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Home My WebLink AboutWAI2021-00564 - WAI General - 10/21/2021 y 415 N.6th STREET,SHELTON WA 98584 :;\ MASONT'jCOUNTY t-� SHELTON:360-427-9670,ext 400 't l' COMMUNITY Y SERVICES BELFAIR:360-275-4467,ext.400 ' ELMA:360-482-5269,ext.400 Building.Planning.Environmental Health,CommonIty Health FAX:360-427-7798 Application for Waiver or Appeal Amount Paid: °6Q " 9/- Receipt Number: s's'c-y WAI Q l COLS6 �J 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 Information Name of Applicant MAJEUR C/O B-LINE CONST. INC. Telephone 360-426-4221 Mailing Address 2971 E PHILLIPS LAKE LOOP RD. City SHELTON State WA Zip 98584 Parcel No. 22010 -- 30 -- 91002 Site Address 520 E SOUTH ISLAND DRIVE Subdivision Name and Lot LOT 2 OF SP# 3122 PART 2: Nature of Waiver/Appeal by Class B Reduce Vertical Separation 0 Food Sanitation Requirements ❑ Building Permit Review Policies 0 Group B Water System Regulations ❑ Location, WAC 246-272A-0210 0 Water Adequacy Requirements ❑ Holding Tank WAC 246-272A-0240 ❑ Enforcement Timelines ❑ Mason County Onsite Standards 0 Departmental Determinations ❑ Contractor Certification Requirements 0 Other (Installer, Pumper, O&M Specialists) Description of Waiver/Appeal (include justification, additional material may be attached.): REDUCE VERTICAL SEPARATION FOR CONVENTIONAL GRAVITY OR PRESSURE OSS CLASS B WAIVER CHECKLIST RECORDED DECLARATION OF ATTENUATION ZONE 2,t '-f 37(a_ Applicant Signature: 10 �, 1! R /a()I?C4fr4c Date: m O�ZQ�� 1'I IieF„ed x.i21201 This form may be scanned and available for public view on the Mason County Web site. Pagel 012 PART 3: Public Health Evaluation (Staff Use Only) 1. Type of Determination Required: Type of Onsite Waiver (if applicable) Appeal a/Waiver None required Class A ✓Class B Class C 2. Identification of Specific Code/ Standard/ Determination (include date of determination or latest Code/ Standard revision): WAC246-272A-0230, TABLE VI 3. Nature of Appeal: REDUCE VERTICAL SEPARATION REQUIREMENTS FOR CONVENTIONAGRAVIT')OR PRESSURE OSS, `` 4. Hearing Official: ❑ Board of Health 0 Health Officer ❑ Pollution Control hearing Board 0 Public Health Director ❑ Certified Contractor Review Board V Environmental Health Manage 5. Mitigating Factors: CLASS B WAIVER CHECKLIST (MEETS ADDITIONAL REQUIREMENTS OUTLINED WITHIN) RECORDED DECLARATION COVENANT FOR OSS ATTENUATION ZONE (AFN 2 i S '-(3 7 )_ 6. I have received this waiver/appeal request. It is complete and mitigation required by the state and local poi has been submitted. Staff Signature: W i`Itn Date: M `l g-,7 PART 4: Determination of the Hearing Official The hearing official has determined that approval of this request will not adversely affect public t, health and is hereby granted. This decision is based on the following findings and conditions: ❑ 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: (-) AAA Health Official Signature: h \-------/ Date: ( O Z ( ZI used 8 1,2017 This form may be scanned and available for public view on the Mason County Web site. P•4ue 2 of 2 MASON COUNTY MASON COUNTY PUBLIC HEALTH -. ) COMMUNITY SERVICES 1 ' / Building,Planning,Environmental Health,Community Health CLASS B WAIVER WORKSHEET 1 415 N.6TH STREET,BLDG 8.SHELTON WA 98584 (State and Local waiver forms required) SHELTON.360-427-9670,EXT.400- BELFAIR.360-275-4467,EXT.400 i ELMA.360-482-5289.EXT 400 • FAX.360-427-7798 I 3 APPLICANT NAME MAJEUR CIO B-LINE CONST. INC. WAI PERMIT NUMBER MAILING ADDRESS 2971 E PHILLIPS LAKE LOOP RD. • CITY SHELTON ;T,7F WA '1 98584 SITE ADDRESS 520 E SOUTH ISLAND DRIVE CITYSHELTON TAX PARCEL NUMBER 22010-30-91002 PROPOSED DRAINFIELO TYPE El CONVENTIONAL GRAVITY CONVENTIONAL PRESSURE i 1 1.SOIL SERIES: 5.VERTICAL SEPARATION: The soil series must be Alderwood,Harstine,Hoodsport, Up-slope vertical separation must be greater than 18" Shelton,or Sinclair Gravelly Sandy Loam. for gravity and greater than 12-for pressure. 1 Alderwood Gravelly Sandy Loam ❑ ElGreater than 12" 0 Harstine Gravelly Sandy Loam IN Greater than 18" 1251 ❑ Hoodsport Gravelly Sandy Loam ❑ -Determined by: Shelton Gravelly Sandy Loam ❑ 0 Depth to hardpan ❑ ❑ ! Sinclair Gravelly Sandy Loam ❑ ❑ Depth to mottling ❑ 0 I Other 0 ❑ Both R ❑ 1 2.SOIL TYPE: 6.WATER TABLE LEVEL: 4 1 Soil types must be Medium Sand,Loamy Sand,or Sandy If test holes show evidence of a seasonal water table i Loam.Gravel percent must be less than or equal to 35%. above restrictive layer,a curtain drain may be required Medium Sand ❑ ❑ -Evidence of seasonal water table: E Loamy Sand r❑ El Yes ru 4 Sandy Loam No 0 El - Percent Gravel: ft,0 -Curtain Drain required: O -Less than or equal to 35% in a Yes -Greater than 35% ❑ No El El 3.SOIL DRAINAGE: 7.HORIZONTAL SETBACKS: c ro PrimaryDrainfield must maintain 200'from down- radi- x Soils must be moderately well drained to well drained. 