HomeMy WebLinkAboutD O H PAPERWORKSTATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL
APPLICANT: Thomas & Mary Osteen
APPLICATION N: AP1410674
PERMIT a:56-SF-04595
DOCUMENT N:FI1354185
DATE PAID; 04/25/2019
PEE PAID:350.00
RECEIPT n:56-PID-3912386
AGENT: MICHAEL STUHR (ASHTON SEPTIC TANKS INC.)
PROPERTY ADDRESS: 8505 Immokolee Rd Fort Pierce FL 34951 S—GANNED
LOT: BLOCK: BY
suBDrnslox: xDH: 1335-230-0001-000.6
St. Lucie County
CHECKED [XI ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED.
TANK INSTALLATION
[013 TANK SIZE [1] 900.00 [21 300.00
[021 TANK MATERIAL Concrete
[031 OUTLET DEVICE
[041 MULTI -CHAMBERED [ Y LIJT
[051 OUTLET FILTER POIylok A100
1061 LEGEND 1. 28-015-04SC3 2. 01-011-93SC4
[071 WATERTIGHT
[081 LEVEL
[091 DEPTH TO LID
DRAINFIELD INSTALLATION
[101 AREA Ell 664 [21 SQFT
[111 DISTRIBUTION BOX HEADER X
[ 1
[121
NUMBER OF DRAINLINES
1. 4.00 2.
[ ]
[131
DRAINLINE SEPARATION
[ ]
[141
DRAINLINE SLOPE
[ ]
[151
DEPTH OF COVER
[ 1
[161
ELEVATION [ ABOVE
/ aELOW IBM 14.00
[ 1
[171
SYSTEM LOCATION
[ 1
[161
DOSING PUMPS
1.00
[ ]
1191
AGGREGATE SIZE
E 1
1201
AGGREGATE EXCESSIVE FINES
[ 1
[211
AGGREGATE DEPTH
SETBACKS
[ ]
[271
SURFACE WATER
FT
E ]
[283
DITCHES
FT
[ 1
[291
PRIVATE WELLS
100
FT
[ 1
[30]
PUBLIC WELLS
FT
[ 1
[311
IRRIGATION WELLS
FT
[ 1
[321
POTABLE WATER
100
FT
[ ]
1331
BUILDING FOUNDATIONS
5
FT
[ ]
[341
PROPERTY LINES
45
FT
[ ]
E351
OTHER
FT
FILLED / MOUND SYSTEM
[ 1
[361
DRAINFIELD COVER
[ ]
[313
SHOULDERS
E 1
[381
SLOPES
[ 1
[391
STABILIZATION 11/15/2019
ADDITIONAL INFORMATION
[ 1
[401
UNOBSTRUCTED AREA
[ 1
[43.1
STORMWATER RUNOFF
[ 1
[421
ALARMS
[ ]
[431
MAINTENANCE AGREEMENT
[ ]
[441
BUILDING AREA
[ 1
1451
LOCATION CONFORMS WITH
SITE PLAN
[ 1
[461
FINAL SITE GRADING
FILL / EXCAVATION MATERIAL
[ 1 [471
CONTRACTOR
MICHAEL W STUHR(ASHTO
[ 1 [221 FILL AMOUNT
I 1 1481
OTHER
MINERAL AGGREGATE
[ 1 [231 FILL TEXTURE
[ 1 [241 EXCAVATION DEPTH
ABANDONMENT
[ 1 [251 AREA REPLACED
[ 1 (49]
TANK PUMPED
[ 1 [261 REPLACEMENT MATERIAL
[ 1 [503
TANK CRUSHED
s FILLED
Comments: Comments are on page 2.
/
t.Lucie CHD
DATE: 10/21/2019
CONSTRUCTION
I APPROVED
DISAPPROVED 1
nv ron tal Speclalistll Brian J ram (ENVIRONMENTAL HEALTH)
FINAL SYSTEM
[ APPROVED / DISAPPROVED ]:
ucle CHD
DATE: 11/15/2019
En ronmental Specialist II Brian J gram (ENVIRONMENTAL HEALTH)
(E�lanation of violation. an following page)
'
DH 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
AP1410674 EID346434
,
tr
Violation Number
Comments
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL
Comment
APPLICATION #:AP1410674
PERMIT #:56-SF-04595
DOCUMENT #:FI1354185
DATE PAID:04/25/2019
FEE RAID:350.00
RECEIPT #:56-PID-3912386
Existing tank information per DH4015 page 4.
Existing ST, filter, DT, and 46B sqft DF used. New 216 sgft, 12 ft wide 4 DL, 18 ft long DF extension added to end of DF. No
violations, system ok to cover. Contractor notified onsite. Needs final inspection for mound system and final site grading.
Final system approved. Contractor and building department emailed final approval.
DH 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 AP1410574 EID346434