HomeMy WebLinkAboutHealth DeptAPPLICATION #: P 45 7 6
STATE OF FLORIDA PERMIT #:56-SF-2026782
DEPARTMENT OF HEALTH DOCUMENT # : FI 1625141
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL DATE PAID,:01/02/2020
FEE PAID:545.00
RECEIPT #:.56-PID-4256985
APPLICANT: St Lucie Habitat for Humanity
AGENT: St Lucie Habitat for Humanity (Ashton Septic)
PROPERTY ADDRESS: 5703 Hickory Dr Fort Pierce, FL 34982
LOT: 24
BLOCK: 63
SUBDIVISION:
Indian River Estates ID#: 3402-609-0422-000-6
CHECKED [XI ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED.
TANK INSTALLATION
SETBACKS
[ 1 [011
TANK SIZE [11 1090.00 [21 [
1 [271
SURFACE WATER FT
[ 1 [021
TANK MATERIAL Polypropylene [
1 (281
HITCHES 18 FT
[ 1 [031
OUTLET DEVICE [
1 [291
PRIVATE WELLS FT
[ 1 (041
MULTI -CHAMBERED [ Y N 1 [
1 [301
PUBLIC WELLS FT
[ 1 [05)
OUTLET FILTER Polylok PL-68 [
1 [311
IRRIGATION WELLS FT
[ ] [061
LEGEND 1. 70-143-11DC4 2. [
] [321
POTABLE WATER 22 FT
[ 1 [071
WATERTIGHT [
1 [331
BUILDING FOUNDATIONS 5 FT
[ 1 [081
LEVEL [
] [341
PROPERTY LINES 5 FT
[ 1 [091
DEPTH TO LID [
1 [351
OTHER FT
DRAINFIELD INSTALLATION
FILLED / MOUND SYSTEM
[ 1 [101
AREA [11 509.4 [21 SQFT [
1 [361
DRAINFIELD COVER
[ 1 (111
DISTRIBUTION BOX HEADER X [
1 [371
SHOULDERS
[ 1 [121
NUMBER OF DRAINLINES 1. 5.00 2. [
1 (381
SLOPES
[ 1 [131
DRAINLINE SEPARATION [
1 [391
STABILIZATION
[ 1 [141
DRAINLINE SLOPE
[ 1 [151
DEPTH OF COVER
ADDITIONAL INFORMATION
1 (16]
ELEVATION [ ABOVE / BELOW IBM 1,00 [
1 [401
UNOBSTRUCTED AREA.
[ 1 (171
SYSTEM LOCATION [
1 (411
STORMWATER RUNOFF
[ ] [181
DOSING PUMPS [
1 [421
ALARMS
[ ] [191
AGGREGATE SIZE [
1 [431
MAINTENANCE AGREEMENT
[ 1 [201
AGGREGATE EXCESSIVE FINES [
] [44]
BUILDING AREA
[ 1 (211
AGGREGATE DEPTH [
1 [451
LOCATION CONFORMS WITH SITE PLAN
[
1 [461
FINAL SITE GRADING
FILL
/ EXCAVATION MATERIAL
[
1 [471
CONTRACTOR Mike Stuhr (Ashton)
[ 1 [221
FILL AMOUNT
[
1 [461
OTHER INFILTRATOR Quick4 Plus EQ36 LP
[ 1 [231
FILL TEXTURE
[ 1 [241
EXCAVATION DEPTH
ABANDONMENT
[ 1 [251
AREA REPLACED [
1 [491
TANK PUMPED
[ 1 [261
REPLACEMENT MATERIAL [
1 [501
TANK CRUSHED & FILLED
Comments: Comments
are on page 2.
/ 4M
St. Lucie CHD DATE : 02/09/2021
CONSTRUCTION
[ APPROVED
DISAPPROVED ] nvironmental Specialist III
rian J Ingram (
IRONMENTAL HEALTH)
FINAL SYSTEM
[ APPROVEI? / DISAPPROVED "] :
St. Lucie CHD DATE: 05/07/2021
Environmental S ecialis II
Ni ole Monta a (Florida Department of He
(Explanation of Violations on following page)
DH 4016, 08/09 (Obsoletes all previous editions which may not be use
Incorporated:
64E-6.003, FAC
Page 2 of 3
EH Database v 1.0.1 AP1459760
EID2026782
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL
Violation Number Comment
Comments
APPLICATION #:AP1459760
PERMIT #:56-SF-2026782
DOCUMENT #: F11625141
DATE PAID : 01 /02/2020
FEE PAID:545.00
RECEIPT #:56-PID-4256985
The system is sized for 3 bedrooms with a maximum occupancy of 6 persons (2 per bedroom), for a total estimated flow of 300
gpd.
New ST, filter, and 5x9 long BED DF installed. No violations, system ok to cover, contractor notified onsite. Needs final
inspection for filled system, gutters, and final site grading.
Final inspection completed. Filled system checked, gutters added, and final site grading completed.
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 AP1459760 EID2026782