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DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 33. -2 -8 BOX 13 � ,. �16 01396 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health Rick Zapp Putnam Engineering 4 Old Route 6 Brewster, NY 10509 Dear Mr. Zapp: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BOND[ County Executive ROBERT MORRIS, PE Director of Environmental Health l April 11, 2007 Re: Proposed SSTS for D'Agostino at Lot # 2 — Merritt Development Corp. (T) Patterson, TM # 33 -2 -86 This Department has received and reviewed the revised plans for the above referenced project and the following comment is offered for your consideration. Upon review of the revised plans the following items will require the issuance of a specific waiver: a. Two (2) bedroom dwelling b, . Toe of :fill,. »ad .Less. than 10 fPPr try property line. c. Fill depth greater than 3.5 feet. d. Regrade SSTS slope from 16% to 15% Please complete and submit the enclosed specific waiver application so that the project can be placed on the agenda for the next regularly scheduled Departmental waiver meeting. Upon completion of the above, this Department will continue its review. Kindly advise us if there are any questions. MJB:kly Enc. Respectfully, Michael J. Director of Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 =6648 LJTNAM ........... EINEERI E, PLLE. Eng/neers and Architects May 3, 2007 Michael Budzinski, P.E. Putnam County Health Department 1, Geneva Road Brewster, NY 10509 RE: Salvatore D'Agostino Towners Road Town of Patterson TM #33 -2 -8 Dear Mr. Budzinski, As per our phone.conversation on May 1, 2007, we have made the following revisions to the SSTS Plans: Surrounding wells and septics have been shown on the plans. 2. The Retaining Wall Profile has been removed from Fill Plan. Enclosed for your approval are 5 copies of the revised SST S Fill Plan and one copy of the revised Trench Plan. Please contact me at this office if you have any questions. Sincerely, PUTNAM ENGINEERING, PLLC i Richard J. pp r. RJZ /ea Enclosure (1,07105) 4 OLD ROUTE 6, BREWSTER, NEw YORK 10509 o (845) 279 -6789 o FAx (845) 279-6769,, EMAIL: info ®putnameng.;com a UTNAM :...... - NGINEERINC.,PLL .. Eng/neers and Architects 4 r: May 9, 2007 Michael Budzinski, P.E. Putnam County Health Department 1 Geneva-Road r Brewster, NY 10509 RE: Salvatore D'Agostino Towners Road Town of Patterson l TM #33 -2 -8 Dear Mr. Budzinski, !'Enclosed for your,ppproval are five copies of the Fill Plan and one copy of the Trench Plan, revised to jei +hut .the location of the existing SSTS on the adjoining lot to the west and location of the proposed well on Lot #1 to the east of the subject property. Please call me if you have any questions. PUTNAM ENGINEERING, PLLC r Richard J J. Z ' .X RJZ /ea Enclosure (L07108) q" 4 OLD ROUTE 6, BREWSTER, NEW YORK 10509 • (845) 279 -6789 • Fax (845) 279 -6769 • EMAIL: info@putnameng.com LJ T NA V9 'N- EANEER .II . E PLLE. - Engineers and Architects~ September 19, 2007 Michael Budzinski, P.E. Director of Engineering Putnam County Health Department 1 Geneva Road. Brewster, NY 10509 RE: Salvatore D'Agostino Towners Road Town of Patterson TM #33 -2 -8 PCHD Permit #SW -06 -07 Dear Mr. Budzinski, I am enclosing two sets of new two bedroom floor plans for the above referenced project. We request your approval of the same. It is my understanding that the Town of Patterson Building Inspector has already issued a Building Permit for this layout. Please let me know if there is any problem with this design. Sincerely, PUTNAM ENGINEERING, PLLC . I , . I RJZ /ea Enclosure (1,07201) 4 Ot_o RouTE 6, BREWSTER, NEW YORK 10509 o (845) 279 -6789 o Fax (845) 279 -6769 o EMAIL: info @putnameng.com LL Z w w J 0 z w O� }QO � � N A w Aw_ �uw cD U } z .040 vcm� QOM <w zOA wwA v LL- Qi �Qw' -'Or 10 OL LLI —► p z IL�p�A Q� Lu J) lu LU < x lu <�W i-- Qom} -�LL.i Qv�cs1�0� -- T QiiAzw ts) ca %J I-IN C, A��pCo D- z O W NQLL! Q— A J _' cn zw� tSlZcfl [L. O O=Ow F— v�v�vA � N 11> i i N N O Q lu z w O� }QO � � N A w Aw_ �uw cD U } z .040 vcm� QOM <w zOA wwA v LL- Qi �Qw' -'Or 10 OL LLI —► p z IL�p�A Q� Lu J) lu LU < x lu <�W i-- Qom} -�LL.i Qv�cs1�0� -- T QiiAzw ts) ca %J I-IN C, A��pCo D- z O W NQLL! Q— A J _' cn zw� tSlZcfl [L. O O=Ow F— v�v�vA ............. ............... . ............ . ......... .. . ............ . ........... . ........ . . - 1pg*Tpal A-90190.9zs 74 ............................... Oj Ol IN x11317 allft M ti PUTNAM COUNTY DEPARTMENT OF HEALTH 14714, CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT SYSTEM PCHD CONSTRUCTION PERMIT # SW - o(o —0-1 Located at 5SS '%>wra,�zs 2.,Afl Town or Village 'PjSQ -r-rE o,J Owner /Applicant Name SAl-y4Tor,_ n o� cSSsr,,Jo Tax Map 35 Block 2 Lot e Formerly 1,IA Subdivision Name Me_Rr_% -r V et-oPrn r corLP Subd. Lot # Z Mailing Address 91 1 1.Y-f_r- 'p(z \-4 r• /"16! V}cPP rL , t J `( Zip i vSA+ 1 Date Construction Permit Issued by PCHD Ibs Separate Sewerage System built by kw-,A Address 216 aLx_t 5yv_,,ou t?o. -na�PAL r" 'y' Consisting of I C)CO Gallon Septic Tank and V744 L. F. ofz 2' 0 1 oil. Trt —,.je i4 Other Requirements: 3�%2' f2- fry��- I2� �• Pur-�P PST /�yEf�F� oy t^+r•n� Imo, 2 �'�yL For na,J Water Supply: Public Supply From Address. or: Private Supply Drilled by P F. e>eAL.4So, 5.i .Ac_ Address 4 Pu-r.ie,,rn Ave. CiP.-sus-,�t� rr R,,ldina T . 1C�h - .- ype- rn ,R S; � -- Has.. eras- ion�ontrA- been- com.pleted2_.__ _.5 Number of Bedrooms 2 Has garbage grinder been installed? r•lo I certify that the system(s), as listed, serving the above premises were constructed essentially as shown on the as- built plans (copies of which are attached), in accordance with the issued PCHD Construction Permit and approved plans and the s dazds, rules and regulatio .Qi e Bepa;r e�I of Health. Date: i 1 u Certified by '' P.E. XC R.A. (Design Professional) Address _Ro i �.1An �J�,,,l�etz,, -� .pt-u:. , $ eg> R 60 License # ©&^l4`-1(D /c9 Z909 Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewage treatment system shall become null and void as soon as a public sanitary sewer becomes available and the approval of the private water supply shall become null and void when a public water supply becomes available. Such approvals are subject to modification or change when, in the judgment of the Public Health Director, such 0 White copy - HD R change is necessary. Title: - Building Inspector; Pink copy - Date: r r 4 copy - Design Professional Form CC -97 BRUCE R. FOLEY Pabl:c Health Dfrecxr DEPARTMENT OF I Geneva. Road Brewster, Now York LORD —=A MOLD AR . RN., &U.N. Atraeror of pat;ant Ssrvicrs HEALTH 10509 'Ea"Cea®Qattl Ileslth (914) 278 - 6130 Fmc (914) 279 . 7921 tiutslrtq Servteq (9141 272 .655E WIC (91.41271 -6678 Fax (914) 278-604.4 Early ioceryeacioa (914) 278 - 6014 preschool (914) 218 -do92 Fmc (914) 218-- 6648 r OWNERS NAiV1E: SAC V 1a4X A i( ' _ TAY -MAP ffU- -NIB ER: E911 ADDRESS: 3Z 3 7 cvAvwr r 00OP0.4 Cr . TOWN: AUTHOR TOWN OFFICIAL: (Sibuature) DATE: The Putnam County Department of Health will not issue a Certificate of Construction Compliance unless fhe above form is completed, i.e., a legal E911 address.is assigned by an authorized town official. This form is to'be submitted -with the application for a Certificate of Construction Conipliance. (E9 ;1 PUTNAM COUNTY DEPARTMENT OF HEALTH' DIVISION OF ENVIRONMENTAL HEALTH SERVICES _. WELL COMPLETION RI =I?OR7 true Well,Locatlon Street Address scca€tGtetri Tovvn/Vtllage :Map Tax Map # : Block Lot(s) GR z:.: Mlelf'Owneri Atld'ress: Sal Dia 3 93 e g 14401= , V i6 3 , Use of Well: 1- Primary 2- Secondary. X Residential ` _Public Supply Air. cond /heat pump _Irrigation Business'. Farm Test/monitoring _Other(specify) - Industrial institutional . Standby. Drilling Equipment Rotary _Cable percussion Y Compressed air percussion Other(specify) . Well Type Screened _Open end casing Open hole in bedrock _Other . Casing Details Total Length . .: 9- _ft. Length below grade 31ft. . Diameter bin. Weight per foot . 19 lb/ft Materials: 1 Steel ... ..Plastic "Other Joints: Welded X Threaded Other Seal: X Cement grout Bentonite . Other Drive shoe: _ x Yes _ No Liner: _Yes Y No Screen Details Diameter (in) Slot Size Length (ft) Dept to- Screen ((ft) Developed? First Yes _No Hours Second Well Yield Test Bailed y Pumped _3(Compressed Air Hours Yield in gpm Depth Date Measure from land surface - static (specify ft) During yield test (ft) l5epth of.c . ornpleted well in ft. Well Log If more detailed information sieve analyses are available, please attach. If yield was tested at different depths during drilling list: Depth From Surface . - Well Diameter ft. ft. Water Bearing in ind SurfaceL nyc r3trrrri �n r Feet Gallons Per Minute Pump /S Pump Type ,;jib Depth 320 4 Voltage 23t1 Tank Tvoe dl` 95f Formation Description e Ta Capacity 3' arm Model ;,,q Al2 HP,'� Volume IaL oai NOTE: Exact Location of well with distances to at least two permanent landmarks to be. provided on a separate sheet/plan. White copy: HD File; Yellow: copy -'Building Inspector; Pink copy - Owner; Orange copy - W611.driller Form WC -97 Rev. 3/06 ,4!* DEPTH ::0.5' 1.0' 2.0' 2.5' 4.0' 4.5' —5.0' 5.5' 6.0' 6.5' . 7.0' 7.5' 8.0' 8.5' DF,sC -WTIUn yr 3vjjuJ W_• _..._ --- HOLE NO. HOLE NO. HOLE N0. _ 9.5' 10.0' 'cat evel at which groundwater is encountered Indic t��di to level at which .mottling is observed 1 icate level to which water level rises after being encountered. Dat eep hole observations made by: W Professional Name: ��� �� '� '� = Design AEZ Address: (i U 7 C Signature: Design Professional's Sea' pUTNAM COUNTY DEPARTMENT OF A-L t ti DWISION OF ENVIRONW,,NTAL HEALTH SERVICES a TP Hi`E 6J TR IEp T SYSTEM JRF SEWAGE DESIGN,DATA _ SLEry `V �4 / _ Owner ,:�33A Address Located at (Street) 72 CZ,:2 _ A-D Tai: Map _3,3_ Block Z- Lot (indicate neargt cross street) Municipality Drainage Basin r1►o1:>L1E5 SOIL PERCOLATION TEST DATA (Fi mot, S�T Date of Percolation Test 1 3 ( O'S Date of Pre -soa tug Hole No. Run No. Time Start - Stop Elapse Time (Min.) Depth to Water From Ground Surface (Inches) Start Stop Water Level Drop In Inc%es Percolation Rate MinAnch 1 2 10:03 - 10 :13 10 19 19— 3 1o: —1a:41 19 5.0 4 /0:11 -(a: 3 5,0 —10:1 2 (co:1`?7 3 fD- 3(o-'to:S3 4 5 2 3" 4 5 ed at same depth anti! approximately equal percolation rates are obtained at eacl NOTES. 1 Tests to be repeated percolation test hole. (i.e. <- i min for 1-30 min/inch, < 2 min for 31 -60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. I pffulm� -H//Vb,,,P. Engineers and Architects SEPTIC SUBMISSION FORM TO: t \ l ��� f5kJD2.( DATE: I �r PUTNAM COUNTY HEALTH DEPARTMENT PROJECT: T�,��czs iLO, ��� t'�^ r �So��, Tn 33 -2-8 . P�c� �n ► `��-ao -0--1 ENCLOSED, PLEASE FIND: COPIES OF THE SSDS PLAN (Tlz&-%c-vv ® COPIES OF THE HOUSE PLANS E CONSTRUCTION PERMIT APPLICATION ® WELL PERMIT APPLICATION ® HEALTH DEPARTMENT FEE ($500.00) ® SHORT EAF DESIGN DATA FORMr�w'rlo� ® LETTER OF AUTHORIZATION ® APPLICATION FOR WASTEWATER. TREATMENT (PC -97) 0 REMARKS: COPIES TO: (sepsubForm -2001) LETTER OF EXPLANATION SIGNED: ?-� G� ZN"'ep 4 OLD ROUTE 6, BREwsTER, NEw YORK 10509 o (845) 279 -6789 . Fax (845) 279 -6769 a EMAIL: info@putnameng.com In/ LJTNAM qII �Ga PLLC. - -� - Eng/neers and Architects - September 24, 2008 Michael J. Budzinski, P.E. Director of Engineering Putnam County Health Department 1 Geneva Road Brewster, NY 10509 RE: - Salvatore D'Agostino Towners Road Town of Patterson TM 433 -2 -8, PCHD Permit #SW -06 -07 Dear Mr. Budzinski, Please be advised, the Trench Plan and Construction Permit application submitted on .September 15, 2008 for the above referenced project has been revised as follows: The primary trench layout has been reconfigured from three 74' long absorption trenches to five 44.5' long trenches located in the uppermost left corner of the fill pad. This revision -was made to locate the primary system in the center_ of the vad and provide additional separation to the top of slope. In addition, I am enclosing a check in the amount of $250.00 made payable to the Putnam County Health Department as required for a revised layout plan. Please contact me at this office if you should have any questions. Sincerely, PUTNAM ENGINEERING, PLLC or -090 �O 0 Fm RJZ /ea Enclosures (L08179) 4 OLD ROUTE 6, BREWSTER, NEW YORK 10509 0 (845) 279 -6789 o FAX (845) 279 -6769 o EmAtu info @ putnameng. com ' :.: i ,.:..., - , 0 02 AM co � ,�'`�,� �t-A SSG .:..< ID \ J)A ... _ Oc FF T1102 c.•:,;.:,•• - /`TAY ' IDEt?�G Q � C-1 z.. Al 114 �• 5 �rA P5 1 I'TIG T PNi i l r V 6' 5 � XIMA TE s `' S APPRP N OF 1 ® �ftPJN .� - i �� / 5 fEXGST NG, 5 C WELL P3 �,- `RIP Rp`Q ,:, '� Q •.. -_- . _....._. APPROXIMATE L OCA TO N OF l EXISTING SSDS / ON- J . ,08 TUE 12:51 FAX PCHD r i LJTN" 1 . r ' -' -,E,- EPLLL 77 Engineer.5 8r7d Architects DATFr3 TO: bfiJVz,,Asr,-1 f FAX NO: 9- "i 3 ! i9Z ( Eli-r) 1@ 001/002 RE: 'SAW is+'rG , 3:2!0,e To- . _ - -rp "f-� F$, � PAGES:_, including this coaxer sheet. rt From the desk of... RICHARD I LAPP JR, SR. PROJECT ENGINEER J8 TUE 12:51 FAX PCHD 1a002/002 . C PUTNAM COUNTY DEPARTMENT OF HF LTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES ATTENTION ntc -kv-cc. REQUEST 'FOR FINAL INSPECTION For: All information must be fully completed prior to any Inspections being made. Fill Trenches PCHD Construction or Repair Permit # 50 —CX Located: a (T) (M __'--- C'r -;zs,o Owner /Applicant Name: ,Gp�y .i TM 33 Block 2 Lot $ Formerly_ r-i Subdivision Name: Subdivision Y_.at # Is system sill completed? Date; 1z/j qk-} Is system complete? r3o Date: h4 AK Is system constructed as per plans? A Is well drilled? r• o Date: Is well located as per plans? Are erosion control measpjes in place? I certify that the system(s), as listed, at the above premises has been constructed.and I have inspected and verified their completion in accordance wi I �CHD Construction Permit and ' �: approved plans and the Standards, Rules and td& tnam County Department of Health. �s~` Date: o Certified by; Address: o3ggg Lic. # ocw -i44Gn Comments: Form FIR -99 .� _ ..____.�r.l�- _------- '�-- -. - - -- f- �-� -- -- _____4�_._______ __ ;� ___ -v 1 A , ;_ � j. � �: � �� �1, 7_ _ . �� J,,+, +/� �+ / _--- _____..________ ___.,_ -- __._ .__ i _ �& __... �.. � _ - _..__ -- - ._.___ - - -- __. - - -- ._- -._... �.._ -- _. -1 .. _ . � �- �l� �_ ,; __ . _ _� _ .__._ _ _ .._i _ __._. a ;� I SITE INSPECTION FOR FILL PAD Date: Inspected by: Fill pad located per the approved plan Fill Pad Length Required Length_ � B Fill Pad Width Required Width 3yi (� Fill Pad Depth Required Depth �0 C `� Run -of -Bank Fill Quality Slope from Top to Toe Impervious Layer Installed - Erosion Control Installed Sieve Test Results a pplicable) Reserved for Field Sketch if ADnlicable �-)JO. Ta c,o 5-7,4 Pat IL W' pu W4 L1. MC FINAL SITE INSPECTION Date: Inspected by: Street Location bwl� Owner 7J'/v�Go�retr�> Town Permit 4 SW-06 d `1 aibdivision Lot - #.... 