HomeMy WebLinkAboutDOH PAPPERSAPPLICANT:
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FIN�ttPPROVAL
NNED
BY
ank St. L-uciP County
AGENT: Total Facility Services
PROPERTY ADDRESS: 5053 Turnpike Feeder Rd Fort Pierce, FL 34951
LOT: 10to13
BLOCK: 179
APPLICATION #.:AP1216174
PERMIT #:56-SF-1628822
DOCUMENT #:FI1059337
DATE PAID:12/10/2015
FEE PAID:515.00
RECEIPT #:56-PID-2859895
SUBDIVISION: Lakewood Park ID#: 130161602210000
CHECKED [X] ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED.
[
[
[
7
1
1
]
1
I
1
1
]
]
1
1
1
1
1
1
TANK. INSTALLATION
[01] TANK SIZE
[02] TANK MATERIAL
[031 OUTLET DEVICE
1041 MULTI -CHAMBERED [ Y N
[051 OUTLETS FILTER Polylok PL-122
1061 LEGEND 1. Unknown 2. Unknown
[071 WATERTIGHT
[081 LEVEL
[091 DEPTH TO LID
DRAINFIELD INSTALLATION
[101 AREA [1] 696
[111 DISTRIBUTION BOX
[121 NUMBER OF DRAINLINES
[131 DRAINLINE SEPARATION
[141 DRAINLINE SLOPE
[151 DEPTH OF COVER
[161 ELEVATION I ABOVE
[1-71 SYSTEM LOCATION
[181 DOSING PUMPS
[191 AGGREGATE SIZE
[201 AGGREGATE EXCESSIVE FINES
[211 AGGREGATES DEPTH
Ell 2000.00 [21 1050.00
Concrete
FILL / EXCAVATION MATERIAL
[ ] [221 FILL AMOUNT
[ 1 [231 FILL TEXTURE
[ 1 [24] EXCAVATION DEPTH
[ 1 [25] AREA REPLACED
[ 1 [261 REPLACEMENT MATERIAL
Comments: Comments are on page 2.
121 696 SQFT
HEADER X
1. 6.00 2.
/ BELOW ]BM 14.00
2:00
CONSTRUCTION I .APPROVED / DISAPPROVED]:
FINAL SYSTEM I ABHAOVED / DISAPPROVED ];
(Explanation of Violations on following page)
SETBACKS
[ ] [271 SURFACE WATER FT
[ ] [261 DITCHES FT
[ 1 [291 PRIVATE WELLS FT
[ 1 [301 PUBLIC WELLS FT
[ 1 [311 IRRIGATION WELLS 65 FT
[ ] 1321 POTABLE WATER FT
[ 1 [33] BUILDING FOUNDATIONS 10 FT
[ 1 [341 PROPERTY LINES 6 FT
[ ] [351 OTHER FT
FILLED / MOUND SYSTEM
[ ] [361 DRAINFIELD COVER
[ 1 [371 SHOULDERS
[ 1 [381 SLOPES
[ 1 [391 STABILIZATION 05/10/2016
ADDITIONAL INFORMATION
[ ] 1401 UNOB D
[ 1 [421 STD U
[ ] [42] ALARMS u ������njjjjjj_:N
[ 1 1431 MAINTENANCE AGREEMENT
[ 1. [44] BUILDING. AREA
[ ] [451 LOCATION CONFORMS WITH SITE PLAN
[. ] [461 FINAL SITE GRADING
[ 1 [471 CONTRACTOR Guillermo Diaz ( Castellar Plu
[ 1 [481 OTHER MINERAL AGGREGATE
ABANDONMENT
[ ] [491 TANK PUMPED
[ ] [501 TANK CRUSHED &.FILLED
St. Lucie CHD DATE: 03/24/2016
St. Lucie CHD DATE: 06/13/2016
DH 4016, 08/09 (Dbsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC Page 2 of 3
EH Database v 1.0.1 AP1216174 EID1628822
•
on
Violation Number
Comments
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL.
Comment
No violations, system ok to cover. Contractor notified onsite.
Needs final for filled system.
Contractor C& I Carlos Maldonado/ Rafael Guillermo Diaz certified plumbing contractor.
Engineer Rosa Baso
Existing ST and DT were within one tank size and were certified by KRK.
750:gal Grease Trap added.
Final tystem approved. Contractor emailed final approval.
APPLICATION s:AP1216174
PERMIT u:56-SF-1628822
DOCUMENT #:F11059337
DATE PAID:12/10/2015
FEE PAID:515.00
RECEIPT
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 AP1216174 EID1628822