Loading...
HomeMy WebLinkAboutWAI2026-00011 - WAI Health Waiver - 2/26/2026 • 415 N.6"'STREET,SHELTON WA 98584 SHELTON:360-427-9670,ext 400 MASON COUNTY BELFAIR:360-275-4467,ext..400 4 .ii:. COMMUNITY SERVICES S i�u t cd�t '.O, u2;i:n•;.tt isin n!.i U.:.i h. WW1' .Sy Ntah ti d� Application for Waiver or Appeal r G� Amount Paid: 0 Receipt Number: 2Y Z4 00 ` WAl ?"0 - 000IS Please note,all approved Onsite Waivers have the same expiration date as their OSS Permits. 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 l(C-/-414-4-O ik ST-Evem 12a- Telephone , ' ' '- Mailing Address 6q(I 'W C4,062_04(.,L.A)// / City H A State l vA Zip CF52, Parcel No. ° a '' -- -- 0 _C a 2— 0 Site Address 6 9 I ( vt/ 64,0 -t) Subdivision Name and Lot PART 2: Nature of Waiver/Appeal ❑ Onsite:Class A Waiver 0 Food Sanitation Requirements O Onsite:Class B Waiver 0 Group B Water System Regulations ,t Onsite:Class C Waiver 0 Water Adequacy Requirements ❑ Onsite: Location,WAC246-272A-0210 0 Building Permit:EH Review Policies ❑ Onsite:Holding Tank,WAC246-272A- 0 Appeal:Enforcement Timelines 0240 0 Appeal:Departmental Determinations O Onsite:Contractor Certification ❑ Other Requirements Description of Waiver/Appeal(include justification,additional material may be,attached.): Ai-'- IN `T1-4 pgiocc5S Dr" /4 /- t 111-y C-6F-mPTIDA) & 1-07-- cry 11 o1V:Sfon) ANO 11-41/6- 4r✓ C-6j5riu 6 wCt;i.- 77-h47 , /op ' f 20rCcrivt- 12,401 us MAT' i i.s'(iX. 1)FCC-r- Fit,CiM9A— O.Uru 6iQG ' Di if/10A0 /'/ i:C -it 9o1-I- Do--- 02_000, (4t. 0(74,440,io 00C-s ttloT- SI.6jJ R4S1124Gt1V Z eovE-Am-4S` Onl Woe._ foraoMenr S: Applicant Signature: ( - Date: 'Z/?/202_ Revised 9/291/2025 This form may be scanned and available for public view on the Mason County Web site. l':ige I of 2 3 PART 3: Public,Health Evaluation (Staff Use Only) 1. Type of Determination Required: Type of Onsite Waiver(if applicable) o Appeal '',Waiver o None required o Class A o Class B \"Class C = Local 2. Identification_of Specific Code/Standard/Determination (include date of determination or latest Code/Standard revision): 7- Z-�''Lk o'47---c> 3. Nature of Appeal: 4. Hearing Official: ❑ Board of Health O Health Officer ❑ Pollution Control hearing Board O Public Health Director ❑ Certified Contractor Review Board M Environmental Health Manager 5. Mitigating Fa tors: CO kfe„ 035111 - 1119 %ph IA c6ri r‘ortvie4-O, rote.Noct-- 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: h f 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' — l Health Official Signature: Date: " Revised 9/29/2(125 This form may be scanned and available for public view on the Mason County Web site. Page 2 or 2. • On-Site Sewage Systems (Chapter 246-272A WAC) Request for Waiver from State Regulations Section L (Completed by applicant) Name:(1) Local Health Jurisdiction Received(2) (See instructions) Address: ---...- -___4.51_1 t ....lit✓ Gz(,J.A.4LU,M.._ _. --_ _ __.._.__. ..... ......... . ....._._ µTelephone: :360 S.56.- 5) 7. Signatur Property Identification:(3) ik 430,x) G ...P .ect"` ..Lf190,1—.is— 00_v.Z.r Section II. (Completed by applicant) WAC Number:(4) WAC Requirement: (5) r Waiver Sought:(6) C-+_, 0.a.) 0 F —24672-72 - 03 -O .PUP et? PR0 cno...0 -2_0,06L. (n)arc--la PiO7'c-c-`ti0A1 Z- Subsection.(2) l b�( 1t i,/ 01 vs 1 1RoVN4 W C-cL. 'R b't,9 P ec-'r CAN oNE- S o6, Justification`(Proposed mitigation measures):(7) P‘ 73)0_6 or pr roP 6ezinj Lr,3's. GREED nt AM an/© 6co u/L.