HomeMy WebLinkAbouthealth departmentSTATE OF FLORIDA
S f..x DEPARTMENT OF HEALTH
4
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
,y CONSTRUCTION INSPECTION AND FINAL APPROVAL
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APPLICANT: Rene SOSa
AGENT:
PROPERTY ADDRESS: 6801 Penny Ln Fort Pierce, FL 34951
APPLICATION #:AP1451878
PERMIT #:56-SF-1764487
DOCUMENT # : FI 1667880
DATE PAID:01/16/2020
FEE PAID:25.00
RECEIPT #:56-PID-4266662
LOT: 16
BLOCK: 111
SUBDIVISION:
Lakewood Park ID#: 1301-611-0246-000-9
CHECKED [X] ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED.
TANK INSTALLATION
SETBACKS
[ ] [01]
TANK SIZE [1] 1090.00 [21 L
] [27]
SURFACE WATER FT
[ ] [021
TANK MATERIAL Polypropylene [
] [28]
DITCHES FT
[ ] [031
OUTLET DEVICE [
] [29]
PRIVATE WELLS 77 FT
[ ] (041
MULTI -CHAMBERED [ Y N ] [
] (30]
PUBLIC WELLS FT
[ ] [051
OUTLET FILTER Polylok PL-68 [
] [311
IRRIGATION WELLS FT
[ ] (061
LEGEND 1. 70-143-11 DC4 2. [
] [321
POTABLE WATER 37 FT
[ ] [07]
WATERTIGHT [
] [331
BUILDING FOUNDATIONS 6 FT
[ ] [081
LEVEL (
] [34]
PROPERTY LINES 16 FT
[ ] [091
DEPTH TO LID [
] [35]
OTHER FT
DRAINFIELD INSTALLATION
FILLED / MOUND SYSTEM
[ ] [10]
AREA [1] 375 [21 SQFT [
] (361
DRAINFIELD COVER
[ ] [11]
DISTRIBUTION BOX HEADER X [
] [37]
SHOULDERS
[ ] [121
NUMBER OF DRAINLINES 1. 5.00 2. (
] [381
SLOPES
[ ] [131
DRAINLINE SEPARATION [
] [39]
STABILIZATION 07/30/2021
( ] [141
DRAINLINE SLOPE
[ ] [15]
DEPTH OF COVER
ADDITIONAL INFORMATION
[ ] [161
ELEVATION [ ABOVE / BELOW ]BM 1.00 (
] [401
UNOBSTRUCTED AREA
[ ] (171
SYSTEM LOCATION [
] [41]
STORMWATER RUNOFF
( ] [18]
DOSING PUMPS [
] [421
ALARMS
[ ] [19]
AGGREGATE SIZE [
] [431
MAINTENANCE AGREEMENT
[ ] [20]
AGGREGATE.EXCESSIVE FINES [
] [441
BUILDING AREA
[ ] [211
AGGREGATE DEPTH [
] [45]
LOCATION CONFORMS WITH SITE PLAN
FILL / EXCAVATION MATERIAL [
] [46]
FINAL SITE GRADING
[ ] [221
FILL AMOUNT [
] [471
CONTRACTOR Bruce T Mc Cullers (Reliable T
[ ] [231
FILL TEXTURE [
] [481
OTHER ADS MPS-9 (9 pipes - 2 tier)
[ ] [241
EXCAVATION DEPTH
ABANDONMENT
( ] [251
AREA REPLACED [
] [49]
TANK PUMPED
( ] [26]
REPLACEMENT MATERIAL [
] [50]
TANK CRUSHED & FILLED
Comments: Comments are on page 2.
/
St. Lucie CHD DATE: 12/15/2020
CONSTRUCTION
L APPROVED
DISAPPROVED ] ' Enviro ntal Specialist
J Ingram (ENVIRONMENTAL HEALTH)
FINAL SYSTEM
[ APPROVED / DISAPPROVED ]:
St. Lucie CHD DATE: 07/30/2021
"'Envif6rimental Specialist I
rian 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
Page 2 of 3
EH Database v 1.0.1 AP1451878
EID1764487
APPLICATION #:AaP1451878
STATE OF FLORIDA PERMIT #:56-SF-1764487
DEPARTMENT OF HEALTH DOCUMENT # : FI 1667880
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL DATE PAID:01/16/2020
FEE PAID :25.00
RECEIPT #:56-PID-4266662
Violation Number Comment
Comments
The system is sized for 3 bedrooms with a maximum occupancy of 6 persons (2 per bedroom), for a total estimated flow of 300
gpd.
New ST, filter, and 5x25' long TRENCH DF installed. No violation, system ok to cover. Contractor notified onsite. Needs final
inspection for mound system, gutters(front entry), and final site grading.
Final system approved. Contractor and building department 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 AP1451878 EID1764487