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HomeMy WebLinkAboutSEWAGE SITE EVALUATIONCAW STATE OF FLORIDA BY DEPARTMENT OF HEALTH a plj.. F` ONSITE SEWAGE TREATMENT ANDDSPOSB SITE EVALUATION AND SYSTEM SPECIFIC APPLICANT: Jeremy & Rebecca Ware CONTRACTOR / AGENT: Pennie Richwine LOT: 4 5 • SUBDIVISION: Lone Pine ID#: APPLICATION # AP1294673 PERMIT # 56-SF-1769375 DOCUMENT # SE1038136 TO BE COMPLETED BY ENGINEER, HEALTH DEPARTMENT EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEERS MUST PROVIDE REGISTEIATION NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS. PROPERTY SIZE CONFORMS TO SITE PLAN: [X]YES TOTAL ESTIMATED SEWAGE FLOW: 520 GALLOb AUTHORIZED SEWAGE FLOW: 1950.01 GALLOT UNOBSTRUCTED AREA AVAILABLE: 2248.00 SOFT BENCHMARK/REFERENCE POINT LOCATION: site BM ME ELEVATION OF PROPOSED SYSTEM SITE 4.00 1 [ .]NO NET USABLE AREA AVAILABLE: 0.78 ACRES PER DAY [ RESIDENCES -TABLET / OTHER -TABLE 2 ] PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE ] UNOBSTRUCTED AREA REQUIRED: 1300.00 SOFT SW / FT ] I ABOVE / BELOW ] BENCHMARK/REFERENCE POINT THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM HE PROPOSED SYSTEM TO THE FOLLOWING FEATURES SURFACE WATER: 150 FT DITCHES /WALES: FT NORMALLY WET: [ ]YES [X]NO WELLS: PUBLIC: FT LIIQTED USE: I FT PRIVATE: FT NON -POTABLE: 100 FT BUILDING FOUNDATIONS: 5 FT PROPERTY LINES: 5 FT POTABLE WATER LINES: 10 FT SITE SUBJECT TO FREQUENT FLOODING? [ ]YE$ [X]NO 10 YEAR FLOODING? [ ]YES [X]NO) 10 YEAR FLOOD ELEVATION FOR SITE: FTC MSL / NGVD ] SITE ELEVATION: FT [ MSL / NGVD onrT. n0e%TT.4 TMWM0 reTTnM sr4T. 1 I SOIL PROFILE INFORMATION SITE 2 USDA SOIL SERIES:Wabasso fine sand Munsell #/Color Texture Depth 10YR 411 Fine Sand 0 TO 11 10YR 5/1 Fine Sand 11 To 31 10YR 6/1 Fine Sand 19 To 31 10YR 311 Fine Sand 31 To 37 10YR 4/3 Fine Sand 37 To 50 10YR 512 Loamy Fine Sand 50 To 72 USDA SOIL SERIES:Wabasso fine sand Munsell #/Color Texture Depth 10YR 4/1 Fine Sand 0 To 13 10YR 511 Fine Sand 13 To 33 10YR 6/1 Fine Sand 23 To 35 10YR 3/1 Fine Sand 35 To 41 10YR 3/3 Fine Sand 41 To 51 10YR 5/2 Loamy Fine Sand 51 To 72 OBSERVED WATER TABLE: 49.00 INCHES [ ABOVE /I BELOW ] EXISTING GRADE TYPE: [ PERCHED / APPARENT ] ESTIMATED WET SEASON WATER TABLE ELEVATION: 19 INCHES [ ABOVE / BELOW ] EXISTING GRADE HIGH WATER TABLE VEGETATION: [ ]YES [X] O MOTTLING: [XIYES [ ]NO DEPTH: 19.00 INCHES SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Fine Sand/0.60 DEPTH OF EXCAVA ` — __ _INCH S DRAINFIELD CONFIGURATION: [ ] TRENCH [ X i] BED [ ] OTHER (SPECIFY) `ate u�� D r e[I�i� REMARKS/ADDITIONAL CRITERIA q q WSWT determined using USDA WSS and soil borings. I NOV / 2 2017 10YR6/1 stripping in 10YRSM matrix >10% with diffuse boundarles starting at 19" in SB1. SB1 4" above BM SB2 5" above BM SITE EVALUATED BY: I F 6/19/2017 Ingram, Brian tle: Environ ental Specialist II) (ENVIRONMENTAL HEALTH) DH 4015, 08/09 (Obsoletes previous editions which may no be used) Incorporated: 64E-6.001, PAC Page 3 of 4 AP1294673 EID1769376 v 1.0.2 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT ANC , SITE EVALUATION AND