HomeMy WebLinkAboutD O H PAPERWORKSTATE OF FLORIDA FI L E
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
CONSTRUCTION PERMIT FOR: OSTDS New
APPLICANT:
PERMIT #:56-SF-1908462
PL AP1387412
E P D:
FEE PAID:
RECEIPT #
DocumNT #: PR1196184
SCANNED
PROPERTY ADDRESS: TBD Palm Dr Fort Pierce, FL 34982 St Lucie County
LOT: 40 BLOCK: 61 SUBDIVISION: Indian River Estates
PROPERTY ID #: 3402-609-0358-000-6 [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
T [ 900 ] 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 [ 500 ] SQUARE FEET Dralnfleld new SYSTEM
R [ ] SQUARE FEET N/A SYSTEM
A TYPE SYSTEM: [ ] STANDARD [X] FILLED [] MOUND
I CONFIGURATION: [ ] TRENCH [X] BED [ ]
N
F LOCATION OF BENCHMARK: Nail in Center of Intersection Of Bartow and Palm
I ELEVATION OF PROPOSED SYSTEM SITE
E BOTTOM OF DRAINFIELD TO BE
L
D FILL REQUIRED: [ 17.001
0
T
H
E
R
6.00 ][ INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT
7.00 ][ INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT
is licensed contractor installing the system Is responsible for Installing the minimum category of tank in accordance with
64E-6.013(3)(0, FAG.
SPECIFICATIONS BY: Brian J Ingryq TITLE: Environmental Specialist II
APPROVED BY: / LE: Environmental Specialist II St. Lucie CHD
Brian J Ingr
DATE ISSUED: 01/04/2019 EXPIRATION DATE: 06/28/2020
DH 4016, 08/09 (Obsoletes all previous editions which maynot be used)
Incorporated: 64E-6.003, FAC Page 1 of 3
v 1.1.4 AP1387412 SE1146520
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.
St. Lucie County Health Department
.•pia 5150 NW Milner Dr Port Saint Lucie, FL 34983
HIML.TH
PAYING ON: PERMIT#,56-SF-1908462 BILL ooc #:56-BID-4051105 CONSTRUCTION APPLICATION #:AP1387412
RECEIVED. FROM: Alexander J Piazza AMOUNT PAID: $ 515.00
PAYMENT FORM: CHECK 4140 PAYMENT DATE: 12/11/2018
MAIL TO: Kenneth Jones
FACILITY NAME:
PROPERTY LOCATION:
TBD Palm or
Fort Pierce, FL 34982
Lot: 40 Block: 61
Property ID: 3402-609-0358-000-6
EXPLANATION or DESCRIPTION:
QUANTITY
FEE
128 - OSTDS Construction System Inspection Research Fee.
1
$
5.00
-1 - Surcharge (All)
1
$
15.00
-1 - OSTDS New Permit Surcharge
1
$
100.00
-1 - OSTDS Construction Application and Plan Review,New
1
$
100.00
123 - OSTDS Construction Site Evaluation
1
$
115.00
126 - OSTDS Construction Permit (New or Mod, Amendment)
1
$
55.00
127 - OSTDS Construction System Inspection
1
$
75.00
133 - OSTDS Construction Reinspection
1
$
50.00
RECEIVED BY: MontanezNM AUDIT CONTROL NO. 56-PID3827332
% STATE OF FLORIDA
4 1.
DEPARTMENT OF HEALTH
i?a ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
APPLICATION FOR CONSTRUCTION PERMIT
APPLICATION FOR:
PERMIT N0, 56-SF-R0% 6A
DATE PAID: lAlItIlis
FEE PAID: aitLjt4O
RECEIPT #: aDIp S4
[✓] New System [ ] Existing System [ ] Holding Tank [ ] Innovative
[ ] Repair [ ] Abandonment [ ] Temporary L 1
APPLICANT: Kenneth M. Jones
AGENT: Alexander J.Piazza PSM,Inc.
MAILING ADDRESS: 619 SW Biltmore Street, Port St. Lucie, Florida 34983
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: 40 BLOCK: 61 SUBDIVISION: Indian River Estates Unit
PROPERTY ID #: 3402-609-0358-000-6 ZONING: R
PLATTED: 1958
I/M OR EQUIVALENT: [ No ]
PROPERTY SIZE: 0.298 ACRES WATER SUPPLY: [ ] PRIVATE PUBLIC [✓]<=2000GPD [ 1>2000GPD
IS SEWER AVAILABLE AS PER 381.0065, FS? [ No ] DISTANCE TO SEWER: FT
PROPERTY ADDRESS: Palm Drive, Fort Pierce, FL 34982
DIRECTIONS TO PROPERTY: SEE MAP
BUILDING INFORMATION
Unit Type of
No Establishment
I RESIDENCE
2
3
4
[ ✓ ] RESIDENTIAL [ ] COMMERCIAL
No. of Building Commercial/Institutional System Design
Bedrooms Area Sqft Table 1, Chapter 64E-6, FAC
3 1,320
[ ] Floor/Equipment Drains [ ✓] Other (Specify) GARBAGE GRINDERS/DISPOSALS
uie�miy:aw M'ni.M�.•�n:a.
Alexander J Piazza
SIGNATURE: au:miuvi u:ummm DATE: 10-01-18
DH 4015, OB/09 (Obsoletes previous editions which may not be used)
Incorporated 64E-6.001, FAC Pagel of 4
STATE OF FLORIDA APPLICATION # AP1387412
DEPARTMENT OF HEALTH PERMIT # 56-SF-1908462
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
#
SITE EVALUATION AND SYSTEM SPECIFICATION DOCUMENT SE1146520
APPLICANT: Kenneth Jones
CONTRACTOR / AGENT: ' AlexanderJ Piazza
LOT: 40 BLOCK: 61
SUBDIVISION: Indian River Estates ID#: 3402-609-0358-000-6
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: 0.30 ACRES
TOTAL ESTIMATED SEWAGE FLOW: 300 GALLONS PER DAY [ RESIDENCES -TABLES / OTHER -TABLE 2 ]
AUTHORIZED SEWAGE FLOW: 750.00 GALLONS PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE ]
UNOBSTRUCTED AREA AVAILABLE: 750.00 SQFT UNOBSTRUCTED AREA REQUIRED: 750.00 SQFT
BENCHMARK/REFERENCE POINT LOCATION:
ELEVATION OF PROPOSED SYSTEM SITE 6.00 [I INCHES I/ FT I [ ABOVE /I EELOW I] 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: FT NON -POTABLE: 100 FT
BUILDING FOUNDATIONS: 5 FT
SITE SUBJECT TO FREQUENT FLOODING?
10 YEAR FLOOD ELEVATION FOR.SITE:
SOIL PROFILE INFORMATION SITE 1
PROPERTY LINES: 10 FT POTABLE WATER LINES: 7 FT
]YES [X]NO 10 YEAR FLOODING? [ ]YES [X]NOI
FT [ MSL / NGVD ] SITE ELEVATION: FT [ MSL / NGVD
USDA SOIL SERIES:Lawnwood sand
Munsell #/Color Texture
Depth
1 OYR 511
Sand
0 To 17
1 OYR 611
Sand
17 To 32
10YR 711
Sand
25 To 32
1 OYR 8/1
Sand
27 To 32
10YR 211
Spodic Material
32 To 47
10YR 3/4
Sand
47 To 62
2.5Y 514
Fine Sand
62 To 67
2.5Y 6/3
Fine Sand
67 To 72
SOIL PROFILE INFORMATION SITE 2
USDA SOIL SERIES:Law .00d sand
Munsell #/Color Texture
Depth
10YR 511
Sand
0 To 17
1OYR 611
Sand
17 To 35
10YR 711
Sand
27 To 35
7.5YR 311
Spodic Material
35 To 45
2.5Y 4/4
Fine Sand
45 To 62
2.5Y 6/2
Fine Sand
62 To 72
OBSERVED WATER TABLE: 62.00 INCHES [ ABOVE / BELOW ] EXISTING GRADE TYPE: [ PERCHED / APPARENT ]
ESTIMATED WET SEASON WATER TABLE ELEVATION: 25 INCHES [ ABOVE / BELOW ] EXISTING GRADE
HIGH WATER TABLE VEGETATION: I ]YES [X]NO MOTTLING: [X]YES [ ]NO DEPTH: 25.00 INCHES
SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Sand/0.60 DEPTH OF EXCAVATION: 47 INCHES
DRAINFIELD CONFIGURATION: [ ] TRENCH [XI BED [ ] OTHER (SPECIFY)
REMARKS/ADDITIONAL CRITERIA
WSWT determined using USDA WES and soil borings.
10YR711 stripping In 10YR611 matrix >10% with diffuse boundaries starting at 25" In S81.
S81 6" below SM. SS2 7" below SM.
SITE EVALUATED BY: DATE: 12/18/2018
Ingram, Brian [Title: Enviro ental Specialist il] [ENVIRONMENTAL HEALTH]
DH 4015, 08/09 (Obsoletes previous editions which may n t be used) Incorporated; 64E-6.001, SAC Page 3 of 4
AP1387412 EID1908462 v 1.0.2
4„ STATE OF FLORIDA PERMIT #.
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
.Y
SITE EVALUATION AND SYSTEM SPECIFICATIONS
APPLICANT: James Day Jr. AGENT: Alexander J. Piazza PSM• Inc.
LOT: 40 BLOCK: 61 SUBDIVISION: Lidian River Estates Unit 8
PROPERTY ID # : 3402-609-0358-000-6 [ 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: 0.298
ACRES
TOTAL ESTIMATED SEWAGE FLOW:
500
GALLONS
PER DAY [RESIDENCES -TABLE I/OTHER-TABLE2
]
AUTHORIZED SEWAGE FLOW:
GALLONS
PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE
]
UNOBSTRUCTED AREA AVAILABLE:
750
SQFT
UNOBSTRUCTED AREA REQUIRED: 750
SQFT
BENCHMARK/REFERENCE POINT LOCATION:
ELEVATION OF PROPOSED SYSTEM SITE IS 34 [INCHES/FT J [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
'MLLS: 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: I ] YES [✓I NO 10 YEAR FLOODING? ( ] YES [✓] NO
LO YEAR FLOOD ELEVATION FOR SITE: FT MSL/NGVD SITE ELEVATION: FT MSL/NGVD
SOIL PROFILE
MUNSELL #/COLOR TEXTURE
TO
TO
TO
TO
TO
TO
TO
USDA SOIL SERIES:
BSERVED WATER TABLE: 40+ INCHES [BELOW
STIMATED WET SEASON WATER TABLE ELEVATION:_
IGH WATER TABLE VEGETATION: [ ] YES [ ] NO
OIL TEXTURE/LOADING RATE FOR SYSTEM SIZING:_
3AINFIELD CONFIGURATION: [,/I TRENCH [ ] BED
'sMARKS/ADDITIONAL CRITERIA:
JHMATIUN SITE 2
TEXTURE DEPTH
TO
TO
TO
TO
TO
TO
TO
TO
USDA SOIL SERIES:
r] EXISTING GRADE. TYPE*:[PERCHED /APPARENT ]
_ INCHES [.ABOVE/BELOW ] EXISTING GRADE
MOTTLING: [ J YES I J NO DEPTH: INCHES
DEPTH OF EXCAVATION: INCHES
[ ] OTHER (SPECIFY)
w �gRderu'-+mnrwn.
Alexander Piazza °mr°°a
:TE EVALUATED BY: oumumnn:wwaav DATE: 10-01-18
4015, 12/11 (Obsoletes previous editions which may not be used) Incorporated: 64E-6.001, FAC Page 3 of 4
APPLICANT'S NAME:
James Day Jr.
LEGAL: DESCRIPTION: Lot 40, Block 61, Indian River(Estates - Unit Eight (PB 10, PG 73)
ME
l certify that there are no potable private wells within 75 feet of the available area for the
proposed septic system, that there are no non -potable wells within 50 feet of the available area
for the proposed septic system,. that there are no wells within 25 feet of a pesticide -treated
building foundation, that there are no public wells that serve less than 25 people or less than
15 homes or businesses within 100 feet of the proposed septic system, that there are no public
wells that serve more than 25 people or more than 15 homes or businesses within 200 feet of
the proposed septic system, that the water line from the water meter or well to the structure is
at least 10 feet from the available area for the proposed septic system unless the plans show
the line to be double sleeved, that there is not a gravity sewer line, low pressure sewer line or
vacuum sewage line in a public easement or right-of-way that abuts the property, that there
ate no lakes, streams, wetlands, or surface water within 75 feet of the available area for the
proposed septic system unless the property was created prior to 1972, that the septic system is
proposed on the side of the lot farthest from surface water, that all private wells, septic
systems and surface water on adjacent or contiguous land within 75 feet of the applicant's lot
are shown on the site plan, that all public wells within 200 feet of the applicant's lot are
shown on the site plan, and that the location of building or residences, swimming pools,
recorded easements, paved areas or driveways, sidewalks, the general slope of the property,
filled areas, drainage features, and surface waters such as lakes, ponds, streams, canals, or
wetlands are shown on the applicants lot.
The natural grade elevation in the area of the. proposed septic system and the benchmark must
be shown on the site plan. Please locate the benchmark within 200 feet of the proposed septic
system.
NOTE: MUST BE CERTIFIED BY A FLORIDA
REGISTERED SURVEYOR OR ENGINEER.
ugnay11 old gaemdvi1sa
ox:uys,wunamua�«l
Alexander) Piazza ��-�.d.)M dEE= 98•
CERTIFIED BY: m�201M m iaa M-
FLORIDA PROFESSIONAL NO.: 6330.
