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HomeMy WebLinkAbout1448DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 34. -2 -36 BOX 13 r jr �. me I NIL me 9 {, I r ,; E , -6 i -i` ^I .'T -r'^ _ ^. ,s., -r F--- -+aa�' -�-,.- -•cF�^';,a -M, - •r—q r x - a,..,K.x•-^,. � 4 'x.'�"°'_�`.-s^,.;f^,�"x?°q ° rz-_" - }...e. �'��. J ,. i 1 !ICATE PUTNAM COUNTY _DEPABTMENT OF HEALTH N,Y 1QSls OF CONSTItUMON COMPLIANCE FOB SEWAGEDISPOSAL •SYSTEM Located at oT� i/ i'G>� Di- . Ter : Town or T n Map Bkpt# Lot Owur /ipplkaotName F., Vii.• t Tne.Forme>IY S ` Name iFPAap 174Q. I :# 2t3 Fee Enclosed Amount:.pp -Date'Permit Issued _ separate se*enge sy** Wt by 5.: A . S� �: S,�c vac Aaaress Consisting of 12 SCS Ganon Septic Tank and 720 L; F. .6-f Water Supply: Pdbpe Supply From Address ors Private supply lhNed by P F. . beta i � So�,s� T =� Address � 6. $., x R $uIldhi nQ'e �.++,�.." ome_ LOt Size as Erosion f nntrnl Roan l`nm= 1 atnA 9 �P�S Number of Bedrooms Has Garbage Grinder. Been Inetelladt /� a Other Requirements I certify that the.syatim(e) as listed.'servinq the above premises were gonatzuc essentially as s on the plans of the completed work f copies of which are attached), and in accordance with the eiandaids, rules.and regula n .in accordance v tie.filed plan, and the permit issued by the Putnam County Department, of Health. , Oats .,°r, _ 9;a. Ceitflsd by 99 P.E. R.A. nea.ess 3's0 Vt r ns � snnr7a 144dw , / �ui M License No. n� f38 nkG^ o N x7174 Any person occupying premises served by the above systeni(y shall pro' .. .,take such agtio ss may 01 necessary to revere the correction' of any unsanitary conditions: resulting fro m -such Yfige Approval of thertdpaistn..^.wwNa�a.syuem pitill,becoTe null a6e'vold'as soon as= a putil;: sanitary sewo beeoma avllible Intl the a p "M of tha private wale supply shilLtueome null id when • Pub)lt water supply - becomes evallable. `Such approvals we sublect t tbri or change when in the •judgment of 'tM :Co 1 ef MMlth.,. rNroeatbn, Modification or change N neeew 3/89 oa. 9y Title i WELL COMFLETIUDI LV_XUr,1 Office Use Only mac DEPARTMENT OF HEALTH ` Division Of Environmental Health Services PUTNAM COUNTY DEPARTMENT OF HEALTH STREET AOURESS: TOWN/ViLEXCEICITY TAX GRIO NUMBER: WELL LOCATION Windsor Oaks. Fair St . Cannel , NY Lot #28 71-1-1 NAME: AOORESS: ❑ P IVATE WELL OWNER Foley Dev. Co.,Inc.983 S.Bedford Rd. ,Mt.Kisco,NY ❑ PUBLIC USE OF WELL 19RESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIR /COND. /HEAT PUMP ❑ ABANDONED 1 - primary ❑ BUSINESS ❑ FARM ❑ TEST /OBSERVATION ❑ OTHER (specify) 2 - secondary O INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND -BY ❑ MOUNT OF USE YIELD SOUGHT gpm. /NO. PEOPLE SERVED / EST. OF DAILY USAGE gal. REASON FOR []REPLACE EXISTING SUPPLY ®TEST /OBSERVATION [:]ADDITIONAL SUPPLY DRILLING VqNEW SUPPLY (NEW DWELLING) []DEEPEN EXISTING WELL DEPTH DATA WELL DEPTH 600 ft. I STATIC WATER LEVEL 4O ft. DATE MEASURED 12/20/89 DRILLING [ROTARY ® COMPRESSED AIR PERCUSSION ❑ DUG EQUIPMENT ❑ WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify): WELL TYPE ❑ SCREENED ❑ OPEN END CASING -'U OPEN HOLE IN BEDROCK ❑ OTHER TOTAL LENGTH __ 31^— ft MATERIALS: Ga STEEL ❑ PLASTIC O OTHER LENGTH BELOW GRADE 30 ft- JOINTS: ❑ WELDED ® THREADED .❑ OTHER CASING DIAMETER 6 in. SEAL: (R CEMENT GROUT O BENTONITE ❑.OTHER DETAILS WEIGHT PER FOOT 19 lb./ft. fl DRIVE SHOE YES ❑ NO LINER: G YES ®NO DIAMETER (in) 'SLOT SIZE LENGTH (ft) DEPTH TO SCREEN (1t) DEVELOPED? SCREEN DETAILS FIRST O YES ONO SECOND HOURS GRAVEL PACK ❑ YES GHAVEL DIAMETER TOP BOTTOM O NO SIZE: OF PACK in. DEPTH ft. DEPTH ft. WELL YIELD TEST 11 If detailed pumping 'If more detailed formation descriptions or sieve analyses WELL LOG are available. please attach. METHOD: p PUMPED 1 tests were done is in- DEPTH FROM Water well -M COMPRESSED AIR ; formation attached? SURFACE Oia- FORMATION DESCRIPTION CODE O BAILED ❑ OTHER ❑ VES ❑ NO ing In it. ft WELL DEPTH DURATION DRAWOOWN YIELD Surface 15 Drilling in overburden clay & boul er ft. hr. min. It, gpm. wit oc at ' 600 6 585 .5 15 31 MrAling in rock,set casing,grout d. 1 600 lina in ock aranite. WATER ❑ CLEAR TEMP. _ QUALITY ❑ CLOUDY HARDNESS. O COLORED ANALYZED? OYES ONO ANALYSIS ATTACHED? O YES O NO STORAGE TANK: TYPE WellXtrol 203 CAPACITY 32 GAL. PUMP INFORMATION WELL DRILLER NAME P . F . Bea 1 & Sons , In TYPE submersible CAPACITY_ MAKER Gould DEPTH 560' ADDRESS PO Box B 1 - Brewster,NY 10,�� i MODEL r 0 2 VOLTAGE 2.3DHP �._ 4 .Kittinger Owner or Purchaser of Building Windsor Oaks Associates Building Constructed By Highview Drive Location - Street Patterson Municipality Residential Frame Construction Building Type 28 Section Block Lot 2194 Tax Map Number Windsor Oaks Subdivision Name 28 Subdivision. Lot GUARANTEE OF SUBSURFACE SEWAGE.DISPOSAL SYSTEM I-represent that I am wholly and completely responsible for the location, workmanship,, construction and drainage of the sewage disposal system serving the above described property, and that it has been constructed as shown on the approved plan or approved - amendment thereto, and in accordance with the standards, rules and regulations of the Putnam County Department of Health,' --.and hereby..guaran -tee -to-the