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HomeMy WebLinkAboutHealth Dept abandonment approval APPLICATION #:AP 1605147 STATE OF FLORIDA PERMIT #:56-SF-2210485 1 DEPARTMENT OF HEALTH DOCUMENT #:FI 1562383 taI ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION INSPECTION A FINAL APPROVAL DATE PAID:12/04/2020 ND FEE PAID:95.00 RECEIPT #:56-PID-4822455 APPLICANT: Dave Golden Homes Inc. AGENT: Ashton Septic PROPERTY ADDRESS: 343 Pandora Ave Fort Pierce, FL 34951 LOT: 2 BLOCK: SUBDIVISION: Bel-Aire Estates ID#: 1312-702-0002-000-0 CHECKED [X1 ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED. TANK INSTALLATION SETBACKS [ 1 [011 TANK SIZE [11 [21 [ 1 [271 SURFACE WATER FT [ 1 [021 TANK MATERIAL [ 1 [281 DITCHES FT [ 1 [031 OUTLET DEVICE [ 1 [291 PRIVATE WELLS FT [ 1 [041 MULTI-CHAMBERED [ Y / N I [ 1 [301 PUBLIC WELLS FT [ 1 [051 OUTLET FILTER [ 1 [311 IRRIGATION WELLS FT [ 1 [061 LEGEND 1, 2. [ 1 [321 POTABLE WATER FT [ 1 [071 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 [ 1 [101 AREA Ill [21 SQFT [ 1 [361 DRAINFIELD COVER [ 1 [111 DISTRIBUTION BOX HEADER [ 1 [371 SHOULDERS [ 1 [121 NUMBER OF DRAINLINES 1. 2. [ 1 [381 SLOPES [ 1 [131 DRAINLINE SEPARATION [ 1 [391 STABILIZATION [ 1 [141 DRAINLINE SLOPE [ 1 [151 DEPTH OF COVER ADDITIONAL INFORMATION [ 1 [161 ELEVATION [ ABOVE / BELOW IBM [ 1 [401 UNOBSTRUCTED AREA [ 1 [171 SYSTEM LOCATION [ 1 [411 STORMWATER RUNOFF [ 1 [181 DOSING PUMPS [ 1 [421 ALARMS [ 1 [191 AGGREGATE SIZE [ 1 [431 MAINTENANCE AGREEMENT [ 1 [201 AGGREGATE EXCESSIVE FINES [ I [441 BUILDING AREA [ I [211 AGGREGATE DEPTH [ 1 [451 LOCATION CONFORMS WITH SITE PLAN FILL / EXCAVATION MATERIAL [ 1 [461 FINAL SITE GRADING [ 1 [221 FILL AMOUNT [ 1 [471 CONTRACTOR MICHAEL W STUHR (ASHTO [ 1 [231 FILL TEXTURE 1 1 [481 OTHER [ 1 [241 EXCAVATION DEPTH ABANDONMENT [ 1 [251 AREA REPLACED [ 1 [491 TANK PUMPED 01/06/2021 [ 1 [261 REPLACEMENT MATERIAL [ 1 [501 TANK CRUSHED & FILLED 01/06/2021 Comments: Comments are on page 2. CONSTRUCTION [ APPROVED / St. Lucie CHD DATE: 01/06/2021 DISAPPROVED 1 ' Environ entaI Speci 'st II r'an J Ingram(ENVIRONMENTAL HEALTH) FINAL SYSTEM [ APPROVED / DISAPPROVED 1 : St. Lucie CHD DATE: 01/06/2021 Environmental Speciali II Brian J Ingram(ENVIRONMENTAL 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 v 1.0.1 AP1605147 EID2210485 ►�4E APPLICATION #:AP160 5147 STATE OF FLORIDA PERMIT #:56-SF-2210485 DEPARTMENT OF HEALTH DOCUMENT #:F11562383 ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM ;y �yN��// CONSTRUCTION INSPECTION AND FINAL APPROVAL DATE PAID:12/04/2020 Q`. ^^u��� FEE PAID:95.00 RECEIPT #:56-PID-4822455 Violation Number Comment Comments Tank pumped and abandoned properly. No violations. Abandonment approved. Contractor emailed final approval. DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC Page 2 of 3 Ell Database v 1.0.1 AP1605147 EID2210485