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HomeMy WebLinkAboutSewageSTATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
CONSTRUCTION PERMIT FOR: OSTDS New
APPLICANT: James Wright
PROPERTY ADDRESS: 6400 Koblegard Rd Fort Pierce, FL 34951
LOT: BLOCK:
SUBDIVISION:
PERMIT #:66-SF-1928661
APPLICATION #: AP1634051
DATE PAID:
FEE PAID:
RECEIPT #:
DocuMENT #: PRI620681
PROPERTY ID #: 1304-211-0001-000-1 [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
[OR TAX ID NUMBER]
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION
381.0065, F.S., AND CHAPTER 64E-6, F.A.C. DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE
SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS,
WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE
PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID.
ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL,
STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY.
SYSTEM DESIGN AND SPECIFICATIONS
T [ 900 ] GALLONS / GPD Septic CAPACITY
A [ ] GALLONS / GPD N/A CAPACITY
N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ ]
D [ 375 1 SQUARE FEET SYSTEM
R [ ] SQUARE FEET N/A SYSTEM
A TYPE SYSTEM: [ ] STANDARD [ ] FILLED [x] FUND [ 1
I CONFIGURATION: [XI TRENCH [ ] BED [ ]
N
F LOCATION OF BENCHMARK: Orange spot NE comer Of existing building porch
I ELEVATION OF PROPOSED SYSTEM SITE J 50.001E INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 35.001E INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT
L
D F
0
T
H
E
R
REQUIRED: [33.UU] INCHES EXCAVATION REQUIRED: [ 31.UU] INCHES
system is sized for 2 bedrooms with a maximum occupancy of 4 persons (2 per bedroom), for a total estimated flow of
gpd.
SPECIFICATIONS BY: Brian J IngrQ TITLE: Environmental Specialist III
APPROVED BY: TITLE: Environmental Specialist III St. Lucie CHD
Brian J In i
DATE ISSUED: 03/12/2021 EXPIRATION DATE: 09/12/2022
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC Page 1 of 3
v 1.1.4 AP1634051 SE1488133
-faioI -o33S
APPLICATION #:AP1400747
`{ STATE OF FLORIDA PERMIT #: 56-SF-1 928661
DEPARTMENT OF HEALTH DOCUMENT #: FI 1275810
t� c ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
RECEIVED 02/28/2019
,y. CONSTRUCTION INSPECTION AND FINAL APPROVAL DATE PAID:
MAR 2 2 2021 FEE PAID :515.00
RECEIPT #:56-PID-3866964
Permitting Department
APPLICANT: James Wright S'. Lucie Court/
AGENT: Jason Hams (All About Septic Services Inc.)
PROPERTY ADDRESS: 6400 Koblegard Rd Fort Pierce, FL 34951
LOT: 1 BLOCK:
SUBDIVISION: ID#: 1304-211-0001-000-1
CHECKED [XI ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED.
TANK INSTALLATION
[ ]
[01]
TANK SIZE [1] 1090.00 [21
[ ]
[021
TANK MATERIAL Polyethylene
[ ]
[031
OUTLET DEVICE
[ ]
[041
MULTI -CHAMBERED [ LLY N ]
[ ]
[051
OUTLET FILTER Polylok PL-68
[ ]
[06]
LEGEND 1. 70-143-11DC4 2.
[ ]
(071
WATERTIGHT
[ ]
[081
LEVEL
[ ]
[091
DEPTH TO LID
DRAINFIELD INSTALLATION
[ ]
[101
AREA [1] 384 [2] SQFT
[ ]
[111
DISTRIBUTION BOX HEADER X
[ ]
[ 12 ]
NUMBER OF DRAINLINES 1. 4.00 2.
[ ]
[131
DRAINLINE SEPARATION
[ ]
[141
DRAINLENE SLOPE
[ ]
[151
DEPTH OF COVER
[ ]
[161
ELEVATION [ ABOVE / BELOW ]BM 35.00
[ ]
[171
SYSTEM LOCATION
[ ]
[181
DOSING PUMPS
[ ]
[191
AGGREGATE SIZE
[ ]
(201
AGGREGATE EXCESSIVE FINES
[ ]
[211
AGGREGATE DEPTH
SETBACKS
[271 SURFACE WATER
100
FT
[281 DITCHES
43
FT
[291 PRIVATE WELLS
100
FT
[301 PUBLIC WELLS
FT
[311 IRRIGATION WELLS
[321 POTABLE WATER
[331 BUILDING FOUNDATIONS
[341 PROPERTY LINES
[351 OTHER
FILLED / MOUND SYSTEM
(361 DRAINFIELD COVER
[371 SHOULDERS
[381 SLOPES
[391 STABILIZATION
ADDITIONAL INFORMATION
[401 UNOBSTRUCTED AREA
[411 STORMWATER RUNOFF
[421 ALARMS
57
[431 MAINTENANCE AGREEMENT
(441 BUILDING AREA
[451 LOCATION CONFORMS WITH SITE PLAN
FT
FT
FT
FT
FT
FILL / EXCAVATION MATERIAL
I
] [46]
FINAL SITE GRADING
[ ]
[221 FILL AMOUNT
I
] [471
CONTRACTOR Jason Hams (All About Septi
[ ]
[231 FILL TEXTURE
[
] [481
OTHER INFILTRATOR Quick4 EQ36 (single c
[ ]
[241 EXCAVATION DEPTH
ABANDONMENT
[ ]
[251 AREA REPLACED
[
] [491
TANK PUMPED
[ ]
[26] REPLACEMENT MATERIAL
[
] [501
TANK CRUSHED & FILLED
Comments: Comments are on page 2.