SYSTEM APPLICANT: Ware LOT: 4 & 5 BLOCK: N/A SUBDIVISION: PROPERTY ID #: DISPOSAL, SYSTEM PECIFICATIONS AGENT: Pine [ Tax b Number PERMIT #. f(P-SI`+Io/ 375 TO BE COMPLETED BY ENGINEER, HEALTH DEPARTMENT EMPLOYEE,OR OTHER QUALIFIED PERSON. ENGINEERS MUST PROVIDE REGISTRATION NUMBER AND SIGN ANDISEAL EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS. PROPERTY SIZE CONFORMS TO SITE PLAN: [✓] YES I[ ] NO NET USABLE AREA AVAILABLE: .781 ACRES TOTAL ESTIMATED SEWAGE FLOW: 420 ,a•ALONS PER DAY [RESIDENCES -TABLE 1 ] AUTHORIZED SEWAGE FLOW: 1500 GA�LONS PER DAY [ 1500 GPD/ACRE ] } UNOBSTRUCTED AREA AVAILABLE: 2248+ SOFT UNOBSTRUCTED AREA REQUIRED: 1000 SQFT BENCHMARK/REFERENCE POINT LOCATION: Mag nail LB! ELEVATION OF PROPOSED SYSTEM SITE IS-9 [ 'road on SW corner i ] [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:35'+ FT NORMALLY WET? [ ] YES [✓] NO WELLS: PUBLIC: 2001+ FT LIMITED USE: L_FT PRIVATE: FT NON -POTABLE: 100'+ FT BUILDING FOUNDATIONS:5'+ FT PROPER LINES:10"+ FT POTABLE WATER LINES:10"+ 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 R SOIL PROFILE INFORMATION SITE 1 MUNSELL #/COLOR TEXTURE DEP7 • TO TO TO TO TO TO TO TO TO USDA SOIL SERIES: SOIL PROFILE INFORMATION SITE 2 MUNSELL #/COLOR TEXTURE DEPTH TO TO TO TO TO TO TO TO TO USDA SOIL SERIES: OBSERVED WATER TABLE: INCHES [ABO /BELOW 11 EXISTING GRADE. TYPE: [PERCHSD/APPARENT ] ESTIMATED WET SEASON WATER TABLE ELEVATION: INCHES [.ABOVE/BELOW ] EXISTING GRADE HIGH WATER TABLE VEGETATION: [ ] YES [ ] O MOTTLING: [ ] YES [ ] NO DEPTH: INCHES SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZI] DRAINFIELD CONFIGURATION: [ ] TRENCH [ REMARKS/ADDITIONAL CRITERIA: SITE EVALUATED BY: DEPTH OF EXCAVATION: INCHES .BED [ ] OTHER (SPECIFY) DATE: DR 4015, 08/09 (Obsoletes previous editions which may, not be used) Incorporated: 64E-6.001, FAC Page 3 of 4 4 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND SYSTEM CONSTRUCTION PERMIT FOR: OSTDS New APPLICANT: Jeremy & Rebecca Ware PROPERTY ADDRESS: 1316 Lone Pine Dr LOT: 4&5 BLOCK: SUBD PROPERTY ID # : 3409-505-0009-000-7 FL SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE ' 381.0065, F.S., AND CHAPTER 64E-6, F.A.C. SATISFACTORY PERFORMANCE FOR ANY SPECIFIC i WHICH SERVED AS A BASIS FOR ISSUANCE OF PERMIT APPLICATION. SUCH MODIFICATIONS MAY ISSUANCE OF THIS PERMIT DOES NOT EXEMPT STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMET PERMIT 0:66-SF-1769376 APPLICATION # : AP 1294573 DATE PAID: FEE PAID: RECEIPT #: DOCUMENT #: PR1066042 Lone Pine [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER] [OR TAX ID NUMBER] WITH SPECIFICATIONS AND STANDARDS OF SECTION DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE RIOD OF TIME. ANY CHANGE IN MATERIAL FACTS, iIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE tESULT IN THIS PERMIT BEING MADE NULL AND VOID. Z APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL, OF THIS PROPERTY. SYSTEM DESIGN AND SPECIFICATIONS T [ 1,350 ] GALLONS / GPD Septic 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 [ 867 ] SQUARE FEET Drainfield new YSTEM R [ ] SQUARE FEET