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HomeMy WebLinkAboutWAI2022-00105 - WAI Health Waiver - 8/10/2022 WR1 aO Oocos._ /L. MASON COUNTY — s — COMMUNITY SERV ICES Building,Planning,Environmental Health,Community Health 415 N 6`h Street, Bldg 8, Shelton WA 98584, Shelton: (360)427-9670 ext 400 Belfair: (360) 275-4467 ext 400 s• Elma: (360)482-5269 ext 400 FAX (360)427-778711;(— cT I �. Application for Waiver/Appeal 1, I' AUG 1 0 2022 I. Amount Paid:• t�. !I t� Receipt Number: - ByVVN 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 Identification Name of Applicant BRUCE LANUM Telephone Mailing Address of Applicant 18225-12TH CT E City SPANAWAY State WA Zip 98387 12-digit Tax Parcel No. 2 2 0 3 2 -__ 5 1 __- 0 0 0 1 2 Site Address 871 SE SOMERS DRIVE-SHELTON Subdivision Name and Lot PART 2: Nature of Waiver/Appeal ❑ Contractor Certification Requirements ❑ Class B Reduction in Vertical (Installer, Pumper, O&M Specialists) ❑ Separation 0 Food Sanitation Requirements ❑, Building Permit Review Policies 0 Group B Water System Regulations M Location, WAC 246-272A-0210 0 Water Adequacy Requirements ❑ Holding Tank WAC 246-272A-0240 0 Enforcement Timelines ❑ Mason County Onsite Standards 0 Departmental Determinations ❑ Other Description of Waiver/Appeal (include justification, additional material may be attached.): REDUCE SETBACK FROM NEIGHBORING WELL TO DRAINFIELD FROM 100FT DOWN TO 75FT. SEE ATTACHED Applicant Signature: Qiet,$k V' 4061i) rl Date: p( � Z-2 J:\EH Forms\Waiver-Appeal Mason County Local Revised 1/20/2017 Page 1 of 2 PART 3: Public Health Evaluation (Staff Use Only) v c-vrA- 1. Type of Determination Required: Type of Onsite Waiver(if applicable) Appeal ,giver i None required Class A u Class B Class C 2. Identification of Specific Code/Standard/Determination (include date of determination or latest Code/ Standard revision) W G,y 71 _ 40 (yl 3. Nature of Appeal: LApc.. a � G 9,deC, 4-ty1-40-44, tc 4. Hearing Official: ❑ Board of Health 0 Health Officer ❑ Pollution Control hearing Board 0 Public Health Director O Certified Contractor Review Board ..B--"Invironmental Health Manager 5. Mitigating Factors: � u 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: --- c---f Date: tilIckrV'L PART 4: Determination of the Hearing Official jal_. 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: 0 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: A J:\EH Forms\Waiver-Appeal Mason County Local Revised 1/20/2017 Page 2 of 2 `' PIONEER DIGGING INC. Robert H. Paysse 3083 E Mason Benson Road Grapeview WA 98546 8/7/2022 Mason Co. Health Dept. Re: Bruce Lanum -22032-51-00012 Reference Requirement Request Mitigation WAC246- 100ft from drainfield 75ft from primary 1)Evidence of 272A-0210 (4) to private wells drainfield to confining layers and & Table IV applicant well excessive depth to ground water. 2) System will be conventional pressure with an additional 12" of vertical separation (36"total) for additional treatment beyond WAC requirements. 3)Notification to well owner sent certified mail Other attachments: • Site plan and detail • Vicinity well logs • Neighbor notification I H 60' H1// SOMERS DRIVE /, / III' I i I _ 1 PROPOSED aiioaroiiu� --—f ——T // I ,I r DRAINFIELD « . I R100' I V II • \ lon�iii/277 � I \ EXIST. I\I y\ f I�, I ,,—,_I-_--- \ WELL \�I `�*�,i ��I,k' �� \,�\� (HART) \\ II l _-� // lid/ \�\\ l 1 / I / I . I`\ \ �� / /� 1 1 / In /\ I \.