CONSTRUCTION
[ APPROVED /
St. Lucie CHD
DATE: 03/22/2019
DISAPPROVED Envir tal Specialist II
n Ingram (ENVIRONMENTAL HEALTH)
FINAL SYSTEM
I APPROVED / DISAPPROVED .
St. Lucie CHD
DATE: 03/22/2019
'Environmental Specialist ll
n 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 AP1400747
EID1928661
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL
Violation Number Comment
Comments
APPLICATION #:AP1400747
PERMIT #: 56-SF-1 928661
DOCUMENT #:F11275810
DATE PAID:02/28/2019
FEE PAID : 515.00
RECEIPT #:56-PID-3866964
The system is sized for 2 bedrooms with a maximum occupancy of 4 persons (2 per bedroom), for a total estimated flow of 300
gpd.
New ST, outlet filter, and 4x8 long TRENCH DF installed. No violations, system ok to cover. Contractor notified onsite. Needs final
inspection for potable water line setback, building foundation setback, mound system, storm water runoff, building area, site plan
conformity, and final site grading.
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 AP1400747 EID1928661
NOTICE OF RIGHTS
A party whose substantial interest is affected by this order may petition for an
administrative hearing pursuant to sections 120.569 and 120.57, Florida Statutes. Such
proceedings are governed by Rule 28-106, Florida Administrative Code. A petition for
administrative hearing must be in writing and must be received by the Agency Clerk for the
Department, within twenty-one (21) days from the receipt of this order. The address of the
Agency Clerk is 4052 Bald Cypress Way, BIN A-02, Tallahassee, Florida 32399. The Agency
Clerk's, facsimile number is 850-413-8743.
Mediation is not available as an alternative remedy.
Your failure to submit a petition for hearing within 21 days from receipt of this order will
constitute a waiver of your right to an administrative hearing, and this order shall become a 'final
order'.
Should this order become a final order, a party who is adversely affected by it is entitled
to judicial review pursuant to Section 120.68, Florida Statutes. Review proceedings are
governed by the Florida Rules of Appellate Procedure. Such proceedings may be commenced
by filing one copy of a Notice of Appeal with the Agency Clerk of the Department of Health and a
second copy, accompanied by the filing fees required by law, with the Court of Appeal in the
appropriate District Court. The notice must be filed within 30 days of rendition of the final order.
1
HEALTH
PAYING ON:
RECEIVED FROM
PAYMENT FORM:
St. Lucie County Health Department
5150 NW Milner Dr Port Saint Lucie, FL 34983
#. 56-SF-1928661 BILL DOC #:56-BID-5191301 CONSTRUCTION APPLICATION #. AP1634051
James Wright AMOUNT PAID: $ 545.00
CREDIT CARD 001399 PAYMENT DATE: 03/01/2021
MAIL TO: James Wright
FACILITY NAME:
PROPERTY LOCATION:
6400 Koblegard Rd
Fort Pierce, FL 34951
Lot:
Block:
Property ID: 1304-211-0001-000-1
EXPLANATION or DESCRIPTION:
128 - OSTDS Construction System Inspection Research Fee
-1 - Surcharge (All)
-1 - OSTDS New Permit Surcharge
-1 - OSTDS Construction Application and Plan Review,New
123 - OSTDS Construction Site Evaluation
126 - OSTDS Construction Permit (New or Mod, Amendment)
127 - OSTDS Construction System Inspection
133 - OSTDS Construction Reinspection
QUANTITY
FEE
1
$
5.00
1
$
45.00
1
$
100.00
1
$
100.00
1
$
115.00
1
$
55.00
1
$
75.00
1
$
50.00
RECEIVED BY: WhighamJL AUDIT CONTROL NO. 56-PID-4895411
e
STATE OF FLORIDA PERMIT NO. - 101 q $ l
DEPARTMENT OF HEALTH DATE PAID: 31 i -L
ONSITE SEWAGE TREATMENT AND DISPOSAL FEE PAID: ,5Hz� ift
SYSTEM RECEIPT #:
•,~`°°"` APPLICATION FOR CONSTRUCTION PERMIT
APPLICATION FOR:
[ ] New System [ ] Existing System [ ] Holding Tank [ ] Innovative
[ ] Repair [ ] Abandonment [ ] Temporary [ ]
APPLICANT: C �br< ��rir�l�-�
AGENT: I TELEPHONE: �✓ -'��5 J
MAILING ADDRESS: �3� /�,��;f,{1t�/`('� �� JrJ►ir�rlc���f'l ��' 33
TO BE COMPLETED BY APPLICANT OR APPLICANT'S AUTHORIZED AGENT SYSTEMS MUST BE CONSTRUCTED
BY A PERSON LICENSED PURSUANT TO 489.105(3)(m) OR 489.552, FLORIDA STATUTES. IT IS THE
APPLICANT'S RESPONSIBILITY TO PROVIDE DOCUMENTATION OF THE DATE THE LOT WAS CREATED OR
PLATTED (MM/DD/YY) IF REQUESTING CONSIDERATION OF STATUTORY GRANDFATHER PROVISIONS.
