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BOX 9
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PUTNAMit-60ity; kA
Pd
4m 6i-VUlage
69 3
Nge
Date,Perr�lt` wed
ws ter,
6won Se dc I
Ad d
ate S6001yDiffiiii
Number of Bedr" Has.Garbstib-i
I cert-�fy`that, it�ha "ayitei(s) as listed serving th� aboy.e.piemides w�re .669 kstru an ially as n ih leted work copies
with the standardi, rule's *a �d :"r* i i g u :L,in, cc plan, a. the- peoi t, issued by the
Outn� -county
,Oita Cartif led, b
'IU RTE 2 MM NY' 8329
Ezi&ee P.
TTE
at
de
h action as !nay a peCOSMYTI. I.i. thl 16i�e'ctlon of 'any unsanitary
va i o. is a di Id ary sewer becomes
resulting rom.
avallable sijpOly shall b666n�w n6114-hil-, blic'Water-supply. becomes available. Such" approvals Are
Date
`
0
`
^
o
BREWSTER LABORATORIES
Box 224 - BREWSTER, N.Y.
(914) 225 -2072
— WATER ANALYSIS REPORT —
SAMPLE NO. 6321
SOURCE: R & R Development Faucet - Well
Old Rte. 22
Patterson, NY
COLLECTED: Sept. � 23 , 1986
BY: P. F. Beal & Sons, Inc.
BACTERIOLOGICAL EXAMINATION
Coliform Count, MF Method p per 100 ml.
This result indicates the source .of the sample was
of satisfactory sanitary quality when. the sample was collected.
Sept. 24, 1986
_ _. - ..�..L.... -r .. w. - .- .v..wva 7.lr'C :r.. «.J:.:1.fv:v = ii:.n1 'i ••'1��::- i�ti.vi�:�..�:..':: p� -._:..
I
WELL-.COMPLETION REPORT - UrrlItUJGU.1It
DEPARTMENT OF HEALTH
Division Of Environmental Health Services — -
PUTNAM COUNTY DEPARTMENT OF HEALTH _..
41
WELL LOCATION
sTREEi ADURESS: fowrtiv0.LAGE /Cll'f fax GRID r+UtaBEi+:
old Route. 22 Patterson,NY
WELL OWNER
HAIME: • ADDRESS:
R &R Development, c/o R.Ra Drewville Rd.,Brewster,NY
❑ r ^gtVATE
Q _FUELIC
USE OF WELL
.1 - primary
2 - secondary
x&) RESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIR /CONO. /HEAT PUMP ❑ ABANDONED
❑ BUSINESS ❑ FARM ❑ TEST /OBSERVATION ❑ OTHER (specify)
❑ JiNIOUSTRIAL ❑ INSTITUTIONAL ❑ STAND -BY ❑
AMOUNT OF USE
YIELD SOUGHT 5 gpm. /N0. PEOPLE SERVED /EST. OF DAILY USAGE cal.
REASON FOR
DRILLING
® NEW SUPPLY = ❑ PROVIDE ADDITIONAL SUPPLY ❑ TEST /08SERVATI0i'l
❑ EEPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL
DEPTH DATA
WELL DEPTH 340. ft.
STATIC WATER LEVEL 20 ft.
DATE MEASURED 7/22/86
DRILLING
EQUIPMENT
a ROTARY ❑ COMPRESSED AIR PERCUSSION ❑ DUG
❑ WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify):
WELL TYPE
❑ SCREENED ❑ OPEN END CASING. IN OPEN HOLE IN BEDROCK ❑ OTHER
TOTAL LENGTH 26 ft.
MATERIALS: . 49 STEEL • ❑ PLASTIC O OTHEF
CASING
LENGTH .BELOW GRADE 2 5 ft.
JOINTS: ❑ WELDED aTHREADED ❑ OTH`R
DETAILS
•
DIAMETER " 6 in.