0 1. Sewage Svstem Area a. STS area located as per approved plans .......... .. ................ b.. Fill section - date of placement 3:1 barrier Lgth. Width . Avg.Dpth c. Natural soil not stripped ......:............ ............................... d. Stone, brush, etc., greater than 15' from STS area.......... e. 100' from water course / wetlands ...... ............................... IL Sewage System a. Septic tank size - 1,000 .......... 1,250 ......... other ................ b. ' Septic tank installed level ................ ............................... c. 10' minimum from foundation .......... ............................... d. Distribution Box 1. All outlets at same elevation -water tested ................. 2. Protected below frost ................................................. 3.. Minimum 2 ft. Original soil between box & trenches e. Junction Bog - properly set .......... ............................... 6. Trenches 1. Length required Length installed 2. Distance to watercourse measured Ft.......... 3. Installed according to plan ....................................... 4. Slope of trench acceptable 1/16 - 1/32" /foot ............. 5. 10 ft. from property line - 20 ft.- foundations.......... 6. Depth of trench <30 inches from surface .................. 7: Room allowed for expansion, 100 % ......................... 8. Size of gravel 3/4 - 1112" diameter clean ...................: 9. Depth of gravel in trench 12" minimum ....... :........... 10. Pipe ends capped ........... ................. I ......................... . g. Pump or Dosed Systems -.. -.. 1 Size of.p .......................... . 2. Overflow tank ................ • ............ ............................... 3. Alarm, visual/ audio ....... .:........... ............................... 4. Pump easily accessible, manhole to grade ................. 5. First box baffled .......................... ............................... 6. Cyycle witnessed by H.D.estimated flow /cycle........... III, House - uildina a. house located per approved plans........... • ........ • • ............ b. Number of bedrooms...................................................... M W ell Well located as per approved plans . ......:.......................• b. Distance from STS area measured ft ........... c. Casing 18" above grade ................................................ d. Surface drainage around well acceptable •.......• .............. V. Overall Workmanship a. Boxes properly grouted ...................... ;........................... b. All pipes partially backfilled ........ ............................... c. • All pipes flush with inside of box ... ............................... d. Backfill material contains stones <4" diameter .............. e. Curtain drain & standpipes installed according to plan.. f. Curtain drain outfall protected & dir.to exist watercourse g. Footing drains discharge away from STS area ............... h. Surface water protection adequate.... ....:.. ........................ i. Erosion control provided ................................................ Rev, 12102 1 F / SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health Putnam Engineering Paul Lynch, PE 4 Old Route 6 Brewster, NY 10509 Dear Mr. Lynch: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 August 8, 2008 ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health Re: Field Inspection — D'Agostino Towners Rd. (T)Patterson, TM 433 -2 -8 A fill pad inspection was made August 7, 2008 at the above address. d�U _ 1 It appears that the pad size is too small to support the trench plan. Please stake out of 11j the trenches and contact this Department when the staking is complete. It appears that the side slopes are not at 2 /1. I -appears- ililyiriviJil3 sGii ila8 i1Gt Ueell'pI'avlded." "' - 4) A sample of the fill has been taken for a sieve test, due to the appearance of fines and silt in the fill. 0 J6, 413109 ZTVC 91 If you have any further questions, please contact me at (845)278 -6130 ext. 2155. Sincer , JD-lm Digit Engineering Aide Environmental Health (845) 278 -6130 Fax (845) 278 =7921 Water Supply Section (845) 225 -51.86 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool (845) 2713 -6014 Fax (845) 278 -6648 Sheet of PUTNAM COUNTY DEPARTMENT OF HEALTH .m • :• - -..:. I3IVISIOIV- O��] ENYII3. O�iME�1�F� .����EA�L)€i::S:E•R�IC -F�:: ..._--- _..,__,- -., � __._..._�.r_ . FIELD ACTIVITY REPORT NAME: � Ted: Street Town State Zip PERSON IN CHARGE C)R TNTFRVTF.W .T)-. natP= Name and Title TYPE OF FACILITY: . z=�1 TNSPEf`TC)R, TFT Signature and Title RFPnRT RFC F.TVFT) BY., I acknowledge receipt of this report: SIGNATURE: 02/96- Title :, Rev_ FFR(1 acknowledge Rev Titl r A •. �'i y.r rj � 1 , r. aa}} I F Y .( ol., �'•l}F, �� / '� 1�F 1 ,.�2 Y, f1 � ('. � •r ��: R' ryltt�iL�f� �t2.. -,,. SY-il gl, �i d itlt .4i not PA S l � 1 i qme 4j x �7 +A JYrrY f l� 4 a is P fit. tt w r S.x ii,i t F (f +C QNW u.. hill _ _, . _ x - � 4 i r _ n �g R jo 7 : #F � itk33t F 'Q total FM i + n�.v. -r_. _I'^.�..- _k;..sa_iSa.J.^.w.. :.�.F . -._r_. .�•t�.i r.": `::s OTT'£'' ,tic �i.� �n 5� �'` �3 u i ?{ ' C s �•.t � _ i i i I SO � r i TANK y K I yd`rr y 3 , 'Q total FM i + n�.v. -r_. _I'^.�..- _k;..sa_iSa.J.^.w.. :.�.F . -._r_. .�•t�.i r.": `::s OTT'£'' ,tic �i.� �n 5� �'` �3 u i ?{ ' C s �•.t � _ i SO � r i PUTNAM ENGINEERING, PLLC LETTER OF TRANSMITTAL ,.. Route Brewster, New York 10509 - - - - -_T - -- Date: • /D.- i � ~� � ~ - Phone: 845- 279 -6789 Fax: 845 - 279 -6769 RE: 5NwA -ro(l- D'Ai�ST-,r -C7 e -mail: putnamengineering @suscom.net P/E Job: TO: err -1e FTC I�i,.7T �y..f: H-�:�.i_'R� 17cPDaZ- �-c"1C�:,►�k' We are sending you � attached under separate cover, the following items via U. S. Mail, Overnight, _ Hand Delivery, . Pick Up: Originals Prints Colored Prints Reports Photographic Exhibit Other: Copies Date Dw . No. Description Et 2 (�-ct ► S ED '��� Pc..��` Plans Specifications These are transmitted: For approval — Approved as submitted — For your use - _ Approved as noted _ As requested _ Returned for corrections _ For review /comment _ Resubmit copies for approval _ Submit _ copies for distribution REMARKS: LA YojI- ►-_s t3i�4 k? ev i Sr-a A-S fa_ i?- oa R-- _ �' � ��-S�S � �-s S ►T'� !J t•r' Mr �TAPt�S 6tN� �� ►rJT A� �.l e' .i�� SwSS� A.r1 ATT0< -6-F ,,(2 i c Ty @-�5 Po (1- "60.)(k- F t E Copies to: _ SIGNED: V=d C"ly Richard J. Zapp Jr. PUTNAM ENGINEERING, PLLC 4 Oid'- *Rc;jbE 6' Brewster, New York 10509 Phone: 845 - 279 -6789 Fax: 845 - 279 -6769 e -mail: putnamengineering @suscom.net TO: G�►.s>`c� (�c9Tn1A�i-� �'yJIL1T'( fi'�A�� - ?r1 aE�f�t(LiT1€n�T LETTER OF TRANSMITTAL Date: b 2 3 RE:t�larrd P/E Job: We are sending you is attached under separate cover, the following items via U. S. Mail, Overnight, Hand Delivery, Pick Up: Originals Reports Plans _ Prints Photographic Exhibit Specification's Colored Prints Other: Copies Date Dw . No. Description s S6 —15 11 E 'PLA1 i These are transmitted: For approval — Approved as submitted — For your use _ Approved as noted _ As requested _ Returned for corrections _ For review /comment _ Resubmit copies for approval — Submit _ copies for distribution REMARKS: Copies to: SIGNED: I G <<— Richard J. Zapp Jr. PERMIT # yj 11 SI ®N OF ENVIR ®N1EN'I'AI. HEALTH SERVI CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM Located at '� 1.�r„lt�R -S t'7 _ Town or Village Ft .-r'r e?-S. ®rJ N►[[�R -�T'r Subdivision name neya ofm Cope. Subd. Lot # 2 Tax Map '?>S_ Block 2 Lot 8 Date Subdivision Approved i 1 h Is _ Renewal Revision Owner /Applicant Name 60st_va. -MM TD'A G- '- M 2 Date of Previous Approval 5/11 o Mailing Address <1 I i.l� 'DfLMA�NoP�c, „ `. �. Zip 10 Amount of Fee Enclosed Sr GL-e Building Type 6.rut'( 9ft c*rk.,Lot Area /.1!4Ac. No. of Bedrooms 2 Design Flow GPD11160 Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of LDC:Q _gallon. septic tank and 222 L, f, O F 2 � � �� �c�TLP�'ro� 7►z -�u� Other Requirements: R,0 -& Fiu-, IZEZ) PUMP To be constructed by }4aw-Ar Cort�rt0, -1 _11,AG . Address e44 13ucx- - XY Water Sumnly: Address Public Supply From . inn ::' ,T�'.."Pr'1V"%1 t'- Si1Yyi j''.hii.11� d 1Jy - c) 1�2 ' G ii-'.f-'i i ic►% Aa�iresS - - I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatment system described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner„ his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the dat f the issuance of the approval of the Certificate of Construction Compliance of the original system or an ere Signed: P.E. R.A. Dated o� Address Lj,. Ocrre (o License # Z9&- 144-e-'o APPROVED FOR CONSTRUCTION: T}iis approval expires Iwo years from the date issued unless. construction of the sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered nAcessary by the Public Health Director. Any revision or alteration of the approved plan requires anew pe it. A proved r ischarge of domestic sanitary se a.ge onl . By: �.. Title: Date: _. White copy - HD File(JYell co y - 'wilding Inspector; Pink copy - Owne ang copy - Design Professio Form CP -97 [qGOULDS PUMPS COMPONENTS MODELS _ ...7 5 8 1-� 2 Order No. ^ 1 Impeller 2 Casing 3 Silicon carbide vs. silicon carbide Mechanical seal 4 Shaft 5 Motor 6 All Ball bearing heavy duty design 7 Power cable 8 0 -ring MODELS _ ...7 5 8 1-� 2 Order No. HP Volts- Phase Max. Am . RPM Solids Wt. Ibs. Heaters WE0311L WE0318L WE0312L WE 3311 M WE0318M WE0312M �' 115 1 9.8 1750 % 56 N/A 200 5.5 230 4.9 115 9.8 200 5.5 230 4.9 WE0511H WE0518H WE0512H WE0539H WE0532H WE0534H WE0511HH WE-0518HH WE05121-11-11 WE0538HH 122093?4MU 53 1/2 115 14.5 3500 - 60 200 8.1 230 7.3 200 3 4.1 K34 230 3.3 K32 460 1.7 K23 115 1 14.5 N/A 200 1 8.1 230 1 7.3 200 3 4.1 K34 230 3.6 K33 460 1.8 K23 E0718H WE0712H WE0738H % 200 1 11.0 10.0 70 N/A 23' 200 3 6.2 K49 WE0732H WE0734H 230 5.4 K39 460 2.7 K28 WE1018H WE1012H 1 - 200 1 14.0 N/A 230 12.5 E1038H WE1032H WE1032H 200 - -.3- 8.1 K50 230 7.0 K43 460 3.5 K32 WE1518H 1 /z 200 1 17.5 50 40 A 230 15.7 80 74 N/A M WE1538HH WE1532HH WE1534HH 200 3 10.6 :`45) K54 230 9.2 35 K52 460 4.6 74 K36 200 1 17.5 - WA 230 15.7 77 WA 200 3 10.6 55 K54 230 9.2 1 17 K52 460 4.6 66 K36 WE2012H WE2038H WE2032H 2 230 1 18.0 83 30 N/A 200 3 12.0 K55 230 11.6 K55 WE2034H 460 5.8 58 K41 EFFLUENT EJECTOR SYSTEM Effluent ejector system offers ease of ordering and installation. A single ordering number specifies a complete system designed for most residential and commercial sump and - effluent pump applications. Package Includes: Submersible Effluent Pump WE0311L, 12L or WE0311 M,12M, WE0511 HH,12HH Mechanical Level Control Switch A2 -5 (115V), A2 -6 (230V) Basin and Cover A7 -1830P Check Valve A9 -2P Order No.: SWE0311 L, SWE0312L, SWE0311M, SWE0312M, SWE0511HH, SWE0512HH. Submersible Effluent Pump 3885 PERFORMANCE RATINGS (gallons per minute) Order No. WE03L WE03M WE05H WE07H WE10H WE15H WEOSHH E151111 WE20H HP '/3 '/3 '/2 % 1 1' /z '/2 1' /z 2 Rpm 1750 1750 3500 3500 3500 3500 3500 3500 3500 5 86' - - - - - - - - 10 70 65 78 94 - - 56 95 140 15 58 58 70 90 103 128 53 93 138 20 30 35 60 85 98 123 50 90 136 25 5 15 48 76 94 117-r 45 87 133 2 30 - - 35 67 88 111 40 84 130 3 35 - - 23 57 82 103 35 82 126 40 - - 12--. 45 74 95 ,i0 77 121 d :`45) - - - 35 64 86 25;1 74 116 v 50 - - - 1 25 53 77 18` 70 110 cc cu 55 - - - 1 17 42 66 104 60 - - - 9 30 63 97 65 C72 58 90 70 - - - - 11 55 83 75 - - - - 4 51 75 80 - - - - - 47 66 90 - - - - - - - 37 51 100 - - - - - - - 28. 30 110 - - - - - - 17 .. ._10 _ .__.120 - - -. - - - - 8 - DIMENSIONS (All dimensions are in inches. Do not use for construction purposes.) KICK -BACK PRINTED IN U.S.A. SPECIFICATIONS ARE SUBJECT TO CHANGE WITHOUT NOTICE. Goulds Pumps tiJ' ITT Industries [qGOULDS PUMPS APPLICATIONS Specifically designed for the following uses: • Homes • Farms • Trailer courts • Motels • Schools • Hospitals • Industry • Effluent systems SPECIFICATIONS Pump Solids handling capabilities: %" maximum. • Discharge size: 2" NPT. • Capacities: up to 140 GPM. • Total heads: up to 128 feet TDH. _ •.Temperat:.1re:- --...— - — -- 104 °F (400C) continuous 140 °F (60 °C) intermittent. • See order numbers on reverse side for specific HP, voltage, phase and RPM'S available. FEATURES m Impeller: Cast iron, semi - open, non -clog with pump - out vanes for mechanical seal protection. Balanced for smooth operation. Silicon bronze impeller available as an option. m Casing: Cast iron volute type for maximum efficiency. 2" NPT discharge. ■ Mechanical Seal: SILICON CARBIDE VS. SILICON CARBIDE sealing faces. Stainless steel metal parts, BUNA -N elastomers. ©1999 Goulds Pumps Effective January, 1999 P'1QQG in Shaft: Corrosion - resistant, stainless steel. Threaded design. Locknut on three phase models to guard against component damage on accidental reverse rotation. m Fasteners: 300 series stainless steel. ■ Capable of running dry without damage to components. ■ Designed for continuous operation when fully submerged. MOTORS ■ Fully submerged in high - grade turbine oil for lubrica- tion and efficient heat transfer. Ii Class B insulation: - METERS FEET 40 130 120 35 110 30 100 °a 90 i 25 80 U z 7070 0 60 F 15 50 ° 40 10 30 5 20 10 0 Submersible Effluent Pump 3-885 PROSURANCE AVAILABLE FOR RESIDENTIAL APPLICATIONS. Single phase: ■ Bearings: Upper and • Built -in overload with lower heavy duty ball bearing automatic reset. construction. • All single phase models ■ Power Cable: Severe duty feature capacitor start rated, oil and water resistant. motors for maximum Epoxy seal on motor end starting torque. provides secondary moisture •'/3 and Y2 HP —16/3 SJTOW barrier incase of outer jacket with 115 V or 230 V three damage and to prevent oil prong plug. wicking. 20 foot standard • % -2 HP —14/3 STOW with with optional lengths bare leads. available. Three phase: • Overload protection must ■ 0 -ring: Assures positive be provided in starter unit. sealing against contaminants • %2 -2 HP —14/4 STOW with and oil leakage. bare leads. n Consult factory for infor- ii Designed for Continuous mation on CSA listed models. Operation: Pump ratings are OEM within the motor manufacturer's AGENCY LISTINGS recommended working limits, can be operated continuously 0_ File 4 anstandardsAssociation File 038549 - v�fifhoilt damage. Fite S 3318 Laboratories Goulds Pumps is ISO 9001 Registered. 