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HomeMy WebLinkAboutOSTDS NEWSTATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT FOR: APPLICANT: Rafael Alvarez OSTDS New PROPERTY ADDRESS: TBD Hartman Rd Fort Pierce, FL 34947 LOT: BLOCK: PROPERTY ID #: 2407-441-0001-000-7 SUBDIVISION: PERMIT #:56-SF-1735202 APPLICATION #:AP1272778 DATE PAID: FEE PAID: RECEIPT #: DOCUMENT #: PR1049400 [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER] [OR TAX ID NUMBER] Q 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 [ 1,050 ] GALLONS / GPD Septic new CAPACITY A [ ] GALLONS / GPD N/A CAPACITY N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS] K I ) GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ D [ 500 ] SQUARE FEET Drainfield new SYSTEM R [ ] SQUARE FEET N/A SYSTEM A TYPE SYSTEM: [ ] STANDARD [ ) FILLED [x] MOUND I CONFIGURATION: [XI TRENCH [ ] BED [ ] N F LOCATION of BENCHMARK: site BM orange capped IR elev 16.86 E prope line Eft from rd I ELEVATION OF PROPOSED SYSTEM SITE [ 9.00 ][INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 1.00 ][ INCHES FT ][ABOVE BELOW] BENCHMARK/REFERENCE POINT L D I 0 T H E R 'ILL REQUIRED: [26.UU] INCHES EXCAVATION REQUIRED: [ 45.001 INCHES The system Is sized for 4 bedrooms with a maximum occupancy of 8 persons (2 per bedroom), for a total estimated flow of 400 gpd. The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance with s. 64E-6.013(3)(f), FAC. S-PECIFICATIONS BY: Brian J Ingram TITLE: Environmental Specialist II -APPROVED BY: TITLE: Environmental Specialist II St. Lucie CHD Brian J I 20fam DATE ISSUED: 02/14/2017 EXPIRATION DATE: 08114/2018 DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC Page 1 of 3 v 1,1,4 AD12'72778 SE1022917 qn P� APPLICANT: STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATIONS Rafael Alvarez PERMIT #I . D (a -,Sr- 17,352eDa. AGENT. Culpepper & Terpening, Inc. LOT: N/A BLOCK: N/A SUBDIVISION: N/A PROPERTY ID #k : 2 4 0 7 - 4 41- 0 0 01- 0 0 0 - 7 [Section/Tovmship/Parcel No. or Tax ID Number] TO BE COMPLETED BY ENGINEER, HEALTH DEPARTEMENT EMPLOYEE,OR OTHER QUALIFIED PERSON. ENGINNEERS• MUST PROVIDE REGISTRATION NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS. PROPERTY SIZE CONFORMS TO SITE PLAN: [X] YES [ ] NO NET USABLE AREA AVAILABLE. 