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Home My WebLink AboutD O H PAPERWORK�:r73w{.a:r,xW STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION INSPECTION AND FINAL APPROVAL rj- APPLICATION #:AP1410740 PERMIT #:56-SF-1944099 DOCUMENT #:FI1371865 DATE PAID:04/25/2019 FEE PAID:515.00 RECEIPT #:56-PID-3912657 AGENT: Gem Builders, Inc PROPERTY ADDRESS: 10648 Pine Cone Ln Fort Pierce, FL 34945 me LOT: 13 BLOCK: St. Lucie Countv SUBDIVISION: Pine Hollow ID#: 2321-801-0013-000-5 CHECKED [X] ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MOST BE CORRECTED. TANK INSTALLATION [ ] [011 TANK SIZE [1] 1090.00 121 [ 1 [021 TANK MATERIAL Polypropylene [ ] E031 OUTLET DEVICE [ 1 [04] MULTI -CHAMBERED [ Y N ] [ 1 [051 OUTLET FILTER POlylok PL-68 [ 1 [061 LEGEND 1. 70-143-11DC4 2. I 1 [071 WATERTIGHT [ ] 1081 LEVEL. [ ] [091 DEPTH TO LID SETBACKS [ ] [271 SURFACE WATER [ 1 [281 DITCHES DRAINFIELD INSTALLATION [107 AREA 111 724.48 [2] SQPT I 1 [111 DISTRIBUTION BOX _ HEADER X I ] [127 NUMBER OF DRAINLINES 1. 8.00 2. 1 ] [131 DRAINLINE SEPARATION I 1 I143 DRAINLINE SLOPE 1151 DEPTH OF COVER I163 ELEVATION [ ABOVE / BELOW ]BM 12.00 [ 1 [171 SYSTEM LOCATION L 1 (181 DOSING PUMPS I 1 [191 AGGREGATE SIZE [201 AGGREGATE EXCESSIVE FINES 1211 AGGREGATE DEPTH FILL / EXCAVATION MATERIAL [ 1 [22] FILL AMOUNT I 1 [23] FILL TEXTURE I ] (241 EXCAVATION DEPTH I ] [251 AREA REPLACED [ 1 [261 REPLACEMENT MATERIAL =ommenta: Coaaments are on page 2 FT FT [291 PRIVATE WELLS 100 FT [301 PUBLIC WELLS FT [311 IRRIGATION WELLS FT [321 POTABLE WATER 68 FT [331 BUILDING FOUNDATIONS 7 FT 1341 PROPERTY LINES 17 FT 1351 OTHER FT FILLED / MOUND SYSTEM [36] DRAINFIELD COVER [371 SHOULDERS [381 SLOPES [391 STABILIZATION 02/11/2020 ADDITIONAL INFORMATION (401 UNOBSTRUCTED AREA (411 STORMWATER RUNOFF [421 ALARMS [43] MAINTENANCE AGREEMENT [441 BUILDING AREA [451 LOCATION CONFORMS WITH SITE PLAN 1463 FINAL SITE GRADING [471 CONTRACTOR MICHAEL W STUHR(ASHTO [48] OTHER INFILTRATOR Quick4 Plus EQ36 LP ABANDONMENT [ I [491 TANK PUMPED [ ] [50] TANK CRUSHED 6 FILLED CONSTRUCTION I APPROVED / DISAPPROVED 7: Environ enfal Specialist 11 Brl J Ingram FINAL SYSTEM L APPROVED / DISAPPROVED ]: En ronmental Spec allst 11 n J Ingran (Explanation of Violations on Po13ov1ng page) CROP DATE:.01/08/2020 .TH) CHD DATE: 02/11/2020 LTH) DE 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC Page 2 of 3 EH Database v 1.0.1 AP1410740 EID1944099 Violation Number Comments STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION INSPECTION AND FINAL APPROVAL Comment -inICATION #:AP1410740 PERMIT #:56-SF-1944099 DOCUMENT #:FI1371865 DATE PAID:04/25/2019 FEE PAID-515.00 RECEIPT #:56-PID-3912657 The system is sized for 3 bedrooms with a maximum occupancy of 6 persons (2 per bedroom), for a total estimated flow of 400 gpd. New ST, filter, and 8x8 long BED DF installed. No violations, system ok to cover. Contractor notified by phone. Needs final inspection for well