00 10 20 90 40 50 60 70 80 90 100 110 120 130 140 150 160GPM 0 5 10 15 20 25 .30 35 m3/h CAPACITY Goulds Pumps ITT Industries 101 NEwl ■ -1 OEM 1;Ngmq N��i. MENEM 2 " ah1 11 MENEM _fral MEEM U211411010111a ==nun PIA. IS I�® a:�l11110M0M 0 E 0 M NEAR MUMMUMM 00 10 20 90 40 50 60 70 80 90 100 110 120 130 140 150 160GPM 0 5 10 15 20 25 .30 35 m3/h CAPACITY Goulds Pumps ITT Industries _ ` 758 10, Rf_MTALLEQ 114 CORNEF FILL PAP- PIA A�O CENTER-Or, AREA Pf;ZIL)R-TO,.ONSTPJJCfION-<DF.,FILL ATION ' ' ' - -- ---- CU 1009 5 690 0 'Rip w P4 --5- APPRQX1A4A 7E LOCA770N OF' KELL SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health November 19, 2008 Rick Zapp Putnam Engineering 4 Old Route 6 Brewster, NY 10509 Dear Mr. Zapp: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County Exerative ROBERT MORRIS, PE Director of Environmental Health Re: Field Inspection — Dagostino Towners Road (T) Patterson, TM # 33 -2 -8 The above referenced separate sewage treatment system can be backfilled. The following comments must be corrected in the field. I. Leave access to distribution box for pump test. 2. Well inspection and bedroom count must still be performed. If you have any further questions, please contact me at (845) 278 -6130. JD:kly Sincerely, 4.seph Digit Environmental Health Engineering Aide Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648 11/18/2008 TUE 10:07 FAX PCHD Q002/002 t • 'c PUTNAM COUNTY DEPARTMENT OF HEALTH DWISION OF ENVIRONMENTAL HEALTH SERVICES ATTENTION REQUEST MR FINAL INSPECTION For; Fill All information must be fully completed prior to any Trenches Inspections being made. PCHD Construction or Repair Permit # -C—�J-1 —Q'" -c"I Located: �o d f,,,, (T) (� Owner /Applicant Name: 4-c,N -r arm_ _ . T_�'�[_�_n -r�r TM S3 Block 2- Lot �5 Formerly: Subdivision Name: z, TT- T>,-va,-3 �.., q Subdivision Lot # 2- Is system fill completed? Date: Is system complete? Date: � 1 t 1 r 7... %a F5 Is system constructed as per plans? Y� Is well drilled? r--�o (Qz,u,,.1�e ua �,,>♦.� -,F� Date: Is well located as per plans? Are erosion control measles in place? I certify that the system(s), as listed, at the above premises has been constructed.and I have inspected and verified their completion in accordance with the issued PCHD Construction Permit and approved plans and the Standards, Rules and Regulations of the Putnam County Department of Health. _1 Date: Certified b • P RA Design Professional Address: , 4 Co Lic. # QC�� L) S'm x P-LY /Q. ca1 Comments: �,. OLL - i r.ls�r-��pAr►v,.t 15 0,kQt, aJ�Py. Y CL,'1C_ r`. Q3: sa= PL Srt 1, ft5. 2 g7r iL T-4!5t t ONJ �i ^�`�` � 1 1.s 1 9- Slr- T- I M' = PtA'D Q 1 C0nP& ET'-Q 1OW rl Y'�' �.�% 1.� Prl�,il7 � eLz!- •tom► -1[- 1^-L 3ni'= �4 Form FIR- 99 `'s� 5�0 6, 11/20/2009 FRI 11:13 FAX pLJTNAM NEl EEjr -?l 6, PLLC. 17 Engineers and Arr_ hI t sc. is IF DATE; 11/20/09 T-O., Gene Reed JOB #. FAX. - 278 -7921 RE; D'Aaostino — T'ow hers RD id — Certificate of Compliance PAGES: 2 , including this comer sheet: ,From the desk of.,. Pay!! M, Lynch, P.E. 4 OLD ROUTE 6, BREWSTER, NEW YORK 10509 - (845) 279 -6789 - FAX (845) 279 -6769 EMAIL: plynch@13utnanmeng.com Q001/002 11/20/2009 FRI 11:13 FAX 10/15/2009 14:31 9143474394 WEX$ 5Y THIS CEdTr�rl�`/ATE OF CliM.PL-'ANCE THE 0002/002 PAGE el NEW YORK ELECTRICAL INSPECTION SERVICES 150 White Plains Road, Suite 104, Tarrytown, NY 90591 CERTIFIES THAT Upon the application of: Upon premises owned by: TJN Electric Inc - Thomas Giustino Salvatore Dagostino 116 Gortlandt Rd. 323 Towners Rd. Mahopar,, NY 10541 Located at: 323 Towners Rd., Patterson, NY Application Number: 10078563 Section: Block: Lot: Patterson, NY Certificate Number: 10078563 BOC: 104 Posemit Number: 1027.09 A visual inspection of the electrical system at this premise described as a Residential occupancy, wherein the premises electrical zystem cehnisting Of electrical devices and wiring, described below, located inion the promises at., 323 Townets Rd., Patterson, NY sasa:ment, Outside. was Inspected in accordance with the NY$ and NFPA 70 -99 and the detail of the Installation, as set forth below, was founded to be in compliance therewith or1 the 13 Day of October 2009. NOTne Date Quautity Rating Circuit Type a.R.rc Saplia Pump A 'NSMUC Alger,+ l Motor I I-9 hp fA Officer: Nick Morabito This certificate may not be uttered In any wwy and is valldated only by the presence of a raised seal at the location indicated. This cortiflestu Is velld far work preformed before date pf In!ppgq;jgrl gn1y. Joannlo , Ounba 14.2009 16 Page I of I C 4 5 11/18/2009 WED 16:53 FAX ®ATE: TO: RE. PAGES. UTlif,�M ElEnglnnr-rs and Architects F." TRANSWITrAL November 18, 2009 Gene Reed -700 0., FAX.- 278 -7921 D'Agostino — Towners Ito id Request for Final Inspection _2 including this cover sheet. From the desk of.. Pau/ M. Lynch. P.E. 4 OLD ROUTE 6, BREWSTER, NEW YORK 10509 - (845) 279 -6789 • FAX (845) 279 -6769 EMAIL: plynch @lputnameng.com Q 001/002 11/18/2009 WED 16:53 FAX 6 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES ATTENTION REQUEST FOR FINAL INSPECTION For: pill All information must be fully completed prior to any 'Trenches Inspections being made. PCHD Constructio—n or Repair Permit # �� �� �•'a `% Located (T) Owner /Applicant Name: f ] ' /.l �S TM -3 Block _ Lot Formerly: Subdivision Name: 66%., , Subdivision Lot # Is system fill completed? Date: Is system complete? Date: Is system constructed as per plans? Is well drilled? Date: 'Iswell located�as per plans? . Are erosion control meas3cs in place? 2002/002 I certify that the system(s), as listed, at the above premises has been constructed and I have inspected and verified their completion in accordance with the issued PCB Construction Permit and approved plans and the Standards, Rules and Regulations of the Putnam County Department of Health. Date; 1 l l Certified by:� PE RA Design Prafessional Address: a4-42 O GI'L'D C� f'��' Lic. # (. ?yy�- Comments: r Form FIR -99 PUTNAM COUNTY DEPARTMENT OF HEALTH ... _ ... _ . ...:DaVIS30N-OF EN`�IRCNI�gFNTA.I; IIEA �-I;I�- SRRV�CES - ..� .,.•:- - -- .. . FIELD ACTIVITY REPORT N AMF AT)T)RFR ,q; aw,yi2s -jZZ, Street Town State Zip PERSON IN CHARGE p ()R TNTFR VTFWFT): Tni�a/I i('lo J T)stP: 4ZA=A,20C1 PUMP TEST : DOSE TEST Q.- �� l� L REQUIRED GALLONS /0 7 - 3, 764 EL. START ' STOP Signature and 'Atle RFPnRT RFr..FTVFT) RY: I acknowledge receipt of this report: SIGNATURE: 02/96 Title: R c -ty ri r (13 t� O O O m l� L REQUIRED GALLONS /0 7 - 3, 764 EL. START ' STOP Signature and 'Atle RFPnRT RFr..FTVFT) RY: I acknowledge receipt of this report: SIGNATURE: 02/96 Title: R c -ty ri r TqAL SiII, iNSPEC IOM Old, Date: Inspected by: Tb 1 c_t T Street Location 7-&u .&j , /2Q Owner C-0 --/ 7n/0 town �-..., . —.__ �7 - er-5-0i _ ._ .. PS u ebr mdl iv t i# s i oa n L of # J- ' � J- v -- . _ r- M # _ t 3 s - 1. Sewage Svstem Area a. STS area located as per approved plans .........::................ b.. Fill section - date of placement 3:1 barrier Lgth. Width . Avg.Dpth c. Natural soil not stripped .................................................. d. Stone, brush, etc., greater than 15 from STS area.......... e. 100' from water course / wetlands ...... ............................... IL Sewage Svstem a. Septic tank size - 1,000 .!!:..... 1,250 ......... other ................ b. ' Septic*tank installed level ................ ............................... c. 10' minimum from foundation .......... ............................... d. Distribution Box 1. All outlets at same elevation -water tested........... 2, Protected below frost .................. ............................... 3.. Minimum 2 ft.Original soil between box & trenches e. Junction Bog - properly set .......... ............................... 6. Irenches , , 1. Length required 22 Length installed 7- Z� 2. Distance to watercourse measured Ft.......... 3. Installed according to plan ......... ............................... 4. Slope of trench acceptable 1/16 - 1/32" /foot ............. 5. 10 ft. from property line - 20 ft.- foundations.......... 6. Depth of trench <30 inches from surface .................. 7. Room allowed for expansion, 100 % ......................... 8. Size of gravel 3/4 - 11h" diameter clean ...................: 9. Depth of gravel in trench 12" minimum .................... 10. Pipe ends capped .................... .........................;✓.... g.. Pump or Dosed Svstems 9.9' X 41 1.Size of s n G:±ncb azbPr 2.�. .... ...........::..:........: 2. Overflow tank ............................. ............................... 3. Alarm, visual/ audio ........:........... ............................... 4. Pump easily accessible, manhole to grade ................. 5. First box baffled .......................... ............................... 6. Cycle witnessed by H.D.estimated flow /cycle........... III. House/BuildinQ a. douse located per approved plans .................. . b. Number of bedrooms ........................... A . V;;.............. N. Well Well located as per apvrov_ed plans ............. �1 fU''. 1.J LQ6L&UWV u W"I' — 1J -ur vu.,a.aavaa�w�v �,:,,y;,:� w........... 'c: Casing 18" above grade ................ ............. ................... d. Surface drainage around well acceptable ....................... V. Overall Workmanship . a. Boxes properly grouted ................... ............................... b. All pipes partially backfilled ........... ............................... c. All pipes flush with inside of box ... ............................... d. Backfill material contains stones <4" diameter .............. e. Curtain drain & standpipes installed according to plan.. f Curtain drain outfall protected & dinto exist watercourse g. Footing drains discharge away from STS area ............... h. Surface water protection adequate.........-... ........................ i. Erosion control provided ................. ............................... Rev. 12/02 YES NO UOMML'NTS A r -o' d/C i� 2� �EAso 0 C , /Uq ),W ( V n/ A I4 Fa-vo R4,j — C6-eck Al, t Al Form S7. F610 -lLr SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health December 10, 2009 Rick Zapp Putnam Engineering 4 Old Route 6 Brewster, NY 10509 Dear Mr. Zapp: DEPARTMENT OF HEALTH 1 Geneva Road. Brewster., New York 10509 Re: Field Inspection — Dagostino Towne;rs Road (T) Patterson, TM # 31-2 -8 ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health A re- inspection at the above referenced lot has been completed. There are no further comments to be addressed at this time in reference to this Departments open work inspection. If you have any further questions, please contact me at (845) 278 -6130, ext. 43261. �. ...... ___ � ,_ � ......._._ ...... . __.. _........ .- Sincerely, GDR:kly Gene D. Reed Sr. Environmental Health Engineering Aide Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 Nursing Home Care Fax (845) 278 -6085 WIC (845) 278 -6678 Early Intervention / Preschool (845)228 -2847 Fax (845) 225 -1580 Page 1 of 1 En vIronmental Serd Inc. ces, � 41 Kenosia Avenue NlATEA, SOIL AND Ain ANALYSIS Danbury, Connecticut 06810 1 Telephone 203 -798 -2229 t . P F Beal and Sons Inc: D'Agostino Mailing Information: Collector's Information: JMS ID: 089383 Name: P F Beal and Sons Inc Name: Chris Scrivanos Address: 4 Putnam Avenue Address of site: 323 Towners Road City: Brewster City: Patterson State: NY Zip: 10509 State: NY Zip: Phone: (845) 279 -2460 Fax: (845) 279 -6613 Phone: Sample's Information: Site: Kitchen Tap Preservative: N/A Temperature: 10.0° C Matrix: Water Sample ID: 1 Date Collected: 1/25/2010 Time Collected: 2:00:00 PM Date Analyzed Test Name 02/03/10 Iron 02/03/10 Manganese 02/03/10 Sodium 01/26/10 4:30 PM E. Coli 01/26/10 4:30 PM Total Coliform 02101/10 Lead 01/26/10 Color 01/26/10 Turbidity 01/26/10 Odor 01/28/10 Alkalinity 01/27/10 Hardness 01/28/10 Chloride 01/28/10 Nitrate 01/28/10 Nitrite 01/28/10 Sulfate 01/26/10 pH Date Received: 1/26/2010 Time Received: 4:00:00 PM Lab No.: J1000482 Result MCL Method *0.838 mg /L 0.3 mg /L 200.7 Rev. 4.4 <0.05 mg /L 0.3 mg /L 200.7 Rev. 4.4 16.5 mg /L N/A 200.7 Rev. 4.4 Absent Absent Colitag Absent Absent Colitag 3.08 ppb 15 ppb E 200.7 ND 15 Units SMWW 2120 B 1.1 NTU 5 NTU SMWW 2130 B ND 3 TON SMWW 2150 B 88 mg /L N/A SMWW 2320 B 268 m 9 /L N/A SMWW 2340-C 141 mg /L 250 mg /L SMWW 4110 B 0.39 mg /L 10 mg /L SMWW 4110 B <0.05 mg /L 1 mg /L SMWW 4110 B 22.3 mg /L 250 mg /L SMWW 4110 B 7.9 S.U. 6.4 -10 S.U. SMWW 4500 H B Comments: *ABOVE MCL At the time of the analysis the sample was Acceptable for Total Coliform At the time of the analysis the sample was Acceptable for E. Coli pH was received and analyzed after the EPA required 1 hour holding time. CFU = Coliform Forming Units MCL = Maximum Contaminant Level mg /L = milligrams per Liter N/A = Not Applicable ND = None Detected NTU = Nephelopmetric Turbidity Unit ppb = parts per billion S.U. = Standard Unit TON = Threshold Odor Number Units = Units Signature: - Reviewed By: =4�040�- Michael Lapman Michael Lapman, President State #: PH -0218 ELAP M 11715 CONNEGTIC.UT. N61,1i YORK AND NP.i.0 CERTIFIED Toll Free 868- JMS -5097 1 Corporate Fax 203 -798 -2408 1 Lab Fax 203- 798 -2107 I www.jmsemironmental.ccrn YML ENVIRONMENTAL, SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 (914) 245 -2800 Albert` 14.- Padov irector ' LAB #: 9.000225 CLIENT #: 61847 NON STAT PROC PAGE: 1 of 1 D'AGOSTINO, SAL DATE /TIME TAKEN: 03/07/10 01:00 91 LAKE DRIVE DATE /TIME RECD: 03/08/10 10:25 MAHOPAC, NY 10541 REPORT DATE: 03/15/10 PHONE: (845)- 628 -4911 SAMPLING SITE: 323 TOWNSEND RD, PATTERSON, NY SAMPLE TYPE..: POTABLE WATER TANK PRESERVATIVES: NONE COLD BY: SAME AS ABOVE TEMPERATURE..: < 4C NOTES.. COLIFORM METH: N/A DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD 03%15/10 :IRON (Fe) 0.063 MG /L 0 -0.3 mg /l SM 18 -20 3111B COMMENTS: Fe /Mn If both iron and manganese are present, their total value combined shall not exceed 0.5 mg /L. THE ABOVE TEST PROCEDURES MEET AIL REQUIREMENTS OF NELAC, AND RELATE ONLY T THEESSE SAMPLES RECEIVED BY THE LAB SUBMITTED BY:. W� Albert H.1 Padovani, M.T.( SCP) Director ELAP## 10323 Engineers end Architects Michael J. Budzinski, P.E. Director of Engineering 1 Geneva Road Brewster, NY 10509 . RE; Salvatore D'Agostino (Lot #2) 323 Towners Road Town of Patterson TM #33 -2 -8 PCHD Permit #SW -06 -07 Dear Mr. Budzinski, I am enclosing a water test report for iron contaminant level for the well at the above referenced. property. As you will recall, the original water analysis indicated the presence of iron at above the maximum allowable contaminant level. The well was flushed and retested by YML Environmental Services. T.hel�we.thtc «�ll.00m}�letP pier ronstruc ±?on �Orr!p11?nce SLIb???iSS1nn, Please contact me at this office if you have any questions. Sincerely, PUTNAM ENGINEERING, PLLC Richard J. Za RJZ /ea Enclosure (L1043) 4 OLD ROUTE 6, BREWSTER, NEW YORK 10509 • (845) 279 -6789 • Fax (845) 279 -6769 • EMaa: info Oputnameng.com IILrr i vtUn 0111 Iri , \ -1 NYLt %.hill! WA1vLt K AYMIUAIWIN � DEPARTP/1"ENT OF HEALTH S(�� Request for Approval of Noncompliance with Bureau of Water Supply Protection the Standards of 1ONYCRR Appendix 75 -A Wastewater Treatment Standards - Individual Household Systems Name of ApnlLCant._-_ rJ Address Street \V E 0ty/rowa MA- ktQPAL- State ('s zip /QS�( Contact Information Pbone< (vZPi -49 1 I BAx: eauu: Location street' 0 A S ctt/Towa P ESJ co�y t.f r tSite zip The following information is being submitted in support. of my application for a specific waiver from compliance with one or more standards of IONYCRR Appendix 75 A,t "Wastewater Treatment Standard:. Individual Household Systems ". 