The URL can be used to link to this page

Home My WebLink AboutHealth Department Septic Permit APPLICATION #.AP1191961 STATE OF FLORIDA PERMIT #:56-SF-1611192 F DEPARTMENT OF HEALTH DOCUMENT #:F11004206 ONSITE SEWAGE TREATMENT AND DISPOSAL .SYSTEM CONSTRUCTION INSPECTION AND FINAL APPROVAL DATE PAID:06/09/2015 FEE PAID:65.00 RECEIPT #:56-PID-2684011 APPLICANT: South Florida Land Clearing AGENT: KRK Enterprises PROPERTY ADDRESS: 707 Savannah St Fort Pierce, FL 34982 LOT: 26/27 BLOCK: 20 SUBDIVISION: Indian River Estates ID#: 3402-607-0180-000-1 CHECKED [X] ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED. TANK INSTALLATION SETBACKS [ 1 [01] TANK SIZE [11 [2] [ ] [271 SURFACE WATER FT [ l [02] TANK MATERIAL [ l [281 DITCHES FT [ ] [03] OUTLET DEVICE [ 1 [29] PRIVATE WELLS FT [ ] 1041 MULTI-CHAMBERED [ Y / N ] [ ] [301 PUBLIC WELLS FT [ 1 1051 OUTLET FILTER [ 1 [31] IRRIGATION WELLS FT [ ] 1061 LEGEND 1. 2. [ ] [32] POTABLE WATER FT [ 1 [07] WATERTIGHT [ 1 [33] BUILDING FOUNDATIONS FT [ 1 [081 LEVEL [ 1 [34] PROPERTY LINES FT [ ] 1091 DEPTH TO LID [ 1 [351 OTHER FT DRAINFIELD INSTALLATION FILLED / MOUND SYSTEM [ 1 [101 AREA [1] [2] SQFT [ 1 [36] DRAINFIELD COVER [ 1 [111 DISTRIBUTION BOX HEADER [ 1 [371 SHOULDERS [ 1 [121 NUMBER OF DRAINLINES 1. 2. [ 1 [381 SLOPES [ 1 [131 DRAINLINE SEPARATION [ ] [39] STABILIZATION [ 1 [14] DRAINLINE SLOPE [ ] [151 DEPTH OF COVER ADDITIONAL INFORMATION [ ] [161 ELEVATION [ ABOVE / BELOW ]BM [ ] [401 UNOBSTRUCTED AREA [ ] [17] SYSTEM LOCATION [ 1 [41] STORMWATER RUNOFF [ 1 [18] DOSING PUMPS [ ] [421 ALARMS [ ] [19] AGGREGATE SIZE [ 1 [43] MAINTENANCE AGREEMENT [ ] 1201 AGGREGATE EXCESSIVE FINES [ 1 [44] BUILDING AREA [ 1 [211 AGGREGATE DEPTH [ 1 [451 LOCATION CONFORMS WITH SITE PLAN FILL / EXCAVATION MATERIAL [ l 1461 FINAL SITE GRADING [ ] [221 FILL AMOUNT [ 1 1471 CONTRACTOR (KRK Enterprises) [ ] [231 FILL TEXTURE [ l 1481 OTHER [ 1 [24] EXCAVATION DEPTH ABANDONMENT [. 1 [25] AREA REPLACED [ 1 [491 TANK PUMPED 06/17/2015 [ 1 [26] REPLACEMENT MATERIAL [ 1 [501 TANK CRUSHED & FILLED 06/17/2015 Comments: Comments are on page 2. n CONSTRUCTION [ APPROVED / G St. Lucie CHD DATE: 06/17/2015 DISAPPROVED ]' Envi, e I Speci t I ob K Kirchner FINAL SYSTEM [ APPROVED / DISAPPROVED ]; -�'%� St. Lucie CHD DATE: 06/17/2015: En v mental specialist I JaCO13rc ner (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 v 1.0.1 AP1191961 EID1611192 1 1 APPLICATION #:AP1191961 STATE OF FLORIDA PERMIT #:56-SF-1611192 DEPARTMENT OF HEALTH DOCUMENT #:F11004206 SITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION INSPECTION AND FINAL APPROVAL DATE PAID:06/09/2015 .� FEE PAID-65.00 RECEIPT #:56-PID-2684011 Violation Number Comment Comments Tank was pumped.The bottom and sides of the tank were crushed and the hole was filled in. Contracter emailed. 