PROPERTY INFORMATION 1
LOT: BLOCK: / 9 %y//A SUBDIVISION:/I-- �•( � PLATTED:
PROPERTY ID # : -3 c- / i4t //— �)(_�7'l-'�J Z�.'� ZONING: 9 l J I/M OR EQUIVALENT: [ Y /Ise ]
PROPERTY SIZE:T, ORES` WATER SUPPLY: [�] PRIVATE
IS SEWER.AVAILABLE AS PER 381.0065, FS? [ Y
�J
PROPERTY ADDRESS:
DIRECTIONS TO PROPERTY:
BUILDING INFORMATION
Unit Type of
No Establishment
1
1 !
2 G
3
4
[ ] Floor/Equ
PUBLIC [ ]<=2000GPD [ 1>2000GPD
4
DISTANCE TO SEWER: �V '/ A FT
[ ],RESIDENTIAL [ ] COMMERCIAL
No. of Building Commercial/Institutional System Design
Bedrooms Area Sqft Table 1, Chapter 64E-6, FAC
711
t Drains [ ] Other (Specify)
DH 4015, 68/09 (Obsoletes previous editions which may not be used)
Incorporated 64E-6.001, FAC
DATE: " "' G� L
Page 1 of 4
Al,
R
STATE OF FLORIDA APPLICATION # AP1634051
DEPARTMENT OF HEALTH PERMIT # 56-SF-1928661
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
DOCUMENT # SE1488133
SITE EVALUATION AND SYSTEM SPECIFICATION
APPLICANT: James Wright
CONTRACTOR / AGENT:
LOT: BLOCK:
SUBDIVISION: ID# : 1304-211-0001-000-1
TO BE COMPLETED BY ENGINEER, HEALTH DEPARTMENT EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEERS MUST PROVIDE
REGISTRATION NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS.
PROPERTY SIZE CONFORMS TO SITE PLAN: [X]YES [ ]NO NET USABLE AREA AVAILABLE: 8.80 ACRES
TOTAL ESTIMATED SEWAGE FLOW: 300 GALLONS PER DAY [ RESIDENCES -TABLET / OTHER -TABLE 2 ]
AUTHORIZED SEWAGE FLOW: 12450.00 GALLONS PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE ]
UNOBSTRUCTED AREA AVAILABLE: 2000.00 SQFT UNOBSTRUCTED AREA REQUIRED: 750.00 SQFT
BENCHMARK/REFERENCE POINT LOCATION: Oranqe Spot NE Corner Of existinq buildinq porch
ELEVATION OF PROPOSED SYSTEM SITE 50.00 [I INCHES I/ FT ] [ ABOVE /I BELOW I] BENCHMARK/REFERENCE POINT
THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES
SURFACE WATER: 100 FT DITCHES/SWALES: 15 FT NORMALLY WET: [ ]YES [X]NO
WELLS: PUBLIC: FT LIMITED USE: FT PRIVATE: 100 FT NON -POTABLE: FT
BUILDING FOUNDATIONS: 5 FT PROPERTY LINES: 70 FT POTABLE WATER LINES: 100 FT
SITE SUBJECT TO FREQUENT FLOODING? [ ]YES [X]NO 10 YEAR FLOODING? [ ]YES [X]NO1
10 YEAR FLOOD ELEVATION FOR SITE: FT[ MSL / NGVD ] SITE ELEVATION: FT [ MSL / NGVD
.gnTT. PRnTVTT.F. TNFARMATTnM RTTF. 1 SATT. PPOPTT.F. TNFr)RMATTAN STTF. 2
USDA SOIL SERIES:
Munsell #/Color
Texture
Depth
10YR 4/2
Loamy Sand
0 To 17
1 OYR 5/8
CMN/PRM RF
9 To 17
1 OYR 7/2
Sand
17 To 23
10YR 5/4
Sand
23 To 26
10YR 512
Sandy Clay Loam
26 To 31
10YR 6/3
Sand
31 To 39
5GY 5/1
Sandy Clay Loam
39 To 50
5GY 6/1
Sand
50 To 72
USDA SOIL SERIES:
Munsell #/Color
Texture
Depth
1 OYR 2/1
Loamy Sand
0 To 4
10YR 512
Loamy Sand
4 To 14
10YR 5/8
CMN/PRM RF
9 To 14
1 OYR 7/1
Sand
14 To 25
10YR 5/3
Sand
25 To 28
1 OYR 5/2
Sandy Clay Loam
28 To 31
10YR 6/3
Sand
31 To 41
5GY 5/1
Sandy Clay Loam
41 To 52
5GY 611
Sandy Clay
52 To 72
OBSERVED WATER TABLE: 56.00 INCHES [ ABOVE / EEI EXISTING GRADE TYPE: [ PERCHED / APPARENT] ]
ESTIMATED WET SEASON WATER TABLE ELEVATION: 9 INCHES [ ABOVE / BELOW ] EXISTING GRADE
HIGH WATER TABLE VEGETATION: [ ]YES EX ]NO MOTTLING: [X]YES [ ]NO DEPTH: 9.00 INCHES
SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING:
DRAINFIELD CONFIGURATION: [X ] TRENCH [
(- REMARKS/ADDITIONAL CRITERIA
Sand/0.80 DEPTH OF EXCAVATION:
] BED [ ] OTHER (SPECIFY)
WSWT determined using USDA WSS and soil borings.
