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HomeMy WebLinkAboutONSITE SEWAGE TREATMENT & DISPOSABLE SYSTEMLOT: BLOCK: SUBDIVISION: PROPERTY ID # 2308-133-0001-000-7 me 0r 4von�n� [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER] [OR TAR 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 [ 4,800 ] GALLONS / GPD Septic Existina CAPACITY A [ 0 ] GALLONS / GPD CAPACITY N [ 0 ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS] K [ 900 ] GALLONS DOSING TANK CAPACITY [133.32 ]GALLONS @[ 6 ]DOSES PER 24 Has #Pumps [ 2 ] D [ 667 ] SQUARE FEET Drainfield New SYSTEM R[ 667 ] SQUARE FEET Drainfeld New SYSTEM A TYPE SYSTEM: [ ] STANDARD [ ] FILLED [X] MOUND I CONFIGURATION: [ ] TRENCH [X] BED [ ] N F LOCATION OF BENCHMARK: Orange Spot on NE Corner of Shed Foundation I ELEVATION OF PROPOSED SYSTEM SITE [ 10.001 INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 10.00][ INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT L 0 T H E R .[ ] ILL REQUIRED: [lts.UU] INCHES EXCAVATION REQUIRED: [ ] INCHES Each pump serves 1/2 of required absorption area pumps to dose alternately. Pumps must be certified as suitable for distributing sewage effluent. System must have a minimum 10 foot separation between the sidewalls of adjacent absorption beds. APPROVED BY: BY: MICHAEL S�TTU'H"R� TITLE: TITLE: Environmental Supervisor I Dianna S Ha DATE ISSUED: 03/01/2019 DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC St. Lucie CED EXPIRATION DATE: • 05/30/2019 Page 1 of 3 I t':: , 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 A-02, Tallahassee, Florida 32399. The Agency Clerk's facsimile number is 850-413-8743. Mediation is not available as an alternative 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 'final 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. St. Lucie County Health Department �F1Oia 5150 NW Milner Dr Port Saint Lucie, FL 34983 HEALTH PAYING ON: u:56-SF-1780307 BILL Doc #:56-BID-4089036 CONSTRUCTION APPLICATION 0: AP1400798 RECEIVED FROM: ASHTON SEPTIC TANKS, INC. AMOUNT PAID: $ 200.00 PAYMENT FORM: CREDIT CARD PAYMENT DATE: 02/28/2019 MAIL TO: (Orange Avenue Baptist Church Inc) FACILITY NAME: PROPERTY LOCATION: 100 Cyclone Dr Fort Pierce, FL 34945 Lot: Property ID: 2308-133-0001-000-7 EXPLANATION or DESCRIPTION: Block: 130 - OSTDS Construction System Inspection Training Cent 127 - OSTDS Construction System Inspection 129 - OSTDS Construction Permit (Repair) 131 - OSTDS Construction Application & Existing System E -1 - Surcharge (All) QUANTITY FEE 1 $ 5.00 1 $ 75.00 1 $ 55.00 1 $ 50.00 1 $ 15.00 RECEIVED BY: MontanezNM AUDIT CONTROL NO. 56-PID-3867128 ay�'5i 'tag'+c-,� Fps � �t sTa?'E ().H .N 3t()R:DA "e ) 0."M!M1MEi�i' OP' 3''Y��V'H Via' OLNSITE SEuuzCla T r �r`'�x�I SYST • �= t�_v�i �35P05�� r N.W APPLICATION FOR: 8 y9tem C ] Existing System I 1 Recai r [ ] Abandonment I ] Holding Taul- C 1 Temporary APPLICANT: O r VAa ^ _ [A. '�) 1 ' GENT: MP_ILING ADDRESS: PERMIT N0. DATE PAID: JlJ FEE PAID: RECEIPT 0: aliltocl CI Innovative C ] TELEPHONE: Zl(e- q8 Z TO HE COMPLETED BY APPLICANT------------ __ EY A PERSON OR pnnLICADIT'S AUTHORIZED AGENT. SYSTEMS MUST BE anoL2��,,, �I oNSED PURSiT_ANT TO 489.105 (3) (m) OR 489.552, FLORIDANSTRUCTED S RESPONSIBILITY TO PROVIDE DOC�NT_aTION p_ .m T,ORID__ STATIITES. IT IS THE PLATTED (MM/DD/YY) IF REOLE mr_ _ IM DATE THE S_ NC CONSIDEAATIODI OF STATUTORYLOT WA3 CREs�mS. OR C-AarJDgaT�R ?R041SSON5. PROPERTY INn ORMkTION — —__ LOT: BLOCK: SUED VISION: p /7 or_ .amED: PROPERTY XD F" :23�$ "f 33 _r�r�n�`�Q� —� ZONING: 1 I/M OR EOUIV_nyglym: [ Y / N ] PROPERTY SIZE: L% ACRES WATER SUPPLY: n C 7 RIVATE PUBLIC [ ]<=2000C-PD f ]>2000C-PD IS SEWEER AvAIL_a_BI,„, AS PER 381.000'S, Fg? /� I Y / rI ] DISTANCE TO SEWER: FT PROPERTY AD DRESlam'S: IDO don Lo lDY DIRECTIONS To PROPERTY: h©p Ucjone •Dv BUILDING INFORMATION C I RESIDEDITT-AL C I COMNERC-TAL Unit T_epe os No No. o= Building Co i Y Establishnent g mmerci a_/Institutional Sys- Design Bedrooms A=ea Scat Table I Chapter 64E-6 K C 9 i 2 1J 4'Ci 3 JL601 4 C ] Floor/Eau+anent Drains 9 S T_GNATURE: �J lt�t�r,r�7��yXy� to 1-4-1 Pf y C ] Other (Specify) DE 4015 / 08 9 Obsoletes previous editions which may not be used) -nco=morate 64E-6.001, rA0 DATE: 2, ( 3 I l 9 -Page .l o= d 0��e'��.� STATE OF FLORIDA '` ` DEPARTMENT OF HEALTH S � t' ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM . SITE EVALUATION AND SYSTEM SPECIFICATIONS PERMIT #. [1,%030 ) APPLICANT: Orange Ave Baptist Church AGENT: Ashton Septic Tanks LOT: N/A BLOCK: N/A SUBDIVISION: N/A PROPERTY ID #: 2308-133-0001-000-7 1Tax IDNumber ] TO BE COMPLETED BY ENGINEER, HEALTH DEPARTMENT EMPLOYEE,OR OTHER QUALIFIED PERSON. ENGINEERS MUST PROVIDE REGISTRATION NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS. PROPERTY SIZE CONFORMS TO SITE PLAN: [✓] YES [ ] NO NET USABLE AREA AVAILABLE: 4.60 ACRES TOTAL ESTIMATED SEWAGE FLOW: 800 GALLONS PER DAY [RESIDENCES -TABLET ] AUTHORIZED SEWAGE FLOW: 6900 GALLONS PER DAY [1500GPD/ACRE ] UNOBSTRUCTED AREA AVAILABLE: 2500 SQFT UNOBSTRUCTED AREA REQUIRED: 2000 SQFT BENCHMARK/REFERENCE POINT LOCATION: Orange Spot On NE Comcr of Shed Foundation ELEVATION OF PROPOSED SYSTEM SITE IS10 [INCHES ] [BELOW ] BENCHMARK/REFERENCE POINT THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES SURFACE WATER: N/A FT DITCHES/SWALES: 20 FT NORMALLY WET? [ I YES I✓] NO WELLS: PUBLIC: 200+ FT LIMITED USE: N/A FT PRIVATE: 115 FT NON -POTABLE: N/A FT BUILDING FOUNDATIONS: 50 FT PROPERTY LINES:10 FT POTABLE WATER LINES: 50 FT SITE SUBJECT TO FREQUENT FLOODING: [ ] YES [✓I NO 10 YEAR FLOODING? I ] YES I✓] NO 10 YEAR FLOOD ELEVATION FOR SITE: N/A FT MSL/NGVD SITE ELEVATION: N/A FT MSL/NGVD 36 TO 72 TO TO TO USDA SOIL SERIES: Pineda 1T W1. A DEPTH 0 TO 8 8 TO 14 14 To 23 23 TO 30 30 To 36 36 To 72 TO TO TO USDA SOIL SERIES: Pineda OBSERVED WATER TABLE:36 INCHES [BELOW '] EXISTING GRADE. TYPE:[PERCBED ] ESTIMATED WET SEASON WATER TABLE ELEVATION:12 INCHES [.BELOW ] EXISTING GRADE HIGH WATER TABLE VEGETATION: [ ] YES [✓] NO MOTTLING: [✓] YES [ ] NO DEPTH:12 