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BOX 14
01497
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I ` CERTTFICAT
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Water Apply': ,.
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p„ DEPARTMENT OF HEALTH
Division Of Environmental Health Services
W O PUTNAM COUNTY DEPARTMENT OF HEALTH,
-Xetzoy
Office Use Only
WELL LOCATION
STREET ADDRESS:
TOWNIVIL11171CUr TAX GRID NUMBER:
WELL OWNER
NAME:
ADDRESS:
PRIVATE
❑ PUBLIC
USE OF WELL
1 - primary
2 - secondary
RESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIR /COND.IHEAT PUMP-, 0 ABANDONED
❑ BUSINESS ' ❑ FARM ❑ TEST/ OBSERVATION ❑ OTHER (specify)
❑ INDUSTRIAL ❑ INSTITUTIONAL O STAND -BY ❑
MOUNT OF USE
YIELD SOUGHT
gpm.lNO. PEOPLE SERVED /EST. OF DAILY USAGE d( )Q gal.
REASON FOR
DRILLING
9NEW SUPPLY ❑ PROVIDE ADDITIONAL SUPPLY ❑ TEST /OBSERVATION
❑ REPLACE EXISTING SUPPLY ❑ DEEPEN EXISTiNG//WEELL
DEPTH DATA
WELL DEPTH f
ft.
STATIC WATER LEVEL 1�ft.
DATE MEASURED
DRILLING
EQUIPMENT
❑ ROTARY eCOMPRESSED AIR PERCUSSION ❑ DUG
❑ WELL POINT ❑ CABLE. PERCUSSION ❑ OTHER (specify):
WELL TYPE
❑ SCREENED ❑ OPEN END CASING. VOPEN HOLE IN BEDROCK ❑ OTHER
CASING
DETAILS
TOTAL LENGTH
ft.
MATERIALS: 9STEEL ❑ PLASTIC ❑ OTHER
LENGTH.BELOW GRADE
�d ft.
JOINTS: ❑ WELDED THREADED ❑ OTHER
DIAMETER
in.
SEAL: CEMENT GROUT ❑BENTONITE ❑OTHER
WEIGHT
PER FOOT
_-I_Z __ lb./ft-
DRIVE SHOE YES D NO
LINER: OYES 9NO
SCREEN
DETAILS
_.._.. _ .
DIAMETER (in)
'SLOT SIZE
LENGTH
(11)
DEPTH TO SCREEN (ft)
DEVELOPED?
T
YES ❑ NO
_ . .URS.
SECON _
_, - _ --
- - -- ._...
_.. ._ _. _
GRAVE PACK
OYES
O NO
GRAVEL
SIZE:
DIAMETER
OF PACK in.
TOP
DEPTH -ft.
BOTTOM.
DEPTH It..
WELL YIELD TEST pumping
If detailed
METHOD:. ❑ PUMPED, 1 tests Were done is in-
ecomPRESSED AIR , formation attached?
❑ BAILED O OTHER ❑ YES ❑ NO
IFLL LOG If more detailed formation descriptions or sieve analyses
are available, please attach.
DEPTH FROM
SURFACE
water
Bear-
ing
Well
Dia-
melt
r In
FORMATION DESCRIPTION
CODE
.
I
WELL DEPTH
It.
DURATION.
hr. min.
BRAYIDOWN
ft.
YIELD
gpm.
Lurtace
+ OLD
.9
S
v
6
ao
6
WATER -CLEAR TEMP.
QUALITY ❑ CLOUDY HARDNESS
O COLORED ANALYZED? O YES ONO
ANALYSIS ATTACHED? O YES O NO
STORAGE TANK :.. TYPE
CAPACITY 0 a GAL. FO
LVff LI ! 'A-f -1 &SONS, INC. DAT1117#9
ADDRESS Well Drilling slGrntTtlRE
Rte. 311 R.R. 2 Box 171A
PATTERSON, NEW YORK 12563
PUMP INFORMATION i
TYPE !21dMer,5; /e CAPACITY
MAKER DEPTH IDO
MODEL !7 S O 9, 11 VOLTAGE HP
Yorktown, Medical Laboratory, Inc. '
321 Kear Street
Yorktown Heights: N. Y. 10598
_.(914)" 45' 128db
Director: Alf)ert H. Padovani M. T. (ASCP)
DOUGLAS WALLACE
RFD 9, `FAIR STREET
CARMEL,NY. 10512
L
r LAB j ' 3,00t&'U
Date Taken: 11%15/89 Time: llam
Date Rc'.d: n/15/b9— Time: pm
_. 'bat-e :9ep0-rted: 0- j:9E_ -::___ _ 777 v.