10YR518 CMN PROM RF mottling in 10YR512 matrix > starting at 9" in S132.
SB1 52" below BM> S62 50 below BM.
SITE EVALUATED BY:
Ingram, Brian e: Environmental Specialist III) (ENVIRONMENTAL HEALTH)
DH 4015, 08/09 (Obsolates previous editions ch may not be used) Incorporated: 64E-6.001, FAC
AP1634051 EID1928661
31 INCHES
DATE: 03/08/2021
Page 3 of 4
v 1.0.2
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
CONSTRUCTION PERMIT FOR: OSTDS New
APPLICANT: James Wright
PROPERTY ADDRESS: 6400 Kobleqard Rd Fort PiercWfL 34951
LOT: 1
BLOCK:
PROPERTY ID #: 1304-211-0001-000-1
PERMIT #:56-SF-1928661
APPLICATION #: AP1400747
DATE PAID•
FEE PAID:
RECEIPT #:
DOCUMENT #: PR1207814
IpN: ,.p.
j [SECTION�,TOWNSHIP, RANGE, PARCEL NUMBER]
R AX _:# NUMBER]
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE --ftT� �G ICATIONS AND STANDARDS OF SECTION
381.0065, F.S., AND CHAPTER 64E-6, F.A.C. DEPAR PROVAL OF SYSTEM DOES NOT GUARANTEE
SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OJ TIME. ANY CHANGE IN MATERIAL FACTS,
WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE
PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID.
ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL,
STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY.
SYSTEM DESIGN AND SPECIFICATIONS
T
-D
[ 900 ]
GALLONS / GPD
Septic new
CAPACITY
A
[ ]
GALLONS / GPD
4N/A
CAPACITY
N
[ ]
GALLONS GREASE
INTERCEPTOR CAPACITY
[MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K
[ ]
GALLONS DOSING
TANK CAPACITY s[ ..
jGAL•LONS`P--'71[ ]DOSES PER 24 HRS #Pumps [ ]
[ 375 1
SQUARE FEET
Drainfield n��YSTB 1
e a W "'4
R [ ] SQUARE FEET N/A 4Y
A TYPE SYSTEM: [ ] STANDARD
I CONFIGURATION: [X] TRENCH [ ] BED [ ]
N
F LOCATION OF BENCHMARK: Orange spot NE corner of existi
I ELEVATION OF PROPOSED SYSTEM SITE
E BOTTOM OF DRAINFIELD TO BE
L
D F
0
T
H
E
R
[ 50.00 ] [ INCHES FT ] [ ABOVE BELOW BENCHMARK/REFERENCE POINT
[ 35.001[ INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT
REQUIRED: [ 33.UU] INCHES EXCAVATION REQUIRED: [ 3'I.UU ] INCHES
system is sized for 2 bedrooms with a maximum occupancy of 4 persons (2 per bedroom), for a total estimated flow of
gpd•
SPECIFICATIONS BY: w Brian J Ingram TITLE: Environmental Specialist II
APPROVED BY: ✓+'TITLE: Environmental Specialist II St. Lucie CHD
Brian a IngraV
DATE ISSUED: 03/19/2019 EXPIRATION DATE: 09/19/2020
DE 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, PAC Page 1 of 3
v 1.1.4 AP1400747 SE1157579
NOTICE OF RIGHTS
A party whose substantial interest is affected by this order may petition for an
administrative hearing pursuant to sections 120.569 and 120.57, Florida Statutes. Such.
proceedings are governed by Rule 28-106, Florida Administrative Code. A petition for
administrative hearing must be in writing and must be received by the Agency Clerk for the
Department, within twenty-one (21) days from the receipt of this order. The address of the
Agency Clerk is 4052 Bald Cypress Way, BIN A-02, Tallahassee, Florida 32399. The Agency
Clerk's facsimile number is 850-413-8743.
Mediation is not available as an alternative remedy.
Your failure to submit a petition for hearing within 21 days from receipt of this order will
constitute a waiver of your right to an administrative hearing, and this order shall become a 'final
order'.
Should this order become a final order,Qa party who,,is adversely affected by it is entitled
to judicial review pursuant to Section 120.68, WO Statutes-IReyiew proceedings are
governed b the Florida Rules of Appel late Pr • WO
Such. roceedi s may be commenced
9 YQ:� � 9� Y
by filing one copy of a Notice of Appeal with t�i Ag �Cy;i le f e Department of Health and a
second copy, accompanied by the filing fees requirwt to Court of Appeal in the
appropriate District Court. The notice must be filed within "; d, sL. rendition of the final order.