INCHES SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: SAND DEPTH OF EXCAVATION:N/A INCHES DRAINFIELD CONFIGURATION: [ ] TRENCH [✓] BED I ] OTHER (SPECIFY) _ REMARKS/ADDITIONAL CRITERIA: SB1= -10" BELOW BM S132= -10" BELOW BM STRIPPING FROM 10 YR 4/1 TO 511 GREATER THAN 10%AT 12" IN THE SOIL MATRIX a SITE EVALUATED BY: DH 4015, 08/09 (Obsoletei Previous editions which may not be used) Incorporated: 64E-6.001, FAC 22 Page 3 of 4 STATE OF FLOR=a DERARTMENl OF lar-ZLTH ONS_TTE SEFACM TREAD' ENT AND DISPOSAT SYSTEM . E.`.USTING SYSTEM -AND SYSTEM REP-TR E-v - U-AT_ON r PERMIT a 1-1$63o-i - APPLICANT: _ _ U Ir go- ft liff K,4a 1 S i u i cl Co � CONTRACTOR / AGENT: J I l I V • l moo / C, -'��O ,L I LOT: BLOCK: U X s-,,Bb--,v-3 3 O.Oa I TO BE COMPLETED BY FLO-RIDB REGISTERED ENGINEER, DEPAM%ENT- FMPLOYEE, SEPTIC M CON-TR$CTOR I OT_*IZR CERTIFIED PERSON. SIGN AND SEA' a-r -�- OR 1+ 1�� SUBMITTED DOCUMENTS. COMPLETE PTrT APVLICaR?,E ITEM COMPLETE TP_NK CERTIFIC-ATION BELOT-T OR NOTE IN REWRFSS WdY THE TPIGAS CR1v7vO�r BE C� m_�r " - ' R-Tx _.D - -E SSTTNG TANK-INFORMa-TiON CATZONS SEPTIC 0mlN{/GPD A-Q-LEC-END: *ramgRZAL: 3��'F LED: / I ] EkLLONS SEPTIC TA1vZC/C-PD ASQ LEGEND:�'ERI_ATa:, EaFFT�ED: '=Tj [Y / C 7 EATLORS CRREASE INTERCEPTOR LEGEND: I&A-TERTa-L: C 1 E=ONS DOSING _aNFC LTEGENTD: iramERT-ZL- 0 PUPS: j ] I CERTIFY TH-kT THE LISTED ZAN-KS WERE PUMPED ON / / BY THE VOLUMES SPECIFIED AS DETERMINED BY C DINIENST_ONS / FILLING /_LE.C-E?GD 1, ARE FREE �7^ OF OBSERVABLE DEFB' T OR LEAKS, a�1�B._k4�,• a [ SOLIDS F'LECTION DE CE -/ OQTLEm F_LTER DEVICE. I aOBS ] NS:...�nD. �L9dce�.D W' SJ AAI,-- I'I ^•+�a_ LC � 1 Sf(tl! S=G rp'-QRE QF LICENSED CONTRACTOR M:.IE 1� EiTSTING ORASI=ID I zORNmTioN C (pR�(Q / 1 SQUArE BEET PRL�iaRY DR -A ?NF-Eix) SYSTEM NO- OF TR NC S C 7 DIMENSIONS: C 1 SQUARE FEVET l0(9 `^SYSTEM NO. OF TRENCHES C 1 DMii'NSIONS: -_ - TYPE OF SYSTEM: [ ] ST-DM211M [ j FT-TlT.ED C j MOUND [ ] CONFIGORA-91ION: C 7 TRENCH HED [ ] i DESIGN: C I Emam-R D-BOX j] GRAJSmY SYSTEM S_�M5DOSED SYSTEM ELV_A?'ION OF BOTTOM Or DRA�7F__TELD IN REL_amION TO EX iST7 C-RA-DF. (- INCHES 8E=,0'vT) SYSTEE}MFAILURE AND REna T_R 2N=oRLiaR'ION . C /i `Y'/}/ 7 SYSTEM --,3SmaT_T.a=TON wum TYPE .OF FT-ST5 [ 1 DOMESTIC T C J COM�PRC_�a- ® can EST r*ASEn SEYRCE FL -OTT HaSELI ON [ 7 METERED TvASER GAE_6, FAC SITE [ I DR7ThL4GE STRUCTURES [ ] POOL RATIO C ] /DECK C I P2Rxc- CONDITIONS: [ i SLOP_TNC- PROPERTY `4-TUR7 OF [ I HYDRAULIC 04ERLOA-D C I SOILS C I MJITTEN7NC3 f I SYSTEM DP GE FAILURE-. I TDRAL^LW—E / _RUN OFF C J ROOTS C 7 W3TER TACT." C 7 'AILURE [ ] SEWRGE ON GROUND [ 1 `Lnia C 7 D HO:/BE-ADER DR Ta _ �v1�. LD ;YT3TOM: [ -1 PLIIMR�iG $a_CKQP EWRECS/A DITION�L CRITERI fl J Y t M v`1 t c-n OF F i i4 i3MTTTE-D BY: ,� An . [ 1 a A T_r_T'r�F/LSC✓NSE -J IG�4 7 Y'J name. -u-10, .uo/ V7 nsoiezes qre-Y=Zs-edit!0ns which may not fie vsed) .corDora=ed 6d_ ' G.001, FAC - - Page 3 0= " _- _- .. RR CC_47Gn-2n7 — LOT: BLOCK: SUBDIVISION: PROPERTY ID #: 2308-133-0001-000-7 [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER] [OR TAR ID NUMBER] SYSTEM MOST 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 [ 4,800 ] GALLONS / GPD SeDtic Existina CAPACITY A [ 0 ] GALLONS / GPD CAPACITY N [ 0 ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:I250 GALLONS] K [- 900 ] GALLONS DOSING TANK CAPACITY [133.32 ]GALLONS @[ 6 ]DOSES PER 24 HRS #Pumps [ 2 ] D [ 667 ] SQUARE FEET Drainfield New SYSTEM R [ 667 ] SQUARE FEET Drainfiield New SYSTEM A TYPE SYSTEM: [ ] STANDARD [ ] FILLED [X] MOUND [ ] I CONFIGURATION: [ ] TRENCH [X] RED [ ] N F LOCATION OF BENCHMARK: Orange Spot on NE Comer of Shed Foundation I ELEVATION OF PROPOSED SYSTEM SITE E BOTTOM OF DRAINFIELD TO BE L D 0 T H E R [ 10.0011 INCHES FT ]I ABOVE BELOW BENCHMARK/REFERENCE POINT [ 10.001[ INCHES FT ][ABOVE EELOW BENCHMARK/REFERENCE POINT +"" . WuY + ; L 10.UUJ LWU: J •:x VAllUN M%2ull : L J 1Nl b Each pump serves 1/2 of required absorption area pumps to dose alternately. Pumps must be certified as suitable for distributing sewage effluent System must have a minimum 10 foot separation between the sidewalls of adjacent absorption beds. APPROVED BY BY: MICHAEL STOHR TITLE: 13)led— /=tCCLyJ TITLE: Environmental Supervisor I Diama S Ma DATE ISSUED: 03/01/2019 EXPIRATION DATE: DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6-003, FAC St. Lucie CHO 05/3012019 Page 1 of 3 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 A-02, Tallahassee, Florida 32399. The Agency Clerk's facsimile number is 850-413-8743. Mediation is not available as an alternative 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 'final 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. ' r St. Lucie County Health Department HEALTH 5150 NW Milner Dr Port Saint Lucie, FL 34983 PAYING ON: u:56-SF-1780307 BILL Doc u:56-BID-4089036 CONSTRUCTION APPLICATION#. AP1400798 RECEIVED FROM: ASHTON SEPTIC TANKS, INC. AMOUNT PAID: $ 200.00 PAYMENT FORM: CREDIT CARD PAYMENT DATE: 02/28/2019 MAIL TO: (Orange Avenue Baptist Church Inc) FACILITY NAME: PROPERTY LOCATION: 100 Cyclone or Fort Pierce, FL 34945 Lot: Block: Property ID: 2308-133-0001-000-7 EXPLANATION or DESCRIPTION: 130 - OSTDS Construction System Inspection Training Cent 127 - OSTDS Construction System Inspection 129 - OSTDS Construction Permit (Repair) 131 - OSTDS Construction Application & Existing System E -1 - Surcharge (All) QUANTITY FEE 1 $ 5.00 1 $ 75.00 1 $ 55.00 1 $ 50.00 1 $ 15.00 RECEIVED BY: MontanezNM AUDIT CONTROL NO. 56-PID-3867128 u MIEW 3Y'ME-% STATE OP FLORI D A ���'SOLDn-PERMIT N0.+-_ffiFEE RA-m - SYSimmTMI-4 S='j AC-L �' 13ZyyETi= f„ , D1SPOSA_, DATE PAID: �R£� 1PPITCLl.=_OT! POACONSTRUCT101ci PERUD_ RECEIPT APPLICATION FOR: bTmw tem [VI Renzsr9 _nr InnovativE C I Existing system [ ] Holding Tank C 7 C I Abandonment t ] Tempara APPLT,r-% T: Q `^ C I ACENT: p- i�LEPBONE: '�-TLI.VC A7DRE55: L FA ar�T P; C. i-c.L' o , FI 349�t� TO BE COMPLETED 3Y auny2CaN, OR paaL2G�NT"S --- R`-' a PERSON LICENSED PURSuT TO 489.205(3) �UTHORIEED AGENT. SYSTEMS MUST CONSTRUCTED PP-TICAN`''S RESPONSIBILITY P ( )(m) OR 989.552, FLORIDA STATUTES. IT IS TIM PI'- TED (MM/7D/Y'± - TO ROv�E DOC N=aTION 0= mcr.