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Home My WebLink AboutD O H PAPERWORKSTATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM PERMIT #: 56-SF-1 875990 APPLICATION # : AP 1363444 DATE PAID: FEE PAID: RECEIPT #: F*F% UW�� FILE CONSTRUCTION PERMIT FOR: OSTDS New APPLICANT: Guiseppe Gambina PROPERTY ADDRESS: 8359 Calumet Ct Port Saint Lucie, FL 34986 elf LOT: 159 BLOCK: SUBDIVISION: Sabal Creek Phase IV StL(iMeCb Y PROPERTY ID #:. 3328-701-0012-000-5 [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER] 1 [OR TAX ID NUMBER] SYSTEM MOIST 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 [ 2,050 ] GALLONS / GPD Septic new CAPACITY A [ ] GALLONS / GPD N/A CAPACITY N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS] K. [ 750 ] GALLONS DOSING TANK CAPACITY [166.673GALLONS @[ 6 ]DOSES PER 24 HRS #Pumps [ 1 ] D [ 625 iI] SQUARE FEET Drainfield new SYSTEM R [ 625 i] SQUARE FEET Drainfield new SYSTEM A TYPE SYSTEM: [ ] STANDARD [ ] FILLED [X] MOUND [ ] I CONFIGURATION: [X] TRENCH [ ] BED [ ] N F LOCATION OF BENCHMARK: NiD in cutout, center of cul-de-sac I ELEVATION OF PROPOSED SYSTEM SITE [ 5.00 ][ INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 4.00 ][INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT L D FILL REQUIRED: _ [19.001 INCHES EXCAVATION REQUIRED: [ 41.001 INCHES The system is sized for 6 bedrooms with a maximum occupancy of 12 persons (2 per bedroom), for a total estimated flow of 0 1000 gpd. T Dose ENTIRE drainfield each cycle. H Pumps must be certified as suitable for distributing sewage effluent. The licenseld contractor installing the system is responsible for installing the minimum category of tank in accordance with E s. 64E-6.013(3)(0, FAC. R SPECIFICATIONS BY: Brian J In r TITLE: i g Environmental Specialist II APPROVED BY:I LE: Environmental Specialist II St. Lucie CHD I Brian J In DATE ISSUED: 10/17/2018 EXPIRATION DATE: 04/17/2020 DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated 64E-6.003, PAC v 1.1.4 AP1363444 SE1117445 Page 1 of 3 NOTICE OF RIGHTS Aparty 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. . I i I 8� HEALTH St. Lucie County Health Department 5150 NW Milner Dr Port Saint Lucie, FL 34983 PAYING ON: PERMIT #: 56-SF-1875990 BILL ooc #:56-BID-3960977 CONSTRUCTION APPLICATION #: AP1363444 RECEIVED FROM: Telese Builders LLC AMOUNT PAID: $ 515.00 PAYMEN I FORM: CHECK 1060 PAYMENT DATE: 09/10/2018 MAIL TO: Guiseppe Gambina i FACILITY NAME: PROPERTI LOCATION: 8359 .Calumet Ct Portl Saint Lucie, FL 34986 Lot: 159 128 - Block: (ID: 3328-701-0012-000-5 EXPLANATION or DESCRIPTION: QUANTITY FEE Construction System Inspection Research Fee 1 $ -1 - Surcharge (All) -1 - OSTDS New Permit Surcharge -1 - OSTDS Construction Application and Plan Review,New 123 - OSTI S Construction Site Evaluation 126 - OSTDS Construction Permit (New or Mod, Amendment) 127 - OSTDS Construction System Inspection 133 - OSTDS Construction Reinspection I RECEIVED BY: VanceMH M 1 $ 15.00 1 $ 100.00 1 $ 100.00 1 $ 115.00 1 $ 55.00 1 $ 75.00 1 $ 50.00 AUDIT CONTROL NO. 66-PID-3706882 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM APPLICATION FOR CONSTRUCTION PERMIT FOR: 6vj-e 5q,�)87-1(-P PERMIT NO. DATE PAID: FEE PAID: RECEIPT #: 1taCna stem [ ] Existing System [ ] Holding Tank [ ] Innovative [ ] Abandonment [ ] Temporary [ ] APPLICANT: Limseppe uamnm AGENT: Joseph Telese Epp ! ,� TELEPHONE: 772-260-4889 MAILING ADDRESS: 703 SW Goldshine Ct. Palm City, Fl. 34990-1528 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: 1591 BLOCK: SUBDIVISION: Sable Creek Phase IV PLATTED: PROPERTY ID #: 3328-701-0012-000-5 ZONING: I/M OR EQUIVALENT: [ No ] PROPERTYISIZE: 2.76 ACRES WATER SUPPLY: [V ] PRIVATE PUBLIC [ ]<=2000GPD [ ]>2000GPD IS SEWER AVAILABLE AS PER 381.0065, FS? [ No ] DISTANCE TO SEWER: FT PROPERTY ADDRESS: 8359 Calumet Ct. PORT ST• LUCIE, Fs. 34g810 DIRECTIONS TO PROPERTY: PGA Village St. Lucie West East Gate Entrance, 1st stop make Left, continue to Calumet Ct. BUILDING INFORMATION 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 Fainily 6 �Z�9 2 3 4 [ ] Flo or/Equ pment Drains [ ] Other (Specify) NA SIGNATURE! I I'11Ai[i[iL. 'll �, AO DH 4015, 08/09 (Obsoletes previous editions which may not be used) Incorporated 64E-6.001, FAC DATE: -4 - -/ 4 Page 1 of 4 APPLICANT: CONTRACTOR LOT: 159 STATE OF FLORIDA DEPARTMENT OF HEALTH I ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATION Guiseppe Gambina AGENT: Telese Builders LLC BLOCK: N SUBDIVISION: Sabal Creek Phase IV In#: 3328-701-0012-000-5 APPLICATION # A P1363444 PERMIT # 56-SF-1875990 DOCUMENT # SE1117445 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: 276 ACRES TOTAL ESTIMATED SEWAGE FLOW: 1000 GALLONS PER DAY [ RESIDENCES -TABLET / OTHER -TABLE 2 ] AUTHORIZED SEWAGE FLOW: 4140.01 GALLONS PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE ] UNOBSTRUCTED AREA AVAILABLE: 6650.00 SQFT UNOBSTRUCTED AREA REQUIRED: 1875.00 SQFT BENCHMARK/REFERENCE POINT LOCATION: NID in cute ELEVATION OF PROPOSED SYSTEM SITE 5.00 center of cul-de-sac / FT ] [ ABOVE /I BELOW11 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: 125 FT NON -POTABLE: FT BUILDING FaUNDATIONS: 5 FT PROPERTY LINES: 5 FT POTABLE WATER LINES•: 100 FT SITE SUBJECT TO FREQUENT FLOODING? [ ]YES [X]NO 10 YEAR FLOODING? [ ]YES [X]NO] 10 YEAR FLOOD ELEVATION FOR SITE: FT[ MSL / NGVD] SITE ELEVATION: FT [ MSL / NGVD SOIL PROFILE INFORMATION STTF. 7 SOIL PROFILE INFORMATION SITE 2 USDA SOIL SERIES: Munsell #/Color Texture Depth 10YR 5/1 Sand 0 To 16 10YR 5/2 Sand 16 To 25 10YR 7/1 Loamy Sand 25 To 41 10YR 5/3 Loamy Sand 36 To 41 1OYR 6/1 Fine Sand 41 To 51 10YR 6/1 Sandy Loam 51 To 65 10YR 6/2 Sandy Clay Loam 65 To 72 I USDA SOIL SERIES: Munsell #/Color Texture Depth 10YR 4/1 Sand 0 To 15 10YR 5/2 Loamy Sand 15 To 23 10YR 7/1 Loamy Sand 23 To 34 10YR 5/8 CMN/PRM RF 23 To 34 10YR 5/3 Loamy Sand 34 To 40 10YR 6/1 Fine Sand 40 To 48 10YR 6/1 Loamy Sand 48 To 60 10YR 612 Sandy Clay Loam 60 To 72 OBSERVED WATER TABLE: 72.00 INCHES [ ABOVE / BELOW ] EXISTING GRADE TYPE: [ PERCHED / APPARENT ] ESTIMATED WET SEASON WATER TABLE ELEVATION: 23 INCHES [ ABOVE % BELOW ] EXISTING GRADE HIGH WATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: [X]YES [ ]NO DEPTH: 23.00 INCHES SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Sand/0.80 DEPTH OF EXCAVATION: 41 INCHES DRAINFIELD CONFIGURATION: [X] TRENCH [ ] BED [ ] OTHER (SPECIFY) REMARKS ADDITIONAL CRITERIA WSWT determined using USDA WSS and soil borings. 