HomeMy WebLinkAboutDOH PAPPERSZfffi #:AP1202751
4" STATE OF FLORIDA PERMIT #:56-SF-1627782
DEPARTMENT OF HEALTH H
au jAPPLICATION
�l)qEi nocc>MENT #:FI1023572
ONSITE SEWAGE TREATMENT]AND DISPOSAL SYST
CONSTRUCTION INSPECTION AND FINAL APPROVAL DATE PAIn:2015
•ryooO we+��• FEE PAID:515.015.00
RECEIPT #:56-PID-2765806
APPLICANT: Margidc Asst, LLC
AGENT: DarrylTnpp
PROPERTY ADDRESS: 18001 Indno Rd Fort Pierce, FL 34945
LOT: BLOCK: SCANNED
BY
SUBDIVISION: ID#: 1213-321-001-000.0 St. LuciaCou*
CHECKED [X] ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED.
TANK INSTALLATION
SETBACKS
[
]
[01]
TANK SIZE [1] 1050.00 [2]
[
]
[27]
SURFACE WATER 78 FT
[
]
[02]
TANK MATERIAL Fiberglass
[
]
[261
DITCHES 78 FT
[
]
[03]
OUTLET DEVICE
[
]
[29]
PRIVATE WELLS 75 FT
[
]
[04]
MULTI -CHAMBERED [ Y N ]
[
]
[301
PUBLIC WELLS FT
[
]
[051
OUTLET FILTER Polylok PL-68
[
]
[31]
IRRIGATION WELLS FT
[
]
[061
LEGEND 1. 28-004-09DC4 2.
[
]
[32]
POTABLE WATER FT
[
]
[071
WATERTIGHT
[
]
[331
BUILDING FOUNDATIONS 9 FT
[
]
[081
LEVEL
[
]
[34]
PROPERTY LINES FT
[
]
[091
DEPTH TO LID
[
]
[351
OTHER FT
DRAINFIELD INSTALLATION
FILLED / MOUND SYSTEM
[
]
[101
AREA [i] 360 121 SQFT
[
]
[361
DRAINFIELD COVER
[
]
[1l]
DISTRIBUTION BOX HEADER x
[
]
[37]
SHOULDERS
[
]
[121
NUMBER OF DRAINLINES 1. 5.00 2.
[
]
1381
SLOPES
[
]
[131
DRAINLINE SEPARATION
[
]
1391
STABILIZATION 11/10/2015
[
]
[141
DRAINLINE SLOPE
[
]
[151
DEPTH OF COVER
ADDITIONAL INFORMATION
[
]
[161
ELEVATION [ ABOVE / BELOW ]HM 16.00
[
]
1401
UNOBSTRUCTED AREA
[
]
[171
SYSTEM LOCATION
[.
]
[411
STORMWATER RUNOFF
[
]
[181
DOSING PUMPS
[
]
[42]
ALARMS '
[
]
[19]
AGGREGATE SIZE
[
]
[431
MAINTENANCE AGREEMENT
[
]
[201
AGGREGATE EXCESSIVE FINES
[
]
1441
BUILDING AREA
[
]
1211
AGGREGATE DEPTH
[
]
1451
LOCATION CONFORMS WITH SITE PLAN
FILL / EXCAVATION MATERIAL
[
]
1461
FINAL SITE GRADING
[
]
1471
CONTRACTOR Raymond Kane.(Shorline Lin
[
]
[221
FILL AMOUNT
_ _ _— —_
-[48].
_OTHER.— ADS _MPS--9,(9.pipe,.-2_tler)__
[
]
[231
FILL TEXTURE
[
]
1241
EXCAVATION DEPTH
ABANDONMENT
[
]
[251
AREA REPLACED
[
]
[491
TANK PUMPED
[
]
1261
REPLACEMENT MATERIAL
[
]
[501
TANK CRUSHED 6 FILLED
Comments: Comments are on page 2.
/
St. Lucie CHI) DATE: 11/02/2015
CONSTRUCTION
[ APPROVED
DISAPPROVED ] Enithonmmental Special)
Brian J Ingam (ENVIRONMENTAL HEALTH)
FINAL
SYSTEM
[ APPROVED / DISAPPROVED ]; v '�
St. Lucie CHD DATE: 1/110/2015
nv-ETiionmnntal speecaiist
1
unan
i Ingisin
V11170WERTALTIMTH)
(Explanation of Violations on 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 v1.0.1 AP1202761
EID1627782
F
� zxa
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL.
ViolationNumber Comment
Comments
APPLICATION n.:AP1202751
PERMIT a:56-SF-1627782
DOCUMENT x:F11023572
DATE PAID:08/31/2015
FEE PAID:515.00
RECEIPT a:56-PID-2765806
No violations, system ok to cover.. Contractor notified onsite. Contractor emailed construction approval.
NEEDS FINAL FOR STABILIZATION.
Final construction 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 v1.0.1 AP1202751 EI01627762