• DATE THEE LOTyya8 CREATE _F REOu£STID7C- CONSIDERATION S.a T D OR -TU_ORY C-R�NDEI T -MR PROVISIONTS. PROPERTY 4_ Oy�9^ION LOT: BLOGTC: SUBD_vISION: -Lqfa'� PROPERTY ID ZONING: O1vL�vC I um OR EOu—rTjA N., [ Y / N 7 PROPERTY 52ZE: ACRES WATER SUPPLY: C I PRI4_a �' PZMLIC [ )<=2000C-PD f I>2000C-PD :S SE*Nr.R ..�=,.a�'LE AS PER 381.0065 F ' S _ C Y / Di I PROPERTY ADDI RESS: SO D25TANCE TO SEWER: FT DIRECTIONS TO PROPERTY: Epp N '(✓ one DY BUILDING INFORM&VION Unit T2Pe o_ NO E//� sJJtabli s_hmE7t 2 C I RESIDENTIAL C I COKSMRCTa1, Bedroms '3""ding Comme=Cia1 I El Systea Designasea Sit Table 1, Chapter 64-6, RaC 3 J�n00i —CdL IU�Prr� X l D l7W'� 1�'?Y S�U a F C I Floor/Eau-a°cent D ; 0 ra_ns C I Other (Specify) n 3IGNA.TURE : Dri 3015, OB/ 9 (Obsoletes Pre-vious editions Which may not be esed =ncor0orate o'4E-6.00�, Far ) DATE: 2 I a) 19 Rage 1 0 A 0�'��9.,1 STATE OF FLORIDA `� DEPARTMENT OF HEALTH ' ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATIONS •'�4b K� PERMIT #. [1, 1) 0301 APPLICANT: Orange Ave Baptist Church AGENT: Ashton Septic Tanks LOT: N/A BLOCK: N/A SUBDIVISION: N/A PROPERTY ID # : 2308-133-0001-000-7 [ Tax ]D Number ] TO BE COMPLETED BY ENGINEER, HEALTH DEPARTMENT EMPLOYEE,OR OTHER QUALIFIED PERSON. ENGINEERS MUST PROVIDE REGISTRATION NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS. PROPERTY SIZE CONFORMS TO SITE PLAN: I✓I YES [ ] NO NET USABLE AREA AVAILABLE: 4.60 ACRES TOTAL ESTIMATED SEWAGE FLOW: 800 GALLONS PER DAY [RESIDENCES-TABLEI ] AUTHORIZED SEWAGE FLOW: 6900 GALLONS PER DAY [1500 GPD/ACRE ] UNOBSTRUCTED AREA AVAILABLE: 2500 SQFT UNOBSTRUCTED AREA REQUIRED: 2000 SQFT BENCHMARK/REFERENCE POINT LOCATION: Orange Spot on NE Comer of Shed Foundation ELEVATION OF PROPOSED SYSTEM SITE IS10 [INCHES ] [BELOW ] BENCHMARK/REFERENCE POINT THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES SURFACE WATER: NIA FT DITCHES/SWALES: 20 FT NORMALLY WET? [ I YES I✓] NO WELLS: PUBLIC: 200+ FT LIMITED USE: N/A FT PRIVATE:115 FT NON —POTABLE: NIA FT BUILDING FOUNDATIONS: 50 FT PROPERTY LINES:10 FT POTABLE WATER LINES: 50 FT SITE SUBJECT TO FREQUENT FLOODING: I I YES [✓I NO 10 YEAR FLOODING? [ ] YES I✓] NO 10 YEAR FLOOD ELEVATION FOR SITE: N/A FT MSL/NGVD SITE ELEVATION: N/A FT MSL/NGVD USDA SOIL SERIES: Pineda SOIL PROFILE SITE 2 TEXTURE SAND SAND DEPTH 0 TO 8 8 TO 14 SAND 14 TO 23 SAND 23 TO 30 Loamy Sand 30 To 36 Refusal 36 To 72 TO TO TO USDA SOIL SERIES: Pineda OBSERVED WATER TABLE:36 INCHES [BELOW '] EXISTING GRADE. TYPE: [PERCHED ] ESTIMATED WET SEASON WATER TABLE ELEVATION: 12 INCHES [.BELOW ] EXISTING GRADE HIGH WATER TABLE VEGETATION: I I YES I✓I NO MOTTLING: [✓I YES I I NO DEPTH:12 INCHES SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: SAND DEPTH OF EXCAVATION: N/A INCHES DRAINFIELD CONFIGURATION: [ I TRENCH [✓I BED I ] OTHER (SPECIFY) REMARKS/ADDITIONAL CRITERIA: SB1= -10" BELOW BM SB2= -10" BELOW BM STRIPPING