HomeMy WebLinkAbout4637 S Header Canal Rd FASTATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL
PERMIT #:
DATE PAID:
FEE PAID:
RECEIPT #:
25.00
56-SF-2153829
DOCUMENT #:FI1698965
AP1566127APPLICATION #:
56-PID-4767806
10/29/2020
LOT:
ID#:
BLOCK:
SUBDIVISION:
APPLICANT:Juan Quinteros
AGENT:Jessica Quinteros
PROPERTY ADDRESS:4637 S Header Canal Rd Fort Pierce, FL 34945
CHECKED [X] ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED.
[01] TANK SIZE[][1]1090.00 [2]
[02] TANK MATERIAL[]Polypropylene
[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[]100
SETBACKS
FT
[28] DITCHES[]100 FT
[29] PRIVATE WELLS[]100 FT
[30] PUBLIC WELLS[]FT
[31] IRRIGATION WELLS[]FT
[32] POTABLE WATER []88 FT
[33] BUILDING FOUNDATIONS[]5.5 FT
[34] PROPERTY LINES[]100 FT
[35] OTHER[]FT
[10] AREA[][1]672 [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 X
[BELOW ]BMABOVE/31.00
[14] DRAINLINE SLOPE[]
[20] AGGREGATE EXCESSIVE FINES[]
[21] AGGREGATE DEPTH[]
[36] DRAINFIELD COVER[]
FILLED / MOUND SYSTEM
[37] SHOULDERS[]
[38] SLOPES[]
[39] STABILIZATION[]09/16/2021
[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[]Roselis Moctezuma (All Coas
[48] OTHER[]INFILTRATOR Quick4 EQ36 (single c
[49] TANK PUMPED[]
ABANDONMENT
[50] TANK CRUSHED & FILLED[]
[22] FILL AMOUNT[]
FILL / EXCAVATION MATERIAL
[23] FILL TEXTURE[]
[24] EXCAVATION DEPTH[]
[25] AREA REPLACED[]
[26] REPLACEMENT MATERIAL[]
Polylok PL-68
1.2.
1.2.7.00
70-143-11DC4
7
3202-5000-0007-000-3
Comments are on page 2.Comments:
CONSTRUCTION []:/CHD DATE:
DISAPPROVED
St. Lucie 04/30/2021APPROVED
Environmental Specialist III Brian J Ingram (ENVIRONMENTAL HEALTH)
FINAL SYSTEM []:/CHD DATE:DISAPPROVED St. Lucie 09/16/2021
Environmental Specialist III Brian J Ingram (ENVIRONMENTAL HEALTH)
APPROVED
(Explanation of Violations on following page)
EH Database v 1.0.1 AP1566127 EID2153829
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 #:
25.00
56-SF-2153829
DOCUMENT #:FI1698965
AP1566127APPLICATION #:
56-PID-4767806
10/29/2020
Violation Number Comment
The system is sized for 3 bedrooms with a maximum occupancy of 6 persons (2 per bedroom), for a total estimated flow of 400
gpd.
New ST, filter, and 7x8 long BED DF installed. No violations, system ok to cover, contractor notified onsite. Needs final
inspection for well inspection/setback/location, mound system and final site grading.
Final system approved. Contractor and Building Department emailed final approval.
Comments
EH Database v 1.0.1 AP1566127 EID2153829
Page 2 of 3
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC