HomeMy WebLinkAboutD O H PAPERWORKSTATE OF FLORIDA PERMIT # .
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
SITE EVALUATION AND SYSTEM SPECIFICATIONS SC�glqEg)
APPLICANT : Thomas & Michelle LoBrutto AGENT: Alexander J. Piazza AMP* a mll,,,g
LOT: 291 BLOCK: 60 SUBDIVISION: Indian River Estates Unit 8
PROPERTY !ID # : 3402-609-0307-000-4 [ Tax ID Number
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: [✓] YES [ ] NO NET USABLE AREA AVAILABLE: ACRES
TOTAL ESTIIMATED SEWAGE FLOW: 767 GALLONS PER DAY [ RESIDENCES -TABLE VOTHER-TABLE 2 ]
AUTHORIZED SEWAGE FLOW: GALLONS PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE ]
UNOBSTRUCTED AREA AVAILABLE: 1200 SQFT UNOBSTRUCTED AREA REQUIRED: 1200 SQFT
BENCHMARK/REFERENCE POINT LOCATION:
ELEVATIONiOF PROPOSED SYSTEM SITE IS 34 [INCHES/FT ] [ABOVE/BELOW'] BENCHMARK/REFERENCE POINT
THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES
SURFACE WATER:100 FT DITCHES/SWALES:15 FT NORMALLY WET? [ ] YES [✓] NO
WELLS: PUBLIC:200 FT LIMITED USE:100 FT PRIVATE:75 FT NON—POTABLE:100 FT
BUILDING FOUNDATIONS:5 FT PROPERTY LINES:10 FT POTABLE WATER LINES: FT
SITE SUBJECT TO FREQUENT FLOODING:
10 YEAR FLOOD ELEVATION FOR SITE:_
SOIL PROFILE INFORMATION SITE 1
MUNSELL #/COLOR TEXTURE
USDA SOIL SERIES:
[ ] YES [✓] NO 10 YEAR FLOODING? [ ] YES ]✓] NO
FT MSL/NGVD SITE ELEVATION: FT MSL/NGVD
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 SERIFS:
OBSERVED WATER TABLE:40+ INCHES [BELOW q EXISTING GRADE. TYPE:[ PERCHED/ APPARENT ]
ESTIMATED WET SEASON WATER TABLE ELEVATION: INCHES ABOVE BELOW ] EXISTING GRADE
HIGH WATER TABLE VEGETATION: [ ] YES [ ] NO MOTTLING: [ ] YES [ ] NO DEPTH: INCHES
SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: DEPTH OF EXCAVATION: INCHES
DRAINFIELD CONFIGURATION: [%/] TRENCH [ ] BED [ ] OTHER (SPECIFY)
REMARKS/ADDITIONAL CRITERIA:
N
SITE EVALUATED BY: DATE: 1-27-18
DH 4015, 12/11 (obsoletes previous editi ns which may not be used) Incorporated: 64E-6.001, FAC Page 3 of 4
N � FILE STATE OF FLORIDA COPY
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
APPLICATION FOR CONSTRUCTION PERMIT
APPLICATION FOR:
i
[v/] New System [ ] Existing System [ ] Holding Tank
[ ] Repair [ ] Abandonment [ ] Temporary
APPLICANT: Thomas & Michelle LoBrutto SCANO BY
AGENT: Alexander J. Piazza PSM, Inc. St Lucie County
ADDRESS: 619 SW Biltmore Street, Port St. Lucie, Florida 34983
PERMIT NO. j%
DATE PAID:
FEE PAID:
RECEIPT #:
[ ] Innovative
TELEPHONE: 772-340-7770
-----------------
-----------------
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: 129 BLOCK: 60 SUBDIVISION: Indian River Estates Unit 8 PLATTED: 1957
PROPER ID # : 3402-609-0307-000-4 ZONING: R I /M OR EQUIVALENT: [ No ]
PROPERTY SIZE: 0.230 ACRES WATER SUPPLY: L�//J eRIVVATE PUBLIC [ ]<=2000GPD [ 1>2000GPD
I /
IS SEWER AVAILABLE AS PER 381.0065, FS? [ No ] DISTANCE TO SEWER: FT
PROPERTY ADDRESS: 5713 Myrtle Drive, Fort Pierce, Florida 34982
DIRECTIONS TO PROPERTY: SEE MAP
BUILDING INFORMATION
Unit Type of
No Establishment
1 RESIDENCE
2
3
4
[ ] Floor/Equipment Drains
SIGNATURE:
DH 4015108/09 (ObsoleteE previous
Incorporated 64E-6.001, FAC
[%/] RESIDENTIAL [ ] COMMERCIAL
No. of Building Commercial/Institutional System Design
Bedrooms Area Sqft Table 1, Chapter 64E-6, FAC
5 2,050
Other (Specify)
GARBAGE GRINDERS / DISPOSALS
ititions which may not be used)
DATE: 1-27-18
Page 1 of 4
i
�.�
STATE OF FLORIDA
PERMIT NO.
