HomeMy WebLinkAbouthealth departmentAPPLICATION # : AP 1612830
STATE OF FLORIDA PERMIT #:56-SF-2220992
DEPARTMENT OF HEALTH DOCUMENT #:F11714900
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL DATE PAID:01/13/2021
FEE PAID:660.00
RECEIPT #:56-PID-4856186
APPLICANT: Michael Young
AGENT: Michael Young
PROPERTY ADDRESS: 121 Eden Creek Ln Jensen Beach, FL 34957
LOT: 12
SUBDIVISION:
BLOCK:
Oaks At Indian River ID#: 4509-807-0015-000-9
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
[ ]
[271
SURFACE WATER
FT
[ ]
[021
TANK MATERIAL Polypropylene
[ ]
[281
DITCHES
FT
[ ]
[031
OUTLET DEVICE
[ ]
[291
PRIVATE WELLS 84
FT
[ ]
[041
MULTI -CHAMBERED [ Y N ]
[ ]
[301
PUBLIC WELLS
FT
[ ]
(051
OUTLET FILTER PolylokPL-68
[ ]
[311
IRRIGATION WELLS
FT
[ ]
[061
LEGEND 1. 70-143-11QC4 2.
[ ]
[321
POTABLE WATER 16
FT
[ ]
[071
WATERTIGHT
[ ]
[331
BUILDING FOUNDATIONS 5
FT
[ ]
[081
LEVEL
[ ]
[341
PROPERTY LINES 13
FT
[ ]
[091
DEPTH TO LID
[ ]
[351
OTHER
FT
DRAINFIELD
INSTALLATION
FILLED / MOUND SYSTEM
[ ]
[101
AREA [1] 667 [21 SQFT
[ ]
(361
DRAINFIELD COVER
[ ]
[111
DISTRIBUTION BOX HEADER X
[ ]
[371
SHOULDERS
[ ]
[121
NUMBER OF DRAINLINES 1. 6.00 2.
[ ]
[381
SLOPES
[ ]
[131
DRAINLINE SEPARATION
[ ]
[391
STABILIZATION
[ ]
[141
DRAINLINE SLOPE
[ ]
[151
DEPTH OF COVER
ADDITIONAL INFORMATION
[ ]
[161
ELEVATION [ ABOVE / BELOW ]BM 2.00
[ ]
[401
UNOBSTRUCTED AREA
[ ]
[171
SYSTEM LOCATION
[ ]
[411
STORMWATER RUNOFF
[ ]
[181
DOSING PUMPS
[ ]
(421
ALARMS
[ ]
[191
AGGREGATE SIZE
[ ]
[431
MAINTENANCE AGREEMENT
[ ]
[201
AGGREGATE EXCESSIVE FINES
[ ]
[441
BUILDING AREA
[ ]
[211
AGGREGATE DEPTH
[ ]
[451
LOCATION CONFORMS WITH SITE PLAN
[ ]
[46]
FINAL SITE GRADING
FILL
/ EXCAVATION MATERIAL
[ ] [221
FILL AMOUNT
[ ] [471
CONTRACTOR Mike Spears (All County Sep
[ ] [231
FILL TEXTURE
[ ] [481
OTHER INFILTRATOR Quick4 Plus EQ36 LP
[ ] [241
EXCAVATION DEPTH
ABANDONMENT
[ ] [251
AREA REPLACED
[ ] [491
TANK PUMPED
[ ] [261
REPLACEMENT MATERIAL
[ ] [501
TANK CRUSHED & FILLED
Comments: Comments are on page 2.
/
f St. Lucie CHD
DATE: 10/11/2021
CONSTRUCTION
[ APPROVED
DISAPPROVED
nvironmental Specialist I Matthe S a' n (Florida Department of He
FINAL SYSTEM
[ APPROVED / DISAPPROVED
St. Lucie CHD
DATE: 10/11/2021
Environmental Specialist I Matt eGi Va'a i (Florida Department of H
(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
AP1612830 EID2220992
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL
Violation Number Comment
Comments
APPLICATION #:AP1612830
PERMIT #:56-SF-2220992
DOCUMENT # : FI 1714900
DATE PAID:01/13/2021
FEE PAID:660.00
RECEIPT #:56-PID-4856186
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 5x10+1x9 long BED DF installed. No violations, system ok to cover. Contractor notified onsite. Well
inspection completed. No final inspection required. Final system approved. Emailed final approval to contractor and building
department.
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 AP1612830 EID2220992