\ ( ,-� // / I 1/�� 1— \ I \ t�� / 1 I �/ 0\ \ I 1 \ I----' I 1 / 1 1 1 \ \ I 1 \ r , ` 1 I 1/ 1 \\ 1 1 \\ 1- I Ijr.14_1,1 1O0 , I \ , 1 I I I I 1 \ II �\ I EXISTING I \I I ►\ \ ���50 WELL (RYAN) I \ I \ 1 \ 1 N. � , / 1 \ \ ��\� POSSIBLE FUTURE WELL \ \ I I \t , \ \ I I I", _ I , '� 100' FROM DRAINFIELDS \ I \ I I 'r=__i__-- 50' FROM TRANSPORT LINES APPROX. �I— \\ 1 I 50' FROM TANKS TOP OF I \ I \ / STEEP `N. \ / SLOPE I PROPOSED T \�, I— __ _ DRIVEWAY APPROX. ]I _ 1 WATERLINE, MAINTAIN 10FT+ SHORELINE I TO SEPTIC LINES AND COMPONENTS I TOTTEN I I INLET 1 r--7 PROPOSED 7 # TRANSPORT LINE. AV. MI APPROX. 1'Aq BUILDING OZ. �\� (MAINTAIN �Iw WAS • 50FT TO WELLS) I SITE I ��P�� .,�.Poy„„; �t . .f �. \ — /4 2.:....-.OB •�!• ,AYSSE �i� \ o D EXPIRES Avi. PROPOSED TANKS \\ LOCATION \ I \\ I AN ASBUILT/INSTALL SIGNOFF FEE WILL \ BE CHARGED AT TIME OF INSTALLATION k PIONEER DIGGING INC. CUSTOMER: BRUCE LANUM TEST HOLE I: TEST HOLE 2: PARCEL# 22032 51-00012 0 6 DK ILLS o-12 DIRTY FILL 6-52 I-MS 12-48 LMS SEPTIC DESIGNS ADDRESS: 871 SE SOMERS DRIVE / 3083 E MASON BENSON R.D. GRAPEVIEW,WA 98546 DESIGNER: ROBERT H.PAYSSE DISCLAIMER:THIS IS NOT A SURVEY.REFERENCES INCLUDE:APPLICANT/COUNTY PROVIDED PLATS OR SURVEYS.FIELD MEASUREMENTS AND COUNTY GIS DESIGN INTENDED FOR SEPnC OFFICE-360-426-1803 FAX-360 427-2353 SHEET: SITE PLAN SCALE 1"=50' PURPOSES ONLY. PROPOSED DEVELOPMENT MAY BE SUBJECT TO OTHER DEPARTMENT/AGENCY REVIEW.DESIGNER NOT RESPONSIBLE FOR SETBACKS UNRELATED TO SEPTIC COMPONENTS. • ' 0Z032,- 5-1 -014 • ' ;,..... . : WATER WELL REPORT Start Card Mo 087508 '•N• STATE OF WASHIMGTOM Water Right Permit No. .;:, =ram= •:�:.. '�' cu:ssir�rs-szM:sa:sxsc+zssss-c �a 's"�-1;4.4.1 Address 2228 CRYSTAL SPRINGS RD TACOMA, WA 98466- n •4°•': QIHER Mace BROWN, ESTiIER ""4 'A2)'•;.':LOCATION OF WELL: County MASON - SV 1/4 SW 1/4 Sec 32 T 20N M., R 2V UN '/..1'-ff:?( ) STREET ADDRESS OF WELL (or nearest address) SOMERS RD — .- ---—...-- -- : ' }p Kassa ` USE: DOMESTIC (10) WELL LOG -. =' (3) PROPOSED ... . . (+i) TYPE OF WORK: Owne 's Number of well Fand structure,Describe and shoow thickessrofter,aquifize ers of the kind :� �� '(If more than one) NEW WELL Method: ROTARY and nature of the Materiel In each stratum penetrated, with --_= at least one entry for each change in formation. - (5) DIMENSIONS: Diameter of well 6 inches Rpi TO • Drilled 188 ft. Depth of completed well 188 ft. MATERIAL • F0 1 --•-•--- --- • - ---•••_._ ----_"ma's men now ORGANICS 1 1 (6) CONSTRUCTION DETAILS: BROW DRY SAND . 133 35 33 Casing installed: 6 " Dia. from +1 ft. to 188 ft. BLUE DRY SAND 35 5 WELDED " Dia. from ft. to ft. BLUE CLAY L SAID" Dia. from ft. to 43 43 ft. GRAY CLAY 55 55 HARD GRAY CLAY 67 64 67 Perforations: NO • GRAY SILTYSAND CLAY 64 67 - Type of perforator used BROWNSILTYSANO CLAY 67 0 SIZE of perforations in. by in. GRAY CLAY 75 75 perforations from ft. to ft. BROW PEAT • perforations from ft. to ft. GRAY CLAY 78 103 perforations from ft. to ft. HARD BR04N PEAT1O3 107 107 SOFT GRAY CLAY 117 117125 Screens: MO BROW CLAY 125 12 Manufacturer's Maras GRAY CLAY 131 1331 * Type Model Mo. GRAY CLAY GRAVEL • 133136 Diem. slot size from ft. to ft. GRAY CLAY• 143 Diem. slot size from ft. to ft. BROW DARK CLAY & SAND 13616 146 HARD GRAY CLAY Gravel pecked: MO Size of gravel143 146 DRY BLACK CLAY & SAND 165 165 Gravel placed from ft. to ft. DRY GRAVEL SAID SAND & GRAVEL WATER 165 175 175 17 Surface seal: YES To what depth? 