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HomeMy WebLinkAboutM050780 '---"'' '- - ' ' '-.- ' • . . , 4 Vs. commutvicksLe pusimmmtni mot.,‘E vatu. ENVIRON*AEtiTAL OtSEASE CONTROL NURSING NLARS4t4G 874 T:$71CS REAL rtrt HEALTH EDUCATt074 . .: -....„ . --=----- ...„:„.„..,, AsyL L U-'--#:'-2. jEFFERSON COLT - -- 7"1"ILEA TR DEPARTAIENT fy., :'1 , t ....-- SHERMAN .pom-x- -7-,------ --------i* fifSENO.WASW ;1 98354 inio ag--------- - VtAl , "7 547 ........... ,_te-L ;, -.: ... N.- BOARD OF HELMkAr...a.11 MEETING HEALTH DEPARTMEWir° CONFERENCE ROOM BOARD MEMBERS: ill'oill- 7 ----li . 15 ph B. O. Brown, Member A.' M.' 'O'Meara, Chairman Carroll M. Mercer, Member jrj Gael Stuart, Administrator MINLPIIRti% May 7, 71_ 080 , ) 1 t 9:30 a.m. Meeting called to order by Clazairman A. M. OMeara. Commissioner Brown was present, Commissioner Mercer W.EtS not, . i ' 1 MINUTES: The minutes of April 2, 1980 were appreor,rd. by motion of Commissioner Brown, , seconded by Commissioner O'Meara. ) CORRESPONDENCE: 1., Gael Stuart advised the Board of a letter given to Johanna Wyatt telling her of necessary work curtailment due tn et decrease in the Home Health work load. 2. Stuart read a letter from the Department of Health, Education, & Welfare informing that the County's Home Health grant application was not approved. 3. Letter from Snohomish Health District requesting information the Health Department's Budget. Mr. Stuart will respfmnd to the letter. 4. Letter from R. 0. Kinberg (attachment #1) . Mr. Kinberg's concerns were resolved at the March 5, 1980 meeting. 5. Copy of letter to Olympus Beach Tracts, Inc. regarding the water system. (attachment #2) The Board read and briefly discussed the letter. OLD BUSINESS: 1. Budget Review. (attachment *3) Mr. Stuart gave a report on the 1980 Health Department Budget along with problems and possible solutions. 2. Home Health Sliding Fee Scale (attachment *4) . Commissioner Brown moved to adopt the fees as submitted, Commissioner O'Meara seconded the motion. 3. Review of the May 2, 1980 Sewage Disposal Meeting. NEW BUSINESS: 1. Update. Southpoint Tavern water supply (attachment #5). The water supply is about 30 feet from the sewage system and after numerous correspondence, nothing has been resolved. Durant reported that there has been a number of application for permits to have food stands at the ferry landing (next to tavern) for the summer. 2. Status report on Lazy C Water system (attachment #6) . Tp!sT;er astern of Lazy C, as of April 15, 1980, has yet to be approved by November of 1978, according to a note in the file, the Board adised not to issue any further sewage disposal permits in Division 3. However, size, that time 4 sewage disposal permits and 4 site evaldations have been apProve,3. Only I complaint regarding low pressure and lz.ck of water '.t. l: 2 - Minutes of May 7, 1980 Health Board Meeting Page 2. June has been received. The Board advised Mr. Durant to continue to issue permits as in the past but water samples should be submitted. • 3. Update. On-Site Sewage Disposal - Swansonville, Port Ludlow; Roy Robeck. (attachment #7) The plans submitted by Mr. Robeck have been reviewed and found, after several site inspections, that there is an area for a drainfield but limited. The Health Department has asked the developer to provide ad- ditional holes for further determination. 4. Refund of sewage disposal permit fee for the Quilcene Fire Hall. Commis- sioner Brown moved to approve the refund, Commissioner O'Meara seconded the motion. 5. Sewage Disposal Permit Violations: a) James W. Williams, Eaglemount •(attachment #8) b) Martins of Cape George. (No response as of this date) c) Lucky Thornton Travel Trailer Park, Mr. Thornton is renting out trailer spaces to self-contained travel trailers. All of the above violations were discussed briefly. REPGRTS 1. Public Health Nurse; Phyllis Bee a) Report on nursing services (attachment #9) Mrs. Bee advised that the report is incomplete because the computer print- outs have not returned. b) Three of the five Vietnamese refugees have positive T.B. skin tests. There is a reimbursement program from the state for the Vietnamese. 2. Environmental Health; Randy Durant a) Activities Report (attachment #10) 3. Public Health; Dr. Fischnaller a) 314D Money. The State Health Officer is working to get the 314D Money increased to equal the amounts in the past years. 4. Administrator; Gael Stuart a) Completion of an audit on the WIC Program found the County's WIC Program to be the best in the state. Meeting adjourned Next meeting-, June 4, 1980 4 y_ a Eett4t ......�'�^- ,. HOME,PHONE 423-2376 OaTB�t&E f�nONEa23.6930 :. ifs` RICHARD C!. NBIERG,ht.F3.<0,C, CMIROPRAGTOR.r.4ATUROGA-TM j�"''�'y j('� 4.0 t ,t.�`w� 3 N, 1452 BROA©WAY Lr�.l L�:.i .. -�`' Lf3Nfa1.t1EW.WASH.96632 .1 ti n April 13, 1a&y APR 2 198G JEFFERSON COUNTY OF COMMISSIONERS a `fawson Gruffly e,€)',Ti3S°ot`srs Court mouse Pout Townsend, alas-in-.gton wentle:rafl; e: business meeting nab oft February 6, 19'10 unbar old business, item t 2 St Peter variance e oca a e _ss.on was given for Lot c to use my drain fj-elo on Lot -'fu __ or Estates. This situation is fine with m.,, but i uauiu`?_ks to nave one thing cleared uc first Will ttis in any may affect ,we shed e I at some future date decide to a cabin on Lot I now have a trailer with water and septic n okup. I do not see snare _,sere s'.,a__u .�.. any difference ostoe_t a trailer and a small cabin as the hookup is c-,are end a cabin ccu_d not dean a.yore people vc,.1d use tce sysiem. I could be t i_ first to c ::riain,if a drainfield earr= over Asa". Use is now at a minimal a ount. ino.-osed is a c aJ of letter -_. ___ on to ouild a stall cabin on my lot 10 umict I U cn't to at that tine, tet am using the :railer. Yours vluly, R. F. Kinberg :'10 DC RiK/ne TINIIMENEWENNA • HEALTH VITAL STATISTICS SANITATIONL1Wh7RATOiY NiALTlt iDtMGT10N. yy'zt- ,;... 2:4 �".. °t :''t . V6' • 141/4 t�a node y v ` t "'�'Ao :a .in.-ton CENTRAL ORRICE: EIS yg jan,x,,r;r 9, 2973 POET Amon.es.$w.NA NON SSTRE ' RW NCM OFFICC: COURTHOUSE . O. Linbero r° �a WASH sou 1452 Broadway } r.on vi_9d '.as "r 2n^to^. 