The URL can be used to link to this page

Home My WebLink AboutOSTDS NEWJ + (09Y W VI7 WL vi✓ Stl R7 SR cr vcur�aa ^."uavauu. IGV U0190I F%U UU1L r101 l.u, rL JY.7YJ LOT: 3 and 4 BLOCK: 2 SUBDIVISION: - [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER] PROPERTY ID #: 2309-501-0015-000-0 [OR TAX ID NUMBER] SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION 3t(1.0065, 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 i T' ; [ 900 ] GALLONS / GPD , Seotic New CAPACITY A,[ ] GALLONS / GPD N/A CAPACITY N[ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS] K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ ] D [ 375 ] SQUARE FEET Drainfield New SYSTEM R [ ] SQUARE FEET N/A SYSTEM A TYPE SYSTEM: [ ] STANDARD [ ] FILLED [X] MOUND [ ] �I CONFIGURATION: [X] TRENCH [ ] BED [ ] fi LOCATION OF BENCHMARK: Set Nail & Disk LB #7903 I ELEVATION OF PROPOSED SYSTEM SITE [ 12.001 INCHES FT ][ABOVE BELOW BENCBMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 6.00 ][INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT L D 1 0 T H E R -JL" kCNVU114Y'U: L L4.UUJ J.NCHE5 E:XUAVATIVN 14ZWU1LIELJ: L 40.VU J 11m L-;n O The system is sized for 3 bedrooms with a maximum occupancy of 6 persons (2 per bedroom), for a total estimated flow of 300 gpd. The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance with s. 64E-6.013(3)(0, FAC. SPECIFICATIONS BY: Dianna S May TITLE' Environmental Specialist I APPROVED BY: "P.s06• -mr- TITLE: Environmental Specialist I St. Lucie CHD Dianna 5 May DATE ISSUED: 02/07/2018 EXPIRATION DATE: DR 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC v 1.1.4 AP1325754 SE1063417 08/07/2019 Page 1 of 3 4 f STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM,SPECIFICATION ,APPLICANT: Katrina & Lawrence Slay CONTRACTOR / AGENT: James Trefelner LOT: 3 and 4 BLOCK: 2 SUBDIVISION: ID#:2309-501-0015-000-0 APPLICATION # AP1325754 PERMIT # 56-SF-1818738 DOCUMENT # SE1063417 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: 0.59 ACRES TOTAL ESTIMATED SEWAGE FLOW: 300 ' GALLONS PER DAY [ RESIDENCES -TABLED / OTHER -TABLE 2 ] AUTHORIZED SEWAGE FLOW: 884.99i GALLONS PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE ] UNOBSTRUCTED AREA AVAILABLE: 700.00 SQFT UNOBSTRUCTED AREA REQUIRED: 563.00 SQFT BENCHMARK/REFERENCE POINT LOCATION: Set Nail & Disk LB EI"ATIONOF PROPOSED SYSTEM SITE 12.00 [FINCH! / FT ] [ ABOVE /IBELOWI] 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: 75 FT NON -POTABLE: FT BUI3.DING FOUNDATIONS: 5 FT, PROPERTY LINES: 9 FT POTABLE WATER LINES: 10 FT SITE SUBJECT TO FREQUENT FLOODING? [ ]YES [X]NO 10 YEAR FLOODING? [ ]YES [X]NOI 10'YEAR FLOOD ELEVATION FOR SITE: FT[ MSL / NGVD ] SITE ELEVATION: FT [ MSL / NGVD enrr_ DVOWTV61 TMVnDMAMTnu CTM7 I SOIL PROFILE INFORMATION SITE 2 USDA SOIL SERIES:Nettles sand Munsell #/Color Texture Depth 10YR 4/1 Sand 0 To 10 i 10YR 5/1 Sand 10 To 22 110YR 6/1 Sand 18 To 31 ;10YR 412 Sand 31 To 35 2.5Y 4/2 Clay Loam 35 To 48 10YR 5/1 Sand 48 To 54 REFUSAL Refusal 54 To 72 USDA SOIL SERIES:Nettles sand Munsell #/Color Texture Depth 10YR 4/1 Sand 0 To 10 10YR 6/1 Sand 10 To 22 10YR 6/1 