FROM 10 YR 4/1 TO 511 GREATER THAN 10% AT 12" IN THE SOIL MATRIX 0 SITE EVALUATED BY: h/ DATE: Z Z DE 4015, 08/09 (Obsole Previous editions which may not be used) Incorporated: 64E-6.001,FAC Page 3 of 4 r` =o 3 abed U-Ta 'TOO"9- v9 P=+zsoason (past as aoa X2m ='rum smoa�ra i ..vaEa y :urTz=WC! V®l��`SiY�2Tf1'Sh1'u O_-Y"� PA U e?d Id0 _--Ro2a=a/sad wa j1v_i mza L ]=rI0,7cVtT.' C ialg=VEa L ] 2lac'k4H/aOE Q C 7 ymwl ] L cN20Z3o NO a3e.Na5 C ] Imo¢-, um-rai C 7 swoop C ] A May, / a5ti=V _C SM.,Wl a naw5eS C 1 SO1S 3,T.-1�Cy? 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S'CaA,A ,1 LOT: BLOCK: SUBDIVISION: RR-Ct^-17Rn4n7 PROPERTY ID #: 2308-133-0001-000-7 [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 T.D:fl:. 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 [ 4,800 ] GALLONS / GPD SeotiC Existlno CAPACITY A [ 0 ] GALLONS / GPD CAPACITY N [ 0 ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS] K [ 900 ] GALLONS DOSING TANK CAPACITY [133.31]GALLONS @[ 6 ]DOSES PER 24 ERE #Pumps [ 2 ] D [ 667 ] SQUARE FEET Drainfield New SYSTEM R [ 667 ] SQUARE FEET Drainfield New SYSTEM A TYPE SYSTEM: [ ] STANDARD [ ] FILT [X] MOUND [ ]- I CONFIGURATION: [ ] TRENCH [x] BED [ ] N F LOCATION OF BENCHMARK: Orange Spot on NE Corner of Shed Foundation I ELEVATION OF PROPOSED SYSTEM SITE [ 10.00][ INCHES FT ][ABOVE E BOTTOM OF DRAINFIELD TO BE [ 10.00][ INCHES FT ][ABOVE L D FILL REQUIRED: [18.001 INCHES EXCAVATION REQUIRED: [ 0 T H E R BENCSMARK/REFERENCE POINT BENCHMARK/REFERENCE POINT Each pump serves 112 of required absorption area pumps to dose alternately. Pumps must be certified as suitable for distributing sewage effluent. System must have a minimum 10 foot separation between the sidewalls of adjacent absorption beds. BY: MICHAEL STUHR TITLE: APPROVED BY: _ �i +� i-wy/ TITLE: Environmental Supervisor I St. Lucie CHU Die,ma S Dfa DATE ISSUED: 03/01/2019 EXPIRATION DATE: 05/30/2019 De 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC Page 1 of 3 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 A-02, Tallahassee, Florida 32399. The Agency Clerk's facsimile number is 850-413-8743. Mediation is not available as an alternative 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 'final 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. St. Lucie County Health Department H 5150 NW Milner Dr Port Saint Lucie, FL 34983 PAYING ON: # 56-SF-1780307 BILLooc#56-BID-4089036 CONSTRUCTION APPLICATION#: AP1400798 RECEIVED FROM: ASHTON SEPTIC TANKS INC. AMOUNT PAID: $ 200.00 PAYMENT FORM: CREDIT CARD PAYMENT DATE: 02/28/2019 MAIL TO: (Orange Avenue Baptist Church Inc) FACILITY NAME: PROPERTY LOCATION: 100 Cyclone or Fart Pierce, FL 34945 Lot: Property ID: 2308-133-0001-000-7 EXPLANATION or DESCRIPTION: Block: 130 - OSTDS Construction System Inspection Training Cent 127 - OSTDS Construction System Inspection 129 - OSTDS Construction Permit (Repair) 131 - OSTDS Construction Application & Existing System E -1 - Surcharge (All) S QUANTITY FEE 1 $ 5.00 1 $ 75.00 1 $ 55.00 1 $ 50.00 1 $ 15.00 RECEIVED BY: MontanezNM AUDIT CONTROL NO. 56-PID-3867128 STATE OP ZORI a '-R. -2 ss__'l�s D1�4aTi72=•d i1!r Ov O��S�fT=3 S�u6a ^R�t3NJS_vT P�7 DTSPOSR l SSSTMI a-P'1"CA--O-N F0---2 CONSTRUCT ON pp7LliTT APPLICATION FOR: C Nap: syatam C ] Existing System C V I Repair C 7 Bbazdonmeat C 1 oldicg Tz*Lk -PpLz xrm? r: C 1 Temnora_*v AC -ENT: Ne, L 4-� e - ) -�'-%rLSNC- ADDRx:59: PERMIT NO, -V -�100 1 DATE RAID: FEE FEE Pa3D: RECEIPT: [ '] Innovative C ] TELEPHONE: TO BE CONLoiETED BY avPT it NT OR a�nilCA*TT�S AIITF_O_RIZE� AGENT. aop�-rPaR-SON iIC;NSED ?URSJ qT TO ngo,�05(3) (m) OR a89�553g�, SY34^�,'rIS MUST BE CONST2UCTED C?v_ S RESPONSIHZr_TY TO PROvIDE DOC�NT_m- _ OR,D__ SM TUTES. IT IS T_H; PLATTED (Dfei/DD/YY) _n REQ E- -ON OF =-- DamE TFm LOT ➢LAS CREATE ST NC- CONS!DERaTZON OF S�I!a D OR TIITORY C-_Zat7DF LTHER PR04=S_TO -S. u_'Zch9TION LOT: BLOCK: SURD=vISION: I O��Q I _ PROPERTY ID ¢: Z3o$-I33 ZONING: OR EOu Zrnr"h„_: [ Y / N ] PROPERTY If SIZE:ACRES WWI-ISR SUPPLY: I __ ] aRTVamE PUBLIC ( ]<=2000C-PD f ]>2000C-PD IS SEWER �tT3I�nBLE AS PER 381.0065 F � S_ C Y / Di ] PROPERTY . 21DDRESS• I D0 o2ldon-c j)y DISTANCE TO SEWER: _FT i DIRECTIONS TO PROPER,,-_: BUIiDING INFORM_a_TION Unit Type of No Establishmept 1 Chu 1 2 I C I RESIDENTTa! [ ] COMMERCIAL Be of Building Commercial/Institutional System Design Bzdrooms area Sit Table 1, Chapter 64E-6 Rnm 3 Je-60I — �1U P 4 [� � X to &P.'I nifY siU � er-{' Bay- F100=/Ecn-amen- D+�-; _ � _Z_ns C ] Other (Soec:E v) n SIGNATURE: Dei 4015, 08/ 9 (Obsoletes pr=_`01's editions ifhi.ch may not be used) _.^_corpora== 64E-6_001, Ram D TIE: 'L 13119 ?agE.l of 4 4 ' 4 STATE OF FLORIDA PERMIT #. 6 1. U 0301 DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATIONS APPLICANT: Orange Ave Baptist Church AGENT: Ashton Septic Tanks LOT: N/A BLOCK: N/A SUBDIVISION: N/A PROPERTY ID # : 2308-133-0001-000-7 I Tax ID Number ] TO BE COMPLETED BY ENGINEER, HEALTH DEPARTMENT EMPLOYEE,OR OTHER QUALIFIED PERSON. ENGINEERS MUST PROVIDE REGISTRATION NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS. PROPERTY SIZE CONFORMS TO SITE PLAN: I✓] YES [ ] NO NET USABLE AREA AVAILABLE: 4.60 ACRES TOTAL ESTIMATED SEWAGE FLOW: 800 GALLONS PER DAY [RESIDENCES-TABLEI ] AUTHORIZED SEWAGE FLOW: 6900 GALLONS PER DAY 11500GPD/ACRE ] UNOBSTRUCTED AREA AVAILABLE: 2500 SQFT UNOBSTRUCTED AREA REQUIRED: 2000 SQFT BENCH hRK/REFERENCE POINT LOCATION ELEVATION OF PROPOSED SYSTEM SITE [ INCHES ] [ BELOW ] POINT THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES SURFACE WATER: N/A FT DITCHES/SWALES: 20 FT NORMALLY NET? [ I YES I✓] NO WELLS: PUBLIC: 200+ FT LIMITED USE: N/A FT PRIVATE: 115 FT NON -POTABLE: N/A FT BUILDING FOUNDATIONS: 50 FT PROPERTY LINES:10 FT POTABLE WATER LINES: 50 FT SITE SUBJECT TO FREQUENT FLOODING: [ ] YES [✓I NO 10 YEAR FLOODING? j ] YES 16/1 NO 10 YEAR FLOOD ELEVATION FOR SITE: N/A FT MSL/NGVD SITE ELEVATION: N/A FT MSL/NGVD 13 TO TO TO USDA SOIL SERIES: Pineda 14 To 23 23 TO 30 30 TO 36 36 To 72 To 1V TO USDA SOIL SERIES: Pineda