SEAL: 99 CEMENT GROUT ❑SENTONITE ❑OTH.E.R
WEIGHT PER FOOT 19 Ib./ ft.
DRIVE SHOE ® YES ❑ NO
I LINER: ❑ YES 93.N0
SCREEN
,DETAILS
DIAMETER (in)' SLOT SIZE
LENGTH (R)
DEPTH TO SCREcN (ft)
DEVELOPED?
FIRST
DYES ❑sa
- HOURS -- .
SECOND
�
GRAVEL PACK
❑ YES
❑ NO
GRAVEL
SIZE:
DIAMETER
OF PACX in.
TOP
DE ?TTi —ft.
SOTT0111
DE Tfi Ii.
WELL YIELD TEST It detailed pumping
METHOD: "UMPED ; tests were done is in-
O COMPRESSED AIR , formation attached?
❑ OTHER ❑ BAILED
L�� It more detailed formation descriptions or Sieve analyses
are available. please attach.
DEPTH FROM
SURFACE
Water
Hear-
well
Dia-
"`r.
FORMATION DESCRIP710tt
c of
I
,
.
WELL DEPTH
ft,
DURATION
hr. min. '
DRAVIDOWN
ft.
YIELD
ypm.
Land
s�r�ac:
4 I
Dr
ll '
ng in overburden clay and bldr .
Hit
ock 4 feet
340 '
6
32,0
15
4
26
D
it
ing in rock,set casing,grou e 1
26
34o
D
it.ing•in
rock granite.
WATER ❑ CLEAR TEMP.
QUALITY O CLOUDY HARDNESS
O COLORED ANALYZED? ❑ YES ❑ NO
ANALYSIS ATTACHED? ❑ YES ONO
I I
STORAGE .TANK; .TYPE 'Well. Xtro1�WX .250 . _` V
CAPACITY 44' ` `" " ' GAL. 13.6
PUMP INFORMATION
TYPE submersible CAPACITY 7 gpm
NAXEA Gn1i1 rl DEPT- -
2'10 .... �
WELL DRILLER NAME P•. F . Beal Sons
s /,' ["/1/23/86
AooRESS Brewster - N Y1050ytcj�
�
I%
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
er or Purchas& of Buildi Section Block Lot
01
Building Constrmtted by o
Locatidi - S ee
Municipality
Building Type
S ub6lvi sion
7
Subdivision Lot #
GUARANM OF SUBSURFACE SEWAGE DISPOSAL SYSTEM
I represent that I am wholly and completely responsible for the location,
workmanship, material, construction and drainage of the sewage disposal system
serving the above described property, and that it has been constructed as shown on
the approved plan or approved amendment thereto, and in accordance with the
standards, rules and regulations of the Putnam County Department of Health, and
hereby guarantee to the owner, his successors, heirs or assigns, to place in good
operating condition any part of said system constructed by me which fails to
operate for a period of two years immediately following the date of approval of the
"Certificate of Construction Compliance" for the sewage disposal system, or any
.repairs made -by me_ to_ such. - system, except where the failure to operate properly is
caused by the willful or negligent act of the occupant of the building utilizing
the system.
The undersigned further agrees to accept as conclusive the determination of
the Director of the Division of Environmental Health Services of the Putnam County
Department of Health as to whether or not the failure of the system to operate was
caused by the willful.:or negligent act of the occupant of the building utilizing
the system.
rev. 9/85
mk
s F
nwr enhil
C-ONSYF,t.U6T'iON' PERM IT ,�FOR SE
' : I I
Subdi4lilon �iibd L6
R
A'Pp
8ulld�ng' Type � Lot Area
xe-W
Number of Bedrooms 2 Design F16�1' q/P/D
. '
_.