1. The wastewater treatment system cannot meet the following standards of 1ONYCRR Appendix 75-A: 'foE ' !r Separation distances cannot be achieved (75- A.4(b), Table,!, Separation Requirements) V Excessive'Slope (75- A.4(1), Soil and Site Appraisal) tic% •r-.-, 15% ❑ Design is not addressed in Appendix 75 -A ❑ Technology is not addressed in Appendix 7S-A E _T 2 F 6baf'_ 2. The following design is proposed to mitigate noncompliance with Appendix 75-A (brief description): Q Lir*,,T des tc,tJ . -fD p iiJA z37 DWf_k l Ck2 ������>✓ PE(L +e1cT�r�- 'ac.E,P�c A- ,90,1 tiD A 2 v,.► 1 SLOE c -tr epovtDe, -rog or .z, -,DM To TAk- Pizv, °EiLT -1 L.,J2 fttil0 �.1t11 r Er1GRAP.CkMP'1F -+JT Gi= F11.� �hi� ini��� E�cS e>P Gam O c$ i as E?�G �;SS or 15 Y . 3. Suporting information provided: 0 Detailed Site Plan ,,Detailed Design at Soil and Site Evaluation • Neighboring conditions of concern (e.g., wells, waterbodies, weitlands, etc.) • Other: Explain: I, (applicant) 6AWAT -O L 17 t AC 'i'i rl (type or, print) acknowledge that this waiver request is necessary because it is not practical-for an onsite wastewater treatment system to meet the referenced standards of 10NYCRR,Appendix 75 -A on .. this property_ l Signature V Ddte I, (engineer) ( hP a or print) acknowledge that this waiver request is necessary because it is not practical for an onsite wastewater treatment system to meet the referenced standards of 1ONYCRR Appendix 75 -A on this property. In my professional opinion, the proposed design described in this a rovide a degree of protection equivalent to the onsite wastewater treatment standard(s) a and will not create an increased risk to public health or the environment. <"-" Signati Z. PE License # * -For. Health Department use only Based upon the information provided in this application to waive the referenced standards of Appendix 75-A and in a cordand with IONYCRR §§ 75.3 and 75.6 (b), the waiver requested is hereby: Approved as proposed. D Approved, with following conditions: D Not acted on, because additional itformation is required: D Denied, because: Note: This Health Depa be revoked should any conditions considered before approving this waiver change after approval. _i-,a-07 vtativk- Signature Date K SHERLITAAMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health February 25, 2010 Putnam Engineering Paul Lynch, PE 4 Old Route 6 Brewster, NY 10509 Dear Mr. Lynch: DEPARTMENT OF HEALTH I Geneva Road. Brewster, New York 10509 Re: Construction Compliance for D'Agostino @323 Towners Rd. (T) Patterson, TM # 33 -2 -8 ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health This Department has received and reviewed the submitted application and plans for the above referenced project and the following comments are offered for your consideration. Two -point tie distances are required to be provided for the distribution box and end of V:(trenches. The submitted water quality analysis indicates the maximum contaminant level for iron is exceeded. Please have the well resampled for iron and resubmit the new water quality results to this office. Upon completion of the above, this Department will continue its review. Kindly advise us if there are any questions. MJB:lm Respectfully, Michael J. ] Director of Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186_ Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 Nursing Home Care Fax (845) 278 -6085 WIC (845) 278 -6678 Early Intervention / Preschool (845) 228 -2847 Fax (845) 225 -1580 V,LUJTNAM NGINEEARINE, PLLC. Engineers and Architects March 3, 2010 Michael J. Budzinski, P.E. Director of Engineering Putnam County Health Department 1 � Geneva Road Brewster, NY 10509 RE: Salvatore D'Agostino 323 Towners Road Town of Patterson TM #33 -2 -8 PCHD Permit #SW -06 -07 Dear Mr. Budzinski, This office is in receipt of your letter dated February 25, 2010 regarding the above referenced project. Please note we have revised 1:he As -Built Plan to include the distances for the distribution box and ends of trenches as requested. I am enclosing five (5) copies of the revised plan for your approval. With regard to your second comment, the owner is having the well retested for iron contaminant level. We will forward the results. to you-under separate cover as soon as they are available. Please contact me at this office if you have any questions. Sincerely, PUTNAM ENGINEERING, PLLC Richard J. RJZ /ea Enclosure (L1031) 4 Or_o RourE 6, BREwsrER, NEw YoRK 10509 0 (845) 279 -6789 o Fax (845) 279 -6769 • EMa►L.: info@putnameng.com PUTNAM "COUNTY DEPARTMENT OF HEALTH DIVISION OOF ENVIR O NMENTAL SALT I ;SERZ'ICES GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM SA�Y�To (Z 'D'�Go sTi� 33 2 g Owner or Purchaser of Building Tax Map Block Lot SPc Lg y<4-� -e1L Constructep'r4c�oST1.J Buildind by TownNillage Location - Street . SiJ6,C c, Building Type ME(tK,tTT cc�X70 Subdivision Name 2 Subdivision Lot # 1 represent that I am' wholly and completely responsible for the location, workmanship, material, construction and drainage of -the sewage treatment system serving the above- described property, and that is 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 treatment system, or any repairs made by me to such system,\cxcept 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 Public Health Director 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. Dated: Month_ Day L7_ Year,2jaZQ Signature: Title: . General Contractor. (Owner) - Signature Corporation Name (if corporation) Address: State tj `t Zip /0541 Corporation Name (if corporation) Address: State Zip Form GS -97 gUUT—NAA4 NCS/i/EERI/VG,.Pcc._._ .. Engineers and Architects SEPTIC SUBMISSION FORM TO: rn le NAEL- e>jOz,,3S r- 1 _ DATE: -,7 /0 PUTNAM COUNTY HEALTH DEPARTMENT PROJECT: SAL-yATo(i flAf.g;,S -ri,JO 323 ToUgE.F-5 20o o PATI-r-tZsorl lY. T"n 33 - 2 - S FLN Pct i T 51oi - o� - 0"1 ENCLOSED, PLEASE FIND: COPIES OF THE SSDS "AS- BUILT" PLAN CONSTRUCTION COMPLIANCE CERTIFICATE WELL LOG HEALTH DEPARTMENT FEE ($300.00 ) WATER ANALYSIS GUARANTEE FORMS - 3 ORIGINALS G S E 911 ADDRESS FORM Cl LETTER OF EXPLANATION REMARKS: COPIES TO: (ScpSuEFonn -2004) SIGNED: —k c_,1 7,4,PP 4 OLD ROUTE 6, BREWSTER, NEw YORK 10509 • (845)•279 -6789 • FAx (845) 279 -6769 • EMAIL: puthamengineering @rcn.com UTNAM NEINEERINEPLLE. Engineers and Architects April 17, 2007 Michael Budzinski, P.E. Director of Engineering Putnam County Health Department I Geneva Road Brewster, NY 10509 RE: Proposed SSTS for Salvatore D'Agostino At Lot #2 — Merritt Development Corp. Town of Patterson TM #33-2-86 Dear Mr. Budzinski, I am enclosing for your review and approval a Specific Waiver Application, as directed for the above referenced project. Please include this with our previously submitted plans and paperwork. At this time we request that you place this project on the Agenda for the next Putnam County Health Department waiver meeting. Please contact me at this office if you should require any additional information. PUTNAM ENGINEERING, PLLC Richard RJZ/cp Enclosures (L)0793) 4 OLD ROUTE 6, BREwsTm, NEW YORK 10509 • (845) 279-6789 • FAx (845) 279-6769 • EmAiL: info@putnameng.com LJ TNAM Engineers and Architects April 5, 2007 Michael Budzinski, P.E. Director of Engineering Putnam County Health Department 1 Geneva Road Brewster, NY 10509 RE: Salvatore D'Agostino SSTS Lot #2 — Merritt Development Corp. Town of Patterson TM #33 -2 -86 Dear Mr. Budzinski, Please be advised, Putnam Engineering is in receipt of your letter dated March 5, 2007 regarding -. the above referenced project and has addressed your comments as follows: 1. As we have discussed, the expansion field trenches has been reconfigured and the side slopes of the fill section reduced to a .1 on 2 slope in order to avoid areas in excess of 20 %. -_ _......_- .... _......_ ........ .. .. . . -2: -. -. -. _-Thesecond-floor floor glair -as-been-i-evised to- reduce the width of tbe-lb- t area-to-- _......_ _.. 6' -6 ". Thereby making the total bedroom count equal to two. 3. The retaining wall has been eliminated from the design and the detail removed from the plans. I am enclosing five copies of the revised fill placement plan, two copies of the revised trench layout plan and three sets of revised floor plans for your review and approval. Please contact me at this office if you have any questions. Sincerely, PUTNAM ENGINEERING, PLLC Richard J. Za r. f RJZ /ea Enclosures 4 OLD otTE 6, BREWSTER, NEW YORK 10509 0 (845) 279 -6789 - FAX (845) 279 -6769 o EMAIL: info@putnameng.com SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health Rick Zapp Putnam Engineering 4 Old Route 6 Brewster, NY 10509 Dear Mr. Zapp: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health March 5,2007 Re: Proposed SSTS for D'Agostino at Lot # 2 — Merritt Development Corp. (T) Patterson, TM # 33 -2 -86 This Department has received and reviewed the submitted application and plans for the above referenced project and the following comment is offered for your consideration. 1. Portions of the proposed SSTS are situated on slopes in excess. of-20 percent which unacceptable. It appears the system could be redesigned to utilize lopes less than or equal -to 20 percent. . The loft area on the second floor will be considered a potential bedroom thereby making the total bedroom count equal to three (3). ✓3. The retaining wall detail is to be revised to show an impermeable barrier behind the wall to prevent wastewater effluent form short circuiting through the wall. Upon completion of the above, this Department will continue its review. Kindly advise us if there are any questions. MJB:kly Respectfully, Michael J. Director of Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early InterventioniPreschool (845) 278 -6014 Fax (845) 278 -6648 2 Sri G� PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Y -SHEET SL rGE — AT�Y'EN SYSTEM VES GIv D TA R t . - Owner Address °!1 1.Ay-e Located at (Street) PgAz--) Tax Map 33 Block 2 Lot y (indicate nearest cross street) Municipality Drainage Basin SOIL PERCOLATION TEST DATA Gcf4a F-esp 6-r- "6) c7�.► ►S C-A gyp' C� C'v r. Gam) Date of Pre - soaking ► z l %3 Date of Percolation Test I L 6003 Hole No. Run No. Time Start - Stop Ela se Time Min.) De th to Water rom Ground Surface (Inches) Start Stop Water Level Drop In Inches Percolation Rate Min/Inch p 1 to is - to %` L 24 14 2 2 3 E. 2 Jv `f-iI`I4 '30 (1 3 '30 4 5 2 lo'431- If-04 2 -L. 4 5 1 2 3 4 5 nt each NOTES: I. Tests to ne repeatea at Samc uupin uuu:. 4JJPIv+uuaway cyuai F %Anus" .v.. - - -- - - - - -- t a to be percolation test hole. (i.e. :5 1 min for 1 -30 min/inch, : --2 min for 31 -60 min/inch) All dat submitted for review. 2. Depth measurements to be made from top of hole. DEPTH 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' XJU ►.71 t is aiaaaa• DESCRIPTION OF SOILS ENCOUNTERED IN 'PEST HOLES HOLE NO. 0 1 HOLE NO. HOLE NO. 03 &"To°Co, L.- M, 7.5' -- 8.0' — 8.5' 9.5' — 10.0' — �LV�� F Indicate level at which groundwater is encountered 001A Indicate level at which mottling is observed r-t %A — Indicate level to which water level rises after being encountered -j Deep hole observations made by: a,s.. L , (jt e.j c--J�6l n WRAF, &Q7Z J 1 (&WPA Date 9 -z� ct� Design Professional Name: fu i rll m e,�G_ d �' ►� P'- own �,, �� ®F���� Address: 4 - NAFt.r Signature: i 06-7 Design Professional's Seal - PUTNA.M COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Y ......._ ..._. ,... _ .� __. bES G DATA H°-""" ' "SUBSURFAC = SE-WAG'E 'REATMEN i ---S ': 'P = - Owner ,3a&v,Aiz,2E ��. `A6c,sT, ,. o- Address 9 i LA, CV- f— M AAMPA-L- n1 Located at (Street) 1-3 tl i?s A� Tax Map3 Block 2 Lot v (indicate nearest cross street) Municipality YA-r,— g� sa,.a Drainage Basin (`�t tny�i✓ a SOIL PERCOLATION TEST DATA Date of Pre - soaking Date of Percolation Test Hole Run No. Time Start - Stop Ela se Time Min.) Didto Water row Ground Surface (Inches) Start Stop Water Level Drop In Inches Percolation to winch 1 3 4 5 2 ..3 4 5 1 2 Z3 4 5 —L. -.--A or Parh NOTES: I. Tests to be repeatea at same aeptn um►! apprummamy Cyua, pumuwauvu I"LVJ µ.ms ��•�••• -� - - percolation test hole. (i.e. <_ l min for 1-30 min/inch, <_ 2 min for 31 -60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. DEPTH 0.51 1.0' 1.51 2.0' 2.5' .).01 3.51 4.01 4.5' 5.01 5.51 6.01 6.5' 7.0' 7.51 8.01 8.51 9.5' 10.01 DESCRIPTION OF SOILS ENCOUNTERED IN TEST ROLES.. HOLE NO. —T-2-4-- : HOLE NO, HOLE NO---�� f. REM ED FEB L 2 12007 Indicate level at which groundwater is encountered Indicate level at which mottling is observed Indicate level to which water level rises after being encountered- I/Al- -Z -7 /P�a ,t Deep hole observations made by: FA-o- L%,uk Le A Date q� Design Professional Name: Pq 0,F NE Address: 4 OL.g> AE4 Z Signature Design Professional's Seal kro 7 O 0 mW UT YAM l\ICl/i/EEl7ll®lC�o PL�C. Engineers and Architects SEPTIC SUBMISSION FORM M l c ikAr-L- 5..;rxz4 r iSi -1 DATE: PUTNAM COUNTY HEALTH DEPARTMENT PROJECT: �A-Ta.a -E V ;^coe2s T o `—rowr axs CTTt��r ENCLOSED, PLEASE FIND: COPIES OF THE SSDS PLAN (?-r--v.se-=?) ❑ 3 COPIES OF THE HOUSE PLANS CONSTRUCTION PERMIT APPLICATION WELL PERMIT APPLICATION ❑ HEALTH DEPARTMENT FEE ($500.00) ❑ SHORT EAF I� DESIGN DATA FORM ❑ LETTER OF AUTHORIZATION ❑ APPLICATION FOR WASTEWATER TREATMENT (PC -97) ❑ LETTER OF EXPLANATION REMARKS: COPIES TO: (SepSubForm -2001) SIGNED: P XC-Y.- ° 4 OLD ROUTE 6, BREWSTER, NEW YoRK 10509 • (845) 279 -6789 . Fax (845) 279 -6769 a EMAIL: info @putnameng.com .. ., ... LORETT?►`IvIOLINARI :: ,.,,., ..- :.e_..� .:.. .....:.... _. Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 _. - .. M ETVI "BONDI County Executive Environmental Health (845) 278- 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention/Preschool (845) 278 - 6014 Fax (845) 279 - 6648 September 9, 2004 Putnam Engineering 4 Old Route 6 Brewster, NY 10509 Re: Proposed SSTS: D'Agostino Towners Road, Lot 2 (T) Patterson, TM # 33 -2 -8 Dear Sir or Madam: Review of plans and other supporting documents submitted at this time relative to the above - regarded project has been completed. Comments are offered as follows: 1. Adequate soil testing has not been provided in the SSTS area, i.e., the minimum of one percolation test and one deep hole test is required in the primary and expansion areas. 