UwU WL"
,n W t
;yw St. Lucie County Health Department
5150 NVV Milner Dr Port Saint Lucie, FL 34983
HEALTH
PAYING ON: #: 56-SF-1928661 BILL DOC #:56-BID-4088905 CONSTRUCTION APPLICATION #: AP1400747
RECEIVED FROM: All About Septic Services Inc. AMOUNT PAID: $ 515.00
PAYMENT FORM: CREDIT CARD PAYMENT DATE: 02/28/2019
MAIL TO: James Wright
FACILITY NAME:
PROPERTY LOCATION:
6400 Koblegard Rd
Fort Pierce, FL 34951
1
Lot: Block:
Property ID: 1304-211-0001-000-1
EXPLANATION or DESCRIPTION:
QUANTITY
FEE
128 - OSTDS Construction System Inspection Research Fee
1
$
5.00
-1 - Surcharge (All)
1
$
15.00
-1 - OSTDS New Permit Surcharge
1
$
100.00
-1 - OSTDS Construction Application and Plan Review,New
1
$
100.00
123 - OSTDS Construction Site Evaluation
1
$
115.00
126 - OSTDS Construction Permit (New or Mod, Amendment)
1
$
55.00
127 - OSTDS Construction System Inspection
1
$
75.00
133 - OSTDS Construction Reinspection
1
$
50.00
RECEIVED BY: MontanezNM AUDIT CONTROL NO. 56-PID-3866964
i
i
i
STATE OF FLORIDA
DEPARTMENT OF HEALTH
' ONSITE SEWAGE TREATMENT AND DISPOSAL
<.. SYSTEM
APPLICATION FOR CONSTRUCTION PERMIT
New System [ ] Existing System
Repair Abandonment
ING ADDRESS:
[ ] Holding Tank
[ ] Temporary
PERMIT NO. F- � asUU
DATE PAID:
FEE PAID: M VS-16
RECEIPT #: r�J W
[ ] Innovative
a�TElT,EPHONE
BE COMPLETED BY APPLICANT OR APPLICANT'S AUTHORIZED AGENT:•.`.S3L�STEMS MUST BE CONSTRUCTED
A PERSON LICENSED PURSUANT TO 489.105(3)(m) OR 489.552, FLORIDA STATUTES. IT IS THE
'LICANT'S RESPONSIBILITY TO PROVIDE DOCUMENTATION OF THE DATE THE LOT WAS CREATED OR
MTED (MM/DD/YY) IF REQUESTING CONSIDERATION OF STATUTORY GRANDFATHER PROVISIONS -
PTO PERTY INFORMATION
LOT:_ BLOCK:_ SUBDIVISION: -'� PLATTED:
PROPERTY ID ## : J Sy 7 - a!L-- ©00 P (00 -' ZONING: I/M OR EQUIVALENT: [ Y
'j
PROPERTY SIZE: 3. ACRE WATER SUPPLY: [TC] PRIVATE PUBLIC { ]<=2000GPD [ ]>2000GPD
I(S SEWER AVAILABLE qqA��S PER 381.0065, FS? [ Y 1/ N DISTANCE TO SEWER: JAIA FT
PROPERTY ADDRESS: V 9 ©C C -� • t S T— �,
DkRECTIONS TO PROPERTY : (- (5 . # �., , tom' YL, o 1Lc� . j �) e ;
.g
j x
BUILDING INFORMATION [-�<] RE4IDEJgEIA. [ ] COMMERCIAL
Unit Type of No. of Building Commercial/Institutional System Design
No Establishment Bedrooms Area Sqft _Table 1, Chapter 64E-6, FAC
I
1 = �'� 3 (
icvyl;r-- � � 5�4�
13
i
4
I
I
] Floor/Equ' m nt Drains [ ] Other (Specify)
. � S IGNATURE : DATE: � r✓,
:iOF
OH 4015, 08/09 (Obsoletes previous editions which may not be used)
incorporated 64E-6.001, FAC Page 1 of 4
i
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
SITE EVALUATION AND SYSTEM SPECIFICATION
APPLICANT: James Wright
CONTRACTOR / AGENT: All About Septic Services Inc.
LOT: 1 BLOCK:
SUBDIVISION: . ID# : 1304-211-0001-000-1
APPLICATION # A P1400747
PERMIT # 56-SF-1928661
DOCUMENT # SF1157579
TO BE COMPLETED BY ENGINEER, HEALTH DEPARTMENT EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEERS MUST PROVIDE
REGISTRATION NUMBER AND SIGN AND SEAL EACH PAGE'OF SUBMITTAL. COMPLETE ALL ITEMS.
PROPERTY SIZE CONFORMS TO SITE PLAN: [X]YES [ ]NO NET USABLE AREA AVAILABLE: 8.30 ACRES
TOTAL ESTIMATED SEWAGE FLOW: 300 GALLONS PER DAY [ RESIDENCES -TABLET / OTHER -TABLE 2 ]
AUTHORIZED SEWAGE FLOW: 12450.00 GALLONS'; PER,. DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE ]
UNOBSTRUCTED AREA AVAILABLE: 5000.00 SQFT X9i a U90BSTgtUCTED AREA REQUIRED: 750.00 SQFT
BENCHMARK/REFERENCE POINT LOCATION: Orangesgo
ELEVATION OF PROPOSED SYSTEM SITE 50.00 �[
BELOWI] BENCHMARK/REFERENCE POINT
THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PRO SED-SYSTEM O THE FOLLOWING FEATURES
SURFACE WATER: 100 FT DITCHES/SWALES: 15 NORMALLY WET: [ ]YES [X]NO
WELLS: PUBLIC: FT LIMITED USE: FT PRIVATE: 100 FT NON -POTABLE: FT
BUILDING FOUNDATIONS: 5 '.FT PROPERTY LINES: 70 FT POTABLE WATER LINES: 100 FT
SITE SUBJECT TO FREQUENT FLOODING? [ ]YES [X]NO 10 YEAR FLOODING? [ ]YES [X]NO)
