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Home My WebLink AboutWAI2023-00087 - WAI Health Waiver - 8/25/2023 .' MASON COUNTY COMMUNITY SERVICES _ Building,Planning Environmental Health,Community Health 415 N 6 th Street,Bldg 8,Shelton WA 98584, Shelton:(360)427-9670 ext 400 ® Belfair:(360)275-4467 ext 400 El Elma:(360)482-5269 ext 400 FAX (3601 427 -7787 Application for Waiver/Appeal Amount Paid: • • Receipt Number: ) 2 i 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 MasonCounty Public Health for review. PART 1. Applicant/Parcel Identification Name of Applicant Frank Beckwith Telephone (970)846-1706 Mailing Address of Applicant 18430 NUTMEG ST SW City ROCHESTER d _ State WA Zip 98579-9115 12-digit Tax Parcel No. I Z 1 Z-5 ' Co —429044 Site Address 30 E.Lexington PI.Shelton,WA 98584 Subdivision Name and Lot TR 9 OF GOVT I MS 3-4 S 3S/177 I OF 1 OF SP 41409 S 3S/173-174 PART 2: Nature of Waiver/Appeal Contractor Certification Requirements Class B Reduction in Vertical (Installer,Pumper,O&M Specialists) Separation Food Sanitation Requirements Building Permit Review Policies Group B Water System Regulations Location,WAC 246-272A-0210 Water Adequacy Requirements Holding Tank WAC 246-272A-0240 Enforcement Timelines Mason County Onsite Standards Departmental Determinations Other Description of W aiver/Appeal(include justification,additional material may be attached.): Reduce vertical seperation to 18 inches,Pressure Districbution minimum seperation requirement is 24 inches Area is serviced by a small community water System,there are no wells with in 700 feet of the cuhjert property Applicant Signature: Date:a 1\EH Forms\Waiver-Appeal Mason County Local Revised 1/20/2017 Pagel oft • "yory cot,tisvNTt MASON COUNTY PUBLIC HEALTH Public it- Health CLASS B WAIVER WORKSHEET Always working for a safer healthier Mason County (State and Local waiver forms required) 41 S N 6th Street lbldg 81 Shelton WA,98584 Shelton-360-42➢-9670 ext 400 Boded 360 2754467 ext 400 APPNCANT NAM[ Frank Beckwith WANFN PERMIT N°„NrR WAI N„L„GAanetss 18430 NUTMEG ST SW en ROCHESTER STAT, WA ,P 98579-9115 N--„per 30 E.Lexington Pl. „Ty Shelton -AxrA,:n NNNarN —2-2+26--1-1-90090jat- III 25 r/6790d LOSEDDRAINnELDTme 0 LCNVLN1Ip'ALGR,yn. ■ COW NngNA:NNea>uIL 1.SOIL SERIES: 5.VERTICAL SEPARATION: C (1lI(� The soil series ust be Alderwood,Ha stifle,Hoodsport. Up-slope vertical separation must be greater than 18' Shelton,or Sinclair Gravelly Sandy Loam for gravity and greater than 12"for pressure. Alderwood Gravelly Sandy Loam 0 0 Greater than 12" ❑ Harstine Gravelly Sandy Loam . 0 0 Greater than 18" • Hoodsport Gravelly Sandy Loam ❑ 0 -Determined by: Shelton Gravelly Sandy Loam . ❑ Depth to hardpan • 0 Sinclair Gravelly Sandy Loam . ... Depth to mottling 0 0 Other ..........0 0 Both 0 0 2. SOIL TYPE: 6.WATER TABLE LEVEL: Soil types must be Medium Sand,Loamy Sand,or Sandy If test holes show evidence of a seasonal water table Loam.Gravel percent must be less than or equal to 359a. above restrictive layer,a curtain drain may be required Medium Sand . ❑ ❑ -Evidence of seasonal water table: Loamy Sand 0 0 o Yes 0 0 _ Sandy Loam 3 No • o Percent Gravel: ( a Pr -Curtain Drain required: -Less than or equal to 35% • LIC Yes - ❑ ,0 ilra l -Greater than 35% . 0 No • fl j 3.SOIL DRAINAGE: 7. HORIZONTAL SETBACKS: c Soils must be moderately well drained to well drained. cop PrimaryDra infield must maintain Zoo'from aowrig radb m z ent marine shorelines,surface waters,and wells. 9 Well Drained . • �'t r Moderately Well Drained ❑ .-U -Are increased horizontal setbacks met: Other ❑ ❑ Yes • No ❑ 4. DRAINFIELD SLOPE: 8.ATTENUATION ZONE Slopes must be between 3%to 30%. 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 3%to 15% ... ❑ II' gradient side of primary drainfield and 16%to 3Py property boundary: Greater than 30% 0 ❑ Yes . N ❑o The 50 foot horizontal attenuation zone is required to he recorded on the deed of the property as unbuildable (T 2 ` ....171 g�C prior to design approval. The attenuation zone is not to be Lsed for the contruction of roads,decks,patios, AFN. A/ \ parking areas,vehicular traffic or other similar such uses.The owner must agree to all these conditions Proor or am •PART • 3: Public Health Evaluation (Staff Use Only) 1. Type of Determination Required: Type of Onsit • . •pplicable) ® Appeal El Waiver ® None required ® Class A ® Class B E Class C 2. Identification of Specific Code/Standard/Determination(incl e date o .etermination or latest Code/ Standard revision) (- 0731 0 3. Nature of Appeal: ✓tr-fiC ,tl 6Cyepi.r.131/ / or re 4. Hearing Official: ® Board of Health E Health Officer E Pollution Control hearing Board ® Public Health Director ® Certified Contractor Review Board E Environmental Health Manager 5. Mitigating Factors: y/ 6. I have received this waiver/appeal request. It is complete and mitigation required by the state and local policy has been submitted. Staff Signature: Date: 10 ? P PART 4: Determine on f e Hearing Official XThe hearing offi ial 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: El 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: ` 0/'� I:\EH Forms\Waiver-Appeal Mason County Local Revised 1/20/2011 Paget of 2 Granting Waivers from Slate 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 1. I (completed br applicant) Name: (7) rF�� e I K-, yqW Local Health Department i District (2) C (.tee instructions) Address: 7 !, e, (CP-,vid-Uw f 1 Telephone: (^r2 r) �' Jc 1/7� Signature: / Property Identification: (3) L2a$ - -C((- `700Li( Section I1. (completed by applicant) WAC Number: (4) r WAC RcgsifEme-nt (5) Waiver Sought: (6) 246-2272A - 0230 ' 24' OF V/S FOR PRESSURE R) 12" OF V/S FOR PRESSURE OSS R) Subsection: TABLE VI 36" OF V/S FOR GRAVITY 18""OF V/S FOR GRAVITY 05S Justification(mitigation measures to be prodded): (7) COMPLETED CLASS B WAIVER CHECKLIST ATTACHED. (OUTLINING ADDITIONAL REQUIREMENTS MET). RECORDED DECLARATION OF COVENANT FOR ATTN. ZONE (AFN: 27,20 t 31 (9 ) Section III. I (completed Are health officer) Review Criteria: (8) Mitigation Measures(in addition to those proposed): (9) ieetti:recl1 Comments/Conditions: (JO) Type of Waiver: (/f) I ]Class A 14Class B I ]Class C—Request DOH review before granting! Yes No Neighbor Notification: (l2) Required? Yes No if needed. are agreements, easements, etc.praperdv tiled? Yes No Section IV. (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 ability to provide public health protection at least equal to that provided by this chapter WAC. I ] Denied KApproved /Granted Suh'l to all comments,conditions and requirements noted in Sections II and III. Local Health Officer (13) Date: /D L/ DOH 337-021