'Collected By: I D.Wallace
Referred By:
Sample Location: Kitchen ap
Burdick Glen Norfh Subdiv.iot
Patterson
Phone # b7b-.954b
Phone # I Sample Type:
Repeat Test? _ (check each)
LABORATORYtREPORT ON THE QUALITY OF WATER
INORGANIC NON - METALS mg /L MICROBIOLOGICAL CFU /100mL)
_ Acidity
_ Alkalinity.
_ Chloride
Detergents, MBAS
_ Hardness, Total
Nitrogen, Ammonia
Nitrogen, Nitrate
Phosphate, Total
_ Sulfate
_ Sulfide
Sulfite
METALS (mg /L)
GENERAL BACTERIA
_ Standard Plate Count
(CFU /1.OmL)
MEMBRANE FILTRATION TECHNIQUE
% Total Coliform e
_ Fecal Coliform
_ Fecal Streptococcus
MOST PROBABLE NUMBER TECHNIQUEI
_ Copper
4 °C
GT
_ Iron
_ Total Coliform Index
Lead
_
pH
-
Mangahesp -
_ Fecal Coli "form -Index_- ..._._. -_ ._
— Mercury
Sodium
KEY FOR
TERMINOLOGY
_ Zinc
CFU =
Colony Forming Units
CON =
Confluent (q.v. TNTC)
MISCELLANEOUS
LT =
C = Less Than
GT =
> = Greater Than
_ pH (units)
N/A =
Not Applicable
Color (units)
S/A =
See Attached
_ Odor (TON)
TNTC=
Too Numerous To Count
Turbidity (NTU) -
_
REMARKS
/COMMENTS ( For Lab Use)
Potable
Non- potable
_ STP. INF
_ STP EFF
Other:
Sample Status:
(check each)
Outgoing
_ HNO3
HC1
_ H2SO4
_ NaOH
ZnOAc
— Na2S203
Other:
- Incomin7g . - .- -
LE
4 °C
GT
4 °C
_
pH
LE 2
_
pH
GE 9
_ pH
GE 12
_ Other:
ELAP No .103
THESE RESULTS INDICATE THAT THE WATER S41PLE 4Jas) (Wasn't) (N /A) OF A
SATISFACTORY SANITARY QUALITY ACCORDING TO TH ORK STATE.PUBLIC DRINKING
WATER CODES, FOR THE PARAMETERS TESTED, AT THE TIME OF SAMPLE COLLECTION.
THESE RESULTS INDICATE THAT THE WATER SAMPLE (Did) (Didn't) (N /A) MEET THE
SATISFACTORY CHEMICAL QUALITY STANDARDS OF THE NEW YORK PUBLIC ING WATER
CODES, FOR THE PARAMETERS TESTED, AT THE TIME OF SAMPLE COLLECTION.
Albert H. Padovani,
, Director
2 /86(Rvsd7 /87)RWE.-
'NSA" ZF (&.
yTr
FpA, ..
A
-W
29s
54'
59L
�SL&l'
721
179 t
1 4'
e7
I.71
151
!ol -Sr
/c7aD
73 ID
91 -ID
6G�
92'
'NSA" ZF (&.
1
FpA, ..
AREA v 40,604 S¢ F1, eeler tL. r°m: GAL rMr ,
O
( /nc /u0et cote --wall
/'efrYe .940581L
It
it c Bq4ZLF.°F
O
2auwloc
. 1 -
7'LerJGi1 as Q e,' o - c - -
8 /. (o'O'e
L•O -Q- FILL . O '
' a {:4
o Putnam County Department Of Health
b ANA`
Division of Environmental Health Services
m
with
to 6y , (•jiOJ
Approved as noted for conformance
C-1
''
/
/
appkiqable Rules and Regulations of the
b
ly °c °c. �' a x�
"6rol
uan:Coun ff Ith,{ Depart ure t.
