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Home My WebLink AboutWAI2023-00096 - WAI Health Waiver - 10/3/2023 l kl 2c9l-3 — bcfj Always working for a safer healthier Mason County PO Box 1666,415 N 6th Street, Bldg 8,Shelton WA 98584, Shelton: (360)427-9670 ext 400 L Belfair:(360) 275-4467 ext 400 C. Elma: (360)482-5269 ext 400 FAX (360)427-7787 Application for Waiver/Appeali9 Amount Paid: a-`3'S— // // Receipt Number: '-� t+q by Instructions I. 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 lea nqpg(,_ />7Qac2ea __ggII /v/^/ 72usf Telephone 5e° 27/- J95'i T J Mailing Address of Applicant r2 1 1&,i& i:^ire '2'C:2 • City )e'::.' State % (S Zip l2-digit Tax Parcel No. 2 2. 3 3 1 -- 5 Z -- b a ) 3 Site Address zb/ )J ' 1�rl,\)-zC< t_J Subdivision Name and Lot( d //iris „Lk , PART 2: Nature of Waiver/Appeal ❑ Class B Reduction in Vertical Separation 0 Food Sanitation Requirements ❑ Building Permit Review Policies 0 Group B Water System Regulations ❑ Location,WAC 246-272A-0210 0 Water Adequacy Requirements EY Holding Tank WAC 246-272A-0240 0 Enforcement Timelines ❑ Mason County Onsite Standards ❑ Departmental Determinations ❑ Contractor Certification Requirements 0 Other (Installer,Pumper,O&M Specialists) Description of Waiver/Appeal(include justification,additional material may be attached.): Install Holding Tank for Recreational/Part-time Use (RV) Meets RSnGs for Holding Tank Design and is on state approved list. Tracking of maintenance through Mason.County maintenance database, Carmody Inc. Applicant Signature: 7 Date: /B—3 - 23 Revised 12/12/2014 This form may be scanned and available for public view on the Mason County Web site. Page 1 oft PART 3: Public Health Evaluation (Staff Use Only) 1. Type of Determination Required: Type of Onsite Waiver(if applicable) 0 Appeal 'Waiver ❑ None required V Class A n Class B ❑ Class C 2. Identification of Specific Code/Standard/Determination(include date of determination or latest Code/ Standard revision) WAC246-272A-0240(2) 3. Nature of Appeal: ALLOW HOLDING TANK FOR RECREATIONAL (RV)- PART-TIME USE 4. Hearing Official: ❑ Board of Health 0 Health Officer ❑ Pollution Control hearing Board ❑ Public Health Director ❑ Certified Contractor Review Board lile Environmental Health Manager 5. Mitigating Factors: 1. 1200 GALLON TANK, ON WASHINGTON STATE APPROVED LIST OF SEWAGE TANKS 2. INSTALLATION BY A MASON COUNTY CERTIFIED INSTALLER 3. LETTER FROM OWNER AGREEING TO REGULAR PUMP OUTS 4.NOTIFICATION TO FUTURE OWNERS RECORDED ON PROPERTY/PARCEL 5. HIGH WATER AUDIONISUAL ALARM, RISERS TO SURFACE, WATER-TIGHT FITTINGS 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: % 9 �� Date: lu l 16 (1---3 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: 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: gVUt/ Date: /0/t 7All Revised 12/12/2014 This form may be scanned and available for public view on the Mason County Web site. Page 2 of 2 Granting Waivers from State 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 I. (completed by applicant) Name: (1)t I Local Health De Department/Di L s29lc ,vCrn.�dy LIVR CO �,R ilS) (sec or) Address ---- 3 Lq( sC, �eti�/ _ Place Telephone: ( Z 7) 57.51 Signatu // /yr, Property Identific�: (3) 6, tog_/ i G." Lo ,. -'3 - ,2233l- -Odo54,3 A9( JL - gG,zrJrce Section II. (completed by applicant) WAG Number: (4) WAC Requirement: (5) Waiver Sought: (6) 246-272A— 0240(2) holding tank used for pernament holding tank used for part-time recreational use Subsection: commercial uses for RV Justification(mitigation measures to be provided): (7) see local waiver form for full outline of mitigation measures: 1. Design criteria consistent with RSnGs for Holding Tank Sewage Systems 2. Tracking through Online RME (Mason County OSS maintenance database) Section III. (completed by health officer) Review Criteria: (8) Mitigation Measures(e'n addition to those proposed): (9) Comments/Conditions: (10) Type of Waiver: (11) 4r4 Cass A ( ] Class B ) ] Class C—Request DOH review before granting? Yes No Neighbor Notification: (12) Required? Yes No If needed, are agreements. easements. etc.properly 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 I -ikpproved/ Granted—Subject to all comments,conditions and requirements oted i9 Sections II and Ill. �fl Local Health Officer (13) air/ _ Date: /J�7/ L) DOH 337-021 Page 26 of 32 Rhonda Thompson From: Len McCready <ptlwsong@hotmail.com> Sent Monday, October 16, 2023 12:16 PM To: Rhonda Thompson Subject: Re: RV Sewage Holding Tank, Annual Pump-Out Agreement Notifiction Caution: External Email Warning!This email has originated from outside of the Mason County Network. Do not click links or open attachments unless you recognize the sender, are expecting the email, and know the content is safe. If a link sends you to a website where you are asked to validate using your Account and Password, DO NOT DO SO! Instead, report the incident. Yes, confirmed. Len McCready (360) 271-5954 From: Rhonda Thompson<RThompson@masoncountywa.gov> Sent: Monday, October 16, 2023 12:11 PM To: Len McCready<ptlwsong@hotmail.com> Subject: RE: RV Sewage Holding Tank,Annual Pump-Out Agreement Notifiction Hi Len, Thank you for your email. Can you please confirm you will have the RV holding tank pumped as needed, with a minimum of once a year? Rhonda Thompson, RS Senior Environmental Health Specialist Mason County Public Health 415 N 6th St. Shelton,WA 98584 360-427-9670 ext. 581 Rthompson@masoncountywa.gov From: Len McCready cptlwsong@hotmail.com> Sent: Monday, October 16, 2023 12:09 PM To: Rhonda Thompson <RThompson@masoncountywa.gov> Cc: Len McCready<ptlwsong@hotmail.com> Subject: RV Sewage Holding Tank, Annual Pump-Out Agreement Notifiction Caution:External Email Warning!This email has originated from outside of the Mason County Network. Do not click links or open attachments unless you recognize the sender, are expecting the email, and know the content is safe. If a link sends you to a website where you are asked to validate using your Account and Password, DO NOT DO SO! Instead, report the incident. Hi Rhonda 1 Per your pho e message this AM regarding a written agreement from me to have a RV Sewage Holding Tank pumped no less than annually, I agree to do so. The property is located at: Collins Lake, 271 Raintree Lane,Tahuya, WA, 98588. Legal Description: Collins Lake 143, Tract 43. Accessor's Tax Parcel: 22331-52-00043 The property is owned by me via: McCready Revocable Living Trust Leonard P 3241 SE Devonshire PI Port Orchard, WA, 98366 If there are any questions or concerns regarding the provided information, please give me a call at the number below. Thank You, Leonard (Len) McCready (360) 271-5954 Mobil (Preferred) (360) 871-5954 Home 2