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HomeMy WebLinkAbout1073DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 25.54-1-13,14 & 16 BOX 11 01073 I 'aaa a t'� iii 1�Ll., V o 1 �, ' 1 is r L. j 'I ,. Lr. I ." . 01073 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner K goNA19`p Y Address Ai)p16ea -biz, 4- `Q gEL M AjZ p a- Located at (Street) ca hi TON 'D`R., Tax Map a 6#5413lock I Lot l-3 —/6 (indicate nearest cross street) Municipality ? - jTgQ:!$pyy Watershed g4.6-' 'RgAge -H SOIL PERCOLATION TEST DATA Date of Pre- soaking l Z % % Date of Percolation Test / l %i 1 2 3 4 G 2 3 4 5 1 2 3 4 5 NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. s 1 min for 1 -30 min/inch, s 2 min for 31760 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD -97 DEPTH G.L. 0.5' 1.0' 1.5' 2.0' 2.5' 3.0' 3.5' 4.0' 4.5' 5.0' 5.5' 6.0' 6.5' 7.0' 7.5' 8.0' 8.5' 9.0' 9.5' 10.0' TEST PIT DATA 2 DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES HOLE NO. _1 HOLE NO. �_ HOLE NO. y Z, e a t - ,er rdvt 7 ' —O Indicate level at which groundwater is encountered 6 a Indicate level at which mottling is observed Indicate level to which water level rises after being encountered Deep hole observations made by: e�7, , g ,-- p Date a 9 g 9 Design Professional Name: Address: Signature: Design Professional's Seal 0 RECORD OF PHONE CONVERSATION Time: 3 5 Date: 3 za 9 Person calling: Phone #: a- 7 g (3 L�vre r� �- Reason () Inspection: KDeeps and /o eres: c 5 04 , Scheduled Field Meeting t � Time: Date: / Y N Tentative /to be confirmed O ( ) Town: ea-41 . _ .. ... ... _Road /Street: A�QG� `1 - - ;f -1� - r. Tax Map rhry l� Comments: RECORD OF PHONE CONVERSATION Time:© Date: Person calling: Phone k _ 78 Reason ( ) Inspection: ee and /or Peres: _ Deeps ON/ Y Scheduled Field Meeting Time: Date: Y N Tentative /to be confirmed ( ) ( ) Town:, Road /Street: ;Ami!g!v/j[ ` a ri I Dei /K.4R. Dr, Tax Map Comments: 7� 16 -- 7&/., 20 6.- NIP i t 1 1 �. N 96a000 1 I I P/0 1 1 I FFt,J6 _ 1 1'Ti/ IJLtO O $ _ `lSd9 �I rsrt� tsrr 1 tus lsfr 6000 rsi '7 J I , 1 1 1 f 60 00 1 I KENWOOD FJ TO I I ,ys,l 1 1 ! I I I ao.°pI 41I ! ! 1 a 140 1 I n c� 1 a / 17 �� a r,. ca oa / o. / /xrs ai✓ � / / / / ircp �o�� leis rrir / 5 m I'j 16�'isir / 17 .aceI 1 I L / DELMAR ROAD . 100 cc tart° 9:11 I I — — — — — — I i 1 1 I 1 firs _ I I I 101 I 1 9i arc 9 s •xr• I tr" I _ I I rvr — — — — — z —1 I I I ao.CO 9t90 • ICO.CO 1Z'" I eoco loo.a tut et t' /atr I I I /nrl lira 1 711 — — — — — — w ti tusl ' trr/ er n r rir 1 I I iur trti i I I 1 6 — 4 IVY _ — I I I I I 1 I 1 I nst — — — — — 16A7 1 i I I IIOb.00 IOT.16 e0 60 u151 ROAD v V z 0 gyp' see Lj 12563 68 - � 3 21 �PJ\�NO °a\p.� l \ rtiaviland ollow l ( 'Mendel Pond 164 65 e Ur AD q1E � T j, Haines �--� g• ,.�, (� Corners ) p s u Igo N — .. pig 3 I � " fi '� r I9'`' E — m Pond @° Lake i. Obrnum orn �Losr`�p Steinbeck Corners .. . rr I' Lake _. . _ Gr new' harles�� 4 d �Farnr�Centet� ' — 22 ero3ic ` peg r st t - -- �U iqueArea Mount Ebo rs Corporate » e 62 " Hs a Corner 'DES ° �� s � Hatdoa s �/ Pond a � c 0. r ,...ate\ ; 54 t' �_, .'Qon _., 2 �� ;B088_�—� ; r Breruster,-," -) §1 Pond pp 38 MS fig ® state o Police C■ old Southeast hurch __ ... :..= 3121 1 s Hers rem e a on , --q,-- ` O ou o w r w \V •(� ;1 4 9 k rrl Brewster t `Woods R tr a � c 0. r ,...ate\ ; 54 t' �_, .'Qon _., 2 �� ;B088_�—� ; r