11�1�4 ! gt7
�� '
`oA.
A z
e 4 i ' x i gyp• a0 �°"
Signature A Title to
Z
Q°
qo
(
1.4809,
:4809•
B p1300
WO GARBAGE 6ZIW9f -IK WAS NSTALL
F - --
S B ''SSD.S
j'
- - - -
LAYOUT -Ag_ - 81:1.1. T_ ° -
C 9
� 32s� Q,g .8-36
I I '.LE /ec/ric Ba 111
..
W Q Y
I SURVEY OF PROPERTY
a 1
... curt r -
2393/'Zt 8 C
PREPARED FOR
�: G L .lunlerti
J ,A (;
DORCHESTER REALTY CORP.
I !f
I
�M
Sr7UA7E IN THE
I
off � �
i I
TOWN OF PATTERSON ,
J. c 1
COUNTY OF PUTNAM
E
'THIS. IS, TO CERTIFY THAT THE SBVdGB DISPOSAL SYSTEM VAS CONSTRUCTER AS
- INDICATED ON, TEIS'PLAD AND TNAT,THE SYSTM VAS. INSPECTED BP Xe BEFORE IT'i
NEW YORK c`
ves coVERED oYER: TBE ? SYSTEN VAS CONSTBucTED IN ACCORDANCE: VITE ALL
SCIALE 1 ' "= 30 ft. DECEMBER /5 , 1988
✓ DEPARTX6NT OF BBALTN_QuRDICK
/ !JJ
��EN � JOATH _ suE5D1 Vl�
°• os�tae Asa TES NEV YORY ST B DEPIARTNENT OF REALM.- .COUNTY
rF I
4
LOT -Od . a
I
i
I
1
y,
�!
i
i
!.
IL�C3TION A,IJAP
SZ�E=�
5. Fi bcx har-_l
PE V! a - . - a o s� . rus t tar
6. Cycle w;_tne_cs- fi- =1
NO
est=ates fic w _- a
DISPOSP.L P.Ftt.�.
-
:�
Fame locates pe_r "'c.*JD Cv� 3 pl_.c"'ns... Y,00000,
_
a_ S?S area—lo=t—_3 as *- aanrcved plans
b.
b. Fill, secticn - Data of plac_=ment
2.1 barrier _ LGM W-= AVG_DPTE
I I
c_ Natural, soil not stri=oe3
`--j'
I
d_ Stone, brush, etc-, ars t`r titan 15' free S'DS are---I
C'
Casing 18" ahove grade.
e_ 100 .ft_ from W=-t_- course wetlands.
I ,-4-- -j
d.
I?. SEr41—r---. DISPOSAL SYSTRA- ,....
a. Semi c tank size 1,00Q 1,250
I
b. Septic tank i nSt• -J lied levej
I
c. 10' mi nip from fcundaticn
C.
PL1 roes flush with inside of box
d_ No 900 bents, cl�*zout wit:-nm 10 -_ of 45° berms
--+- -r
d.
e. DIS=UTTICti BC'X
P?1 OuC1°_—s at scmms el-L— t t
1-4
2. Protec=� below f_c
3. Minim= 2 ft_ Crijf laib L-;-_riesn bqX.4fid
g.
Footing drams ns disc =ae away from SDS area I
f. TUITION BOX - vrope
I
h_
Surface ` t
�e
i.
`=-oszen con`o Dray der cn slooes areat_rr t= 15$_
d S
a nS�
2. Dist -a c° to waterco rsa ux—ed ' -'-f t. •
3. L--s -a 11 cC'Or ' T '2Q iff 11uF-ri j A
I {
a Di s a-- c° cam- =
I I
5. Slorz of t= - 1!F16 3
-}-
6. IO fit f=na r ;� e - 20 t5At - four.=.crs
7. rem-En or t_ancz < pones
8. Rccan Z! CSv CL - n53On,
°. Size of _ 3/4 - 1-' arme err
10. Denth of - in n 12" m ;
2-1. • Pi-pe ene-s or.3 I 1b2
h.. _ _ OR
1. Size of o*
4 ENJ -1v
5. Fi bcx har-_l
6. Cycle w;_tne_cs- fi- =1
est=ates fic w _- a
I
IV. fiCi
a.
