HomeMy WebLinkAboutHealth Dept APPLICATION #:AP1270920
STATE OF FLORIDA PERMIT #:56-SF-1732341
DEPARTMENT OF HEALTH DOCUMENT #:F[1094584
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
.� CONSTRUCTION INSPECTION AND FINAL APPROVAL DATE PAID:01/13/2017
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FEE PAID:65.00
RECEIPT #:56-PID-3170174
APPLICANT: P&C Construction of the Treasure Coast, LLC
AGENT: Paul.Jaquln
PROPERTY ADDRESS: 4000 Avenue L Fort Pierce, FL 34947
LOT: 16 BLOCK: 30
SUBDIVISION: Sunland Gardens ID#: 2405-601-0559-000-7
CHECKED [X1 ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED.
TANK INSTALLATION SETBACKS
I 1 (011 TANK SIZE (11 [21 I 1 (271 SURFACE WATER FT
( 1 [021 TANK MATERIAL [ 1 [281 DITCHES FT
I 1 (03) OUTLET DEVICE [ 1 [291 PRIVATE WELLS FT
[ 1 [041 MULTI-CHAMBERED [ y / T] ] [ 1 [301 PUBLIC WELLS FT
[ 1 [051 OUTLET FILTER [ 1 [311 IRRIGATION WELLS FT
[ ) [061 LEGEND 1. 2. [ ) (321 POTABLE WATER FT
( 1 [07) WATERTIGHT [ '1 [331 BUILDING FOUNDATIONS FT
[ 1 (081 LEVEL [ 1 [341 PROPERTY LINES FT
[ 1 [091 DEPTH TO LID [ 1 (351 OTHER FT
DRAINFIELD INSTALLATION FILLED / MOUND SYSTEM
I 1 [101 AREA (1) [2) SQFT ( 1 [361 DRAINFIELD COVER
[ 1 (111 DISTRIBUTION BOX HEADER [ 1 [37) SHOULDERS
[ ) [12) NUMBER OF DRAINLINES 1. 2. [ 1 [361 SLOPES
( 1 [131 DRAINLINE SEPARATION [ 1 [391 STABILIZATION
[ 1 [141 DRAINLINE SLOPE
[ 1 [151 DEPTH OF COVER ADDITIONAL INFORMATION
[ 1 [161 ELEVATION [ ABOVE / BELOW )BM ( 1 [401 UNOBSTRUCTED AREA
[ 1 1171 SYSTEM LOCATION [ 1 [411 STORMWATER RUNOFF
I 1 (18) DOSING PUMPS [ ) (421 ALARMS
[ ) (19) AGGREGATE SIZE [ 1 [431 MAINTENANCE AGREEMENT
I 1 [201 AGGREGATE EXCESSIVE FINES [ 1 [441 BUILDING AREA
( 1 (21) AGGREGATE DEPTH [ 1 [45) LOCATION CONFORMS WITH SITE PLAN
FILL / EXCAVATION MATERIAL I 1 [46) FINAL SITE GRADING
[ ) [221 FILL AMOUNT I 1 (47) CONTRACTOR
[ 1 1231 FILL TEXTURE [ 1 [481 OTHER
[ 1 [241 EXCAVATION DEPTH ABANDONMENT
[ ) [251 AREA REPLACED [ 1 [491 TANK PUMPED
01130/2017
[ ) [26) REPLACEMENT MATERIAL [ 1 [501 TANK CRUSHED & FILLED 01/30/2017
Comments: Comments are on page 2.
r
CONSTRUCTION [ APPROVED St. Lucie CHD DATE: 01/30/2017
DISAPPROVED 1' Enviro ental Manager Victor F (Department of Heajh✓keec
FINAL SYSTEM [ APPROVED / DISAPPROVED ): L uucie CHD DATE: 01/30/2017
(Explanation of Violations on following page) Efivftnrnontal Manager Victor Faco ti jDopartment of Health in Okee
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 AP1270920 EID1732341
APPLICATION #:AP 1270920
STATE OF FLORIDAPERMIT #:56-SF-1732341
DEPARTMENT OF HEALTH
t ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM DOCUMENT #:F11094584
w
CONSTRUCTION INSPECTION AND FINAL APPROVAL DATE PAID:01/13/2017
FEE PAID:65.00
RECEIPT #:56-PID-3170174
Violation Number Comment
Comments
Inspected by B Ingram
tank removed emailed to cotractor
DH 4016, 06/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC Page 2 of 3
EH Database v 1.D.1 AP1270920 EID1732341