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Home My WebLink AboutWAI2026-00052-WAIVER/APPEAL - WAI Health Waiver - 7/1/2026 �, 415 N.6`h ST SHELT e4TE ( 1 MA SO N CO U N TY BELF 1' 60 -4467 ext.400 2 � 2026 Public Health & Human Services Ry Application for Waiver or Appeal Amount Paid: 3(O Receipt Number: - WAI ap- y(7d`J2 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 ZANE VANDERWAL Telephone Mailing Address 721 SUNSET COURT City SHELTON E LTO N State WA Zip 98584 Parcel No. 4 2 1 2 5 7 6 9 0 0 4 3 Site Address 60 E LEXINGTON PLACE Subdivision Name and Lot PART 2: Nature of Waiver/Appeal ❑ Onsite: Class A Waiver ❑ Food Sanitation Requirements ❑✓ Onsite: Class B Waiver ❑ Group B Water System Regulations ❑ Onsite: Class C Waiver ❑ Water Adequacy Requirements ❑ Onsite: Location, WAC246-272A-0210 ❑ Building Permit: EH Review Policies ❑ Onsite: Holding Tank,WAC246-272A- ❑ Appeal:Enforcement Timelines 0240 ❑ Appeal:Departmental Determinations ❑ Onsite: Contractor Certification ❑ Other Requirements Description of Waiver/Appeal (include justification, additional material ched.): Reduce Vertical Separation for Conventional Gravity Pressure OSS Class B Waiver Checklist Recorded Declaration of Attenuation Zone Applicant Signature: &a Date: ZZ Z(o Revised 03/03/2026 This form may be scanned and available for public view on the Mason County Web site. Page 1 of 2 PART 3: Public Health Evaluation (Staff Use Only) 1. Type of Determination Required: Type of Onsite Waiver (if applicable) ❑Appeal ❑✓ Waiver ❑ Class A El Class B ❑Class C ❑ Local State Waiver Criteria Number of Bedrooms:____ Nitrogen Treatment: ❑Yes VNo Soil Type: �� Minimum Lot Size: 1 O.L . Water Source:❑Public Private This Lot Size: 1. �aCi-4!_ sel-ft Is This Lot Eligible for State Waivers: Yes ❑ No ❑ N/A Hearing Official: ❑✓ Environmental Health Manager ❑ Public Health Director ❑ Other: 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 Conventional Gravity or Pressure OSS 5. Mitigating Factors: Class B Waiver Checklist (Meets additional requirements outlined within) Recorded Declaration Covenant for OSS Attenuation Zone (AFN 'fi `(1 ) 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: 12� 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: ❑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: Health Official Signature: Date: Revised 03/03/2026 This form may be scanned and available for public view on the Mason County Web site. Page 2 of2 MASON COUNTY COMMUNITY SERVICES MASON COUNTY PUBLIC HEALTH Building,Planning,Environmental Health,Community Health CLASS B WAIVER WORKSHEET 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 APPLICANTNAME /J 1 s� WAIVER PERMIT NUMBER IA/Al MAILING ADDRESS ?Z I s,. tJ s c-P �j� CITY S Gt9COrJ STATE L4 A ZIP S � SITE ADDRESS 1E t' C CITY TAX PARCEL NUMBER j'1_/2 7(o •, 9v85/3 PROPOSED DRAINFIELDTYPE ❑ CONVENTIONAL GRAVITY IAff CONVENTIONAL PRESSURE 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. Alderwood Gravelly Sandy Loam................................❑ 0 Greater than 12"................................................................ N; Harstine Gravelly Sandy Loam..................................... ❑ ❑ Greater than 18"................................................................ ❑ ❑ Hoodsport Gravelly Sandy Loam................................ ❑ 0,� s -Determined by: s Shelton Gravelly Sandy Loam.......................................z M Depth to hardpan............................................................. ❑ 0 Sinclair Gravelly Sandy Loam........................................❑ 0 Depth to mottling.......................................................... ❑ ❑ Other ........❑ 0 Both....................................................................................... 2.SOILTYPE: 6.WATER TABLE LEVEL: Soil types must be Medium Sand,Loamy Sand,or Sandy If test holes show evidence of a seasonal=required Loam.Gravel percent must be less than or equal to 35%. above restrictive layer,a curtain drain maybe t '-tb Medium Sand..................................................................... ❑ Q Z' -Evidence of seasonal water table: LoamySand........................................................................ ❑ 0 o " Yes.......................................................................................;.. ,0g'- SandyLoam........................................................................ � No........................................................................................ ❑ Percent Gravel: -Curtain Drain required: Lessthan or equal to 35%................................ �....... a Yes......................................................................................... ❑ ,Q � -Greaterthan35%.........................................................❑ ❑ No......................................................................................... 3.SOIL DRAINAGE: 7.HORIZONTAL SETBACKS: t; Soils must be moderately well drained to well drained. "'" Primary Drainfield must maintain 200'from down-grads ent marine shorelines,surface waters,and wells. _ x WellDrained...................................................................... ❑ 0 ; Moderately Well Drained...............................................2 l ; -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%...................................................................... ❑ ❑ -Is there 50 ft or greater between the down 3%to 15%.......................................................................... I® gradient side of primary drainfield and 16%to 30%........................................................................ ❑ 0 , property boundary: Greaterthan 30%............................................................. ❑ 0 Yes.......................................................................................No.......................................................................................... ❑ . The 50 foot horizontal attenuation zone is required to be recorded on the deed of the property as unbuildable , ` L('' J prior to design approval.The attenuation zone is not to be used for the contruction of roads,decks,patios, AFN: P/ parking areas,vehicular traffic,or other similar such uses.The owner must agree to all these conditions. Proof of Recording: THIS FORM MAYBE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE. updated 3/2/2017 On-Site Sewage Systems (Chapter 246-272A WAC) I Weihtngte65tate'Departmentaf Request for Waiver from State Regulations • N E LT Sect%on l.: (Completed by applicant) Name: (1) ZANE VANDERWAL Local Health Jurisdiction Received(2) ..... ._............._..............._ ..........................._.._. ......................................................................................... (See,.fn`s tr.Uctions) Address: 721 SUNSET COURT Mason County SHELTON WA 98584 .........--..-_.___... .................. ..........._...._.....__._-._............._._...-.-----...._._........._...._...._......__..................................__ Telephone: ...._................. --._._.. .........._...__ ..__...._ _....._.. — —._... Signature: Property Identificati n:(3) ...__... .._..---- --._.... —.._......_......._..-._..................__—..._..._.._......---....__..._............................_..._...._...._................_...........................--.--._...-........----..........._............._.._..—_......_...................._...._.__........----.............. — — 42125-76-90043, 60 E LEXINGTON PLACE ....... ...... .... . ........._.........._............._............._...................__..................._............ Section 11: , 'sI (Completed by applicant) WAC Number: (4) WAC Requirement: (5) Waiver Sou ht: (6) .................................----...........------...................._................_---................................_......_................_............_..............................................................._......................................................_..............._.... ..__.....I ._.........................._.._......................_....... ..................................._._.._...._..__................................. 