HomeMy WebLinkAboutHealth Deptr e STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
,'!'.' CONSTRUCTION INSPECTION AND FINAL APPROVAL
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APPLICANT: Beth Brown (Dave Golden Homes)
AGENT: Dave Golden (Dave Golden Homes)
PROPERTY ADDRESS: 3601 Arnold Rd Fort Pierce, FL 34981
LOT: 13 & 14
BLOCK: 3
APPLICATION #:AP1582925
PERMIT #:56-SF-04355
DOCUMENT # : FI 1629844
DATE PAID:10/06/2020
FEE PAID:545.00
RECEIPT #:56-PID-4745632
SUBDIVISION: Cross Trail ID#: 2420-601-0044-000-1
CHECKED [X] ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED.
TANK INSTALLATION
[ ] [O1] TANK SIZE [11 1090.00 [21
[ ] [021 TANK MATERIAL Polyethylene
[ ] [031 OUTLET DEVICE
[ ] [041 MULTI -CHAMBERED [ Y N ]
[ ] [051 OUTLET FILTER Polylok PL-68
[ ] [061 LEGEND 1. 70-143-11DC4 2.
[ ] [071 WATERTIGHT
[ ] [081 LEVEL
[ ] [091 DEPTH TO LID
DRAINFIELD INSTALLATION
[ ] [101 AREA [l] 543.36 [21 SQFT
[ ] [111 DISTRIBUTION BOX HEADER X
[ ] [121 NUMBER OF DRAINLINES 1. 8.00 2.
[ ] (131 DRAINLINE SEPARATION
[ ] [141 DRAINLINE SLOPE
[ ] [151 DEPTH OF COVER
[ ] [161 ELEVATION [ ABOVE / BELOW ]BM 6.00
[ ] [171 SYSTEM LOCATION
[ ] (181 DOSING PUMPS
[ ] [191 AGGREGATE SIZE
[ ] [201 AGGREGATE EXCESSIVE FINES
[ ] [211 AGGREGATE DEPTH
FILL / EXCAVATION MATERIAL
[ ] [221
FILL AMOUNT
[ ] [231
FILL TEXTURE
[ ] [241
EXCAVATION DEPTH
[ ] [251
AREA REPLACED
[ ] [261
REPLACEMENT MATERIAL
Comments:
Comments are on page 2.
SETBACKS
[ ] [271
SURFACE WATER
FT
[ ] (281
DITCHES
FT
[ ] (291
PRIVATE WELLS 79
FT
[ ] [301
PUBLIC WELLS
FT
[ ] [311
IRRIGATION WELLS
FT
[ ] [321
POTABLE WATER 55
FT
[ ] [331
BUILDING FOUNDATIONS 6
FT
[ ] [341
PROPERTY LINES 5
FT
[ ] [351
OTHER
FT
FILLED / MOUND SYSTEM
[ ] [361
DRAINFIELD COVER
[ ] [371
SHOULDERS
[ ] [381
SLOPES
[ ] [391
STABILIZATION 05/24/2021
ADDITIONAL INFORMATION
[ ] [401
UNOBSTRUCTED AREA
[ ] [411
STORMWATER RUNOFF
[ ] [421
ALARMS
[ ] [431
MAINTENANCE AGREEMENT
[ ] [441
BUILDING AREA
[ ] [451
LOCATION CONFORMS WITH SITE PLAN
[ ] [461
FINAL SITE GRADING
[ ] [471
CONTRACTOR MICHAEL W STUHR (ASHTO
[ ] [48]
OTHER INFILTRATOR Quick4 Plus EQ36 LP
ABANDONMENT
[ ] [491
TANK PUMPED
[ ] [501
TANK CRUSHED & FILLED
CONSTRUCTION I APPROVED / St. Lucie CHD
DISAPPROVED I ' Environ ntal Specia' III Ingram (ENVIRONMENTAL HEALTH)
FINAL, SYSTEM [ APPROVED / DISAPPROVED ]: St. Lucie CHD
Env onmental Specialist III )an 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
EH Database v 1.0.1 AP1582925 EID346188
DATE: 04/14/2021
DATE: 05/24/2021
Page 2 of 3
STATE OF FLORIDA
r r'� DEPARTMENT OF HEALTH
c� s ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL
Wa'
Violation Number Comment
Comments
APPLICATION #:AP1582925
PERMIT #:56-SF-04355
DOCUMENT # : FI 1629844
DATE PAID:10/06/2020
FEE PAID.545.00
RECEIPT # :56-PI D-4745632
The system is sized for 3 bedrooms with a maximum occupancy of 6 persons (2 per bedroom), for a total estimated flow of 300
New ST, filter, and 8x6 long BED DF installed. No violations, system ok to cover, contractor notified by phone. Needs final
inspection for mound system, gutter on porch, final site grading, and "as built survey" with correct well location(NW property
corner).
Final system approved. Contractor 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 AP1582925 EID346188