N/A YSTEM A TYPE SYSTEM: [ ] STANDARD [ ] FILLED DO MOUND [ ] I CONFIGURATION: [ ] TRENCH [x] BED [ ] n N F LOCATION OF BENCHMARK: site BM NiD SW property corner I ELEVATION OF PROPOSED SYSTEM SITE [ 4.00 ]L INCHES FT I ABOVE BELOW] BENCHMARK/REFERENCE POINT u E BOTTOM OF DRAINFIELD TO BE [ 9.00 ] INCHES FT I ABOVE BELOW] BENCHMARK/REFERENCE POINT L D FILL REQUIRED: [23.001 INCHES EXCAVA ION REQUIRED: [ ] INCHES The system is sized for 3 bedrooms with a maximum occupancy of 6 persons (2 per bedroom), for a total estimated flow of O 520 gpd. T The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance with H s. 64E-6.013(3)(Q,, FAC. E R SPECIFICATIONS BY: Brian J Ingram APPROVED BY: ] TITLE: Environmental Specialist II TITLE: Environmental Specialist II St. Lucie CHD DATE ISSUED: 06/20/2017 DH 4016, 08/09 (Obsoletes all previous editions " Incorporated: 64E-6.003, FAC v 1.1.4 EXPIRATION DATE: 12/20/2018 may not be used) AP1294573 SE1038136 Page 1 of 3 NOV 2 0 2017 f STATE FL IDA RERMIT APPLICATION C ST UCT, G .epeTs7q a x r , x !... REPAIR Q, , OR'ABANRON A WELL r PerrilitNo " .y, ' ❑ SOUth Florida Unique dD PEASE FILL OUTALL APPLICABLE'FIELDS ,� ❑North Where Applicab(e) Perrnh Stipulations Requiied (See Attached) ky `❑St,Johns River " . •. IC South Florida The�warerwef1,coMrodorlsresponsrble(orcomplegng. _ ..- this(onrrandfarivmdm�thepeirnrtapphcatfontotfie 62-524 Quad No. Delineation No. ❑Suwannee River app;o ltim k• r. pdatedeleydiedar}thoritywhere applicable: ❑DEP CU)VW Application No ❑ Delegated:Authority: (If Applicable) . } z - 1. Jeremy antl Rebecca Ware 1195 Country Gardens Lti, Fort Pierce FLr34982 `Owner, Legal Name If,Coiporagon' *Alftlress *City R�%WM�ow ski— s State' "ZIP Telephone IVuiriber 2.1316MLone Plne. Dr Fort Pierce FL 34982 3 "Well Location Address Road NaTq or'Number City 3.340950500090007 ' 4.& 5 4 OPParcellD No PIN) or Alternate Key (Chile :One) Lot Block Unit 36 . , 4U St t UCl I Lone Plne Check if 62-524.Q Yes Q' Nu *Section or Land Grant *Township *Rarige Coun Subdivision 5; Tlmotfiy W UVilhams; ,1 T 3 7:72464 2967 t ttmwllliams4cw@bellsouth net a "Water Well Contractor "Licelse Number ._ "Telephone Number' E-nadAddr"ess6:7803 Eden Road Fort Pierce F.951 Waterl%VeICContractor's Address Crty State. Zip 7. "Type of Work Q Co''nstltrctlon: `[] Repair �` .Modification© Abandonment 8: *Number of Proposed Wails •Reason for Repair, Modifi 9.. 'Specify,lntended Uses) ofWell(s):IVA Domgs6c � qq L! . ✓ Landscape Imgatron . f. � D [❑ Agriculture} Imgation Site Investigations [] Bottled Water Supply Recreatron,Area Irrigation 0. LI estock Morhtonng 0 Publio:lNater Supply (Limited Use%pOH) [� N rseryamgation Test J.t7N 2 0 Public Water Sppply`(Cdrrimunity:or Non-CommunitylDEP} Commeraal/industrial ❑ 7'7 Class Gdnlectton I i Earth Goupled:Geothennal•., G If Course Irngation HVAC Supply B HVAG 12etum Class V ln)ecUon 0, Recharge Q CammerclaVlndustriatDispos I ,Q AgLitfer�Storage and Recoveryi�] Drainage '; FDOH M StLW�ACO Rernedratiofi Recovery 0 Air Sparge Q. Other (oe'stxitej NVIi��%I�If� Other ,(oesaiihe) i I I a se nl 10 •Distance 4oM,Septic System rf � 2Q0,4n a 10® 11..Faclhty Des nption rest erica 12 Estimated Start ;Date 13."Estimated Well Depth �20 ft *Estimated.Casrng Depth 1.00 ft P:nma"ry Casing Diameter�2 m: Open Hole From To ', ft. 1`4.