HomeMy WebLinkAbout3927 kirby loop rd aba approvalSTATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL
PERMIT #:
DATE PAID:
FEE PAID:
RECEIPT #:
95.00
56-SF-2293203
DOCUMENT #:FI1643958
AP1664288APPLICATION #:
56-PID-4987923
05/18/2021
LOT:
ID#:
BLOCK:
SUBDIVISION:
APPLICANT:Robert Nuellee
AGENT:Robert Nuelle
PROPERTY ADDRESS:3927 KirbyLoop Rd Fort Pierce, FL 34981
CHECKED [X] ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED.
[01] TANK SIZE[][1][2]
[02] TANK MATERIAL[]
[03] OUTLET DEVICE[]
[04] MULTI-CHAMBERED[][]Y N/
[05] OUTLET FILTER[]
[06] LEGEND[]
[07] WATERTIGHT[]
[08] LEVEL[]
[09] DEPTH TO LID[]
TANK INSTALLATION
[27] SURFACE WATER[]
SETBACKS
FT
[28] DITCHES[]FT
[29] PRIVATE WELLS[]FT
[30] PUBLIC WELLS[]FT
[31] IRRIGATION WELLS[]FT
[32] POTABLE WATER []FT
[33] BUILDING FOUNDATIONS[]FT
[34] PROPERTY LINES[]FT
[35] OTHER[]FT
[10] AREA[][1][2]
[11] DISTRIBUTION[]
[12] NUMBER OF DRAINLINES[]
[13] DRAINLINE SEPARATION[]
[15] DEPTH OF COVER[]
[16] ELEVATION []
[17] SYSTEM LOCATION[]
[18] DOSING PUMPS[]
[19] AGGREGATE SIZE[]
DRAINFIELD INSTALLATION
SQFT
BOX HEADER
[]BMABOVEBELOW/
[14] DRAINLINE SLOPE[]
[20] AGGREGATE EXCESSIVE FINES[]
[21] AGGREGATE DEPTH[]
[36] DRAINFIELD COVER[]
FILLED / MOUND SYSTEM
[37] SHOULDERS[]
[38] SLOPES[]
[39] STABILIZATION[]
[40] UNOBSTRUCTED AREA[]
ADDITIONAL INFORMATION
[41] STORMWATER RUNOFF[]
[42] ALARMS[]
[43] MAINTENANCE AGREEMENT[]
[44] BUILDING AREA[]
[45] LOCATION CONFORMS WITH SITE PLAN[]
[46] FINAL SITE GRADING[]
[47] CONTRACTOR[]MICHAEL W STUHR (ASHTO
[48] OTHER[]
[49] TANK PUMPED[]
ABANDONMENT
[50] TANK CRUSHED & FILLED[]
06/01/2021
[22] FILL AMOUNT[]
FILL / EXCAVATION MATERIAL
[23] FILL TEXTURE[]
[24] EXCAVATION DEPTH[]
[25] AREA REPLACED[]
[26] REPLACEMENT MATERIAL[]
1.2.
1.2.
2420-332-0001-000-3
Comments are on page 2.
06/07/2021
Comments:
CONSTRUCTION []:/CHD DATE:
DISAPPROVED
St. Lucie 06/07/2021APPROVED
Environmental Specialist III Brian J Ingram (ENVIRONMENTAL HEALTH)
FINAL SYSTEM []:/CHD DATE:DISAPPROVED St. Lucie 06/07/2021
Environmental Specialist III Brian J Ingram (ENVIRONMENTAL HEALTH)
APPROVED
(Explanation of Violations on following page)
EH Database v 1.0.1 AP1664288 EID2293203
Page 2 of 3
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL
PERMIT #:
DATE PAID:
FEE PAID:
RECEIPT #:
95.00
56-SF-2293203
DOCUMENT #:FI1643958
AP1664288APPLICATION #:
56-PID-4987923
05/18/2021
Violation Number Comment
ST pumped and abandoned properly. No violations. Abandonment approved.
Comments
EH Database v 1.0.1 AP1664288 EID2293203
Page 2 of 3
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC