HomeMy WebLinkAboutD O H PAPERWORKMission:
To protect, promote & Improve the health
of all people in Florida through integrated
state, county & community efforts.
!+',• - F}/.';s-i Rick Scott
Cwar a s,"•. Governor
FILE to Surgeo e[lp, MI SreMPH
- HFALT 1
Vision: To be the Healthiest State in the Nation
Florida Department of Health in St. Lucie County
Conditions for Issuance of Water Well Permits
Effective July 24, 2017 SCA BY
St. Lucie County
• Contact the Florida Department of Health in Saint Lucie County (FDOH — St. Lucie)
prior to constructing or abandoning any well.
a. Call the FDOH — St. Lucie Well Line at 772-873-4936 or email
SLCDOH-WELLSCcDFLHEALTH.GOV
RECEIVED
b. Provide the following information:
i. Permit number JAIN `.1 01,9
ii. Driller name ST. Lucie County, Permitting
iii. Address
iv. Date and time to begin construction/abandonment
• A minimum of 24 hours' notice is required before constructing any public water supply
wells. Please call our main office at 772-873-4931 and speak with Environmental
Health Staff or provide notification by email to SLCDOH-WELLS(a)FLHEALTH.GOV
• Submit revisions to permit and/or site map and associated fee within 48 hours of well
construction or abandonment.
Florida Department of Health
St Lucie County ° Division or Disease Control and Health Protection
Bureau of Environmental Health
5150 NW Milner Drive
Port St Lucie, FL 34983
PHONE: 772/873-4931 • FAX: 772/695-1306
FloridaHealth.gov
Accredited Health Department
Public Health Accreditation Board
r V '
STATE OF FLORIDA PERMIT APPLICATION TO CONSTRUCT,
..,.� REPAIR, MODIFY, OR ABANDON AWELL
❑SOUlI1WBSt PLEASE FILL OUTALLAPPLICABLE FIELDS
0 Northwest ('Denotes Required Fields Where Applicable
[]St. Johns River
❑South Florida Theore;an flrl croandingh pomil appffsa on to the
_ this fore; to delegate
whom
lothe
❑Suwannee River epprepdafa tlalegafetlauthodty whore appgcab/a.
v ❑DEP
pl- ❑ Delegated Authority (if Applicable)
- I$ti/ro
No, UV-4000U
Unique ID
SOpula6ons Required (See Attached)
Quad No. Delineation No.
3.
'Parcel ID No. (PIN) or Alternate Key (Circle One) _ Lot Block Unit
4. I CI f, Check if 62-524:_Yes No
'Section or Land Grant To ship 'Range County Subdivi§Ion ,
5. l'-t i?L;4,-'a:/[! 77-Z,2�;''S4�1 /ii?Ittt��2�(=Lil.�(�JyI/)u.,
'Water Well Contractor `License Number 'Telephone Number E-mail Address
7. *Type of Work:,/ Construc8or _Repair _Modification Abandonment
B.'Number of Proposed Wells 1 •Reason for Repair, Noddleatlon,orAbordda�unent ,fib
9. _'S ecIfy Intended Use(s) of Well(s): /A\ O ll
`r Domestic Landscape Irrigation _Agriwllural Irrigation _Site Investigation lr+�
_Bottled Water Supply _Recreation Area Irrigation _Livestock Monitoring
_Public Water Supply (Limited Use/DOH) _Nursery Irrigation _Test DEC 2 0 201
_Public Water Supply (Community or Non-Community/DEP)—CommerciaglndusUlal ' _Earth -Coupled Geothermal
_Golf Course Irrigation _HVAC Supply
_Class I Injection _HVAC Return
Class V Injection: _Recharge _Commemiaglndustrial Disposal _Aquifer Storage and Recovery Drainage DOH In St Lucie 0
Remediation: _Recovery Air Sparge _Other posedba) nnRolhdhdBN-FALH1
_Other (oescdno) 11 (Note: Net an types ohvens are permuted by a given pemineng authcrlty)
10.'Distance from Septic System if s200 It 11. Facility Description 12. Estimated,
13.'Estimated Well Depth �ILft. -Estimated Casing Depth _ft. 'Primary Casing Diameter in. Open Hoie
14. Estimated Screen Interval: From_To_It.
IVIsrimary Casing Material: _Black Steel '/Galvanized _PVC _Stainless Steel
_Not Cased _Other.
