HomeMy WebLinkAboutWater Well PermitsRon DeSantis
Mission:
Governor
To protect, promote & improve the health
'
of all people in Florida through integrated'
Scott A. Rivkees, MD
state, county & community efforts.
C A 8 .T
State Surgeon General
Vision: To be the Healthiest State in the Nation
Florida Department of Health in St. Lucie County
Conditions for Issuance of Water Well Permits
Effective July 24, 2017
• Contact the Florida Department of Health in Saint Lucie County (FDOH — St. Lucie)
prior to constructing or abandoning any well.
a. Call the FDOH — St. Lucie Well Line at 772-873-4936 or email
SLCDOH-WELLS(&-FLHEALTH.GOV
b. Provide the following information:
i. Permit number
ii. Driller name
iii. Address
iv. Date and time to begin construction/abandonment
• A minimum of 24 hours' notice is required before constructing any public water supply
wells. Please call our main office at 772-873-4931 and speak with Environmental
Health Staff or provide notification by email to SLCDOH-WELLS(M-FLHEALTH.GOV
• Submit revisions to permit and/or site map and associated fee within 48 hours of well
construction or abandonment.
Florida Department of Health
St. Lucie County Accredited Health Department
5150 NW Milner Drive • Port St. Lucie, FL 34983 Public Health Accreditation Board
PHONE: 772/462-3800 - FAX: 7721871-5360
StLucieCountyHealth.com
TO CONSTRUCT,
west
PLEASE FILL OUT ALL APPLIC FIELDS
(TeAotes ReciUkred:Fields%151e��'A pp tile) F4
64i: River
Th 0 wal ter Well wn;Imqctor is �qp 6 * 1p!? (Of c*o N oh#
ih1i0*iWdt6Md41*tkj'j ffo*96do-t6the
Cat
11000-Auth'arit
(If P �A If ble)
4. 11 353
*80-,on' r Gfifit 'Township
S...
'Wateryyeplqpptractor
VMt Well'C60iftr's Address
7.
8. *Number of.Phdoloadd Wells'.
Class. V lhjecddh:El Re6h4rge Cc
Remecil . AXI ;nAR6ciovery.0 AlrSp"p
Other tbendbe)
I VDIstance,from S6ptI6,80lat6:1f,5 2d&fl
11. lEslimatedWeII,Ddpth'. 126
K Estimbted'Scieen Intervalf- Fromn7
mry Casing mit6nal.- Blacks
Not Caw
I 0.,Spcondary Casing: : Telescopdtai
17.,! Secondary Cailng Material: Black 1
I'VWhodl of CohistrILiblion, Repair., -or Abat
19. Proposedrproutlhq Interval for the ;Prime
From ' S
T SeaLm6t
mm- Seal7uiati
From To, to,
mq..'
oibl To
20. 116dicaN ioia(numbet of existing,well§ of
21641atfils'.wk &a n-
P, y�e stlnp*lormater
or ,
QyP Application? %y0ij-
2Z Latitude
23. Data Obtained From., 6PS
Fee Riumlved t.
THIS., PERMIT IS
59-31038
Unique ID
supyla,ticins ftulred- (See At!ached)
Quad No. Dellh6idomft
12A.13 6
Lot Bid& Unit
19E, St Lucie, Check.lf 62-524.[] -Ybs:,Vj-- No
*
7919
h - C d1int' y- :S6bdiWsIdn
- . 1 .
113 52 954�1,8118-42691 dDwht6Aole(0An6t,
°License NjLiffiIJ0 7�
144ailAclftss
Port St. Lucie Fl 34988.
; State ZIP
ep•air [3 ModIflutionE] -Abandonment:..
'1363s6n idr. RipWr. NII:IdjBcepap. or AWqftnmItht-
I Batton. A§dcultUral Ifflgallon !a Site .16ves tigatIons U i��M
1=9 B
Al'41IT1913116h g Livestock. ut: Ej MorIltdrlrig
I' - ,,.qrqpry lhigation .Test
iaiiJh-,Cdupfed Geothertnal
S E P 1 4 20201
El'-Acigifer-Sto444
�qe.And,RadvVervf] Drainage.
.1,1. FacIIIIy.DdgcrIptlo6. FrqpQpB.cI,'esiaenQa, 12,,, E '!A
stitnated Blatt Dite^% F,
d;.Casing Depth Primarydasihg Diameter�Diameter2 n. 006"n.Hplav leFrom
alvanized 6fainless Steel
s DiameterWrier Sudacd�Ca Ing
11 Gal.vanized, PVC Stainless Side[ .:Other
merit: Augpr Cable Tool
Jetted, Sonic
Point, P Hand -iIvbn. (Well j6,an . o nd'P'ln� PointHydrau'llic'1(Direct Push)
— I . ' ApprpVed Method Other (oedcdbe
3econdary, and Addlif
6 1 1,, j'I'L
Other
Bent,onite Ndat CeM*' ent Othev., 1
entonite Neam-C,66t Oiher=;
:,; . I Other ,:
0
List number of eAsindunUs,ed Wellston site 0
d-rawaW'nAh9owner's 66ntIgUdus rope covered und6ricon Otivv/,Wdter Use Permit (CUPJWUP).
fyes, complete g: C, /WLJP'06DistdctWdU Dft.
27
i,
11352
V
BILLOW TH IS LINE - FOR OFFICIAL —VE 011r1f,
- i 111� DFlie
issue Date E
tda
RdbEilpt'No. Check No.
1EP BYARAUITHPRIIZEDOFFICER OR REPRESENTATIVE OF THE %MD1011 DELEGATED AUTHORITY. THE