setback, potable water line setback, mound system, and final site grading. Final system approved. Contractor and building department emailed final approval. Da 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC Page 2 of 3 EH Database v 1.0.1 AP1470740 EID1944099 FeceVev May 2110 QegaTtment STATE OF FLORIDA ?et5etm9QCo�'t" DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL, SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATIONS FILE COPY PERMIT #. SCANNED BY St. Lucie County OT:J3 BLOCK: SUBDIVISION: nL /7OL/(,P' , 14ioj ROPERTY ID # : [ Section/Township/Parcel No" or Tax ID Number O BE COMPLETED BY ENGINEER, HEALTH DEPARTMENT EMPLOYEE,OR OTHER QUALIFIED PERSON. ENGINEERS UST PROVIDE REGISTRATION NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMITTAL- COMPLETE ALL ITEMS. ROPERTY SIZE CONFORMS TO SITE PLAN: [ YES [ ] NO NET USABLE AREA AVAILABLE: p( V ACRES OTAL ESTIMATED SEWAGE FLOW:p0 GALLONS PER DAY IRES]DENCES-TABLET/OTHER-TABLE2 ] UTHORIZED SEWAGE FLOW: D O GALLONS PER DAY [ 1500 GPD/ACRE OR 2500 GPD/Q CRB ] NOBSTRUCTED AREA AVAILABLE: SQFT UNOBSTRUCTED AREA REQUIRED• 6z o SQFT ENCHMARK/REFERENCE POINT LOCATION LEVATION OF PROPOSED SYSTEM SITE HE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES URFACE WATER- i/7 FT DITCHES/SWALES: 4,1 FT NORMALLY WET? [ [ YES iX NO ELLS: PUBLIC:— (]()J FT LIMITED USE: /00 FT PRIVATE:--/--�lFT NON —POTABLE: 5'Q FT UILDING FOUNDATIONS: � � FT PROPERTY L32MS:FT POTABLE WATER LINES:__(j,_FT ITE SUBJECT TO FREQUENT FLOODING: [ ] YES Vj NO 10 YEAR FLOODING?. [ ] YES ]� NO 0 YEAR FLOOD ELEVATION FOR SITE: FT MSL/NGVD SITE ELEVATION: FT MSL/NGVD SOIL PROFILE INFORMATION SITE 1 MUNSELL #/COLOR TEXTURE TO TO TO TO USDA SOIL SERIE9: MUNSELL #/COLOR TEXTURE DEPTH TO TO TO TO TO TO TO TO TO USDA SOIL SERIES: 3SERVED WATER TABLE: INCHES [ABOVE/BELOW '] EXISTING GRADE- TYPE:[PERCHBD/APPARENT ] 3TIMATED NET SEASON WATER TABLE ELEVATION: INCHES [.ABOVE/BELOW ] EXISTING GRADE (GH. WATER TABLE VEGETATION: [ ] YES [� NO MOTTLING: [ ] YES .[(] NO DEPTH: INCHES )IL TEXTURE/LOADING RATE FOR SYSTEM SIZING: DEPTH OF EXCAVATION: ZAINFIELD CONFIGURATION: [ ] TRENCH [ ] BED [ ] OTHER (SPECIFY) _ :MARKS/ADDITIONAL CRITERIA: -TX EVALUATED 401S, 12/11 (Obeoletes Previous editions which may nQt be used) Incorporated: 64E-6.001, FAC INCHES 3 of STATE OF FLORIDA APPLICATION # AP1410740 DEPARTMENT OF HEALTH pERMT # 56-SF-1944099 ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM DOCUMENT # SE1175960 SITE EVALUATION AND SYSTEM SPECIFICATION APPLICANT: GEM Builders, Inc CONTRACTOR / AGENT: Gem Builders, Inc LOT: 13 BLOCK: SUBDIVISION: Pine Hollow ID#: 2321-801-0013-000-5 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: 1.01 ACRES TOTAL ESTIMATED SEWAGE FLOW: 400 GALLONS PER DAY [ RESIDENCES -TABLET / OTHER -TABLE 2 ] AUTHORIZED SEWAGE FLOW: 1515,01 GALLONS PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE ] UNOBSTRUCTED AREA AVAILABLE: 1225.00 SQFT UNOBSTRUCTED AREA REQUIRED: 1000.00 