! 8�TSZ -p
DEPARTMENT OF HEALTH
DATE PAID
'
ONSITE SEWAGE TREATMENT AND DISPOSAL
FEE PAID:
�� �_
SYSTEM
RECEIPT #:
APPLICATION FOR CONSTRUCTION PERMIT
APPLICATION FOR:
New System
[ ] Existing System [ ] Holding Tank
[ ] Innovative
[ ]
Repair
[ ] Abandonment [ l Temporary
[ ]
APPLICANT: Thomas & Michelle LoBrutto %iUA1M14WU
BY
AGENT: Alexander J. Piazza PSM, Inc.PHONE: 772-340-7770
MAILING ADDRESS: 619 SW Biltmore Street, Port St. Lucie,'Florida 34983
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: 129 BLOCK: 60 SUBDIVISION: Indian River Estates Unit 8 PLATTED: 1957
PROPERTY ID #: 3402-609-0307-000-4 ZONING:
PROPERTY SIZE: 0.230 ACRES WATER SUPPLY: [ ] PRIVATE
IS SEWER AVAILABLE AS PER 381.0065, FS? [ No ]
PROPERTY ADDRESS: 5713 Myrtle Drive, Fort Pierce, Florida 34982
DIRECTIONS TO PROPERTY: SEE MAP
I
BUILDINGIINFORMATION
Unit Type of
No Establishment
I
1 RESIDENCE
2
3
4
[ ] Floor/Equipment Drains
SIGNATUREI:
DH 4015, 08/09 (Obsoletes p
Incorporated 64E-6.001, FAC
R I/M OR EQUIVALENT: [ No ]
PUBLIC [ ]'<=2000GPD [ ]>2000GPD
DISTANCE TO SEWER: FT
RESIDENTIAL [ ] COMMERCIAL
No. of Building Commercial/Institutional System Design
Bedrooms Area Sqft Table 1, Chapter 64E-6, FAC
5 2,050
[,(] Other (Specify) GARBAGE GRINDERS / DISPOSALS
editions which may not be used)
DATE: 1-27-18
Page 1 of 4
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
SITE EVALUATION AND SYSTEM SPECIFICATION
APPLICANT:, Thomas & Michelle Lobrutto
CONTRACTOR / AGENT:
LOT: 29
Alexander J Piazza PSM, Inc.
