HomeMy WebLinkAboutPROJECT INFORMATIONY rr. a u
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION T§SPECTTION AND FINAL APPROVALCANNED
O
R V 00
APPLICANT: Wildar Inc -1 pNo
AGENT: Darlene Or B
PROPERTY ADDRESS:
LOT:
2 0 10
ArPLxcamxoN #:AP1355173
PERMIT #:56-SF-1859709
DOCUMENT #:F11203155
DATE PAID:07/20/2018
FEE PAID:3I0.00
RECEIPT #:56-PID-3651673
3500 S US Hwy 1 Fort Pierce FL 34982 u•
BLOCK:
SUBDIVISION:
ID#: 2427-801 A037-000.4
CHECKED [X] ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR ROLE AND MOST BE CORRECTED.
TANK INSTALLATION
SETBACKS
[
]
[01]
TANK SIZE [1] 750.00 [2] 463.00
[
] I273
SURFACE WATER
FT
[
]
[02]
TANK MATERIAL Concrete
[
] [26]
DITCHES
FT
[
]
[03]
OUTLET DEVICE
[
] [29]
PRIVATE WELLS
FT
FT
[
]
[04]
MULTI-CBAMBERED [ Y N
[
] [30]
POHLIC WELLS
[
]
[OS]
OUTLET FILTER PDiylok PL-122
[
] [31]
IRRIGATION WELLS
FT
[
]
[06]
LEGEND 1. Unknown 2. 70-143-54SC4
[
] [32)
POTABLE WATER 100
FT
[
]
[07]
WATERTIGHT
[
] [33]
SIIILDING FOUNDATIONS 9
FT
[
]
[OB]
LEVEL
[
] [34]
PROPERTY LINES 94
FT
[
]
[09]
DEPTH TO LID
[
] [35]
OTHER
FT
DRAINFIELD INSTALLATION
FILLED / MOTRID SYSTEM
[
]
[30]
AREA [1] 840 [2] SQFT
[
] [361
DRAINFIELD COVER
[
]
[11]
DISTRIBUTION BOX _HEADER X
L
j I371
SHOULDERS
[
]
[12]
NUMBER OF DRAINLINES 1. 7.00 2.
I
1 I383
SLOPES
[
]
[13]
DRAINLINE SEPARATION
[
] [39]
STABILIZATION
'[
]
[14]
DRAINLINE SLOPE
[
]
[15]
DEPTH OF COVER
ADDITIONAL INFORMATION
[
]
[16]
ELEVATION [ ABOVE / HELON ]eM 19:00
[
] [40]
UNOBSTRUCTED AREA
[
]
[17]
SYSTEM LOCATION
[
] [41]
STORMWATER RUNOFF
[
]
[16]
DOSING PUMPS 1.00
[
] [42]
Ar.naenS
[
]
[19]
AGGREGATE SIZE
[
] [43]
MAINTENANCE AGREEMENT
I
]
[20]
AGGREGATE EXCESSIVE FINES
[
) [44]
SDILDING AREA
[
]
[21]
AGGREGATE DEPTH
I
7 L951
LOCATION CONFORMS WITH SITE PLAN
[
] [46]
FINAL SITE GRADING
FILL / EXCAVATION MATERIAL
[ ] I971
CONTRACTOR Dad Whiteside (Accurate Se
vi
[ ]
[22] FILL AMOUNT
[ ] [48]
OTHER INFILTRATOR Ouick4 E036 (single c
[ ]
[23] FILL TEXTURE
[ ]
[24] EXCAVATION DEPTH
ABANDONMENT
L 7
I257 AREA REPLACED
I 1 [491
TAKE PUMPED
[ ]
[26] REPr.nranmNT MATERIAL
[ ] [50]
TANK CRUSHED 6 FILLED
Comments: Comments are on page 2.