:�
Fame locates pe_r "'c.*JD Cv� 3 pl_.c"'ns... Y,00000,
b.
hLmhe-- of be�rccnz
V. --?.r.
a_ W--1 lccat= as rA--- a---::)rovea clan
I I
b.
Distance from SD-S area 'ra lr t_
I
C'
Casing 18" ahove grade.
d.
Surface '+C -*,-L, =-ce a--c -d wZl ac toll
a_ Bcxes orco_e =1y ercuted
b.
:U pi ces pc---=" a2 i y backJ 1 ed
C.
PL1 roes flush with inside of box
d.
Eck ill material contains stones < 4" in diam°ter I
e.
0- 1-tai-n drain installed according to plan
f.
C?rtai n dra 1 cutfall L;rot-- t--:.a & di r. to exist.Watarcoursrz!
ALL OK Qlau
g.
Footing drams ns disc =ae away from SDS area I
I
h_
Surface ` t
�e
i.
`=-oszen con`o Dray der cn slooes areat_rr t= 15$_
sm<7
PUTNAM COUNTY DEPARTM M OF HEALTR
DIVISION OF ENVIRONMENTAL HEALTH_ SERVICES__
Owner. or Purchaser of Building Section Block
Building Constructed by
Location - Street '
-. Municipality
.\J", CD 1`1 � �J i� l� to u ; tU_
Building Type
Lot
1�ts (" 1t -K6 N Nl�k -1-H
Subdivision Name -
g - l
_.Subdivision.Lot #
GUARANI'EE OF SUBSURFACE SEWAGE DISPOSAL Sy=4
I represent.that I aim wholly and - completely.- responsible - for the. location,
workmanship, material, construction' and drainage of the sewage disposal . system
serving the above described property, and that it has been constructed as shown on
the approved plan or approved a- ndment`tliereto 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
_ '. 'Certifi.cate._:of:ConstructiQn _.Compliance "- .fo;r-,the_ se4aage_disposal.aystsn,. _ot .any.- .. -_
repairs made by ire to such system, except where the failure to operate properly is
caused .by the willful or negligent act of the occupant of the building utilizing
the system.
The undersigned further agrees to accept as conclusive the determination of
the Director of the Division of Environmental Health Services of the Putnam County
Department of Health as to whether or not the failure of the system to operate was
caused by the willful or negligent act of the occupant of the building utilizing
the system.
Dated this 23 day of 19 Signature
Title
General ntr or ( er) - ignature &rc4eo4tee Cp
Corporation Name (if Corp.
Corporation Name (if Corp.) P4 9,r-. 1, 5 / r e
Address
Address
rev. 9/85
mk _. _
Nw
PUTNAM COUNTY HEALTH DEPARTMENT _
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
John M. Simmons, M.D.
Deputy Commissioner of Health - FIELD ACTIVITY REPORT - Sheet ,bf
•4
ADDRESS
TH No.
MAILING ADDRESS
P.O. Box Post Office Zip Code
PERSON IN CHARGE
OR INTERVIEWED
Name and Title
DATE TYPE FACILITY .
TIME ARRIVED TIME LEFT
INSPECTION
Orig. Routine
Orig. Complain
Orig. Request
Complaint Comp'
_ Final
_ Group Illness
Construction
Reinspection
Field, Sampling Only
Field Conference
Other
Explain
INSPECTOR: TELEPHONE:
Signature and Title
PERSON IN CHARGE OR INTERVIEWED:
I acknowledge this Field Activity .'Report. SIGNATURE:
6/86 TITLE:
PUTNAM COUNTY HEALTH _DEPARZMENP
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
John M. Simmons, M.D.
Deputy Camnissioner of Health — FIELD ACTIVITY REPORT -
PWXZ
Street /1 TH No.
MAILING ADDRESS
P.O. Box Post
TELEPHONE
PERSON IN CHARGE
OR INTERVIEWED
Name -and Title
DATE TYPE FACILITY.
TIME ARRIVED TIME LEFT
Sheet of
INSPECTION
Orig. Routine
Orig. Canplain
..Orig. Request
Canpliance .