2.57 ACRES TOTAL ESTIMATED SEWAGE FLOW: 400 GALLONS PER DAY [RESIDENCES -TABLE 1/OTHER-TABL�2] AUTHORIZED SEWAGE FLOW: 6424 GALLONS PER DAY (1500 GPD/ACRE OR 2500 GPD/ACRE] UNOBSTRUCTED AREA AVAILABLE: 750 SQFT UNOBSTRUCTED AREA REQUIRED: 750 SQFT iron rod and cap 6' from west E/P, 120' North BENCHMARK/REFERENCE POINT LOCATION: of S.E. Property Corner see 1plot lan ELEVATION OF PROPOSED SYSTEM SITE IS $ [INCHES FT] ICABOVE BELOW] BENCHMARK/REFERENCE POINT THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES SURFACE WATER: NONE FT DITCHES/SWALES:' 1851 FT NORMALLY WET? [ ] YES [X] NO WELLS: PUBLIC: NONE FT LIMITED USE: NONE FT PRIVATE: NONE FT NON -POTABLE: NONE FT BUILDING FOUNDATIONS: 23' FT PROPERTY LINES: 15' FT POTABLE WATER LINES: 23 51FT SITE SUBJECT TO FREQUENT FLOODING: [ ] YES [X] NO 10 YEAR FLOODING? [ ] YES [X] NO 10 YEAR FLOOD ELEVATION FOR SITE: N/A FT MSL/NGVD SITE ELEVATION: N/A FT MSL/NGVD SOIL PROFILE INFORMATION SITE 1 MUNSELL #k/COLOR TEXTURE DEPTH TO TO TO TO TO TO TO TO TO USDA SOIL SERIES: SOIL PROFILE INFORMATION RTTP.. 9 MUNSELL #/COLOR TEXTURE DEPTH TO To - TO TO TO TO TO TO TO �. USDA SOIL SERIES: OBSERVED WATER TABLE: INCHES [ABOVE / BELOW] EXISTING GRADE. TYPE:[PERCHED / APPARENT] ESTIMATED WET SEASON WATER TABLE ELEVATION: INCHES [ABOVE / BELOW] EXISTING GRADE HIGH WATER TABLE VEGETATION: [ ] YES [ ] NO MOTTLING: [ ] YES [ j NO DEPTH: INCHES SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: 0.8 DEPTH OF EXCAVATION- INCHES DRAINFIELD CONFIGURAT, ,', t (i jrrTF NCH [ ] BED [ ] OTHER (SPECIFY) MMARKS/ADbITIONAL CR2 RIB= k SPITE EVALUATED BX :-� �) !t DATE: !t DH 4015, 08/09 (Obsoletes Ptevirous•- editions Whiah' may not .be used) Incorporated: 64E-6.001, FAC Page 3 of 4 lei STATE OF FLORIDA PERMIT NO. -�6 77�5� Z >, DEPARTMENT OF HEALTH DATE PAID: ONSITE SEWAGE TREATMENT AND DISPOSAL FEE PAID: '.h,c' SYSTEM RECEIPT #: vir.APPLICATION FOR CONSTRUCTION PERMIT raj APPLICATION FOR: [X] New System [ ] Existing System j ] Holding Tank [ ] Repair [ ] Abandonment j ] Innovative [ ] Temporary [ ] APPLICANT'. Rafael Alvarez AGENT: Culpepper & Terpenina, Inc. TELEPHONE: 772-464-3537 MAILING ADDRESS: 2980 South 25th. Street, Ft. Pierce, FL 34981 TO BE COMPLETED BY APPLICANT OR APPLICANT'S AUTHORIZED AGENT SYSTEMS MUST BE CONSTRUCTED BY A PERSON LICENSED PURSUANT TO 489.105(3)(m) OR 489.552, FLORIDA STATUTES. IT IS THE APPLICANT'S RESPONSIBILITY TO PROVIDE DOCUMENTATION OF THE DATE THE LOT WAS CREATED OR PLATTED (MM/DD/YY) IF REQUESTING CONSIDERATION OF STATUTORY GRANDFATHER PROVISIONS. -------------------- —== _-- PROPERTY INFORMATION LOT: N/A BLOCK: N/A SUBDIVISION. N/A PLATTED: N/A - PROPERTY ID 0: 2407-441-0001-000-7 ZONING: Res. I/M OR EQUIVALENT: [ Y PROPERTY SIZE: 2.57 ACRES WATER SUPPLY: [X] PRIVATE PUBLIC [ ]<=2000GPD [ 1>2000GPD . IS SEWER AVAILABLE AS PER 381.0065, FS? [ Y /�N ] DISTANCE TO SEWER: N A FT PROPERTY ADDRESS: Hartman Road DIRECTIONS TO PROPERTY: From Okeechobee Road go North on Hartman Road 1.2 miles BUILDING INFORMATION [X] RESIDENTIAL [ ] COMMERCIAL Unit Type of No, of Building Commercial/Institutional System Design No Establishment Bedrooms Area Sqft Table 1, Chapter 64E-6, FAC 1 ' Single Family Res. 4 2653 SF 2 (house + hobby room) _ 3 4 • ; `; . -1 , l f f • .elf , ' / r < <. meii � riids" ['. ] Other (Specify) SIGNATURE'-.'