�E c,� !jam -a Li izqo 0-02_030) �vSr t• v�s I s `Pme3-674 4N4 0o6s 6-tor- tQ-��:un...,� RFspietc-riv6_ C.ov6NA.Hi Section III.. I (Completed by local health officer) Review Criteria:(8) Additional Mitigation Measures:(9) Comments/Conditions:(10) Type of Waiver:(11) Class A Class B (CTa—siD Request DOH review before granting? Yes No Neighbor Notification:(12) Required?Yes No If needed,are agreements,easements,etc.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 ability to prde public health protection at least equal to that provided by this chapter WAC. Denied Approved/Granted Sub"et°to all comments,conditions and requirements no ed"in Sec ns it and lii. Local Health Officer(13) Date: L } r DOH 337-175 February 2024 1 Rhonda Thompson From: Parker, Roger J (DOH) <Roger.Parker@doh.wa.gov> Sent: Wednesday, February 25, 2026 1:35 PM To: Rhonda Thompson Cc: Ian Tracy Subject RE:Class C waiver request for Mason County Hi Rhonda, Thanks for the nudge. I totally meant to get to this earlier this week. For the Class C waiver,we agree that this one seems appropriate. Thank you for asking. Roger Parker,.RS,CHES OSS Technical.Assistance Staff Wastewater Management Section Office of Environmental Health and Safety Washington State Department of Health Roger.Parlw@doh.wa.gov NEW NUMBER 360-489-53051 www.dob.wa.gov Act From: Rhonda Thompson<RThompson@masoncountywa.gov> Sent:Wednesday,February 25, 2026 1:21 PM To: Parker, Roger J (DOH)<Roger.Parker@doh.wa.gov> Cc: Ian Tracy<itracy@masoncountywa.gov> Subject:RE:Class C waiver request for Mason County External Email Hi Roger, Just checking back on this one to see if you need any other information for review. Thanks, Rhonda Thompson, RS Senior Environmental Health Specialist Mason County Public Health 415 N 6th St.Shelton,WA 98584 360-427-9670 ext. 581 RthompsonCamasol.00u.t.tywa.go_v 1 From:Rhonda Thompson Sent: Friday, February 13,2026 12:46 PM To: Parker,Roger J (DOH)<roger.parker@doh:wa.gov> Cc: Ian Tracy<ITracv@masoncountywa.gov> Subject:Class C waiver request for Mason County Hi Roger, We have a Class C waiver proposal to WAC246-272A-0320(2)(b)(ii).The land owners drilled a private well on parcel 419041300020 last year, and the 100ft well radius encroaches onto two neighboring parcels.The parcel with the well on it is now trying to do a large-lot subdivision,and because the existing well protective radius extends onto neighboring lots,we are requiring them to record restrictive covenants.They have gotten the east neighbor to agree to sign the recording,and they are just waiting to record it. However,the parcel to the south is Green Diamond forestry land,and they will not sign any restrictive covenants.This presents.a problem with compliance to WAC246-272A-0320(2)(b) (ii),thus they are submitting a Class C waiver request.Please see attached.The county is in support of granting this waiver request, but would like feedback from DOH. Thank you for your time, Rhonda Thompson, RS Senior Environmental.Health Specialist Mason County Public Health 415 N 5th St.Shelton,WA 98584 360-427=9670 ext.581 Rthomp oit@maaonmunly_uy,a,goy 2 1 • N FOUND NOT,lilt.CONES _ [ h. F[tNND AS NOTED - - --_ - * 01 ...---"1.) .------10 0° U;,�,/� 233.94 ,.r BASIS OF GEARING 1S THE SOUTH UNE OE t r;;C ( 4.j 6D v/�.'E,ACLe LEGEND THE NORTHEAST'QUARTER G�'SECTION 4, 5..---',,,3( ,99• EGRESS &U0 ry x7..^:. TOWN'..t'flP 19-NORTH RANGC 4 WEST OF)HE ... I, o „1465�+.