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Home My WebLink AboutWAI2016-00050 - WAI General - 6/8/2016 ' ON COU Public Health !� JUN 28 2016 Li Always wfing for a healthler Mason Como 415N6`"Street,Bldg 8,Shelton WA98584, BY•--- --_.__ Shelton:(360)427-9670 ext 400 4r Belfair:(360)275-4467 ext 400 ? Elma:(360)482-5269 ext 400 FAX (360)427-7787 Application for Waiver/Appeal Amount Paid: Receipt Number: Ar; E°>(to Instructions 1. Complete Parts 1 and 2.No determination can be made until these parts are fully completed. 2. Fees may be billed for waivers and appeals,based on the Environmental Health Fee Schedule. 3. Submit completed application with attachments to Mason County Public Health for review. PART 1.Applicant/Parcel IdentificationName of Applicant 6r,n7- Ca//,h Telephone 415- g-95c9 Mailing Address of Applicant 2163/ lye 2 ` C3%erzL City________________________ state I _ zip 98fl2t 12-digit Tax Parcel No. 3 V Z— 0 7 -- .- O -- 0 0 Site Address k1Ck /Vt≤ /Uoi"$h2540re—fgos, 7aA70_ Subdivision Name and Lot %M c &eac h f l o7-4- / PART 2: Nature of Waiver/Appeal ❑ Class B Reduction in Vertical Separation O Food Sanitation Requirements ❑ Building Permit Review Policies O Group B Water System Regulations I Location,WAC 246-272A-0210 O Water Adequacy Requirements ❑ Holding Tank WAC 246-272A-0240 ❑ Enforcement Timelines ❑ Mason County Onsite Standards O Departmental Determinations ❑ Contractor Certification Requirements O Other (Installer,Pumper,O&M Specialists) Description of Waiver/Appeal(include justification,additional material may be attached.): Reduce- 1iprtcn4/ 00 r 75 ' o [4 6/i b ✓ 1 over n hor4v,, flvv1ckG / uccepkb;I;3s,i 11(Qvv co Applicant Signature: 2 z411z._- (ic„ ow ) Date: 3 /9//6 1:\EH Forms\Waiver-Appeal Mason County Local Revised 12/1/15 Page I of 2 PART 3: Public Health Evaluation(Staff Use Only) 1. Type of Determination Required: Type of Onsite Waiver(if applicable) ❑ Appeal ,Waiver ❑None required ❑ Class A ❑ Class B ❑ Class C I.O(AA- 2. Identification of Specific Code/Standard/Determination(include date of determination or latest Code/Standard revision)2. -z.-i2 A. -01 3. Nature of Appeal: ice_ sba.AL M sine D . 4. Hearing Official: ❑ Board of Health O Health Officer ❑ Pollution Control hearing Board Public Health Director ❑ Certified Contractor Review Board vironmental Health Manager 5. Mitigating Factors: 1 11 • 6. I have received this waiver/appeal request. It is complete and mitigation required by the state and local policy has been sub ' S. Staff Signature: .. Date: 7_1 - PART 4: Determination of the Hearing Official The hearing official has determined that approval of this request will not adversely affect public health and is hereby granted. This decision is based on the following findings and conditions: O The hearing official has determined that approval of this request could potentially adversely effect public health and is hereby denied.This decision is based on the following findings and conditions: Hearing Official Signature: Date:1! J:\EH Forms\Waiver-Appeal Mason County Local Revised 12/1/15 Page 2 of 2 evtl/trotech Ev►,4 iteerI, t C,eotechvv.Ccat° ehvLrovt.w.entpl°DraIwage °Roadw j March 11,2016 Grant Callin 21631 NE 24'"Street Sammamish,Washington 98074 Reference: Geotechnical Evaluation for Property Located on NE North Shore Road(Parcel 32207- 50-00951), Tahuya, Washington Dear Mr.Callin, Envirotech Engineering has completed a geotechnical report, dated March 11, 2016, for the referenced property. This geotechnical report has been filed with the Mason County Department of Community Development,and provides conclusions and recommendations for constructing a single family residential structure and septic system on the referenced property. It has been determined through our geotechnical investigation that the proposed septic system, as designed by Envirotech,will not contribute to the instability of nearby critical landslide hazard areas. Thank you for the opportunity to work on this project. If you have any questions or need any further assistance,please contact Michael Staten at 360-275-9374. Sincerely, Envirotech Engineering ��,CLYDE S ,G`s`� 0 ASN T'9T App k 43045q� OA FGISTER� �SS�ONALE�G Michael Staten, P.E. Project Director JUN 082016 BY:------ --- PC OA984 SetffLr, wshLtetow9528 off: 360-2759374 CeLL: 360-689- 045 eivLroteck@geoteckü caLL fo.con