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Home My WebLink AboutDOH PAPPERSSTATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION INSPECTION AND FINAL APPROVAL SCANNED RECEIPT 8:56-PID-2867286 BY APPLICANT: Thomas & Sindy Cyril St I I Iciq Ggunt AGENT: Jason Hans (All About Septic Services) PROPERTY ADDRESS: 1107 S 33rd St Fort Pierce, FL 34950 APPLICATION II AP1217581 PERMIT 0:56-SF-1649961 DOCUMENT N:F11037922 DATE PAID:12/21/2015 FEE PAID-315.00 LOT: BIRCH: SUBDMSION: ID$: 2417.214-0007.000.2 CRECRED [X1 ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED. TANK INSTALLATION loll TANK SIZE [1] 1350.00 [21 483.00 1021 TANK MATERIAL Fiberglass 1031 OUTLET DEVICE 1041 MULTI -CHAMBERED [LYy N 1 1051 OUTLET FILTER Polylok PL-68 [061 LEGEND 1. 28-004-17DC4 2. 70-143-54SC4 [071 WATERTIGHT [091 LEVEL 1091 DEPTH TO LID DRAINFIELD INSTALLATION 1103 AREA [1] 871.64 [21 SOFT (11] DISTRIBUTION BOX _ HEADER X 1123 NUMBER OF DRAINLINE3 1. 8.00 2. (131 DRAINLINE SEPARATION [141 DRAINLINE SLOPE [151 DEPTH OF COVER SETBACKS [ 1 [271 SURFACE WATER FT [ 1 [281 DITCHES FT [ 1 1291 PRIVATE WELLS 75 FT [ 1 [301 PUBLIC WELLS FT [ 1 [311 IRRIGATION WELLS FT [ ] [321 POTABLE WATER 10 FT ( 1 [331 BUILDING FOUNDATIONS 3 FT I 1 (341 PROPERTY LINES 5 FT [ 1 [351 OTHER FT FILLED / MOUND SYSTEM [ 1 [361 DRAINFIRLD COVER [ 1 [37] SHOULDERS [ 1 [381 SLOPES [ 1 [391 STABILIZATION 1161 ELEVATION [ ABOVE / Fmmov133M 10.00 [ 1 (171 SYSTEM LOCATION [ I 118] DOSING PUMPS 1.00 [ 1 [191 AGGREGATE SIZE I 1 (201 AGGREGATE EXCESSIVE FINES I 1 1211 AGGREGATE DEPTH I 1 [ 1 ADDITIONAL INPORMATION [401 UNOBSTRUCTED AREA 1411 STOP14HATER RUNOFF [421 ALARMS [431 MAINTENANCE AGREEMENT [441 BUILDING AREA [451 LOCATION CONFORMS WITH SITE PLAN [461 FINAL SITE GRADING FILL / EXCAVATION MATERIAL [ 1 1221 FILL AMOUNT [ 1 (471 CONTRACTOR Jason Harris (All About Sept [ 1 1231 FILL TEXTURE [ 1' [481 OTHER INFILTRATOR Quick4 Plus EQ36 LP ( 1 [241 EXCAVATION DEPTH ABANDONMENT [ 1 [251 AREA REPLACED [ 1 [491 TANK PULPED 03/03/2016 [ 1 [261 REPLACEMENT MATERIAL [ 1 [501 TANK CRUSHED 6 FILLED 03/03/2016 Comments: Comments are on page 2. CONSTRUCTION I APPROVED St Lucie CHU DATE: 03/03/2016 DISAPPROVED 1 % Env/panmental 8pportaat I OHM J Ingnm (ENWRONMENTAL HEALTH) SINAL BYSTEM [ APPROVED / DISAPPROVED ]: / -C/!/I SL LUCIe CHD DATE: 03/03/2016 v mnmen pec a an ngnm TH) (Explanation of Violations on following page) DH 4016, 08/09 (Obsolete® all previous editions which may not be used) Incorporated: 64E-6.003, PAC ge 2 of 3 EH Database v1.0.1 AP1217681 E101649961 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SE1ta►GE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION INSPECTION AND FINAL APPROVAL Violation Number Comment Cemmanta 1050 Grease Trap installed, SST 1050. 