Form DEP 4015, Application for Construction Permit, Onsite Sewage Treatment and Disposal System (OSTDS) Instructions

Provide the specific location or description of the benchmark or reference point.

Check this box if the building is for residential use.

Check this box if the building is for commercial use.

Enter the depth of excavation in inches.

Check this box if the drainfield configuration is a trench.

Check this box if the drainfield configuration is a bed.

Check this box if the drainfield configuration is an option other than trench or bed, and requires specification.

Specify the type of drainfield configuration if it is not a trench or bed. Fill only if 'Other' is 'Yes'.

Enter the elevation of the bottom of the drainfield in relation to the natural grade.

Enter the Munsell number and color for the eighth soil profile row of Site 1.

Enter the soil texture description for the eighth soil profile row of Site 1.

Enter the starting depth for the eighth soil profile row of Site 1.

Enter the ending depth for the eighth soil profile row of Site 1.

Enter the Munsell number or color for the eighth soil profile layer at Site 2.

Enter the texture of the eighth soil profile layer at Site 2.

Enter the starting depth of the eighth soil profile layer at Site 2.

Enter the ending depth of the eighth soil profile layer at Site 2.

Enter the estimated sewage flow in gallons per day (GPD). Fill only if 'Metered Water', 'Table I, 62-6, FAC' is 'Yes', any.

Check this box if the estimated sewage flow is based on metered water usage.

Check this box if the estimated sewage flow is based on calculations from Table I, 62-6, FAC.

Provide the date the site was evaluated.

Check this box if sewage is observed on the ground as a system failure symptom.

Check this box if the tank is identified as the source of the system failure or symptom.

Check this box if the distribution box or header is identified as the source of the system failure or symptom.

Check this box if the drainfield is identified as the source of the system failure or symptom.

Check this box if a plumbing backup is identified as a system failure symptom.

Enter any additional failure symptoms not listed as checkboxes. Fill only if 'Drainfield Failure' is 'Yes'.

Enter the Munsell number or color for the fifth soil profile row.

Enter the texture description for the fifth soil profile row.

Enter the starting depth for the fifth soil profile row.

Enter the ending depth for the fifth soil profile row.

Enter the Munsell number or color for the fifth soil profile layer at Site 2.

Enter the texture of the fifth soil profile layer at Site 2.

Enter the starting depth of the fifth soil profile layer at Site 2.

Enter the ending depth of the fifth soil profile layer at Site 2.

Enter the Munsell number or color for the first soil profile row of Site 1.

Enter the texture of the soil for the first soil profile row of Site 1.

Enter the starting depth of the soil layer for the first soil profile row of Site 1.

Enter the ending depth of the soil layer for the first soil profile row of Site 1.

Provide the Munsell number and color for the soil profile's first layer at Site 2.

Provide the soil texture for the soil profile's first layer at Site 2.

Enter the starting depth of the soil profile's first layer at Site 2.

Enter the ending depth of the soil profile's first layer at Site 2.

Enter the type of establishment for the first unit.

Enter the number of bedrooms for the first unit. Fill only if 'Building Information Type: Residential' is 'Yes'.

Enter the building area in square feet for the first unit.

Enter the commercial or institutional system design information according to Table I, Chapter 62-6, FAC for the first unit. Fill only if 'Building Information Type: Commercial' is 'Yes'.

Check this box if the site is subject to frequent flooding.

Check this box if the site is not subject to frequent flooding.

Check this box if the site is subject to 10-year flooding.

Check this box if the site is not subject to 10-year flooding.

Enter the 10-year flood elevation for the site. Fill only if 'Site Subject To Frequent Flooding Yes' is 'Yes'.

Enter the site's elevation. Fill only if '10 Year Flooding Yes' is 'Yes'.

Check this box if a Coastal Construction Control Line Permit or an exemption notice from the Department of Environmental Protection is applicable, especially if any component of the system will be seaward of the Coastal Construction Control Line or if a survey is needed to determine the control line's location.

Check this box if all plans and forms submitted by a licensed engineer are dated, signed, and sealed as required for the site plan.