BLOCK: 60
SUBDIVISION: Indian River Estates ID#: 3402-609-0307-000-4
APPLICATION # A P1362973
PERMIT # 56-SF-1875286
DOCUMENT # SE1104920
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: 0.23 ACRES
TOTAL ESTIMATED SEWAGE FLOW: 460 GALLONS PER DAY [ RESIDENCES-TABLEI / OTHER -TABLE 2 ]
AUTHORIZED SEWAGE FLOW: 575.01 GALLONS PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE ]
UNOBSTRUCTED AREA AVAILABLE: 1200.00 SQFT UNOBSTRUCTED AREA REQUIRED: 1150.00 SQFT
BENCHMARK/REFERENCE POINT LOCATION
ELEVATION OF PROPOSED SYSTEM SITE
Site BM painted "x" CL of Myrtle Dr center of
3.00 [ INCHES / FT ] [ ABOVE / I B
] BENCHMARK/REFERENCE POINT
THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES
SURFACE WATER: FT DITCHES/SWALES: 15 FT NORMALLY WET: [ ]YES [X]NO
WELLS: PUBLIC: FT LIMITED USE: FT PRIVATE: 95 FT NON -POTABLE: FT
BUILDING FOUNDATIONS: 5 FT PROPERTY LINES: 5 FT POTABLE WATER LINES: 5 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
GATT. PROFTT.F. TWVnPMATTON STTF. 1 SOTT. PRnVTT.F. TNFORMATTON SITE 2
USDA SOIL SERIES:Lawnwood sand
Munsell #/Color Texture
Depth
1 OYR 5/1
Sand
0 To 13
1 OYR 5/2
Sand
13 To 21
1 OYR 6/1
Sand
21 To 34
1 OYR 7/1
Sand
23 To 34
1 OYR 2/2
Spodic Material
34 To 45
1 OYR 4/3
Sand
45 To 61
HOLE CAVING:
Refusal
61 To 72
USDA SOIL SERIES:Lawnwood sand
Munsell #/Color Texture
Depth
1 OYR 5/1
Sand
0 To 16
1 OYR 5/2
Sand
14 To 21
1 OYR 6/1
Sand
19 To 37
1 OYR 7/1
Sand
21 To 39
1 OYR 2/1
Spodic Material
39 To 45
7.5YR 4/3
Fine Sand
45 To 60
HOLE CAVING
Refusal
60 To 72
OBSERVED WATER TABLE: 28.00 INCHES [ ABOVE / BELOW ] EXISTING GRADE TYPE:
ESTIMATED WET SEASON WATER TABLE ELEVATION: 21 INCHES [ ABOVE
HIGH WATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: [X]YES [ ]NO
[ PERCHED / APPARENT ]
EXISTING GRADE
DEPTH: 21.00 INCHES
SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Sand/0.60 DEPTH OF EXCAVATION:
DRAINFIELD CONFIGURATION: [ ] TRENCH [X ] BED [ ] OTHER (SPECIFY)
REMARKS/ADDITIONAL CRITERIA
WSWT determined using USDA WSS and soil borings.
10YR7/1 stripping in 10YR6/1 matrix >10% with diffuse boundaries starting at 21" in SB2.
SB1 0" above BM. SB2 3" below BM. iy
SITE EVALUATED BY: f
Ingram, Brian (Title: En onmental Specialist II) (ENVIRONMENTAL HEALTH)
DH 4015, 08/09 (Obsoletes previous editions which may not be used) Incorporated: 64E-6.001, FAC
i
AP1362973 EID1875286
45 INCHES
DATE: 09/25/2018
Page 3 of 4
v 1.0.2
4o STATE OF FLORIDA PERMIT # .
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
'.� SITE EVALUATION AND SYSTEM SPECIFICATIONSVIE
APPLICANT : Thomas & Michelle LoBrutto AGENT: Alexander J. Piazza PSM, l I#.% _
OUP
LOT: 29 BLOCK: 60 SUBDIVISION: Indian River Estates Unit 8
I
PROPERTY ID # : 3402-609-0307-000-4 [ Tax ID Number _ ]
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:
[✓] YES [ ]
NO NET USABLE AREA AVAILABLE:
ACRES
TOTAL ESTIMATED SEWAGE FLOW: 767
GALLONS
PER DAY [ RESIDENCES -TABLE 1/OTHER-TABLE 2
]
AUTHORIZED SEWAGE FLOW:
GALLONS
PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE
]
UNOBSTRUCTED AREA AVAILABLE: 1200
SQFT
UNOBSTRUCTED AREA REQUIRED: 1200
SQFT
BENCHMARK/REFERENCE POINT LOCATION:
ELEVATION IOF PROPOSED SYSTEM SITE IS 34 [INCHES/FT ] [ABOVE/BELOW'] BENCHMARK/REFERENCE POINT
THE MINIMUM SETBACK WHICH
SURFACE WATER : 100 FT
WELLS: PUBLIC:200 FT
BUILDING FiOUNDATIONS:5
CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES
DITCHES/SWALES:15 FT NORMALLY WET? [ YES [✓] NO
LIMITED USE: 100 FT PRIVATE: 75 FT NON -POTABLE: 100 FT
FT PROPERTY LINES:10 FT POTABLE WATER LINES: FT
SITE SUBJECT TO FREQUENT FLOODING:
10 YEAR FLOOD ELEVATION FOR SITE:-
SOIL PROFILE INFORMATION SITE 1
[ ] YES [✓] NO
FT MSL/NGVD
MUNSELL #%COLOR TEXTURE DEPTH,
TO
TO
TO
TO
TO
TO
TO
TO
f TO
USDA SOIL SERIES:
i
10 YEAR FLOODING? [ ] YES [✓] NO
SITE ELEVATION: FT MSL/NGVD
SOIL PROFILE INFORMATION SITE 2
MUNSELL,#/COLOR TEXTURE DEPTH
TO
TO
TO
TO
TO
TO
TO
TO
TO
USDA SOIL SERIES:
OBSERVED WATER TABLE:40+ INCHES [BELOW r] EXISTING GRADE. TYPE: [PERCHED%APPARENT ]
ESTIMATED NET SEASON WATER TABLE ELEVATION: INCHES [.ABOVE/BELOW ]' EXISTING GRADE
HIGH WATERITABLEVEGETATION: [ ] YES [ ] NO MOTTLING: [ ] YES [ ] NO DEPTH: INCHES
SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: DEPTH OF EXCAVATION: INCHES
DRAINFIELD CONFIGURATION: [V(] TRENCH [ ] BED [ ] OTHER (SPECIFY)
REMaRKS/ADDITIONAL CRITERIA:
SITE EVALUATED BY: W-1---�rsl.- DATE: 1-27-18
DH 4015, 12/ill (Obsoletes previous editions which may not b use Iricor�orated: 64E-6.00.1, FAC Page 3 Of 4
'STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
PERMIT # : 56-SF-1875286
APPLICATION #: AP1362973
DATE PAID:
FEE PAID:
RECEIPT #:
DOCUMENT # : PR1.154943
CONSTRUCTION PERMIT FOR: OSTDS New a �� 7�� ?�
APPLICANT: Thomas & Michelle Lobrutto Ely �1
PROPERTY ADDRESS: 5713 Myrtle Dr Fort Pierce FL 34982 MLucie County
LOT: 29 BLOCK: 60 ' SUBDIVISION: Indian River Estates
PROPERTY ID # : 3402-609-0307-000-4
[SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
[OR TAX ID NUMBER]
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION
381.0065,1 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 IOF 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 [ 1,200 ] 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 0[ ]DOSES PER 24 HRS #Pumps [ ]
D [ 767 ] SQUARE FEET / Drainfield new SYSTEM
R [ ] SQUARE FEET N/A SYSTEM
A TYPE SYSTEM: [ ] STANDARD [ ] FILLED [x] MOUND
I CONFIGURATION: [ ] TRENCH [x] BED [ ]
N
F LOCATIONI OF BENCHMARK: Site BM painted "x" CL of Myrtle Dr center of I
I ELEVATION OF PROPOSED SYSTEM SITE
I
E BOTTOM OF DRAINFIELD TO BE
L
D i
O
T
H
E
R
J
[ 3.00 ][ INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT
[ 0.00 ][ INCHES FT ][ABOVE BELOW] BENCHMARK/REFERENCE POINT
ZED: [ Z'I.UU] INCHES EXCAVATION REQUIRED: [ 45.UU J iNcrir;s
is sized for 5 bedrooms with a maximum occupancy of 10 persons (2 per bedroom), for a total estimated flow of
460 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.
FILE DOPY
SPECIFICATIONS BY: Brian J Ingraq., TITLE: Environmental Specialist II
APPROVED BY: E: Environmental Specialist II St. Lucie CHD
Brian J Ing
DATE ISSUED: 09/26/2018 EXPIRATION DATE: 03/26/2020
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC Page 1 of 3
v 1.1.4 AP1362973 SE1104920
NOTICE OF RIGHTS
A party 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.
00
M
rye N
/STATE OF FLORIDA - 0 l
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL, APPROVAL
I
APPLICANT: Thomas & Michelle Lobrutto
AGENT: :Alexander J Piazza PSM, Inc.
PROPERTY ADDRESS, 571.3 Myrtle Dr Fort Pierce, FL 34082
APPLICATION #:AP1362973
PERMIT #:56-SF-1875286
DOCUMENT #: FI1313003
DATE PAID:09/06/2018
FEE PAID:515.00
RECEIPT #:56-PID-3701368
LOT: 29
SUBDIVISION:
. BLOCK: 60
Indian River Estates ID#: 3402-609-0307-000-4
BY
t Lucie County
CHECKED [X) ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED.