3sar Yr. Kinberg PThis 1__is letter is to confirm ourte?cwtane conrer's- d fill onS e ^..�i. � lots 3 and if in the Pleasant Harbor tar On :tea ..b_r 50, 1972 I *jade a 4 site inspection of the two lot - ,- the possibility of locating 2 one well and two 1rainfiel4s apnro._-:.. ..ex- 75 feet = ores ofr..ottwo lots. Ffro- s t' r Ltd�e rrox-r -el-. 52 to '7 'O h x }t coz.id b: drilled aion toe rol _ e i for r»:o drain on ot 9 with rooms erouzh for a drain- field 75 feet exec fro . len- in; i._ locnt_r. strJoture ._. r: :n donev- 1 -wit? e t n. s, and r..:_or i of ore tr drajfield cc:. d . _ r= _led or Lot 10 ,rovided _ + are met. e �a, e cax3 ions pn ovinT rrovicus4: erience on l o- x :2 -r , 13 and 14, soil eaneitioas ;e r}to be sat1 .=ct, for . is n on of a septic tank and n 12: on Lot- - of�. beGI aG:.1 a or ...alter. ,s in yo _ case,. re- __ trailer sold on satisfactory. nc o sd is _t;i c 1n o _.so-it t to devrloTinv; the lots .rdslt Da-ant 1. 1 s ArN , • • f ,• r • i . . . : F At. 2 Xinberg �FERSON COUNV(CO �tir*ISSIONERS • 1452 Broadway } . Longview, WA 98632 I PORTTOWNSEND,WASHINGTON 98368 ; }yuCC T- 'AT6 Lot #10, Pleasant Harbor Estates. k May 6, 1980 MESSAGE: , 1 Inregards to your letter dated April 18, 1980, please find enclosed . the minutes from the Jefferson County Health Board meeting of March S, 1986. I hope this addresses your concerns. If you have any further questions feel free to get in touch with the Health Depart • - ment or this office. • : . ow.4parYa-ou e.,T fliT,}c..ow.x+s Lime REPLY TO 0- sia.ra REPLY • .AA,;AND s IttfACT,AAT 1 a•._+c 31r.,rf4..«. °MEI NA TOP'S COPY OP tORPPYTP4 PO'.7,M AY.,P15'tlt t ltCW'l Ve " s H4 k. STATE " " HEALTH OF f• DIAL AND SERVICES-cs'L WASHit, TON Olympwa,Washington 98SOR t +•. Day Lee Ray Governor M+r> Jyl3.a _February 12, 1980 REBEVIED FC MAY 6198i1 Mr. Roger French, P.E. eik (Olympic Peninsula Enterprises t �a JEFFERSON COUNTY 4437 Washington Street -5', BOARD Of Coisos Port Townsend, WA 98368 k. 90 Cad gfav ect: Olympus'Beach Tracts, Inc. 'ah Water System y` Dear 2'.r. French: Following are my comments regarding the subject water system. QUALITY 4 I do not consider the four sources to be artesian wells. On the contrary, they appear to be shallow spring sources resulting from run-off from the hillside. In accordance with WAC 248-54-660(3), the minimum treatment for springs shall be disinfection,'unless sufficient evidence can be provided showing that the spring originates in the stratum not subject to contamination. In order to demonstrate the existence of a protected artesian supply, the following data shoud be provided. 1. Depth to a non-artesian ground water. 2. Depth of the upper and lower confining layers about the artesian aquifer. 3. Peizometric surfaces in wells one through three. 4. Elevation of the "side outlets" of wells relative to the spring elevation.,, 5. More details regarding well construction. What features preclude non- artesian ground water from entering the casing, the side outlets, or from penetrating the artesian aquifer? 6. A description of the recharge area that supplies the artesian aquifers. The primary concern is what, if any, cen_trcl exist_ over activities • likely to adversely affect water quality (logging, spraying, human activity, etc.). 7. Provide any historical bacteriological records which would document the quality of the sources,. QUANTITY As you know, the subject water system cannot meet current source and pumping capacity requirements per Department of Social and Health Services design stand- ards for public water supplies. I have two basic concerns regarding the system: 1. The adequacy of the hydraulic capacity of the gravity distribution system to supply 20 gpm/service at 30 p.s.i.g. et— a • ..ir. Roger French = 4 February 12, 1980 Page two 2. The adequacy of the present source and storage imam instantaneous water demands perartmentcofao Social to meet amax- lth Services red book"Design StandardsforpPublic WaterSup ands Health Hydraulic CapacitySupplies". R which - Performance data (pressure and flow tests) assures that each service can provide a minimum should be at 30 p,s,i,g Your analysis should consider upperof 20 provided eleva- tion head angallons per minute d lower lots which may have excessive f lots which may lack L° consider opening a blow-off at the distal end of the friction losses. to instantaneous demand flows• the system, You may want Systea. and measuringY simulating max- pressures at various points in the Source CapacitF and Storage Source ciypatotage are Minimum a f csourcefproduction capability reAt uir d storaget , representatives from Olympusservice and nection the number nic tof dsi cotoe eekns. approval for 70 veraice cow: Beach indicated a desire to I will need additional data which addresses Your report addressesseek 51 service corrections, 1. Minimum source capacities re quired for 51 services and 70 services.2. ,Minimum standby storage requirements for 51 and 70 service connections. Your analyses of the requested data should clearly indicate any deficiencies the existing system with respect to minimum quantities. passible to gain approval in Lois requiresleo documentation oval with less than red book flows availyouable. it is of actual water use. I will acedmonths do so, data including water use during peak days. I believe the a good peak 12 of use day. Water use must be 4th of July would be active service. Simply reporting total gallonseused isd in notoadequate. used/ Storage - Appropriate valving should be provided such that each tank passed.' Each reservoir should be provided with a lockable cover, can be by- Distribution System - Provideblow-off the location of any known valves or blow- offs. If the end of the four inch line, one will be required.is at detailed map depicting the layout of the line is but for future system essential not only A more Y operations and expansion. Y for my review, '''R'L'perations - A certified o and tendoperator will be required to maintain the chlorination system, the booster pumps Water Right - The .1930 water right eay f this g• t (permit number 1510) is for 22.5gpm. Permit relative to Department of Social andThe minimum flows should be evaluated. If the Health Services application should be made far a required flow exceeds 22.5,inept of Ecology,s new water right. Contact Pat Purvis, thene men 1932ofcertificate lympi wafor r the ppropriate procedures 7 Depart- ment Olympus rightnor the 1930 application allow)me torten Ympus Beach Tracts, Incorporated water system. the Department of Socialcertify and Health Services is this severalver indicates, in addition to withdraw' rights. concerned with items SYSTEM EXPANSION I would not recommend that the system be expanded until the questions I have raised t dozer French t Are iebruary 12, 1980 -Page three - ; have'been satisfactorily answered. If you should have any further questions on this please feel free to contact me at (206) 754-1400. Sincere' , t gii Bill Liecthy District Engineer Water Supply and Waste Section Mail Stop LD-ll . 