.1s.�-piratisewerage�,� System;
To -,.be constructed
,Water supply:;__ Public Supply From
'Pirvate 'drilled.*-!by,,..'--�f 0
.��Up
Z io
A
Other -Requ ;ehts
f or the design
above .,described will be'const-ruct'dd%as,shown"6i!NtO-P approy_ amendmi
ounty'"6epartment of ,.Heat
,
merit and- a,writte
be -su 'submitted ,to- the ' -' Depai
,'
...:,place -in good,- operating. cond,i tion any part" 64', said sewage dispose
nce Ahe :approval of 'the Certificate ructlQP- _Ipqmp 'a nci
'will be located as _t_qyn:qn .-approved p lan apdIthat, said well Jkilljbe.
Address
APPROVED :rORCONST,R. Ui1 IT'- l ZN,,TfilsI"— approval expues onw, years
,. evocable for causeQor . amended
n consider
- requires .a new,,per,mIX;!or ' P 0
' a
Z 7
Y.,
P
A
x.
ENGINEER -.�-TP -'P.Rp,,V PERMIT I'
-I DE
ION ��CA R� F TC CEO
COMP
7pt i cAT
fh Y
N illage
P.,
.Tax
0
P 4e 'i.' 'API'
4.1
��R�r Fill Section Only ❑
Ni�iih _ati .4u, red
C
A fr-
7�
?Rd XI M,,,. A;,
cation of�the proposed` systems) 1) 7
i4,sepmratesewa Ie disposal system to
fre.to and in"
o Putnam
'
ulations of., the
accordance ' . issictner of Will
ed ( t6nstr'6ctloA�- blffiplia,ncell�� sat istactory to , lhq�.. C om rn
t
t t" 6u"ild6r,- hat:.said -builder will
Im - iy f6116viiiig thedata ofthejsiu-
L he* tWr�iiioj!,2)*ihattfie drillid well descr I 'bad above
Putnam
A
F!.E.
License IN ot
f,09
a in ;undertaken and Is',
C� ifkih 'of, cons ruc on
Ih
to water
j
_ V' ..� .�'`A�" jy:t.�ti'31'77!4ti� 4.i,'..'..•I�.}�, ••�c;.� —� -t Y,iJ��..�}:�.. .? _ _.w — - � ':'f" " %•:: -. ..: ;.__.. -,; ;
'X%-.. _ � vim.. ..� -- !y �� -e I� ��� • - � •
T .nSkY•S:. .• = r- ..W'V.•?r -• � f� I� �41M. )•s'• . Y . . 4:• y: '.' �. .. � .. �� . .. .- y..��'• _�`.
PUTNAM couary DEPAMMU OF HEALTH - DIVISION OF F�IVIRONME.NTAL HEALTH. SERVICES
- FIELD INSPECTION REPORT
���� DATE:.
O /��-�.� <5? INSP.-BY:
(Name of Own (Street Location)
INITIAL SITE INSPECTION YES NO OOMME M
Wetlands;-,on /or proximate to property.........
Prope -rty .lines or corners found........ - -• Can estimate house location... ...............:
Will driveway need cut ............. .............. -
Dust trees be removed - note these.................
Deep holes representative of entire SDS area......
Additional deep holes needed .......................
Sufficient SDS area available.considering driveway
cut, house location, separation distances,etc...
Adjacent wells/ septics ..........................
"A-- , -- 4-^ wAi l i nr nt -ion for drilling.... .
D. H.' 1 Lot `
Depth to G.W.
Depth to rock
Soil Descriptio
0 ft.
3 ft.
6 ft.
9 ft.;
12 ft.
MORNMRWO
D. H. 2 Lot
Depth to G.W.
Depth to rock
0 ft.
D.H. - Deep hole
G.W.-Groundwater-
D.H. 3 Lot
Depth to G.W. 2 9
Depth to rock
Soil Description
0 ft.
3 ft.
6 ft.
�� • � �iFfi
YES i NO
House SSDS located per approved plan ...........:.
Length of trench measured L/30
Width of trench average
Slope of tile line and trench acceptable.........
Roan allowed for expansion trenches ........:.....
L
a
Over 100 ft. fran watercourse ....................
