HomeMy WebLinkAboutOSTDS ABANDONMENT.STATE OF FLORIDA ���� ����
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
CONSTRUCTION PERMIT FOR: OSTDS Abandonment
APPLICANT: (Chobee Land Enterprises Co)
PROPERTY ADDRESS: 8560 Okeechobeey/esf§yystem)-k2 Fort Pierce, FL 34945
LOT: BLOCK:
SUBDIVISION:
PERMIT #4 56-SF 24233.43 '
APPLICATION # : AP 1766528
DATE PAID•
FEE PAID•
RECEIPT #:
DOCUMENT #: PR1691844
PROPERTY ID #: 2323-331-0000-000-5 [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
[OR TAX ID NUMBER]
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION
381.0065, F.S., AND CHAPTER 64E-6, F.A.C. DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE
SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS,
WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE
PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID.
ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL,
STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY.
SYSTEM DESIGN AND SPECIFICATIONS
T [
A [
N [
K [
] GALLONS / GPD
] GALLONS / GPD
] GALLONS GREASE INTERCEPTOR CAPACITY
] GALLONS DOSING TANK CAPACITY [
CAPACITY
CAPACITY
[MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
]GALLONS @[ ]DOSES PER 24 HRS #Pumps [
D [ ] SQUARE FEET SYSTEM
R [ ] SQUARE FEET SYSTEM
A TYPE SYSTEM: [ ] STANDARD [ ] FILLED [ J MOUND [ ]
I CONFIGURATION: [ ] TRENCH [ j BED [ ]
N
F LOCATION OF BENCHMARK:
I ELEVATION OF PROPOSED SYSTEM SITE [ ][ / ][ABOVE / BELOW BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ ][ / ][ABOVE/ BELOW] BENCHMARK/REFERENCE POINT
L
D FILL REQUIRED: [ 0.00] INCHES EXCAVATION REQUIRED: [ ] INCHES
Have the tank abandoned in accordance with the following procedures:(a) The tank shall be pumped out.(b) The bottom of
o the tank shall be opened or ruptured, or the entire tank collapsed so as to prevent the tank from retaining water, and(c) The
T I tank shall be filled with clean sand or other suitable material, and completely covered with soil. Have the system inspected
H by the health department after it has been pumped and ruptured but before it is filled with sand and covered.
P.
R
SPECIFICATIONS PY:
APPROVED BY.:
DATE ISSUED: 11
DH 4016, 08/09 (Obsoletes all previous edi
Incorporated: 64E-6.003, FAC
TITLE:
Environmental Specialist II St. Lucie CHpD
ddEXPIRATION-DATE 02/27/2022 _ f
which may not be used)
Page 1 of 3
v 1.1.4
AP1766528
SE-1
NOTICE OF RIGHTS
A party whose substantial interest is affected by this order may petition for an
administrative hearing pursuant to sections 120.569 and 120.57, Florida Statutes. Such
proceedings are governed by Rule 28-106, Florida Administrative Code. A petition for
administrative hearing must be in writing and must be received by the Agency Clerk for the
Department, within twenty-one (21) days from the receipt of this order. The address of the
Agency Clerk is 4052 Bald Cypress Way, BIN A-02, Tallahassee, Florida 32399. The Agency
Clerk's facsimile number is 850-413-8743.
Mediation is not available as an alternative remedy.
Your failure to submit a petition for hearing within 21 days from receipt of this order will
constitute a waiver of your right to an administrative hearing, and this order shall become a 'final
order'.
Should this order become a final order, a party who is adversely affected by it is entitled
to judicial review pursuant to Section 120.68, Florida Statutes. Review proceedings are
governed by the Florida Rules of Appellate Procedure. Such proceedings may be commenced
by filing one copy of a Notice of Appeal with the Agency Clerk of the Department of Health and a
second copy, accompanied by the filing fees required by law, with the Court of Appeal in the
appropriate District Court. The notice must be filed within 30 days of rendition of the final order.
r j St. Lucie County Health Department .
� 5150 NW Milner Dr PortSaint Lucie, FL 34983
HEALTH
PAYING ON: #: 56-SF-2423343 BILL DOC #:56-BID-5705854 ICONSTRUCTION APPLICATION #: AP1766528
RECEIVED FROM: Reliable Septic & Service AMOUNT PAID: $ 95.00
PAYMENT FORM: CREDIT CARD 056838 PAYMENT DATE: 11/29/2021
MAIL TO: (Chobee Land Enterprises Co)
FACILITY NAME:
PROPERTY LOCATION:
8560 Okeechobee Rd
Fort Pierce, FL 34945
Lot: Block:
Property ID: 2323-331-0000-000-5
EXPLANATION or DESCRIPTION: QUANTITY FEE
-1 - Surcharge (All) 1 $ 45.00
134 - OSTDS Construction Abandonment Permit and Inspecti
1
$ 50.00
RECEIVED BY: AdamsC AUDIT CONTROL NO. 56-PID-5374118