HomeMy WebLinkAboutD O H PAPERWORKSTATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
CONSTRUCTION PERMIT FOR:
APPLICANT: Anne lanniccheri
PERMIT #:56-SF-1767495
APPLICATION a:AP1406060
DATE PAID:
FEE PAID:
RECEIPT fl:
SCANNED DOCUMENT #: PR1211549
BY
OSTDS New. St. Lucie County
PROPERTY ADDRESS: 12739 Refuge Ln Fort Pierce, FL 34982
LOT: 2 BLOCK:
SUBDIVISION: Edens
PROPERTY ID q: 4504-702-0003-000-5 [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 [
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 @[ ]DOSES PER 24 HRS #Pumps [ ]
D [ 575 ] SQUARB FEET - Dralnfield New SYSTEM
R [ ] SQUARE FEET N/A SYSTEM
A TYPE SYSTEM: [X] STANDARD [ ] FILLED [ ] MOUND
I CONFIGURATION: [X] TRENCH [ ] BED [ ]
N
F LOCATION OF BENCHMARK: site BM painted X CL of Rd, center of property
I ELEVATION OF PROPOSED SYSTEM SITE
E BOTTOM OF DRAINFIELD TO BE
L
D
O
T
H
E
R
[ 55.00 3 11 INCHES FT ][ ABOVE BELOW]BENCHMARK/REFERENCE POINT
[ 25.0011 INCHES FT ][ ABOVE BELOW] BENCHMARK/REFERENCE POINT
w Wuitteu: L U.UUI INCHES EXCAVATION REQUIRED: [ ] INCHES
system is sized for 3 bedrooms with a maximum occupancy of 6 persons (2 per bedroom), for a total estimated flow of
gpd.
WSWT. BOTTOM OF DRAINFIELD NOT TO BE > 30" BELOW FINISHED GRADE.
SPECIFICATIONS
BY: J Ingram
TITLE: Environmental Specialist
II
APPROVED BY:
^Brian
6
TITLE: Environmental Supervisor I
St. Lucie CHO
Dianna 5 Mayor
DATE ISSUED:
04111/2019
EXPIRATION DATE:
10/11/2020
DH 4016, 08/09
(Obsoletes all previous
editions which may not be used)
Incorporated:
64E-6.003, PAC
.
Page 1 of 3
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
Y i _
H�.� 5150 NW Milner Dr Port Saint Lucie, FL 34983
PAYING ON: #:56-SF-1767495 BILL DOC#:56-BID-4115951 CONSTRUCTION APPLICATION #:AP1406060
RECEIVED FROM: Dave Golden Homes AMOUNT PAID: $ 95.00
PAYMENT FORM: CREDIT CARD PAYMENT DATE: 03/29/2019
MAIL TO: Anne lanniccheri
FACILITY NAME:
PROPERTY LOCATION:
12739 Refuge Ln
Fort Pierce, FL 34982
2
Lot: Block:
Property ID: 4504-702-0003-000-5
EXPLANATION or DESCRIPTION: QUANTITY FEE
-1 - OSTDS Revision 1 $ 25.00
126 - OSTDS Construction Permit (New or Mod, Amendment) 1 $ 55.00
-1 - Surcharge (All) 1 $ 15.00
RECEIVED BY: MontanezNM AUDIT CONTROL NO. 56-PID-3892503
AV\
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
APPLICATION FOR CONSTRUCTION PERMIT
APPLICATION FOR:
New System [ ] Existing System
[ ] Repair [ ] Abandonment
PERMIT NOS `�U.�p
DATE PAID: �j '� ( I_
FEE PAID: 5 CC
RECEIPT #: ,
[ ] Holding Tank [ ] Innovative
[ ] Temporary [ ]
APPLICANT: C /^
AGENT: (�ti �G..�c.A \/�C r TELEPHONE.j-ja)3U1-'5alnl
MAILING ADDRESS: Y7(�X !��! p C2� VA —
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: II� j
BLOCK: SUBDIVISION: PLATTED: l4-
PROPERTY ID #: l^�O,}. -ClV6� O]-5ZONING: d� I/M OR EQUIVALENT: [ Y / N ]
PROPERTY SIZE: V .\ ACRES WATER SUPPLY: [ ] PRIVATE PUBLIC [ ]<=2000GPD [ 1>2000GPD
IS SEWER AVAILABLE AS PER 381.0065, FS? [ Y / N ] DISTANCE TO SEWER: FT
PROPERTY ADDRESS: d
DIRECTIONS TO PROPERTY:
BUILDING INFORMATION
Unit Type of
No Establishment
[ ] RESIDENTIAL [ ] COMMERCIAL
No. of Building Commercial/Institutional System Design
Bedrooms Area Sqft Table 1, Chapter 64E-6, FAC
Yo
4
[ ] Floor/Equipment Drains [ ] Other (Specify)
SIGNATURE: DATE:
DH 4015, 08/09 (Obsoletes previous editions which may not be used).
Incorporated 64E-6.001, FAC Page 1 of,4
1
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
SITE EVALUATION AND SYSTEM SPECIFICATION
APPLICANT: Anne Ianniccheri
CONTRACTOR / AGENT: Dave Golden Homes
LOT: 2 BLOCK:
SUBDIVISION: Edens Refuge ID#: 4504-702-0003-000-5
APPLICATION # AP1403262
PERMIT # 56-SF-1767495
DOCUMENT # SE1158775
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: EX ]YES [ ]NO NET USABLE AREA AVAILABLE: 0.61 ACRES
TOTAL ESTIMATED SEWAGE FLOW: 400 GALLONS PER DAY [ RESIDENCES -TABLET / OTHER -TABLE 2 ]
AUTHORIZED SEWAGE FLOW: 915.01 GALLONS PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE ]
UNOBSTRUCTED AREA AVAILABLE: 1000.00 SQFT UNOBSTRUCTED AREA REQUIRED: 1000.00 SQFT
BENCHMARK/REFERENCE POINT LOCATION: Site BI
ELEVATION OF PROPOSED SYSTEM SITE 55 nn
/ FT ] [I ABOVE I/ BELOW ] BENCHMARK/REFERENCE POINT
THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES
SURFACE WATER: FT
DITCHES/SWALES: FT
NORMALLY WET: [ ]YES
[X]NO
WELLS: PUBLIC: FT LIMITED USE: FT PRIVATE:
100 FT NON -POTABLE:
FT
BUILDING FOUNDATIONS: 5 FT
PROPERTY LINES: 5 FT
POTAELE WATER LINES:
50 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
SOIL PROFILE INFORMATION SITE 1
SOTT, PROFTT.F.
TNFnRMATTnN ETTE 9
USDA SOIL SERIES:St.
Munsell #/Color
Lucie sand
Texture
Depth
10YR 4/1
Sand
0 To 19
10YR 5/1
Sand
19 To 27
10YR 6/1
Sand
27 To 40
1 OYR 711
Sand
40 To 53
1 OYR 8/1
Sand
53 To 72
USDA SOIL SERIES:St.
Munsel[ #/Color
Lucie sand
Texture
Depth
10YR 4/1
Sand
0 TO 10
10YR 5/1
Sand
10 To 22
10YR 611
Sand
22 To 37
10YR 711
Sand
37 To 56
10YR 811
Sand
56 To 72
OBSERVED WATER TABLE: 72.00 INCHES [ ABOVE / BELOW ] EXISTING GRADE TYPE: [ PERCHED / APPARENT ]
ESTIMATED WET SEASON WATER TABLE ELEVATION: 72 INCHES [ ABOVE / BELOW]] EXISTING GRADE
HIGH WATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: [ ]YES [X]NO DEPTH: 72.00 INCHES
SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Sand/0.80 DEPTH OF EXCAVATION:
DRAINFIELD CONFIGURATION: [X ] TRENCH [ ] BED [ ] OTHER (SPECIFY)
r- REMARKS/ADDITIONAL CRITERIA
WT determined using USDA WSS, soil borings, and area topography.
WSWT indicators in any SBs.
1 55" above BM. SB2 25" abo%BM. 3rd SB done downj4iltto verify no WSWT Indicators at lower elevation. S83 15" above SM. .
SITE EVALUATED BY:
Ingram, Brian (Tide: Ee4(ronmental Specialist II) (ENVIRONMENTAL HEALTH)
De 4015, 08/09 (obsoleted previous editions which Cvay not be used) Incorporated: 64E-6.001, FAC
INCHES
DATE: 03/22/2019
Page 3 of 4
AP1403262 EID1767495 v 1.0.2
4, STATE OF FLORIDA PERMIT #..56-sx_,�(��yyg
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
c.� SITE EVALUATION AND SYSTEM SPECIFICATIONS
APPLICANT: 14V7 i
I ) 4/' �n
�V 1 1 AGENT:. 7 T
LOT: B'L/O
'CK: -- SUBDIVISION: �� �r �
PROPERTY ID #: �d �- 70(. -� 0203 [Section/Township/Parcel No, or Tax ID Number]
TO BE COMPLETED BY ENGINEER, HEALTH DEPARTMENT EMPLOYEB,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: Pe] YES [ ] NO NET USABLE AREA AVAILABLE: �'y� I ACRES
TOTAL ESTIMATED SEWAGE FLOW: GALLONS PER DAY [RESIDENCES -TABLE 1/OTHER-TABLE21
AUTHORIZED SEWAGE FLOW: GALLONS PER DAY 11500 GPD/ACRE OR 2500 GPD/ACRE]
UNOBSTRUCTED AREA AVAILABLE: SQFT UNOBSTRUCTED AREA REQUIRED: SQFT
BENCHMARK/REFERENCE POINT LOCATION:_!�
ELEVATION OF PROPOSED SYSTEM SITE IS
POINT
THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES
SURFACE WATER: 1QO FT DITCHES/SWALES:�FT NgWMLLY WET? [ ] YES Kl NO
WELLS: PUBLIC: _Z-O'O FT LIMITED USE: 00 FT PRIVATE: '75 FT NON -POTABLE: FT
BUILDING FOUNDATIONS: '� FT PROPERTY LINES: �_FT POTABLE WATER LINES: —fih sFT
`✓'�
SITE SUBJECT TO FREQUENT FLOODING: [ ] YES NO 10 YEAR FLOODING? [ ] YESgj N0
10 YEAR FLOOD ELEVATION FOR SITE: FT MSL/NGVD SITE ELEVATION: FT MSL/NGVD
SOIL PROFILE INFORMATION SITE 1
MUNSELL #/COLOR TEXTURE DEPTH
TO
�^ TO
TO
TO
TO
TO
TO
TO
TO
USDA SOIL SERIES:
UKMATION SITE 2
TEXTURE
USDA SOIL SERIES:
DEPTH
TO
TO
TO
TO
TO
TO
TO
TO
OBSERVED WATER TABLE: INCHES [ABOVE / BELOW] 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:
SITE EVALUATED BY:
DS 4015, 08/09 (Obsoletes Previous editions which may not be used) Incorporated: 64E-6.001, FAC Page 3 of 4
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EClEIVE
nm�n
STATE OF FLORIDA WELL COMPLETION REPORT Date stamp
Southwest
PLEASE. FILL ROUTequired
ALL APPLICABLE FIELDS
Northwest ('Denotes Required Fields Where Applicable) AR 14
2M D
4 $ St. Johns River
K t �
-I South Florida
Suwannee River '.•J_
. LIME fr• DEP kiStf ude
Delegated Authority (If Applicable) ENVIRONMENTAL HEALFH
I. -Permit Numbers-�J- 0110'0:7'&UPA NUP Number 'DID Number
62-524 Delineation No.
