HomeMy WebLinkAboutD O H SEWAGE DISPOSAL SITE EVALUATION SYSTEM SPECS - 5-13-97STATE' „IOF;'FLORIDA PERMIT ,,# s Jiz�� , ' P
DEPARTMENT .OF ,HEAL'TH• ANb` REHABILITA'I'ZVE, SERVICES
ONSITE -'SEWAGE DISPOSAL SYSTEM s; ,, r r ,' �• '
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SITE, •EVALUATION AND. SYSTEM' SPECIFICATIONS�+,gN��+D v' ':
APPLICANT „ AGENT: QY '
MICHAEL � JOHNSON[TRACY DIGEORGIO P�� �iIQ((i 1 OFERI IES/AYLOR e. M.
LOT: BLOCK: SUBDIVISION
Indfain River Estates ,#6
,PROPERTY ID`jl{ [8ection%Township/Range/Parcel No. or'Tax ID Number]
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TO BE COMPLETED BY ENGINEER, HEALTH UNIT EMPLOYEE,, .OR OTHER QUALIFIED PERSON. ENGINEER'S MUST
PROVIDE REGISTRATION'NUMBER:AND SIGN AND.SEAL EACH PAGE OF SUBMITTAL COMPLETE ALL ITEMS,
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PROPERTY SIZE CONFORMS TO SITE, PLAN:—[ [ Xj YES [., ] NO , ': NET USABLE 'AREAAVAILABLE.,42,240SQ.FT.ACRES.
'TOTAL'ESTI 'TED SEWAGE FLOW 200, .;GALLONS PER DAY [RESIDENCES=TABLE 1 /'OTHER -TABLE 2]
AUTHORIZED EWAGE FLOW:., 270 " GALLONS „PER-DA'Y-, [J1 DO' GPD/ACRE OR, ,2500. GPD/,ACRE],
UNOBSTRUCTEW:AREA AVAILABLE: 1750 SQFT UNOBSTRUCTED 'AREA REQUIRED , 924 SQFT
BENCHMARK/REFERENCE POINT LOCATION:, C/L Silver Oaks Dr. -painted red, sixty -elev.=18',03 _ V.D.
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ELEVATION` O1';,PROPOSED .SYSTEM SITE IS 3 INCH 0 T:] B0VE LOWL�BEI�CHMARK FERENCE POINT
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THE ;MINIMUM.. I,$ET ACK •WHICH- CAN BE ;MAINTAINED FROM THE„ PROPOSED ,SYSTEM• ••TO THE FOLLOWING FEATURES
SURFACE WATER. 75 FT, DITCHES• SWALES ' 15 „ FT NORMALLY WET? [ ] YES [X],' NO
WELLS:,' PUBLIC: 2QO FITED ,USE. 100 ! FT "PRIVATE 75 FT NON=POTABLE 50 FT,';
BUILDING FOUNDATIONS: 7, '.FT, PROPERTY LINES11 "FT 'POTABLE WATER LINES A/A F-T
,-.,SITE' SUBJECT ,TO, FREQUENT.,FLOODING:.' [. ] ,YES, [X].'NO;,, ;,. ,..10.YEAR•FLOODING? ;[„;]„'YES [X]- NO
10 YEAR FLO QD ELEVATION FOR SITE: FT. MSt/NGVD SITE ELEVATION' 17.8 FT.MSL/NGVD
'SOIL, PROFILI,-INFORMATION SITE'l' SOIL PROFILE INFORMATION SITE 2
Munsell #/Color Texture' Depth'
to
6p to
P5 Ikt to 2A
z to
to. z..
'• �r [ i Y� to jr
I�s
00 /7
USDA SOIL ERIES:
OBSERVED WILR'TABLE: kof3INCHES'[ABOVE /'BELOW ] EXISTING 'GRADE. TYP [PERCHED J APPARENT]
ESTIMATED W T SEASON,WATER TABLE ELEVATION:.'. 'Q INCHES [,_ABOVE / BELOW ISTING GRADE.