16. Secondary Casing: _Telescope Casing _ Liner _ Surface Casing Diameter In.
Secondary Casing Material: _Black Steel _Galvanized _PVC _Stainless Steel _Other
'Method of Construction, Repair, orAbandonment: _Auger ✓ Cable Tool _Jetted _Rotary _Sonlc
_Combinatlon (Two or More Methods) _Hand Driven (Well Point, Sand Point) _Hydraulic Point (Direct Push)
_Horizontal Drilling _Plugged by Approved Method _Other leosvina)
19. Proposed Grouting Interval for the Primary, Sdwndary, and Additional Casing:
From /l To-!jL2- Seal Material L_Bentonite_Neat
Cement
Other 1
From To L Seal Material
Cement —Other
1
_Bentonite_Neat
From Material L_Bentonite_Neal
Cement
Other 1
-TO—Seal
From To Seal Material ( Be/nttonite_Neat
Cement
Other )
20. Indicate total number of existing wells on site
List number of existing unused wells on site 0
21.'Is this well or any existing well orwaterwithdrawal on the owner's contiguous property covered under a Consumptiver Nater Use Permit (CUP/WUP)
or CUPIWUP Application? Yes No If yes, complete the following: CUPIWUP No. District Well ID No.
22. Latitude Longitude_
23. Data Obtained From:_GPS _Map _Survey
'License No.
Datum: _NAD 27 _NAD 83 _WGS 84
1 mNNWI IMNe ow,vr do. eooeM.NetlMtrro oo oeMdbaavr Wa
Approval Granted By/ r""'a" Issue Date r�/10 Expiradon 1
Fee Received $ _ _ Receipt No. Check
1 311,9
-Date
Hydrologist Approval
mmw.
THE
DEP Form: 62-532.900(1) Incroryomtsd in 62-532A00(1), FAC. Effective Date: October 7, 2010 ., Page 1 of 2
I
�
r
SECTION 20,
TOWNSHIP 35 SOUTH,
RANGE 40 EAST
CATCH BASIN IN
SET MAG NAIL IN DISK CONCRETE APRON
\ ROLLINS PLS 4945 TOP ELEVATION = 17.06
SITE BENCHMARK TWO
ELEVATION = 17.90 ARNOLD ROAD
18 �
os (RIGHT—OF—WAY VARIES) — —
_ (BASIS OF BEARINGS) EDGE OF PAVEMENT
"Ss
N 89'41'09" (M) 140.00' ) AND (M)
— —
T
T-4
T-5
T-2-
PROPOPOSED T-6
SEPTIC TANK
40.E
39.1
0
in
w
M
0
0
o_
vi
I _
�--T-7
PROPOSED
26' WIDE o
CONCRETE - I
DRIVEWAY °0
M
ELL PIPE
PROPOSED COVERED I
CONCRETE PORCH ago 3g.27' O/S
3E0 CONCRETE
ETE \ STEPS
I
S PROPOSED 1 STORY
CONCRETE BLOCK STRUCTURE
PROPOSED FINISHED FLOOR o
ELEVATION = 19.56 TO MEET 4
f.
18" ABOVE THE CROWN OF ROAD •cr
I
MAY NEED TO ADJUST TO MEET
-
DRAINFIELD REQUIREMENTS
\
I60.00'
\
40.87' O/S
COVERED COVERED
:ONCRET�CONCRETE
PORCH LLLL����JJ����JJ1I PORCH_ I
0
S 89-41'09" W (M)
CORNER POST IS
- x - x - x - x - x x - x -
140.00' (L.D.) AND (M)
' PERMIT #:56-SF-1891633
STATE Ol
DE PARTM�
ONSITE S �'
SYSTE-N2—,LSD -- - — --
CONSTRUCTION PERMIT FOR: CSTDS New
APPLICANT: Gonzalo
PROPERTY ADDRESS:.
LOT: BLOCK:
PROPERTY ID #: 2420-224-0002-000-8
3498
SUBDIVISION:
DATE PAID:
FEE PAID:
#: PR1195603
JAN 4,.3 'J9
Lucie County,
[SECTION, TOWNSHIP, RANGE, PARCEL NUMEER]
[OR TAR ID NUMBER] -
SYSTEM MOST 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
[ 1,350 ]
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 8[ ]DOSES PER 24 Has #Pumps [
D [ 625 ] SQUARE FEE'.
R [ ] SQUARE FEE:
A TYPE SYSTEM: [ ]
I CONFIGURATION: [X]
N
F LOCATION OF BENCHMARK:
Drainfield new SYSTEM
N/A SYSTEM
STANDARD [ ] FILLED [X] MOUND [ ]
TRENCH [ ] BED [ ]
Site BM#1 N]D CL of 38th St., S property line extended W
I ELEVATION OF PROPOSED SYSTEM SITE
E BOTTOM OF,DRAINFIELD TO BE
L
D
0
T
H
E
R
[ 6.00 ][ INCEES FT ][ABOVE LBEEL—OW11 BENCHMARK/REFERENCE POINT
[ 4.00 ][ INCHES FT ][ABOVE BELOW BENCBNARE/REFERENCE POINT
The system is sized for 5 bedrooms with a maximum occupancy of 10 persons (2 per bedroom), for a total estimated flow of
500 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, FAG.
SPECIFICATIONS BY: Brian J Ingr TITLE: Environmental Specialist II
APPROVED BY: TmT•E: Environmental Specialist II St. Lucie CHU
Brian J Ingr
DATE ISSUED: 12/20/2018 7 1 EXPIRATION DATE: 06/20/2020
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Page 1 of 3
Incorporated: 64E-6.003, FAC
v SE1145319
1.1.4 AP1373068
NOTICE OF RIGHTS
A party whose substantial interest is affected by this order may petition for an
_administrative h_earing_pursuant to section_s_1_20.569 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 tosubmita 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
lid data 5150 NW Milner Dr Port Saint Lucie, FL 34983
H€ALTH---
-------- ----- --------------------- --------
PAYING ON: PERMIT#: 56-SF-1891633 BILL DOC#:56-BID-4016212 CONSTRUCTION APPLICATION#: AP1373068
RECEIVED FROM: Gozalo Zamudio AMOUNT PAID: $ 515.00
PAYMENT FORM: CASH PAYMENT DATE: 11/13/2018
MAIL TO: Gonzalo Zamudio
FACILITY NAME:
PROPERTY LOCATION:
TBD Arnold Rd
Fort Pierce, FL 34981
Lot:
�!A
Property ID: 2420-224-0002-000-8
EXPLANATION or DESCRIPTION:
128 - OSTDS Construction System Inspection Research Fee
-1 - Surcharge (All)
-1 - OSTDS New Permit Surcharge
-1 - OSTDS Construction Application and Plan Review,New
123 - OSTDS Construction Site Evaluation
126 - OSTDS Construction Permit (New or Mod, Amendment)
127 - OSTDS Construction System Inspection
133 - OSTDS Construction Reinspection
QUANTITY FEE
1 $
5.00
1 $
15.00
1 $
100.00
1 $
100.00
1 $
115.00
1 $
55.00
1 $
75.00
1 $
50.00
RECEIVED BY: MontanezNM AUDIT CONTROL NO. 56-PID-3792074
v Po
STATE OF FLORIDA
DEPARTMENT OF HEALTH
PERMIT NO.
DATE PAID:
I1 )8 t�
ONSITE SEWAGE TREATMENT AND DISPOSAL
FEE PAID:
S515
-
-
-SYSTEU— - -- - — -- - --- - _RECEIPT-#:
---
ry`°°""`�
APPLICATION FOR CONSTRUCTION PERMIT
APPLICATION FOR:
[✓]
New System
[ ] Existing System [ ] Holding Tank
[ ] Innovative
[ ]
Repair
[ ] Abandonment [ ] Temporary
[ ]
APPLICANT: GONZALO ZAMUDIO
AGENT: GONZALOZAMUDIO TELEPHONE:956-543-6661
MAILING ADDRESS: 2605 CHESTERFIELD DRIVE, FORT PIERCE, FLORIDA 34982
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: BLOCK: SUBDIVISION:
PLATTED:
• PROPERTY
ID #:
2420-224-0002-000-8
ZONING: RM-5 I/M OR EQUIVALENT:
[ No ]
. PROPERTY
SIZE:
0.334 ACRES WATER SUPPLY:
[ ✓] PRIVATE PUBLIC [ ]<=2000GPD [
]>2000GPD
CIS SEWER AVAILABLE AS PER 381.0065, FS? [ No ] DISTANCE TO SEWER:
PROPERTY ADDRESS: SOUTHEAST CORNER OF ARNOLD ROAD AND SOUTH 38TH STREET
FT
DIRECTIONS TO PROPERTY: FROM VIRGINIA AND US HWY 1 GO WEST TO SOUTH 35TH STREET AND GO SOUTH.