SQFT BENC1H ARK/BEFERENCE POINT LOCATION: Site BM, orange painted triangle, CL of rd, center of property ELEVATION OF PROPOSED SYSTEM SITE 14.00 ( INCHES / FT 1 [ ABOVE / BELOW ] BENC1DMRK/REFEBENCE POINT THE MMlb= SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES SURFACE WATER: FT DITCHES/SWALES: FT NORMALLY WET: I ]YES [X]NO WELLS: PUBLIC: FT LIMITED USE: FT PRIVATE: 100 FT NON -POTABLE: FT BUILDING FOUNDATIONS: 5 FT PROPERTY LINES: 5 FT POTABLE WATER LINES: 75 FT SITE SUBJECT TO FREQUENT FLOODING? [ ]YES [X]NO 10 YEAR FLOODING? I ]YES', [X]NO] 10 YEAR FLOOD ELEVATION FOR SITE: FT[ MSL / NGVD ] SITE ELEVATION: FT [ MSL / NGVD RDTT. DRnWTT.R. T AWVATTON HTTE 1 EDTT. DRDFTT.7 TNFORMATTDN HTTF. 2 USDA SOIL SERIES:Nettles sand Munsell #/Color Texture Depth 1 OYR 4/1 Sand 0TO 15 1 OYR 511 Sand 15 To 38 10YR 6/1 Sand 26 To 38 10YR 411 Sand 38 To 60 10YR 4/3 Fine Sandy Loam 60 To 72 USDA SOIL SERIES:Nettles sand Munsell #/Color Texture Depth 1 OYR 411 Sand 0 To 16 10YR 5/1 Send 16 To 37 10YR 6/1 Sand 28 To 39 10YR 4/1 Sand 39 To 52 10YR 3/1 Loamy Sand 52 To 58 10YR 413 Fine Sandy Loam 58 To 72 OBSERVED WATER TABLE: 72.00 INCHES [ ABOVE / BELOW ] EXISTING GRADE TYPE: [ PERCHED / APPARENT ] ESTIMATED WET SEASON WATER TAELE ELEVATION: 26 INCHES t ABOVE / BELOW ] EXISTING GRADE HIGH WATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: [X]YES I ]NO DEPTH: 26.00 INCHES SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Sand/0.80 DEPTH OF EXCAVATION: DRAINFIELD CONFIGURATION: IX ] TRENCH I ] BED [ ] OTHER (SPECIFY) r- REMARKS/ADDITIONAL CRITERIA NIT determined using USDA WSS and soil borings. Stripped Matrlx40YRS11 stripping in 10YRSII matrix >10% with diffuse boundaries starting at 26" In SH1. 14" above BM. SB215" above BM. — SITE EVALUATED BY: Ingram, Brian (Tide: Da 4015, 08/09 (Obsolete9 previous editions shich( ronmental Specialist II) (ENVIRONMENTAL HEALTH) not be used) Incorporated: 64E-6.001, FAC INCHES DATE: 05/13/2019 Page 3 of 4 AP1410740 EID1944099 v 1.0.2 re STATE OF FLORIDA DEPARTMENT Or HEALTH P ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM APPLICATION FOR CONSTRUCTION PERMIT APPLICATION FOR: C�] New System C ] Repair _ APPLICANT: AGENT: V,A MAILING ADDRESS:x [ ] Existing System C _-I,,Abando ent ./ ...I weu, No SA - aqu5g PERMIT NO. U-SF- IqQogq DATE PAID: FEE PAID: 33l°l RECEIPT $: [ ] Holding Tank [ ] Innovative C ] Temporary I 7 IA/ -\ 4-- 1N. f, 0 TELEPHONE: K TO BE COMPLETED BY APPLICANT OR APPLICiNT'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 )J ""INFORMATION //11jll �s�,,^ LOT: /.