2.•Number of permitted wells constructed. repaired. or abandoned: 'Number of permihed wells not constructed, repaired. or abandoned _
3'Owner's Name r ` f
I'1^f2n 7 •'A�i1L�IL'Y—�4.'Completion Date &-4o- ?Florida Unique ID
7.'County CA 12 •Seciun
Land Grant 'Township-
y!il -Ra e �
8. Latilude _
9. Data Obtained
Longitude
;_Lf GPS P9 Map n Survey Damm NAD 27 NAD 83 WGS 84
Construction ❑ Repair ❑ Modification Abandonment
__-_ _.;e(s) of Well a Site Investigations
Domestic Landscape Irrigation ;�.{1 Agricultural Irrigation
"Bottled Water Supply H Recreation Area Irrigation H Livestock Test Monitoring
❑ Public Water Supply (Limited Use/DOH ❑ Test
n Nursery Irrigation (� Earth•Coupled Geothermal
® Class (Water Supply (Community or Non-CommunilylDEP) HVAC Supply
(� Golf Corr algndusirial ILA-'Jql
Class I Injection ❑ Golf Course Irrgation HVAC Return Class V Injection: ❑ Recharge ❑ Commercial/Industrial Disposal ulfer Storage and Recover
Recovery ❑ A q 9 Y ❑ Drainage
Remedialion:
❑ R'❑ Air Sparge ❑Other rhascnne)
❑ Other (oacmps)
12.'Dn71 Mejhod❑ Auger ❑Cable Tool Rotary ❑ Combination (Two or Mom Metnotls) ❑Jailed ❑ Sonic
❑ Horizontal Drilling ❑ Hydraulic Point (Direct Push) ❑ Other
13.'Measured Static Water Level fl. Measured Pumping Water Level ft. After Hours at GPM
4.'Measudng Point (Describe) Which is __ fi_ Above_ Below Land Surface 'Flowing:0 Yes ❑ No
5.'Casing Material: ❑ Black Steel ❑ Galvanized PVC ❑ Stainless Steel ❑ Not Cased []Other
6•*Total Well Depth 12J flCased Depth
- p .,At�.,. R. 'Open Hole: From in n •s r.,.... !np r_ r f y. ,. ,.... _. ..,
i r.ro Oaraonmenb
U Other
(Explain)
From
Front
_ a.
R.
To_h.
To—ft.
No. of Bags_
Seal Material (Crack One).
Neat Cement
From
_
ft.
TO—ft.
No. of Bags_
Seal Material (Check One):
Neat Cement
From
_
f.
To_R.
No. of Bags
No, of Bags_
Seal Material (Check One):
Seal
Neal Cement
From
_
R.
To_R.
Material (Check One).
Neal Cement
_
No. of Bags_
Seal Material (Check One):
Neat Cement
18,'Surface Casing Diameter and Depth:
Dia
_ In. From ft.
To
ft.
Dia
_ in. Froin_ft.
To_ft.
I O.'Primary Casing Diameter and Depth:
Din
Dla
in. From,�y_ft.
In.
Tom- ft.
From —ft.
To
It.
Dia
_ in. From fl.
To_
ft.
Die
_ in. From_fL
To_
ft
Dia
_ In. From R.
To
ft.
2DlLiner Casing Diameter and Depth:
Dia
in. From ft.
To
ft.
Dia
—,in. From__R.
To_
ft.
Dia
_ in. From—ft.
To_
ft.
2 1. 'Telescope Casing Diameter and Depth.
Dia
_ in. From ft.
To
R.
Dia
in. From__R.
To
R.
Dia
_ In. From_ft.
To_
ft.
22. Pump Type (if Known):
❑ Centrifugal ❑ Jet
Horsepower
Pump Depth U.
24, Water Well Contractor.
'Contractor Name fllr
Bentonite Other
Bentonite Other
Bentonite Other
No. of Bags_
No. of Bags_
Seal Material (Check One):
Seal
8
Neat Cement e
Bentonite[]
Other
Material (Check one):
Neat Cement
Benlonne
Other
No. of Bags
r sS Seal Material (Check One):RNea(Ce
Neal Cement
Bentonite
Other
No. of Bags_
No. or Bags_
Seal Material (Check One):Neat
Seal Material (Check One):Neat
Cement
Cement
Bentonlle
Bentonite
Other
No. of Bags_
Seal Material (Check One):Neat
Cement
Bentonite
Other
Other
No. of Bags_
Seal Material (Check One):ment
Bentonlle
Other
No. of Bags_
No. of Bags_
Seal Malarial (Check One):
Seal Material (Check One):
Neat Cement
Neal Cement
Bentonite
Bentonite
E] Other
Other
No. or Bags_
Seal Material (Check One):
Neat Cement
Bentonite
Other
No. of Bags_
No, of Bags_
Seal Material (Check One):
Seal Material (Check One):
Neat Cement
Neat Cement
Bentonite
Benlonue
Other
Other
,
No. of Bags_
Seal Malcrlal (Check Onep
Neat Cement
Bentonite
Other
❑ Submersible ❑ Turbine
Pump Capacity (GPM)
Intake Depth ft.
