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UU 3 0 2018
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ENVIRONMENTAL HEALTH FILE REVIEW
Washington County
Dept. of Health and Human Services Refer: Septic System
Environmental Health Subject: HHS Approval
155 N. First Avenue; Suite 160 Location: 2S1-1 DB-619
Hillsboro, Oregon, 97124 13280 SW 76th Ave.
Phone: (503) 846-8722 Applicant"Tyler& Margaret Ellenson
Purpose: Addition of a pavillion to existing home(allowing maintenance to tank.)
Health and Human Services requirements have been met in full: YES: X NO
Additional requirements, as follows, must be met before the Dept.
of Health and Human Services approval can be given: YES: NO: X
COMMENTS: (1.) No change of use to take place
(2.) No increase in sewage flow
(3.) All DEQ setbacks must be observed
f3t3o()g
igned date
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