-.7 BLOCK: SDBDIVISION:O,/�✓�Ow 0AFv�r U/{e,PLATTED: PROPERTY ID ih a3;4-gol-w6-(/z-5 �Z�ONING• :�.S-Cl/M OR EQUIVALENT: C Y / N ] PROPERTY SIZE: /,GJ/ ACRES WkTER SUPPLY: [_X] PRIVATE PUBLIC [ ]<=2000GPD C 1>2000GPD IS SEWER AVAILABLE AS PER 381.0065, FS? [ Y /�n] DISTANCE TO SEWER: FT BUILDING INFORMATION [ y] RESIDENTIAL [ ] COM0RCIAL Unit Type of No. of Building Commercial/Institutional System Design No Establishment Bedrooms Area Sqft Table 1, Chapter 64E-6, FAC 2 3 4 [ ] Floor/ quipment D s [�10t-he= (Specify) SIGNATURE: DATE: K DH 4015, 08/09 (Obsoletes previous editions which may not be used) Incorporated 64E-6.001, FAC Page 1 of 4 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT FOR: OSTDS New APPLICANT: (GEM BuildersInc) PROPERTY ADDRESS: 10648 Pine Cone Ln . Fort Pierce FL 34945 PEST #:66-SF-1944099 APPLICATION #:AP1410740 DATE PAID: FEE PAID: RECEIPT #: DOCUMENT #: PR1226463 LOT: 13 BLOCK: SUBDIVISION: Pine Hollow [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER] PROPERTY ID #: 2321-801-0013-000-5 [OR TAX 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 [ 1,050 ] 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 ERE #Pumps [ D [ 500 ] SQUARE FEET Drainfleld new SYSTEM R [ ] SQUARE FEET N/A SYSTEM A TYPE SYSTEM: [ ] STANDARD [X] FILLED [] MOUND [ ] I CONFIGURATION: [x] TRENCH [ ] BED [ ] N F LOCATION OF BENCHMARK: Site BM, orange painted tdangl( I ELEVATION OF PROPOSED SYSTEM SITE E BOTTOM OF DRAINFIELD TO BE L D O T H E R CL of rd, center of [ 14.001 d INCHES FT I [I ABOVE BELOW] BENCHMARK/REFERENCE. POINT [ 12.001[ INCHES FT ][ ABOVE BELOW]BENCHMARK/REFERENCE POINT system is sized for 3 bedrooms with a maximum occupancy of 6 persons (2 per bedroom), for a.total estimated flow of gpd• SPECIFICATIONS BY:: �1 Brian J Ingram TITLE: Environmental Specialist II APPROVED BY: / y`^i� TLE: Environmental Specialist II St Lucie CHD Brian T Ingi DATE ISSUED: 05/15/201 EEXPIRATION DATE: 11/15/2020 DH 4016, 08/09 (Obsoletes all previous editions Which may not be used) Page 1 of 3 Incorporated: 64E-6.003, FAC v 1.1.4 A21410740 SE1175960 a 5. STATE OF FLORIDA PERMIT APPLICATION TO CONSTRUCT, REPAIR, MODIFY, OR ABANDON A WELL f:soulhwest nt.,,9 r.,1hEACQR.X .1 Northwest (•Denotes equiredFields Where Appli _JSL Johns River - Asoutfi Florida rr-e wvu, wNirw:rv:r:a.+wFanv:arlrr.wmhM4 IIA rRIRI.iUId INI111Fef A'N(y^n.�!^%e'nrar.41u1V Suwannee River uulaWuvrc: ✓d,viawldrcnv:AYr++nv.:ym•64nm• I DEP :-1 Delegated Authonty (If Aoplicable) _ iG No. SU-SF-194y0q( Fk; 59-2945tl Sbrydnlmns Raq�uad Isis Attached) thmrt Nu. _._Oeoneation No. — UP ADWI:alibn NO.__ Telephone Number or Alternate Key (Circ llefpi e) I f I L Let IiIOCk l lnir ' AA .�y _ Y 1 l 1 Cam' i i.• c is Check if 62-5240 Yes Q No S SulIcl neon e _ - _ � 1 .( 1"tt �_• '•I"`I '" r;.{ � e ;°•y.;f tf ��l 'f_. is or ' 'License Number •T gY< :i` I � , r elepha lq Nwnl>Fr - . � �E�mml AddresY - . -- 'or's Address ,'5:-. Ciry _ __ .r--!'_.._ 1 State LIP 7. 'Type of Work: Construction [] Repair Modificalion0 Abandonment S. 