4 J SL:dab cc: Randy Durant f 4 1. a s 1 , s i I i1 I t 9 I t sA • AtleitAtelrf#3 HEALTH DEPARTMENT BUDGET 301.00 Cash.Balance $19,126.64 310.00 Taxes 311.10 Real and Personal Property 17,068.48 75,500.00 330.00 INTERGOVERNMENTAL REVENUE - /f' d,p r 333.62 314 D $ 3,484.00 333.62.02 WIC Program 11,000.00 333.62.03 MCH Grant • 23,439.00 333.62.04 Home Health 28,000.00 340.00 CHARGES FOR SERVICES 346.52 Water 150.00 346.53 Solid Waste Insp. Perm. 180.00 346.54.01 Septic Tank' 8,500.00 346.54.02 Site Evaluations 6,300.00 346.54.03 Plats 1,500.00 346.54.04 Installers & Pumpers 600.00 346.56.01 Restaurants and Cocktail 1,100.00 346.56.02 Grocery and Meat Markets 500.00 346.56.03 Food Handler 750.00 346.70.01 Vital Records 1,200.00 346.70.02 X-rays, skin tests 104.00 346.70.02 Immunizations 300.00 346.70.03 Pregnancy tests 70.00 346.70.04 Foot Care 1,200.00 $ 88,377.00 88,377.00 $183,005.00 $202,500.00 - $183,005.00 = $ 19,495.00 562.00.10 PERSONAL SERVICES .11 Salaries and Wages Extra Hire - $ 1,650.00 Clerk Hire - 6,652.00 Home Health Aide — 2,551.00 Office Supervisor (Sylvia) + 747.00 .13 Fringe - 2,496.00 Fringe (own budget) - 2,638.00 562.00.31 Professional Services 01 Dr. Fischnaller - 200.00 02 Contract Services 562.00.32 Communication - 1,000.00 33 Travel 34 Advertising - 500.00 35 Printing _ - 200.00 $ 17,140.00 $19,495.00 - $17,140 = S2,355.00 I • • w3`. PROBLEMS: 1. Raise of mileage allowance from .17 to .20. 2. Home Health Grant was not received and the income in the program could be less than anticipated. 3. Fee collections in Environmental Health have not met expectations and could continue to decrease. POSSIBLE SOLUTIONS: 1. Increase property tax for the health department. In 1978, $122,074.11 was contributed in property tax revenue to the department. This represented 77% of the budget of the department. In 1980, only $92,598.03 is being contributed to the department. This represents 33% of the budget of the department. 2. Charge school districts for services. In 1978 they contributed $5,574.00. .Now they contribute nothing. 3. Raise fees for Environmental Health service. 4. Reduce personnel. • 5 t • • • 4mi4#£ ! 4044 ,J .J . a 4, d, 44 44 44 4* tD lO 01 V 01 (.s CV N N —• O J tt 0 A Co/ O011 CT, 3 Ft. CO -A N CC/ Cr)O ON CD O CD O # O O O O O O C I I I I 1 I I I 1 I ! 1 1 + V/ M M M Ht M M 4*t t 4* M 2 a V (D C+.. . 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O (n --Ar G7 aOt a0e a0e a0e a0e Ire ae a8 ae at -4, T m m • o CO U1 (�T1 (fin A (wr1 (NJ1 (J, (T Cl < D ae ae ae ae ae ae ae ae ae ae ur r m R -41 • CO LT CT CI, (71 (T CT 01 (T tT CT, V CCD at at ae ae a8 ae a8 *4 *4 ae CD OD V Cl (T . W N K et ae at ae ae as ee ae co m V 01 CT - (J N j tO O O O O O O O O O ae ae ae ae ae ae ae at ae CO V V (7, '�' ('..i N Gn CT O O Vs O (n 01 CTCP 01 i.e ae VI ae ae ac as ae 4 .{ 1 r t j t • LE PUB' IEALTH HOME VITF ENVIRONMENTAL HEALTH e=14112FGONTROL A SING NURSING STATIt ., HEALTH EDUCATION } Af w t+1 .J JEFFERSON COUNTY HEALTH DEPARTMENT 802 SHERIDAN PORT 70WHSENO,WASH.98368 (206)315-0722 L a March 19, 1980 Wally Peterson P.O. Box 7 Quilcene, WA 98376 Ray Bucbmann ; 2106 E. 2nd Avenue Port Angeles, WA 98362 Dear Sirs: RE: Southpoint Ferry Well and Tavern Well - Jefferson County I understand from a discussion with Mr. Buchmann on February 25, 1980, control of a complete 100' radius around the ferry landing well had been consumated. Since that time, I have not heard of any further progress in gaining approval of the well. Nor has a satisfactory bacteriological water sample report from the tavern well been received by this office since January 29, 1980. Your February llth sample • arrived too old for testing at Bremerton. Please submit a bacterio- logical sample every two weeks as per our discussions and requested in my November 1979 and January 24, 1980 letters. Bill Liechty, District Engineer, DSHS, as of March 14, 1980, informed me he has not received any additional information from you or Tom Opheim of Department of Transportation regarding the ferry well. Enclosed is a copy of a recent memorandum from DSHS regarding what is necessary for approval of the ferry well. This is consistant with the guidelines you received previously. Also enclosed is the address and phone number of Mr. Bill Liechty, District Engineer with DSHS,with whom lies the responsibility for review and approval of your proposed water system. f In the interim, would you please submit bacteriological water samples every two weeks as per our previous discussions. — continued . s S' c ( If you have any questions or comments please contact this office. Sincerely, Randall M. Durant, R.S. Dir. of Environmental Health RMD/cp cc: Carroll Mercer, County Commissioner Bill Liechty, DSHS Fischnaller, M.D., Health Officer Tom Opheim, Department of Transportation 4 F !` r-, 0 • � 4 TE OF DEPARTMENT OF SOCIAL AND HEALTH SERVICES t t r � W STATE S'iINGTON o ate,ve C ♦ r Din'Lee RAY MEMORANDUM 55 DATE: February 6, 1980 RECEIVE° TO: File ,1) 3' 1 I FROM: Bill Liec lhfy., District Engineer d FF eflU SUBJECT: S00 PO UST FERRYE�t LANDING WELL, JEFFSON COIINT1EA T O ' T'H This mano will summarize the conversation I had on February 6 with Tom Opheim, Washington State Ferries regarding the South Point Ferry Landing well. Approval of the new well will be contingent upon: 1. The present well serving the tavern being abandoned. 