10YR518 CMN PROM RF mottling in 10YR7/1 matrix >2% starting at 23" in S132. SE11 3" below BM. !SB2 5" below BM. 111) SITE EVALUATEDIBY: Ingram, Brian (Title: Envitoental Specialist II) (ENVIRONMENTAL HEALTH) DR 4015, 08/09 (Obsoletes previous editions which may not be used) Incorporated: 64E-6.001, FAC AP1363444 EID1875990 DATE: 09/17/2018 Page 3 of 4 v 1.0.2 Mission: To protect, promote & improve the health of all people in Florida through integrated state, cou'ty & community efforts. c+ 4) 9� Y�{��f�f +r=ayry'�,�•'r HEALTH Vision: To be the Healthiest State in the Nation Rick Scott Governor Celeste Philip, MD, MPH State Surgeon General and Secretary Florida Department of Health in St. Lucie County Conditions for Issuance of Water Well Permits Effective July 24, 2017 Contact the Florida Department of Health in Saint Lucie County (FDOH — St. Lucie) prior to constructing or abandoning any well. a. Call the FDOH — St. Lucie Well Line at 772-873-4936 or email SLCDOH-WELLSO-FLHEALTH.GOV b. Provide the following information: i. Permit number ii. Driller name iii. Address iv. Date and time to begin construction/abandonment • �A minimum of 24 hours' notice is required before constructing any public water supply wells. Please call our main office at 772-873-4931 and speak with Environmental Health Staff or provide notification by email to SLCDOH-WELLS(CD.FLHEALTH.GOV • Submit revisions to permit and/or site map and associated fee within 48 hours of well construction or abandonment. i Florida Department of Health St. Lucie County • Division of Disease Control and Health Protection Bureau of Environmental Health 5160 NW Milner Drive Port St. Lucie, FL 34983 Accredited Health Department PHONE: 772/873-4931 • FAX: 772/595-1306 • : Public Health Accreditation Board FloridaHealth.gov , y y STATE OF FLORIDA PERMIT APPLICATION TO CONSTRUCT, 5F ✓Y ��q st%g REPAIR MODIFY, OR ABANDON A WELL r Permit No. �t i uSOL1thW8Sl , Florida Unlyue ID C LEASE FILL OLIT ALL APPLICABLE FIELDS " _I Northwest ('Denotes Required Fields Where Applicable) Permit Stipulations Required (See Attached) -) St. Johns River ISouth Florida !7/Bf;Rrc'Y'NL•(!:V/l:r<ICIVr IS t{;)�7/lSI�IC rGr ((NIIOIt'1lOU �" f — dpcformandlof:vardingrla',e«nCopp!r(awnro/he 62-5240uadNo. Delineation Plo. �3gser�-1Suwannee River opprnpnore.iuhratr.;'uu;hn«t,IiherrappltcahlP. �.. � -:7 DEP CUP?wuP Application No. 0 Delegated Authority (If Applicable) , t. IA 6i m ram,. -703Sca, 0[CJsl�.11�eCf� __ C• '0 vnet. Leg I Name it Corp ratiolt I� Adddress `City 3 'State ZIP Telephone Number ' C3 55 - - u I (�5� 'Well Location - Address, Road Name or Number, City on12— -0 a0 P' rcel ID No. (PIN),or Alternate Ksy (Circle One) Lot Block nit 4. 5t tx k r } t"' ", 6 Lac Check if 62-524:❑ Yes❑`_ No �ecticn or Land Urant Tgnrnship , 1Pange (;oynty A �5ubdry I n a ? f i' Jlater Well Contractor license Number Telephone Number < F-Tnai]Address 'Wa'ate Well Contractor's Address City State zip 7. 'T 8. `N 9. -S of Work: IS Construction ❑ Repair ❑ Modification❑ Abandonment ,er of Proposed Wells �_ `_ Reasan?cr P,epar. ;dodihcahen fy Intended Use(s) of Well(s): %p1 sstic Landscape Irrigation H Agricultural Irrigation ❑ Site Investigations �d Water Supply Recreation Area Irrigation Livestock ❑ Monitoring Water Supply (Limited Use/DOH) ❑ Nursery Irrigation ❑ lest - Water Supply (Community or Non-Community/DEP)❑ Commercial/Industrial Earth -Coupled Geothermal I Injection ❑ Golf Course Irrigation H HVAC Supply 1 7 2018 HVAC Return Class V Injection: ❑ Recharge ❑ Commercial/Industrial Disposal ❑ Aquifer Storage and Recovery ❑ DrainapPD H in St Lucie County P.emediatton: ❑ Recovery ❑ Air Sparge ❑ Other (Da.11bc) F F1 ❑ Other (Describe; ONWIr- 10,1Distance from Septic S ystem if <_ 200 ft. _ ,11. FacilityDescription e � 12. Estimated Start Date 13.'Esi (mated Well Depth ft. t'Estimated Ca`�sffit!