OBSERVED WATER TABLE:36 INCHES [BELOW 7 EXISTING GRADE. TYPE:[PERCHED ] ESTIMATED WET SEASON WATER TABLE ELEVATION: 12 INCHES [.BELOW ] EXISTING GRADE HIGH WATER TABLE VEGETATION: I ] YES [✓] NO MOTTLING: [✓] YES [ I NO DEPTH:12 INCHES SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: SAND DEPTH OF EXCAVATION: N/A INCHES DRAINFIELD CONFIGURATION: [ ] TRENCH IV] BED I ] OTHER (SPECIFY) REMARKS/ADDITIONAL CRITERIA: SB1=-10" BELOW BM SB2=-10" BELOW BM 0 SITE EVALUATED BY: DATE: 2 Z DH 4015, 08/09 (Obsoleteyr Previous editions which may not be used) Incorporated: 64E-6.001, FAC Page 3 of 4 t . STa-lrm OF FL-OR='B CEPqiRTMcNi OF BE_aLTH ONSITE SE6AC-E TRE_amnENT aN•D Dr_SPOS-a_, SYSTEM . EXISTING SYSTEM_ aND SYS_zm REPPEt E--. v _ZUzjT7ON PPLIC?NT: OV T1 f 1.Qe I 1 �1..� 1 Ci�,O Ste] (� 1V'Y� -�rf.�"_� CONTRaC`SOR / AGEiv=: J f l 1 U • ! < _l 0(i�/ [ 1 r171L jple i1 J LOT: AALBLOCK: SDBb---v: TO BE COMEDIETED BY FLORID REC-ISTERED ENG-714EER, DER7aRn. XT EMPLOYEE, SEPTIC TANK OTHER CERT =-FIED PERSON. ST_ aAp CON''rQ;CTOR 04 GN _ O OR N TE REI.- _TES WHCIIMR.NTS. COMPLETE nT•r an�1,TCaa-la Tm,F�M COMPLETE Z�NK RT ICaS_rON BELOW OR NOTE ITi RnM�RFCS WiP_' THE ^_aMKS CASZv02' BE CSP.T_s r_,D. 3XI,STM7G TIZVNK IN-wo- MAE--70N / ' n (H C-AZ,ONS SEPTIC Z4NFC/GPD p=0-LEGEND: i.mTERrar,_� gaF=TIED: [Y' / l / ] EUiSONS SEPTIC TZklgK/C-_D -1TIJ S.e,GEND: L�a=R_aS:. B_a'F'F*ED: L ] GAIW 55 - E- SE INTERCEPTOR LEGEND: M� E�aJ: L 7 CaTLONS DOSING T_aNK rEGUND: MA2ERa1,: P UMPPS. N] I ] I CERTIFY '=34T THE LISTED TMgKS WERE P[TMnED ON THE VOIDNES SPECIFIED AS DETERMINE:) EV C DIMENSIONS ` FiaJE / F-T IKG /- �.^ J2129D ] , PRE ERFE 0.: OBSERvP3T,E DEFT T OR _E;SCS AND EC_ION DE G -/ OOTIEm Fia,TER DEICE, a08S "3 , ii342,' a [ SOLIDS n^ca m ] SNSZ�e.D_ i(i✓ CE ED CONTRA S=G�-^� O_R.E LICENSED CONTRACTOR BUSIXESS N4ME D—� EXISTING- DRas-L m=. iTT'ORNLaSION L (0(9� ] SQUA_RE FEET PR-UO-RY DRPTN=IELD SYSTEM NO_ OF T? m=—S C ] D�NS_IOivS: R [ 10(9-7 ] SQUARE =EET SYSTEM NO. OF TRENCHES [ ] DI�+�=NSIOLvS: • g TYPE OF SYSTEM- FI-EED [ ] MOTr7D [ ] CONFIC-URa?'ION: [ ] TRENCH J6,'BED I. DESIGN: C ] REPLIER ><:j:D-BOX [ " ] kiwwzw_v SYSmERY ->4'DOSED SYSTEM ELEV_aSION OF BOTTOM OF DRP�-NFTEI:D rn7 REI�a=20NTOX5TsCC-aD-�5 BELwu 2- SYSTEM. FPSLORE AND RERA-M Zff�-ORGiaTION . [ /w/ ] SYSTEM i^TSmar r.aT20N wom TYPE .OF 1Zs5TE C 1 DOMESTIC C ] cor�Rc_ay C-PO EST La-vD SEPMGEE F-LOW B_aSEb ON C I METERED -w-- FR -Ta i dam_ 6, RAC SITE [ ] DRas*L-LGE STRUCTURES [ ] POOL [ ] RATIO / DECK Pa [ ] RTCNG CONDITIONS: [ ] SLOPING- PROPERTY Z`TORE OF [ ] HPDRAU-LIC OVERL0.n.D [ ] SOILS C 7 iK�TFE?�tNCE j ] SVSTE_--K Aa-KAG -1AU ,URE: C 1 TDR2I�LL-E / RIIN OFF ROOTS -a==LRF C ] SEVLAJU-E ON GROUND �YMPT D BOR/HE_�ER C ] DRa?�v 'IELD OM: [ , ] PLIIL+iB�TC- $�SCKIIP [ ] 11 E�1Z•G5/- DTT- OLti�I, CRITERI— V 'i Y 1Ytr`i d -r aJ- R ,aci — 33 f A �aM_rmTED BY• O • _ ���•!�� �I \ A ■ T _, �=S��FILIC'GNSE S IL®B� 1 KP�S 1-IIlTR . L �u1O, •UDIUV DSOleLS �Y•e-✓3Ous-ediaons wni.ch may not be .used) .cox- 6-^--6_001, PAC