28-015-01DC4 concrete No violations, system ok to cover. Contractor notified onsite. No final inspection needed. Final system approved. Contractor emailed final approval. APPLICATIoN n:AP1217581 PsMaT a:56-SF-1649961 DOCIMENT e:F11037922 DATE PAID:12/21/2015 M PAID:315.00 RECEIPT #:56-PID-2867286 DH 4016, 08/09 (Obsoletee all previous editions which may not be used) Incorporated: 64E-6.003, EWC Page 2 of 3 EH Database v 1.0.1 AP1217581 EID1649961 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEK CONSTRUCTION PERMIT CONSTRUCTION PERMIT FOR: OSMS Repair APPLICANT: Thomas & Bindy Cyril PROPERTY ADDRESS: 1107 S 33rd St Fort Pierce, FL 34950 LOT: BLOCK: SUBDIVISION: PROPERTY ID @: 2417-214-0007-000-2 PERMIT @:66-SF-1649961 APPLICATION x:AP1217581 DATE PAID: FEE PAID: RECEIPT #♦: DOCUMENT #: PR1002022 [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 [ 1,350 1 GALLONS / GPD Septic CAPACITY A I O 1 GALLONS /, GPD CAPACITY N [ 750 1 GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS] K ( 1 GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS @Pumps [ ] D [ 867 1 SQUARE FEET SYSTEM R [ 0 ] SQUARE FEET SYSTEM A TYPE SYSTEM: [x] STANDARp- [ ] FILLED I ] MOUND [ ] I CONFIGURATION: I I TRENCH' [x] HED. r ] N F LOCATION OF BENCHMARK: orange spot on building slab N side of building I ELEVATION OF PROPOSED SYSTEM SITE E BOTTOM OF DRAINFIELD TO BE L D I 0 T H E R [ 3.00 11INCHES FT I[JAB= BELOW] BENCHMARK/REFERENCE POINT C 13.001[ INCHES FT I[ABOVE BELOW BENCHMARK/REFERENCE POINT I" a Sluincu: L L.UU 1 11 U=* aµe+ve..iva. uy„a an..: L � Required drainfield area based on rule 64E-6.015(6)(d)2.b. Install a new dralnfield to achieve Drainfield size requirement. The licensed contractor installing the system is responsible for Installing the minimum category of tank in accordance with s. 64E-6.013(3)(f), FAC. Have the tank abandoned in accordance with the following procedures:(a) The tank shall be pumped out.(b) The bottom of the tank shall be opened or ruptured, or the entire tank collapsed so as to prevent the tank from retaining water, and(c) The tank shall be filled with dean sand or other suitable material, and completely covered with soil. (Comments SPECIFICATIONS BY: Brian J Ingram TITLE: Environmental Specialist I APPROVED BY: ' TITLE: Environmental Specialist I St. Lucia CHU Heise d Ia sm DATE ISSUED: 01/25/2016 EXPIRATION DATE: 04/2412016 DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC Page 1 oYv v 1.1.4 AP1217581 SE960619 uocvrnerr N: PR1002022 the system Inspected by the health department after it has been pumped and ruptured but before it is filled with sand and i must be abandoned in conjunction with new system Installed to avoid reinspection fees OBTAIN AN IM OPERATING PERMIT BEFORE FINAL APPROVAL. 