2. The septic tank and drainfield serving a mobile home near the proposed sell will be abandoned. 3. Information regarding well construction and well log will be provided - if possible. } 4. .The topography immediately surrounding the well should be graded such - that surface spills will not enter the well. S. A sanitary seal in accordance with Department of Ecology minimum - standards for construction and maintenance of water wells, Chapter 173-160 WAC, should be provided. ''.' 6. An easement will be obtained to assure a 100 foot protective radius - around the well. 7. A detailed site map will be provided., 8. The well head will be protected from cars, trucks, and other vehicles. BL:ah cc: 4ady Durant, Jefferson County Realth District Tom Opheim, Department of Transportation — 1 1 op P:1Bt.fi.• 'i_TH K.it*E v,'AL E':%PC.,.%::NTAt NE ALTH .s t.'Ktt N:SB t;;!.S:`G 5%-:S7,C r!EALTH 801CATION ..� i�F y� ter'_/ ./^^�-^� ��1 -e= 5 ` ..4.$ �,`E JEFFERSON COUNTY HEALTH DEPARTMENT 4.N. -7 `.)". \C'Z4 q 802 SHEaDAN PORT TOWNSENO,WASH,38368 12081 3E5 3722 tu. i €mot,; �s ., -ii'''.,;% " January 24, 1980 1 Wally Pederson ii ik P.O. Box 7 Quilcene, WA 98376 Ray Buclmmann - i Re: South Point Ferry Well and Tavern Well if Dear Sirs: , Since my letter of November 19, 1979, 1 have been notified by DSHS that they have not yet received any information from you regarding the ferry well. Enclosed is another copy of "What is needed for water system approval" check- list. This is the information necessary for review by DSHS. I did receive a vacinity map noting the well location and radius from Tom Opheim, Washington State Ferries. However- it did not show what property in the radius is owned by yourself and those properties which are not. Results from your last water sample from the tavern well January 8, 1980 was satisfactory. Previous sample was not. Please continue sampling every two weeks. Gaining approval of the ferry well as immediately as possible is necessary due to a potential health hazard (DSHS letter October 18, 1979). Please submit information requested to: DSHS District,Engineer, Bill Liechty, Water Supplies and Waste Section, Health Services Division, Mail Stop LD-11, Olympia, WA 98504 Phone: 754-1400 - with a copy to this office within the next two weeks. I wish to emphasize again continued water sampling is necessary. Another sample is needed immediately as the last sample was just two weeks ago. If you have any questions or con-vents please contact this office. ,e-S-incerely, , Randall ?°. Durant, R.S. Dir. of Env. Health . Ri D1cp cc: J.E. Fisct',-aller, Health Officer Bill L echty, District r.•riner -- 4r,. C C)hf,,-, L,,,,P, c: tci,'t.«,1..{.a r,r% ,-':a` .t_r .. , i • STATE OF AR 1 MENT OF SOCIAL AND HEALTH SERVICES '"0, WASHING TON 4. ' rnc�.4.w.xa�=,9t.,,,somas I7t G.,.. ' :. ww q "�frav'x $j October 18, 1979 Mr. Randall Durant Jefferson County Health Department Multi-Services Building, 2nd Floor 802 Sheridan Port Townsend, Washington 98368 Subject: Southpoint Tavern Water System, Jefferson County • Dear Randy: In response to your recent request, I wish to offer the following comments concerning the situation :of possible contamination to the water supply for the Southpoint Tavern: It appears that the proximity of septic tanks and drainfields to the tavern well presents significant potential public health hazard. Due to the seriousness of the situation, action must be taken to assess the condition of this water system and determine a course of action which will be both adequate to protect the public health and provide reasonable recourse to the tavern establishment- By copy of this letter, I wish to urge the tavern owner, Mr. Walter Pederson, to cooperate in the gathering of the necessary information, such as well logs and monthly bacteriological sampling. It appears that in this situation, not even continuous chlorination of the tavern's water will be sufficient to eliminate the current public health hazard. As there is a second, and probably safer well, on the land owned by Mr. Pederson, I strongly suggest considering the possibility of tapping the tavern into this well, and abandoning the tavern's current source of water. _ - Sincerely, 9' .e.„. 6.4„),".€4.3, J. C. Kennedy District Engineer • Water Supply and Waste Section Mail Stop LD-11 JCK:slt cc: Walter H. Pederson meNNOINNINNON • pusuc f' TH HOME VITAL ENVIRONMENTAL HEALTH fROt. NL SF - NURSING STATISTIC HEALTH EDUCATION `. " JEFFERSON COUNTY HEALTH DEPARTMENT 802SHERIDAN FORT TOWNSEND.WASH-98363 (206)3650722 November 19, 1979 3 Wally Pederson P.Q. Boa 7 Quilcene, WA 98376 Re: South Point Ferry Well and Tavern Well Dear Mr. Pederson: Enclosed are two copies of the well log for the Bridgehaven well which was located on the spit. I forwarded one copy to Judith Kennedy, DSHS. I hope this helps. I have not received any water sample results on the tavern well since the last unsatisfactory sample. Please check to see • if one was sent in. If not please do so and then every two weeks until the water source is resolved. Also enclosed is a copy of a business card which may give you a lead on more information on your well. If you have any questions or comments please contact this office. Sincerely, Randall M. Durant, R.S. - Dir. of Env. Health -RMD/cp Encls cc: Judith Kennedy OWWWWWWOMM ANOMIMMNIMIN • • PUNUC"'A HOME VITAL ENVIRONMENTAL HEALTH NU NURSING STATIST! HEALTH EDUCATION JEFFERSON COUNTY HEALTH DEPARTMENT 3 I 802 SHERIDAN PORT TOWNSEND,WASH.98368 12003850722 A.. October 1, 1979 Walter B. Pederson P.O. Box 7 Quilcene, WA 98376 Dear Wally; i y Re: South Point Tavern - Water Supply - Jefferson County The construction and close proximity of the well to the septic tank and drainfield for the tavern are cause for concern. Increased useage of the well and sewer system due to the passenger ferry service increases the possibility of contamination of your water supply. To better evaluate this possibility and to protect the public's health as the water supply serves a food extablishment, you must begin submitting monthly batter- logical samples. Also install a well seal on the