09 `O ent marine shorelines,surface waters,and wells. ,,ss,,�� I Well Drained Ly Moderately Well Drained ❑ -Are increased horizontal setbacks met: , Other El Yes No ❑ 4.DRAINFIELD SLOPE: 8.ATTENUATION ZONE Slopes must be between 3%to 30%. 1 Gravity is only allowed on slopes from 3%to 15%. A 50 foot horizontal attenuation zone is required Pressure is allowed on 3%to 30%. down-gradient of the primary drainfield. Less than 3% 0 ❑ -Is there 50 ft or greater between the down t 3%to 15% Ipi • Rgradient side of primary drainfield and 16%to 30% ❑ property boundary: Greater than 30% ❑ ❑ Yes iA F No ❑ The 50 foot horizontal attenuation zone is required to be recorded on the deed of the property as unbuildable. prior to design approval.The attenuation zone is not to be used for the contruction of roads,decks,patios, AFN: 2I (J �J(� O f 37 i parking areas,vehicular traffic,or other similar such uses.The owner must agree to all these conditions. Proof of Recording. THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE. updated 372120 17 i 3 I 1 i Granting Waivers from State On-Site Sewage System Regulations Chapter 246-272A WAC Effective Date: July 1,2007 Revised April 2017 On-Site Sewage Systems (Chapter 246-272A WAC) Request for Waiver from State Regulations Section I. I (completed by applicant) \anic. (1) MAJEUR C/O B-LINE CONST. INC. Local Health Department/District (2) (see instructions) Address. 2971 E PHILLIPS LAKE LOOP RD. SHELTON, WA 98584 Telephone: (360)426-4221 Signature: r 1 A ( (-61. AMI:(/!4 Property Identi t'in: (3) 22010-30-9100 Section IL I (completed by applicant) \VAC Number: (4) WAC Requirement: (5) Waiver Sought: (6) 246-272A— 0230 24" OF V/S FOR PR - - • (OR) 12" OF V/S FOR P• _ URE OSS (OR) Subsection. TABLE VI 36" OF V/S F• - GRAVITY 18" OF V/S FO• GRAVIT OSS Justification (mitigation measures to be provided): (7) COMPLETED CLASS B WAIVER CHECKLIST ATTACHED, (OUTLINING ADDITIONAL REQUIREMENTS MET). RECORDED DECLARATION OF COVENANT FOR ATTN. ZONE (AFN: 2(CC 1/73‘' ) Section III. I (completed by health gfficer) Review Criteria: (8) Mitigation Measures(in addition to those proposed): (9) _Pr/1. 1-0 64. Oil-e ( Comments/Conditions: (10) Type of Waiver: (l1) [ ] Class A [ ] Class B [ ] Class C—Request DOH review before granting? Yes___ No___ Neighbor Notification: (12) Required? Yes^__ No_____ if needed, are agreements. easements, eta properly filed? Yes No Section IV. I (completed by health officer) This Request For Waiver From State Regulations has been reviewed according to the provisions of Chapter 246-272A WAC On-Site Sewage Systems. The review criteria applied,and the mitigation measures proposed and/or required.have been evaluated for their abilit\ to provide public he�althh protection at le st eq 'o that provided by this chapter WAC. [ ] Denied Q(J`Approve / r to —Subject to all comments,conditions and requirements noted in Sections II and Ill. Local Health Officer (13) �� Date: /O -il - 1 DOH 337-021 Page 26 0132 Z Z e OO6LEZS OOBLEZS WLL£ZS 009LEZS OOSI£Z5 007L£ZS OOELEZS OOZLfZS OOLL£ZS OOOLQS 0060E2S N w- M,�I4,45 oZZT 's;�t na. • -- M„Ib,bS oZZT O O Yad Cr) aL ar I Ii. ..� it Y . ti • ..�, � , ,p4elsi�y;nogg cn LE co • • N� do , x u)a A >o R OR t nC a a O ,,'€ ; X 8'>: er € to z � � `U cZ 0o :: p L f ::ii"`. p , .d a 4r '"*u 3 _',. s$ - �M, o q ''r, }" �� `iry P m ` ., g qS 4 ' F &'5a t lglya a co 4 ° g 1:g y. 4 i, �g Nu E I SI g .a 2 o r d 8 C O d g� C M . 0 S a O L a a O CO t 2 O 0-- 7 1, N C Q § z m O Z U M.,6S SS oZZi M„65,SS oZZI � OO6LEZS OOBL£ZS WLLQS 0091£ZS OOSI£ZS OObICZS OOCIFIS OOZI£ZS OOIL£ZS OOOL£ZS OOfiOFLS z z ry N N a Soil Map—Mason County,Washington Map Unit Legend Map Unit Symbol Map Unit Name Acres in AOI Percent of AOI Ha 1 Harstine gravelly ashy sandy I 76.9 34.0% loam,6 to 15 percent slopes Hb Harstine gravelly ashy sandy I 1.2 0 5% loam, 15 to 30 percent slopes y 36.2% So Sinclair shott loam,5 to 15 82.1 �. percent slopes Totals for Area of Interest 226.4 100.0% USDA Natural Resources Web Soil Survey 10/3/2021 11111111 Conservation Service National Cooperative Soil Survey Page 3 of 3