.€`r DH 4015, 08/09'•10b Q.letes^•pee,•Vious editions which may not be used) Incorporated.64E=$:0'O1, "FAC DATE: I ww Page 1 of 4 ;`K=€ St. Lucie County Health Department 9 5150 NW Milner Dr Port Saint Lucie, FL 34983 HEAALTH A' PAYING ON: PERMIT#: 56-SF-1735202 BILL ooc #:56-BID-3336844 CONSTRUCTION APPLICATION #: AP1272778 RECEIVED FROM: Culpepper & Terpening, Inc AMOUNT PAID: $ 515.00 PAYMENT FORM: CHECK 1004 PAYMENT DATE: 01/25/2017 MAIL TO: Rafael Alvarez FACILITY NAME: PROPERTY LOCATION: TBD Hartman Rd Fort Pierce, Fl- 34947 Lot: Block: Property ID: 2407-441-0001-000-7 EXPLANATION or DESCRIPTION: -1 - OSTDS Construction Application and Plan Review,New 123 - OSTDS Construction Site Evaluation 126 - OSTDS Construction Permit (New or Mod, Amendment) 127 - OSTDS Construction System Inspection 128 - OSTDS Construction System Inspection Research Fee 133 - OSTDS Construction Reinspection -1 - Surcharge (All) -1 - OSTDS New Permit Surcharge QUANTITY FEE 1 $ 100.00 1 $ 115.00 1 $ 55.00 1 $ 75.00 1 $ 5.00 1 $ 50.00 1 $ 15.00 1 $ 100.00 RECEIVED BY: VanceMH AUDIT CONTROL NO. 56-PID-3175746 I I "� --------------------- I ,a p Rm • .:w ate] -ono— rot B;s it v,urr F 114 5 I i PARCEL IDN - 2407-441-0001—ooc-7 mx » rwvam Y roar ..a I ' a_cGfeL�_l_-_3aWoso-v x_Iw,mvaro- ' �m` m_., mKR�.d �S DESCRIPTION EBCRIPfIONnns L3E3 GSeA6bSv�L, _. *'�• tn/orr_rz+. b' 'Iv,'Wra waarv° .. �.- S=y.�q ys 9" e2 I-,_.......__... l c!Nfwlee eEPtoOfntNwi lCY6+.36PB3Ef5E3>1 aflOaaVi0at .4x'envNNp'anNeGad l�vann]Pte�p&°lntl Rc!nmIa,lWe SuEoeum]JW uBIalh]a pa eet of N34&4] fet tpmf; lYngM-9NSLWl'Rnb8ep- 3feet foei,mq v a-o_,. tvs.mrome ""k_•-I w-_.f. r c]�¢1¢b I e as IIli -.a..ev-raco-z -a+�o: RNOTES A.o GE.Er .C' r:'":°vv vr9,c f a�" rnwxm .aPmp, .m,.; �e�at ea..axF,amw'. i .• n8 ' •."":�-. i4III "N e. ....z.a..].-_ .._... ......„ __.� ,,• �k•- . ' iK�i o' %oo"n l0l b I .v, vxrn.a rx .0 ru x.m-m,-m]p-mc: xamc� sr5,`o':• r-a", px,.�,., • of &3--�1 a Tus �" I I � ..._ _, _. E r w� s ieg* I wss � � F xaz em-mee-vvv-e A (.zi . pnvr.m`�°s ^ I a- &lt x,a] m I�r oo>x � 9 3 1 -�b a Nn Neb39']YE 36a. r - a.•er>:x 1 rooNsat,.re.exr , fi I min I Ib.b,r Pitrmo rbse vtelcmMm lrs„'l.0e.°Na. kb310 -Nu�l m Te Lm.P,.,�E�,,P,P,,Ex.Istu..b,nm.T.x�s..P.11,w1mP...E.P•.N°d..Ie,N�wvO.