-Estrr►iated S`t reen" Interval From. ..I,.,. - PnmatyCasmg MatenaG Bladt Steel. Galvanized (PVC. Stainless Steel �. • l Not CasedOther: 16:_SecondaryCasrrig iTelescc paCasrng loner Surt ceCasing Diameter in. 17. Secondary Casing Material: Black Steel Galvanized RVG Stemless Steel they. `l 98;"Method of Construction I eparr or Abandonment: Auger Gable Tool Jetted q („ ./ RotarySonb' i Combinairon (rwo or MpreyMethoda) Hand Driven rneif Point Sand Point)' Hydraulic Pdint (Direct Push) Hon ntal Drilhngged by Approved Method.. I Other IoesFribej , 19: Proposed Grouting Interval for the Primary Secondary ,and Addih[ Casing ' Seal Material (; Bentonite . Nett Cement Other, ) From f ' To; ` Seai Material ( %ntorite Nealt Cement Other j From To Seal Material (•• Bentonite Neat Cement Qthel y Seal Material (• Bentonite Neat Cement :&er ) 20. Indicate total number of existing wells on site: 0 . , i Ist number of existirt unused wells.on site 9. i 21.'Is this well or anysexi nra •we ll or;water withdrawal on the owners onhgtious property covered under.a Consumpgve/hUater 11se.Permit (CUP/WUP) or CUPIUVUP'Apphcahon Yes ;(' No If yes complet the•fQllowing G /WUP No Disthd WeII,ID No 22. Latitude Longitude:: I Data Obtained From G" , Map Survey Datum: NAD 27 NAD 83 WGS 84. lieidtry cerafy Nat itMll tompry,yio the epp6ceble cures of Tift¢'.g0 dnAdm(nFstraave Coda end that a Ovate • I cerhN ttj ` . am tlt'. '. er of e.pro , ny p�a(tlie (nrortm6on provl`d_oil is accurate: and lh'ai l om awaro of t use pomut oraNdddl recfi aporrrq if needed lies been orvril obtained prior to wirsfieoCBrneat ofvre➢ cor 9iugron. I (udlici that oil mfortiadon'Rovided In ViI tespore dos u rCha" 37'l, pb I m", to metnteln:or mmyy ' . ••- p radon is aaureta and thatl 6abtaln'-'' � propeay abendontlds wa .tu lceN c necessary approvltrom er tedoral, ate orluml av the eg tfor die en' the tnfortlon providodiaecwrato; ra'ti(plehan re' olhe a ifapp6rable".lagree to pro`dldeawed r dUtles s'slateda o er cone too a/ldlhet ihavc info lned,lho aWiptrofUltlir., Ntaan 3o 9e n: the ConetNc4on ropair nadiHcetlon,pr b t'ln9 personnof of this WMD of DWaaateQ Audiodtysxess' . ,utisnifoa tr/1N permit rm pa- r o Hirrcheverocpura Srst. , 4alt dudng'th nrepair 6cation orabarlCont'rcnt nuth �' � otiigdW the polmik; . - �. 11-3 $i nature of C tractor License No • nat(ire of O er r gent Date `- r � "•pit y°' tb ra .. ^n x i.a- Approval Granter) By r Issue Date' ier rs r' } Ezptratron Date /Z :;ZG / HylrologistApprovaP xf Fee' Recewed' $ Receipt No Check. No; THIS PERMITc'IS NOT VALID UNTIL PROPERLY SIGNED BY AN AUTHORIZED OFFICER OR REPRESENTATIVE.OF IHE WMQ OR DELEGATED AUTHORITY. THE PERMIT SHALL BE AVAILABLE AT`THE WEt L SITE DURING ALL CONSTRUCTION REPAIR MODIFICATION OR ABANDONMENT ACTLVfTIES. DEP Form:6253290d(]) Incotpo[atedin¢2`,592400(1yFAC EffecUve'bate Odoper72010 - y _ of 2 •. . '-Page 1