Check this box if the evaluator has documented the locations of all soil profiles on the site plan.

Enter the Munsell color code for the fourth soil layer at Site 1.

Enter the textural classification for the fourth soil layer at Site 1.

Enter the starting depth of the fourth soil layer at Site 1.

Enter the ending depth of the fourth soil layer at Site 1.

Provide the Munsell number and color for the fourth soil profile layer at Site 2.

Provide the texture description for the fourth soil profile layer at Site 2.

Provide the starting depth of the fourth soil profile layer at Site 2.

Provide the ending depth of the fourth soil profile layer at Site 2.

Enter the type of establishment for the fourth unit.

Enter the number of bedrooms for the fourth unit. Fill only if 'Building Information Type: Residential' is 'Yes'.

Enter the building area in square feet for the fourth unit.

Enter the commercial or institutional system design information according to Table I, Chapter 62-6, FAC for the fourth unit. Fill only if 'Building Information Type: Commercial' is 'Yes'.

Enter the minimum setback distance in feet from surface water.

Enter the minimum setback distance in feet from ditches or swales.

Enter the minimum setback distance in feet from public wells.

Enter the minimum setback distance in feet from limited use wells.

Enter the minimum setback distance in feet from private wells.

Enter the minimum setback distance in feet from non-potable wells.

Enter the minimum setback distance in feet from building foundations.

Enter the minimum setback distance in feet from property lines.

Enter the minimum setback distance in feet from potable water lines.

Check this box if the nature of the failure is a hydraulic overload.

Check this box if the nature of the failure is related to the soils.

Check this box if the nature of the failure is related to maintenance issues.

Check this box if the nature of the failure is due to system damage.

Check this box if the nature of the failure is due to drainage or run off.

Check this box if the nature of the failure is caused by roots.

Check this box if the nature of the failure is related to the water table.

Check this box if the nature of the failure is specifically in the drainfield. Fill only if 'Water Table' is 'Yes'.

Enter any details or a description regarding the nature of the system damage. Fill only if 'System Damage' is 'Yes'.

Enter the Munsell color notation for the ninth soil profile layer at Site 1.

Enter the texture description for the ninth soil profile layer at Site 1.

Enter the starting depth of the ninth soil profile layer at Site 1.

Enter the ending depth of the ninth soil profile layer at Site 1.

Enter the Munsell soil color and/or number for the ninth soil profile layer at Site 2.

Enter the soil texture for the ninth soil profile layer at Site 2.

Enter the starting depth of the ninth soil profile layer at Site 2.

Enter the ending depth of the ninth soil profile layer at Site 2.

Check this box if the area is normally wet.

Check this box if the area is not normally wet.

Enter any additional notes or comments related to the site plan.

Check this box if the building includes floor or equipment drains.

Check this box if there is other building information not covered by the listed options, and specify it in the provided space.

Provide specific details for other building information not listed. Fill only if 'Other (Specify)' is 'Yes'.

Please enter the permit application number.

Indicate the plan approval status by entering initials or a mark if the plan is approved.

Indicate the plan approval status by entering initials or a mark if the plan is not approved.

Enter the date when the plan was reviewed and either approved or not approved. Fill only if 'Plan Approved Status Indicator', 'Plan Not Approved Status Indicator' is selected, for any.

Enter the full name of the individual from the County Health Department who performed the plan review and made the approval decision. Fill only if 'Plan Approved Status Indicator', 'Plan Not Approved Status Indicator' is selected, for any.

Enter the net usable area available for the property.

Enter the total estimated sewage flow in gallons per day.

Enter the authorized sewage flow in gallons per day.

Enter the unobstructed area available in square feet.

Enter the unobstructed area required in square feet.

Check this box if the property size conforms to the site plan.

Check this box if the property size does not conform to the site plan.

Enter the elevation of the proposed system site relative to the benchmark/reference point.

Provide any additional remarks or criteria that apply to this evaluation or system specifications.

Provide any remarks or additional criteria regarding the system evaluation.

