HomeMy WebLinkAboutSewage 6-4-12STATE OF FLORIDA
k ' DEPARTMENT OF HEALTH
P ONSITE SEWAGE -TREATMENT AND DISPOSAL SYSTEM
SITE EVALUATION AND SYSTEM SPECIFICATIONS
PERMIT #.
APPLICANT: Joseph W. & Sondra W. Jaksch AGENT: Alexander J. Piazza PSM, Inc.
LOT: 6
BLOCK: 17 SUBDIVISION: Indrio Unit #1
PROPERTY ID # : 1416-601-0060-000-3 [ Tax ID Number ]
TO BE COMPLETED BY ENGINEER, HEALTH DEPARTMENT EMPLOYEE,OR OTHER QUALIFIED PERSON. ENGINEERS
MUST PROVIDE REGISTRATION NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS.
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PROPERTY SIZE CONFbRMS TO SITE PLAN: [✓] YES [ ] NO NET USABLE AREA AVAILABLE: 0.276 ACRES
TOTAL ESTIMATED SEWAGE FLOW: GALLONS -PER DAY [RESIDENCES -TABLE I /OTHER -TABLE 2 ]
AUTHORIZED SEWAGE FLOW: GALLONS PER DAY [1500 GPD/ACRE OR 2500 GPD/ACRE ]
UNOBSTRUCTED AREA AVAILABLE: 500'SQFT UNOBSTRUCTED AREA REQUIRED: 500 SQFT
BENCHMARK/REFERENCE POINT LOCATION: Nail near edge of pavement (a, intersection of Del Mundo Street and Arcadia Avenue
ELEVATION OF PROPOSED SYSTEM SITE IS• 34 [INCHES ] [ABOVE ] BENCHMARK/REFERENCE POINT
THE MINIMUM SETBACK WHICH CAN BE MAINTAINED'FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES
SURFACE WATER:100 FT
DITCHES/SWALES:15 FT
NORMALLY WET? [ i YES (✓]
NO
WELLS: PUBLIC:200 FT
LIMITED USE:100 FT PRIVATE:50
FT NON—POTABLE:50
HT
BUILDING FOUNDATIONS:6
FT PROPERTY LINES:10 FT
POTABLE WATER LINES:100
FT
SITE SUBJECT TO FREQUENT
FLOODING: [ ] YES [✓] NO 10
YEAR FLOODING? ( ] YES (✓]
NO
10 YEAR FLOOD ELEVATION
FOR SITE: FT MSL/NGVD SITE ELEVATION:•.., FT MSL/NGVD
SOIL PROFILE INFORMATION SITE 1 1, RnTT. AT2nFTT.F.
TNFnRMATTnN RTTF. 9
MUNSELL #/COLOR TEXTURE DEPTH
TO
TO
TO
TO
TO
TO
TO
TO
TO
USDA SOIL SERIES:
OBSERVED WATER TABLE: 40+ INCHES [BELOW
ESTIMATED WET SEASON WATER TABLE ELEVATION:_
HIGH WATER TABLE VEGETATION: [ ] YES [ ] NO
MUNSELL #/COLOR TEXTURE
USDA SOIL SERIES:
DEPTH
TO
TO
TO
TO
TO
TO
Tn
TO
TO
q EXISTING GRADE. TYPE: [PERCHED/ APPARENT ]
_ INCHES ABOVE BELOW ] EXISTING GRADE
MOTTLING: [ ] YES [ ] NO DEPTH: INCHES
SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZIN9-;0' DEPTH OF EXCAVATION: INCHES
DRAINFIELD CONFIGURATION: [ ] TRENCH OTHER (SPECIFY)
REMARKS/ADDITIONAL CRITERIA: ;
SITE EVALUATED BY: �� 6L_` DATE: 6-04-12
- �_.
DH 4015, 12/11 (Obsoletes previous edit
,Xons which may not bdo'�setfjlncorporated: 64E-6.001, FAC Page 3 Of