HomeMy WebLinkAboutD O H PAPERWORKSTATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
CONSTRUCTION PERMIT
PERMIT #: 56-SF-1431319
APPLICATION #: AP1083920
DATE PAID:
FEE PAID:
SCANNE&IPT #:
BYDOCUMENT #: PR885679
St Lucie County
CONSTRUCTION PERMIT FOR: CSSTDS Abanddnmen.
APPLICANT: (One Const. SeN01es Corp)
PROPERTY ADDRESS: 7 30 Rasc Robles B vd Fort Pierce, FL 34951
LOT: BLOCK: SUBDIVISION:
PROPERTY ID #: [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
[OR TAX ID NUMBER]
SYSTEM MUST 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 [
A [
N [
K [
900 ] GALLONS / GPD
] GALLONS / GPD
] GALLONS GREASE INTERCEPTOR CAPACITY
] GALLONS DOSING TANK CAPACITY I
D [ ] SQUARE FEET
R [ ] SQUARE FEET
A TYPE SYSTEM: [ ] STANDARD
I CONFIGURATION: [ ] TRENCH
N
F LOCATION OF BENCHMARK:
I ELEVATION OF PROPOSED SYSTEM SITE
E BOTTOM OF DRAINFIELD TO BE
L
D FILL REQUIRED: [ 0.001 INCHES
0
T
H
E
R
CAPACITY
CAPACITY
[MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
]GALLONS @[ ]DOSES PER 24 HRS #Pumps [
SYSTEM
SYSTEM
[ ] FILLED [] MOUND [ ]
[ ] BED [ ]
][ABOVE/ BELOW] BENCHMARK/REFERENCE POINT
][ABOVE/ BELOW] BENCHMARK/REFERENCE POINT
EXCAVATION REQUIRED: [ ] INCHES -
ve the tank abandoned in accordance with the following procedures: -
The tank shall be pumped out.
The bottom of the tank shall be opened or ruptured, or the entire tank collapsed so as to prevent the tank from
wining water,
Have the system inspected by the health department after it has been pumped and ruptured but before it is filled with
id and covered.
The tank shall be filled with clean sand or other suitable material, and completely covered with soil.
SPECIFICATIONS BY: James C Duncan TITLE: Environmental Specialist II
APPROVED BY:
ITLE: Environmental Specialist II
Jam O c
DATE ISSUED: 09/24/2012
DH 4016, 08/09 (Obsoletes all previous editions which may not be used;
Incorporated: 64E-6.003, FAC
v 1.1.4 AU1083020
EXPIRATION DATE:
4E-1
St. Lucie CHD
12/23/2012
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