Enter the Munsell number and color for the second soil profile row of Site 1.

Enter the texture for the second soil profile row of Site 1.

Enter the starting depth for the second soil profile row of Site 1.

Enter the ending depth for the second soil profile row of Site 1.

Enter the Munsell number and color for the second soil profile row of Site 2.

Enter the texture description for the second soil profile row of Site 2.

Enter the starting depth for the second soil profile row of Site 2.

Enter the ending depth for the second soil profile row of Site 2.

Enter the type of establishment for the second unit.

Enter the number of bedrooms in the second unit. Fill only if 'Building Information Type: Residential' is 'Yes'.

Enter the total building area in square feet for the second unit.

Enter the commercial or institutional system design information for the second unit as per Table I, Chapter 62-6, FAC. Fill only if 'Building Information Type: Commercial' is 'Yes'.

Enter the Munsell color and number for the seventh soil profile row for Site 1.

Enter the texture of the soil for the seventh soil profile row for Site 1.

Enter the starting depth of the seventh soil profile row for Site 1.

Enter the ending depth of the seventh soil profile row for Site 1.

Enter the Munsell number or color for the seventh soil profile layer at Site 2.

Enter the texture of the seventh soil profile layer at Site 2.

Enter the starting depth of the seventh soil profile layer at Site 2.

Enter the ending depth of the seventh soil profile layer at Site 2.

Check this box if drainage structures are present as a site condition.

Check this box if a pool is present on the site.

Check this box if a patio or deck is present on the site.

Check this box if parking is present on the site.

Check this box if the property has a slope as a site condition.

Enter the specific condition or value related to the sloping property. Fill only if 'Parking' is 'Yes'.

Enter the name of the person or entity who submitted the site plan.

Enter the date the site plan was submitted.

Enter the Munsell number and color for the sixth soil profile layer at Site 1.

Enter the texture description for the sixth soil profile layer at Site 1.

Enter the starting depth of the sixth soil profile layer at Site 1.

Enter the ending depth of the sixth soil profile layer at Site 1.

Enter the Munsell color notation for the sixth soil profile layer at Site 2.

Enter the soil texture description for the sixth soil profile layer at Site 2.

Enter the starting depth of the sixth soil profile layer at Site 2.

Enter the ending depth of the sixth soil profile layer at Site 2.

Provide the soil texture and loading rate for system sizing.

Enter the title or license number of the person submitting the form.

Enter the date of submission.

Check this box if the system configuration is a trench.

Check this box if the system configuration is a bed.

Check this box if the system configuration is a mound.

Please enter the specific configuration detail or value for the mound system.

Check this box if the system design uses a header.

Check this box if the system design uses a D-box.

Check this box if the system design is a gravity system.

Check this box if the system design is a dosed system.

Enter the date the system was installed.

Check this box if the drainfield system is a standard type.

Check this box if the drainfield system is a filled type.

Check this box if the drainfield system is a mound type.

Check this box if the drainfield system is of a type not listed among the standard options.

Provide the specific numerical value for the Mound System Type.

Enter the Munsell color code for the third soil profile at Site 1.

Enter the texture description for the third soil profile at Site 1.

Enter the starting depth for the third soil profile at Site 1.

Enter the ending depth for the third soil profile at Site 1.

Enter the Munsell number or color description for the third soil profile row at Site 2.

Enter the soil texture description for the third soil profile row at Site 2.

Enter the starting depth of the third soil profile row at Site 2.

Enter the ending depth of the third soil profile row at Site 2.

Enter the type of establishment for the third unit.

Enter the number of bedrooms for the third unit. Fill only if 'Building Information Type: Residential' is 'Yes'.

Enter the building area in square feet for the third unit.

Enter the commercial or institutional system design details for the third unit, referencing Table I, Chapter 62-6, FAC. Fill only if 'Building Information Type: Commercial' is 'Yes'.

Enter the USDA Soil Series for Site 1.

Enter the USDA soil series name for Site 2.

Check this box if the type of waste is domestic.

Check this box if the type of waste is commercial.