HomeMy WebLinkAboutD O H SEWAGE TREATMENT - DISPOSAL EVALUATION SYSTEM SPECIFICATIONS 7-24-18STATE, OF FLORIDA
DEPARTMENT OF,HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
SITE EVALUATION AND SYSTEM SPECIFICATIONS
APPLICANT: I Nicholas & Hi
LOT: BLOCK:
PERMIT #.
her Tubito AGENT: Alexander J. Piazza PSM, Inc.
SUBDIVISION:
PROPERTY I0 #: 3409-114-0004-000-2
I Tax ID Number
PO 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.
?ROPERTY SIZE CONFORMS TO SITE PLAN: V] YES [ ] NO NET USABLE AREA AVAILABLE: 3.771 ACRES
COTAL ESTI TED SEWAGE FLOW: 767 GALLONS PER DAY [ RESIDENCES -TABLE I/OTHER-TABLE 2 ]
LUTHORIZEDSEWAGE FLOW: GALLONS PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE ]
)NOBSTRUCTED AREA AVAILABLE: 1200 SQFT UNOBSTRUCTED AREA REQUIRED: 1200 SQFT
I
ELEVATION
'HE MINI
URFACE
ELLS: P
UILDING
ITE SUB,
D YEAR :
ERENCE POINT LOCATION:
"PROPOSED SYSTEM SITE is 34 [ INCHES / FT ] [ ABOVE / BELOW •] BENCHMARK/REFERENCE POINT
SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES
R:100 FT DITCHES/SWALES:15 FT NORMALLY WET? [ ] YES [✓] NO
C:200 FT LIMITED USE:100 FT PRIVATE:75 FT NON—POTABLE:100 FT
NDATIONS:5 FT PROPERTY LINES:10 FT POTABLE WATER LINES: FT
TO FREQUENT FLOODING: 1 ] YES [✓] NO 10 YEAR FLOODING? ] YES ]v/] NO
ELEVATION FOR SITE: FT MSL/NGVD SITE ELEVATION: FT MSL/NGVD
SOIL PROFILE INFORMATION SITE 1
YIUNSELL #/COLOR
i
USDA SOILI,SERIES:
TEXTURE DEPTH
TO
TO
TO
TO
TO
TO
TO
TO
TO
SOIL PROFILE INFORMATION SITE 2
MUNSELL #/COLOR TEXTURE DEPTH
TO
TO
TO
TO
TO
TO
TO
TO
TO
USDA SOIL SERIES:
SERVED WATER TABLE:40+ INCHES [BELOW ►] EXISTING GRADE TYPE: [PERCHED /APPARENT ]
PIMATED WET SEASON WATER TABLE ELEVATION: INCHES ABOVE BELOW ] EXISTING GRADE
,H WATER TABLE VEGETATION: ( ] YES ( ] NO MOTTLING: [ ] YES [ ] NO DEPTH: INCHES
EL TEXTURE/LOADING RATE FOR SYSTEM SIZING: DEPTH OF EXCAVATION: INCHES
,INFIELD CONFIGURATION: [,/] TRENCH [ ] BED ] ] OTHER (SPECIFY)
4ARKS/ADDITIONAL CRITERIA:
'E EVALUATED BY:
DATE: 7-24-18
1015, 12/11 (Obsoletes Previous editions which may not be' used) Incorporated: 64E-6.001, FAC Page 3 of 4