�g Depth� . ft, Primary Casing Diameter _t, —in. Open Hole: From To ft. 14. Estimated Screen Interval: From �To 15.'PriIMary Casing Material: Black Steel Galvanized i PVC} Stainless Steel Not Cased Other. 16. Secondary, Casing: Telescope Casing Liner Surface Casino Diameter _ in. 17. Secondary Casing Material: Black Steel Galvanized PVC Stainless Steel Other 18.'MJthod of Construction, Repair, or Abandonment: Auger Cable Tool . Jetted Rotary Sonic Combination (Two or More Methods) Hand Driven (Well Point. Sand Point) Hydraulic oint (Direct Push) Horizontal Drilling Plugged by Approved Method Other (Descnin.; 19. Proposed G o sting Intelval for the Primary, Secondary, and Additional Casino: From__ To -) Seal Material ( Bentonite MCILement outer ) From To Seat Material ( Bentonite G -Cement Other ) From -i•o Seal Material ( Bentonite Neat Cement Other ) From To Seal Material ( Bentonite Neat Cement Other ) 20. Indicate total number of existing wells on site _ Lis' number of existing unused welts on site _ 21.'Is or 22. La 23. De I hmoby n is well or any existin well or water withdrawal On the owner's contiguous property covered under a Consumptive/Water Use Permit (CUPMJUP) UPANUP Application Yes No )f yes, complete the following: CUl VVUP No. District Well ID No. tide Longitude Obtained From: GPS Map } Survey Datum: NAD 27 NAD 83 WGS 84 y Ihol1 wLi carp Iv mill the apldurable M I., of ldla a itransh.lbve, Cady nad trial a avatar I wruti that orn the nValol of file plopotty, that Ile u17011Pabon ded ProtnW attufale. end ilunf air,aw, army whicial—l'arae pem¢t.' seeded, has boon Vr a1h ha cAll—ed Ili- to camnt Gncmnanl of :volt recpoltsunitibus undt, choplla 373, Florida S(utUtot, Ia nI.Inh nl or P.Pdly nbandral h* wHi, e:.I will? UMII I on, I lunhor CoMy in it all Inlanna4o7 plovidad in this application or accurate and Nat 1 ,;itatt a, cho agunt for the avraor. that the aitonnal on provided is actuate. and I1.011 have mfonnod the oxner of Milk olaval rroa the, toriwnl. 6tal+. or In^-UI gOVCfnNalllC. d application. I ngt091. plealdt a xmu respehsibWBus ns staled ohovo,. Olmcr aansents to nlfovaap porsonrel or ttrin V.'!tA or DaItpJ4^d Au:holny acoas pUR!n IIIa t)i;Uici V.1tial :rU dayo ahR( COfnpl4hOn oI liln GGnf1IroGItOn. roltNr, rnad�i0ltnn, a: intha well aile during the conaUuctian rn.^ih. n-rhimalion. or ubundon;nent UUM'1%iG"d by Uan PO—it.aot,wrrol by this pc 3. al Nf• pefr.•;I nxpir.tlgneh:chnvor trmn:a Brat. a p i -License No. Sienahue'of neror of 'Date Approv i l Granted•By _ Issue Date ? t U I i � Expiration Date -!f/17 ZvAgydrologisl Approval "mmatr. Fee Received 5 Receipt No: Check No. THIS PERMIT 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. =EP FoTm. 62-532.900(7) Incorporated in 62-532.400(1), F.A.C. EHerlive Date: October T. 2010 Papa t f s 40 �1 ...... .... . . ... ... .... ... . 2 ..09, -7 < 67' N 11.33'N 5.67'0 Z ri %0 Go XI 15-3 13.6 13.33' %D CE 10 1 Ul 00 wi D, 7, . 3067' r%) cl� 4% FD 6.67' 00 3.33' CA) - .... ... i ...... C', 3.67' PROPOSED SINGLE fu FAMILY RESIDENCE it FFE= 28.50 N!GVD Pmn FFE= 27.00 NAVI) T- -0 a cs t. cs -5 C7 4.0' .01 c N 14.33' 7.0' 0 30-33' 6 67' 43 eovp 9.38 4.53' ol Cl L—ILO--- X.!,k FZ, %D 26.33' 28.0' U! .0 LENT t�; T CO P cl, COVP 29.V33' OPEN DECK co POOL cp SPA Olt:f,l 111.33' 60.0' 5.67' E 18.67' W ca PRC)P()-,;Fh I