-. ^ l,.:1..ITiE., I FOUND. QUARTER CORNER AS NOTED W'LLAMt?It MERIDIAN(3 8$'44.43.ET c71 y `" �J 1(NCH TOO FEET i. /~ `�- 5T' ,� .�� FOUND 5/8 ROAR/YELLOW ALAS=CAP ® 250. "( 'ti%i"a �+1Qp'a-o .NARKED'HOLMAN 75653'AFN 627435 0 SO 100 200 `.A., 14 J c FOUND 7/2`REBAR/Y£LLOW PLASTIC CAP Y ,s0.,-....e......... ry_ 0 N, O MARKED'ESM 2482✓AFN 548752 y 0 `.\ C1 Opt' FOUND 5/8"REBAR/YELLOW PLASTIC CAP (. C� E"' •�^C@yg\_ `"�' kirA� O MARKED'MCIRNN 50705'NO RECORD FOUND zp DESCRIPTION: X40 `\ Bye??r9 •" \\ �4� • CAP MARKED GALVANIZED 40012'E/YE L0N PLASTIC ALL THAT PORTION or THE WEST HALF OF THE SOUTHWEST '� \ ,O WARTED OF THE NORTHEAST WARTED,LYING SOUTHERLY OE t...,....":„...-' ''?Jf. .% \ .8�h THE SOUTHERLY RIGHT-OF'-WAY LINE Or CLOWALLUM Rona, m 04 q 4.' i CWNTY ROAD NO.100^0.AND 711E SOUTHEAST QUARTER Or THE r.:. ,., 6 �� E C2\ 1 I ' SOUTHWEST QUARTER OF THE NORTHEAST QUARTER.ALL IN 4wf 'xG,; =✓S. ,0'5[,'° 1 { 1 ... .'- SOUTHWEST SECRdN 4, TOWNSHIP 19 NORTH,RANCE 4�WEST:WM.,IN MASON n 5, FfEBi�V�t� y NgA •TIDE l ! •COUNTY,WASHtNCTCN gyp\ T TAX PARCEL NUMBER 41904-L7-00720 40',V....;„:V"' .9 4'oi,I. ,P c� LOT 3 4e.c,` , f / / 17195 514 ZANE STEVENS "y /4?/bt O Q NE8;T72',1 66217' /`��i x Area inoiCa Mellor / { t 1 CHICaw.KEN 53209` ——— • 'n a 28.20.,Soft. GARAGE { \ CHICKEN 'i a 0.65 Ac roc a r 5 CCS•L.,_....„, HOUSE EQULPJENT Sc AROC_EP.-[RR,E •-f Ay Aroo Nte Buffer n VV \ • aTZ)24i•� di- F' ha0 TRAVERSE LONG A TFTMOLE$6 OVO'0S"TOTAL I+ PROPOSED 180.879 sail. 10'42'00' d-.10278'44- yIELL or 4.36 AUCs ;E4 \. \ R-770.00' R= 90.07' STATION. THIS SURVEY MEETS OR EXCEEDS INC '� /�. `'z3NL A 7B,68' L a 167.71' STANDARDS CONTAINED IN WAC 332-130-090 AND \ / TOTAL AREA ,`�'"'�,_ / �^ `4 N WAG 337-730-fOD q 3 f\',A 279.777 ^ •. � ,'" „N o 4.'ip� Sa.Ft a 5.01 or?''�-'''\,.. C; C4. g `� '°Oo1�� Acr¢s 4*+3916'55- d--42032l' �+ CO a 445 5 CMEF0CNLY CICCC_�,y P R-100.05' R- ISO'. vw. a TU0KP:Lgan15_.. \ \,,s L. L=155,83' I+-73.10' s'Yq 0 V re C) /� N&4'44'35-W •\\. \ \\ k, 4i'a S A • • ar 307.93' . 359.41' 0700 ,��0}©0 435At' N 58118,1107"E.-GG2.84' p �T 7 3T i <;c44� LOT 2 h &o' Q' HOUSE (9 1/[9C lft 97!t/A NC 1m .J`Si 6 GRACE(STEVENS)JOYCE s LOT I DPAwr2'Q v' fo.uotmJD $ r4 , RR:CHARD Jr. is KATHERINE o Armor 5.03 Anc959.^-,c.Ft. \ a STEVENS H n / (PARGM.) < ".PHph- Moo a 720,607 So.Ff, /''V O%F` or JESS Avec WELL 11 —_______ GS3:50' \ 663.57' CENTER QUARTER LCDNCD SELDOM 4,T 10 • S88 3'44'4'E 2654,02 7;727. I' 3 N.R 4 N.N.M.TOUND-As NOTED ~- 4' GREEN DIAMOND RESOURCE CO. EA sr QUARTER CORNER SECTION 4. !14 N, TPN dI904-00020QO R 4 W, WM,FOUNU.SIMF'SON WHEN HL'%AOCR1 BRASS DISK ULARGE LOT EXEMPTION FOR THEODGHEMASURVEYIN/\ (167)500 053 E-bWL ArmedO8ITH0BmaLt.com RICK d:ST CI.O wE STEVEN5 L 00`'- 601?WEST STWA 98$84 LUM ROAD B.BERRY 2-9-2020 25000 06CAL500 5C40C. 1010011 BH9 1"-.700' ? Or. 2 EMERGENCY VEHICLE R = 100.00' R = 100' 'n TURN AROUND ®\. \ L = 155.83' L = 73.40' • \rRs \ \ Ste\ \ <' \ 5 O C \ \ \ Cn 'T o ➢ iir 302.93' \� ``-.r \v 359.91' � W 0 S88'43'07"E 662.84' cf- LOT 2 0 c4 cb (S 1/2 SE 1/4 SW 1/4 I1E 2/4) Z °b' C:\ 1-LiGRACE (STEVENS) JOYCE DRAINFIELD its - (DAUGHTER) o ✓= TINE 71- o Area = 218,972 Sq.Ft. - o oor 5.03 Acres o ----___1O0' Bo 7- 1 INCH = 100 FEET /10/��C7>✓F 1 IN= mot 88.3' 0 50 100 - 200 WELL Cr) • 663.51' / 132701' S8 '44'43"E 2654.02' �� 4 MOND RESOURCE CO. EAST QUARTER CORNER SECTION 4, T 19 N, X1904-OOQ20D0 R 4 W, W.M. FOUND SIMPSON TIMBER HEXAGON BRASS DISK