20 ft. HEAVING GRAVEL PEA GRAVEL Material used in sal BENTONITE Did any strata caitain unusable water? NO Type of water? Depth of strata ft. • Method of sealing strata off (7) PUMP: Manufacturer's Name H.P. Type _ (8) WATER LEVELS: Land-surface elevation • above mean sea level ... ft. Static level 161 ft. below top of well Date 07/01/92 Artesian Pressure lbs. per square inch Date Artesian water Controlled by stork started 07/01/92 Completed 07/01/92 _y - • - (9) WELL TESTS: Dr.wdown is amount water level is lowered below WELL CNSSTUC ed CERTiFICATIOMtsrespOnsibitity for con- static level. Was a pump test made? NO If yes, by whom? struction of, this well, and its caepliance with all Yield: gal./site with ft. drawdown after hrs. Washington td sthee informat well �truction reported above are true Materials bee knowledge and belief. Recovery data Time Water Levet Time Water Level Time Water Level MAME ARC(PeS DRILLING I rm, or ration) (Type aa'print) • ADDRESS SE 170 WALKER PARK RD Date of tat / / License Mo. 0950 Bailer test gal/Min. ft. drawdown after hrs. (SIGMEDI • Air test 10 gal/min. W stem set at 178 ft. for 2 hrs. 'Artesian flow g.p.m. Date contractor's Temperature of water Was a chemical analysis made? MO Registration Mo. ARCADDi147K1 Date 07/02/92 messes AilifW--c�--rill=== sr"a=--This=7a tax=__m=� - - i - . Printed From Mason County DM Printed from Mason Cc nE'y DMS 2 2 032, -5 1-000ll0 WATER WELL REPORT Start Card No. W055982 Unique Well I.D. A AHP164 STATE OF WASHINGTON Water Right Permit No. S. (1) OWNER: Name ALAN C. BATES Address SI 851 SCUM DR 83QLTON, MA 98584- Cli (2) _ __LOCATION OP WELL, Count MASON . Ids (2a) STREET ADDRESS OF WELL (or nearest address) SAMI, SBJLT0A - SI 1/4 SW 1/4 c Sec'32• T 20N N. R 2W WM __ (3) PROPOSED USE: DNNWYSTIC = (10) WELL LOG -- (4) TYPE OF WORK: Owner's Number of well Formation; Describe by color, character, size of material H (If more than one) and structure, and show thickness of aquifers and the kind = NEW WILL Method: CABLE and nature of the material in each stratum penetrated, with .i.+ at least one entry for each change in formation. C (5) DIMENSIONS: Diameter of well 6 inches 0 Drilled 184 ft. Depth of completed well 184 ft. MATERIAL FROM TO - _. BLACK FILL DIRT 0 4 0 (6) CONSTRUCTION DETAILS: BROWN SANDY CLAY 4 48 ;4„� Casing installed: 6 " Dia. from +1 ft. to 184 ft. PIA GRAVEL AND SAND 48 54 OS MILD= CASING " Dia. from ft. to ft. BLDI CLAY 54 69 E " Dia. from ft. to ft. BROWN PEAT BOG 69 73 C)4r IL=E SILT CLAY 73 80 Perforations: ND GRAY SANDSTONE SOFT 80 89 C Type of perforator used BROWN PEAT BOG 89 104 SIZE of perforations in. by in. BLUR CLAY 104 134 CO perforations from ft. to ft. BROM SANDY CLAY 134 140 . perforations from ft. to ft. BROWN BARD PAN 140 147 L perforations from ft. to ft. RID CLAY BAND S GRAVEL 147 154 o _,. BROWN CLAY GRAVEL Q WATER 161 ..0 C: NO ILDI CLAY 1 179 L. Manufacturer's Name BANDY GRAVEL 179 183 OS Type Model No. ILACR C2 RNTED SAND 183 Diam. slot size from ft. to ft. 4.1 Diam. slot size from ft. to ft. It.: ,43 17 (3 1E3> . ❑ Gravel packed: NO Size of gravel � ' ... CD Gravel placed from ft. to ft. y.-; `4-i Surface seal: YES To what depth? 20 ft. a x- IV LT' >1 Material used in seal BENTONITE le C: Did any strata contain unusable water? No Y - 03 Type of water? Depth of strata ft. E..