well. Please provide a copy'of the well log. This will show us how deep the well is, static water level and type of soil the casing passes through. If the well passes through clay, the water aquifer is better protected from sewage contamination. As this is an existing situation, we will work with you in maintaining this water system in a safe and sanitary manner. We will drop off water bottles at the tavern for you to use with instruc- tions. The last water sample recorded was May 15, 1979. This sample was satisfactory. John Hayes, of this office, left a bottle at the tavern on August 8, 1979. As this is a public water supply, this matter has also been discussed with the Water Supplies and Waste Section District Engineer, Judy Kennedy. Should the contamination be found, continuous clorination will be required, and if necessary, abandonment of the well. Your cooperation will be appreciated. If you have any questions or comments, please contact this office. 'ncerely, Randall M. Durant, R.S. Director of Environmental Health cc: Judith Kennedy Dr. J. E. Fisthnalier • COMMUNICABLE PUBLIC HEALTH HOME VITAL ENVIRONMENTAL HEALTH y,,,.DrJEASE CONTROL N.JRSING NURSING STATISTICS HEALTH EDUCATION ", .a=21r JEFFERSON COUNTY HEALTH DEPARTMENT a. dO2 SHERIDAN PORT TOWNSEND,WASH.98368 12081.38S-0722 41/44 April ,17, 1980 ' T >. TO: Board of County Commissioners RE: Status Report - Lazy C Water System 4 I was advised by DSHS, the water system is still not approved as of April 15, 1980. Last letter from DSHS in file dated January 4, 1979 confirms this. I have a note in the file dated November 6, 1978 from me indicates at a meeting with the board, I was advised not to deny further sewage disposal permits and site evaluations in Division 1, but to not approve any sewage disposal permits in Division 3. The note also indicates Bill Howard was present during this discussion. I checked the minutes of the November 6, 1978 meeting today and found no mention of this discussion. Since November 6, 1978, four sewage disposal permits and four site evaluations have been approved in Division 3, the latest being March 13, 1980. In Division 1, five sewaae disposal permits and 1 site evaluation have been approved, the latest being April of this year. We have had only one complaint since November 6, 1978, and this was regarding low pressure and lack of water for three days during June. This was on lot 234, Division 3. This was referred to DSHS District Engineer, Judith Kennedy. DSHS still recommends, as per Janaury 4, 1979 letter to John Swift, (which had copies to Commissioners, Bill Howard, Asst. A.G. . myself) no expansion of the system. Swift has not responded to the January 4, 1979 letter nor has DSHS followed up on enforcement or kept this depart- ment informed. Lazy C also has not su`wmitted the required bacteriological samples as per DSHS requirements. What is your recommendation on the issuance of further sewage disposal permits and site evaluations in Lazy C? cc: Bill Howard MEMO TO FILE • October 5, 1979 REw No.water,for three days to Lot 234, Division 3, Lazy C. On June 26, 1979, a complaint was received from Robert Makein, [( Lot 234, Division 3, Lazy C. He has lived at this site preman- k: ently since Christmas. The water problem began a month earlier and for the three previous days he has had no water. There was 4 plenty of pressure but tank completely dry. Owner thinks pump 5 - is out. On June 28, 1979, I was on site and was informed a Mr. Swift had fixed a- broken pipe. I was shown that water was running through -there still might be a problem with the pump due to reduced pressure. • • • • • 4 e; . $ . .,' $ , — -- . .,. .. „ . . . . „.• . . - ' ,,,_) ;- wsTAAsTEHINGOFTori 0 w _ ,,,,,DEPARZENT9,0OF SOCIAL AND HEALTH SERVICES .7.‘,,,-,-,-„:-• 41) . - V' Dixy Lee Ray Gotaemee ,!. ,•ere.* - . " 06110 , January 4, 1979 ".t. 3f.'Ff-w DV WI" . *;4 - John D. Swift and Associates, Ian. 91/5 Martin Way _ - Olympia, Washington 98503 . ------ ;-; Re: Lazy C Water System, Jefferson ' ;-. „. •. - County rt _--- Dear Mr. Swift; . . $ As you know I reinspected this water system on December 5, 1978. I have also . reviewed the information received from you on December 15. 1$ As a result, I am satisfied with the simultaneous pump test data. It indicates :$ that each well is capable of producing 30 GPM. Although airline and gauges are not available at each well it will be possible to use an electric tape or electrode sounding device, either purchased or home-made, to measure water ' _depen in each well. Screened vents were available at each well and although they were crude they are functional. It is my understanding from Mr. Tinker that the Lazy C Club, Inc. will be responsible for having the alarm lights at the booster station rewired. This will he satisfactory. ;. • As we discussed by telephone the Ecodyne chlorinator you installed has a - I maximum working pressure of 75 psi and is not capable of operating against ; . the 75-80 psi line pressures which occur at the well head. Your proposal to use a single chlorine injection point is suitable, providing that the chlorinator operates whenever either or both pumps come on. You have accurately pointed out that chlorine feed adjustments will have to be halved whenever one Bell is taken out of service. However, such an arrangement does not eliminate ; . the need for a backup chlorinator that can quickly replace the primary unit should a failure occur. This unit should be sized to effectively operate against maximum line pressure. It may be used as an on the shelf item under the control of the water system manager. Our feelings regarding potential contamination caused by nearby septic tanks, coarse soil conditions, and high ground water remain unchanged. An appropriate chlorinator must be purchased and available at the water system prior to our approval. The elevation/pressure data does not show that at least 20 psi is available at the highest lot under peak flow conditions. Using elevations of 320.6 feet for the pumphouse, 463 feet for the highest residence, 1900 feet of 3 inch ..;_:. D. Swift t� . .nuary 4, 1979 Page 2 waterline, and flow rates of 52 GPM, you find approximately 14.7 feet of friction loss. Adding values of 142 feet (152' - 10') plus 46.2 feet residual pressure (20 psi x 2.31) plus 14.7 feet of friction loss results in a minimum head requirement of 203 psi (87.8 psi). Therefore, in order to provide minimum pressure at all lots you must increase your booster pump controls to insure that the lowest pressure rating for pump activation is 88 psi. Please advise me of these alterations. These adjustments are also necessary prior to approval. Lastly, your work on the reservoir foundation was a definite improvement for the stability of the tank. Unfortunately,, there is now a small but persistent leak_from the inlet/outlet pipe connection at the tank base which will result in erosion-that may cause shifting or settlement of the newly laid foundation. This too will require correction prior to approval. `. Once you have provided written notification that these three items have been - corrected I will again conduct an inspection. Until then I can not approve , - the system and am returning your certificate of completion. Until this approval is issued, any expansion of the system must be denied. I want to clarify that fi this action comes at my decision based solely on an evaluation of the water system. 1 Three weeks should provide you with sufficient time to make all the necessary purchases, alterations, "etc. Therefore, I expect to hear from you by January 26, - 1979. Sincerely, - - a - -John M. Maxwell District Engineer Water Supply and Waste Section ' ' ES LD-ll JMM:dgs " cc: Jefferson County Commissioners efferson County Health Department William Howard, Jefferson County Prosecuting Attorney Byron Brown, Assistant Attorney General Enclosure i • • • 41-0 // :el - V��•l '� ''` - • o 4 t la €' 'f STATE OF DEPARTMENT OF SOt .AL AND HEALTH SERVICES r'` WASHINGTON amvv.Washington sas°` `w DxyFeeRav ta Governor RECEJ\'CD October 31, 1978 1 ral 2'78 'JEFF. C.i3UNTY Mr. Randy Durant HEALTH DEFT. Jefferson.CountY Health Department ? 802 Sheridan Fort Townsend, Washington 98368 11 Re: Lazy C Water System Dear Randy: 1' rovements to have been t On October 24, 1978 I conducted a reinspection of imp 1 made by May 1, 1978 on the above system, as previously detailed to Mr. ts . Sw Swift in numerous letters. Unfortunately,s I did not find all of these imp to be complete. 1. An inoperative second chlorinator. 2. Submittal of pump test data simultaneously conducted on ,, both wells. i! 3. Submittal of pressure/elevation data for the upper division. 4. Installation of a screened vent at each well. 5. .A method of measuring water depth at each well. 6. Disconnection of alarm lights wired to show malfunction of booster pumps. se Both Mr. Tinker and Mr. Swift tohave etbeen nnaadvised notified toeserdeficiencies. Mr-. Swift has been verbally itemin by December 1, 1978. Until these items are corrected I am again requesting that septic tank permits be denied on this system. Sincerely, 1 111. f 11r..:w John H. Maxwell District Engineer Water Supply and Waste Section MS ID-11 JKM:dgs cc: Lazy C Club, Inc. John D. Swift William Howard, Jefferson County Prosecuting Attorney Byron Brown, Assistant Attorney General .- CQ„`. F A' E PUPA.IC HEALTH HOME DISEASE CONT6DL NURSING NURSING STATISTICS HEAL ALENY HEAL FENTAL HEALTH TH EDUCATION t - • k j `w..i .....ram,. = -tea--4.-3y,"e 1 :-,, .: — 'N--k},- %s' F. �' `ei ` �t JEFa ERSON Cf UNT Y HEALTH _ .�LT�f DEPARTMENT _' '4. i ` �fF-- 0� ,t, 802 SHERIDAN. PORT TOWNSEND. WASH.98368 12061 385-0722 ��� •�Y� 1 April 28, 1980 a1�l 1 Henry N. Alai, P.E. Tom G. Clement ) Regional Environmental Specialists, Inc. P.O. Box 2106 Olympia, WA 98507 1 Dear Sirs: 4. RE: Sewage disposal system proposal for restaurant, Forest Hill 1 Stables - Jefferson County. r Your plans have been reviewed by David Lenning of D.S.H.S. and this i office. Several trips have been made to the site to evaluate the December, 1979, soil logs and the proposed lay out of the drainfield._ (Plans received April 2, 1980). We have the following questions and comments. 1. Please provide hydraulic analysis of pump sizing and of the distribution system. 2. Pump chamber sizing. (Chamber should be large enough to provide • for extra days flow above the high water alarm switch. - DSHS Mound Guidelines) 3. Provide additional soil logs, backhoe or hand-dug on the down slope side of the drainfield and the up slope side to determine size of area available for design of initial and reserve drain- field areas. This information will also assist in determining if-adequate treatment may occur down slope of the drainfield, up hill from where water ponds on a seasonal basis. 4. As per O.S.H.S.. Soil Evaluation Guidelines and your soil descrip- tion, we feel a .75 gallons per day per square foot is more applicable than the proposed 1.1 gallons per day per square foot. With the design, also provide a contour map utilizing two foot contours in the initial drainfield area. Stake out the proposed drainfield lines on site.. A more specific work up on the reserve drainfield area is also necessary. 5. Include flow rate generated by boat building shop and other uses of the restaurant building during,before or after business hours. Mrs. Pam Coulter has indicated the renu for the restaurant would consist of dinner only, therefore your too turnovers per day is adequate. She and Roy Robeck also indicated the restaurant would Page 2 7-4 be closed during some of the winter months, thereby relieving some loading of the system during the wettest period. 6. Use of low water use fixtures is highly recoulrended. 