Natural soil not stripped or SDS area
unnecessarly graded....... ............ •..
U
10 ft. maintained fran property line and
20 ft. fran house..
Distance well to SSDS (ft.) ......... .....
i
Number of bedrooms checks.., .....................
Stones, brush, stumps, rubble, etc., greater
than 15 ft. fran nearest trench ................
15 ft. of peripheral soil horizontally
...... ........................
fran trench.....................................
Boxes properly set...............................
Could surface runoff fran driveway, roads,..
ground surface,_etc., channel near SDS area....
Does lot drainage.appear OK in area of SDS :......
•.:F,INAL GRADNG OF SITE A�TAS1' F
(I.L.
�In
1 1111
„11 n
4� I11
111"
11211
t
4811
Im
will
fG,ll
frllt
1111 11
Geord�e` Weigand
� /Cyitnv ,�AP�
'TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION
DESCRIPTION OF SOILS ENCOUN'T'ERED IN TEST HnT..V. g. _...__._...._.. .
BOLE NO. IA HOLE NO.. 113
oam
S
I.
I
III UCIA11t: LEVEL AT WHICH GROUND WATER IS ENCOUNTERED
1111 ICATIi: LEVEL `i'0 INCH WATER LEXEL RISES AFTER BEING ENCOUNTER
Tl-:151'b MADE BY � 6 %N 6bour Date 2��85
DESIGN
!41111 lViLe Used /6 Min/l "Drop: S.D. Usable Area Provided
Ill►. of Bedrooms 3 Septic Tank Capacity ./4040 Gals. Type 1b*-%w 12,V
A l morpl..l.on Area Provides By 4Z 9 L. F. xW.' ) „ C, rene i s
ThIS SPACE FOR USE BY HEALTH DEPARTMENT
Soil Rate Approved Sq. Ft /Gal.
COR,
L
1980
• `VFW Y ��`�
CheclY d...Hy Date
F�
PUMAM. COUNT
DEPT- OF HEALTH
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512
DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM
OwnerGeorge Weigand
FILE NO.
Address% Scout Realty Rte 6 & 22 Brewster, NY
10509
Located at (Street Rte 22 /Rte 164 Sec. 69 131ock5 Lot
�Indicate neares cross street)
Municipality Patterson Watershed Croton
SOIL PERCOLATION TEST DATA REaUIRED TO BE SUBMITTED WITH APPLICATIONS
Lot 1
bole
Number CLOCK
TIME
PERCOLATION
PERCOLATION
Tun
Elapse
Depth to Water
W a U er ve
No.
Time
From Ground Surface
in Inches
Soil Rate
Start =Stop
Min.
Start Stop
Drop in
Min. /in drop
Inches Inches
Inches
125 - 55
30
21 23 3/8
2 3/8
12.6
256 - 26 30 . 21 231 2 * 13.3
327 - 57 30 21 23 7/8 2 3/8 12.6
5
258 -.28 30 21 22 7/8 1 3/4 '17.1
329 - 59 30 21 22 7/8 1 7/8 16
W�
1
2
3
5 P111H A AA 1pu61re
DEPT. OF HEALTH
flotes: 1) Tests to be repeated at same depth until approximately equal soil
rates are obtained at each percolation test hole. All data to be submitted
for review.
2) Depth measurements to be made from top of hole.
i IiIS IS •i U CERT I. "Y THA f THE SEWAGE
,.DISPOSAL SYSTEM WAS CONSTRUCTED AS'
INDICATED ON THIS PLAN AND THAT 'THE
SYSTEM WAS INSPECTED UNDER MY
SUPERVISION BEFORE IT WAS COVERED
OVER. THE SYSTEM WAS CONSTRUCTED
IN ACCORDANCE WITH ALL STANDARD
RULES AND REGULATIONS OF THE
PUTNAM COUNTY DEPARTMENT OF HEALTH
AND THE NEI
OF HEALTH.
" B PORA
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