Sand 18 To 31 10YR 4/2 Sand 31 To 35 2.5Y 4/2 Clay Loam 35 To 48 10YR 5/1 Sand 48 To 54 REFUSAL Refusal 54 To 72 OBSERVED WATER TABLE: 31.00 INCHES [ABOVE / BELOW ] EXISTING GRADE TYPE: [ PERCHED / APPARENT ] ESTIMATED WET SEASON WATER TABLE ELEVATION: 18 INCHES [ ABOVE / BELOW ] EXISTING GRADE . HIGH WATER TABLE VEGETATION: [ ]YES EX ]NO MOTTLING: [X]YES [ ]NO DEPTH: 18.00 INCHES SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Sand/0.80 DEPTH OF EXCAVATION: DRAINFIELD CONFIGURATION: [X] TRENCH [ ] BED [ ] OTHER (SPECIFY) r REMARKS/ADDITIONAL CRITERIA 3WT determined using USDA WSS and soil borings.10YR611 stripping in a 10YR5/1 matrix >10% with diffused boundaries starting 18" in SB7. SB1 and SB212" below BM. SITE EVALUATED BY: —_nAo „ Zftfi DATE: May, Dianna (Title: E ironmental Specialist 1) (Florida Department of Health in St Luc DH 4025, 08/09 (Obsoletes previous editions which may not be used) Incorporated: 64E-6.001, FAC AP1325754 EID1818738 48 INCHES 02/02/2018 Page 3 of 4 v 1.0.2 STATE OF FLORIDA PERMIT APPLICATION TO CONSTRUCT, REPAIR, MODIFY, OR ABANDON A WELL - Permit No. .a ❑ Southwest Florida Unique ID -'>•3 PLEASE FILL OUT ALLAPPLICABLE FIELDS ❑ Northwest (=Denotes Required Fields Where Applicable) Permit Stipulations Required (See Attached) El St. Johns River OSouth Florida The water well contractor is responsible for completing this form and.forwarding the permit application to the 62-524 Quad No. Delineation No. fit/ 3; ❑ Suwannee River appropriate delegated authority where applicable. ❑ DEP CUP/WUP Application No. ❑ Delegated Authority (if Applicable) ABOVE THIS LINE - FOR OFFICIAL USE ONLY 1.hcA+,(',,Ack lo,\A I rC1ef �'i.1 Y Pie CQ L. 3yC{ Z a01 Owner, Leal Name tf Corpora Ion Address' `City 'State ZIP'Telephone Number 2. Well Locatioo``n Ad ess, Road Name or Number, City Parcel ID No. (PIN) or Alternate Key (Circle One) Lot Block Unit 4. OCI 35S 3�tP- S ,Luc',e- =Section or Land Grant 'Township 'Range 'CouSubdivision Check if 62-524: _ Yes _ No 5. /r?M 6+11'GZ2Alh,S_ I (nty -� 7 -oa lA(P4-',)g'�I -}-',mir)'tli,cky,,S LlCw& ��e11s ,,f•h :Water Well Contractor =License Number "Telephone Number E-mail Address 6. n`b03 EdenP_d ��rk .�rC11 "Water.Well Contractor's Address State ZIP 7. "Type of Work: _ Construction _Repair _Modification _Abandonment 8. 'Number of Proposed Wells Reason for Repair, Modification, orAbandonment 9. "Specify Intended Use(s) of Well(s): Date Stamp ,Domestic Landscape Irrigation Agricultural Irrigation _Site Investigation G _Bottled Water Supply _Recreation Area Irrigation _Livestock _Monitoring _v Public Water Supply (Limited Use/DOH) _Nursery Irrigation Test _Public Water Supply (Community or Non-Community/DEP) —Commercial/Industrial _Earth -Coupled Geothermal _Golf Course Irrigation _HVAC Supply _Class I Injection _HVAC Return F E B 7 2018 Class V Injection: _Recharge _Commercial/Industrial Disposal _Aquifer Storage and Recovery _Drainage Remediation: _Recovery _Air Sparge _Other (Describe) Other (Describe) (Note: Not all types of wells are permitted by a given permitting a 10 - Distance from Septic System if <_200 ft.' `� S 11. Facili Descri (ion `�4�liIIRONMENTAL HEAL hr P 12. Estimated Start Date 13,`Estimated Well Depth(• ft. 