- pw {`Ti 6., Method of sealing strata off -.,C Ca 4r __----- --__ _ ,�,.. a (7) PUMP: Manufacturer's Name '¢c====.=>v==.==�................. `G= Type H.P. I— O (8) WATER LEVELS: Land-surface elevation Z above mean sea level ... ft. H Static level 155 ft. below top of well Date 10/15/94 CDArtesian Pressure lbs. per square inch Date 0 Artesian water controlled by 'Q Work started 10/07/S4 Completed 10/15/94 >I (9) WELL TESTS: Drawdown is amount water level is lowered below WELL CONSTRUCTOR CERTIFICATION: 0 static level. I constructed and/or accept responsibility for con- was a pump test made? NO If yes, by whom? etruction of this well, and its compliance with all V Yield: gal./min with ft. drawdown after hrs. Washington well construction standards. Materials used W and the information reported above are true to my best knowledge and belief. ORecovery data Time Water Level Time Water Level Time Water Level NAME ARCADIA DRILLING INC. C (Person, firm, or corporation) (Type or print) d ADDRESS SI 70 +' P • ,RD ya Date of test ./ / / . . QL. Hailer test I5 gal/min. 6 ft. drawdown after 1 hrs. [SIGNED) ./ .gr �/ _j License No. 0950 . Air teat gal/min. w/ stem set at ft. for hrs. ID Artesian flow g.p.m. Date Contractor's ❑ Temperature of water Was a chemical analysis made? NO Registration No. ARCADDIO983:1 Date 11/17/94 (10 — . , • WATER WELL REPORT CURRENT t,t, ,,,,I Original&1"copy-Ecology,2"copy-owner,3'''copy-driller Notice of Intent No. WE05821 Unique Ecology Well ID Tag No. AL7495 Construction/Decommission("x"in circle) Water Right Permit No.EXEMPT WELL El Construction ❑ Decommission ORIGINAL INSTALLATION Notice Property Owner Name W.G.PROPERTIES INC. .53 I (1�`- of Intent Number Well Street Address 921 SE SOMERS DRIVE PROPOSED USE: m Domestic ❑ Industrial 0 Municipal City SHELTON County MASON ❑DeWater ❑Irrigation 0 Test Well ❑Other Location SW 1/4-1/4 SW 1/4 Sec 32 Twn20N R2W Event 0 cheer: TYPE OF WORK: Owner's number of well(if more than one) LOT 8 wwm ❑ one m New well ❑Reconditioned Method.❑Dug ❑Bored ❑Dnven❑Deepened El Cable m Rotary 0 teRed (Lat/Long(s,t,r Lat Deg Lat Min/Sec Still REQUIRED) DIMENSIONS: Diameter of well 6 inches,drilled 200 ft. Long Deg Long Min/Sec Depth of completed well 195 ft. 220325100008 Tax Parcel No. CONSTRUCTION DETAILS Casing m Welded 6 " Dram from+2 ft.to 195 ft. Installed: Diam.from ft to ft to ft•ft. CONSTRUCTION OR DECOMMISSION PROCEDURE 8 Lrnennstalled Threaded " Diam.from Fo matron: Describe by color,character,size of material and structure,and the kind and Perforations: ❑Yes 0No nature of the material in each stratum penetrated,with at least one entry for each change of Type of perforator used information. (USE ADDITIONAL SHEETS IF NECESSARY.) , SIZE of perfs in.by in and no.of pods from_ft.to�ft. MATERIAL FROM TO _ 0 6 Screens: ❑Yes l�No ❑K'PaL' Location BROWN SILTY CLAY,GRAVEL 26 Manufacturer's Name ---- BROWN SILTY SAND,SOME GRAVEL 6 Type Model No. — GRAY STICKY CLAY 26 96 Diam from ft.to ft. Diann Slot size ptyn. Slot size from ft. ft. BROWN SILTY CLAY 96 114 to 114 132 [21 No 0 Size ofgraveLhand GRAY STICKY CLAY Gravel/Filterviaplaced packed:❑Yesft to ft. BROWN CLAY 132 153 Materials from 167 Surface Seal:©Yes ❑No To what depth?20 R. BROWN SILTY CLAY,SOME GRAVEL 153 BROWN SILT,GRAVEL,WET 167 173 Material used in seal BENTONITE CHIPS GREEN SILT,GRAVEL,WET 173 190 Did any strata contain unusable water? El Yes la No 190 200 - Depth ofstrata GRAVEL,SOME SAND,WATER Type of water?