23. Chemical Analysis (Men Required):
Iron ppm Sulfate ppm Chlonde ppm
❑ Laboratory Test ❑ Field Test Kit
'License Number E-mail Address
'Driller's Name
1 of
SOUTHWEST FLORIDA WATER MANAGEMENT DISTRICT
2379 BROAD STREET, BROOKSVILLE, FL 34604-0899
PHONE: (352) 796-7211 or (800) 423-1476
1A WV.SWFWMD.STATE.FL.US
ST. JOHNS RIVER WATER MANAGEMENT DISTRICT
4049 REID STREET, PALATKA. FL 32178-1429
PHONE: (386) 329-4500
WWVV W.SJRWMD.COM
NORTHWEST FLORIDA WATER MANAGEMENT DISTRICT
152 WATER MANAGEMENT DR., HAVANA, FL 32333-4712
(U.S. Highway 90, 10 miles west of Tallahassee)
PHONE: (850) 539-5999
WvVW.NWFWMD,STATE. FL. US
-Permit
SOUTH FLORIDA WATER MANAGEMENT DISTRICT
P.O. BOX 24680
3301 GUN CLUB ROAD
WEST PALM BEACH, FL 33416-4680
PHONE: (551) 686-8800
WVWV.SFWMD.GOV
SUWANNEE RIVER WATER MANAGEMENT DISTRICT
9225 CR 49
LIVE OAK, FL 32060_
PHONE: (386) 362-1001 or (800) 226-1066 (Florida only)
WW W MYSU WANNEERIVER.COM
M=Medium and C=Coarsel every zo It. or at
formation changes. Note cavities antl de
From (: N.
From i k;
To `7y «.
To I
Color
Color
Grain Size (F, M, C)
From l
Grain Size IF. M, C)
-_� ft.
FromT
To J R,
ft.
Color
Grain Size IF. M. C)
Fromm'`> fl-
From
---5}-+—off.
To a ft.
Color
Color
Grain Size IF. M, C)
Grain Size IF. M. C)
To R.
Color
From f4
«-
Color
Grain Size (F. M. C)
From k.
To «.
Color
Grain Size (F. M. C)
From ft.
To ft.
Color
Grain Size (F, M, C)
From R
To rt.
Color
Grain Size (F. M. C)
From ft.
To - ft.
Grain Size IF. M, Cj
From ft.
To
Color
Grain Size IF, Id, Cj
From «
ft.
To
Color
Grain Size (F. M, C)
.
From ft.
«.
To ft.
Color
Grain Size (F, M. C)
From ft.
To
Color
Grain Size (F. M. C)
From ft.
k.
T6 ft
Color
Grain Size (F. M. C)
From ft.
.
To fl.
Color
Color
Grain Size (F, rAC)
From If..
To ft.
Color
Grain Size (F, M., C)
From ft.
To —it.
Color -- -
Grain Size IF. M. C)
- - ._M',
From ft.
To R.
Color
GrairtSlze IF, C)
From R.
To R.
Color
Grain Size (F. M, C)
From ft.
To ft.
Color
Grain Size (F. M, C)
From R,
To ft.
Color
Grain Size (F. M, C)
Grain Size (F, M, C)
Comments:
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DEP Form 62-532.900(2) Inmrporated in 62-532.410, F.A.C. Ek.tWe DaW October 7, 2010
Material
Material
Material
Material
Material
Material
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Material
Material
Material
Material
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Material _
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Material _
Material
Material
zone. Gra'g1 Size:
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