2. For fill sections greater than two feet in depth, fill plans must be submitted. ...... .... ... .. .... -._.: 4. Remove drainpipe outlet from retaining wall detail. 5. This Department will consider a 2:1 side -slope for the fill section. The construction of this sewage disposal system may tie subject to local wetlands regulations. You should contact local wetlands officials in this regard. If percolation tests were not witnessed by a representative of the New York City Department Environmental Protection on this lot, percolation tests must be witnessed by a representative of this Department. Upon receipt of a submission, revised to reflect the above: comments, this application will be considered further. Very y yours, Robert Morris, P.E. Senior Public Health Engineer RM:km P4JTNAM E11IG1NEER/NG, PLLC LETTER OF TRANSIViITTAL 4 Old Route 6 Brewster, New York 10509 Date: ��� �a Phone: 845 - 279 -6789 Fax: 845- 279 -6769 RE: A' e -mail: putnamengineering @rcn.com p/E Job: _752 We are sending you attached under separate cover, the following items via U. S. Mail, Overnight, ,---Aand Delivery, Pick Up: Originals Reports Plans Prints Photographic Exhibit Specifications Colored Prints Other: These are transmitted: _ For approval _ Approved as submitted _ for your use — Approved as noted _As requested Returned for corrections _ For review /comment — Resubmit copies for approval — Submit _ copies for distribution REMARKS: Copies to: ` SIGNED: f If enclosures are not as noted, kindly notify this office. March 29, 2004 Robert Morris, P.E. Putnam County Health Department Geneva Road Brewster, NY 10509 _ RE: D'Agostino Lot 2 Tax Map 33 -2 -8 Town of Patterson Dear Mr. Morris: In response to the Putnam County Health Department letter dated March 25, 2004, we have revised the attached plan, specifically, the following is offered: 1. Fill plan attached. 2. Retaining wall detail provided. 3. Force main moved 10' from property line. 5. Pump curve provided. 6. 10 foot separation cannot be provided (toe of slope to property line) due to existing topography. A waiver will be requested. It should be noted that the adjacent property is owned by the applicant. 7. The majority of the existing topography in the SSTS area is between 13 & 15 %. A very small section of the existing topography is a slope of 22.2 %. It should be noted that the current proposed SSTS area is the most conforming on this previously approved subdivision lot. 8. A small area of the northwest SSTS fill pad has 6 feet of fill. It should be noted that this area is 10 feet downhill from any proposed septic fields, and as noted above, the SSTS area is the most conforming area on this previously approved subdivision lot. (L04189) 4 OLD RouTE 6, BREw8TER, NEw YoRK 10509 0 (845) 279 -6789 o FAh' (845) 279 -6769 o EMA/L: putnamengineering@rcn.com .,Should you have any questions please feel free to contact me at this office. Very truly yours, PUTNAM ENGINEERING, PLLC Denis L. Girard DLG /cp Enclosures (L04189) PUTNAM ENGINEERING, PLLC Englneers and Archltects 4 OLD RouTE 6, BREmTER, NEw YORK 10509 • (845) 279 -6789 • FAx (845) 279 -6769 • EMAIL: putnamengineering@rcn.com LORETTA MOLINARI Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, Tfew York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention/Preschool (845)278-6014 Fax (845) 278 - 6648 March 25, 2004 Putnam Engineering 4 Old Route 6 Brewster, NY 10509 RE: Application to Construct a Subsurface Sewage Treatment System Merritt Development Group (T) Patterson, TM #33 -2 -8 Dear Sir or Madam: ROBERT J. BONDI County Executive The Putnam County Department of Health (Department) has determined that the above referenced application, received by the Department on February 18, 2004 is incomplete. Please be advised that the following information is required before the Department may • Fill plans have not been submitted • Retaining wall detail is to be provided on plan • Minimum distance from main to property line is 10 feet • Cross out or remove Lot #1 • Pump curve has not been provided • Minimum distance from the top of fill to the property line is 10 feet • The SSTS is designed on a slope of approximately 23% in areas. Maximum slope allowed by current codes is 15% • Fill is shown in depths of approximately 6 feet in areas. Maximum depth of fill allowed by current codes is 3.5 feet. The. review of your application will commence once the Department receives the requested information and determines that the application is complete. The Department will notify you within 10 days of its receipt of the requested information as to the completeness of your application. Please be advised that failure to submit information to the Department or to follow procedures is sufficient grounds to deny approval, pursuant to the New York City Department of Environmental Protection Watershed Regulations and Putnam County Department of Health regulations. ,r ' Letter to: Putnam Engineering - March 25, 2004. -2- Should you have any questions or care to discuss this matter, please contact me at (845) 278 -6130 ext. 2166. Ve lyyo s Robert Morris, P. E. RM: lm Senior Public Health Engineer BRUCE R. FOLEY Public Health Director NAME: G_mm►w DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (84.5) 278 - 6678 Fax (845) 278 - 6085 Early Intervention/Preschool (845) 278 - 60f4 Fax (845) 278 - 6648 PUTNAM COUNTY DEPARTMENT OF HEALTH SPECIFIC WAVIER SITE LOCATION: 4_0 A,(,) i.�r 2-- DATE: STAFF PRESENT: Rob M., Mike B., Gene R., Shawn R., Bill H., Joe P. SPECIFIC WAVIER REQUEST:tLi D,�.,, (�� Q L c rim. S9 0 >J DOES THE PROPOSED VARIANCE REQUEST POSE A HEALTH HAZARD OR ENVIRONMENTAL CONTAMINATION PROBLEM? YES NO WILL DISAPPROVAL RESULT IN A SIGNIFICANT HARDSHIP? YES NO DISCUSSION REQUEST APPROVAL OR DENIED APPROVED .- DENIED REASON FOR DENIAL DATE: DIRECTOR OF PUBLIC HEALTH (SPECWANER) UTNAM NEINEERINE, PLLE. Eng/neers'and Architects April 15, 2004 Robert Morris, P.E. Putnam County Health Department Geneva Road Brewster, NY 10509 RE: D'Agostino Lot 2 Towners Road Tax Map 33 -2 -8 Town of Patterson Dear Mr. Morris: In response to your April 8, 2004 letter regarding the above, the following is offered: 1. As noted in our March 29, 2004 letter (copy attached) the proposed fill does exceed 3.5 feet, however, it is only a small area northwest of the SSTS fill pad. This area is also 10 feet' downhill from any proposed absorption trench. Also as previously noted, the SSTS area is the most conforming area on this previously approved subdivision lot. 2. Also as noted in our March 29, 2004 letter; the 10 foot separation between the toe of slope and property line cannot be provided due to the existing topography. We also noted that this property owner owns the adjacent lot. 3. In our referenced letter we noted that the slope does exceed 15% in a very small section, 5 We g.,, p However tire'maJorrty or the SSTS is oii slopes! :,�,vecn ,s and 1� /o. ..., must a k.n olnt out • that the selected SSTS area is the most conforming area on this previously approved subdivision lot. We will therefore have to request waivers for these items as they cannot be improved upon. Should you have any questions please feel free to contact me at this office. Very truly yours, PUTNAM ENG C Gary A. retsch GAT /cp Enclosures (1,04230) 4 OLD RouTE 6, BREW8TER, NEw YORK 10509 • (845) 279 -6789 - Fax (845) 279 -6769 • EMa/L: putnamengineering @rcn:com LORETTA MOLINARI Public Health Director April 8, 2004 DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (84'-5) 278 - 6678 Fax (845) 278 - 6085 Early Intervention/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 Gary Tretsch Putnam Engineering 4 Old Route 6 Brewster, New York 10509 Dear Mr. Tretsch: ROBERT J. BONDI County Executive Re: Proposed SSTS — D'Agostino Towners Road, Lot # 2 (T) Patterson, TM# 33 -2 -8 Review of plans and other supporting documents submitted at this time relative to the above regarded project has been completed. Comments are offered as follows: The construction of this sewage disposal system may be subject to local wetlands regulations. You should contact local wetlands officials in_this regard:, If percolation tests were not witnessed by a representative of the New York City Department Environmental Protection on this lot, percolation tests must be witnessed by a representative of this Department. 1. Maximum depth of fill allowed is 3.5 feet. 2. Minimum distance from the end of the fill section to the property line is 10 feet. 3. The SSTS is proposed on.a slope greater than 15 %. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. RM:cj Ve nlly yours, Robert ]Morris, PE Senior Public Health Engineer g TNAM G, PLLE. nglneers and Arch/tects March 29, 2004 Robert Morris, P.E. Putnam County Health Department Geneva Road Brewster, NY 10509 RE: D'Agostino Lot 2 Tax Map 33 -2 -8 Town of Patterson Dear Mr. Morris: In response to the Putnam County Health Department letter dated March 25, 2004, we have revised the attached plan, specifically, the following is offered: 1. Fill plan attached. 2. Retaining wall detail ,provided. 3. Force main moved 10' from property line. 4. Lot #1 crossed out. 5. Pump curve provided. 6. 10 foot separation cannot be provided (toe of slope to property. line) due to existing topography. A waiver will be requested. It.should be noted that te adjacent property is owned by the applicant.. 7. The majority of the existing topography in the SSTS area is between 13 & 15 %. A very small section of the existing topography is a slope of 22.2 %. It should be noted that the current proposed SSTS area is the most conforming on this previously approved subdivision lot. 8. A small area of the northwest SSTS fill pad has 6 feet of fill. It should be noted that this area is 10 feet downhill from any proposed septic fields, and as noted above, the SSTS area is the most conforming area on this previously approved subdivision lot. (L04189) 4 OLD RouTE 6, BREmTER, NEW YORK 10509 • (845) 279 -6789 - Fax (845) 279 -6769 • EMAIL: pufnamengineering@rcn.com LORETTA MOLINARI Public Health Director April 8, 2004 DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, 1Jew York 10509 Environmental Health (845) 278 -.6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 Gary Tretsch Putnam Engineering 4 Old Route 6 Brewster, New York 10509 Dear Mr. Tretsch: ROBERT J. BONDI County Executive Re: Proposed SSTS — D'Agostino Towners Road, Lot # 2 (T) Patterson, TM# 33 -2 -8 Review of plans and other supporting documents submitted at this time relative to the above regarded project has been completed. Comments are offered as follows: The construction of this sewage disposal system may be subj ect to local wetlands regulations. You should contact local wetlands officials in this regard. If percolation tests were not witnessed by a representative of the New York City Department Environmental Protection on this lot, percolation tests must be witnessed by a representative of this Department. 1. IMaximum.depth of fill allowed is 3.5 feet. 2. Minimum distance from the. end of the fill section to thr property line is 10 feet. 3. The SSTS is proposed on a slope greater than 15 %. Upon receipt of a submission, revised to reflect the -above comments, this application will be considered further. Ve ly� yours, , E,J/ Robert Morris, PE Senior Public Health Engineer U 08/04/2004 WED 08:43 FAX 444 PCHD 1@001/002 'r -,- - LfTNAm N INEERI ilG.ac:c Engineers and Architects r WE: r0: FAXND; RE; Iz- PAGES, r /bdud Fqg [IIJ.S covff From the desk of... GARYA. WETSCH 4 Old Route 6, arcwster, N,-w York x0509 • phone (645)279 -6789 • Fax (845)279 -6769 AUG -4 -2004 WED 08:45 TEL:845- 278 -7921 HAME:PUTNAM COUNTY DEPARTMENT OF P. 1 08;04/2004 WED 08 :43 FAX X44 PCHD $� Ub i gEnglL T1 ., W,f neers and Ar-0-d LL-cts April 15, 2004 Robert Morris, P.E. Putnam County Ilealth Department Geneva Road Brewster, NY 10509 RE: D'Agostino Lot 2 Towners Road Tax Map 33 -2 -$ Town of Patterson Dar Mr, Morris: In response to your April 8, 2004 letter regarding the above, the following is offorcd: 121002/002 1. As noted in our March 29, 2004 letter (copy attached) the proposed fill does exceed 3.5 feet, however, it is only a small are4 northwest of the SSTS fill pad. This area is also 10 feet downhill from any proposed absorption trench- Also as previously noted, the SSTS area is the most conforming area on this previously npproved subdivision lot. 2. Also as-noted in our March 29, 2004 letter, the 10 foot separation between the toe of slope and Property line cannot be provided due to the existing topography. We also noted that this property owner owns the adjacent lot. 3. In our referenced letter we noted that tice slope. does exceed 15% in a very small section,. _..,.._ <__..... _ <..._...,.._ ;- ,1►owever- the - majorityoftheSS TS- is'onT'sIopes�bevAeen t3 ° and- i5 � o.V e-Wlistaga.in- 00int-out ___... _._...._.__...._ that the selected SSTS area is the most conforming area on this previously approved subdivision lot, . We will therefore have to request waivers for these items As they cannot be improved upon. Should you have any questions please feel free to contact me at this office. Very truly yours, PUTNAM ENG C Gary A. retsch GAT /cp Enclosures p,o4z;ol 4 OLD ROUTE 6, SREWSTER, Nrw YORK 10509 • (645) 279 -6789 • FAX (845) 279 -6769 • EMAm putrnaetengineering @rcn.ctiom AUG -4 -2004 .WED Oe:45 TEL:845- 278 -7921 NAME:PUI-NAM COUNTY DEPARTMENT OF P. 2 SENDING CONFIRMATION DATE : AUG -4 -2004 WED 08:37 NAME PUTNAM COUNTY DEPARTMENT OF HEALTH TEL 845 - 278 -7921 PHONE : 92796769 PAGES : 1/1 START TIME : AUG -04 08:36 ELAPSED TIME : 0012511 MODE : ECM RESULTS : OK FIRST PAGE OF RECENT DOCUMENT TRANSMITTED... M J a I.NMI-H 1h D U,RI y ROBERT J. BOND, Pu6ae 1MIth pmnor Goanry GxaevrJv. DEPARIWW.NT ()F HEAi.,TH . i Geneva Road, Brewsen, v,:w York )aS09 6a1tnsteeatal health (845)T18 -6131 Nx(945) 278. 7921 Nvntag Sankt., (845)278.65J8 WIC (945)278 -6678 F.(941)278 -6oss Gary ]aterreaeoMreeehaal (945)278 -601: Far(845)279 -6608 April 8, ?.004 Gary Tretsch ! Pumam Engineering 4 Old Rollie 6 Rl ewster, Now York 10509 1'rupo.�d'SSi3= 'D'Agostinr; .._ Towners Road, Lot 9 2 R 1 Dear Mr. T retsch: (T) Patterson, TV# 33 -2 -8 ! I Review of plats and other supportutg documents submitted at this time relative to the above regarded project has been completed. Comments arc n(Tered as fn! low,: 1'Itc construction of this sewage disposal system may he snL,.cct In Incal wotlan& regulations. You ! should contact local wetlands officials in this rclprd. if percolation tests were not witnessed by a representrtivr of the New York City Department Environmental Protection on this lot, percolatiun'lests must be witnessed bya representative of this Department. ' i 1. Maximum depth of fill allowed is 3.5 feet. 2. Minimum distance from the end of tho fill scctiou to the property lute is 10 feet. 1 I. The SSTS is proposed on a slope greater than 15 "�6. i Upon receipt of a submission, revised m reflect the ahm- comments, this application will he considered farther. V ynu y an_- I I Robert Morris, PP. i RM:cj Senior Pah;ic Health Engineer I PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE TREATMENT SYSTEMS . _ , .REVIEW SHEET FOR CONSTRUCTION PERMIT.._ NAME OF OWNER: STREET LOCATION: REVIEWED BY: RM, GR, AS, SRDATE: TAX MAP #: (CONFIRMED) Y -N DOCUMENTS (PERMIT APPLICATION )WELL PERMIT OR PWS LETTER �PC -97 LETTER OF AUTHORIZATION (D( ,�DESIGN DATA SHEET (DDS) A )CORPORATE RESOLUTION (SHORT EAF ( )PLANS -THREE SETS LU HOUSE PLANS - TWO SETS C__)VARiANCE REQUEST SUBDIVISION (� LEGAL SUBDIVISION (_SUBDIVISION APPROV C PERC RATE ( _2�FILL REQUIRED DEPTH (__)(_)CURTAIN DRAIN REQUIRED GENERAL (LOCATED IN NYC WATERSHED PLANS SUBMITTED TO DEP DELEGATED TO PCHD DEP APPROVAL, IF REQ'D DEEP TEST HOLES OBSERVED PERCS TO BE WITNESSED EX- APPROVAL SSDS ADJ, LOTS WETLANDS (TOWN/DEC PERMIT REQ'D ?) (_) DATA ON DDS PLANS & PERMIT SAME PRE 1969 NEIGHBOR NOTIFICATION ( * )LETTER BFZBA / 100 YR. FLOOD ELEVATION W/1200' - (_) SOIL TESTING LOTS >10. YEARS OLD REQUIRED DETAILS ON PLANS SEWAGE SYSTEM PLAN - (NORTH ARROW) SSDS HYDRAULIC PROFILE GRAVITY FLOW CONSTRUCTION NOTES 1 -15 DESIGN DATA: PERC & DEEP RESULTS T CONTOURS EXISTING & PROPOSED DRIVEWAY & SLOPES, CUT FOOTING /GUTTER/CURTAIN DRAINS USDA SOIL TYPE BOUNDARIES (_) TITLE BLOCK; OWNERS NAME ADDRESS TM #, PE/RA; NAME, ADDRESS, PHONE# DATE OF DRAWING/REVISION DATUM REFERENCE (_) , LOCATION OF WATERCOURSES, PONDS LAKES,WETLANDS WITHIN 200' OF P.L. (_)(_)PROPOSED FINISH FLOOR AND BASEMENT ELEVATIONS WELLS & SSDS'S WAIN 200' OF SSTS UPROPERTY METES & BOUNDS (_)(_)EROSION CONTROL FOR HOUSE, WELL & SSTS, EROSION CONTROL NOTE COMMENTS: (REVSHEET)09 /01/00 Y� flKEOUIRED DETAILS ON PLANS CONT'D) HOUSE SEWER -1/ FT. 4 "0'; TYPE PIPE CAST IRON NO BENDS; MAX BENDS 450 W /CLEANOUT RENEWALS ((__)SITE NOTE (NO CHANGE) FILL SYSTEMS (�`( 10' HORIZONTAL; PAST TRENCH SLOPES 3:1 TO GRADE CFILL SPECS/ FILL NOTES 1 -5 FILL PROFILE & DIMENSIONS (_)FJI,LIN EXPANSION AREA FILL GRF,ATF,R TN_A_ IV 2 FF,_F.T UU CLAY BARRIER U(__)FII,L CERTIFICATION NOTE (__)(__)DEPTH GAUGES UUVC,L. ON PLAN FOR RO.B., UNCLASSIFIED & IMPERVIOUS (_)(_SEPARATION DISTANCE FROM TOE OF SLOPE TRENCH (I ELF TRENCH PROVIDED 60FT MAX. PARALLEL TO CONTOURS 10(1% EXPANSION PROVIDED U )DETAIL/DUST FREE CRUSHED STONE OR WASHED GRAVEL LLz) TO P I,. VFnWAY, LARGE TREES, TOP OF FILL ""UNDATION WALLS 0)100' TO WELL, 200' IN DLOD,150' TO PITS �) 100' TO STREAM, WATERCOURSE, LAKE (inc. expan) (�50' TO CATCH BASIN, 35' STORMDRAIN, PIPED WATER ( l�10' TO WATER LINE (pits - 20') (�50!,LNT —vP—' 'I'TLNT- DILALWALGE COURSE. �(--)10'MINTO 200'/500' RESERVOI , ETC. _ 150' GALLEY SYSTEMS LEDGE OUTCROP SEPTIC TANK LX�310' FROM FOUNDATION; 50' TO WELL WELL DIMENSIONS TO PROPERTY LINES (_)()LOCATION OF SERVICE CONNECTION (_)MIN 15' TO PROPERTY LINE SLOPE L SLOPE IN SSTS AREA (S20 %) _)REGRADED TO 15 %, IF REQUIRED DOSE/PUMP SYSTEMS (_/( _)PUMP NOTES DOSE 75% OF PIPE VOLUME/DOSE VOLUME NOTED (,,!!J DETAIL FOR FORCE MAIN, (PIPE TYPE, ETC.) L� PIT AND D -BOX SHOWN & DETAILED f 1 DAY STORAGE ABOVE ALARM 1 CURTAIN DRAIN t,l kNDPIPES, 5' BOTH SIDES, DETAIL :20"*IN to CDS = >5 %, 20' -4 %, 25' -3 %, 35' -1 %,100 % - <1% to CD DISCHARGE /100' with 182 cons day discharge MIN to NON - PERFORATED PIPE k PUTNAM COUNTY D£PARTME \T OF HEALTH .. DMSION OF ENVIRONMENTAL HEALTH INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE TREATAIE \T SYSTEMS REVIEW SHEET FOR CONSTRUCTION PERMIT NAME OF OWNER: STREET LOCATION: REVIEWED BY: RIM, OR, AS, SRDATE: 1' DOCUMENTS PERMIT APPLICATION WELL PERMIT OR PWS LETTER. PC -97 LETTER OF AUTHORIZATION LD DESIGN DATA SHEET (DDS) CORPORATE RESOLUTION SHORT EAF - PLANS-THREE SETS HOUSE PLANS TWO SETS (�(JVARLANCE REQUEST SUBDIVISTON GAL SUBDIVISION SUBDIVISION APPROVAL CHECTCED PERC RATE CU FILL REQUIRED DEPTH CURTAIN DRAIN REQUIRED GENERAL C� LOCATED IN NYC WATERSHED PLANS SUBMITTED TO DEP - DELEGATED TO PCHD . DEP APPROVAL, IF REQ'D L)DEEP TEST HOLES OBSERVED )PERCS'TO BE WITNESSED ( jL,EX- APPROVAL SSDS AVJ, LOTS UWETLANDS''fI'OWN/DEC.PERIY.UT. REQ'D ?) (DATA Oiv DDS :PLANS. &:PERiNM. SANM L) PRE 1969 NEIGHBOR NOTIFICATION LETTER BI/ZBA L)100 YR FLOOD ELEVATION NVA 200' ( )L)SOIT. TESTIi`TG LOTS>10 YEARS OLD l?EOUTRED DETAILS ON PLANS CL )(_- SEWAGE SYSTEM PLAN - (NORTH ARROW), ( JSSDS HYDRAULIC PROFILE UV_)GRAVITY FLOW DESIGN DATA: PERC & DEEP RESULTS 2' CONTOURS EXISTING & PROPOSED C DRIVEWAY & SLOPES;. CUT ' FOOTING /GUTTER/CURTAIN DRAINS C_ LJ. USDA SOIL TYPE BOUNDARIES UX_JTITLE BLOCK; OWNERS NAME ADDRESS TNV, PE/RA; NAME, ADDRESS, PHONEN (�L�DATE OF DRAWING/REVISIQN L_)LJDATUM REFERENCE . UULOCATION OF WATERCOURSES, PONDS - LAKES,WETLANDS WITHIN 200' OF P.L. ( _JLJPROPOSED FINISH FLQOR AND BASEMENT ELEVATIONS L_)LJWELLS & SSDS'S WAN 200' OF SSTS (.J(__)PROPERTY METES & BOUNDS UUEROSION CONTROL FOR HOUSE, WELL SSTS, EROSION CONTROL NOTE . COMMENTS: (REVSHEET)09 101 /00 TAX 1,LAP=: (CONIF&%fED) Y N (REQUIRED DETAILS ON PLA \S CONT'D) UUHOUSE SEWER -'R' FT. 4 "0'; TYPE PIPE CAST IRON. C )LJNO BENDS; MAY BENDS 450 NUCLEANOUT RENEWALS L�L_)SIIE NOTE (NO CHANGE) FILL SYSTENTS U(__)10' HORIZON ?AL; PAST TRENCH SLOPES 3:1 TO GRADE C__)UFILL SPECS! FILL NOTES 1 -5 UUFILL PROFILE & DIMENSIONS )L-)FILL IN EXPANSION AREA FILL GREGiFR TN.4V 2 FEET (__)C� CLAY BARRIER C�UFELL CERTIFICATION NOTE. UUDEPTE GAUGES (__)(__)VOL O- i PLAN FOR RO.B., UNCLASSIFIED & IMPERVIOUS C_JUSEPARATION DISTANCE FROM TOE 'OF SLOPE TRENCH ' LJLJLF TRENCH PROVIDED LOFT MAX. UUPARALLEL TO CONTOURS UU100 */o EXPANSION PROVIDED - (__)L _JDETAIL/DUST FREE CRUSHED STONE OR WASHED GRAVEL. UL_)GEOTEXTILE COVER SEPAR�:TION DTSTA`iCS ON PLAN : FROiti1 SSi S ( )(�10' TQ P.L. DRIVEWAY, LARGE TRBESJOP OF FILL . (-J(--)20' TO FOUNDATION WALLS •(__)(_,100' TO'WELL, 200' IN.DLOD,150' TO PITS " . (;_)( _)100' TO STREADI, WATERCOURSE, LAKE (Ine. ezpau) (__)( _)50' TO CATCHBASIN,35' STOWVIDItAD, PIPED WATER ( —JLJ10' TO WATER LM (pits -20') U�50' �.I.FR`11TTFN'I' nP ANDS. �C:Cn,JP.SE. _ (_JC_)200' /500' RESERVOIR, ETC. 150' GALLEY SYSTEMS. C__)(__)10'.bILYTO LEDGE OUTCROP -. SEPTIC TANK U(U10' FROM FOUNDATION; 50' TO WELL ' ti_VELL - -- DIti1ENSIO;ISTO-PROPERTY LMES ._._...__ UCH CJCJLOCATION OF SERVICE CONNTECTIO\ UUtiln 15' TO PROPERTY L1NE ' SLOPE CJUSLOPE IN SSTS AREA (520 %) s UUREGRADED TO 15 %, IF REQUIRED DOSE/PUNIP SYSTEMS L_)CJPUbIP NOTES L j( _JDOSE 75% OF PIPE VOLUNIE/DOS•E VOLUME NOTED (__)(_JDETAIL FOR FORCE MAIN, (PIPE TYPA, ETC.) UUPIt AND D -BOX SHOWN & DETAILED ( )L j1 DAY STORAGE ABOVE ALARM CURTAI, iDR4TN L�L)STANDPIPES, 5' BOTH SIDES, DETAIL (�L _)15' bIrN to CDS = >5 %, 20'-4 %j 25' -3%, 35' -10/6' ,100 % -<I% & UL_--)20' b1IiI to CD DISCHARGE 1100' with 182 cons day discharge (- JL_)10' MLY to NON-PERFORATED PIPE UTl® AAA NCIN�E RINE PLLE. Engineers and Architects SEPTIC SUBMISSION FORM TO: _ DATE: PUTNAM COUNTY HEALTH DEP TMENT PROJECT: ENCLOSED, PLEASE FIND: f, COPIES OF THE SSDS PLAN a",- 4 �� `t %k r-T-" t� !R- COPIES OF THE HOUSE PLANS CONSTRUCTION PERMIT APPLICATION LLY WELL PERMIT APPLICATION ❑ HEALTH DEPARTMENT FEE (S400.00) 6� SHORT EAF J - Q- DESIGN DATA FORM LETTER OF AUTHORIZATION APPLICATION FOR WASTEWATER. TREATMENT (PC -97) ❑ LETTER OF EXPLANATION REMARKS: COPIES TO: 4 OLD RouTE 6, BREWSTER, NEW YORK 10509 - (845) 279 -6739 - Fax (845) 279 -6769 - EMAIL: puteng@bestweb.net Me o^ nn ®®. 14.18 -4 (9195) —Text 12 PROJECT I.D. NUMBER 617.20 SEAR Appendix C _._ ... _ State 'Enviroatraeniai`Ouaiily Reviea: ,.. SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS. Only PART I— PROJECT INFORMATION (To be completed by Applicant or Project sponsor) 1. APPLICANT /SPONSOR vT^'4,.,j 2. PROJECT NAME f O //� :vEC I� 6QS SS S L p 3. PROJECT LOCATION: Municipality County 4. PRECISE LOCATIO (Street address and road intersections, prominent landmarks, ate., or provide map) 5. IS PROPOSED ACTION: 4 New ❑ Expansion ❑ Modllicatlordalteratlon 8. DESCRIBE PROJECT BRIEFLY: 7. AMOUNT OF LAND AFFECTED: Initially i acres Ultimately acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? LJd'Yes ❑ No It No, describe briefly 8. WHATJS PRESENT LAND USE IN VICINITY OF PROJECT? Residential ❑ Industrial ❑ Commercial ❑ Agriculture . 0 Park/Fotesi/Open space ❑ War Describe 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)?� C3 Yes a No it yes, list agency(s) and permlUapprovals 11. DOES.ANY ASPEr7 OF THE ACTION HAVE A CURRENTLY VAUD PERMIT OR APPROVAL? 13 Yes L NNo If yes, list agency name and permiUapproval r 12. AS A RESULT OF PPOOOSED ACTION WILL EXISTING PERMIT /APPROVAL REQUIRE MODIFICATION? ❑ Yes No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE � {�7ivflM Appllcantisponsor name: SAL 41,4 X _ ' 1� .4 s7 i�l (� E��7iyEf /LT l!� Date: Few '1 —Og- signature: If the action is In the Coastal Area,' and you are a state agency, complete the Coastal Assessment Form. before proceeding with this assessment OVER 1 M PART II— ENVIRONMENTAL ASSESSMENT (To be completed by Agency) A. DOES ACTION EXCEED ANY TYPE 1 THRESHOLD IN 6 NYCRR. PART 617.4? If yes, coordinate the review process and use the FULL EAF. 763 L-1 N0. .... • -•- - - - _ . - B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No. a negative declaration many be superseded by another involved agency. !J Yes t_i No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Arawers may be handwritten, if legible) Cl. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic patterns, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: C2. Aesthetic, agricultural. archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: CJ. Vegetation or fauna. fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: C4. A community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain briefly. CS. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly. C6. Long term, short term, cumulative, or other effects not identified in C1 -CS? Explain briefly. C7. Other impacts (including changes in use of either quantity or type of energy)? Explain briefly. D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CEA ?_ ❑ Yes I__I No E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL. ADVERSE ENVIRONMENTAL IMPACTS? ❑ Yes ❑ No It Yes, explain briefly PART III — DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect Identified above, determine whether it is substantial, large, Important or otherwise significant. Each effect should be assessed in connection with Its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) Irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse Impacts have been Identified and adequately addressed. If question D of Part II was checked yes, the determination and significance must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA. ❑ Check this box If you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FULL EAF and /or prepare a positive declaration. ❑ Check this box if you have determined, based on the information and analysis above and any supporting� documentation, that the proposed .action WILL.,NOT result In any significant adverse environmental imp qql AND provide on attachments as necessary, the reasons supporting this determination: 4� Name of Lea Agency .,;y Print or Type Name of Respomililt Officer in Lead AaencY it e o Responsible Officer Signature o Responsible Officer in Lead Agency Signature o reparer different from responsible officer) ». Date PART (I— ENVIRONMENTAL ASSESSAENT (To be completed by Agency) A. DOES ACTION EXCEEO ANY TYPE (THRESHOLD IN 6 NYCRR, PART 617:12? If yes, coordinate the review process and use the FULL EAF. ❑ Yes E] No B. WILL ACTION RECEIVE COORDINAT i c. n _ ... 7=7 REV EW ,R,,, n0;'Ii�Fu F, �Riiir�iSrEU ACTIONS-iR-6 NYCiR. PART 617.6? It No, a negative declaration -ay ue superseded by another Involved agency. ❑ Yes ® No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten. If legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic patterns, solid waste production or disposal, potential for erosion,. drainage or flooding problems? Explain briefly. NO C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: NO C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: NO C4, A community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain briefly. NO C5. Growth, subsequent development, Or related activities likely to be induced by the proposed action? Explain briefly. NO C6. Long term, short term, Cumulative, or other effects not identified In C1-CS? Explain briefly. NO C7. Other impacts (including changes In use of either quantity or type of energy)? Explain briefly. NO D. t &THERE, OR IS THERE LIKELY TO 6E, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? ❑ Yes No If Yes, explain briefly PART 111 — DETERMINATION OF SIGNIFICANCE (O be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether It Is substantial, large, important or otherwise significant. Each effect should be assessed In connection with Its (a) setting (i.e. urban or rural); (b) probability of. occurring; (c) duration; (d) Irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse Impacts have been Identified and adequately addressed. ❑ Check this box if you have identified one or more potentially large or significant adverse Impacts which MAY occur. Then proceed directly to the FULL EAF and /or prepare a' positive declaration. Check this box If you have determined, based on the Information and analysis above and any supporting documentation, that the proposed action WILL NOT result In any significant adverse environmental Impacts AND provide on'attachments as necessary, the reasons supporting this determination: PUTNAM COUNTY DEPARTMENT OF HEALTH Name of Lead Agency �fCfiACL 3vDZl�rs�1 DIRECTOR Of "ISIAIF.F. IA14 Print or Type Name o Responsi le O ice, in lead Agency Title o Responsib e O Fits, Signature o Responsible Ot icer in lead Agency iignature of Preparer(If differewt from responsible officer) Date 2 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES 1. C 7 -STEM. `j�4161,TE-T- --SURSUIT GE-117REN - A1%._.,M SIG 70 4;i� lei I Located at (Street pnan Tax Map 3 3ffMock 2 Lot (indicate nearest cross street) Municipality Drainage Basin SOIL PERCOLATION TEST DATA P -E AFv-X5 "4?40 Date of Pre-soaking Date of Percolation Test Hole No. Run No. Time Start - Stop Ela6y Time in.) Djpth to Water from Ground Surface (Inches) Start Stop Water Level Drop Incites In es Percolation ate Mn/Inch DD /8` �2 — 2Z-2 3 Z f-2—Z2- 4 2 .3 &3_1 z z_ :3 4 5 2 3 arp nintninprint each NU4Zb'. I. tests to i7c repeateu UL W1111C UUPL11 Wit pdjcolati s 5 IGn test hole. (i.e. : I min for 1-30 min/inch, : 2 min for 31-60 min/inch) All data to be subrnffied for review. 