modification of any access connection required as a result of changes to property site use in accordance with WAC 468-51-110, except as provided in Section 17 of this permit. 29. MODIFICATION OR REVOCATION OF PERMIT OR CLOSURE OF ACCESS CONNECTION In addition to other provisions of this permit, the Department may initiate an action to modify, revoke, or close this permit in accordance with the specific terms of WAC 468-51-110 and 468-51-120, including if., • Significant changes have occurred in the use, design, or traffic flow of the property or of the state highway, requiring the relocation, alteration or closure of the access connection, or • The connection was not constructed at the location or to the design specified in the permit, or • The permit provisions were not met, or • The connection causes a safety, maintenance, and/or operational problem on the state highway system. The Permit Holder may have appeal rights as provided under WAC 468-51-150. In addition, WAC 468-51-120(3) authorizes the Department to take immediate remedial action, including the closure of an access connection, if there is an immediate and serious danger to the public health, safety, and welfare, in compliance with chapter 47.32 RCW. This permit is also subject to any and all causes of revocation as allowed by state laws, as amended. Page 7 of 8 30. ASSIGNMENT OF PERMIT This permit is assigned to the identified parcel(s) served by the access connection and shall remain appurtenant to the identified parcel(s). Should the identified parcel(s) be inherited, sold, assigned, or transferred in any way, this permit shall run with the land to the extent that the identified parcel(s) remain in compliance with the terms of this permit, unless the permit is revoked, modified, or closed by the Department as provided by law or the current Permit Holder requests the cancellation of the permit and closure of the access. 31. HIGHWAY ADVERTISING CONTROL No signs shall be placed on state highway right-of-way. Any advertising adjacent to the state highway shall be in compliance with the Scenic Vistas Act of 1971, chapter 47.42 RCW and chapter 468-66 WAC. 32. APPLICABLE WAC's AND RCW's In addition to the specific state laws and rules identified in this permit, this permit is also subject to all applicable provisions of chapters 468-51 and 468-52 WAC, and chapters 47.32, 47.44, and 47.50 RCW, and amendments thereto. 33. AMERICANS WITH DISABILITIES ACT This permit is subject to all applicable provisions of the United States Government American's with Disabilities Act (ADA). Any current or future work shall comply with all applicable ADA requirements in effect at the time of the work Page 8 of 8 EXHIBIT "A" ■61k Washington State w. Deparbnent of Transportation Permit No. 62359 Applicable provisions are denoted by (Wj Special Provisions for Access Connection Permit Managed Access Highways Only Not for use within an Incorporated City or Town [] 1. No work provided by this permit shall be performed until the Permit Holder is authorized by the following WSDOT representative: Area 3 Maintenance Port Angeles Maintenance Facility 1707 South C Street Port Angeles, WA 98363-7456 360-565-0680 As of February 2025 Connie Rae - Maintenance Superintendent Gerald Page - Assistant Maintenance Superintendent 0 2. The Permit Holder shall only perform the construction worts authorized by this permit during the following work hours - There are no work hour restrictions and weekend work is allowed, except per General Provision #21 when no work and no traffic control is allowed during Holidays or Holiday weekends, except for traffic control needed to secure the work area. WSDOT also reserves the right to restrict or prohibit any traffic control operations when WSDOT must implement or allow other traffic control for whatever reasons WSDOT considers to be of a higher priority- 0 3. The Permit Holder, unless specified otherwise in this permit, shall only implement the Traffic Control Plans approved for this permit during the following work hours: There are no traffic control work hour restrictions and weekend work is allowed, except per General Provision #21 when no work and no traffic control is allowed during Holidays or Holiday weekends except for traffic control needed to secure the work area. WSDOT also reserves the right to restrict or prohibit any traffic control operations when WSDOT must implement or allow other traffic control for whatever reasons WSDOT considers to be of a higher priority. Q 4. Pre -Paving Inspection The Permit Holder shall contact WSDOT to request a pre -paving inspection prior to paving any Hot Mix Asphalt (HMA) or Bituminous Surface Treatment (BST), No paving shall occur without first receiving WSDOT's prior written approval to pave Failure to obtain this approval may result in WSDOT directing the Permit Holder to remove, repair, and/or add more paving at the Permit Holder's sole cost and expense. The pre -paving inspection is required to permit WSDOT to verify that the paving, before it is placed, will meet WSDOT's design requirements for the access connection. Items to be inspected include, but are not limited to, paving limits, culvert placement, material installation, side slopes, and grading of the access connection to DOT Form 224-713 Page 1 Revised 02/2020 ensure that stormwater will not flow onto the existing state highway pavement after the access connection paving is completed. a 5. Paved Access Connection The Access Connection shall be constructed with the following materials, listed from top lift to bottom lift. The thicknesses shown are minimum requirements, as additional material may be necessary to properly construct the access connection. ❑✓ See Exhibit "C " for design details and paving requirements 3 inches of Mix Asphalt (HMA) ❑ Bituminous Surface Treatment (BST), also known as chipseal inches Crushed Surfacing Top Course (CSTC) 6 inches Crushed Surfacing Base Course (CSBC) inches of Rock Cap F] Geotextile for separation or soil stabilization ❑ 6. Gravel Access Connection The Access Connection shall be constructed with the following materials, listed from top lift to bottom lift. The thicknesses shown are minimum requirements, WSDOT may require additional material as necessary to properly construct the access connection. See Exhibit' for additional desgin details and gravel requirements inches Crushed Surfacing Top Course (CSTC) inches Crushed Surfacing Base Course (CSBC) inches of Quarry Spalls inches of Rock Cap ❑ Geotextile for separation or soil stabilization ❑ 7. Culvert Installation The access connection shall include the installation of a culvert installed in a straight line and with a grade that matches the existing grade of the highway ditch or swale such that the existing conveyance of stormwater will not be adversely impacted. The culvert to be installed shall be 18 inch minimum diameter culvert ❑ 8. Culvert Beveled End Treatments The open ends of the culvert run shall be beveled to match the existing slopes of the ditch or Swale and access connection fill material. ❑ 9. Culvert End Treatments — Quarry Spalls Quarry spalls shall be placed around the open ends of the culvert. The quarry spalls shall be placed below, along the sides, and on the top of the open end of the culvert for a minimum length of two (2) feet in all directions ❑ 10. Gated and Locked Access This access connection shall be gated and locked when not in active use. ❑ 11. Access Connection for Emergency Use Only This access connection is for emergency use only and shall be gated and locked at all times to the general public. ❑ 12. Temporary Access Connection This is a temporary access connection that shall be immediately closed and removed by the Permit Holder when no longer needed, or by the date listed below, whichever comes first: When the access connection is removed, the Permit Holder shall restore the state highway right-of-way to its original condition, including reseeding if required. Failure by the Permit Holder to remove the access DOT Form 224.713 Page 2 Revised 0212020 connection as specified herein may result in WSDOT removing the access connection at the Permit Holder's expense. ❑ 13. Surety To ensure proper compliance with all terms and conditions of this permit, a surety amount in the form of a Bond, Assignment of Escrow, Certificate of Deposit, Irrevocable Letter of Credit, Check or Money Order shall be provided to WSDOT in the amount listed below. If a bond is provided, it shall be written by a surety company authorized to do business in the State of Washington. The surety amount shall be, The surety bond shall remain in force until all work under this permit has received final concurrence by WSDOT, and WSDOT issues a written release of the surety bond. 14. This is a Non -Conforming Access Connection Permit: Nonconforming Access Connection Permits (WAC 468-51-100) do not meet WSDOT's location and spacing criteria standards at the time of the permit application submittal, but denial would leave the property without reasonable access onto the public road system. Nonconforming