— _ Method of sealing strata oft PUMP: Manufactures sName fi P Type: - - WATER LEVELS: Land-surface elevation above mean sea level ft Static level _170 _ ft.below top of well Date 1/3/07 - Artesian pressure —lbs.per square inch Date Artesian water is controlled by valve,eta WELL TESTS: Drawdown is amount water level is lowered below static level Was a pump test made?❑Yes m No If yes,by whom? ft.drawdown after hrs. Yield' Pal/min.withhrs. Yield dal/min.with ft drawdown after Yield: gal./nun with_ ft.drawdown after hrs. ti-...�b� Recovery data(hme taken or zero when pump turned c f)(water level measured from well top to water level) Time Water Level Time Water Level Time Water Level FER A 0 9007 — — N1'ashineto,� Mate Bate test Dep:j-tment o.t Ecology Baderr t test gnllmin.with ft drawdown after hrs. Airiest 20 gat./min with stem set at 100 ft.for 1 his. Artesian flow g.p.m. Date^____ Temperature of wafer Was a chemical analysis made? ❑Ycs m No Start Date 1/3/07 Completed Date 1/3/07 WELL CONSTRUCTION CERTIFICATION: I constructed and/or accept responsibility for construction of this well,and its compliance with all Washington well construction standards. Materials used and the information reported above are true ARCAD my IA IA DRILLING INC best e and belief. El NELSON Drilling Company Driller 0 Engineer❑Trainee Name(Pnn Driller/Engineer/Trainee Signature Address PO BOX 1790 _- _ City,State,Zip SHELTON WA 98584 Driller or trainee License No 1886 — If'rRAINEE egistra Contractor's . ARCADDI098K1 Date 1/5/07 Rtion NoDriller's Licensed No. - Driller's Signature Ecology is an Equal Opportunity Employer ECY 050-1-20(Rev 3/05) Pioneer Digging Inc. 3083 E. Mason Benson Rd. Grapeview, WA 98546 CHRISTOPHER J RYAN 863 SOMERS DR SE SHELTON WA 98584 Mr. Ryan: I am a Septic Designer working with your neighbors on Somers Drive,Bruce Lanum, on a new septic design. This letter is to inform you that Bruce has made application for a waiver to locate their septic drainfield closer than the standard setback of 100 ft. from the well located on your parcel,but not closer than 75ft. Actual distance from the proposed primary drainfield is 85ft to the lowest point on the primary system. Washington State allows these setback reductions provided it meets specific mitigation measures which include enhanced treatment prior to disposal, and evidence of confining layers. This proposal design will meet all required mitigation measures. I have attached the site plan from the design for your information. We are required to notify you of this application as part of the review process. If you have any questions or concerns you may contact myself or Mason County Health Department at the numbers below. Thank you for your time. Pioneer Digging Inc. - 360-426-1803 - (Robert H. Paysse/Designer) Mason County Health Department - 360-427-9670 -Ext. 400 U.S. Postal Service"' CERTIFIED MAIL° RECEIPT Domestic Mail Only Q' For delivery information,visit our website at www.asps.corn Sh oir ( 1 1 A L USE r- Certified Mail Fee $4.i++1 038E $ sit CIO '1. 05 Extra Services&Fees(check box,add Me te) Y- (/ m ERL 5s �i Io$ to i ( Hero ❑Adult Signature Required $ $il..0lt . ❑Adult Signaturo Restricted Delivery$ 1/40: O Postage ra $ 0I • Total Postage and Tr.o = bil I U Sent - O Street and A .N(a. or PO-air\:1rC airy tiara, '+4 • V S$LI PS Form 3804,April 2015 PSN 7530 02-000 0047 See Reverse for Instructions