'Number Of Proposed Wells�� •Resortlw Pxruc Y.tmgQlu 9 `Specify Intended Use(s) of ' El Landscape Domestic L Landscape irrigation Agriadlural Irrigation ® Site (n"Sliganore Bottled Water Supply Recreation Area lingation Uvestock Monitoring Public Water Supply Wmited Use/DOH) Nursery lI igation j`I Test MAY 1 5 2b19 Public Water Supply (Community or Non-ComirrunitylDEP) CbmmerciaUlndustdal tuu�-Il Ear�pup)yq Geothermal Gass I Injection Golf Course Irrigation HVAC Supply HVAC Return Gass V Injection: ❑ Recharge f7 CummercialRrtdustrial Disposal ❑ Aquifer Storage and Recovery E] DrauriagaM014 h St LLWO OK Remediabon:0 Recovery] Air Sparge Q Other IbIriI.TSei Fj Other utm,bai 10.'Dislanoe from Septic Sysfetim it 5 200 it. 71. FacditY Dascdpnan ! � 12. Estimated Start Date 13.'Esvmated Well Depth A. •Esnmalbd Casing Depth � j ft Primary Caslrg Diameter in. Open Hole- From _„To �ft 14. Estinrsted Screen Interval: From �� TOL c 3 M. , --N I5.1Pnmary Casing Material: Blade Steel owvamzed VC j Stainless steel Not Cased Other 15. secondary Casing. Telescope Casing Liner Surface Casing Diarneler„m. 17. Secondary Casing Material: Black Steel Galvanized PVC Stainless Steel ,Otl\er 18.'Method or Construction. Repair. or Abandonment: Auger Cable Tool Jehed Rotary, Some Combination (Two or More Methods) Hand Driven (Well Poinu Sand Point) HydraulN51(Direct Push) Horizontal Drilling Plugged by Approved McVIOU Driver 19. Proposed ,Grouting erw4for the Primary, Suou dart'. and sing' From. r io Seal Material ( Sentomte Other J Front To Seal. Material( Sentonile Neat Cement Other From To Seal Material ( Bentonne Neat Cement Other 1 Fmm To Seal Material ( Bentonde Neat Cement Other 1 20. Indicate total numb&r of existing wails on site List number of existing unused walls a1 site 21.'Is this well or and extstirl�vlCB w water x1ln �I rI tense owners s conugril)us pprroperly coverer! under a ConsumpuveNvaler Vse Perini[ (CUPNWIP) orCUPIWUPApplication. Yes No oltjyes completelnefoflowrnp.0 ANUPNO._ District Well ID No. 22. Latitude 23. Date Obtained From' CPS .,, Maps1 Sdf vuy Datum: _NAD 27 _ _ NAD 83 _,WGS 84 I XnW/reNr gIIIVImaYFUT Yn gKCY,JU, 9:eb W�YM1II�MYJM1lCWV.�Mv.aar4 Icv,tlfYm, 1YP.Y yiryxvr tlW MnlurxgYnmw•rcminwmW.4lWIo, J.VCNW '.W em1aN a"sglnehmXYnM Y,NDY•I. Mlvcn mralueaaraJt+r w.maknxrnrvi W+,ml .srpnrAwYunYe OwHR 1r1 FbrJe trnur %. n.nv+tan+wwery.emurora,Yer,s ImMRn lJo, ppetuchn lrANCIriY Wlbn�iYUKIugaYaVlmeaaltvsnzNatJISJMInnIW aN.v. wpiwb Mmumr RM Fa nbnuYm.wuwkuw+✓vl v+ItlwlYn+udmMpu.w,nulMw tCRpYY Vr NOPCA WYkY1.4i. Vil NrKiilp•MNIYOY. .I�rGDY IrYM'.'S4TAlJW.I •.1P1r,iKVNiIAIIY.UtOI. iMICIIp.,.L11 M}L•I.h'r/"Nfff•)tYM9elpm ni%WaiWwPIVJCNR :WflYt Iep/INMeart41'Nvl^A4.r•141NmyA&aNh W:Yu[Im. Tm'mR.N.e: p.Ta ma u+.Yxy�w VmnFr're.Jrrl nMfrlM, .rwnM1lelMliuRwvNMM1'a"W. !r . •..a _ - ._.LLi._...-�...__.._.. ......_... 'Si0 ki(04 Onvacbr - 'LOense No. 'SglwtufeMAlmerrnAgenl _ Applovel Gm,fed ay — 196 0.114 [ 7Tl Ezprcatw Hydrolagsd Appmear reel. Flro Recenad S____ _X_ Recegt No. a Chen. No. - ___— THISPERMIT ISNOT VALID UNTIL PROPERLY SIGNED BYANADYHOAIZED OFFICER OR REPRESENTATIVE OF THE VIAAD OR DELEGATED AUTHORITY THE PERMIT SHALL BE AVAILABLE ATTHE WELL SITE DURING ALL CONSTRUC TION. REPAIR. MODIFICATION. OR ABANDONMENT ACTIVITIES_ __ _ E!(j�bmf