The URL can be used to link to this page

Home My WebLink AboutWAI2022-00111 - WAI Health Waiver - 9/13/2022 415 N.6'"STREET,SHELTON WA 98584 MASON COUNTY SHELTON:360427-9670,eet 400 COMMUNITY SERVICES BELFAIR:360-275-4467,e#.400 as.ldit Fa„moy.r-m, -lo..1,c,.,,m ELMA:360-482-5269,ext.400 FAX:360427-7798 ApplicCati-on for Waiver or Appeal Amount Paid: $ -11 !L Receipt Number: Z Cu7 WAI 2U1-;k- - ool l L �§ 1'/ Instructions: 1. Complete Parts 1 and 2. No determination can be made until these parts are full com 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 CRESTO C/O B-LINE CONST. Telephone 360.426.4221 Mailing Address 2971 E PHILLIPS LAKE RD City SHELTON State WA Zip 98584 Parcel No. 3 2 0 2 6 7 7 0 0 0 9 0 Site Address 470 SE YARROW LN Subdivision Name and Lot TR9 OF SURVEY 7/57 f PART 2: Nature of Waiver/Appeal 51' Class B Reduce Vertical Separation ❑ Food Sanitation Requirements ❑ Building Permit Review Policies ❑ Group B Water System Regulations ❑ Location,WAC 248-272A-0210 ❑ Water Adequacy Requirements ❑ Holding Tank WAC 248-272A-0240 ❑ Enforcement Timelines ❑ Mason County Onsite Standards ❑ Departmental Determinations ❑ Contractor Certification Requirements ❑ Other (Installer, Pumper, O&M Specialists) Description of Waiver/Appeal (include justification, additional material may be attached.): REDUCE VERTICAL SEPARATION FOR PRESSURE OSS CLASS 8 WAIVER CHECKLIST RECORDED DECLARATION OF ATTENUATION ZONE Applicant Signature ti Aov Date A ZZ Revised 8/21/2017 This form may be scanned and available for public view on the Mason County Web site. Page I of 2 PART 3: Public Health Evaluation (Staff Use Only) 1. Type of Determination Required: Type of Onsite Waiver(d applicable) ❑ Appeal ®Waiver ❑ None required ❑ Class A VClass B c 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 PRESSURE OSS. 4. Hearing Official: ❑ Board of Health ❑ Health Officer ❑ Pollution Control hearing Board ❑ Public Health Director ❑ Certified Contractor Review Board � Environmental Heah nage 5. Mitigating Factors: CLASS B WAIVER CHECKLIST MEETS ADDITIONAL REQUIRE/ OUTLINED WITHIN RECORDED DECLARATION COVENANT FOR OSS ATTENUATON ZONE AFN 10, 6. 1 have received this waiver/appeal request. I�>4s'complete and mitigation required by the state and local policy has been submitted. Staff Signature: Date: PART 4: Determination of the H ring Official ❑ The hearing official has determ' ed that approval of this request will not adversely affect public health and is hereby grant his decision is based on the following findings and conditions: ❑ The hearing officiVhas 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: Health Official Signature: Date: Revised 8/212017 This form may be scanned and available for public view on the Mason County Web site. Page 2 of 2 ® MASON COUNTY COMMUNITY SERVICES MASON COUNTY PUBLIC HEALTH w,MMsw .Eln.—Mrana.—.„.... CLASS B WAIVER WORKSHEET 415 N.SmN STREET N-OG 9,SHELTON NN¢rear (State and Local waiver forms required) SHELTpI:]m4.I.EST.4m'oulAIR: 2ISNrl,E%T.Na ELMN:1eHe2.S299.E%T rm FA%Y!M]]'1i69 µSIIVM N.WE CNESTO GV E-LINE ag CEIRLS NON,INC. waN"O.NNJMHEP WA MNI.shater5 .11 E PHILLIPa 1PM1E RO pry 9,01. 'ran NA Saes SEE,mee,,1. E VMRCW LN CnY SHELTgY At FNQFL HJMBFP 2'N"saFr. 'FaOMWratore ❑ onfar Wlk. I♦ C[HVENIY-WLLW.Fl 1.SOIL SERIES: 5.VERTICAL SEPARATION: ThewilseriesmuAb Aldmv ,Hambne,Hoodsport Up'sbpe verticaleparanonmuslbegreaRrMan1R- SM1e)ion,or Sinclair Gravely Sandy loam. forgravityandgreater Man ITfarpressure. Alderwood Gravelly Sandy Loam............................_..❑ ❑ Greater than l2-_..........................................._......... ❑ ❑ Hafstine Gravelly Sandy Loam..........-.............._......._ ❑ ❑ Greater than l8'_...................................................... 0 ❑ Hoodsport Gravelly Sandy Loa in..................._........ ❑ ❑ -Determined lon Shelton Gravelly Sandy Loam......_..............._......._._..❑ ❑ Depth to hardpan............................................._........ ❑ ❑ Sinclair Gravelly Sandy Loam...................................❑ ❑ Depth to nothing..................................-........__... ❑ ❑ Other ...._.._❑ ❑ Both..................... .................................. 2.SOILTYPE: 6.WATER TABLE LEVEL: SO.I.Amsmustbe Medluss Sand Loamy SaF or Sandy Rtestholes Wevidencedaseawnalwaoertable Loam.Gravel percent must be kss than ore sus to 35%. above residctive layer,a curtain drain may be required Medium Sand.................................