HomeMy WebLinkAboutHealth Department ApprovalSTATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL
APPLICANT: William Hardman
AGENT: Jamie DlFranceSCo (All Contractor Services)
PROPERTY ADDRESS: 4000 Edwards Rd Fort Pierce, FL 34981
LOT
BLOCK:
APPLICATION #:AP1610381
PERMIT # : 56-S F-2217640
DOCUMENT #:F11566023
DATE PAID : 01 /04/2021
FEE PAID:95.00
RECEIPT #:56-PID-4849084
SUBDIVISION: ID# . 2429-222-0005-000-0
CHECKED [X] ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED.
TANK
INSTALLATION
[ ] [01]
TANK SIZE [1] [2]
[ ] [02]
TANK MATERIAL
[ ] [03]
OUTLET DEVICE
[ ] [04]
MULTI -CHAMBERED [ Y / N ]
[ J [051
OUTLET FILTER
[ ] [06]
LEGEND 1, 2.
[ ] [071
WATERTIGHT
[ ] [081
LEVEL
[ ] (091
DEPTH TO LID
DRAINFIELD INSTALLATION
[ ] (101
AREA [1] [21 SQFT
[ J [111
DISTRIBUTION BOX HEADER
[ ] [12]
NUMBER OF DRAINLINES 1. 2.
[ ] [131
DRAINLINE SEPARATION
[ ] [14]
DRAINLINE SLOPE
[ ] [15]
DEPTH OF COVER
[ ] [16]
ELEVATION [ ABOVE / BELOW ]BM
[ ] [17]
SYSTEM LOCATION
[ ] [181
DOSING PUMPS
[ ] [191
AGGREGATE SIZE
[ ] [201
AGGREGATE EXCESSIVE FINES
[ J [21]
AGGREGATE DEPTH
FILL / EXCAVATION MATERIAL
[ ] [22] FILL AMOUNT
[ ] [23] FILL TEXTURE
[ ] [24] EXCAVATION DEPTH
[ ] [25] AREA REPLACED
[ ] [26] REPLACEMENT MATERIAL
Comments: Comments are on page 2.
I
SETBACKS
[27] SURFACE WATER
[28] DITCHES
[29] PRIVATE WELLS
[301 PUBLIC WELLS
[311 IRRIGATION WELLS
[32] POTABLE WATER
[331 BUILDING FOUNDATIONS
[34] PROPERTY LINES
[35] OTHER
FILLED / MOUND SYSTEM
[36] DRAINFIELD COVER
[37] SHOULDERS
[38] SLOPES
(39] STABILIZATION
FT
FT
FT
FT
FT
FT
FT
FT
FT
ADDITIONAL INFORMATION
[ ] [40] UNOBSTRUCTED AREA
[ ] [41] STORMWATER RUNOFF
[ ] (42] ALARMS
[ ] [43] MAINTENANCE AGREEMENT
[ ] [44] BUILDING AREA
[ ] [45] LOCATION CONFORMS WITH SITE PLAN
[ ] [46] FINAL SITE GRADING
[ ] [47] CONTRACTOR Jamie DiFrancesco (All Contr
[ ] (48] OTHER
ABANDONMENT
[ J [ 4 9 J TANK PUMPED 01 /25/2021
[ J [50] TANK CRUSHED & FILLED 01/25/2021
I APPROVED / St. Lucie CHD
CONSTRUCTION
DISAPPROVED Environ ntal Speciali I Br J Ingram (ENVIRONMENTAL HEALTH)
FINAL SYSTEM [ APPROVED / DISAPPROVED ]: St. Lucie CHD
Environmental Specialist II ian 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 AP1610381 EID2217640
DATE: 01 /25/2021
DATE: 01 /25/2021
Page 2 of 3
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL
Violation Number Comment
Comments
APPLICATION #: AP 1610381
PERMIT #:56-SF-2217640
DOCUMENT # : FI 1566023
DATE PAID : 01 /04/2021
FEE PAID:95.00
RECEIPT #:56-PID-4849084
ST pumped and abandoned properly. Abandonment approved. No violations. Contractor and building department emailed
abandonment 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 AP1610381 EID2217640