HomeMy WebLinkAbout11097 s ird fa�'t� �T
g" STATE OF FLORIDA
� � ��� DEPARTMENT OF HEALTH
c • ' �u.Q' ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL
coo u� �4"� .
APPLICANT: Gary Williams
AGENT: Pace 2000, InC
PROPERTY ADDREss: 11097 S Indian River Dr Fort Pierce, FL 34982
APPLICATION #:AP15O$76S
PERMIT #:56-SF-2089461
DOCUMENT # : FI 1624578
DATE PAID : 06/08/2020
FEE PAID:545.00
RECEIPT #:56-PID-4444734
LOT:
SUBDIVISION:
BLOCK: 2
ID#: 3532-503-0020-000-3
CHECKED (X] ITEMS ARE NOT IN COMPLIANCE WITH
STATUTE OR RULE AND MUST BE CORRECTED.
TANK INSTALLATION
SETBACKS
[ ] [O1]
TANK SIZE [1] 1090.00 [2]
[ ] [27]
SURFACE WATER
230
FT
( ] [02]
TANK MATERIAL Polypropylene
[ ] [28]
DITCHES
FT
[ ] [03]
OUTLET DEVICE
[ ] [29]
PRIVATE WELLS
gg
FT
[ ] [04]
MULTI -CHAMBERED [ Y N ]
[ ] [30]
PUBLIC WELLS
FT
[ ] [05]
OUTLET FILTER POlylok PL-68
[ ] [31]
IRRIGATION WELLS
FT
[ ] (06]
LEGEND 1, 70-143-11DC4 2.
[ ] [32]
POTABLE WATER
5$
FT
[ ] [07]
WATERTIGHT
[ ] [33]
BUILDING FOUNDATIONS
16
FT
[ ] [OB]
LEVEL
[ ] [34]
PROPERTY LINES
21
FT
[ ] [09]
DEPTH TO LID
[ ] [35]
OTHER
FT
DRAINFIELD INSTALLATION
FILLED / MOUND SYSTEM
[ ] [10]
AREA [1] 384 [2] SQFT
[ ] [36]
DRAINFIELD COVER
[ ] [11]
DISTRIBUTION BOX HEADER X
L l [37]
SHOULDERS
[ ] [12]
NUMBER OF DRAINLINES 1. 4.00 2.
[ ] [38]
SLOPES
[ ] [13]
DRAINLINE SEPARATION
[ ] [39]
STABILIZATION
[ ] [14]
DRAINLINE SLOPE
[ ] [15]
DEPTH OF COVER
ADDITIONAL INFORMATION
[ ] [16]
ELEVATION [ ABOVE / BELOW ]BM 2,00
[ ] [40]
UNOBSTRUCTED AREA
[ ] [17]
SYSTEM LOCATION
[ ] [41]
STORMWATER RUNOFF
[ ] [18]
DOSING PUMPS
( ] [42]
r.r.nRMc
[ ] [19]
AGGREGATE SIZE
[ ] [43]
MAINTENANCE AGREEMENT
[ ] [20]
AGGREGATE EXCESSIVE FINES
[ ] [44]
BUILDING AREA
[ J [21]
AGGREGATE DEPTH
[ ] [45]
LOCATION CONFORMS WITH
SITE PLAN
[ ] [46]
FINAL SITE GRADING
FILL / EXCAVATION MATERIAL
[ ] [22]
FILL AMOUNT
[ ] [47]
CONTRACTOR Jeff Nelson (JEFFREY K NEL
[ ] [23]
FILL TEXTURE
[ ] [48]
OTHER INFILTRATOR Quick4 EQ36 (single c
[ ] [29]
EXCAVATION DEPTH
ABANDONMENT
[ ] [25]
AREA REPLACED
[ ] [49]
TANK PUMPED
[ ] [26]
REPLACEMENT MATERIAL
[ ] [50]
TANK CRUSHED � FILLED
Comments:
Comments are on page 2.
/
�v vy
Q� St. Lucie CHD
DATE : 05/05/2021
CONSTRUCTION
I APPROVED
DISAPPROVED
�
� ' E v�ir/o�nm�,.eQn�tal Spec'alist I
onta a (Flo 'da Department of He
FINAL SYSTEM
[ APPROVED / DISAPPROVED
`>L�v"�' �
St. Lucie CHD
DATE: O5/O5/2021
Environmental Spec alist II
'tole Montan (F ride Department of He
(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
AP1508768
EID2089461
�,��
�,}� STATE OF FLORIDA
- .f DEPARTMENT OF HEALTH
��`�s` ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
pry CONSTRUCTION INSPECTION AND FINAL APPROVAL
�i wE s
Violation Number Comment
Comments
APPLICATION #:AP15p8768
PERMIT #:56-SF-2089461
DOCUMENT #:F116p24578
DATE PAID:O6�O8�2020
FEE PAID:545.00
RECEIPT #:56-PID-4444734
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 4x8 long TRENCH DF installed. No violations, system ok to cover. Contractor notified by phone. Final system
approved.
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 AP1608768 EID2089461