CONSTRUCTION L APPROVED / St. Lucie c� DATE: 08/17l2018
DISAPPROVED ] � Enviro ental Specialist II Br J ram (ENVIRONMENTAL HEALTH)
FINAL SYSTEM L APPROVED / DISAPPROVED ]: St. Lucie C8D DATE: 08/17/2018
Environmental Specialist If Brian gram (ENVIRONMENTAL HEALTH)
(Explanation of Violations on following page)
DE 4016, 08/09 (Obsolates all previous editions which may not be used)
Incorporated: 64E-6.003, FAC Page 2 0£ 3
EH Database v'1.0.1 Ap1355173 EID1959709
Violation Number
Comments
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL
Comment
APPLICATION #:AP1355173
PERMIT #:56-SF-1859709
DOCUMENT #:FI1203155
DATE PAID:07/20/2018
PEE PAID:310.00
RECEIPT #:56-PID-3651673
Existing tank Information per DH4015 page 4. Existing STs used. 2nd tank in series was a 483 gal Infiltrator. New 1200 gal
dosing tank installed legend (01-011-12DC3) The baffle had been removed. New PL122 outlet filter, liberty 1/3 hp pump, and 7x10
long DF installed. No violations, system ok to cover. Contractor notified onsite. No final inspection required. Final system
approved. Contractor, owner, and building department emailed final approval.
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, SAC Page 2 of 3
EH Database v 1.0.1 AP1355173 EID1959709
Mission:
To protect promote 3 improve the health
of all people in Florida through integrated
state, county 8 oanmunily efforts.
HEALY H
St. LLicie County
Rick Scott
Governor
Celeste Philip, MD, MPH
Surgeon General and Secretary
Vision; To belhe Healthlest Stale In the Na6M '
HAZARDOUS WASTE SCREENING Fee $10.00 (03/2018)
FOR A LOCAL BUSINESS TAX RECEIPT
DATE 41 k Location: 3855 S US 1 Hwy, Ste. A, Fort Pierce, FL 34982
PLEASE PRINT
BUSINESS NAME:
2. BUSINESS OWNEF
3. BUSINESS PHONE: �i �l vZ • 5 95- q t/-3 5
4. BUSINESS ADDRESS:,95_,90 S US 6(.114 F77Ple68- /z- 3v9yA
5. MAILING ADDRESS:
US , /coy l
6. NAME OF COMMERCIAUSHOPPING CENTER:
., .7. PROPERTYIPARCELID#:
8. BRIEF DESCRIPTION OF ACTIVITIES:
9. DOES THIS BUSINESS OPERATE AT ANY OTHER LOCATIONS OR BUIL91NGS IN THIS COUNTY
OTHER THAN AT THE BUSINESS ADDRESS LISTED ABOVE? OYES NO IF SO, WHAT LOCATION:
PLEASE CHECK THE FOLLOWING THAT APPLY TO THIS BUSINESS: (MUST BE COMPLETED FOR APPROVAL)
SEWAGE: D PUBLIC SEWER OR Y SEPTIC TANK WATER SYSTEM: k PUBLIC WATER OR DWELL
'A
DOES THIS BUSINESS GENERATE OR DISPOSE OF ANY OF THE FOLLOWING: PAINT PRODUCTS, SOLVENTS, BATTERIES, CLEANING
SOLVENTS, PESTICIDES, USED OILS, PETROLEUMS, OR OTHER HAZARDOUS WASTE? OYES k NO
DOES THE BUSINESS GENERATE AND / OR DISPOSE OF MEDICAL WASTE? 1" YES YNO
DOES BUSINESS CURRENTLY HAVE A LICENSED HAULER: U YES C NO RCN/A
I HEREBY AGREE THAT THE BUSINESS ABOVE WILL COMPLY WITH ALL FEDERAL, STATE AND LOCAL HAZARDOUS WASTE LAWS.
1)py I PA11 e- l 5-b n V I p✓v.Gu Ee,,[z. ,�Gca�T� rl� .
PRINT NAME (AGENT FOR THE ABOV E BUSINESS) SIGNATURE
HEALTH DEPARTMENT PERMIT REQUIRED7My 'IN
PERMIT NUMBER: IU'
Florida Department of Health -St Lucia County
Division of Disease Control and Health Protection
Bureau of Environmental Health
Location 3855 S US Highwayl Ste. A, Fort Pierce, FL 34982
Mailing 5150 NW Mllnor Drive, Port St Lucie, FL 34983
Phone 772-B73.4931
Fax 772-595.1306
FloridaHeallh.gov
JUL 2 0 2018
FDOH In St Lucle
Accredited Health Department
Public Health Accreditation Board
,Pv� lx/5