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 # A02, Tallahassee, Florida 32399-1703. The Agency Clerk's facsimile number is 850-410-1448. Mediation is not available as an aftemative 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 Tinal 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. at. Lucie County Health Department 5150 NW Milner Dr Port Saint Lucie, FL 34983 PAYING ON: PERMIT*.56-SF-1649961 BILL DOCm56-BID-2999567 CONSTRUCTION APPUCATION#.AP1217501 RECEIVED FROM: All About Septic Services AMOUNT PAID: $ 315.00 PAYMENT FORM: CREDIT CARD PAYMENT DATE: 12/21/2016 MAIL TO: Thomas & Blndy Cyril FACILITY NAME: _ PROPERTY LOCATION: 1107 S 33rd St Fort Pierce, FL 34950 Lot: Block: Property ID: 2417-214-0007-Ooa2 EXPLANATION or DESCRIPTION: QUANTITY FEE 124 - OSTDS Construction Repair or Mod Site Evaluation bWa 1�341 IS- 1 $ 115.00 127 - OSTDS Construction System Inspection 1 $ 75.00 129 - OSTDS Construction Permit (Repair) 1 $ 55.00 130 - OSTDS Construction System Inspection Training Cent 1 $ 5.00 131 - OSTDS Construction Application & Existing System E 1 $ 50.00 -1 - Surcharge (All) 1 $ 15.00 RECEIVED BY: WhichamJL AUDIT CONTROL NO. 56-PID-2867286 STATE OF FLORIDA APPLICATION M Ap1217581 DEPARTMENT OF HEALTH PERMIT 8 56-SF-1649961 ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM DOCUMENT t) SE980819 SITE EVALUATION AND SYSTEM SPECIFICATION APPLICANT: Thomas & Bindy Cyril CONTRACTOR / AGENT: All About Septic Services LOT: BLOCK: SUBDMSION: IDW: 2417-214-0007-000-2 TO BE COMPLETED By ENGINEER, BRALTH DEPARTMENT EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEERS MU87 PROVIDE REGISTRATION NUMBER AND HIGH AND HEAL EACH PAGE OF SUBMITTAL, COMPLETE ALL ITEMS PROPERTY SIZE CONFORMS TO SITE PLAN: [X ]YES [ ]NO NET USABLE AREA AVAILABLE: 0.37 ACRES TOTAL ESTIMATED SEWAGE FLAW: 520 GALLONS PER DAY [ RESIDENCES—TABLEI / OTHER —TABLE 2 ] AUTHORIZED SEWAGE FLOW: 924.00 GALLONS PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE I UNOBSTRUCTED AREA AVAILABLE: 1400.00 SQFT UNOBSTRUCTED AREA REQUIRED: 1300.00 SQFT BENCHIARRK/REFEREHCE POINT LOCATION: orange spot on building slab N ELEVATION OF PROPOSED SYSTEM BITE 3.00 I F,NCHE9 / FT ] BELOW ] BENCSIO. /REFERENCE POINT THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES SURFACE WATER: FT DITCHES/SHALES: ET NORMALLY WET: [ ]YES [XINO WELLS: PUBLIC: FT LIMITED USE: FT PRIVATE: FT NON —POTABLE: FT BUILDING FOUNDATIONS: 5 FT PROPERTY LINES: 5 FT POTABLE WATER LINES: 10 FT SITE SUBJECT TO FREQUENT FLOODING? I ]YES EX ]NO 10 YEAR FLOODING? [ ]YES [X]NOI 10 YEAR FLOOD ELEVATION FOR SITE: FT MSL / NGVD ] SITE ELEVATION: FT [ MSL / NGVD SOIL PROFILE INFORMATION RTTF. 1 USDA SOIL SERIES:Pepper aand MunsellAfColor Texture Depth 10YR 311 Sand O TO 13 10YR 4/1 Sand 13 To 24 10YR 511 Sand 24 To 34 10YR 6/1 - Sand 34 To 45 1OYR 211 SpodioMatedal 45To49 10YR 22 Sand 49 To 59 IGYR 313 Sand 59 To 62 1 OYR 513 Sand 62 To 66 10YR 62 Loamy Sand 66 To 72 SOIL PROFILE INFORMATION RTTR 7 USDA SOIL SERIES:Popper eamd MunselllNColor Texture Depth I OYR 311 Sand 0 To 13 10YR 4/1 Sand 13 To 24 10YR 5/1 Sand 24 To 34 1 OYR 6/1 Sand 34 To 45 1 OYR 211 Spodic Material 