GO TO ARNOLD ROAD AND GO WEST TO SOUTH 38TH STREET AND THE PROPERTY ON THE LEFT.
BUILDING INFORMATION [✓] RESIDENTIAL [ ] COMMERCIAL
Unit Type of No, of Building Commercial/Institutional System Design
No Establishment Bedrooms Area Sqft Table 1 Chanter 64E-6, FAC
1 �1'S� 6 2556
2 Dip IR� 3 12-00 +~
3 Z 1200 �f Z
4
[ ] Floor/Equipment Drains [ //7/�� �{ot/h�e�r (Specify)
SIGNATURE: " � V - V DATE.. 11/01/2018
DE 4015, 08/09 (Obsoletes previous editions which may not be used)
Incorporated 64E-6.001, FAC Page 1 of 4
STATE OF FLORIDA
APPLICATION # AP1373068
ti -v;r i'o;f±iy urareu�avac, avi vc aau.auaaa PERMIT #`w-"�-`�"""'
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
V SITE EVALUATION AND SYSTEM SPECIFICATION DOCUMENT # SE1145319
- - - - - - - - - - - - - - - - - - - - - - -- - - - - ---
9 1
APPLICANT: Gonzalo Zamudio
CONTRACTOR / AGENT: GOzalo Zamudio
LOT: BLOCK: \
SUBDIVISION: ID#: 2420-224-0002-000-8
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: 0.33 ACRES
TOTAL ESTIMATED SEWAGE FLOW: 500 GALLONS PER DAY ( RESIDENCES -TABLET / OTHER -TABLE 2 ]
AUTHORIZED SEWAGE FLOW: 501.38 GALLONS PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE ]
UNOBSTRUCTED AREA AVAILABLE: 1256.00 SQFT UNOBSTRUCTED AREA REQUIRED: 1250.00 SQFT
BENCHMARK/REFERENCE POINT LOCATION: Site BM#1 NiD CL of 38th St., S property line
ELEVATION OF PROPOSED SYSTEM SITE 6.00 [ INCHEB / FT ] I ABOVE /F
BENCHMARK/REFERENCE POINT
THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES
SURFACE WATER: 100 FT DITCHES/SWALES: FT NORMALLY WET: [ ]YES [X]NO
WELLS: -PUBLIC: FT LIMITED USE: FT PRIVATE: 97 FT NON -POTABLE: FT
BUILDING FOUNDATIONS: 5 FT PROPERTY LINES: 5 FT POTABLE WATER LINES: 55 FT
SITE SUBJECT TO FREQUENT FLOODING?
l'b YEAR FLOOD ELEVATION FOR SITE:
_ nCTTC TNCl19MTTTl1N CT.T£ 1
[ ]YES [X ]NO 10 YEAR FLOODING? [ ]YES [X]NO]
FT I MSL / NGVD ] SITE ELEVATION: FT [ MSL / NGVD
USDA SOIL SERIES:Tantile sand
Munsell #/Color Texture
Depth
1 OYR 4/2
Sand
0 To 11
1 OYR 4/1
Sand
11 To 17
1 OYR 5/1
Sand
17 To 35
10YR 6/1
Sand
22 To 35
1 OYR 2/1
Spodic Material
35 To 51
1 OYR 313
Fine Sand
51 To 58
HOLE CAVING
Refusal
58 To 72
USDA SOIL SERIES:Tantile sand
Munsell #/Color Texture
Depth
10YR 4l2
Sand
0 To 13
1 OYR 4/1
Sand
13 To 17
1 OYR 5/1
Sand
17 To 37 '
1 OYR 6/1
Sand
25 To 38
1 OYR 212
Spodic Material
38 To 54
1 OYR 312
Sand
54 To 66
HOLE CAVING
Refusal
66 To 72
OBSERVED WATER TABLE: 37.00 INCHES [ ABOVE / BELOW ] . EXISTING GRADE. TYPE: [ PERCHED / APPARENT ]
ESTIMATED WET SEASON WATER TABLE ELEVATION: 22 INCHES [ ABOVE / BELOW ] EXISTING GRADE
HIGH WATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: [X IYES [ ]NO DEPTH: 22.00 INCHES.
SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Sand/0.80 DEPTH OF EXCAVATION: 54 INCHES
DRAINFIELD CONFIGURATION: I ] TRENCH [ ] BED [ ] OTHER (SPECIFY)
7 REMARKS/ADDITIONAL CRITERIA
JT determined using USDA WSS and soil borings.
t611 stripping in 10YR5/1 matrix >10% with Diffuse boundaries starting at 22" in S131.
6" below BM. S82 5" below BM.
SITE EVALUATED BY:
DATE: 12/18/2018
Ingram, Brian (Title: E vironmental Specialist 10 (ENVIRONMENTAL HEALTH)
DH 4015, 08/09 (Obsoletes previous editions which Y not be used) Incorporated: 64E-6.001, FAC
Page 3 of 4
AP1373068 EID1.891633 v 1.0.2
d txe
& STATE OF FLORIDA PERMIT—
'.'3r DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
SITE EVALUATION -AND --SYSTEM- SPECIFICATIONS - - - -- - - -- ------ - -- -- ----
APPLICANT: GONZALO ZAMUDIO AGENT: GONZALO ZAMUDIO
LOT: BLOCK: SUBDIVISION
PROPERTY ID # : 2420-224-0002-000-8 [ Tar 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: 0.334 ACRES
TOTAL ESTIMATED SEWAGE FLOW: GALLONS PER DAY [RESIDENCES-TABLEI/OTHER-TABLE2 ]
AUTHORIZED SEWAGE FLOW: GALLONS PER DAY [ 1500 GPD/ACRE 0R 2500 GPD/ACRE SQFT
UNOBSTRUCTED AREA AVAILABLE' SQFT UNOBSTRUCTED AREA REQUIRED:
BENCHMARK/REFERENCE POINT LOCATION: SITE BENC:HMAK&I w v Inn Junvni BENCHMARK/REFERENCE POINT
ELEVATION OF PROPOSED SYSTEM SITE IS0.8 [FT ] [BELOW ]
THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES
SURFACE WATER: 75 FT DITCHES/SWALES: 15 FT NORMALLY WET? [ ] YES ] ] NO
WELLS: PUBLIC: 200 FT LIMITED USE: 100 FT PRIVATE:15 FT NON -POTABLE: 50 FT
FT POTABLE WATER LINES:
BUILDING FOUNDATIONS:5 FT PROPERTY LINES:10 10 FT
SITE SUBJECT TO FREQUENT FLOODING: ( ] YES ]NO 10 YEAR FLOODS I I NO
MSL/NGVD SITE ELEVATIONING' [ ] FT MSL/NGVD
10 YEAR FLOOD ELEVATION FOR SITE: FT
SOIL PROFILE INFORMATION SITE 1
MUNSELL #/COLOR TEXTURE DEPTH
TO
TO
TO
TO
TO
TO
TO
TO
TO
USDA SOIL SERIES:
wNSELL #/COLOR TEXTURE DEPTH
TO
TO
TO
TO
TO
TO
TO
TO
TO
USDA SOIL SERIES:
OBSERVED WATER TABLE: INCHES [ABOVE/BELOW 1] EXISTING GRADE. TYPE: [ PERCHED /APPARENT ]
ESTIMATED WET SEASON WATER TABLE ELEVATION:
INCHES [.ABOVE/BELOW ] EXISTING GRADE
HIGH WATER TABLE VEGETATION: [ ] YES [ ] NO MOTTLING: [.1 YES [ ] NO DEPTH: INCHES
SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: DEPTH OF EXCAVATION:
DRAINFIELD CONFIGURATION: [ ] TRENCH [ ] BED ] ] OTHER (SPECIFY)
REMARKS/ADDITIONAL CRITERIA:
SITE EVALUATED BY:
Z`
DR 4015, 12/11 (obsoletes previous editions which may not be used) Incorporated: 64E-6.001, FAC
: li/01/2018
INCHES
Page 3 of 4
•
,a fi g •"'�'.�'
Rick Scott
• Mission:
`�"w3, �" r='�t'
Governor
To protect, promote & improve t�heallh _ —
-
-- —
•((�
of all people in Florida through integrated
�' `���
Celeste Philip, MD, MPH
state, county & community efforts.
i TH
HEALTH
Surgeon General and Secretary
Vlslon : To be the Healthiest State in theNation- - - - - - - - -
December 03, 2018
Gozalo Zamudio
2605 Chesterfield Drive
Fort Pierce, FL 34982
Application Denial and Notice of Right to Administrative Proceedings
Application Document No: AP1373068
TBD Arnold Rd
Fort Pierce, FL 34981
Lot: Block: Subdivision:
Dear Applicant:
This will acknowledge receipt of an application and plans for an onsite sewage treatment and disposal
system construction permit dated November 13, 2018 for a proposed system to. be constructed on the
above referenced property.
You are hereby notified that your application is denied because the proposal described does not meet
the requirements of section 381.0065, Florida Statutes, or Chapter 64E-6, Florida Administrative Code.
Specifically the proposal has the following violations:
Code Citation Letter Detail Code Citation Description
381.0065(4)(e)6 or 7, FS Setback from surface water bodies
381.0065(4)(g)2.b., FS
Estimated sewage flow exceeds 1500
gpd/acre
As an applicant who has been denied a permit, you have the right to request a variance or hearing
to appeal the department's action. Requests for a hearing must be made to this office in writing no later
than 21 days from the receipt of this letter. Mediation pursuant to S.120.573, Florida Statutes, is not
available to resolve this dispute.
Your lot may qualify for a performance based treatment system under Part IV, Chapter 64E-6,
Florida Administrative Code. You should consult with a professional engineer registered in Florida for
further information on performance based systems.
Florida Department of Health www.FloridasHealth.com
An ST. LUCIE COUNTY TWITiER:HealthyFLA
5150 NW Milner Dr, Port Saint Lucie, FL 34983 FACEBOOK:FLDepartmentof ieaith
Page two
December 03, 2018
If you have any questions on this matter, please call our office at (772) 873-4905.
Sincerely,
4
Brian Ingram, Environt nmeal Specialist II
Page three
December 03, 2018
NOTICE TO POTENTIAL VARIANCE APPLICANTS
If pursuing a variance application, please note that the following information is taken from the section
of Florida Statutes dealing with variance applications for onsite sewage treatment and disposal systems.
To find the Florida Statutes on the internet, please go to http://www.leg.state.fl.us/Statutes/index.cfm.
Scroll down and click on 'Title XXIX." Find and click on "Chapter 381." Find and click on "381.0065."
The citation to look for is Chapter 381.0065(4)(h)l., Florida Statutes.
The department may grant variances in hardship cases which may be less restrictive than the
provisions specified in this section. A variance may not be granted under this section until the
department is satisfied that:
a. The hardship was not caused intentionally by the action of the applicant;
b. No reasonable alternative, taking into consideration factors such as cost, exists for
the treatment of the sewage; and
c. The discharge from the onsite sewage treatment and disposal system will not
adversely affect the health of the applicant or the public or significantly degrade the
groundwater or surface waters.
Where soil conditions, water table elevation, and setback provisions are determined by the
department to be satisfactory, special consideration must be given to those lots platted before
1972.
While the final authority to grant or deny variances rests solely with the Department of Health,
variance applications are reviewed by a State Variance Review and Advisory Committee. The
committee meets once a month in a predetermined location in Florida. You are invited to attend, at your
own expense, or send someone to represent you. The committee will evaluate your request during the
meeting, and will make a recommendation on the disposition of your application to the department.
Please note there are specific requirements and deadlines for variance applications. Please call your
local county health department representative for information on how to file for a variance request.
i
1701 South 37t1 Street (34947) :'' j . Phone: 772.466.1600
PO Box 3191, Fort Pierce, FL 34948 £ %pj Fax: 772.468.2414
Water/Wastewater Engineering
"Committed to Quality"
October 16, 2018
SUBJECT: Property located at the corner of S. 381h Street and -Arnold Road.
Dear Mr. Zamudio,
Unfortunately, Fort Pierce Utilities Authority (FPUA) does not currently have water or wastewater
services readily available to serve the property at the corner of S. 381h Street and Arnold Road.
The nearest mains are along Virginia Avenue to the North, 350 feet away for water and 435 feet
away for wastewater. Should you have any questions please contact Richard Mutterback at 466-
1600 ext.3425.
Sincerely,
Richard Mutterback
Environmental Engineer
Ec: James Carnes III, P.E. Supervising Engineer
_ _ ev;,v.fpuasom
Our mission is to provide our customers with economical, reliable and friendly service
in a continuous effort to enhance the duality of life in our communitv.
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