10 YEAR FLOOD ELEVATION FOR SITE: FT[ MSL / NGVD ] SITE ELEVATION: FT [ MSL / NGVD
SOIL PROFILE INFORMATION SITE 1 SATT. PRnFTT.F. TNFARMATTAN STTF. 9
USDA SOIL SERIES:Pineda sand
Munsell #lColor Texture
Depth
1 OYR 4/2
Loamy Sand
0 To 17
10YR 5/8
CMN/PRM RF
9 To 17
1 OYR 7/2
Sand
17 To 23
1 OYR 5/4
Sand
23 To 26
1 OYR 5/2
Sandy Clay Loam
26 To 31
1 OYR 6/3
5GY 5/1
Sand
Sandy Clay Loam
31 To 39
39 To 50 r.
5GY 6/1
Sand
50 To 72
OBSERVED WATER TABLE: 56.00 INCHES [ ABOVE / BELOW ] EXIS'TING GRADE TYPE:
ESTIMATED WET SEASON WATER TABLE ELEVATION: 9 INCHES [ ABOVE
HIGH WATER TABLE VEGETATION: [ ]YES EX ]NO MOTTLING: [X]YES [ ]NO
SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Sand/0.80 DEPTH OF EXC.'
DRAINFIELD CONFIGURATION: [X ] TRENCH [ ] BED [ ] OTHER (SPECIFY)
r REMARKS/ADDITIONAL CRITERIA
WSWT determined using USDA WSS and soil borings.
10YR5/8 CMN PROM RF mottling in 10YR5/2 matrix >2% starting at 9" in SB2.
SB1 52" below BM. SB2 50" below BM. /-7
SITE EVALUATED BY:
Ingram, Brian (Titi : nvironmental Specialist 11) (ENVIRONMENTAL HEALTH)
DH 4015, 08/09 (Obsoletes previous editions which may not be used) Incorporated: 64E-6.001, FAC
AP1400747 EID1928661
USDA SOIL SERIES:Pineda sand
Munsell #lColor Texture
Depth
1 OYR 2/1
Loamy Sand
0 To 4
1 OYR 5/2
Loamy Sand
4 To 14
1 OYR 5/8
CMN/PRM RF
9 To 14
1 OYR 7/1
Sand
14 To 25
''I OYRo5/3,,.
Sand
25 To 28
OYk-, 5/2F ', w
Sandy Clay Loam
28 To 31
10® t 6/, = %
Sand
31 To 41
50f 5/1w
Sandy Clay Loam
41 To 52
5 6/
Sandy Clay
52 To 72
[ PERCHED / APPARENT ]
EXISTING GRADE
DEPTH: 9.00 INCHES
ATION: 31 INCHES
DATE: 03/08/2019
Page 3 of 4
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Custom Soil Resource Report
p Soil Map
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5551M 56622, 5EM 566320 55MM 5554M 555470
3 3
Map Scale: 1:2,130 & printed on A porhait (8.5' x 11") sheet
� Mebis
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0 30 80 120 180 $
A0 100 200 400 600
Map projection: Web Mercator Corner mordfnates: WG584 Edge ta: UIM Zone 17N WGS84
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27" 33' 31" N
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ZP 33 17" N
Custom Soil Resource Report
St. Lucie County, Florida
32—Pineda sand, 0 to 2 percent slopes
Map Unit Setting
National map unit symbol: 2x1 nb
Elevation: 0 to 100 feet
Mean annual precipitation: 47 to 58 inches
Mean annual air temperature: 70 to 77 degrees F
Frost -free period. 355 to 365 days
Farmland classification: Farmland of unique importance
Map Unit Composition
Pineda and similar soils. 85 percent
Minor components: 15 percent
Estimates are based on observations, descriptions, and transects of the mapunit.
