HomeMy WebLinkAboutAbandonment approval from health deptdF�y�
APPLICATION #:AP1468328
S, 9" STATE OF FLORIDA
PERMIT #:56 -SF -2039924
= DEPARTMENT OF HEALTH
DOCUMENT #:F11427771
c ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
.y CONSTRUCTION INSPECTION AND FINAL APPROVAL
DATE PAID:02/18/2020
WS
FEE PAID:' 95.00
RECEIPT #:56 -PID -4295189
APPLICANT: Gregory Johnson
AGENT: Maurice Shazier (George & Assoc, LLC)
PROPERTY ADDRESS: 3705 Avenue I Fort Pierce, FL 34947
LOT: 1,2,3 BLOCK: A
SUBDIVISION: Sumner Heights ID#: 2405-704-0001-000-7
CHECKED [X] ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED.
TANK INSTALLATION
SETBACKS
[ ] [01] TANK SIZE [1] [2] [
] [27]
SURFACE WATER FT
[ ] [02] TANK MATERIAL [
] [28]
DITCHES FT
[ ] [03] OUTLET DEVICE [
] [29]
PRIVATE WELLS FT
[ ] [04] MULTI-CHAMBERED [ Y / N ] [
] [30]
PUBLIC WELLS FT
[ ] [05] OUTLET FILTER [
] [31]
IRRIGATION WELLS FT
[ ] [06] LEGEND 1. 2. [
] [32]
POTABLE WATER FT
[ ] [07] WATERTIGHT [
] [33]
BUILDING FOUNDATIONS FT
[ ] [08] LEVEL [
] [34]
PROPERTY LINES FT
[ ] [09] DEPTH TO LID [
] [35]
OTHER FT
DRAINFIELD INSTALLATION
FILLED / MOUND SYSTEM
[ ] [10] AREA [1] [2] SQFT [
] [36]
DRAINFIELD COVER
[ ] [11] DISTRIBUTION BOX HEADER [
] [37]
SHOULDERS
[ ] [12] NUMBER OF DRAINLINES 1. 2. [
] [38]
SLOPES
[ ] [13] DRAINLINE SEPARATION [
] [39]
STABILIZATION
[ ] [14] DRAINLINE SLOPE
[ ] [15] DEPTH OF COVER
ADDITIONAL INFORMATION
[ ] [16] ELEVATION [ ABOVE / BELOW ]BM [
] [40]
UNOBSTRUCTED AREA
[ ] [17] SYSTEM LOCATION [
] [41]
STORMWATER RUNOFF
[ ] [18] DOSING PUMPS [
] [42]
ALARMS
[ ] [19] AGGREGATE SIZE [
] [43]
MAINTENANCE AGREEMENT
[ ] [20] AGGREGATE EXCESSIVE FINES [
] [44]
BUILDING AREA
[ ] [21] AGGREGATE DEPTH [
] [45]
LOCATION CONFORMS WITH SITE PLAN
FILL / EXCAVATION MATERIAL [
] [46]
FINAL SITE GRADING
[ ] [22] FILL AMOUNT [
] [47]
CONTRACTOR CAVALIER PLUMBI (CAVAL
[ ] [23] FILL TEXTURE 1
] [48]
OTHER
[ ] [24] EXCAVATION DEPTH
ABANDONMENT
[ ] [25] AREA REPLACED [
] [49]
TANK PUMPED 05/21/2020
[ ] [26] REPLACEMENT MATERIAL [
] [50]
TANK CRUSHED & FILLED 05/21/2020
Comments: Comments are on page 2.
CONSTRUCTIONI APPROVED / r
)
St. Lucie CHD DATE: 05/21/2020
DISAPPROVED ' Enviro ental Specialist
r n J Ingram (ENVIRONMENTAL HEALTH)
FINAL SYSTEM [ APPROVED / DISAPPROVED ):
St. Lucie CHD DATE: 05/21/2020
Environmental Specialist
rian J Ingram (ENVIRONMENTAL HEALTH)
(Explanation of Violations on following page)
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC
Page 2 of 3
EH Database v 1.0.1 AP1468328
EID2039924
q" STATE OF FLORIDA
1 DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
�yr CONSTRUCTION INSPECTION AND FINAL APPROVAL
WI& I
Violation Number Comment
Comments
APPLICATION #:AP1468328
PERMIT #:56 -SF -2039924
DOCUMENT #.F11427771
DATE PAID:02/18/2020
FEE PAID:95.00
RECEIPT #:56 -PID -4295189
Tank pumped and abandoned properly. No violation, system ok to cover. Contractor and building department emailed building
approval.
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC Page 2 of 3
EH Database v 1.0.1 AP1468328 EID2039924