1.1 °Depthmeasurements to be made from top of hole. C__ nn-01 &Mal K&A "&MAIM DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. HOLE NO. G. 0.51 2.0 4 _G 4Q42,0 4.5' 77, 5.0 zZ. 7.Ot HOLE NO. 5.51 77, zZ. 7.Ot 8.01 8.5 9.5 4, Jl_ Indicate level at which groundwater is encountered /Vc/L1C__ Indicate level at which mottling is observed Indicate level to which water level fists after being encountered 111114 Deep hole observations made by: i -y- e- I 'a /j 0"\ 1h>X= Signature: I W\\II,, Design Professional's Seal PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION FOR APPROVAL OF PLANS FOR - A WASTEWATE=R �`REATMENT- SYS'T'EM - - rt.. 1. Name and address of applicant: 2. Name of project: 1-y", 6* LZQa e,,, 7— 3. Location&: . co2D •Fond 4. Design Professional: ;>vrw/,,-,,-r tic�,a _ 5. Address: alp 7` l 6. Drainage Basin: /i1�DDCF .Biti�f� /l)r- 7. Type of Project: _ K Private/Residential Food Service Commercial Apartments Institutional T Mobile Home Park Office Building Realty Subdivision Other (specify) 8. Is this project subject to State Environmental Quality Review -(SEQR)? Type Status check one .: ... Type I Exempt Type II Unlisted' 9. Is a Draft Environmental Impact Statement (DEIS) required? ...... 111p 10. Has DEIS been completed and found acceptable by Lead'Agency? ............... 11. Name of Lead Agency 12. Is this project in. an area under the control of local planning, zoning,-or other . officials, ordinances? .................................. :.......................... ..,:,._.,. ; .,,.......;...,.: 5 =. 13. If so, have plans been submitted-to such authorities ?.... ;.......... .... ............:... No 14. Has preliminary approval been granted by such authorities? Date granted: X10 15. Type of Sewage Treatment System `Discharge ................. surface.water _Zgroundwater 16. If surface water discharge-, what is the stream class designation? .................... 17. Waters index number (surface) ...... ....................... ,.... ............... 18. Is project located near a public water supply system ?p 19. If yes, name .of water supply r1 /lam , Distance to water supply LE 20. Is project site near a public. sewage collection 'or treatment system? ................ 2.1. Name of sewage-systein Distance.to sewage system 22. Date test holes observed – 4, – ()3 23.. Name of Health Inspector (6 46 L6!n 24. Project design flow (gallons per day) ..................... ............................... 25. Is State Pollutant Discharge Elimination System ( SPDES) Permit required ?... No 26. Has SPDES Application been submitted to local DEC office? . ......................... —fin Form PC =97 2 -27. Is any portion of this project located within a designated Town or State wetland? 28. Wetlands _lDNurnber- ,. .............::.:. ... - -- _ - - . 29. Is Wetlands Permit required? ....... ............................... Has application been made to Town,or Local DEC office? . �O 30. Does project require a DEC Stream Disturbance Permit? . 31. Is or was project site used for agricultural activity involving application of pesticides, to orchards or, other crops, solid or hazardous waste disposal, ' landfilling; sludge application or industrial activity? ... .................. .::.. Yes/No �C> 32. Is project located within 1,000 feet .of existing or abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or any other potentially known source of contamination? DESCRIBE: 33. Is. there a local master plan on file with the Town or Village? .......................:: 34. Are community water and/or sewer facilities planned to be developed within 15 y e'` ars in or adjacent to project site ?.. .. ........:......:.......: .................. .............. 35. Are any sewage treatment ared sin in excess of 15% slope? .......: ::....................... p - 36. Tax Map ID Number ................ ............................... ... Map 3 - Block ®2 Lot 37. Approved plans are to be returned to ..... --- Applicant Design*Professional NO p,...a.iens for reriew and approval ufa new SS T fo be loeated vv�thu the NYC Watershed shall be sent to the Department, and need not be sent in duplicate to the DEP, although the project may require DEP approval of the STS prior to final approval by the Department. Projects within the watershed may also require DEP review and approval of other.aspects ofa project, such as stormwater plans or the creation of impervious surfaces, and the project applicant should obtain the appropriate forms for such activities from DEP and submit those forms to DEP for review and approval. If the application is signed by a person other than the applicant shown in Item I .,the application must be 'accompanied by a Letter of Authorization (Form LA -9'l). Failure to comply with this provision may be grounds for the rejection of any submission. I hereby affirm, under penalty of perjury, that information provided on this form is true Id the best of my knowledge and belief.. False statements made herein are punishable as a Class A misdemeanor pursuant to Section 21 D w. SIGNATURE'S & OFFICIAL TITLES. Mailing Address :.............: ..............:....ca7�i�A�i,c! �.zF!� (a PAC: pUTNA1VI COUNTY" DEEARI IENT OF,HEALTH r. DIVISION OF ENVIRONMENTAL HEALTH SERVICES LETTER OF AUTHORIZATION RE: Property of wL ✓/,�2 ,D�A�QS%`�NO Located at TD t u�vc.2s ,QoA•0 Ov A.4A.59n56,&j Tax Map # .33 Block .2 Lot 8 Subdivision of '' ,Oe-;e Icts � Subdivision Lot # Gentlemen: This letter is to authorize Pv7''iS/�� a duly licensed Professional Engineer _/,:ff or Registered Architect to apply for the required wastewater treatment and /or water supply permit(s) to serve the above noted property in accordance with the standards, rules or regulations as promulgated by the Public Health Director of the Putnam- County Health Department, and-to sign ali necessary papers on my behalf in connection with this matter and to supervise the construction of said wastewater treatment and /or water supply systems in conformity with the provisions of Article 145 and /or 147 of the Education Law, the Public Health Law, and the Putnam dun ,,,Sanitary Code. X11 Very truly yours, Countersigned: R.A., #� Mailing Address: State: N Y Zip: Telephone: iS�is) Signed: (Owner of Property) Address:�l/� State: Zip: S Telephone: tq — i 4`0'0" BREAKFAST I ` BATH 9'6'h" X 12'11" FAMILY ROOM I 12'10" X 12'11' KITCHEN 10'2` X 26'9." — -- wi !uP ; DWtj I DINING ROOM LIVING ROOM 14.10" X 12.11' FOYER -- 10`8 °x12"1" f. I I I a� i i t I I BEDROOM t BEDROOM. 2 1 12'8'' X 16'8" t 2'Sh' X 13'0" OPEN TO FOYER ,t �d 't �f SI I L �1 I o- i( 4F .f .j li r is BATH BATH 2—+-� FlrSi BEDROOM 3 x10'` 8 9'7" 1/t" X 9 7" � �, t r� fk'. f.. I BEDROOM t BEDROOM. 2 1 12'8'' X 16'8" t 2'Sh' X 13'0" OPEN TO FOYER ,t �d 't �f SI I L �1 I o- i( 4F .f .j li r a i 1 NS AND EI.EVATIpOG OF ALL UWU Afl HOMES ' _ OCULAR HOI-S RE9HiVEg THE RIGHT 70 MAIAR MNt3R pOAHpF•3mjL alsoRm ON9 AS 11R®PROTEC MODULAR CON�9LE IM1 (T WDN a � "*uo aEVATEN& BUILDER SITE LOC.: --- In L3�5EMq Pdlaf�l Z ADDRESS: `� ®�i4 `l7 °�ihf0�°.irl I SHEET # A -3n PROJ. ID I#: C666 I Doo. BY: PW rn PL •r? ANS AND ARCHITECT'S STAIR VALID ONLY FOR MODULAR NSYRUCTION DY CHELSEA MODULAR HOMES. INC. ANUFAOTURCR "FORMATION CHELSEA MCHELSEA MOIXILAR HOMES INC. P.O. BO% 1108 ROUTE 9V MAR SWO. M.Y. 12542 914- 236 -3311 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES.. 2- DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner 446©zrZAJO Address 7 e,!p,4D Located at (Street) Tax Map Block Lot 7- (indicate nearest cross street) Municipality Watershed 141T)-p1_,-- L2>re,4A,1e_# SOIL PERCOLATION TEST DATA Date of Pre-soaking Date of Percolation Test A t Z _ZZ z .................... . . ... .. . ...... .. ................ ....... .... ............... .............. .... ....... .......... ... e W . . to P ... ....................... ... From: v Pe too .......... .. ...... ........................ ...... ...... Ti a Ala se Tare ace (1Caches) fro )Cn . ........ . . . . . . .... ....... .... ....... .... ........................ ......................... ........ .. .... .. ...... ..... .... a:. .. .......... 2 3 4 5 3 2 3 3 30' 11 4 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 I min for 1-30 min/inch, s 2 min for 31-60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD-97 TEST PIT DATA 2 DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES a a -DEPTH :,HOLE NO. .. _� .. = :- HGLE NG G.L. — 1.0' r i / 2.0' 2.5' 3.0' 4.5' g, 5.0' Merl. 5.5' Rk, 6.0' 7.0' 7.5' 8.5' 9.0' 10.0' Indicate level at which groundwater is encountered Indicate level at which mottling is observed Al L nJ L Indicate level to which water level rises after being encountered Deep hole observations made by: Date Design Professional Name: Address: Signature: Design Professional's Seal a PUTNAM COUNTY DEPARTMENT OF HEALTH _ _ :.IVLSIQl_ OF ENVIRONMENTAL HEALTH SERVICE S G� DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner Address 70c1,v01-z5 7ZO Located at (Street) ___ L�iZ ST Tax Map 33, Block Lot (indicate nearest cross street) Municipality. Q, zy -���oN Watershed /f>TJ'TJLE t3jWAJf:_g SOIL PERCOLATION TEST DATA Date of Pre - soaking /// %O 3 Date of Percolation Test Z / 2- lv 3 NOTES: 1. Tests to he reneated at same denth until annroximately enual percolation rates are obtained at each percolation test hole. (i.e. s 1 min for 1 -30 min/inch, s 2 min for 31 -60 min/inch) All data to be submitted for.review._ 2. ' Depth measurements to be made from top of hole. Form DD -97 1 /0 "/0 iot s . ' g _ . l 8 °- �_2 /,3 2 /0,'M — 40121 3 2 iot /9- /Of 26 7 /8 — ;Z- 3 10sz9 - /o; 36 a 10-21 3 2,-7. 4 1,9 30 - -/D% TEST PIT DATA 2 DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES ' DEPTH HOLE NO. HOLE NO. HOLE NO. -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' Indicate level at which groundwater is encountered Indicate level at which mottling is observed Indicate level to which water level rises after being encountered Deep hole observations made by: Date Design Professional Name: Address: Signature: Design Professional's Seal PUTNAM COUNTY DEPARTMENT OF HEALTH -- _ - T:- ---DIVISLON O .ENVW.N. MENTAL. HEALTH— SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner 2) 5 % IAIO Address 7©4-1A!! 5 Z.!5 Fa4p Located at (Street) "/Q 5 Z j Tax Map .33. Block ;Z- Lot _ (indicate nearest cross street) Municipality .&rrA oAi Watershed A1 1[2121-i5 J `pAA6g 1& SOIL PERCOLATION TEST DATA Date of Pre - soaking 9/ %D� Date of Percolation Test Form DD -97 t:... ::::::::...:::::... :a... :...:..... ,...... tar.;:t.�t .3 N; of - //; 20 19 /9— 2-2- 3 4 5 2 /0,,33 -io; 2-0 - X3 I 1, -7 5 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 31 -60 min/inch) All data to be sub—msitted for review._ 2. Depth measurements to be made ftom top of hole. Form DD -97 DEPTH G.L. 0.5' 1.0' 1.5' 2.0' ._ :,2.5' 3.5' 4.0' 4.5' 5.0' 5.5' ,6.0' 6.5' 7.0' 7.5' 8.0' 8.5' 9.0' 10.0' TEST PIT DATA 2 DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES HOLE NO. ~ HOLE NO. HOLE NO. Indicate level at which groundwater is encountered AIOAI,4 Indicate level at which mottling is observed ,Ce ,qy,! Indicate level to which water level rises after being encountered Deep hole observations made by: Date Design Professional Name: Address: Signature: Design Professional's Seal PUTNAM COUNTY DEPARTMENT OF HEALTH ' � M DIVISION OF ENVIRONMENTAL. HEALTH: S_ ,ERVICE,S , ... _ INITIAL INDIVIDUAL /COMMERCIAL SITE INSPECTION FORM SECTION A. GENERAL INFORMATION Name of Project 7��,g1�r/ 0 ,�(1 y) &ixggSoAj County Py; i 1,4HI Site Location TDGV�IJ�7Z5 2pr73 3 , = - 7 8 GoTST Building construction begun __ Extent Is property within NYC Watershed ? ................. 116es F--J No SECTION B. TOPOGRAPHY (Pleas check all appropriate boxes) 1. F-1 Hilly Rolling Steep slope 0 Gentle.slope a Flat 2. 0 Evidence of wetlands 0 Low area subject to flooding 0 Bodies of water aDrainage ditches Q Rock outcrops 3. Property lines or corners evident ....................... ............................:.. Yes No 4. Do water courses exist on or adjoin the property? .�+!1:'{�..`,l...5 . Yes a N 5. Will these affect the design of the sewage system facilities? ............ Y s No 6. Do watershed regulations apply in this development ?....................... Yes No 7 Will extensive grading be necessary? ................. ............................:.. Yes No 9. -Will-extensive-fill be-necessary for ......................... _ Yes F 9. Do filled areas exist within the SSTS area?..... .. ............................... Yes No If yes, what is the condition of the fill? SECTION C. SOIL OBSE ATIONS 10. Appearance of soil: Sand = Gravel EZ Loam FBackhoe Clay a Hardpan Mixture 11. Observed from: a Borings a Bank cut excavations 12. Soil borings /excavations observed by 4< -17-66V on 16 - 13. Depth to groundwater "Al,-,' on 14. Depth to mottling AJOAI e on 15. Are test holes representative of primary & reserve areas ...... ................ ................ es 0 No 16. Soil percolation tests made by fl'u-fajAmnea; tieo.� M on 17. Soil percolation tests witnessed by j ?'t,r-,Ea on SECTION D (on back) Form ST -I 2 T SECTION D. DRAINAGE 18. Will proposed grading materially alter the natural drainage . in this or adjacent areas? Yes No ac 19. Will groundwater or surface drainage require sp No special consideration? ..................... F-1 Yes 20. Will gullies, ditches, etc, be filled and watercourses be relocated? ......................... E:] Yes EJ No -,7> SECTION E. REMARKS 21. If a common water supply is proposed, has an inspection been made of 'the existing or proposed source and facilities? .............................................. ...... ........ Ye's F No Inspection data Er V/W 22. Do adjacent wells and/or sewage systems exist? ..................................................... . . �Yes FF No 23. Additional comments 24. Site observer /inspector and title > 25. Date(s)-of.observa.tion(s)inspection(s) ---------- TEST PIT PROFILES Hole # -Lot # Hole # Lot # -Hole Lot # Depth to water Depth to water Depth to water Depth- to mottling Depth to mett.1ir.- liTN ep th-- to mottling Depth to rock/imp. Depth to rock/imp.. Depth to rock/imp. G.L. G.L. ------ G.L. .0.5 0.5 1.0 1.0 1.0 2.0 2.0 2.0 3.0, 3.0 3.0* 4.0 4.0 4.0, 5.0 5.0 5 . .0 6.9 6.0 6.0 7.0 7.9 7.0 8.0 8.0 8.0 9.0 9.0 9.0 10.0 ------------------ 10.0 10.0 r S h eet--J_of PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION..O_F ENVIRONMENTAL,IJEATLII .,.SERVICES. FIELD ACTIVITY REPORT AT)T)RRQR: le- M/!/6IZS •(Cdr & ;Mg 5el-i It, Street Town State Zip PERSON IN CHARGE Name and Title f f TYPE OF FACILITY: �op©S> ) 5�5, 0/ vL FINDINGS : n�rr,.— pele A.Ie � � - •� Zdat /© -3 utCT� A / d ✓ •�l�/i��/g�IO�Lr 2/11401 6 l` Signature and Title I acknowledge receipt of this report: SIGNATURE: 1'j�11(4 "W 02/96 Title: Rev. 770 770 \ _ S 2 °3604„ W 4 760 195.00 LOT kap T \ � _ 81,541 SO E °\ «j pnt FooNnD ln (Typ.) I owe7/Jnp I 710 F, F. 70,9 1 ed - 700 DaePlf =p ewoy Rood ed 155.40 ,�li 286.11 % , o TO OAD 670 H" 750 - -�,h LOT #2 ,_ .073 SQ° �,% AREA S�oyERLAP PARCEL),, Q AREA(, lip -- ���rlop parcel 1692 sq. ft' IN o� 2 j .prop o11 ed vo - Existing Well `o 1 Line — Nom! �n 11/03/2003 MON 17:51 FAX 1 845 279 6769 PUTNAM ENGINEERING -*44 PCHD BRUCE R. FOLEY Public Health Director r@001/001 LORETTA MOLINARI- R.N.. KS-N. ,issaeiate Public health Director Direetar of Patient Savioes DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 STING RJU FST FOR FILL} IEL ATTENTION: o ADAM STrEBELING A�fENR REED All information below must be filet completed prior to any scheduling. DAM-"::3-2— o3 ENGINEER OR FIRM; l- ;+ %J.A,,s7 15 6I.t/C`,l Zoe PHONE REA40N: �64116--1 Ge= cW 7aooFW7'j Aj&W r�f.fc+.�..+L 7FS74r.,G7 ®7e3o DEEPS; AC— - PERCS; AL PUMP TEST: O p FtJ—/— 1tOADSMET: �/9 U.!_ . o�s TOWN: TAX MAP #: 3 3 SUBDIVISION: engf4 C Z22! Ocl, CEO. LOT# -. OWNER. 2 D� Ire l~ NO Proposed SSTS within the drainage basin of West BrAnch or Boyds Corner Reservoirs. G Proposed 55 75 wifciain 500 Ieet ui a reservoir, rraervuir Sti:m o, coatiof lake. Proposed SSTS within 200 feet of a watercourse or a DEC wetland. rev Proposed SSTS design flow greater than 1000 gallons/day or SPDFS Permit required. Proposed SSTS for a Commerical Project. It is the responsibility of the design professional to provide the above information prior to soil testing. This Department will determine the NYCDEP - project status (Joint or Delegated) based on the response. If you answered j= to any of the questions, NYCDEP must witness the soil besting. 'this Department will coordinate a mutually suitable time for field testing with the PCDOH, the Design Professional and NYCDEP. If a project has been determined to be Delegated based on the above response and then subsequent information indicates NYCDEP is required to witness the soil testing, it will be the sole responsibility of the design professional to schedule re- witnessing of the soil testing with NYCDEP. Fo& COUNTY USE ONLY r DATE: % 02. .7 a : 3,o fig. a2 el CA1r1MENT3: (FEHLDTEST) D(97 O a A NO Proposed SSTS within the drainage basin of West BrAnch or Boyds Corner Reservoirs. G Proposed 55 75 wifciain 500 Ieet ui a reservoir, rraervuir Sti:m o, coatiof lake. Proposed SSTS within 200 feet of a watercourse or a DEC wetland. rev Proposed SSTS design flow greater than 1000 gallons/day or SPDFS Permit required. Proposed SSTS for a Commerical Project. It is the responsibility of the design professional to provide the above information prior to soil testing. This Department will determine the NYCDEP - project status (Joint or Delegated) based on the response. If you answered j= to any of the questions, NYCDEP must witness the soil besting. 'this Department will coordinate a mutually suitable time for field testing with the PCDOH, the Design Professional and NYCDEP. If a project has been determined to be Delegated based on the above response and then subsequent information indicates NYCDEP is required to witness the soil testing, it will be the sole responsibility of the design professional to schedule re- witnessing of the soil testing with NYCDEP. Fo& COUNTY USE ONLY r DATE: % 02. .7 a : 3,o fig. a2 el CA1r1MENT3: (FEHLDTEST) D(97 08!08 /2003 FRI 08:23 FAX 1.845 279 6769 PUTN!1M ENGINEERING BRUCE R FOLEY Public Health Director 1@001/001 .. , D Z.- LO OLINAlt1 .S.N. Assar�ate P fR s cror Dkeetar of Patient Services DEPARTNffiNT OF HEALTH I Geneva Road Brewster, New York 10509 t + Q . R FIELD TESTING ATTENTION: o ADAM STIEBELING P<&NE REED All information below must befuh completed prior to any scheduling. DATE: JV ENGINEER OR FIRM:4��i'1►/ATM �N61ac�lz�r3� -� e/'�-- (p'7�'�j - - - - - - - - - -- 1 PRONE #: REASON: DEEPS: PERCS1 PUMP TEST: (3 ROAD /STREET: S a$)eko TOWN: -- _ TAX MAP#: 3 ___ -- SUBDIVISION: LOT #: '�-- OWNER: SAL 1/+TIY245- D i 0�-&as—, Wo NYC= CRITERIA FOR JOINT REVIEW AND WITNI?SSRJrx !QF SQIL TESTING YES Nq, - -- - - -- - - -- .o._ _. :., .S . _ Proposed $ST$_within the draiatuge..un:P West Braltc% ar Eogds Corn�e_r Reserrvoirs : n Proposed SSTS within 500 feet of a reservoir, reservoirl:tem or control lake. o Proposed SSTS within 200 feet of a watercourse or it DEC wetland. Q Proposed SSTS design flow greater than 1000 gallons /day or SPDES Permit required. a Proposed SSTS for a Commerical Project. It is the responsibility of the design professional to provide the above information prior to soil testing. This Department will determine the NYCDEP project status (Joint or Delegated) based on the response. If you answered ya to any of the questions, NYCDEP must witness the soil testing. This Department will coordinate n mutually suitable time for field testing with the PCD011, the Design Professional and NYCDEP. If a project has been determined to be Delegated based on the above response and then subsequent information indicates NYCDEP is required to witness the soil testing, it will be the sale responsibility of the design professional to schedule re- witnessing of the soil testing with DWCDEP. POIL COUNW i7S$ ONLY PATE- o `� TIME: ,. _ 7 �s ME=& (FMLUTEST) 4mw We ^J;• 09/,05/2003 FRI 12:47 FAX 1 845 279 6769 PUTNAM ENGINEERING BRUCE R. FOLEY Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road Brewster, Now York 10509 0001/001 LORET A MOLINARI R.N., M.S.N. Associate Public Health Director Director of P400d Services AT'T'ENTION: ❑ ADAM STIEBELING XIGENE PXED All information below must be ftsilx completed prior to any scheduling. DATE. 3.44 ENGINEER OR (FIRM; �v�i� .p7 �,��°^,y��c=,�y i1t G. PHONE #: ,,3 8di REq$ON: DEEPS: o PERCS: )e," PUMP TEST: o ROAD /STREET: owA;= 12D40 TOWN:. �4-u�sD1' -� TAX W4: 8 SUBDIVISION: d±499 E AZ aa!:n� tae LOT #: 19F .... YES NO __❑ .... .. ._ . _ _...Ve .. _. _proposed SSTS within the drainage basin of West l3rat►ch or $oyds Corner ervatrs... a Proposed SETS within 500 feet of a reservoir, reserv61r stem or confedii lake. - (3 Proposed SSTS within 200 feet of a watercourse or a DEC wetland. • )K proposed SSTS design flow greater than 1000 gallons/day or SPDES Permit required. • W Proposed SSTS for a Commerical Project. It is the responsibility of the design professional to provide the above information prior to soil testing. This .Department will determine the NYCDEP project status (.Point or Delegated) based on the response. If you answeredya to any of the questions, NYCDEP must witness the soil testing. This Department will coordinate a mutually suitable time for field testing with the PCDOH, the Design Professional and NYCDEP. If a project has been determined to be Delegated based. on the above response and then subsequent information indicates NYCDEP is required to witness the soil testing, it will be the sole responsibility of the design professional to schedule re- witnessing of the soil testing with NYCDEP. OJ FOR COUNTY USE ONLY AI,/ r TIME: �v cortHli.NTS; (FIELDTEST) Well Location Street Address: Town/Village: Tax Map # GPS 1° 27 37 N 323 Towners Road Patterson Map Block Lot(s) 073 039.18 W Well Owner: Name: Address: Sal D'Agostino, 91 Lake I've, Mahopac, NY 10541 Use of Well: X Residential _Public Supply Air cond /heat pump _Irrigation 1- Primary Business Farm Test/monitoring —Other(specify) 2- Secondary Industrial Institutional Standby Drilling Equipment X Rotary _Cable percussion X Compressed air percussion Other(specify) Well Type _Screened _Open end casing ___X Open hole in bedrock Other Total Length 32 ft. Materials: X Steel Plastic Other Casing Details Length below grade 31ft. Joints: Welded X Threaded Other Diameter 6in. Seal: X Cement grout Bentonite Other Weight per foot 19 lb/ft Drive shoe: X Yes _ No Liner: _Yes -L-No Diameter (in) Slot Size Length (ft) Dept to Screen (ft) loped? Screen Details First J Yes No Second I lHours Well Yield Test _Bailed X Pumped XCompressed Air Hours __6_ Yield 10 gpm Depth Date Measure from land surface - static (specify ft) During yield test (ft) Depth of completed well in 60' 300' .405' Well Log Depth From Surface Well Diameter If more detailed ft. ft. Water Bearing in) Formation Description information Land surface 5 Drilli - n descriptions or Hit rock at 5' sieve analyses 5 32 -Drilling in rock. set casire. grouted are available, 32 405 Drilling in rock granite please attach. If yield was tested Feet" , er Minute Pump /Storage Tank Information at different depths Pump Type sub Capacity 5 Um during drilling Depth 320' Model 5GS07412 list: Voltage 230 HP-3/4 Tank Type WX250 Volume 44 gal. Date Well Completetl ' Vllell Driller PCCertificate. #plg NY.,State # _: Date;gf Report 1014/08 NYRD10105 12/17/09; Furnp Installer PC Certificate # 024' NY State, #: Well :Driller Name; AAddress We sl P F;: Beal So ,.4 Putnam Avenue', Brewster; NY 10509'; hl� e 1 ump Install P er Name &��Address�: Puin r P Beax &Sons, Inc ,i4 Putnam Avenue, Brewster, NY 10509 irli.p.. J' eal wl NOTE: Exact Location of well with distances to at least two permanent landmarks to be provided on a separate sheet/plan. White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 Rev. 3/06 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES - � :Ar .:= S .: -� "'" �:.ztri .c.:,: .'¢�,.'..a :£ .- -- r' ... ;.._... •:. w'.5.. .� .�_�_ :..t _-. ._ may'.: -' i :. ,,, "- "- �: .�trs .:. ..:: -':... ,.�.,.i : Z '.- - : -:-a- i. __.... y'.S; ':c y..i� DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner S ,�,(�� Address E'eA�_ . 'Located at (Street) Tax Map _33 Block Lot (indicate nearest cross street) Municipality �'�j A/ Watershed Mjt2 71 f. & NC-a I� 2 SOIL PERCOLATION TEST DATA Date of Pre - soaking 7 ZI y /o_; Date of Percolation Test `7115-10t, 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 31 -6U min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD -97 TEST PIT DATA 2 DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES - BEPTY I HOLE NO! ; _ 1- OGLE -NO..- - $ xiGLE N0. G.L. 0.5' .. 5 1.0 _ 2.0' p 2.5' O ` 3.0' 1 3.5' 4.0' -3, 4.5' 5.0' 5.5' 6.0' 6.5' f' 7.0' 7.5' 8.5' 9.0' 10.0' Indicate level at which groundwater is encountered Al ®,y_ Indicate level at which mottling is observed Aj 9 Indicate level to which water level rises after being encountered Deep hole observations made by: , ? sc, E,04, Date Design Professional Name: Address: Signature: Design Professional's Seal 06/02/2005 THU- 09:21 FAX BRUCE R. FOLEY Public Health Dlreclar 0 002/002 LOREYI'A MOLINARI R.N., M.S.\;. Avsociare Public Health Dip-ft-10, Director of Porten J'ervices DEPARTMENT I' OF HEALTH 1 Geneva Road Brewster, New ` ork 10509 REQUEST FOR FIELD TESTING ATTENTION: ❑ JOSEPH PARAVA I, it FNE REED All information below must be t`ully completed pr io. t" s:ny schcdulir „. DATE: 'Z O�z; ENGINEER OR FIRM- �� 'fir "1 r ;r�1.r -— PHONE #-. •2=Ff -C� -lam MASON: DEEPS: -V/ PUICS:. PUNTP TEST: ❑ ROAD/,STREET! j �LJ yJ,.► c �Z� (;,� � TOWN: TAX MAP #: SUBDIVISION: fngp-r, Cxvetu ?r��,.;i" c '���:” 3 LOT S OWNTrR: �7�l.al��ti,'Z� D.. A�C:�� ►- i ;� U NYCDEP CRITERIA FOR JOINT REVIEW AND W r1'NEsSJ G OF SOIL 'I'VST1N Cr YES NO - ❑ (. Pi posed SSTS within the drainage basin of West Branch orBoyds Corner Rescivoirs. - ❑ . ) Proposed SSTS within 500 feet of a reservoir, reservoir stem or control lake. ❑ Proposed SSTS within 200 feet bf a watercourse or'si DEC wetland. ❑ Proposed SSTS design flow greater than 1000 gallons /day or SPDES Permit required. . n Proposed SSTS for Commercial Project. Zt is cbe responsibility of the design professional to provide the above information prior to soil testing. This"Department 'will determine the N'YCDEP project status (Joint or Delegated) based on the respoi.tn. .if .you answered yes to any of the, questions.. NYCDEP md.0 witness the soil tests. This Departmesitwill coordinate a mutual ly suitable time; for field testing with the Design Professional and NYCDEP. If a project has been determined to be- Delegated based on the above response and then subsequent information indicates NYCDEP 6. iequired to witness the soil tests, it will be the sole responsibility of the design professional to schedule re- witnessing of the soil testing with.NYCDEP. FOR COUNTY USE ONL1 DATE, / �U TIME: COMMENTS (HEMAEoT) TI IN- ?- PMR1 -, twi I no • or- rGi . nn� n-n -n— Public Health Director �LORETTA MOL'INARI R.N., M.S.N. Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road -Brewster, New York 10509 REQUEST FOR FIELD TESTING . ATTENTION: ❑ JOSEPH PARAVATI _.` 'G'ENE REED All information below must be fully completed prior to any scheduling. DATE: V— I 22 cA ell ENGINEER OR FIRM: IrT' i QACK PHONE #: REASON: DEEPS: PERCS:,y PUMP TEST: ❑ ROAD /STREET: Ta J&ti YzS tCzoA -n TOWN: TAX MAP #: SUBDIVISION: F- rt��>t�el�- r,r,ltti�►`i,.�, LOT #: 2 OWNER: S y-VLV r}- M.2 NYCDEP CRITERIA FOR JOINT REVIEW AND WITNESSING OF SOIL TESTING YES NO ,Q. .: Preposoed- SSTS withinthedraina be- basi&bf- W- 6stlit ranch %orBoydsC Sorrier- Reservoirs: ° �- ❑ Proposed SSTS within 500 feet of a reservoir, reservoir stem or control lake. ❑ Proposed SSTS within 200 feet of a watercourse or a DEC wetland. ❑ ,� Proposed SSTS design flow greater than 1000 gallons /day or SPDES Permit required. ❑ Proposed SSTS fora Commercial Project. It is the responsibility of the design professional to provide the above information prior to soil testing. This Department will determine the NYCDEP project status (Joint or Delegated) based on the response.. If you answered yes to. any of the questions, NYCDEP must witness the soil tests. This Department will coordinate a mutually suitable time for field eld testing with the Design Professional and NYCDEP. If a project has been determined to be Delegated based on the above response and then subsequent information indicates NYCDEP is required to witness the soil tests, it will be the sole responsibility of the design professional -to schedule re- witnessing of the soil testing with NYCDEP. FOR COUNTY USE ONLY DATE: TIME: I® COMMENTS (FIELDTEST) PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SKEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner /V i a2 E�Z Address % ®c,�/,a1 iCS - j <:y 7L> Located at (Street) Tax Map Block Lot (indicate nearest cross street) Municipality ,�¢� ®j Watershed SOIL, PERCOLATION TEST DATA Date of Pre - soaking Date of Percolation Test 1 2 3 4 61 3 5 1 2 ki 5 MOTES: 1. Tests to be repeated at same rates are obtained at each percolation test hole. (i.e. s 1 min for 1 -30 min/inch, s 2 min for 31 -60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD -97