HomeMy WebLinkAboutHealth Department SepticSTATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL
APPLICANT: Beth Brown (Dave Golden Homes)
AGENT: Ashton Septic Tanks Inc.
PROPERTY ADDRESS: 3601 Arnold Rd FortPierce, FL 34981
LOT: 13 & 14 BLOCK: 3
APPLICATION #:AP1586173
PERMIT #:56 -SF -04355
DOCUMENT #:F11526295
DATE PAID :10/21 /2020
FEE PAID:9 5.0 0
RECEIPT #:56 -PID -4759891
SUBDIVISION:
Cross Trail ID#:
2420-601-0044-000-1
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 MICHAEL W STUHR (ASHTO
[ ]
[23]
FILL TEXTURE
[ ]
[48]
OTHER
[ ]
[24]
EXCAVATION DEPTH
ABANDONMENT
[ ]
[25]
AREA REPLACED
[ ]
[49]
TANK PUMPED 11/03/2020
[ ]
[26]
REPLACEMENT MATERIAL.
[ ]
[50]
TANK CRUSHED & FILLED 11/0.3/2020
Comments:
Comments are on page 2.
CONSTRUCTION [ APPROVED / DISAPPROVED ]:
Environ entaIS C
FINAL SYSTEM [ AppgOVED / DISAPPROVED ]:
Environmental Spe
(Explanation of Violations on following page)
DH 4016, 08/09 (Obsoletes all previous editions which'
Incorporated: 64E-6.003, FAC
EH Database v 1.0.1 AP1586173
I- , St. Lucie CHD
plan J Ingram (ENVIRONMENTAL HEALTH)
St. Lucie cHD
Brian J Ingram (ENVIRONMENTAL HEALTH)
not be used)
EID346188
DATE: 11 /03/2020
DATE: 11/0312020
Page 2 of 3
APPLICATION #:AP1586173
STATE OF FLORIDA PERMIT #:56 -SF -04355
DEPARTMENT OF HEALTH DOCUMENT #:F11526295
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL DATE PAID: 10/21/2020
FEE PAID:95.00
RECEIPT #:56 -PID -4759891
Violation Number Comment
Comments
Existing ST pumped and abandoned properly. No violations, system ok to cover. Contractor notified by phone. Abandonment
approved.
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 AP1586173 EID346188