'Estimated Casing Depth (i ft. `Primary Casing Diameter 9, in. Open Hole: From TC ft. 14. Estimated Screen Interval: From To ft. 15: Primary Casing Material: Black Steel Galvanized /PVC Stainless Steel Not Cased Other: 16. Secondary Casing: Telescope Casing Liner Surface Casing Diameter in. 17. Secondary Casing Material: Black Steel Galvanized PVC Stainless Steel Other 18'Method of Construction, Repair, or Abandonment: Auger Cable Tool Jetted Rotary Sonic Combination (Two or More Methods) Hand Driven (Well Point, Sand Point) Hydraulic Point (Direct Push) Horizontal Drilling Plugged by Approved Method Other (Descrbe> 19. Proposed Grouting Interval for the Primary, Secondary, and Additional Casing: From To Seal Material C_Bentonite Neat Cement Other ) From To Seal Material L_Bentonitt Neat Cement Other_ ) From To Seal Material ( Bentonite Neat Cement Other m ) FroTo Seal Material C_Bentonite Neat Cement Other ) 20. Indicate total number of existing wells on site List number of existing unused wells on site 21: Is this well or any existing well or water withdrawal on the owner's contiguous property covered under a Consumptive/Water Use Permit (CUP/WUP) or CUP/WUP Application? Yes '-/ No If yes, complete the following: CUP/WUP No. District Well ID No. 22. Latitude Longitude 23. Data Obtained From: .GPS Map Survey Datum: NAD 27 NAD 83 WGS 84 I herby certty That I cunt ply wen the applicable rules of dIe40, Florida Administrative Code, and that a water I certify that 1 am tho owner of the properly, that the infarination provided is accurate, and that 1 am aware of my use permit Ora rge permit, if neoded, has bee or will bo obtained pdor to commencement of well responsibllities under Cha➢terM Flodda Statutes, to maintain orpropedy abandon Ois welt: or, l eerliry that f'am construction. 1 fu a ce y that an informaeon previd n this application is accurate and that I Wit obtain the agent for the owner, that the Inform ll provided is aavmto, and that I have informed Uro comer of their necessary re otherfederal, stale, or local emments, 0 applicable. I agree to provide a wen responsibilities as stated above. Owner consents to allowin oompledon re rt stdct wie4n 30 days after potion of the canstniction, ropair, modification. or to tha wen site du 9 fabanda l of lids WMD or by this par Authority access abandonme e s ennil, the pe 'xPoalbn, wlddlever oxirs first. 00�on• repair, odl0ptlon, or ebandonmenl aulhori[ed by this permit, ' Z9 'Sig tut , of ontr actor 'License No. '`Sign re of Owner or nt Date Approval Granted By_ �-7 />' Issue Date 4-7_ 14% Expiration Date vo OtHydrologist Approval 100, Initials Fee Received $ Receipt No. Check No. THIS HERMIT IS NOT VALID UNTIL PROPERLY SIGNED BY AN AUTHORIZED OFFICER OR REPRESENTATIVE OF THE WMD OR DELEGATED AUTHORITY. THE PERMIT SHALL BE AVAILABLE AT THE WELL SITE DURING ALL CONSTRUCTION, REPAIR, MODIFICATION, OR ABANDONMENT ACTIVITIES. / DEP Form: 62-532.900(1) Incorporated in 62-532.400(1), F.A.C. Effective Date: October 7, 2010 Page 1 of 2