HIGH WATER�;ABLE VEGETATION:[YES j j1 f X MOTTLING': [1 ] YES [X ] NO DEPTH: INCHES
�[ ] NO '
SOIL'TEXTU /LOADING RATE .FOR;SYSTEidk4ING• �J, DEPTH OF EXCAVATION: K INCHES
'DRAINEIELD CONFIGURATIgN;'. J , [ ] TRENCH-,',[, �G] ,' IiED, [ ]; OTHER (SPECIFY) ,
REMARKS/ADD, TIONAL CRITERIA-,,.
v,
SITE; `EVALUA, ED- `BY:, 'tT ° Cae SEORGE M.- AYLOR; JR.-REGISTERED, LAND' SLIRVEXOR DATE., , 5-13-97
HM-H' Eohm 4015I Mar 92. (bbsoletesaprevrous, editions .wh`nchAnay`not ,be- used). 'Page ,3 "of, 3
.(Stock Numbee 5744-003 401,5-1> �, N:-°" 1
I
INSTRUCTIONS:
PERMIT N:
Permit tracking number assigned by CPHU.
APPLICANT:
F + Property owner's full name.
AGENT:
Property owner's legally authorized representative.
LOT, BLOCK, SUBDIVISION:
Lot, block, and subdivision for lot.
PROPERTY ID#:
i
27 for (property appraiser ID N or section/township/range/parcel number
character number property.
ii
PROPERTY SIZE:
Check if property size at site conforms to submitted site plan. Record net usable area available - lot area exclusive of
all paved areas and prepared road beds within public rights -of -way or easements and exclusive of streams, lakes,
normally wet drainage ditches, marshes, or other such bodies of water.
I
SEWAGE FLOW:
Record the estimated sewage flow for the establishment from Table 1 (residences) or Table 2 (non-reslidential), Chapter
1 OD-6, FAC. Record the authorized sewage flow for the lot based on net usable area and water supply (1500 gallons
per day per acre for private water supplies and 2500 gpd per acre for public water supplies). If authorized sewage flow
does not equal or exceed the estimated sewage flow, the application must be denied.
UNOBSTRUCTED AREA:
BENCHMARK INFORMATION
MINIMUM SETBACKS
FLOOD INFORMATION
SOIL PROFILE INFORMATION:
WATER TABLE:
SOIL TEXTURE:
DEPTH OF EXCAVATION:
DRAINFIELD CONFIGURATION:
ADDITIONAL CRITERIA
SITE EVALUATED BY:
ELEVATION WORKSHEET
BENCHMARK
[+] SHOT:
H.I.
Record the square feet of unobstructed area available and the amount required. Unobstructed area to Est be at least 2
times as large as the drainfield absorption area and at least 75 percent of the unobstructed area must eet minimum
setbacks in Chapter 1013-6, FAC. The unobstructed area must be contiguous to the drainfield.
Record the location of the benchmark. If using a surveyor's benchmark record the actual elevation. record the
elevation of the proposed system site in relation (above or below) to the benchmark.
Record minimum setbacks which can be meet to all listed features. Actual measurements must be rec rded or "NA"
for non applicable features. Features on site plan or within 75 feet of the applicant lot must be measu�ed. The location
of any public drinking well within 200 feet of the applicant's lot must also be verified.
Record information on lot's subject to flooding. For lots subject to flooding record 10 year flood elevation for site and
actual site elevation.
Two soil profiles within the proposed absorption area to a minimum depth of 6 feet or refusal are requi red. Soil
identification will use USDA Soil Classification methodology (Munsell colors and USDA soil textures):- Refusals must
be clearly documented. Provide USDA soil series if available, record "UNK" if the series cannot be determined.
I
Record the depth of the observed water table at the time of the evaluation. Mark "perched" or "appar Int" as
appropriate. Record the estimated wet season water table elevation based on site evaluation, USDA solil maps, and
historical information. Indicate if there is high water table vegetation present. Indicate if mottling is present and depth.
Record soil texture or loading rate for system sizing.
If applicable record depth of excavation required. Record "NA" if not applicable.
Check drainfield configuration required. If other, specify type.
Record any additional remarks pertinent to site or installation. Ex. dosing required.
Signature of evaluator, title, and date of evaluation. Professional engineers must seal all documentation submitted
ELEVATION OF BENCHMARK / REFERENCE POINT IS:
SITE 1 SITE 2
H.I. - H.I.
[-] SHOT [-] SHOT
SITE 3
H.I.
[-] SHOT