Complaint Camp
_ Final
_ Group Illness
Construction
Reinspection
Field, Sampling Only
Field Conference
Explain.
_FINDINGS:_..._ _ ^ ^ -- - 4 L 6 'W.
INSPECTOR: rI��� /� /L TELEPHONE:
Siqnature and Title
PERSON IN CHARGE OR INTERVIEWED:
I acknowledge this Field Activity Report. SIGNATURE:
6/86 TITLE:
PUTNAM COUNTY HEALTH DEPARTMENT
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
John M: Simmons, M.D.
Deputy Cammi.ssioner of Health - FIELD ACTIVITY REPORT.-
F.11
Na
WOW
MAILING ADDRESS
P.O. Box Post Office Zip Code
TELEPHONE
PERSON IN CHARGE
OR INTERVIEWED
Name and: Title
DATE °i�� /R9 TYPE FACILITY /7,A D ,6��� ✓UDC .
TIME ARRIVED TIME LEFT
Sheet of
Orig. Routine
Orig. Complain
Orig. Request
Campliance
Complaint Camp
Final
Group Illness
Construction
Reinspection
Field, Sampling Only
Field Conference
Other
Explain
INSPECTOR: ��� ��/I TELEPHONE:
Signature and Title
PERSON IN CHARGE OR INTERVIEWED:
I acknowledge this Field Activity Report. SIGNATURE:
6/86 TITLE:
Prepared by: Baldwin & Cornelius, P.C.
September 28, 1988
��SF� � �r���►ARy 2+�j1`i89
FRICTION & DYNAMIC LOSSES
utilizing 2" PVC Forcemain:
Utilizing 2" PVC Forcemain...
Length of Forcemain: 222 Ft.
+inside pump pit (4.33 4- 1= 5.-33) 6 Ft
228 Ft.'
LOT #8, BURDICK'GLENINORTH SUBDIVISION
DATA:
Proposal -is for a 3- bedroom house ® 200 Gallons
/Bedroom '.
Total anticipated flow: 600 GPD
Percolation`.Rate: 17.min /in
Sanitary field length: 429 LF
DOSING REQUIREMENTS
Using 4" PVC Pipe - (Area = .07669 S.F.)
Volume: 429. L.F. x .:0769.9 S.F. =
32.90 Ft3
Dose: 75%.;x 32.90,Ft3 K.0.48 gallon /ft3 _
184.6.Gallon
Max Dose permitte`.by PCHD:
.100 Gallon
PUMP PIT SIZING:
-Use 41- x 61 - -(- 180 - Gallons/ ver,- 1cal ...ft...- o.f..li.qu.id.)._._
__..._ ..
100 Gallon Dose .56 ft =;6:67 in; say 6 in •(90
gallon dose)
180 Gallon /V.F. i'..
Required Storage -: -1 day's flow 600 Gallon
600 Gallon = 333 = 314" (from alarm level
to inlet
from house)
180 Gallon /V.F.
LOSSES
STATIC HEAD: J. Box Elevation: 730.625
,Pump Pit.Elev.: 709.85
:20.77 Ft. Say
21 Ft.
FRICTION & DYNAMIC LOSSES
utilizing 2" PVC Forcemain:
Utilizing 2" PVC Forcemain...
Length of Forcemain: 222 Ft.
+inside pump pit (4.33 4- 1= 5.-33) 6 Ft
228 Ft.'
• Fasteners: 300 Series Stainless
Steel
• Capable of Running Dry Without
Damage to Components
FEATURES
Impeller Cast iron, semi -open,
non -clog with pump -out vanes for
mechanical seal protection. Bak
anced for smooth operation. Bronze
impeller available as an option.
Casing: Cast iron volute type for
maximum efficiency. 2" NPT dis-
charge adaptable for, slide rail
systems.
Mechanical Seal: Ceramic vs
carbon sealing faces. Stainless steel
metal - parts, -BUNA- N-elastomers. - - -
Shaft: Corrosion- resistant
stainless steel. Threaded design.
Locknut on three phase models to
guard against ',component damage
on accidental reverse rotation.
Motor. Fully submerged in high -
grade turbine oil for lubrication and
efficient heat transfer.