7. Soil conservation service representative also recommends after review of the site, the inclusion of a ditch on the up slope side of the proposed drainfield along the property line as he feels it will divert surface water away from the site. This office concurs. Please provide a copy of your revised proposal to this office and one to David Lenning and Bill Liechty, D.S.H.S., Water Supplies and Waste Section, Mail Stop LD-11, Olympia, Washington, 98504. Telephone 753-1400. Please advise when soil logs will be provided and we will schedule an inspection accordingly. Hopefully, some form of sewage disposal can be approved which meets the needs of the owner and also is in compliance A with state and local regulations. Yet to be resolved.is providing an approved water system. This would be a Class Ill System and the approving agency is D.S.H.S. Contact Bill Liechty, District Engineer, Water Supplies and Waste Section, Mail Stop LD-il, Olympia, Washington, 98504, telephone 753-1400, regarding gaining approval of the system. Secondly, specific plans and specifications for the food service operation should be submitted at such time water supply and sewage disposal reaches the approval stage. _ i Should you have any questions or comments, please contact this office and/or David Lenning. jncerely, Randall M. Durant, R.S. Director of Environmental Health • RMDfjc • cc:: Roy Robeck ,,4efferson County Board of Health Dr. J. E. Fischnaller, Health Officer David Lenning, D.S.H.S. Bill Liechty, D.S.H.S. • Jefferson County Commissioners 1st- ,. -_ 6O1l*TMOYSE • PORT TOWMSEMO.WASMNVDTDM 98369 ..14t11 % �. ...iF , �r A..M.Q'MEARA.DISTRICT 1.CNAIRMAM d 7' ' CARRDI!M.MERCER.DISTRICT 3 i_0.DROWN,DISTRICT 2 DATE: May 12, 1980 4 TO: Frances Hansen, Jefferson Co. Treasurer FROM: Board of Commissioners Please refund to the Jefferson County Fire District #2, the cost they paid for the Sewage Disposal Permit, receipt # 9928, the amount of $30.00. A. M. O'Meara Chairman B. . Brown, Member Carro M. Mercer, Member ' 010111WWWWWWW0 imas,,am,,,,,,,,,, r , , . . - , . . .-,- • . . ' ..........,... . - . Ailirahhr..m4 44-g....----.. ..............COMNIUNICABLE PUBLIC HEALTH HOME VITAL ENVIRONMENTAL HE, TH DISEASE Cowraot. NURSING NURSING STATISTICS HEALTH EDUCATION •••• , ... • ,-, ,..4110811iih. i,.• I , '''' ' - •-• -nt=ir it- iite„,,--? ..47... , o . • ........... 7 JEFFERSON COUNTY HEALTH DEPARTMENT : 802 SHERIDAN. PORT TOWNSEND, WASH. 98368 12061 385-0722 ..4'S*' 41/4 . . , April 24, 1980 4 -A4-- ' James W. Williams - 4 P.O. Box 125 Hadlock, WA 98339 Dear Mr. Williams: On at least five separate dates, beginning with April 27, 1279 to. June 14, 1979, at your request, representatives of this office made site and soils evaluations on a ten acre parcel in Section 31, Township 29 North, Range 1 West, Eaglemount area, which you were considering purchasing. These inspections were in response to your sewage disposal permit applica- tion of April 13, 1979. On June 15, 1979, you were advised in writing, the site conditions observed ' - were not aeceptable,for on-site sewage disposal as per WAC 248-96 and Jeffer- . sou County Ordinance 2-77. Much effort was made by this office in trying to assist you in any available alternative. You then proceded to purchase the property on July 11, 1979 (Assessor's records) and on October 18, 1979, it was found you had moved a mobile home onto the property without an approved building permit. You indicated during a visit by Merilee Blaine, you were using your parent's toilet. On December 14, 1979, Ms. Blaine, while making an evaluation of the adjacent property, discovered you were disposing of sewage in an improper manner (on top of the ground, below the trailer) in violation of WAC 248-96 and Jefferson County Ordinance 2-77. She discussed with you this unsanitary condition. You were advised this was unacceptable and a potential disease causing source and pollutant to ground water and possibly the nearby stream. The only option was to find somewhere on your property spitAble soils for an approved sewage disposal system. A recent visit to your property by Ms. Blaine on April 14, 1980, revealed worsening conditions. , , • James W. Williams Page 2. As this condition cannot be allowed to continue, my only recommendation is for you to provide additional soil logs elsewhere on the property to hopefully find adequate soils in a sufficient area for at least greywater dispo a1 with toilet waste being handled by use of an approved compost toilet. I wish to assist you in resolving this matter in a satisfactory manner for all concerned. -Your immediate response will be appreciated. Sincerely, Randall M. Durant, R.S. Director of Environmental Health RMD/Cp cc: J.E. Fischnaller, M.D., Health Officer 1 William E. Howard, Jefferson County Prosecuting Attorney • • • t . ww+.rrr..r /1441. wreo,f'14p REPORT OF NURSING SERVICE • MONTH APRIL, 1980 Ineomp1ete:as computer printouts are not back. • 4 April March April 1980 1980 1979 HIME VISITS 374 OFFICE VISITS 13.6 , NEWBORN 40 18 A UNDER 1 - YEAR 84 57 . 6 1 - 5 . 98 51 E 5 - 19 30 16 20 - 60 100 50 , 60 + 302 34 WC M.C.H. 106 101 145 C.C.S. 8 4 WELL CHILD CLINIC 76 71 1R ? P ACUTE COMMUNICABLE DISEASE CONTROL - IMMUNIZATIONS 189 140 6 R Y.D. 4 2 A 8 6 SCHOOL HEALTH 696 119 Seen by Nutriticnist 8 6 W.I.C. 40 4? P5 FOOT CARE 63 64 27 HOME HEALTH (AIDE) 48 36 179 HOME HEALTH (P.H.N.) , 55 34 155 • • COMMUNICABtE PUBLIC HEALTH HOME VITAL ENVIRONMENTAL HEALTH DISEASE CONTROL NURSING NURSING STATISTICS HEALTH EDUCATION 401101N►?I‘t ' 41( * - JEFFERSON COUNTY HEALTH DEPARTMENT 802 SHERIDAN, PORT TOWNSEND, WASH. 98368 12061 385-0722 • To: Jefferson County Board of Health From: Randall M. Durant, R.S. Director of Environmental Health Date: May 5, 1980 Subject: Activities - Environmental Health Section, April 1980 Field Work: Decrease in sewage disposal permits and site evaluations compared to same period last year. Minimal decrease (3 less S.D.P. & 2 less S-E.) and much less of a decrease compared to other areas of western Wash- ington. A major portion of staff time was spent on Cape George sewage disposal survey, Robecks sewage disposal, organization and pre- paration for May 2 meeting, 1000 Trails, Engman holding tank and American Campgrounds in Gardiner. Increase in food service inspections. This trend will continue through June. Other Field Work: Food Complaints Water Other Finals Follow-up Total 21 3 2 17 15 149 (115*) 207 *-Cape George sewage survey - to date. To date: Cape George Colony Cape George Village Surveyed - 82 Surveyed - 37 ` Failures - 2 Failures - 7 Possible Failures 1 Possible Failures - 3 Contacts: Office, Telephone calls, Plan review Sanitarians: 483 Telephone and office Secretaries: 147 Telephone 54 Office contacts NT Total for secretaries 689 Total for secretaries and sanitarians Total contacts year to date: 2,801 (Does not include field contacts or food handler tests) Food Handler Permits: April - 35 116 year to date Sewage disposal system repairs to date, 1900 - 5 1 111011111101110111 f .,....r,w,.,«..._ ... .,-..,... ...,.,.a,,. . y...v _.. .,we, ,. az�.Cd1AC.C.