---------------- 11 ❑ 2 -Evidence of aaaspnal watertable: LoamySand....................... .....❑ ❑ B Yes....................................................._. m an .Sdy Loam._................................................._._.._...❑ ❑ No.................................................................................. ❑ ❑ s Percent Gravel: -Curtain Drain required: -Less than or equal to 35%............................... ❑ ❑ Yes.............................................................................. El ❑ -Greater than 35%............................................❑ ❑ n No...._........._........._......................................._.................. ❑ ❑ 3 3.SOIL DRAINAGE: '^� 7.HORIZONTAL SETBACKS: .re'.. „ c Soilsmustbemoderatelyweldinedtowelldmlmd. O Primary Drainfield must maintain 2oo'from down-gnarl- O Mt marl0e shorellneesufecewatee,clod WGIS p_ Well Drained.................. ❑ ❑. ...................._..................._... -fl Moderately Well Brainedd....................................... ❑ ❑ selncrease W CREW horlaontelsatbac Other Yes................... 4.DRAINFIELD SLOPE: B.ATTENUATION ZONE Slopes must betw be een 3%to 30%. Gre.,is only allowed on slopes from 3%to 15%. A50faot hafimntal attenuation zone is required Pressure Is allowed on 3%to 30%. 1 dawn-gradient of the primary drainfieid. Less than 3%................................................................ ❑ ❑ -Is there Solt or greater between the down 3%to 15%............................... ....... ❑ ❑ gradient side of primary drainfield and 16%to 30%....................................._.._...__.__...___... ❑ ❑ property boundary: Greaterthan 30%......................_.._.._...__..._....._........ ❑ ❑ Yes..........................._........._........._...._......._......................❑' ❑ No........._.................................__....__.._...__...................... ❑ 113 The 50 font homantal attenuation zone Is required to be receded an the deed orthe property as unbulldabk prior to design approval.The attenuation me is not to be used for her cammuctlon of hads,tlmks,patios, AIEN: padingareas,vehkulartherl or other similar such uses.The owner must agreeto allthese conditions. F,am,shn—caner MIS FORM WY OF SCANNIM AND PVaLAnE FOR FUNK NEW ON ME MASaN COUMV WESSIIE. uWa..'am, Granting Waivers from State On-Site Sewage System Regulations Chapter 246-272A WAC Effective Date: July I,2007 Revised April 2017 On-Site Sewage Systems (Chapter 246-272A WAC) Section I. (completed slicant fort) Waiver from State Regulations Re ue by app Name: (1)CRESTO C/O B-LINE CONSTRUCTION, INC. Local Health Department/District (2) fee instructions) Address: ........................._...-......................._.....................—_.......................................... .-_... -..-..--_----_—__----_ 470 SE YARROW LN .. -- -- -- SHELTON, WA 98584 Telephone: ( ) 360-426-4221 ....- _..........o-. ............ Signature: property lden ' i (3J ' ...................___. -..-...................-_................... —.— _ -....... —.._ TR 9 OF SURVEY 7/57 (comalete_dstyyJp fp icontl WAC Numtler14) WA_C.RRRR%Qms t 0) Waiver Sought:.(6) 246-MA 0230 24" OF V/S FOR PRESSURE (OR) 12 OF V/S FOR PRESSURE OSS (OR) Subsection TABLE VI Justification hmnvarion measures to 6e provided): (7) COMPLETED CLASS B WAIVER CHECKLIST ATTACHED, ...__ ___... .-_. ...._ .._—...... (OUTLINING ADDITIONAL REQUIREMENTS MET) RECORDED DECLARATION OF COVENANT FOR ATTN. ZONE(AFN ) Section III. (completed by heal[6ofcer,) Review Criteria', (8) Mitigation Measures(in addition tothose proposed): (9) Comments/Conditions:,.(19) Type of Waiver: (1/I 1 ]Class A [ ]Class B [ ]Class C—Request DOH review before granting? Yes_ No_ Neighbor Notification: (14) Required?.Yes_ No If needed, are agreements, easements, etc.properlvfled? 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 in tied,have been evaluated for thgir ability to provide public health protection at least equal to that provided by this chapter WAC. I I Denied ) 1 Approved /Granted—Subject to all comments,.conditions and requirements noted in Sections II and III. Local Health Officer (13) Date: DOH 111-011 Sao � As I Or C S l J'. C � c, F S ry C r 11k—`Tf 1- sfi- l SJ R.V�'1 �I WUtVIc' �S' e g ON1 AiR (1� .r✓, E1 \C1 IC�IS A.. Ariz (wA� ,5 4cf- .Al* . 1 5�6v� �4L S k—S �( Gl�szs� ��f S L So' IS 44t;, � as 8 (JOIN .— o Sca