On-Site Septic System Property Transfer Report

Transcription

1 4/10/2017 2:19:12 PM Application Summary: Submitted: 4/10/2017 2:18:47 PM Completed: 4/10/2017 2:18:47 PM Addresses Applicant's Address TERRY RTON EVERGREEN SANITATION INC. PO BOX 259 LAKE STEVENS, WA OSM #: 037 Property Owner CHUCK THOMPSON NE 199TH PL WOODINVILLE, WA Application No: Phone: Phone: Property Being Reported Tax Parcel Number Assessors Parcel Number: Seller's Agent Buyer's Agent Title or Escrow Company Application ID: Applications powered by the SkipThePaper

2 Property Address NE 199TH PL WOODINVILLE, WA Questions Overview Q: Is the house occupied? Q: The Construction Record Drawing included is A: Existing Q: Water Supply A: Municipal Q: Approved bedrooms according to site design A: Information unavailable Septic System - General Q: Date tank pumped last (N/A if unknown) A: 4/6/17 Q: Tank accessibility (If tanks are not accessible, the Title 13 code at the time of system approval shall apply) A: All tank(s) is(are) T accessible. The system IS in compliance according to Title 13. Q: At the time of this inspection were any risers or monitoring ports installed? A: No Q: Upon evaluation of the septic system were any repairs made? A: No Gravity Septic Systems Q: Is the septic system gravity? Q: Condition of D-Box A: Inaccessible Q: Performance Evaluation: Amount (Gallons) (N/A if not gravity) A: 450 Q: Performance Evaluation: Duration of test (Time) (N/A if not gravity) A: 1:00 Application ID: Applications powered by the SkipThePaper

3 Q: Did the system accept the water from the stress test without backing up Pressure Distribution Septic Systems Q: Does the septic system utilize pressure distribution? A: No OSM Certification Q: I certify to the best of my knowledge, that this inspection report is true, accurate and complete. Service Summary Service OSS operation and maintenance program fee $ Processing Fee. TE: this charge is from OnlineRME, LLC. $10.00 Payment Log Date Amount Description Bank Response Fee Total charges for application: $ /10/2017 $ Application Fee This transaction has been approved. 4/10/2017 $10.00 Processing Fee This transaction has been approved. Total amount Paid: $ Application ID: Applications powered by the SkipThePaper

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5 4/10/2017 OPERATION / PERFORMANCE MONITORING REPORT Environmental Health Division, SE Eastgate Way, Bellevue, WA 98007, Tel. (206) Inspection Type: PROPERTY SALE - Correction Status: All corrections made Tax ID: Inspection Date: 04/06/2017 GENERAL SYSTEM TYPE: Gravity with Pump Customer / Property Owner Name: Site Address: NE 199TH PL City: WOODINVILLE Mail Address: City: Zip: OSM Company: Evergreen Sanitation, Inc. OSM Name: TERRY RTON OSM Tel#: Submitted 04/10/2017 by: COMMENTS & GENERAL INSPECTION TES Deficencies Were Noted: Corrections were made to resolve the deficiencies. TANKS PUMPED AT TIME OF INSPECTION. COULD T LOCATE DISTRIBUTION BOX, INACCURATE DIMENSIONS ON AS BUILT. RAN 450 G. STRESS TEST SURFACING OR PONDING OBSERVED IN DRAINFIELD AREA. TANKS ARE T EXPOSED BUT ARE IN COMPLIANCE WITH TITLE 13 GENERAL SITE & SYSTEM CONDITIONS The General Site and System Conditions were: All Components accessible for maintenance, secure and in good condition: If a dye test was performed, did the dye surface? (N/A if no dye test) Effluent leaking onto the surface of the ground from any component? (If yes, explain in comments) Improper encroachment (roads, buildings, etc.) onto component(s): Component settling problems observed: Subsurface components adequately covered Period average daily flow (gallons per day) Site maintenance required (e.g. Landscape maintenance) If yes, describe in comments: Occupant compliance problem (occupant not operating the system properly). If, describe in notes: Structures connected to onsite sewage system occupied. If explain in comments: Alterations made to the OSS (valves adjusted, timer settings modified, ports installed, etc.) (If, describe in notes): Risers and lids secured: OSS Working Properly Pre-failing Signs Record Drawing Modified Record Drawing New - Corrected N/A N/A ONSITE SEWAGE SYSTEM INSPECTION DETAIL TANK: Septic Tank - 2 Compartment Effluent level within operational limits (if explain in comments): All required baffles in place (N/A = No baffles required): Effluent Filter Cleaned (N/A = Not Present): Compartment 1 Scum accumulation (Inches, if other specify): 14 Compartment 1 Sludge accumulation (Inches, if other specify): 6 Compartment 2 Scum accumulation (Inches, if other specify): 1 Compartment 2 Sludge accumulation (Inches, if other specify): 5 Pumping needed: Corrected ReportID: View inspection reports online at Page 1 of 2

6 TANK: Pump Tank Compartment 1 Scum accumulation (Inches, if other specify): 0 Compartment 1 Sludge accumulation (Inches, if other specify): 6 Pumping needed: Panel: Alarm - High Water Alarm mechanism functioning as intended: Pump: Effluent Pump Controls functioning: Pump Vault Filter cleaned (N/A = not present): N/A Tested gallons per minute flow: 60 Distribution: D-Box Component appears to be functioning as intended: Drainfield (disposal): Gravity Component settling problems observed: Surface water, downspouts diverted away from drainfield: Load test performed with satisfactory results (N/A = Not Performed): Evidence of vehicular traffic or livestock over drainfield: Observation ports present and accessible: A method, such as aeration, was used to reduce clogging of the biomat in this component (If yes, provide detail in comments): Not Inspected Corrected This report indicates certain characteristics of the onsite sewage system at the time of visit. In no way is this report a guarantee of operation or future performance. ReportID: View inspection reports online at Page 2 of 2