45 To 49 IOYR 22 Sand 49 To 59 10YR 3/3 Sand 59 To 62 10YR 513 Sand 62 To 66 t OYR 62 Loamy Sand 66 To 72 EX'[8TING GRADE PE TYPE: [ RCHED / APPARENT ] OBSERVED WATER TABLE: 54.00 INCHES [ ABOVE /] ESTIMATED WET SEASON WATER TABLE ELEVATION: 22 INC HIGH WATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: INCHES [X]YES [ ]NO DEPTH: 22.00 INCHES SOIL TEXTURE/LCADING RATE FOR SYSTEM SIZING: Sand/0.60 DEPTH OF EXCAVATION: INCHES DRAINFIELD CONFIGURATION: [ I TRENCH [XI BED I I OTHER (SPECIFY) REMARKS/ADDITIONAL CRITERIA WSWT determined by using USDA WSS and soil borings. 10YR611 Stripping In 10YR411 matrix at 22" SBt and S82 3" above SM SITE EVALUATED BY: DATE: 12/29/2015 Ingram, Van (Tina: Emdmnmental Speelallet I) (ENVIRONMENTAL HEALTH) DE 4015, 08/09 (Oysolates piwicus editions which may not be used) Iacozporated: 649.6.001, rAC Page 3 of 4 AP1217631 EIDIS49961 V 1.0.2 K 4�STATE OF FLORIDA '�'ONSITE SEWAGE TFZJLTMSNT AM DISPOSAL jai•• +SYSTEM APPLICATION FOR CCMSrv,�UAP.10T- 9FCATION FOR: NOW System Repair APPLICANT: [ ] Existing System [ ] Abandonment V Rld T NO.Sice 91ceI DAM PAID: FEE PAID: RECEIPT #: [ ] Holding Tact [ ] Innovative [ ] Temporary ( ] TO HE P.CMIXTED By APPLICANT OR APPLICANT'S AUTHORIZED AGENT. SYSTEMS MUST 88 CONSTRUCTED BY A PERSON LICENSED PURSUANT TO 489.105(3)(a) OR 489.552, FLORIDA. STATUTES. IT IS TE APPLICANT'S RESPONSXBIISRr TO PROVIDE noccbffimA19mm OF TEE DATE THE LOT WAS CREATED OR PLATTED O!®i/DD/Yr) IF REQUESTING CONSIDERATION OF STATUTORY GRANDFATHER PROVISIONS. LOT: BLOCK: SUSDIVISION: PLATTED: '1 ' o- 1IS PROPERTY ID $:a�1 1^011�• VW 7`VW A ZONING: 1. G I/M OR EQUIVALENT: [ Y / N 3 PROPERTY SIZE: 13 ACRES WATER SUPPLY: [ ] PRIw= PUBLIC [ )-2000GPD [ 1>2000GPD IS SZ1M AVAIIABM A8 PER 382.0065, `FS?��[ ``Y / N ] nJ� (D}ISTANC��E(( TO SEWER: FT PROPERTr ADDRESS: 110� S. SSCA 4:4. . � YI�P/1Ce. �. �(igso DIRECTIONS TO PROPERTY: n BUILDING xurcRbamoN [ ] RESIDENTIAL 1>0 COMMERCIAL Unit Type of No. of Building ComnarC al/Institutional System Design No Establishment Sedr0om8 Area haft Table 1, Chapter 64E-6, FAC 1 1L$6 35 y00 9�c/ 2 Other (Specify) ot DATE: / DH 4015, 08109 (Cb6cletez pzavlous editions which may not be used) Incorporated 64$-6.001, FAC Page 1 of 4 6G c�1AlS „S)L Q � St Lucie County Health Department Environmental Health Division ( / Site Plan Approved for Construction VSupersedes All previous Site plans for D Date. 1 2--S6_(0 6t S WeD #�� Date: I ?.S /G C\ eviewer. nn` !/ f) -7 c 25Z 9" ^rya attr}L.' V SPIMME • - _ • • t• E,r ONSITS ^Mq` TRMMUCHT MID DISPOSAM SWTUt-im, tarn: ySITS E7ALUXTION AM SySTM4• APPLICANT: PER,.m. 0. SC-SRI b y LOT: BLOCK: SUBDIVISION: - PROPERTY ID # ��.. ��^ 1^QdU [Section/Township/Parcel No. or Tax ID Number] TO BE•COMPLETSD BY -ENGINEER, SEALTB DEPARTEMENT EM'PL0YEE,OR OTHER QUALIv*RD PERSON. ENanWEERS MOST PROVIDE REGISTRATION NUMBER AND SIGN AND SEAL EACH PAG'B OF SUMaTTAL. COMPLETE ALL ITEMS. PROPERTY SIZE CONFORMS TO SITE PLAN• Epp-aES [ ] No NET USABLE 43m- p, TOTAL ESTIMATED EEFLOW &"yO6J:_ GALLONB PER DAY 8 S- AUTHORIZED SEWAGE FLOP' GALLONS PER DAY MOO GPO/ACC OUNOBSTRCTCTED AREA A�TT.anT�`. 