TANK INSTALLATION
SETBACKS
[ )
;[O1]
TANK SIZE [1] 1537.00 [21
[
3
[271
SURFACE WATER FT
[ ]
[021
TANK MATERIAL Polypropylene
[
]
[281
DITCHES 15 FT
I[03]
[ ]
OUTLET DEVICE
[
]
[29]
PRIVATE WELLS FT
[ ]
[041
MULTI -CHAMBERED ELIJ N ]
[
]
[301
PUBLIC WELLS FT
[ )
'[05]
OUTLET FILTER Polylok PL-68
[
]
[311
IRRIGATION WELLS FT
[ ]
[061
LEGEND 1. 70-143-16DC4 2.
[
],
[321
POTABLE WATER 5 FT
[ )
[071
WATERTIGHT
[
]:
[331
BUILDING FOUNDATIONS 6 FT
[ ]
[081
LEVEL
[
)
[341
PROPERTY LINES 8 FT
]
[091
DEPTH TO LID
[
)
[351
OTHER FT
DRAINFIELD INSTALLATION
FILLED. / MOUND SYSTEM
[ ]
i
[101
AREA [1] 815.04 [21 SQFT
[
]
[36]
DRAINFIELD COVER
[ ]
[111
DISTRIBUTION BOX HEADER X
[
3
(371
SHOULDERS
( )
[121
NUMBER OF DRAINLINES 1 1. 9.00 2.
[
]
[381
SLOPES
[ )
[13]
DRAINLINE SEPARATION
[
)
[391
STABILIZATION 08/05/2019
[ ]
[143
DRAINLINE SLOPE
[ )
i
[i151
DEPTH OF COVER
ADDITIONAL INFORMATION
[ ]
[116]
ELEVATION [ ABOVE / BELOW ]BM 2.00
[
1
[401
UNOBSTRUCTED AREA
[ ]
['171
SYSTEM LOCATION
[
]
[411
STORMWATER RUNOFF
[ ]
[181
DOSING PUMPS
[
]
[423
ALARMS
[ 3
[19)
AGGREGATE SIZE
[
3
[431
MAINTENANCE AGREEMENT
[ ]
[20]
AGGREGATE EXCESSIVE FINES
[
]
(441
BUILDING AREA
[ ]
[21]
AGGREGATE DEPTH
[
)
(451
LOCATION CONFORMS WITH SITE PLAN
FILL
/ EXCAVATION MATERIAL
[
]
[461
FINAL SITE GRADING
[ ]
[22]
FILL AMOUNT
[
3
[471
CONTRACTOR MICHAELWSTUHR.(ASHTO
]
(231
FILL TEXTURE
[
)
(481
OTHER INFILTRATOR Quick4 Plus EQ36 LP
[ )
[24]
EXCAVATION DEPTH
ABANDONMENT
[ ]
[25)
AREA REPLACED
[
3
[491
TANK PUMPED
[ ]
[261
REPLACEMENT MATERIAL
[
]
[501
TANK CRUSHED G FILLED
Comments': Comments are on page 2.
CONSTRUCTION I / ,�---- St. Lucie CHI DATE: 06/03/2019
APPROVED ��- „�'
DISAPPROVED ) non taIs I (ENVIRONMENTAL HEALTH)
FINAL SYSTEM [ APPROVED f DISAPPROVED ]: St. Lucie CHD DATE: 08/05/2019
Environmental Specialist II B n J Ingram (ENVIRONMENTAL HEALTH)
(Explanation of Violations on following page)
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC Page 2 of 3
EH Database v 1.0.1 AP1362973 EID1875286
STATE OF FLORIDA
F DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL,
fft
APPLICATION #:AP1362973
.PERMIT #:56-SF-1875286
Docubm T #: FI'1313003
DATE PAID:09/06/2018
FEE PAID : 515.00
RECEIPT #:56-PID-3701368
Violation Number Comment
uommenrs
The system is sized for 5 bedrooms with a maximum occupancy of 10 persons (2 per bedroom), for a total estimated flow of 460
gpd•
New ST, filter, and 9x8 long DF installed. No violations, system ok to cover.. Contractor notified by phone. Needs final inspection
for mound system and final site grading.
Finale system approved. Contractor and bu8ilding department emailed final approval.
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.,003, FAC Page 2 of 3
EH Database v 1.0.1 AP1362973 EID1875286