Description of Pineda
Setting
Landform: Drainageways on marine terraces, flats on marine terraces
Landform position (three-dimensional): Tread, dip, talf
Down -slope shape: Linear
Across -slope shape: Concave, linear-- ---------- - - - - -
Parent material. Sandy and loamy marine deposits
Typical profile
A - 0 to 5 inches. sand
E - 5 to 19 inches. sand
Bw - 19 to 35 inches: sand
Btg/E - 35 to 38 inches: sandy loam
Btg - 38 to 60 inches: sandy loam
Cg - 60 to 80 inches: loamy sand
Properties and qualities
Slope: 0 to 2 percent
Depth to restrictive feature: More than 80 inches
Natural drainage class: Poorly drained
Runoff class: Very high
Capacity of the most limiting layer to transmit water (Ksat): Moderately low to
moderately high (0.06 to 0.20 in/hr)
Depth to water table: About 3 to 18 inches
Frequency of flooding: None
Frequency of ponding: None
Calcium carbonate, maximum in profile: 4 percent
Salinity, maximum in profile: Nonsaline to very slightly saline (0.0 to 2.0
mmhos/cm)
Sodium adsorption ratio, maximum in profile: 4.0
Available water storage in profile: Low (about 4.6 inches)
Interpretive groups
Land capability classification (irrigated): None specified
Land capability classification (nonirrigated): 3w
Hydrologic Soil Group: C/D
16
Custom Soil Resource Report
Forage suitability group: Sandy over loamy soils on flats of hydric or mesic
lowlands (G155XB241FL)
Other vegetative classification: Slough (R155XY011 FL)
Hydric soil rating: Yes
Minor Components
Malabar
Percent of map unit: 6 percent
Landform: — error in exists on —
Landform position (three-dimensional): Tread, dip, talf
Down -slope shape: Linear, concave
Across -slope shape: Linear, concave
Ecological site: Slough (R155XY011 FL)
Other vegetative classification: Slough (R155XY011 FL)
Hydric soil rating: Yes
Wabasso
Percent of map unit: 5 percent
Landform: Flatwoods on marine terraces
Landform position (three-dimensional): Tread, talf
Down -slope shape: Linear
Across -slope shape: Linear
Other vegetative classification: South Florida Flatwoods (R155XY003FL)
Hydric soil rating: No
Valkaria
Percent of map unit: 2 percent
Landform: Drainageways on flatwoods on marine terraces
Landform position (three-dimensional): Tread, dip, talf
Down -slope shape: Linear
Across -slope shape: Concave, linear
Other vegetative'classification: Slough (R155XY011 FL)
Hydric soil rating: Yes
Hallandale
Percent of map unit: 2 percent
Landform: Flatwoods on marine terraces
Landform position (three-dimensional): Tread, talf
Down -slope shape: Linear
Across -slope shape: Linear
Other vegetative classification: South Florida Flatwoods (R155XY003FL)
Hydric soil rating: Yes
38—Riviera fine sand, 0 to 2 percent slopes
Map Unit Setting
National map unit symbol: 2tzw2
Elevation: 0 to 80 feet
Mean annual precipitation: 44 to 59 inches
Mean annual air temperature: 68 to 77 degrees F
17
Custom Soil Resource Report
Frost -free period. 350 to 365 days
Farmland classification: Farmland of unique importance
Map Unit Composition
Riviera and similar soils: 80 percent
Minor components: 20 percent
Estimates are based on observations, descriptions, and transects of the mapunit.
Description of Riviera
Setting
Landform: Flats on marine terraces, drainageways on marine terraces
Landform position (three-dimensional): Tread, talf, dip
Down -slope shape: Linear
Across -slope shape: Linear, concave
Parent material: Sandy and loamy marine deposits
Typical profile
A - 0 to 6 inches: fine sand
E- 6 to 28 inches: fine sand
BM/E - 28 to 32 inches: fine sandy loam
Btg - 32 to 42 inches: sandy clay loam
C - 42 to 80 inches: fine sand
Properties and qualities
Slope: 0 to 2 percent
Depth to restrictive feature: More than 80 inches
Natural drainage class: Poorly drained
Runoff class. Very high
Capacity of the most limiting layer to transmit water (Ksat): Moderately high to
high (0.60 to 6.00 in/hr)
Depth to water table: About 3 to 18 inches
Frequency of flooding: None
Frequency of ponding. None
Salinity, maximum in profile: Nonsaline to very slightly saline (0.0 to 2.0
mmhos/cm)
Sodium adsorption ratio, maximum in profile: 4.0
Available water storage in profile: Moderate (about 6.0 inches)
Interpretive groups
Land capability classification (irrigated): None specified
Land capability classification (nonirrigated): 3w .
Hydrologic Soil Group: A/D
Forage suitability group: Sandy over loamy soils on flats of hydric or rriesic
lowlands (G155XB241FL)
Other vegetative class cation: Slough (R155XY011 FL)
Hydrcc soil rating: Yes
Minor Components
Wabasso
Percent of map unit. 8 percent
Landform: Flatwoods on marine terraces
Landform position (three-dimensional): Tread, talf
Down -slope shape: Convex, linear
Across -slope shape: Linear
Other vegetative classification: South Florida Flatwoods (R155XY003FL)
18
Custom Soil Resource Report
Hydric soil rating: No
Hallandale
Percent of map unit: 4 percent
Landform: Flatwoods on marine terraces
Landform position (three-dimensional): Tread, talf
Down -slope shape: Linear
Across -slope shape: Linear
Other vegetative classification: South Florida Flatwoods (11155XY003FL)
Hydric soil rating: Yes
Pinellas
Percent of map unit: 4 percent
Landform: Flatwoods on marine terraces
Landform position (three-dimensional): Tread, talf
Down -slope shape: Convex, linear
Across -slope shape: Linear
Other vegetative classification: Cabbage Palm Flatwoods (R155XY005FL)
Hydric soil rating: No
Floridana
Percent of map unit: 2 percent
Landform: Depressions on marine terraces
Landform position (three-dimensional): Tread, dip
Down -slope shape: Concave, linear
Across -slope shape: Concave, linear
Other vegetative classification: Freshwater Marshes and Ponds (R155XY010FL)
Hydric soil rating: Yes
Oldsmar
Percent of map unit: 2 percent
Landform: Flatwoods on marine terraces
Landform position (three-dimensional): Talf
Down -slope shape: Convex, linear
Across -slope shape: Linear.