2 SQFT UNOBSTRUCTED AREA REQUIRESOFT BENCHMARK/REFERENCE POINT LOCATION: ELEVATION Or PROPOSED SYSTEM SITE I TER tdxNn4m4 AR FT TCEEs � POSED SYSTEM TO WET FOLLOWING YES u BUILDING FOUNDATIONS: FT PROPERTY L S:pR HT PpTA T NCR I,g1Eg:E�� FT �///�kk SITS SUBaRcT TO FREQUENT FLOODING: ] YES f�Y\NO 10 YEAR VZOODMG 7 YES Ova, 10 YEAR STMOD m.MoammnN FUR SITE: 8T /NGOD SITE ET-acraTRON: PT MSL/N t� USDA SOIL SERIES: vU : [A A•• •' Y' '�'•1" USDA SOIL SERIES: OBSERVED VULEER TABLE: INCHES (ABOVE / BELOW] EXISTING GRADE. TYPE: CPSRCUND / APPARENT] ESTIMATED WET SEASON WATER TABLE ET-EVIMON: INCBES CABOVE / BELOW] EHISTIHG GRADE UGH WAM VE(mmTION: C 1 YES C ] NO MOTTLING; [ ] YES [ ] NO DEPTH: INCHES s02L'TSRwm/L0ADING RATS &OR SYSTEM SIZING: DEPTH OF EXCAVATION: INCHEs DEthINEIELD CONFIGURATION: C ] TRENCH [ ] BBD [ ] OTHER (SPECIFY) PJR0MRS/ADDITIONAL CRITEo33• as 401S, 08/OB (0b—ln lasvdfova cditi.onv .mica n�w m be yuep.) In=q w ted: 04E8.0(n..FAC �� . VGV® 3 of 4 ,•,•.YY�; 4tC I LOT: SUBDIV: PREMIT # SG-SC-Iby9f4f Fi.?:110 ff ✓T47✓A = ToBEN•` 1' : Y:. r By Frm= Emrxsmm ENGINEER,DEPARnam C, I• • I:{: SEPTIC C ' 1CMM=Tm • " OTHER CERTIFIEDI• cl: C•R• I UHr •• •I.I:A •• 1• Y: _ ITEM. •.•".P : Y: Va ICERTIFICATION-•'v h• OR • V: IN '1:A M " {C I:Y :L 'V' IS CANNOT BE CERTIMD. y� GALLONS SEPTIC J' I I AM LEGEND: Y:A- �� 1i; BAFFLED:c C%UJMS SEPTIC TAHK/GPD ATU LEGEND: YC ' :ir N3"J I: __-V: Y:G .Ar 1. .d't' II 1•q• ON /1l,�'LI�G _-_.— HFLVE .1' • • I: I>. 1:I •' YC/'+..0 1: r C I I.I: NFILLING: LEGEND 'L 'CiE OF •::1:{• DEFECTS N- 1 U " • I• II: •! I : M: • I4Y C • YC • M: I L{I •�i i • Y" C r IP1' • Zap' ' : I CONTRACTOR •I' I : I I: 1. I: m=Tnm DRAnanam INFORMATION C 2,007 SgaM FEET PRng= DRAINBIELD SYSTEM NO. OF TRENCHES I 7 DIMENSIONS: I 7 SQU7M FEET SYSTEM NO. OF TRENCHES ( 7 DDMNSIONS: 8 TYPE OF SYSTEM: [�-1-S2ANDARD 17 FILLED C 7 MOUND C 7 ' CONFIGURATION: I 7 TRENCH PII-BED - E 7 DESIGN: [ ] HEADER E-4hD- 7 GRAVITY SYSTEM I 7 DOSED SYSTEM ELEVATION OF BOTTOM OF DRAINFIELD IN RELATION Tnm GRADE .ODID INCHRS [ ABOVE / BELOW] SYSTEM FAILMM AND REPAIR nary MA'mN I 7 SYSTEM INSTALLATION DATE TYPE OF WASTE I 7 DOAII:STIC I pillCOHbwmCIAL [ 4 V ,n v I GPD ESTIMMW SEf1 M FLOW BASED ON I 7 .METERED WATER (./4, TABLE 1, 64E-6, FAC SITE I ] DRAINAGE STRUCTURES I 7 POOL CONDITIONS: [ ] sL)PII3G PROPERTY I 7 -NATURE OF I I HYDRAULIC OVERLDAD FAILURE: I 7 DRAnvaz / Rum OFF c 'i c •; n r I N'u I 7 PATIO / DECK I 7 PARKING C 7 sons I 7 bV-UlTMVaXX I 7 ROOTS [ 7 SLATER TABLE I l SYSTEM DAMAGE [ 7 SUBMITTED BY: If •riutsi+++a:cn� .� ti •� • W `� 1 DH 4015, 08/09 (O o.etes previous editions which mw not be used) Incorporated GALE- 01, FAC Page of 4