Designed for Continuous Opera-
tion: Pump ratings are within the
motor manufacturer's recommended
working limits, can be operated
continuously without damage.
Bearings: Upper and lower
heavy duty ball bearing con-
struction.
Power Cable: Severe duty rated,
oil and water resistant. Epoxy seal
on motor -end provides secondary
moisture barrier in case of outer
jacket.damage and to prevent oil
wicking.
O -Ring: Assures positive sealing
against contaminants and oil
leakage.
C0 1986 Goulds Pumps, Inc. Effective July 1986
Motor:
APPLICATIONS
e Single Phase: 1/3 HP, 115 or 230
Volt 60Hz, 1750 RPM
Specifically-designed for the
'/z HP, -115 V, 60 Hz;-3500 RPM
following uses:
'/z HP thru 11/2 HP 230 V, 60 Hz,
• Homes
3500 RPM
• Farms
Built -in Overload With Automatic
• Trailer Courts
Reset
Motels
Class B Insulation
_....._.•- Schools°
Three Phase:' /z HP thru 11/i HP. - -
• Hospitals
208/230 V, 460 V, 60 Hz,
• Industry
3500 RPM
• Effluent Systems
Class B Insulation, Overload
Protection must be Provided in
Starter Unit.
• Shaft: Threaded, 400 Series
SPECIFICATIONS
Stainless Steel.
• Bearings: Ball Bearings Upper
Pump:
and Lower
• Solids Handling Capabilities:
• Power Cord: 15 Foot Standard
3 /d' Maximum
Length (Optional Lengths
• Discharge Size: 2" NPT
Available)
• Capacities: Up to 114 GPM
Single Phase: % and'h HP -16/3
• Total Heads: Up to 123 Feet TDH
SJTO with three prong plug.
• Mechanical Seal:
N thru 1'h HP -14/3 STO with
Carbon -Rotary Seat/Ceramic-
Bare Leads
Stationary Seat
Three Phase: 1h thru 11h HP -14/4
300 Series Stainless Steel Metal
STO with Bare Leads'
Parts BUNA -N Elastomers
On CSA Listed Models — 20'
• Temperature: 160° F (71 ° C)
Length SJTW and STW are
Maximum
Standard.
• Fasteners: 300 Series Stainless
Steel
• Capable of Running Dry Without
Damage to Components
FEATURES
Impeller Cast iron, semi -open,
non -clog with pump -out vanes for
mechanical seal protection. Bak
anced for smooth operation. Bronze
impeller available as an option.
Casing: Cast iron volute type for
maximum efficiency. 2" NPT dis-
charge adaptable for, slide rail
systems.
Mechanical Seal: Ceramic vs
carbon sealing faces. Stainless steel
metal - parts, -BUNA- N-elastomers. - - -
Shaft: Corrosion- resistant
stainless steel. Threaded design.
Locknut on three phase models to
guard against ',component damage
on accidental reverse rotation.
Motor. Fully submerged in high -
grade turbine oil for lubrication and
efficient heat transfer.
Designed for Continuous Opera-
tion: Pump ratings are within the
motor manufacturer's recommended
working limits, can be operated
continuously without damage.
Bearings: Upper and lower
heavy duty ball bearing con-
struction.
Power Cable: Severe duty rated,
oil and water resistant. Epoxy seal
on motor -end provides secondary
moisture barrier in case of outer
jacket.damage and to prevent oil
wicking.
O -Ring: Assures positive sealing
against contaminants and oil
leakage.
C0 1986 Goulds Pumps, Inc. Effective July 1986
W-U-1011 POW"
07
MODELS
Series
,
WE0312M
No.
Series
HP
volt
ph ase
.,Max
HP
'43
70
RPM
1750
WE0311L
5
115
T
6.4
WE0312L
1/3
.230.
60
4.7
WE031 I M
36
115
1
0.4
WE0312M
30
238
35
WE611H
.115
43
13.0
WE0512H
30
230
50
6.5
WE0532H
55._
208/230
3
3.4
WE0534H
1/2
460
WE051.lHH
115
1
13.0
WE0512HH
80
--- - 230.'
6.5-
WE0532HH
70
2081230
3
3.3
WE0534HH
460
-
1.7
WE0712H
230
1
9.0
WE0732H
3/4
2081230
3
5.4
WE0734H
4.60
2.7
:WE1012H
230
1
11.6
WE1032H
1
2081230
3
6.4
WE1034H
460
3.2
WE1512H
230
1
13.3
WE1532H
208/230
3
9.2
WE1534H
1-1/2
460
4.6
WE1512HH
230
1
13.3
WE1532HH
..
2108/230
3
9.2
WE1534HH
460
4.6
EFFLUENT EJECTOR SYSTEM
Rpm I Solids
3500
3/4"
IOC
Submersible
ffi
E ent
u
I IWE0511HI I I IWE0511HHI
WE0311M
Series
,
WE0312M
No.
WEMII
WE03121
1750
HP
'43
70
RPM
1750
65
5
100
Weight
10
80
(Lb•
15
60
26
20
36
56
25
67
30
61
35
52
3z 40
43
-a 45
30
50
17
60
55._
6
4'60
.m C5
76
75
80
70
100
110
120
I IWE0511HI I I IWE0511HHI
WE0311M
WE0532H
WE0732H
WE0312M
WE05UH
WE0734H
3,/4
1750
.3500
W)
70
80
90
65
76
87
57
71
83
45.
65-
78
26
59
73
50
67
.40
61
26
52
10
43
30
17
6
DIMENSIONS
80
(All dimensions in inches)
(Do not use for construction purposes.)
12'h• -
I- 55Y4 " -1
rMnTATIIIN
01
1
3500
106
102
98
94
89
84
79
72
64
54
42
28
16
5
WE1534H
3500,
114
108
104
100
96
91
86
79
63
53
26
14
4
3500
60
55
52
48
42
39
34
30
23
18
12
3
WE1512HH
WEI532HH
WE1534HH
1' /z
3500
83
73
77
68
72
63
66
58
60
52
54
45
47
37
40
33
24
15
4
Package Includes: D
Effluent ejector system offers Submersible Effluent Pump,- T, 2" NPT
ease of ordering and Installa- WE031 1 L. 12L or WE031 I M. 12M. 81h", i
lion. A single ordering number r WE651 I HH, 12HH
specifies a complete system Mercury Level.Control Switch
designed for most residential A2-5 (115 V), A2-6 (230 V)
and commercial sump and
Basin A7-1801S 31/4
effluent pump applications.
Basin Cover A8-1822
Check Valve A9-2P KICK -BACK
Order No.: SWE031 1 L, SWE0312L,
SWE0311M.SWE0312M, D* 1/2, 3/4 and 1 HP = 15" except for model WE0712H & WE1012H 18";
SWE051 1 HH. SWE0512HH. 1112 HP = 18"
Available Certifications: %!,P Canadian Standards Association
C Pennsylvania Bureau of Mines for non-face applications - BOTE 91.
SENECA FALLS NEW YORK 13148 SPECIFICATIONS ARE SUBJECT TO CHANGE WITHOUT NOTICE. PRINTED IN U.S.A.
I
AiMINO FEFT
1
1
i 1
�r
I
D
J
0
AJ-
.... 01985 Goulds Pumps, Inc.
0 10 20 30 40 50 60 70 80 90 100 110 120 GPM
_ CAPACITY
Effective Ju
UOUICIS
Effluent and Sewage
5,
�....._ __. S9id ie
_ .__.. Ra Systems
11%4" & 2 Discharge
Slide Rail Systems
Provides Easy Means of Re-.
moving Pump From Wet -Well by
Utilizing a Quick Disconnect and
Guide Assembly. Eliminates Need
to Enter Wet -Well
Corrosion Resistant Design
Includes: Stainless Steel,Rails,
Cross Brace, Quick Disconnect
Plate, Base Plate, lift Cable; .
Bronze Quick DisconnecL
Adaptable to A11.2 Inch NPT
Vertical Discharge Effluent and
Sewage Pumps
Designed.for use with Horizontal
Discharge Systems
SYSTEM CUMPONENTCZ
Basic Slide Rail
Assembly include:
• 96" Long Guide Rails.
o Wall Bracket
• Top Pump
Bracket
• