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SITE EVALUATION REPORT
JEFFERSON COUNTY HEALTH DEPT.
Multi -Service Building
802 Sheridan Avenue
Port Townsend, Washington 98368
(206) 385.0722
Applicant Dean W. Amdal
1
6577
Rec#ipt No:
Fee: __ 40.00 -- - - -
Date:. 8-11-83
981 Tala Shore Drive
Address: Sec. 15 Twn. 28N Rg lE
Port Ludlow, WA 98365
Telephone: 437-2294
THIS REPORT DOES NOT CONSTITUTE APPROVAL OF A
BUILDING OR SEWAGE DISPOSAL PERMIT- THOSE
PERMITS SHALL BE GRANTED ONLY UPON APPLICATION
AND WILL BE REVIEWED IN ACCORDANCE WITH
CONDITIONS AND REGULATIONS EXISTING ON THE DATE
OF THE PERMIT APPLICATION. THIS REPORT IS NOT A
PERMIT APPLICATION.
L
Lot 13, lat of Fern Bay Unrecorded plat
Legal Description (Div., 81k.. Loll
Directions for Locating Site (Draw map on back).
Site Size 120' x 700'
Seller — -- ---- — -- .
Buyer --- ---- ----- -- –
I request this site evaluation for single family residence or evaluation of existing system _
INSTRUCTIONS: A minimum or two soil log holes at least 4 feet deep, 2 feet diameter, and 50 feet apart must be dug in the proposed
drainfield area and flagged before the evaluation is made. See attached instruction sheet.
August 16, 1983 b this department and the
A site evaluation of the above property was made on y p
property has been found:
Cl ACCEPTABLE • Soil and site conditions are acceptable for installation of a sewage disposal system, as requested above, under
existing conditions and regulations.
❑ CONDITIONALLY ACCEPTABLE - Soil and site conditions are acceptable for installation of a sewage disposal system, as requested
above, under existing conditions and regulations, provided THE CONDITIONS SET OUT BELOW
ARE MET.
❑ UNACCEPTABLE - Soil and site conditions are unacceptable for installation of a septic tank system.
COMMENTS -
SOIL LOGS:
As of this date the system was functioning in approved of manner.
Respectfully,
Jo Hayes, R.S.
ENVIRON TAL HEALTH SPE IST
S/7-710 -
KAA
i
GOOD MAN INC.
Star Route 3 Box 2018
PORT TOWNSEND, WASHINGTON 98368
Phone 385.2557
CUSTOMER'S ORDER NO. PHONE y .DATE
19
NAME
ADORE G
c2 {tl
CASH C. HARG MDg,RET'D. PAID OUT
h.... cy
I
I
YTAX
SOLD HV RECEIVED BY J-
TOTAL
AN claims and returned goods MUST be
accompanied by this biN.
_ _`�ank`You
5146
SITE EVALUATION REPORT
JEFFERSON COUNTY HEALTH DEPT.
multi -Service Building
802 Sheridan Avenue
Port Townsend, Washington 98368
(206) 385.0722
Applicant _Dean W Amdal
Address: Route 1. Box 453—B
Port Ludlow WA 98365
Telephone:
THIS REPORT DOES NOT CONSTITUTE APPROVAL OF A
BUILDING OR SEWAGE DISPOSAL PERMIT. THOSE
PERMITS SHALL BE GRANTED ONLY UPON APPLICATION
AND WILL BE REVIEWED IN ACCORDANCE WITH
CONDITIONS AND REGULATIONS EXISTING ON THE DATE
OF THE PERMIT APPLICATION. THIS REPORT IS NOT A
PERMIT APPLICATION.
Rejeipt No: 2150
Fee: $30.00
Date: 4-7-81
15 __Twn. 28N Fig _ IE
Lot 13, Plat of Fern Bay, LnrecordPei plat
Legal Description (Div., Wk., LOU
Site Size
Seller _
Buyer _
Directions for Locating site (Draw map on back).
120' x 700'
I request this site evaluation for single family residence or Piz l tt tion of exi R tInn ate of
installation?
INSTRUCTIONS: A minimum or two soil log holes at least 4 feet deep, 2 feet diameter, and 50 feet apart must be dug in the proposed
drainfield area and flagged before the evaluation is made. See attached instruction sheet.
A site evaluation of the above property was made on 5-1-81 by this department and the
property has been found:
Ci -ACCEPTABLE - Soil and site conditions are acceptable for installation of a sewage disposal system, as requested above, under
existing conditions and regulations.
E CONDITIONALLY ACCEPTABLE - Soil and site conditions are acceptable for installation of a sewage disposal system, as requested
above, under existing conditions and regulations, provided THE CONDITIONS SET OUT BELOW
ARE MET.
O UNACCEPTABLE - Soil and site conditions are unacceptable for installation of a septic tank system.
COMMENTS: Observed top of steel septic tank, not rusted. Appears to be 1,000 gallon.
Portion of drainfield close to beach. System is functioning in a proper
manner on this date. Pump septic tank.
SOIL LOGS:
Respectfully.
Merilee L. Blaine, R.S.
ENVIRONMENTAL HEALTH SPECIALIST
Enclosure
76