HomeMy WebLinkAboutD O H - FINAL APPROVALAPPLICATION #:AP1404163
STATE OF FLORIDA PERMIT #:56-SF-1933956
DEPARTMENT OF HEALTH DOCUMENT #:F]1315609
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM 03l20/2019
CONSTRUCTION INSPECTION AND FINAL APPROVAL DATE PAID:
FEE PAID:515.00
,
(�� RECEIPT #:56-PID-3887020
APPLICANT:
Amanda Allih
AGENT:
RJM Custom Homes, Inc
,
IV pI
PROPERTY ADDRESS: 4705 Elm Ave Fort Pierce FL 34982
PROPERTY
LOT: 17
BLOCK:
/
,t' `:IC%e C
bounty
SUBDIVISION:
White City ID#: 3404501-0632-000.6
CHECKED [X] ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED.
TANK INSTALLATION
SETBACKS
[
1
1013
TANK SIZE [1] [21
[
1 [271 SURFACE WATER
FT
[
]
[021
TANK MATERIAL
[
1 [28] DITCHES
FT
[
1
[031
OUTLET DEVICE
[
] [291 PRIVATE WELLS
FT
[
1
(041
MULTI -CHAMBERED [ Y / N 1
[
1 (301 PUBLIC WELLS
FT
[
1
105]
OUTLET FILTER
[
1 [3l] IRRIGATION WELLS
FT
[
1
1061
LEGEND 1. 2.
[
1 [321 POTABLE WATER
FT
[
1
[071
WATERTIGHT
[
1 [331 BUILDING FOUNDATIONS
FT
[
1
[08]
LEVEL
[
1 [341 PROPERTY LINES
FT
[
]
[091
DEPTH TO LID
[
1 [351 OTHER
FT
DRAINFIELD INSTALLATION
FILLED / MOUND SYSTEM
[
1
1101
AREA [1] [21 SOFT
[
1 [361 DRAINFIELD COVER
[
1
1111
DISTRIBUTION BOX _ HEADER
[
1 [371 SHOULDERS
[
]
[121
NUMBER OF DRAINLINES 1. 2.
[
1 [381 SLOPES
[
]
[131
DRAINLINE SEPARATION
[
1 [391 STABILIZATION
[
]
[141
DRAINLINE SLOPE
[
1
[151
DEPTH OF COVER
ADDITIONAL INFORMATION
[
1
[16]
ELEVATION [ ABOVE / BELOW IBM
[
1 [401 UNOBSTRUCTED AREA ,
[
]
[171
SYSTEM LOCATION
[
] [4l] STORMWATER RUNOFF
[
1
[181
DOSING PUMPS
[
1 [421 ALARMS
[
1
(193
AGGREGATE SIZE
[
1 [431 MAINTENANCE AGREEMENT
[
1
[201
AGGREGATE EXCESSIVE FINES
[
] [44] BUILDING AREA
[
1
1211
AGGREGATE DEPTH
[
1 [451 LOCATION CONFORMS WITH SITE PLAN
C
1 [461 FINAL SITE GRADING
FILL
/ EXCAVATION MATERIAL
[
1 [471 CONTRACTOR
[
1
[221
FILL AMOUNT
[
1 1481 OTHER
[
1
[231
FILL TEXTURE
[
]
(241
EXCAVATION DEPTH
ABANDONMENT
[
1
(251
AREA REPLACED
[
1 [491 TANK PUMPED 07/31/2019
[
1
[261
REPLACEMENT MATERIAL
[
1 1501 TANK CRUSHED 6 FILLED 07/31/2019
Comments:
Comments are on page 2.
/
St. Lucie CHU
DATE: 07/31/2019
CONSTRUCTION
[ APPROVED
DISAPPROVED 1 `
Environmental Specialist 1716 J Ingram (ENVIRONMENTAL HEALTH)
FINAL SYSTEM
[ APPROVED / DISAPPROVED
Q St. Lucie ORD
DATE: 07/3112019
Environmental Specialist I rian J Ingram (ENVIRONMENTAL HEALTH)
(Explanation of Violations on following page)
DR 4016, 08/09
(Obsoletes all previous editions which may not he used)
Page 2 0£ 3
Incorporated:
64E-6.003r FAC
EH Database v 1.0.1
AP1404163 EID1933956
N
Violation Number
a
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL
Comment
APPLICATION n:AP1404163
PERMIT a:56-SF-1933956
DOCUMENT a:F11315609
DATE PAID:03/20/2019
FEE PAID:515.00
RECEIPT #
The system is sized for 4 bedrooms with a maximum occupancy of 8 persons (2 per bedroom), for a total estimated flow of 400
gpd.
ABANDONMENT INSPECION ONLY
ST pumped and abandoned properly. Tank removed completely. Contractor notified that hole ok to cover.
DH 4016, 08109 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, PAC Page 2 of 3
EH Database v 1.0.1 AP1404163 EID1933956