HomeMy WebLinkAbout4803 header canal fa- health department approvalSTATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL
APPLICANT: Felipe & Julie Jose
AGENT: David Whiteside (Accurate Septic Services Inc)
PROPERTY ADDRESS: 4803 Header Canal Fort Pierce, FL 34945
LOT: 5 BLOCK:
APPLICATION #:AP1552208
PERMIT #:56-SF-2138562
DOCUMENT #:F11660543
DATE PAID:03/31/2021
FEE PAID:55.00
RECEIPT #:56-PID-4914825
SUBDIVISION: ID# : 3202-500-0005-000-9
CHECKED [X] ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED.
TANK INSTALLATION
[ ] [01] TANK SIZE [11 1050.00 [21
[ ] [02] TANK MATERIAL Concrete
[ ] [03] OUTLET DEVICE
[ ] [04] MULTI -CHAMBERED [ L_jj N ]
[ ] [051 OUTLET FILTER Polylok PL-122
[ ] [061 LEGEND 1. 01-011-09DC3 2.
[ ] [071 WATERTIGHT
[ ] [081 LEVEL
[ ] [091 DEPTH TO LID
DRAINFIELD INSTALLATION
[ ] [101 AREA [1] 336 [21 SQFT
[ ] [111 DISTRIBUTION BOX HEADER X
[ ] [12] NUMBER OF DRAINLINES 1. 4.00 2.
[ ] [131 DRAINLINE SEPARATION
[ ] [141 DRAINLINE SLOPE
[ ] [15] DEPTH OF COVER
[ ] [161 ELEVATION [ ABOVE / BELOW ]BM 11.00
[ ] [171 SYSTEM LOCATION
[ ] [181 DOSING PUMPS
[ ] [19] AGGREGATE SIZE
[ ] [201 AGGREGATE EXCESSIVE FINES
[ ] [211 AGGREGATE DEPTH
FILL / EXCAVATION MATERIAL
[ ] [221 FILL AMOUNT
[ ] [23] FILL TEXTURE
[ ] [24] EXCAVATION DEPTH
[ ] [251 AREA REPLACED
[ ] [261 REPLACEMENT MATERIAL
Comments: Comments are on page 2.
CONSTRUCTION [ APPROVED / DISAPPROVED ]
Enviro ental Specialist
FINAL SYSTEM [ APpROVED / DISAPPROVED ]:
Environmental Specialis
(Explanation of Violations on following page)
DH 4016, 08/09 (Obsoletes all previous editions which may
Incorporated: 64E-6.003, FAC
Eli Database v 1.0.1 AP1552208
SETBACKS
[ ] [27]
SURFACE WATER 100
FT
[ ] [28]
DITCHES 100
FT
[ ] [291
PRIVATE WELLS 100
FT
[ ] [301
PUBLIC WELLS
FT
[ ] [311
IRRIGATION WELLS
FT
[ ] [32]
POTABLE WATER 65
FT
[ ] [331
BUILDING FOUNDATIONS 12
FT
[ ] [341
PROPERTY LINES 99
FT
[ ] [351
OTHER
FT
FILLED / MOUND SYSTEM
[ ] [361
DRAINFIELD COVER
[ ] [371
SHOULDERS
[ ] (381
SLOPES
[ ] [39]
STABILIZATION 06/24/2021
ADDITIONAL INFORMATION
[ ] [40]
UNOBSTRUCTED AREA
[ ] [41]
STORMWATER RUNOFF
[ ] [421
ALARMS
[ ] (43]
MAINTENANCE AGREEMENT
[ ] (441
BUILDING AREA
[ ] (451
LOCATION CONFORMS WITH SITE PLAN
[ ] [46]
FINAL SITE GRADING
[ ] (47]
CONTRACTOR John Baker (Accurate Septic
[ ] [48]
OTHER INFILTRATOR Quick4 EQ36 (single c
ABANDONMENT
[ ] [ 4 91
TANK PUMPED
[ ] [501
TANK CRUSHED & FILLED
%%^— St. Lucie CHD
Ingram (ENVIRONMENTAL HEALTH)
ISA- St. Lucie CHD
I Ingram (ENVIRONMENTAL HEALTH)
be used)
E102138562
DATE: 04/27/2021
DATE: 06/24/2021
Page 2 of 3
Q" STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
iy•r ,scCONSTRUCTION INSPECTION AND FINAL APPROVAL
Violation Number Comment
Comments
APPLICATION #:RP1552200
PERMIT #:56-SF-2138562
DOCUMENT # : FI 1660543
DATE PAID : 03/31 /2021
FEE PAID:55.00
RECEIPT #:56-PID-4914825
New ST, filter, and 4x7 long BED DF installed. No violations, system ok to cover, contractor notified by phone. Needs final
inspection for potable water line setback, mound system, and final site grading.
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 AP1552208 EID2138562