Other vegetative classification: South Florida Flatwoods (R155XY003FL)
Hydric soil rating: No
55—Winder loamy sand
Map Unit Setting
National map unit symbol: 1 jpwk
Mean annual precipitation: 49 to 58 inches
Mean annual air temperature: 70 to 77 degrees F
Frost -free period: 350 to 365 days
Farmland classification: Farmland of unique importance
Map Unit Composition
Winder, drained and bedded,. and similar soils: 67 percent
Winder, hydric, and similar soils: 15 percent
Minor components: 18 percent
19
Custom Soil Resource Report
Estimates are based on observations, descriptions, and transects of the mapunit.
Description of Winder, Drained And Bedded
Setting
Landform: Flats on marine terraces
Landform position (three-dimensional): Talf
Down -slope shape: Convex, concave
Across -slope shape: Linear
Parent material. Sandy and loamy marine deposits
Typical profile
A - 0 to 6 inches: loamy sand
E - 6 to 12 inches: sand
Btg1- 12 to 33 inches: sandy clay loam
Btg2 - 33 to 49 inches: sandy loam
Cg1- 49 to 61 inches., loamy sand
Cg2 - 61 to 80'inches: sand
Properties and qualities
Slope: 0 to 2 percent
Depth to restrictive feature: More than 80 inches
Natural drainage class. Poorly drained
Runoff class: High
Capacity of the most limiting layer to transmit water (Ksat): Moderately low to
moderately high (0.06 to 0.20 in/hr)
Depth to water table: About 12 to 18 inches
Frequency of flooding. None
Frequency of ponding: None
Calcium carbonate, maximum in profile: 5 percent
Salinity, maximum in profile: Nonsaline to very slightly saline (0.0 to 2.0
mmhos/cm)
Sodium adsorption ratio, maximum in profile: 4.0
Available water storage in profile: Low (about 5.8 inches)
Interpretive groups
Land capability classification (irrigated): None specified
Land capability classification (nonirrigated): 3w
Hydrologic Soil Group: C/D
Forage suitability group: Loamy and clayey soils on flats of hydric or mesic
lowlands (G 1 56BC341 FL)
Hydric soil rating:- No
Description of Winder, Hydric
Setting
Landform: Flats on marine terraces
Landform position (three-dimensional): Talf
Down -slope shape: Linear, concave
Across -slope shape: Linear
Parent material. Sandy and loamy marine deposits
Typical profile
A - 0 to 6 inches: loamy sand
E - 6 to 12 inches. sand
Btg1-12 to 33 inches. sandy clay loam
Btg2 - 33 to 49 inches: sandy loam
20
Custom Soil Resource Report
Cg1- 49 to 61 inches: loamy sand
Cg2 - 61 to 80 inches. sand
Properties and qualities
Slope: 0 to 2 percent
Depth to restrictive feature: More than 80 inches
Natural drainage class: Poorly drained
Runoff class: Very high
Capacity of the most limiting layer to transmit water (Ksat): Moderately low to
moderately high (0.06 to 0.20 in/hr)
Depth to water table: About 0 to 12 inches
Frequency of flooding: None
Frequency of ponding: None
Calcium carbonate, maximum in profile: 5 percent
Salinity, maximum in profile: Nonsaline to very slightly saline (0.0 to 2.0
mmhos/cm)
Sodium adsorption ratio, maximum in profile: 4.0
Available water storage in profile: Low (about 5.8 inches)
Interpretive groups
Land capability classification (irrigated): None specified
Land capability classification (nonirrigated): 3w
Hydrologic Soil Group: C/D
Forage suitability group: Loamy and clayey soils on flats of hydric or mesic
lowlands (G156BC341FL)
Hydric soil rating: Yes
Minor Components
Pineda
Percent of map unit. 3 percent
Landform: Drainageways on marine terraces, flats on marine terraces
Landform position (three-dimensional): Dip
Down -slope shape: Linear
Across -slope shape: Concave
Hydric soil rating: Yes
Riviera
Percent of map unit: 3 percent
Landform: Flats on marine terraces
Landform position (three-dimensional): Talf
Down -slope shape: Linear
Across -slope shape: Linear
Hydric soil rating: Yes
Floridana
Percent of map unit: 3 percent
Landform: Depressions on marine terraces
Landform position (three-dimensional): Dip
Down -slope shape: Concave
Across -slope shape: Concave
Hydric soil rating: Yes
Hallandale
Percent of map unit. 3 percent
Landform: Flats on marine terraces
Landform position (three-dimensional): Interfluve, talf
21
Custom Soil Resource Report
Down -slope shape: Convex
Across -slope shape: Linear
Hydric soil rating: No
Winder, shell substratum, hydric
Percent of map unit: 2 percent
Landform: Flats on marine terraces
Landform position (three-dimensional): Talf
Down -slope shape: Linear, concave
Across -slope shape: Linear
Hydric soil rating: Yes
Wabasso
Percent of map unit: 2 percent
Landform: Flats on marine terraces
Landform position (three-dimensional): Talf
Down -slope shape: Convex
Across -slope shape: Linear
Hydric soil rating: No
Wabasso, gravelly substratum
Percent of map unit: 2 percent
Landform: Flats on marine terraces
Landform position (three-dimensional): Talf
Down -slope shape: Convex
Across -slope shape: Linear
Hydric soil rating: No
22