DATE: 10/01/18 JOB NO.: 18-4002
dots/fo trns/sep tics/ScpdcApppPage207
RecEw"D
STATE OF FLORIDA SEP 11'IN
DEPARTMENT OF HEALTH Qartment
ONSITE SEWAGE TREATMEHRICta� a0diraPOSAL SYSTEM
CONSTRUCTION INSPECTIOR AND FINAL APPROVAL
APPLICANT: Kenne
AGENT: AleXanderJ
PROPERTY ADDRESS:
LOT: 40 BLOCK: 61 i
St Lucie County
SUBDIVISION: Indian River Estates ID#: 3402.609-0358.000.E
CHECKED [X] ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED.
APPLICATION #:AP1387412
PERMIT #:56-SF-1908462
DOCUMENT #:FI1319596
DATE PAID:12/11/2018
FEE PAID,515.00
RECEIPT #:56-PID-3827332
Inners
FL 34982
TANK INSTALLATION
51s-X a As
[ ]
[Ol]
TANK SIZE [1] 1090.00 [21
[ ] [271
SURFACE WATER
FT
[ ]
[021
TANK MATERIAL Polyethylene
[ ] [281
DITCHES 16
FT
[ ]
[031
OUTLET DEVICE
[ ] [29]
PRIVATE WELLS 81
FT
[ ]
[041
MULTI-CRAMBERED [ Y
N
[ ] [301
PUBLIC WELLS
FT
[ ]
[051
OUTLET FILTER Polylok PL-68
[ ] [311
IRRIGATION WELLS
FT
[ ]
[061
LEGEND 1. 70-143-11DC4 2.
[ ] [321
POTABLE WATER 13
FT
[ ]
1071
WATERTIGHT
[ ] [331
BUILDING FOUNDATIONS 5
FT
[ ]
[081
LEVEL
[ ] [341
PROPERTY LINES- 9
FT
[ ]
1091
DEPTH TO LID
[ ] [351
OTHER
FT
DRAINFIELD INSTALLATION
FILLED / MOUND SYSTEM
[ ]
[101
AREA 111 509.4 121
SQFT
[ ] [361
DRAINFIELD COVER
[ ]
[111
DISTRIBUTION BOX _ HEADER
X
[ ] [371
SHOULDERS
[ ]
[121
NUMBER OF DRAINLINES 1, 5.00 2.
[ ] [38]
SLOPES
[ ]
[131
DRAINLENE SEPARATION
[ ] 1391
STABILIZATION 09/1012019
[ ]
[141
DRAINLINE SLOPE
[ ]
[15]
DEPTH OF COVER
ADDITIONAL INFORMATION
[ ]
[161
ELEVATION [ ABOVE /
BELOW
]BM
6.00
[ ] [401
UNOBSTRUCTED AREA
[ ]
[171
SYSTEM LOCATION
[ ] [411
STORMWATER RUNOFF
[ ]
[18]
DOSING PUMPS
[ ] [421
ALARMS
[ ]
[19]
AGGREGATE SIZE
[ ] [43]
MAINTENANCE AGREEMENT
[ ]
[20]
AGGREGATE EXCESSIVE FINES
[ ] 1441
BUILDING AREA
[ ]
[211
AGGREGATE DEPTH
[ ] [45]
LOCATION CONFORMS WITH SITE PLAN
[ ] [461
FINAL SITE GRADING
FILL
/ EXCAVATION MATERIAL
[ ] [471
CONTRACTOR MICHAEL W STUHR(ASHTO
[ ]
[221
FILL AMOUNT
[ ] [481
OTHER
[ ]
(231
FILL TEXTURE
[ ]
[241
EXCAVATION DEPTH
ABANDONMENT
[ ]
[251
AREA REPLACED
[ ] [491
TANK PUMPED
[ ]
[261
REPLACEMENT MATERIAL
[ ] [501
TANK CRUSHED & FILLED ,
Comments: Comments are on page 2.
CONSTRUCTION I APPROVED / DISAPPROVED ]:
II Brian J Ingram
FINAL SYSTEM I APPROVED / DISAPPROVED St
De
Environmental Specialist I Hunter l: o-C�ler )Florida De
(Explanation of Violations on following page)
DR 4016, 08/09 (Obseletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC
EH Database v 1.0.1 AP1387412 - EID1908462
Lucie CHD DATE: 08/02/2019
NTAL HEALTH)
Lucie CHD DATE: 09/10/2019
Page 2 of 3
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL
Comment
APPLICATION #:AP1387412
PERMIT #:56-SF-1908462
DOCUMENT #:FI1319596
DATE PAID:12/11/2018
PEE PAID:515.00
RECEIPT #
The system Is sized for 3 bedrooms with a maximum occupancy of 6 persons (2 per bedroom), for a total estimated flow of 300
ST, filter, and 5xg long bed OF installed. No violations, system ok to cover. Contractor notified by phone. Needs final
:clion for mound system and final site grading.
system approved. Emailed to contractor and building department.
DH 4016, 108/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, PAC Page 2 of 3
EH Database v1.0.1 AP1387412 EID1908462