+3.A�.'11� OZ©MT•ve..3g3'1t� t9 O A f6 e e c s.1v °'cr3 e. cavasna ncrr�to -�otc -% .0 sn t. (4VaO'3 J.0 -Ss= IpCDorfctcCn ��cw �.. O a w m Qrm m cr 3 t+ J?a -t * cra a re i �. M ........ ... 7r ty*la 2 .Oi O VP�'O'N e 01 w COT V O to - y! 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N Q'V t0 N O tT CT CT CT V1 O • tC OOOtn tT co Pt 0 0 0 0 0 0 0 0 0 0 0 O _ 0 a00000000000 ' 1,0 O �.,, A A V—�O(.11 CT mo4.w,. t+ N O V Cis N-+ V O w CT toO. O '.' 00V. 0 O.UI V01*FO"1 m at a)CT as CT i� • __ CAS AAUUS -'CS'NCJ i! C•1N,i.� —. COT Ol Vt 0100-+CTCT CTO 'VJ a a a ®. 0 0• O•0 0 0 0 C. 0 0 0 0 O O a C 000 CT00000000 0 rC r{et 0 et _ CT A A- 1 wa.0.CTVa)a �� CT .�..taws--..0 NO CT�p 1-. N 1 I' f I 0 1 t0 a,CO s Co v N ,0 Li, .p O 0 tr u' to 0 00 O / -�0 - .. r wr.y • ENVIRONMENTAL HEALTH TOTALS 1979 1380 Septic Tank and Drainfield $3,683.00 (124) Site Evaluations 2,325.00 (190) 3,165:00 (158) Platting 471.00 (3 long,9 short) 495.00 (1 long, 9 short) Food Establishments 843.50 (29 restaurants 110.00 ) 25.00 (1 restaurant) C7 groceries) 00 (0 groceries) Food Handler Permits 334.00 (167) 232.00 (116) Installers, Pumpers 575.00 (19) 365.00 (li $8,374-50 $7,647.00 1 • • . . = . COMMUNICABLE PUBLIC HEALTH HOME VITAL ENVIRONMENTAL HEALTH WV-OSP CONTROL NURSING NURSING STATISTICS HEALTH EDUCATION Jr, 0 **: 4 JEFFERSON COUNTY HEALTH DEPARTMENT 802 SHERIDAN, PORT TOWNSEND, WASH.98368 f 2061 385-0722 ; 4 1114.4 BOARD OF HEALTH MEETING AGENDA May 7, 1980 9:30 a.m. Health Department Conference Room Approval of minutes of previous meeting. Correspondence Old Business A. Budget Review` B. Other Old Business New Business A. Environmental Health Problems 1. 'Update regarding Southpoint water supplies 2. Letter R..0- Kinberg - Lot 10, Pleasant Harbor 3. Bec4etts Point sewage disposal - Ron Priest, West Beach, Lot #37 4. -Lazy C 5. Update Roy Robeck: on-site sewage disposal - Swansonville, Port Ludlow 6. 4efund sewage disposal permit fee for Quilcene Firehall 7. Sewage disposal permit violations B. Other New Business Reports A. Public Health Nurse B. Environmental Health C. Public Health Officer D. Administrator The next regular meeting will be June 4, 1980. Nate ot TO & U4v( ,�.:/.{'� 5;y4:,. \LiltFngtOn II S ry ce5 ;� FROM: . F�,CE OR.CET a.u^? _<wo; ,S 5 DATE SUBJECT at j4 ffJC & re 1?/`30"Gd MESSAGE f14e ^ ts' lea �d c'4 r/ems_ fle Cerf16cs( /f Per •r f O RIE@EEUED • tp MAY 61980 ccV.0G � JEFFERSON COUNTY BOARD OF CO OF CO►MMISS#ONERS 4vt‘ �FFG'�.. pppp ORIGINATOR. DO NOT WRITE BELOW THIS LINE SIGNEDC Za:7/'S REPLY s, P , ?-"'' STATE OF DEPARTMENT OF SOCIAL AND HEALTH SERVICES S ,�. <. WASHINGTON 04M04,Washington msos Dixy Lee Ray ., Governor .C N May 2, 1980 Jim Jaeger Thousand Trails, Inc. 4800 South 188th Way Seattle, Washington 98119 Re: Thousand Trails Campground Water System, Jefferson County Dear Mr. Jaeger: t This letter acknowledges receipt of the certification of inspection and - installation for the subject water system which was signed by your engineer, Einar Gundersea. This certificate indicates that the project has been completed according to plans and specifications which were approved by this office. The system is now capable of serving 40 campsites. Sincerely, T l Bill Liechty District Engineer ' Water Supply and Waste Section Nail Stop LD-11 . . BL:dab cc: Jefferson County Health Department F C Ds • P i CERTIFICATION OF INSPECTION AND INSTALLATION OF PUBLIC WATER SYSTEM PROJECTS Effective January 4, 1978 the following Regulation applies: WAC 248-54-650 - Within sixty f days'following the completion of and prior to the use of any project or portion thereof for which plena and specifications have received the approval of the Secretary, certification shall be made to the Secretary and signed by a professional engineer that the project was inspected by him or his authorized agent and that it was constructed in accordance with the plans and specifications approved by the Secretary. Instructions: (a) If a project is being completed in stage construction, attach a map and description of portion'of project being certified as completed as approved on date given below. (b) As future portions of staged construction projects are completed, each must be certified as required by WAC 248-54-650. (c) Additional certification forms are available upon request from DSHS offices listed below. Thousand Trails Campground Water System Name of Water System DariS Water System No.-I 4800 So. 188th Way Mailing Address Referendum J i Seattle, WA 98188 No. (if any) 1111111111 City State Zip Date Plans and Specifications Approved by Department of Social and Health Services PROJECT NAME AND DESCRIPTIVE TITLE: ► (51 }.*,'Y Z© 1C,"( Phase I ►V Date Project or Portions Thereof Completed Hood Canal Preserve April 18, 1980 The undersigned engineer or his authorized agent has inspected the above-described project, which as to layout, size and type of pipe, valves and materials, reservoir and other designed physical facilities has been constructed in accordance with the plans and speci- fications approved by the Secretary, Department of Social Health Serv" s,)and in the opinion of the engineer, the installation, testing and d" in ction o e carried out in Ord'an e lwith the specifications app ved the S reta for-the project. f g1neer E = Seal:: a' 4 /f� ,/�CC) �• ' r� Y ,.e f�," Date �t�:" ju1YAL Please return completed form to DSHS office checked below. Seattle Regional Office `RI Olympia Regional Office O Spokane Regional Office Health Services Division ealth Services Division Health Services Division Water Supply 4 Waste Section Water Supply & Waste Section Water Supply S Waste Sections Smith Tower Building Mail Stop LD-l1 West 924 Sinto Seattle, Washington 98104 Olympia, Washington 98504 Spokane, Washington 99201 ci DSHS 9-346 (1-78) w - � . ,-..surN+Y:wain !j k s