Access Connection Permits may continue only until WSDOT determines that a Conforming Access Connection can be constructed, in such case the Nonconforming Access Connection shall be removed. Flit does not meet the minimum spacing from another adjacent driveway or public road intersection of: ❑ 125 feet ❑ 250 feet ❑ 330 feet L, 660 feet ❑ 1320 feet ❑ It does not meet the minimum corner clearance standards of WAC 468-52-040(6) of ❑ 75 feet ❑ 100 feet ❑ 115 feet ❑ 125 feet ❑ 230 feet ❑ It exceeds the number of access points for one parcel or contiguous parcels under the same ownership by one or more additional access connections. ❑ The existing topography, site conditions, and/or wetland or stream restrictions and buffers prevent the access to be constructed to current standards. Therefore, this access connection shall only continue until such time that a conforming access connection can be constructed or another access to the local street system becomes available and is permitted. Variance Access Connection Permits are only issued on Class 2 through 5 highways. ❑ 15. This is a Variance Access Connection Permit: Variance Access Connection Permits (WAC 468-51-105) may be issued, at the discretion of WSDOT, for certain connections not meeting the access classification location and spacing or that exceed the number of connections allowed by the standards adopted for a particular highway segment. ❑ It does not meet the minimum spacing from another adjacent driveway or public road intersection of, ❑ 125 feet ❑ 250 feet ❑ 330 feet ❑ 660 feet ❑ It does not meet the minimum corner clearance standards of WAC 468-52-040(6) of: ❑ 75 feet ❑ 100 feet ❑ 115 feet ❑ 125 feet ❑ 230 feet ❑ It exceeds the number of access points for one parcel or contiguous parcels under the same ownership by one or more additional access connections. ❑ The existing topography, site conditions, and/or wetland or stream restrictions and buffers prevent the access to be constructed to current standards. Therefore, this access connection shall only continue until such time that a conforming access connection can be constructed or another access to the local street system becomes available and is permitted. DOT Form 224-713 Page 3 Revised 0212020 EXHIBIT "B" T,30N R1W W\A n Zia a.r-. 48 Cc- . . . . . . . . . . EXHIBIT "C" a LEGEND —�•• —.m, P...J aom E—bft G.." ao.a �. Pawl. C-- I R V)u � (D z zo 3� 3' F do l-zcc � a O r O5 z�.n �g V Z °r`a Vz u G3 < F ��a o y U�CI Do 5 °o° SHELITKo t OF 1 DAlF-- 08/07/2025 PFRA4Tr EXHIBIT "D" Olym�c Region Traffic Management Center TMC Requirements The Olympic Region Traffic Management Center (TMC) is the central resource for tracking highway traffic activity reporting relative to all maintenance, construction, and other highway work activities that are or will be occurring in the Region. The TMC is staffed 24 hours a day seven days a week. Traffic impact activities to be called in and reported by the permit holder include, but are not limited to, the following: • Any lane closure on a state highway. ■ Any shoulder closure on a state highway in the more urban higher traffic volume areas. + Any work activity of any kind on a state highway limited access freeway. ■ Any work activity that may or does cause traffic delays or other distractions to the traveling public on a state highway. The permit holder shall call the TMC at (253) 538-3300 each time a possible traffic impact activity is about to commence or occurs. The permit holder shall call the TMC 30 minutes in advance of the activity commencing, during the activity if conditions arose that initially did not require the call -in, and at the conclusion of any activity that was reported. Information that shall be provided to the TMC each time an activity begins shall include the following: • Name of caller, State Route (SR) number, ■ SR milepost if known, or other description adequately describing the location of the activity (e.g. nearest intersection), + Brief description of the activity that is about to start, • The expected duration of the activity that is about to occur, ■ Permit number allowing the work, + Contact names and phone number(s) that allow for direct communication between the TMC and the person(s) onsite that is/are in charge of the activity that is occurring. Please note the TMC number listed above is to be used for official state business only, and is not a public number to be used for inquires or other reporting of activities on the state highway system. 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