HomeMy WebLinkAboutHeath DeptSTATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL
APPLICANT: Denise Rigdon
AGENT: Ernesto Gamez (SEPTIC ENVIRONMENTAL SERVICES)
APPLICATION # : AP1681569
PERMIT #:56-SF-2313344
DOCUMENT #:F11646575
DATE PAID :11 /26/2019
FEE PAID :545.00
RECEIPT #:56-PID-5052182
PROPERTY ADDRESS: 10151 S Indian River (Guest House) Fort Pierce, FL 34982
LOT: BLOCK:
SUBDIVISION: ID#: 3529-231-0008-000-9
CHECKED [X] ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR
RULE AND MUST BE CORRECTED.
TANK INSTALLATION
SETBACKS
[ ] [01]
TANK SIZE [1] 1090.00 [2]
[ ] [27]
SURFACE WATER
100
FT
[ ] [02]
TANK MATERIAL Polypropylene
[ ] [28]
DITCHES
FT
[ ] [03]
OUTLET DEVICE
[ ] [29]
PRIVATE WELLS
137
FT
[ ] [04]
MULTI —CHAMBERED [ Y N ]
[ ] (30]
PUBLIC WELLS
FT
[ ] [05]
OUTLET FILTER Polylok PL-68
( ] [311
IRRIGATION WELLS
FT
[ ] [061
LEGEND 1. 70-143-11DC4 2.
[ ] [321
POTABLE WATER
40
FT
[ ] [07]
WATERTIGHT
[ ] [331
BUILDING FOUNDATIONS
7
FT
[ ] [08]
LEVEL
[ ] [34]
PROPERTY LINES
8
FT
[ ] [09]
DEPTH TO LID
[ ] [35]
OTHER
FT
DRAINFIELD
INSTALLATION
FILLED / MOUND SYSTEM
[ ] [10]
AREA [1] 584 [2]
SQFT
[ ] [36]
DRAINFIELD COVER
[ ] [11]
DISTRIBUTION BOX HEADER
X
[ ] [37]
SHOULDERS
[ ] [12]
NUMBER OF DRAINLINES 1. 4.00 2.
[ ] [38]
SLOPES
[ ] [13]
DRAINLINE SEPARATION
[ ] [391
STABILIZATION
[ ] [14]
DRAINLINE SLOPE
[ ] [15]
DEPTH OF COVER
ADDITIONAL
INFORMATION
[ ] [16]
ELEVATION [ ABOVE / BELOW ]BM
35.00
[ ] [40]
UNOBSTRUCTED AREA
[ ] [17]
SYSTEM LOCATION
[ ] [41]
STORMWATER RUNOFF
[ ] [18]
DOSING PUMPS
[ ] [42]
ALARMS
[ ] [19]
AGGREGATE SIZE
[ ] [431
MAINTENANCE AGREEMENT
[ ] [201
AGGREGATE EXCESSIVE FINES
[ ] [441
BUILDING AREA
[ ] [21]
AGGREGATE DEPTH
[ ] (45]
LOCATION CONFORMS WITH
SITE PLAN
[ ] [46]
FINAL SITE GRADING
FILL
/ EXCAVATION MATERIAL
[ ] [47]
CONTRACTOR Ernesto Gamez (SEPTIC EN
[ ] [221
FILL AMOUNT
[ ] [48]
OTHER INFILTRATOR Quick4 EQ36 (single c
[ ] [23]
FILL TEXTURE
[ ] [24]
EXCAVATION DEPTH
ABANDONMENT
[ ] [25]
AREA REPLACED
[ ] [49]
TANK PUMPED
[ ] [26]
REPLACEMENT MATERIAL
[ ] [501
TANK CRUSHED & FILLED
Comments:
Comments are on page 2.
/
St. Lucie CHD
DATE: 06/09/2021
CONSTRUCTION
[ APPROVED
DISAPPROVED
] ' vironmenta��Sp 'alis 1 Nic le Mont n
(Florida Department of He
FINAL SYSTEM
[ APPROVED / DISAPPROVED
St. Lucie CHD
DATE: 06/09/2021
Environmental Sp Icialist I Nic le Mon
(Florida Department of He
(Explanation of Violations on following page)
DH 4016, 08/09
(Obsoletes all previous
editions which may not be use
Incorporated:
64E-6.003, FAC
Page 2 of 3
EH Database v 1.0.1
AP1681569
EID2313344
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL
Violation Number Comment
Comments
APPLICATION # : AP 1 681 569
PERMIT #:56-SF-2313344
DOCUMENT #: F11646575
DATE PAID" 1 /26/2019
FEE PAID :545.00
RECEIPT #:56-PID-5052182
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, filter, and 5x9 long BED DF installed. No violations, system ok to cover. Contractor notified by phone. No final
nspection required. Final system approved. Emailed final approval to contractor.
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 AP1681569 EID2313344