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 AP1191961 EID1611192 PERMIT #:56-SF-1611192 d!F APPLICATION #:AP 1191961 STATE OF FLORIDA DATE PAID: DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM FEE PAID: CONSTRUCTION PERMIT RECEIPT #: • DOCUMENT #: PR977723 CONSTRUCTION PERMIT FOR: OSTDS Abandonment APPLICANT: (South Florida Land Clearing) PROPERTY ADDRESS: 705 Savannah St Fort Pierce, FL 34982 LOT: 26/27 BLOCK: 20 SUBDIVISION: Indian River Estates PROPERTY ID #: 3402-607-0180-000-1 [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 [ 900 ] GALLONS / GPD existinq septic CAPACITY A [ 0 ] GALLONS / GPD CAPACITY N [ 0 ]' GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS] K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ ] D [ ] SQUARE FEET SYSTEM R [ 0 ] SQUARE FEET SYSTEM A TYPE SYSTEM: [ ] STANDARD [ ] FILLED [ ] MOUND [ ] I CONFIGURATION: [ ] TRENCH [ ] BED [ ] N F LOCATION OF BENCHMARK: I ELEVATION OF PROPOSED SYSTEM SITE [ ] [ / ] [ABOVE/BELOW]BENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ ] [ / ] [ABOVE/BELOW]BENCHMARK/REFERENCE POINT L D FILL REQUIRED: [ 0.00] INCHES EXCAVATION REQUIRED: [ ] INCHES Have the tank abandoned in accordance with the following procedures:(a)The tank shall be pumped out.(b)The bottom O of the tank shall be opened or ruptured, or the entire tank collapsed so as to prevent the tank from retaining water, and(c) T The tank shall be filled with clean sand or other suitable material,and completely covered with soil.Have the system H inspected by the health department after it has been pumped and ruptured but before it is filled with sand and covered. E R SPECIFICATIONS BY: Kyle D Kelly TITLE: Septic contractor APPROVED BY: .17' TITLE: Environmental Manager St. Lucie CHD David J Koerner DATE ISSUED: 06/12/2015 EXPIRATION DATE: 09/09/2015 DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC Page 1 of 3 v 1.1.4 AP1191961 SE-1 ti J STATE OF FLORIDA PERMIT # rt DEPARTMENT OF HEALTH ONSITE SEWAGE ,TREATMENT AND DISPOSAL SYSTEM EXISTING SYSTEM AND SYSTEM REPAIR EVALUATION APPLICANT: South Florida Land Clearing CONTRACTOR / AGENT: K.R..K. Enterprises, Inc. / Kyle D. Kelly, Contractor LOT: 26&27 BLOCK: 20 SUBDIV: Indian River EStates ID#: v402-607-0180-000-1 TO BE COMPLETED BY FLORIDA REGISTERED ENGINEER, DEPARTMENT EMPLOYEE, SEPTIC TANK CONTRACTOR OR OTHER CERTIFIED PERSON. SIGN AND SEAL ALL SUBMITTED DOCUMENTS. COMPLETE ALL APPLICABLE ITEMS. COMPLETE TANK CERTIFICATION BELOW OR NOTE IN REMARKS WHY THE TANKS CANNOT BE CERTIFIED. EXISTING TANK INFORMATION [ 900 ] GALLONS SEPTIC TANK/GPD ATU LEGEND: UNKNOWN MATERIAL: CONCRETE BAFFLED: [Y / N] [ ] GALLONS SEPTIC TANK/GPD ATU LEGEND: MATERIAL: BAFFLED: [Y / N] [ ] GALLONS GREASE INTERCEPTOR LEGEND: MATERIAL: [ ] GALLONS DOSING TANK LEGEND: MATERIAL: # PUMPS: [ ] I CERTIFY T T LISTED TANKS WERE PUMPED ON _ 06/09/15 BY Justin W/ KRK , HAVE THE VOLUMES PE IFIED AS DETERMINED BY [ DIMENSIONS / FILLING / LEGEND ] , ARE FREE OF OBSERVABLE ]DEFECTS 0 11S, AND VE A LIDS DEFLECTION DEVICE / OUTLET FILTER DEVICE J INSTALLED. K.R.K. Enterprises, Inc. 9 ]un 2015 SIGNATU OF LICENS D-'CONTRACTOR BUSINESS NAME DATE EXISTING DRAINFIELD INFORMATION [ ] SQUARE FEET PRIMARY DRAINFIELD SYSTEM NO. OF TRENCHES [ ] DIMENSIONS: X [ J SQUARE FEET SYSTEM NO. OF TRENCHES [ ] DIMENSIONS: X TYPE OF SYSTEM: [ ] STANDARD [ ] FILLED [ J MOUND [ ] CONFIGURATION: [ ] TRENCH [ ] BED [ ] DESIGN: [ ] HEADER [ J D-BOX [ ] GRAVITY SYSTEM [ ] DOSED SYSTEM