-s..,n�I a -REVISIONS - cPs HAffM ROAD rm Pltt a.IuB. eS 0w-N 170 $. ALVAR82 " nx.lw 3 24--SP- 1736 Zak Michelle Franklin, CFA -- Saint Lucie County Property Appraiser -- All rights reserved. Property Identification Site Address: HARTMAN Parcel ID: 2407-441 -0001 - Account#: 152042 Sec/Town/Range: RD 000-7 07/35S/40E Map ID: 24/07S Zoning: RS-3 Use Type: 0000 Jurisdiction: Saint Lucie County Ownership Legal Description Rafael S Alvarez Jr 7 35 40 FROM NE COR OF SE 1/4 OF SE 1/4 RUN W 25 FT 280 N Brocksmith rd TO W R/W LI OF HARTMAN RD AND POB,TH CONT W Fort Pierce, FL 34945 282.50 FT,TH SLY 475.5 FT,TH ELY 282.52 FT TO W R/W LI,TH N ALG W R/W LI 225.01 FT,TH W 210 F I ,TH N 104 FT THE E 210 FT,TH N 142.49 FT TO POB (2.57 AC) (OR 3525-619) Current Values I Historical Values 3-year JustMarket: $39,800 Assessed: $39,800 Year Just/Market Assessed Exemptions Taxable Exemptions: $0 Taxable: $39,800 2016 $39,800 $39,800 $0 $39,800 2015 $38,200 $38,200 $0 $38,200 2014 $38,200 $38,200 $0 $38,200 Date 05-13-2013 • 02-20-2004 07-20-2001 View: Year Built: N/A Primary Wall: Bedrooms: 0 Full Baths: 0 Half Baths: 0 Sale History Book/Page Sale Code Deed Grantor 3525 / 0619 0001 WD Rivera,Heriberto 1980 / 1901 XX01 QC Roberts,Donna M 1425 / 1953 XX02 WD Leben,Michael E Primary Building Information Finished Area of this building: 0 SF Gross Area of this building: 0 SF Exterior Data Type Roof Cover: Roof Structure; Frame: Grade: Story Height: No. Units: 0 Interior Data A/C %: 0% Electric: Heated %: N/A% Heat Type: Sprinkled %: 0% Heat Fuel: Total Areas Price $24,900 $I00 $130,000 Building Type: Effective Year: 2014 Secondary Wall: Primary Int Wall: Avg Hgt/Floor: 0 Primary Floors: Finished/Under Air 0 (SF): Gross Area (SF): 0 Land Size (acres): 2.57 Land Size (SF): 111,950 Total Building Count: 1 Special Features and Yard Items Qty Units Year Bit This information is believed to be correct at this time but it is subject to change and is not warranted. 0 Copyright 2017 Saint Lucie County Property Appraiser. All rights reserved. ttp://www.pasic.org/RECard/ 1/25/2017 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. STATE OF FLORIDA APPLICATION # AP1272-770 DEPARTMENT OF HEALTH PERMIT # 56-SF-1735202 ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM DOCUMENT # SE1022917 SITE EVALUATION AND SYSTEM SPECIFICATION r APPLICANT: Rafael Alvarez CONTRACTOR / AGENT: Culpepper & Terpening, Inc LOT: BLOCK: SUBDIVISION: ID# : 2407-441-0001-000-7 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. PROPERTY SIZE CONFORMS TO SITE PLAN: [X]YES [ ]NO NET USABLE AREA AVAILABLE: 2.57 ACRES TOTAL ESTIMATED SEWAGE FLOW: 400 GALLONS PER DAY [ RESIDENCES- LEI / OTHER -TABLE 2 ] AUTHORIZED SEWAGE FLOW: 3854.99 GALLONS PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE ] UNOBSTRUCTED AREA AVAILABLE: 750.00 SQFT UNOBSTRUCTED AREA REQUIRED: 750.00 SQFT . BENCHMARK/REFERENCE POINT LOCATION: site BM orange capped IR elev 16.86 E property line 6ft from rd ELEVATION OF PROPOSED SYSTEM SITE 9.00 [ INCHES / FT ] [ ABOVE / BELOW ] BENCHMARK/REFERENCE POINT THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES SURFACE WATER: FT DITCHES/SWALES:' FT NORMALLY WET: [ ]YES [X]NO WELLS: PUBLIC: FT LIMITED USE: FT PRIVATE: FT NON -POTABLE: FT BUILSING FOUNDATIONS: 20 FT PROPERTY LINES: 5 FT POTABLE WATER LINES: 65 FT SITE SUBJECT TO FREQUENT FLOODING? [ ]YES [X]NO 10 YEAR FLOODING? [ ]YES [XINO] 10 YEAR FLOOD ELEVATION FOR SITE: FTC MSL / NGVD J SITE ELEVATION: FT [ MSL / NGVD GATT_ DDf\WTTF TWWnPMIITTnW STTF. 1 SOIL PROFILE INFORMATION SITE 2 USDA SOIL SERIES: . Munsell if/Color Texture Depth 10YR 4/2 Fine Sand 0 To 9 10YR 512 Fine Sand 9 To 20 1OYR 518 CMN/PRM RF 14 To 59 1 OYR 612 Loamy Sand 20 To 31 10YR 7/2 Fine Sandy Loam 31 To 38 10YR 6/2 Sandy Loam 38 To 45 10YR 5/1 Fine Sand 45 To 61 1 OYR 6/1 Loamy Fine Sand 61 To 72 USDA SOIL SERIES: Munsell #/Color Texture Depth 1 OYR 4/2 Loamy Fine Sand 0 To 9 10YR 512 Fine Sand 9 To 20 1OYR 5/8 CMN/PRM RF 15 To 24 10YR 612 Loamy Sand 20 To 31 1OYR 712 Fine Sandy Loam 31 TO 38 1 OYR 5/2 Loamy Fine Sand 38 To 45 1 OYR 511 Fine Sand 45 To 63 10YR 6/1 Fine Sand 63 To 72 OBSERVED 14ATER TABLE: 67.00 INCHES [ ABOVE / BELOW ] EXISTING GRADE TYPE: ( PERCHED / APPARENT ] ESTIMATED WET SEASON WATER TABLE ELEVATION: 14 INCHES [ ABOVE / BELOW ] EXISTING GRADE HIGH WATER TABLE VEGETATION: [ ]YES EX ]NO MOTTLING: [X]YES [ ]NO DEPTH: 14.00 INCHES SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Fine Sand/0.80 DEPTH OF EXCAVATION: 45 INCHES •DRA_INFIELD CONFIGURATION: [X ] TRENCH [ ] BED [ j OTHER (SPECIFY) I- REMARKS/ADDITIONAL CRITERIA IWSWT determined using USDA WSS and soil borings. Soil similar to Riviera fine sand. 10YR 518 cmn prom RFs in 10YR 512 matrix starling at 14" in SB1 SB1 9" below BM. SB2 8" below BM. _ SITE EVALUATED BY: Ingram, Brian Ole: Environmental Specialist II) (ENVIRONMENTAL HEALTH) DR 4015, 08/09 (Obsoletes previous editions which may not be used) Incorporated: 64E-6.001, PAC DATE: 02/14/2017 Page 3 of 4 AP1272778 EID1735202 v 1.0.2 STATE OF OF FLORIDA File COPYAPPLICATION # AP1272778 DEPARTMENT OF HEALTH PERMIT # 56-SF-1735202 ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATION DOCUMENT # SE1022917 RECEII.'rD M1Ai?77017 APPLICANT: Rafael Alvarez - CONTRACTOR / AGENT: Culpepper & Terpening, Inc LOT: BLOCK: SUBDIVISION: ID# : 2407-441-0001-000-7 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. PROPERTY SIZE CONFORMS TO SITE PLAN: [X]YES [ ]NO NET USABLE AREA AVAILABLE: 2.57 ACRES TOTAL ESTIMATED SEWAGE FLOW: 400 GALLONS PER DAY [ RESIDENCES-TABLEI / OTHER -TABLE 2 ] AUTHORIZED SEWAGE FLOW: 3854.99 GALLONS PER DAY [ 1500 GPD/ACRE I OR 2500 GPD/ACRE ] UNOBSTRUCTED AREA AVAILABLE: 750.00 SQFT UNOBSTRUCTED AREA REQUIRED: 750.00 SQFT BENCHMARK/REFERENCE POINT LOCATION: Site BM Oral ELEVATION OF PROPOSED SYSTEM SITE 9.00 [ IR elev 16.86 E property line 6ft from rd / FT ] [ ABOVE /I BELOW I] BENCHMARK/REFERENCE POINT THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES - SURFACE WATER: FT DITCHES/SWALES: FT NORMALLY WET: [ ]YES [X]NO WF,LLS: PUBLIC: FT LIMITED USE: FT PRIVATE: FT NON -POTABLE: FT BUILDING FOUNDATIONS: 20 FT PROPERTY LINES: 5 FT POTABLE WATER LINES: 65 FT SITE SUBJECT TO FREQUENT FLOODING? 10 YEAR FLOOD ELEVATION FOR SITE: A[]TT. VPnWTT.F. TWVnVI.MMTnM cant• I [ ]YES [X]NO 10 YEAR FLOODING? [ FT [ MSL / NGVD ] .SITE ELEVATION: FT USDA SOIL SERIES: Munsell #/Color Texture Depth 10YR 4/2 Fine Sand 0 To 9 10YR 5/2 Fine Sand 9 To 20 10YR 5/8 CMN/PRM RF 14 To 59 10YR 6/2 Loamy Sand 20 To 31 10YR 712 Fine Sandy Loam 31 To 38 10YR 5/2 Sandy Loam 38 To 45 10YR 5/1 Fine Sand 45 To 61 10YR 6/1 Loamy Fine Sand 61 To 72 SOIL PROPTT.P. TNPARMATTnV 14TT7 7 ]YES [X]NO] [ MSL / NGVD USDA SOIL SERIES: Munsell #/Color Texture Depth 10YR 412 Loamy Fine Sand 0 To 9 10YR 5/2 Fine Sand 9 To 20 10YR 5/8 CMN/PRM RF 15 To 24 10YR 6/2 Loamy Sand 20 To 31 1 OYR 7/2 Fine Sandy Loam 31 To 38 10YR 5/2 Loamy Fine Sand 38 To 45 10YR 5/1 Fine Sand 45 To 63 10YR 6/1 Fine Sand 63 To 72 OBSERVED WATER TABLE: Z67.00 INCHES [ ABOVE / HELOW ] EXISTING GRADE TYPE: [ PERCHED / APPARENT ] ESTIMATED WET SEASON WATER TABLE ELEVATION: 14 INCHES [ ABOVE / BELOW ] EXISTING GRADE HIGH WATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: [X]YES [ ]NO DEPTH: 14.00 INCHES - SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: DMINFIELD CONFIGURATION: [X ] TRENCH [ I- REMARKS/ADDITIONAL CRITERIA ] BED Fine Sand/0.80 DEPTH OF EXCAVATION: 45 INCHES [ ] OTHER (SPECIFY) WSWT determined using USDA WSS and soil borings. Soil similar to Riviera fine sand. 10YR 518 cmn prom RFs in 10YR 612 matrix starting at 14" in SB1 S131 9" below BM. SB2 8" below BM. SITE EVALUATED BY: Ai --- Ingram, Brian Vrtle: Environmental Specialist II) (ENVIRONMENTAL HEALTH) DH 4015, 08109 (Obsoletes previous editions which may not be used) Incorporated: 64E-6.001, FAC DATE: 02/14/2017 Page 3 of 4 AP1272778 EID1735202 v 1.0.2