HomeMy WebLinkAboutHealth Department Septic Approval APPLICATION #:AP1219613
STATE OF FLORIDA PERMIT #:56-SF-1653199
DEPARTMENT OF HEALTH DocUMENT #:F11035730
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL DATE PAID:01/11/2016
• FEE PAID:65.00
RECEIPT #:56-PID-2875052
APPLICANT: Ralph Jr.&Catherine Ray
AGENT: Mike Stuhr(Ashton Septic Service)
PROPERTY ADDRESS: 485 Bddlewood Way Fort Pierce, FL 34945
LOT: 2 BLOCK: E
SUBDIVISION: Dorian ID#: 2310-801-0050-000-2
CHECKED [X1 ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED.
TANK INSTALLATION SETBACKS
[ ] [01] TANK SIZE [1] [21 [ ] [27] SURFACE WATER FT
[ ] [02] TANK MATERIAL [ 1 [281 DITCHES FT
[ ] [03] OUTLET DEVICE [ 1 [291 PRIVATE WELLS FT
[ 1 [041 MULTI-CHAMBERED [ Y / N ] ( ] [30] PUBLIC WELLS FT
[ 1 [05] OUTLET FILTER [ 1 [311 IRRIGATION WELLS FT
[ ] (061 LEGEND 1. 2. [ ] [32] POTABLE WATER FT
[ ] [071 WATERTIGHT [ 1 [331 BUILDING FOUNDATIONS FT
[ 1 [08] LEVEL [ ] [341 PROPERTY LINES FT
[ 1 [091 DEPTH TO LID [ 1 [351 OTHER FT
DRAINFIELD INSTALLATION FILLED / MOUND SYSTEM
( l [10] AREA [1] [21 SQFT [ ] [36] DRAINFIELD COVER
( 1 [111 DISTRIBUTION BOX HEADER [ ] [371 SHOULDERS
[ 1 [121 NUMBER OF DRAINLINES 1, 2. [ 1 [38] SLOPES
[ 1 [131 DRAINLINE SEPARATION [ 1 [39] STABILIZATION
[ 1 [14] DRAINLINE SLOPE
[ 1 [151 DEPTH OF COVER ADDITIONAL INFORMATION
[ ] [16] ELEVATION [ ABOVE / BELOW ]HM [ 1 [40] UNOBSTRUCTED AREA
[ l [171 SYSTEM LOCATION [ 1 [41] STORMWATER RUNOFF
[ 1 [18] DOSING PUMPS [ ] J [42] ALARMS
[ ] [19] AGGREGATE SIZE [ ] [43] MAINTENANCE AGREEMENT
[ l [201 AGGREGATE EXCESSIVE FINES [ 1 [44] BUILDING AREA
[ 1 [21] AGGREGATE DEPTH [ ] [45] LOCATION CONFORMS WITH SITE PLAN
FILL / EXCAVATION MATERIAL [ 1 [461 FINAL SITE GRADING
( ] [22] FILL AMOUNT [ 1 [47] CONTRACTOR MICHAEL W STUHR(ASHTO
[ ] [231 FILL TEXTURE [ ] [48] OTHER
[ 1 [241 EXCAVATION DEPTH ABANDONMENT
[ 1 1251 AREA REPLACED ( ] [49] TANK PUMPED 01/26/2016
( ] [26] REPLACEMENT MATERIAL [ 1 [501 TANK CRUSHED 6 FILLED 01/26/2016
Comments: Comments are on page 2.
CONSTRUCTION [ APPROVED / St. Lucie CHD DATE: 01/27/2016
DISAPPROVED Environ ental Specialis Brian Ingram(ENVIRONMENTAL HEALTH)
FINAL SYSTEM ( AppgpVED / DISAPPROVED ]; St.Lucie CHD DATE: 01/27/2016
nvironmenta pecia ist n Ingram E IR TH)
(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 AP1219613 EIDISS3199
APPLICATION #:AP1219613
STATE OF FLORIDA PERMIT #:56-SF-1653199
DEPARTMENT OF HEALTH DOCUMENT #:FI1035730
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
ty� c` CONSTRUCTION INSPECTION AND FINAL APPROVAL DATE PAID:01/11/2016
FEE PAM:65.00
RECEIPT #:56-PID-2875052
Violation Number Comment
Comments
No violations.Tank abandoned properly.
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 AP1219613 EID1653199