HomeMy WebLinkAboutHealth Dept reportSTATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL
APPLICANT: White City Rentals LLC
AGENT: Bruce Mc Cullers (Reliable Treasure Coast Services)
PROPERTY ADDRESS: 5009 Melville Rd Fort Pierce, FL 34982
LOT: BLOCK:
APPLICATION #:AP1525108
PERMIT #:56-SF-2108559
DOCUMENT #:F11452383
DATE PAID:07/15/2020
FEE PAID:95.00
RECEIPT #:56-PID-4501944
SUBDIVISION:
ID# : 3403-502-0062-000-9
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
i. ] [47] CONTRACTOR
[ ] (23]
FILL TEXTURE
I. ] [46] OTHER
[ ] [24]
EXCAVATION DEPTH
ABANDONMENT
[ ] [25]
AREA REPLACED
[ ] [49] TANK PUMPED 07/24/2020
[ ] [26]
REPLACEMENT MATERIAL
[ ] [50] TANK CRUSHED & FILLED 07/24/2020
Comments: Comments are on page 2.
/
St. Lucie CHD DATE: 07/24/2020
CONSTRUCTION
[ APPROVED
DISAPPROVED
Environ entail Special' t 11 B ' n J Ingram (ENVIRONMENTAL HEALTH)
FINAL SYSTEM
[ APpROVED / DISAPPROVED
]: St. Lucie CHD DATE: 07/24/2020
Environmental Sped Brian J Ingram (ENVIRONMENTAL HEALTH)
(Explanation of Violations on following page)
zyis
DH 4016, 08/09 (Obsoletes all previous
editions which mot beused)
Incorporated:
64E-6.003, FAC
Page 2 of 3
EH Database v 1.0.1
AP15251D8 EID2108559
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL
Violation Number Comment
Comments
Tank pumped and abandoned properly. Tank removed and hauled offsite. Hole filled while onsite.
APPLICATION #:AP1525108
PERMIT #:56-SF-2108559
DOCUMENT #:F11452383
DATE PAID . 07/15/2020
FEE PAID:95.00
RECEIPT #:56-PID-4501944
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 AP1525108 EID2108559