HomeMy WebLinkAboutHealth Dept Final Approval ,•'�yi�i�s A.PPLICATION #:AP1427632
STATE OF FLORIDA PERMIT #:56-SF-1980993
DEPARTMENT OF HEALTH
L t' DOCUMENT #:F11560834
tr1 ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL DATE PAID:08/07/2019
FEE PAID:
RECEIPT #:56-PI D-4033646
APPLICANT: Adams Homes of Northwest Florida, Inc
AGENT: Benjamin Drew"s Plumbing& Drain Services
PROPERTY ADDRESS: 5609 Palm Dr Fort Pierce, FL 34982
LOT: 40 BLOCK: 55
SUBDIVISION: Indian River Estates ID#: 3402-609-0138-000-8
CHECKED [XI ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED.
TANK INSTALLATION SETBACKS
[ ] [01] TANK SIZE [11 1090.00 [21 [ ] [271 SURFACE WATER FT
[ ] [021 TANK MATERIAL Polypropylene [ ] [281 DITCHES FT
[ ] [031 OUTLET DEVICE [ ] [291 PRIVATE WELLS 100+ FT
[ ] [041 MULTI-CHAMBERED [ Y N ] [ 1 [301 PUBLIC WELLS FT
[ ] [051 OUTLET FILTER Polylok PL-68 [ ] [311 IRRIGATION WELLS 100+ FT
[ ) [0 6) LEGEND 1. 70-143-11 DC4 2. [ ] [32] POTABLE WATER 29 FT
[ ] [071 WATERTIGHT [ ] [331 BUILDING FOUNDATIONS 5 FT
[ ] (081 LEVEL [ ) [341 PROPERTY LINES 14 FT
[ ] [091 DEPTH TO LID [ ] [35) OTHER FT
DRAINFIELD INSTALLATION FILLED / MOUND SYSTEM
[ ] (101 AREA [1] 516 [21 SQFT [ ] [361 DRAINFIELD COVER
[ ] [111 DISTRIBUTION BOX HEADER X [ ] [371 SHOULDERS
[ ) [121 NUMBER OF DRAINLINES 1. 4.00 2. [ ] [381 SLOPES
[ ] [13) DRAINLINE SEPARATION [ 1 [391 STABILIZATION 12/29/2020
[ ] [141 DRAINLINE SLOPE
[ ] [151 DEPTH OF COVER ADDITIONAL INFORMATION
[ ] [16) ELEVATION ( ABOVE / BELOW ]BM 7.00 [ ] [401 UNOBSTRUCTED AREA
[ ] [171 SYSTEM LOCATION [ ] [41) STORMWATER RUNOFF
[ ] [18) DOSING PUMPS [ 1 [421 ALARMS
[ ] [191 AGGREGATE SIZE [ ] [431 MAINTENANCE AGREEMENT
t ) [201 AGGREGATE EXCESSIVE FINES [ ] [441 BUILDING AREA
[ ] [211 AGGREGATE DEPTH [ ] [451 LOCATION CONFORMS WITH SITE PLAN
FILL / EXCAVATION MATERIAL t l [461 FINAL SITE GRADING
[ ] [221 FILL AMOUNT [ l [471 CONTRACTOR Bruce T Mc Cullers (Reliable T
[ ] [231 FILL TEXTURE I. 1 [481 OTHER ADS MPS-9(9 pipes-2 tier)
[ ] [241 EXCAVATION DEPTH ABANDONMENT
[ ] [25) AREA REPLACED [ ] [491 TANK PUMPED
[ ] [261 REPLACEMENT MATERIAL [ ) [50) TANK CRUSHED & FILLED
Comments: Comments are on page 2.
CONSTRUCTION ( APPROVED / St. Lucie CHD DATE: 11/02/2020
DISAPPROVED Enviro mental Speci keem V Frett(Florida Department of Health
FINAL SYSTEM ( APPROVED / DISAPPROVED 1: St. Lucie CHD DATE: 12/29/2020
Env ronmental SpeciaUst 11 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 AP1427632 EID1960993
Oki APPLICATION #:AP1427632
STATE OF FLORIDA PERMIT #:56-SF-1980993
. > DEPARTMENT OF HEALTH
r � � ONSITE SEWAGE TREATMENT A DISPOSAL SYSTEM DOCUMENT #:FI 1560834
- ND
CONSTRUCTION INSPECTION AND FINAL APPROVAL DATE PAID:08/07/2019
FEE PAID.
545.00
RECEIPT #:56-PI D-4033646
Violation Number Comment
Comments
The system is sized for 4 bedrooms with a maximum occupancy of 8 persons(2 per bedroom),for a total estimated flow of 400
gpd.
Verified soils, setbacks, and elevations. Hold for mound requirements, depth of cover, building walkthrough, and final grading.
New ST,filter, and 440.5+10'at footer TRENCH DF installed. No violations.
Final system approved. Contractor and building department 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
EH Database v 1.0.1 AP1427632 EID1980993