owner, his successors,. heirs, - -or assigns, to place in good operating condition any part of said constructed system constructed by me which fails to operate for a period of two years immediately following the date of approval of the "Certificate of Construction Compliance" for the sewage disposal system, or any -.repairs made by me to such system, except where the failure to operate properly is caused by the willful or negligent act of the occupant utilizing the system. The undersigned further agrees to accept as conclusive the determination of the Director of the Division of Environmental Health Services of the Putnam County Department of. Health as to whether or not the.failure of the system to operate was caused by the willful or negligent act of th ., occ pant of . the building utilizin, the- s Dated this day o v - 19 Y'O Signature— V. ?. Fold De Co. of Pat2ti4 on Inc. ^er or Owner - Signature Wnsor aks Associates S.A.F. Septic Corporation Name (if Corp. Corporation Name if Corp. 83 S. Bedford Rd., Mt: Kisco, NY 10549 P.O. Box 141 Cross River NY 1051E Address Address C C Windsor Oaks _ - - - - — - -BREW-STER LABORATORIES :....... Box 224 - BREWSTER, N.Y. (914) 2794945 WATER ANALYSIS REPORT -- SAMPLE NO., 76 Fol0 TEST WELL ey Dev. SOURCE: Windsor.Oaks Lot1128 Fair St. Carmel, N.Y. COLLECTED„ 3-21-90 BY:. P.F. Beal & Sons BACTERIOLOGICAL EXAMINATION Colilorm Count, MF Mothod 0 per 100 ml. This result indicates the source of the sample was of satisfactory sanitary quality when the sample was collected. 3 -23 -90 J;. ITT . FINAL SITE, I%,IScrC!' =CV Cat_ d Ins; by e eav l ,•G1T_ SGN %�AG�,VI CRIER !J .� --, C94 _ .,,t,TC -•rn„ rrm .� � l/ � J�ln/Y n/Yl ��r /q ., e. P Ll CL'r L e _. G _ Saule elel7at_Cn - Wa =r t =s �.•- ti M i n -, ,; L -- _ cric % )re' t' , C- t..... .".�^, < 30 t 1•. ^. /, DISPOSAL AELE I 1 1 a_ SIDS are-= JC —+— as '" a=roved Dlans b. P-11 Date of placsn--nt I I I 2.1 baTriEr . I=- . W- =H A�TC_D FT? 'H -AI . C_ t'atur- soil r_ct _=trircU I --- I d p= E_5' _`+ ac=ss —Zble rran cle to crace I d_ Stone, b_rus etc- , cre=_t`r tt'1cn 15' f_cm SDS arEa- " I - S Firs= hcx h=f=1ed I I e. 100 ft_ fro:. ccnr_a /Ye DISPCG . SYSTEM 1I -4- 1 a. Sect; c 1,000 1 ` es ti*:'at _^ cN der cy c a_ Ecuse lcc == rer accrcvea pla-r =s- I b. &_uL1C tc:,-k level C . -La, lILi rl' TIiL -t CLLr: - on - V- Ono Wi -r1 i r, 10 ft. cf 45'3 I e. P Ll CL'r L e _. G _ Saule elel7at_Cn - Wa =r t =s �.•- ti M i n -, ,; L -- _ cric % )re' t' , C- t..... .".�^, < 30 Rccn =cr] E`s-, ns i cn, 5� % Q vlG C C�:Cl 3/A diam L c =v e-T- in t=ench 12" mini7a--,l 1. Size of C'.iu,s - 2. C e--=:'lc- tB-TI I d p= E_5' _`+ ac=ss —Zble rran cle to crace I I - S Firs= hcx h=f=1ed I ! I 6 . C4rc1e w _- -- _ � by Hea- ul es ti*:'at _^ cN der cy c a_ Ecuse lcc == rer accrcvea pla-r =s- c -j4 -Z Z cT"Drcve, plans I I I b_ D'qt rice =_..-.: .`.L' a= �-- c_ C= =ina 18" jE]2c�e d_ S..�a�� �� _- �•cr =:c wz? eccect� i e I -- IIf ---III v__ cvE:7 .. WoRK.LaSrr b. P -1 ices i�1-� becLi� i I —I� I c_ P_ pices f �•_`� Wi t_-i inside of bct d_ E=: ICf; I� Ii. =t_ =� cCr_t? *'n= s`cne=_ < 4" in di "F e. C= n era; = irs -i1-A accordinc to plan •-�- -�'-1 i. C_*-n d=:. : cwt = =i1 prcte =-'c & d4-.to c _ r'-ct? na C?'a_ G'_= G ^.GrC° aSvaV t -cCR SDS area I �1 h_ ace wat -- crctec =ica adept° I -I 1. E C_sIcif c_. .=c i crcvid =d cn sicCes creter GENERAL NOTES I ® I ® 1. ALL SURVEY INFORMATION TAKEN FROM SURVEY PREPARED BY BADEY 8 ® WATSON, SURVEYING & ENGINEERING, P.C., COLD SPRING, N.Y. • �^ 2. 'AS- BUILT" MEASUREMENTS WERE TAKEN 3/27/90 BY STEVEN J. HYMAN ASSOCIATES CONSULTING ENGINEERS, RONKONKOMA, N.Y: DRAINAGE _ N lO'30 32 E _ 150.00' AREA = 40,537 aF. CONTROL POINT Q93 Ac STRUCTURE I POINT "A" ® W SEPTIC TANK 1 48.5' i 19.7' O JUNCTION BOX 2 94.3' 73.6' JUNCTION BOX 3 93.2' f 76.0' N / N JUNCTION BOX 4 92.6' 79.1' ® u/e s o' rrr. m ® JUNCTION BOX 5 92.2' 82.1' N / y JUNCTION BOX 6 92.2 85.8' JUNCTION BOX 7 92.7' 89.7' ✓UNCTION BOX (TYP,.) JUNCTION BOX 8 94.2' 94.0' e JUNCTION BOX 9 95.9' 98.6' O' 7YP JUNCTION BOX 10 98.4' 103.6' r POINT 11 132.5' 112.6' POINT 12 131.9' 114.6' r POINT 13 131.6' 118.6' a POINT 14 131.4' Roe/ 1 POINT 15 31.6' 121.3' I . SEPTr TANK POINT 16 132.7' 124.8' /250 GAL / POINT 17 133.9' 128.2' POINT 18 134.7' 131.5' Putnam County Department of Health POINT 19 138.7' 135.3' PT. a" Division of Environmental Health Servioan 54.3' 37.2' 3 POINT 20 , 416' FRAME POINT 21 51.4' 41.2' DWELL /NG Approved as.noted for oonformanoe with POINT 22 50.7' 47.7' . N co applioable Rules and Regulations of the POINT 23 50.3' _53.2' -.b 45.8' N them Co ty Health Departme t. POINT 24 49.6' 59.2' y _ a o POINT 25 51.0' 84.0' gyp- Signature do Title Da a POINT 26 52.5' 70.0' v POINT 27 58.0' 78.0' wEZt POINT 28 60.0' 82.0' 5.03'38'33" W /50.00' DESIGN INFORMATION 4 BEDROOM HOUSE HIGHVIEW DRIVE LATE RATE' 30 H REQUIRED- LATERAL LENGTH REOUIRED- 887 LF LATERAL LENGTH PROVIDED- 720 LF FILED MAP AT Z194, FILED 121.0/86 � F ���oN gc °q FAIR STREET SUBD /VISION 10 SEPh y�4 LOT 28 TOWN OF PA TTERSON i NEW YORK N Z ' MALVERNE, MY. / fD/i! 599-3661 Js� R/OQC; N.Y. //961. THIS 19 TO CERTIFY THAT THE SEWAGE DISPOSAL SYSTEM WAS CONSTRUCTED AS (! /sv sa .0-3230 INDICATED ON THIS PUW AND WAS INSPECTED BY A REPRESENTATIVE OF OUR s� aA C>� ALE: ppo%NO,: oAlE: ' SHEET OFFICE BEFORE R WAS COVERED OVER. THE SYSTEM WAS CONSTRUCTED IN G q wNP 50' 8939 ✓UNE!l990 ACCORDAPICE WRH ALL STANDARD RULES AND REGULATIONS OF THE PUTNAM COUNTY. °FESS R.� ✓fq,. =�. 'AS -BOIL T" SSDS 8 WELL �? DEPAR•T*IEW OF HEALTH AND THE NEW YORK STATE DEPARTMENT OF HEALTH. i .-^7 • V �--icYs wa.wa.r + SF Sa1�Jiirisrzj 6lb+:i,.ti .a` = Tmallor A�Nl+.e i r M� I��s� a. ►as ?ors natP.S s ulid� vis Ic,ii , Fee Enclosed: A,nr,t;nr � �"� o°a vaiaos PC®eN Wa 1s Y•4�6red Whee P®b N�Mr .c sae.... Deai�t M4 G P D a4kad s.�.a•sar..�.Sr•�aa.rt1 „r' '°72c' iF. o ��l" 1`,�*► -yr = h�'e�iL. - T. M •wM .dd b' Adiho" f wow s.�y» t•.... � Fe..' � Add... A 4 400 77; 1yb OOwlty O�YNtrnant ,of "on's and,mwk On c#!!Oetbn the, M �rbinitt•d-,.to'tMl)aPartennt an0 -;a writtin,YuaaM•ii t>ys'a'�k+.'Nfaoo oP•►atYM conOltion int+,. Dart- ;ot,_siW sfwaM arl•. or <tM aPprarat of tha.;Certiftc�te or •Construetbn .Co Wo be torat•d a. dwww. on e1i.':vwor.e`w.n ana That saie•we CobntY Ob�ii rtrfrarlt W'- I4•alth. Otte rJ� 2� wtlar•s �0�-�- �'r4n� APP,PROdVEO FOR CONBTfi T10N ThN aOprowl eYONes'.tw r•rocabl•, for �Uillw or.'maY be fnwrwae o� ro00itiw when eon requires • �OW UL P AOWowtl for'difpoUl of tlOrMSlle Rev. 10/88 oete ntlntent thin` to an0 an aceoreana with tM stanGrtls, rule`s a rpu n} o - m a'�c.rttfi�aa of Construdbn:Cornpliane•� Ytidaeto►y fo tM Co�imiplohM of HeNthwill We fufnilll•A the owrW* his 'W mos as: MMS Oi.assyns by. the butkNr, that W builder will V" iyftNii durinj tM,pMba of two,`(21 Y!!!f NnrnadifitNy followfn�'tMat• of;tM Nina of "tM yiriai systain o► any rpairt t"Stoc t) that the drilled, will deco OW' abO Ill be Mttal • with the dandarda; rulu ;and rpu%aiio s of0f•', the.PYtM1n ,. NI•tl% �- _ P E: R.A. S,v.i�v M nkos�araa i�1 le OxS) ' t_arq• No liwe "fro"► tM data' issued . unk" cgnstiuetion -of tna. bifiginy fws :been• undirtakeil aril if Mi0 11eCefYry` by; tM. COMTipiOM/ Of',MMlth. Any chirps or alteratioe of CpnftruC[bn it y a«�i+�•. /oi�privab `water suolihy only: TRIG DEPARTMENT OF HEALTH Division of Environmental Health Services 110 OLD ROUTE SIX CENTER; CARMEL, N.Y. 10512 (914) 225 -0310 LPPLICATION TO CONSTRUCT A WATER 'WELL PCHD PERMIT #P�31_47 WELL LOCATION Street Address /Town /Village City Tax Grid Number WELL OWNER Name Mailing Address FoI e Y, Deve/a p ave f- & . I , G e3 SO-44-41 "l mo kis c� � � J S ,) rivate O Public USE OF WELL - primary 2 - secondary ,RESIDENTIAL ® BUSINESS ®. INDUS TRIAL OPUBLIC SUPPLY O FARM U INSTITUTIONAL ❑AIR /COND /HEAT PUMP O TEST /OBSERVATION O STAND -BY 13ABANDONED O OTHER (specify, AMOUNT OF USE Y,IELL SOUGHT gpm /# PEOPLE SERVED /EST. OF DAILY USAGE__gal O REPLE,CE EXISTING SUPPLY ® TEST /OBSERVATION Gb ADDITIONAL SUPPLY NEW (SUPPLY NEW DWELLING 13 DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING r'I v e e�Gr 'r S - .- dP eI. �v a /llp -►y I! r ineo,.� S�fG%�Vlsl�cr WELL TYPE DRILLED ®DRIVEN ®DUG C]GRAVEL OTHER IS WELL SITE SUBJECT TO FLOODING? YES X NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME.OF SUBDIVISION: ,Ir Lot No. x WATER WELL CONTRACTOR: Rime r, E. -R,,e ] Address : eeps•}e, All 1050) IS PUBLIC WATER SUPPLY AVAILABLE.TO SITE: YES NO NAME OF PUBLIC WATER SUPPLY: ,V4- TOWN /VIL /CITY bISTAANCE TO PROPERTY FROM NEAREST WATER MAIN: tiJ LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED �ON SEPARATE SHEET (date) (signa re) PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted Linder the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirty (30) days of the completion of water well construction, the appl i cant s.hal 1 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department. Date of Issue: d9 19 e�rtm t ssui ng ci Date of Expiration: 19 %f Permit is Non - Transferrable Mite copy: H.D. File Yellow, copy: Building Inspector Rev. 10/88 Pink Copy: Owner Orange copy: Well Driller PUTNAM COUNTY DEPARTMENT OF HEALTH Division.of Environmental. Health Services AFFIDAVIT - CORPORATE OWNER APPLICATION FOR PERMIT APPLICATION- SUBMITTED TO PUTNAM COUNTY HEALTH DEPARTMENT APPENDIX L TO: Commissioner of Health ' In the matter of application for: 4- i+ee, -- 'Su lod i visr opi • �'J�d�vldU� [ �S s 41�d ,�ej^ Su /. -_.-f -6y- Lo4 No. u l fi0 14e represent that I am an officer or employee of the corporation and am authorized to act for P i@ �2Ve�p g�4- Co . o- �G'E~�-ei -sow �hC . (Name of -Corporation) having offices at e .7_.. ,5OL �'J. �je�'�►'(�. K(�GLt Whose officers are: ) President: Vice- President: S4vzrue 83 Sou-41 73,ecl -Ward Raid r. A44-, e1sco n(-� 10S0 and Address) nd Address) Secretary: �C.�liri_ue� ole�4 (Name and Address) g $aLl+l, O�-4d Treasurer: t'Cf 4 1 i*Sco -(Nam and 'Address)`. _"_:.::•_'.�._.., r� '- =r.: =� and that I am and Will be individually responsible for any and all acts of the corporation With respect to the approval . requested - and all subseauen acts- relating -' thereto. /7 Sworn to before me this 42?3 _ day Signed.: j f o£ (_� `� 19 Title: j�rZZ SilJE^'7� �tl Notary Public . -;- 8/84 MARIA HARDMAN Notary Public, State of New York No.4934641 Qualified In Westchester Countyip Commission Expires May 31, .3 9t; Corvorate Sea ,1 ' - PUTNAM COUNTY DEPARTMENT OF HEALTH Division.of Environmental. Health Services AFFIDAVIT - CORPORATE OWNER APPLICATION FOR PERMIT APPLICATION- SUBMITTED TO PUTNAM COUNTY HEALTH DEPARTMENT APPENDIX L TO: Commissioner of Health ' In the matter of application for: 4- i+ee, -- 'Su lod i visr opi • �'J�d�vldU� [ �S s 41�d ,�ej^ Su /. -_.-f -6y- Lo4 No. u l fi0 14e represent that I am an officer or employee of the corporation and am authorized to act for P i@ �2Ve�p g�4- Co . o- �G'E~�-ei -sow �hC . (Name of -Corporation) having offices at e .7_.. ,5OL �'J. �je�'�►'(�. K(�GLt Whose officers are: ) President: Vice- President: S4vzrue 83 Sou-41 73,ecl -Ward Raid r. A44-, e1sco n(-� 10S0 and Address) nd Address) Secretary: �C.�liri_ue� ole�4 (Name and Address) g $aLl+l, O�-4d Treasurer: t'Cf 4 1 i*Sco -(Nam and 'Address)`. _"_:.::•_'.�._.., r� '- =r.: =� and that I am and Will be individually responsible for any and all acts of the corporation With respect to the approval . requested - and all subseauen acts- relating -' thereto. /7 Sworn to before me this 42?3 _ day Signed.: j f o£ (_� `� 19 Title: j�rZZ SilJE^'7� �tl Notary Public . -;- 8/84 MARIA HARDMAN Notary Public, State of New York No.4934641 Qualified In Westchester Countyip Commission Expires May 31, .3 9t; Corvorate Sea _ pGP�lDL� 3 Fr�r2P:� C✓L 'T r L' ? `TT OF f= —LLI — 0I"1?SICI OF KNVJ ?C`�`TLR.L E3r-,E Surma °r•I � Su�:,�•cF�r^ ac"c.'u7�" DISi -r �L S"iS��� CAT'_, ! �Y \ .• 1/ ' � C� C a .is ° ��"G, �.,. � � � ,gyp ! I /=`�i ' � !/. Z-E Y : `'.a°��.�..,G._a�— =''C.vr- % LCcz Cl) C� .t�TlS I YES I NO I DCC"l r Plans - T"--,rzc sa s Design Data Sl:ee: (:. CE ) Dec-z :lcl� Lcc CCr.S_Stan t- Per:. Per= ccie Deota ECL:Sc Plc`!: - TT-ic Se -_ wiel1 E=L =; Variance Re=,,..:as ,... vi, cz RZ;:ULnJ DF ' g CSI F= Mr 1 �% _ -Cj C,:. �l� -_. .,�. - -T I I S =•vcGc S:a�?; ,�iC= . =....! _C c' -C = - -= '.�'- .:__' --_ 2r�� Lam_ reScrvCi =, F-11-1 P -VL -_e & D? cr,c_C :S - Jam, =-•= s -=ct -c TarfK - Sl ze, Detail We_,1 Der =.,1, Ser'aice L: i= cc`_ CeS_Gn Da — : per cr'ic c ee_ TT, c-FcCt CcnL-cur: & Dr:.-';eYaV & Sle_ce- Cat F'COL?.riC��`.T'__r Ci� =.' Dr =_nc (C_5:�:�r•�= Perc & De_n Ecles Lcc_ ReDreser-tative C CH, S ...��'151CII nrn3 ;SilC;vi? ;Grc�1` ;i :_C`,J�S'1L ;. 5_�c Pit & D Ecx SlLCWL-1 & Hcuse - I'TC. CL Ee:d--c.s Wells & S'S-S's W /:n 200 1-. C= :-tc cs-7 ictl Ecuse Setzack Ne__ sa_ ( EcuSz Se:ve Nc BEndss ; SZPA A"'I1-N, Fi?IcS tic); TY7 Pin Max. Een s 45° w /c_ -�ncu- DIET =ti=-:Z s?EC_ ^^ C._ PT.�ti 10' t0 P _L. , Dri.'Ve av, 20' to FcL'nCaticn Wc1lS LLce T'= e—s jc Cr _ 100' to We11 ; 200' in D.L.C.D, 100' to Stream, �1c-= r'".JlLSc, -_'G (�r=C. ii �`- 13' tc Dry i nS C r' n, 35"= GtC:l si:1,5iC'_ -mac ;,01 We --r 10' to at-=r Line 50' int:- ,r CF Of71SIC21 CF � -Y D E-c-aze W. L- 7 S='CS R T DNT =-MT- c c f i c -C cy. t Lc cm) d t�- 1 cal--c-=s f —7c: Lqcj "I P A & , - DD I Z-4-- I D ol 7: C = == C -- -------- CeS.=- Cam E:_== 7-, C E -_,i-7Z- 1.7 ct=!i 4w S c-,, T-'; a gerc ar.d- d=-=-:- r=-=7' E-c-aze W. L- 7 S='CS R C-L.=-'lrr.F,r-y- er c f i c -C cy. d t�- 1 cal--c-=s "I & , - DD I Z-4-- I D ol 7: C = == C -� ct=!i 4w S c-,, T-'; a gerc ar.d- d=-=-:- r=-=7' P= "C-L-acs Lcc:z- -Z E�z c C-L.=-'lrr.F,r-y- er f i c -C d t�- 1 cal--c-=s "I F-zc-zans C-- Are—=;s�-CC El- ]KC. C-f: Wel & S S'7-s- s w, n 200 & -7 10' tz CZ 20' to Fc -L:r. da ti c in D_r..0 1001 to ',�all; 200' 100, tc 35' PUrNAM COUNTY DEPARTMENT OF DIVISION OF ■• •' M is v L HEALTH SERVICES _...DESIGN _DATA..SHM, SUBSUFACE SEWAGE. •DISPOSAL SYSTEM- - F. -NO 4"z)leY P-evelops4le, #- Co. NqA_? Owner o-P P t4rsah Iv,G . Address S3 5oufl7 _P_xad'-(�rd 145co nIy �t3s►� `j Located at (Street) f 41 q view 'Eco r- S+- Sec. -7& Block 1 Lot 1 (in 'sate nearest cross street) Municipality C J 4erSok Watershed • ■ • 01• �• •' Y�. • • V.-V . L• ■• �■ • ■ �• • • • Date of Pre- Soaking Date of Percolation Test HOLE NUMBER CL= TIME PERCOLATION PERCOLATION Run Elapse Depth.to Water From Water Level No. Time Ground Surface In Inches Soil Rate Start -Stop Min. Start Stop Drop In Min /In Drop Inches Inches Inches 2 (!e- 'I0"S e 0Ked 3 6-v - P Okl 4 1 �ec� km'312 Ckld Aeprovc4 er75jkj.eRr1k1'zj 5 C�P'nU_') -'iC S 2 3 4 k 1 2 3 4 5 NOTES: 1. Tests to be repeated at same depth until approximately equal soil rates are obtained at each percolation test hole. All data to'be submitted for review. 2. Depth measurements to be made fran top of hole. rev. 9/85 TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES REMVED DEPTH,-- ..:HOLE NO. EHM]l - -HOLE - NO. G.L. '89 AT 29 A 3 :4 4- 21 31 4' 51 61 71 81 91 .10, 12' 13' 14' INDICATE LEVEL AT WHICH GROUNDWATER IS ENCOUNTERED INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED DEEP HOLE OBSERVATIONS MADE BY: DATE: Soil Rate Used Min/1" Drop: DESIGN S.D. Usable Area Provided" q teem+'- No. of Bedroom Septic Tank Capacity/ gals. Type Absorption Area Provided By _710 L.F. x 24" width trench Other Name 13kiltiq kwj di Signature V Address k SEAL /177) IN. THIS SPACE FOR USE BY HEALTH DEPARDTM ONLY: Soil Rate Approved sq.ft/gal. Checked by Date �a r F � Q v 3 o cV 00 `e .y o� F2 .n � 0 V h r � V k C F J V a r 0 0 �e 2� t�j o O O °j Q �a r F � Q v 3 o cV 00 `e .y o� F2 .n � 0 V h r � V k C F J V a r 0 0 �e 2