HomeMy WebLinkAboutHealth Dept. final approvalSTATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL
APPLICANT: Edward Groenwoldt
AGENT: Edward Groenwoldt
PROPERTY ADDRESS: 7437 Gullottl PI
LOT
Port Saint Lucie, FL 34952
BLOCK.
APPLICATION #:AP1506256
PERMIT #:56 -SF -1732142
DOCUMENT #:F11428547
DATE PAID:05/26/2020
FEE PAID: 470.00
RECEIPT #:56 -PID -4417570
SUBDIVISION: St. Lucie Gardens ID#: 3414-501-1106-100-9
CHECKED [X] ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED.
TANK INSTALLATION
SYSTEM LOCATION
[ ] [01]
TANK SIZE [1] 1090.00 [2]
[ ] [19]
[ ] [02]
TANK MATERIAL Polypropylene
AGGREGATE EXCESSIVE FINES
[ ] [03]
OUTLET DEVICE
FILL / EXCAVATION MATERIAL
[ ] [04]
MULTI-CHAMBERED [LIJ N ]
[ ] [23]
[ ] [05]
OUTLET FILTER Polylok PL -68
EXCAVATION DEPTH
[ ] [06]
LEGEND 1. 70-143-11 DC3 2.
[ ] [26]
[ ] [07]
WATERTIGHT
Comments are on page 2.
[ ] (08]
LEVEL
FT
[ ] [09]
DEPTH TO LID
FT
DRAINFIELD INSTALLATION
[ ] [10]
AREA [1] 384.88 [2]
SQFT
[ ] [11]
DISTRIBUTION BOX HEADER
X
[ ] [12]
NUMBER OF DRAINLINES 1. 4.00 2.
[ ] [13]
DRAINLINE SEPARATION
[ ] [14]
DRAINLINE SLOPE
[ ] [40]
[ ] [15]
DEPTH OF COVER
[ ] [41]
STORMWATER RUNOFF
[ ] [42]
[ ] [16]
ELEVATION [ ABOVE / HELOW ]BM
3.00
[ ] [17]
SYSTEM LOCATION
[ ] [18]
DOSING PUMPS
[ ] [19]
AGGREGATE SIZE
[ ] [20]
AGGREGATE EXCESSIVE FINES
[ ] [21]
AGGREGATE DEPTH
FILL / EXCAVATION MATERIAL
[ ] [22]
FILL AMOUNT
[ ] [23]
FILL TEXTURE
[ ] [24]
EXCAVATION DEPTH
[ ] [25]
AREA REPLACED
[ ] [26]
REPLACEMENT MATERIAL
Comments:
Comments are on page 2.
SETBACKS
[ ] [27]
SURFACE WATER
FT
[ ] [28]
DITCHES
FT
[ ] [29]
PRIVATE WELLS 100
FT
[ ] [30]
PUBLIC WELLS
FT
[ ] [31]
IRRIGATION WELLS
FT
[ ] [32]
POTABLE WATER 70
FT
[ ] [33]
BUILDING FOUNDATIONS 8
FT
[ ] [34]
PROPERTY LINES 8
FT
[ ] [35]
OTHER
FT
FILLED / MOUND SYSTEM
[ ] [36]
DRAINFIELD COVER
[ ] [37]
SHOULDERS
[ ] [38]
SLOPES
[ ] [39]
STABILIZATION 05/29/2020
ADDITIONAL INFORMATION
[ ] [40]
UNOBSTRUCTED AREA
[ ] [41]
STORMWATER RUNOFF
[ ] [42]
ALARMS
[ ] [43]
MAINTENANCE AGREEMENT
[ ] [44]
BUILDING AREA
[ ] [45]
LOCATION CONFORMS WITH SITE PLAN
[ ] [46]
FINAL SITE GRADING
[ ] [47]
CONTRACTOR Brian Davis (Brian Davis Sept
[ ] [48]
OTHER INFILTRATOR Quick4 Plus EQ36
LP
ABANDONMENT
[ ] [49]
TANK PUMPED
[ ] (50]
TANK CRUSHED & FILLED
CONSTRUCTION[ APPROVED / St. Lucie CHD
DISAPPROVED ] ' Enviro fbntal Specialist 11 Ingram (ENVIRONMENTAL HEALTH)
FINAL SYSTEM [ APpROVED / DISAPPROVED ]: St. Lucie CHD
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
EH Database v 1.0.1 AP1506256 EID1732142
DATE: 05/29/2020
DATE: 05/29/2020
Page 2 of 3
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL
Violation Number Comment
Comments
APPLICATION #:AP1506256
PERMIT #:56 -SF -1732142
DOCUMENT #:F11428547
DATE PAID:05/26/2020
FEE PAID:470.00
RECEIPT #:56 -PID -4417570
The system is sized for 3 bedrooms with a maximum occupancy of 6 persons (2 per bedroom), for a total estimated flow of 300
apd.
'onstruction inspection performed 3/22/2017, no violations. Permit expired without final approval. Owner repermitted system for
Inal approval within 5 years of construction inspection. Owner submitted all required documentation. no changes to permitted
-onditions. Final system approved. Contractor, building department, and owner emailed final 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 AP1506256 EID1732142
7347 Gullotti Place
Port St Lucie, FL, 34952
Brian,
This is a written statement affirming that nothing at the above address has changed that would
affect the system as it was previously approved for construction, installed and inspected.
Thank you,
Edward Groenwoldt, owner.