HomeMy WebLinkAbout3433 gordy rd aba faSTATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL
APPLICANT: Alicia Ragoobar
AGENT: Brian Davis (Brian Davis Septic)
PROPERTY ADDRESS: 3433 Gordy Rd Fort Pierce, FL 34945
LOT:
BLOCK:
APPLICATION #:AP1637070
PERMIT #:56-SF-2249976
DOCUMENT #:F11605351
DATE PAID:03/11/2021
FEE PAID:95.00
RECEIPT #:56-PID-4902407
SUBDIVISION:
ID# :
2326-411-0010-000-2
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
[ ] [311
IRRIGATION WELLS
FT
[
]
[06]
LEGEND 1.
2.
[ ] [32]
POTABLE WATER
FT
[
]
[07]
WATERTIGHT
[ ] [33]
BUILDING FOUNDATIONS
FT
[
]
[08]
LEVEL
[ ] [341
PROPERTY LINES
FT
[
]
[09]
DEPTH TO LID
[ ] (351
OTHER
FT
DRAINFIELD
INSTALLATION
FILLED / MOUND SYSTEM
[
]
[10]
AREA [1] [2]
SQFT [ ] [36]
DRAINFIELD COVER
[
]
[11]
DISTRIBUTION BOX
HEADER
[ ] [371
SHOULDERS
[
]
[12]
NUMBER OF DRAINLINES
1. 2.
[ ] [38]
SLOPES
[
]
[13]
DRAINLINE SEPARATION
[ ] [39]
STABILIZATION
[
]
[141
DRAINLINE SLOPE
[
]
[15]
DEPTH OF COVER
ADDITIONAL INFORMATION
[
]
[16]
ELEVATION [ ABOVE / BELOW ]BM
[ ] [40]
UNOBSTRUCTED AREA
[
]
[17]
SYSTEM LOCATION
[ ] [411
STORMWATER RUNOFF
[
]
[18]
DOSING PUMPS
[ ] (42]
ALARMS
[
]
[19]
AGGREGATE SIZE
[ ] [43]
MAINTENANCE AGREEMENT
[
]
[20]
AGGREGATE EXCESSIVE FINES
[ ] [441
BUILDING AREA
[
]
[21]
AGGREGATE DEPTH
[ ] [45]
LOCATION CONFORMS WITH SITE PLAN
FILL
/ EXCAVATION MATERIAL
[ ] [46]
FINAL SITE GRADING
[
]
[221
FILL AMOUNT
[ ] [471
CONTRACTOR Brian Davis (Brian Davis Sept
[
]
[23]
FILL TEXTURE
[ ] (48]
OTHER
[
]
[24]
EXCAVATION DEPTH
ABANDONMENT
[
]
[25]
AREA REPLACED
[ ] [49]
TANK PUMPED 04/02/2021
[
]
[26]
REPLACEMENT MATERIAL
[ ] [50]
TANK CRUSHED & FILLED 04/05/2021
Comments: Comments are on page 2.
CONSTRUCTION [ APPROVED / /µ{M St. Lucie CHD DATE: 04/05/2021
DISAPPROVED ] ' Env ro ntal Specialist II ria ngram (ENVIRONMENTAL HEALTH)
FINAL SYSTEM [ APPROVED / DISAPPROVED ] : St. Lucie CHD DATE: 04/05/2021
nvironmental Specialist III Van 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 AP1637070 EID2249976
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL
Violation Number Comment
Comments
APPLICATION #:AP1637070
PERMIT #:56-SF-2249976
DOCUMENT #:F11605351
DATE PAID:03/11/2021
FEE PAID:95.00
RECEIPT #:56-PID-4902407
ST pumped and abandoned properly. No violations. system ok to cover. Abandonment approval emailed to GC and building
lepartment.
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 AP1637070 EID2249976