HomeMy WebLinkAboutD.O.H. PAPPERWORK. STATE OF FLORIDA '
DEPARTMENT OF HEALTH 9Fc
ONSITE SEWAGE TREATMENT AND DISPAL
SYSTEM SCANNED °
QsnA6t�s` BY �GClPQIO OiD
St. Lucie County
CONSTRUCTION PERMIT FOR:
APPLICANT: (GEM Builde
PROPERTY ADDRESS: 131:
LOT: 21 BLOCK:
OSTDS New
SUBDIVISION: Lone
PERMIT #: S&SF-2006347,
APPLIOATIoN #:AP1447067
DATE PAID: _
FEE PAID:
RECEIPT #!
DOCUMENT #: PR1266899
PROPERTY ID #: 3409-505-0026-000-2 ISECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
[OR TAX ID NUMBER]
'SYSTEM MOST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION
3S1.0065, 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 Sentic new. CAPACITY
A [ I GALLONS / GPD N/A CAPACITY
N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [ I GALLONS DOSING TANK CAPACITY I ]GALLONS @.I ]DOSES PER 24 SHE #Pumps I
D -I.... 500 1 SQUARE FEET Dralnfield new SYSTEM
—R L I SQUARE FEET NIA` SYSTEM
A TYPE SYSTEM: I I STANDARD [ I FILLED [X] MOUND I I
I CONFIGURATION: IX]TRENCH I I BED,:: I I
N
F LOCATION OF BENCHMARK: Site BM; pink dayglow paint triangle, S•side of circle, elev 8.25
I ELEVATION OF PROPOSED SYSTEM SITE [ 8.00 1[:ZNM_0S FT ][ABOVE BELOW I BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 11.00II INCHE3 FT I ABOVE BELOW I BENCHMARK/REFERENCE POINT
L
D FILL.REQUIRED; [21.001 INCHES EXCAVATION. REQUIRED: r 8.00 1 INCHES
0
T
H
E
R
system is sized for 4 bedrooms with a maximum occupancy of 8 persons (2 per bedroom), for a total estimated flow of
gpd• \tea
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SPECIFICATIONS BY: Brian .T In TITLE:
_ y� _ Environmental Specialist II
APPROVED BY: TITLE: Environmental Specialist II St. Lucie CHD
Brian J Ia
DATE ISSUED: 10/16/2019 EXPIRATION DATE: 04/16/2021
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, PAC Page 1 of 3
v 1.1.4 AP1447067 SE1215823
STATE OF FLORIDA APPLICATION # AP1447067
DEPARTMENT OF HEALTH PERMIT # 56-SF-2006347
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
SITE EVALUATION AND SYSTEM SPECIFICATION DOCUMENT # SE1215823
APPLICANT: GEM Builders, Inc
CONTRACTOR / AGENT: Gem Builders, Inc
LOT: 21 BLOCK:
SUBDIVISION: Lone Pine ID#:
TO BE COMPLETED BY ENGINEER, HEALTH DEPARTMENT EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEERS MUST PROVIDE
REGISTRATION NUMBER AND SIGN AND SEAL BACH PACE OF SUBMITTAL. COMPLETE ALL ITEMS.
PROPERTY SIZE CONFORMS TO SITE PLAN: Ex ]YES I ]NO NET USABLE AREA AVAILABLE: 0.38 ACRES
TOTAL ESTIMATED SEWAGE FLOW: 400 GALLONS PER DAY [ RESIDENCES-TABOTHER-TABLE 2 ]
AUTHORIZED SEWAGE FLOW: 950.01 GALLONS PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE ]
UNOBSTRUCTED AREA AVAILABLE: 1335.00 SQFT UNOBSTRUCTED AREA REQUIRED: 1000.00 SQFT
BENCHMARK/REFERENCE POINT LOCATION: Site. BM, pink dayglow paint triangle, S side of Circle, elev 8.25
ELEVATION OF PROPOSED SYSTEM SITE 8.00 [[INCHES / FT I [IABOVE]/ BELOW I BENCHMARK/REFERENCE POINT
THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM TEE PROPOSED SYSTEM TO THE FOLLOWING FEATURES
SURFACE WATER: FT DITCEES/SWALES: FT NORMALLY WET: [ ]YES [X]NO
WELLS: PUBLIC: FT LIMITED USE: FT PRIVATE: FT NON -POTABLE: ET
BUILDING FOUNDATIONS: $ FT PROPERTY LINES: 5 FT POTABLE WATER LINES: 8 FT
SITE SUBJECT TO FREQUENT FLOODING? [ ]YES IX]NO 10 YEAR FLOODING? [ ]YES IX]NOI
10 YEAR FLOOD ELEVATION FOR SITE: FT L MSL / NGVD ] SITE ELEVATION: FT L MSL / NGVD
SOIL PROFILE INFORMATION SITE 1 SOIL PROFILE INFORMATION SITE 2
USDA SOIL SERIES:
Munsell #/Color
Texture
Depth
I OYR 52
Sandy Clay Loam
0 To 8
10YR 5/1
Fine Sand
8 To 29
1 OYR 6/1
Fine Sand
21 To 29
1 OYR 4/2
Fine Sand
29 To 34
1 OYR 32
Fine Sand
34 To 40
1 OYR 4/4
Fine Sand
40 To 53
10YR 42
Sandy Clay Loam
53 To 72
USDA SOIL SERIES:
Munsell #/Color
Texture
Depth
I OYR 42
Organic Soil
O To 6
I OYR 411
Fine Sand
6 To 9
1 OYR 5/1
Fine Sand
9 To 30
10YR 6/1
Fine Sand
23 To 34
1 OYR 42
Fine Sand
34 To 40
1 OYR 3/3
Fine Sand
40 To 52
10YR 413
Fine Sand
52 To 56
1 OYR 4/2
Sandy Clay Loam
56 To 72
OBSERVED WATER TABLE: 44.00 INCHES I ABOVE /piz;71I EXISTING GRADE TYPE: [ PERCHED / APPARENT ]
ESTIMATED WET SEASON WATER TABLE EIZMION: 21 INCHES [ ABOVE /F�L7= I EXISTING GRADE
HIGH WATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: IXIYES [ ]NO DEPTH: 21.00 INCHES
SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Fine Sand/0.80 DEPTH OF EXCAVATION: 8 INCHES
DRAINFIELD CONFIGURATION: [X ] TRENCH [ I BED [ ] OTHER (SPECIFY)
r REMARKS/ADDITIONAL CRITERIA
/T determined using USDA WSS and soil borings.
t611 stripping In 10YR5/1 matrix>10% with diffuse boundaries starting at 21" In SB1.
8" above SM. SB2 9" above BM.
SITE EVALUATED BY:
Ingram, Brian M110- nWronmental Specialist II) (ENVIRONMENTAL HEALTH)
OR 4015, 08/09 (Obsoletes previous editions which may not be used) Incorporated: 64E-6.001, SAC
AP1"7067 EID2006347
DATE: 10/14/2019
Page 3 of 4
v 1.0.2