HomeMy WebLinkAboutHealth Department Septic Permit APPLICATION 592559
✓ STATE OF FLORIDA PERMIT #.56-SF-2182977
DEPARTMENT OF HEALTH DOCUMENT #:F11784834
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
'.� CONSTRUCTION INSPECTION AND FINAL APPROVAL DATE PAID,10/05/2020
we
FEE PAID.:545.00
RECEIPT #:56-P1D-4743782
APPLICANT: Charlotte Stahlberg
AGENT: Charlotte Stahlberg
PROPERTY ADDRESS: 1310 Copenhaver Rd Fort Pierce, FL 34945.
LOT: BLOCK:
SUBDIVISION: ID#: 2313-123-0003-000.6
CHECKED [41 ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED:
TANK INSTALLATION SETBACKS
[ ] [01] TANK SIZE [1] 1090:00 [21 483.00 [ ] [271 SURFACE WATER FT
[ ] [021 TANK MATERIAL Polypropylene [ ] [28] DITCHES FT.
[ ] 1031 OUTLET DEVICE [ j [291 PRIVATE WELLS FT
[ ] 043 MULTI-CHAMBERED [ Y N ] ( ] [30] PUBLIC WELLS FT
[ ] [05] OUTLET FILTER Polylok PL-68 [ ] [31] IRRIGATION WELLS FT
[061 LEGEND 1. 70-143-11DC4 2. 70-143-54SC4 ( ] [121 POTABLE WATER
75 FT
[ ] (071 WATERTIGHT [ ] [33] BUILDING FOUNDATIONS 7.5 FT
[ ] [08] LEVEL [ ] (341 PROPERTY LINES
100 FT
[ ] [091 DEPTH TO LID [ ] [351 OTHER FT
DRAINFIELD INSTALLATION FILLED / MOUND SYSTEM
[ ] 1101 AREA [1] 384 [2] SQFT [ ] [361 DRAINFIELD COVER
j ] [111 DISTRIBUTION BOX HEADER X j ] [37] SHOULDERS
[ ] [121 NUMBER OF DRAINLINES 1.. 4.00 2. [ ] [38] SLOPES
[ ] 1131 DRAINLINE SEPARATION [ ] [39] STABILIZATION 02/09/2022
[ ] [14] DRAINLINE SLOPE
[ ] [151 DEPTH OF COVER ADDITIONAL INFORMATION
[ ] [16] ELEVATION [ ABOVE / BELOW ]BM 5.00 [ ] [40] UNOBSTRUCTED AREA
[ ] (17] SYSTEM LOCATION [ ] [41] STORMWATER RUNOFF
[ ] [18] DOSING PUMPS 1.00 [ ] [42] ALARMS
[ ] [19] AGGREGATE SIZE [ ] [43] MAINTENANCE AGREEMENT
[ ] [20] AGGREGATE EXCESSIVE FINES [ ] [441 BUILDING AREA
[ ] [21] AGGREGATE DEPTH [ ] [451 LOCATION CONFORMS WITH SITE PLAN
FILL / EXCAVATION MATERIAL [ ] [461 FINAL SITE GRADING
[ ] [221 FILL AMOUNT [ ] [471 CONTRACTOR Jeff Nelson(Jeffrey Nelson Se
[ ] [23] FILL TEXTURE [ ] [A8] OTHER INFILTRATOR Qulck4 E036(Single c
[ ] 1241 EXCAVATION DEPTH ABANDONMENT
[ ] [25] AREA REPLACED [ ] [491 TANK PUMPED
[ ] [261 REPLACEMENT MATERIAL [ ] [501 TANK CRUSHED S FILLED
Comments: Comments are on page 2.
CONSTRUCTION I APPROVED / St.LUcle CED DATE: 12/21/2021
DISAPPROVED nvironmental Specials S- nyi(FI Department of He
FINAL SYSTEM [ APPROVED DISAPPROVE St: ucle CHD DATE: 02/09/2022
nvironmental(Explanation of Violations on following page) Sp ciall t 11 NIT MonteoD a D artment of He
DR 4016, 08/09 (ObsoleteS all previous editions which may not be use
Incorporated: 64E-6-.003r FAC Page 2. of 3
EH Database v 1.0.1 AP1582559 EID2182977
r
APPLIcATIoN #:AP1582559
STATE OF FLORIDA PERMIT #:56-SF-2182977
' DEPARTMENT OF HEALTH
. ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM DOCUMENT #:Fi1784834
CONSTRUCTION INSPECTION AND FINAL APPROVAL DATE PAID:10/05/2020
WE FEE PAID:545.00
RECEIPT #:56-P1D-4743782
Violation Number Comment
Comments
The systern 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,DT,Liberty 1/3 hp pump,and 4x8 long TRENCH DF installed. No violations,system ok to cover. Contractor notified by
phone. Needs final inspection for alarm/pump function,verify that pump wires exit DT in conduit through the riser wall,gutters,
mound system,depth of cover,and final site grading.
2/9/2022-Final inspection completed.Mound system checked,verified wires.ran through conduit-,and final site grading
completed.Copy emailed to contractor and building department.
DH 4016, 0.6/09 (obsoletes all previous editions which may not be used)
Incorporated: 69E-6.003, FAC Page 2 of 3
EH Database v 1.0.1 AP1582559 EID2182977