HomeMy WebLinkAboutHealth Department Approval From: 08/03/2020 13:01 #811 P.006
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TIMM APPLICATION #:AP1229664
STATE OF FLORIDA PERMIT #:56-SF-16675598
DEPARTMENT OF HEALTH DOCUMENT #:F11075609
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL DATE PAID:03/14/2016
FEE PAID:65.00
RECEIPT #:56-PID-2903583
APPLICANT: State of FL DOT
AGENT: Meeks Plumbing,Inc.
PROPERTY ADDRESS: 1000 Kings Hwy Fort Pierce, FL 34945
LOT: BLOCK:
SUBDIVISION: ID#: 2313-221.0000-0006
CHECKED (X1 ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED.
TANK INSTALLATION SETBACKS
[ 1 [01] TANK SIZE [1). [2) [ 1 [271 SURFACE WATER FT -
[ 1 1021 TANK MATERIAL [ 1 [281 DITCHES FT
1 1 [031 OUTLET DEVICE [ 1 (29] PRIVATE WELLS FT
[ ] [04] MULTI-CHAMBERED [ Y / N ] ( 1 [30) PUBLIC WELLS FT
( ] [051 OUTLET FILTER [ 1 [311 IRRIGATION WELLS FT
[ ] [06]. LEGEND 1. 2. [ 1 [321 POTABLE WATER FT
[ 1 [07) WATERTIGHT [ ) [331 BUILDING FOUNDATIONS FT
[ ) [081 LEVEL [ 1 [341 PROPERTY LINES FT
[ ] [09] DEPTH TO LID [ ] 1351 OTHER FT
DRAINFIELD INSTALLATION FILLED / MOUND SYSTEM
[ 1 1101 AREA (11 [2] SQFT [ 1 (36] DRAINFIELD COVER
[ 1 1111 DISTRIBUTION BOX HEADER ( 1 [371 SHOULDERS
[ -1 1121 NUMBER OF DRAINLINES 1, 2- ( 1 (381 SLOPES
[ 1 [13) DRAINLINE SEPARATION ( 1 .[391 STABILIZATION
[ ] (141 DRAINLINE SLOPE
[ 1 [151 DEPTH OF COVER ADDITIONAL INFORMATION
[ ] [16] ELEVATION [ ABOVE / BELOW IBM 1 1 (401 UNOBSTRUCTED AREA
1 1 [171 SYSTEM LOCATION ( 1 [411 STORMWATER RUNOFF
j 1 [181 DOSING PUMPS [ 1 [421 ALARMS
1 ] [191 AGGREGATE SIZE [ 1 [431 MAINTENANCE AGREEMENT
I 1 [20) AGGREGATE EXCESSIVE FINES [ 1 (441 BUILDING AREA '
[ 1 [211 AGGREGATE DEPTH ( ] [45] LOCATION CONFORMS WITH SITE PLAN
FILL / EXCAVATION MATERIAL [ 1 [46] FINAL SITE GRADING
[ ] [22] FILL AMOUNT [ 1 1471 CONTRACTOR RONALD E MEEKS(0000245
[ 1 (231 FILL TEXTURE ( 1 [48] OTHER
( ] [241 EXCAVATION DEPTH ABANDONMENT
L 1 (251 AREA REPLACED 1 ] [491 TANK PUMPED 06/06/2016
[ 1 1261 REPLACEMENT MATERIAL ( 1 (50) TANK CRUSHED 6 FILLED 06/10/2016
Comments: Comments are on page 2.
CONSTRUCTION (�/ St.Luce CHD DATE: 0 912 6/2 01 6
APPROVED DT SAPP(iDV EC 1 Jyvlro mental Specialist 1 James E Ends ey(Florida Department of Health I
FINAL SYSTEM [ APpROVED / DISAPPROVED St.Lucia CHD DATE: 09126/2016
rronmen a pec a s aures n e ey r a Department o 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 v1.0.1 AP1229654 F.ID1667698 -
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