ELEVATION OF BOTTOM OF DRAINFIELD IN RELATION TO EXISTING GRADE 7 INCHES [ ABOVE / BELOW] SYSTEM FAILURE AND REPAIR INFORMATION [ 1977 ] SYSTEM INSTALLATION DATE TYPE OF WASTE DOMESTIC [ J COMMERCIAL [ 200 ] GPD ESTIMATED SEWAGE FLOW BASED ON [ ] METERED WATER TABLE 1, 64E-6, FAC SITE [ ] DRAINAGE STRUCTURES [ ] POOL [ ] PATIO / DECK [ ] PARKING CONDITIONS: [ ] SLOPING PROPERTY [ ] NATURE OF [ ] HYDRAULIC OVERLOAD [ ] SOILS [ ] MAINTENANCE [ ] SYSTEM DAMAGE FAILURE: [ ] DRAINAGE / RUN OFF [ J ROOTS [ ] WATER TABLE [ ] FAILURE [ ] SEWAGE ON GROUND [ ] TANK [ ] D BOX/HEADER [ ] DRAINFIELD SYMPTOM: [ ] PLUMBING BACKUP [ ] REMARKS/ADDITIONAL CRITERIA Tank to be abandoned by South Florida Land Clearing (SFLQ DIMENSIONS: 4' x 7.5' x 4.5' . . .equates to 900-gallon septic tank Date/Time of abandonm nt o be coordinated with SLCPHU, KRK and SFLC SUBMITTED BY: TITLE/LICENSE PRES/SR0931151 DATEt Jun 2015 DH 4015, 08/09 (Ob letes pr =bus editions which may not be used) Incorporated 64E-6.0 , C Page 4 of 4 APPLICATION #:AP1191961 STATE OF FLORIDA PERMIT #:56-SF-1611192 DEPARTMENT OF HEALTH DOCUMENT #:F11004206 ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM -� CONSTRUCTION INSPECTION AND FINAL APPROVAL DATE PAID:06/09/2015 -- FEE PAID:65.00 RECEIPT #:56-PID-2684011 APPLICANT: South Florida Land Clearing AGENT: KRK Enterprises PROPERTY ADDRESS: 705 Savannah St Fort Pierce, FL 34982 LOT: 26/27 BLOCK: 20 SUBDIVISION: Indian River Estates ID#: 3402-607-0180-000-1 CHECKED [X] ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED. TANK INSTALLATION SETBACKS [ ] [01] TANK SIZE [1] [2] [ ] [27] SURFACE WATER FT [ ] [02] TANK MATERIAL [ ] [28] DITCHES FT [ ] [03] OUTLET DEVICE [ ] [29] PRIVATE WELLS FT [ ] [04] MULTI-CHAMBERED [ Y / N ] [ ] [30] PUBLIC WELLS FT [ ] [05] OUTLET FILTER [ ] [31] IRRIGATION WELLS FT [ ] [06] LEGEND 1. 2. [ ] [32] POTABLE WATER FT [ ] [07] WATERTIGHT [ ] [33] BUILDING FOUNDATIONS FT [ ] [08] LEVEL [ ] [34] PROPERTY LINES FT [ ] [09] DEPTH TO LID [ ] [35] OTHER FT DRAINFIELD INSTALLATION FILLED / MOUND SYSTEM [ ] [10] AREA [1] [2] SQFT [ ] [36] DRAINFIELD COVER [ ] [11] DISTRIBUTION BOX HEADER [ ] [37] SHOULDERS [ ] [12] NUMBER OF DRAINLINES 1. 2. [ ] [38] SLOPES [ ] [13] DRAINLINE SEPARATION [ ] [39] STABILIZATION [ ] [14] DRAINLINE SLOPE [ ] [15] DEPTH OF COVER ADDITIONAL INFORMATION [ ] [16] ELEVATION [ ABOVE / BELOW ]BM [ ] [40] UNOBSTRUCTED AREA [ ] [17] SYSTEM LOCATION [ ] [41] STORMWATER RUNOFF [ ] [18] DOSING PUMPS [ ] [42] ALARMS [ ] [19] AGGREGATE SIZE [ ] [43] MAINTENANCE AGREEMENT [ ] [20] AGGREGATE EXCESSIVE FINES [ ] [44] BUILDING AREA [ ] [21] AGGREGATE DEPTH [ ] [45] LOCATION CONFORMS WITH SITE PLAN FILL / EXCAVATION MATERIAL [ ] [46] FINAL SITE GRADING [ ] [22] FILL AMOUNT [ ] [47] CONTRACTOR [ ] [23] FILL TEXTURE [ ] [48] OTHER [ ] [24] EXCAVATION DEPTH ABANDONMENT [ ] [25] AREA REPLACED [ Vi] [4 9] TANK PUMPED [ ] [26] REPLACEMENT MATERIAL [� [50] TANK CRUSHED 6 FILLED Comments: CONSTRUCTION [ _ CHD DATE: "�7 APP DISAPPROVED 0 ED. ] : FINAL SYSTEM [ APPROVED / DISAPPROVED - CHD DATE: (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 v 1.0.1 AP1191961 EID1611192