246-272A- 0230 24"of V/S for Pressure(or) 12"of V/S for Pressure O (or) .................................................................... ..................................... . .......... ...... ... Subsection: Table VI 36"of V/S for Gravity or ravity OSS Justification (Proposed mitigation measures): (7) Completed Class B Waiver Checklist Attached,(Outlining Additional Requirements Met). Recorded Declaration of Covenant for ATTN. Zone (AFN: �TZ .Z1, ) Section 111. (Completed by local health officer) Review Criteria: (8) Additional Mitigation Measures:(9) ... ......................................................._............................................................................................I.................... Comments/Conditions: (10) ...._.........._._.....__............._.....------..._..._....----.....-........_...._ __.._...._.—._._.____........._............ — —..._.__......................_............._..._.._........._............__ _—_._.__.._..-----...—_.......__.._......._.._.__..........----.........._.—_............-......._...._. See Class B Waiver Worksheet Type of Waiver:(114IJ Class A Class B Class C— Request DOH review before granting? Yes❑ No Neighbor Notification:(12) Required?Yes�No If needed,are agreements,easements,etc.filed? 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. ❑Denied IIIL I Approved/Granted—Subject to all comments,conditions and requirements noted in Sections II and III. Local Health Officer(13) Date: y' DOH 337-175 February 2024 1 Rhonda Thompson From: Alex Paysse <alex@alpinesepticdesign.com> Sent: Wednesday,July 1, 2026 8:06 AM To: Rhonda Thompson Subject: Re: SWG2026-00197 Hey Rhonda. I did look at that western neighbor McKaig and anchored it into my cad file. Yes it's 100 + from the applicants parcel and upgradient. It's right up close to the southern side of home. I didn't see any signs of surface water sources either. If you drove out there you'd clearly see it's up gradient and I believe 150'+\- from parcel. I hope this email suffices, as I don't have access to my PC for a couple weeks. You are welcome to add a note yourself and put "per designer" or something. Or just attach this email to your scanned copy. Thank you! Alex Paysse ---- On Tue, 30 Jun 2026 14:58:52 -0700 Rhonda Thompson <RThompson@masoncountywa.gov> wrote ---- Hey Alex, I am reviewing the Zane Vanderwal application at 60 E Lexington P1(421257690043). I am good with this proposal, but I know management wants to see some depiction on the site plan of the 200ft downgradient of the primary drainfield without surface water or wells. I see the downgradient well on the lot to the north that is over 200ft away but it looks like the 200ft downgradient of the drainfield actually extends onto the property to the west.Would you be able to provide an updated site plan showing this? Or even just add a note on the site plan that tells us you looked on that parcel for their well or any surface water? Thanks, Rhonda Thompson, RS Senior Environmental Health Specialist Mason County Public Health 415 N 6th St.Shelton,WA 98584 360-427-9670 ext.581 RthompsonCa)masoncountywa.gov To register for an upcoming homeowner septic workshop, please visit: https://extension.wsu.edu/mason/event/septic- summer/2026-06-18/ 1 ason County WA GIS Mason County Hornepage • r• • 1+>; - _ i Measurement -' �' `�. *,• — - . t .,,, 'ga aye ,✓ �� Clear ///' : msqs d i ' ?\-- / - \\ \ tl Jf! • L�' 0 3 BEDROOM DRAINFIELD (CONVENTIONAL PRESSURE DIST.) ♦ \ FUTURE HOME LOCATION ATTENUATION ZONE 50' DOWNSLOPE �\ FUTURE WATERLINE \ \ ♦ (MAINTAIN IU+FROM SEPTIC \ \ \ COMPONENTS&LINES) SEPTIC TANK & PUMP TANK ♦ �� EXISTING -- �—l WELL //\ I / f b j FUTURE WELL' / 1\ I (LOCATE 200'FROM DF -♦ / 50'FROM TANKS) / -...�� c 51 393 , ALEX L PAY E ?r � a LICENSED DESIGNEit / ExPRE5 \` + -+-' \ CUSTOMER:ZANE VANDERWAL TEST HOLE 1 TEST HOLE 2 TEST HOLE 3 (N\ PARCEL: 4 2 1 2 6 - 7 6 - 9 0 0 4 3 ALPINE SEPTIC SITE: 60 E LEXINGTON PL '1J1 SIGN- ALEX L PAYSSE,OE GE R SHEET:SITE PLAN SCALE: 1"=70 DUUMA°E'" 1) 15 I A SURVEY. RET889ES V ID AP PUG ANTAC0UNTY PROVIDED PLATS OR 3089 E MASON BENSON RD SURVEYS,FEED MEASUREMENTS MD COP 1'(CSS. DESMN NTT)DED FOR SEPTIC PURPOSES ONLY.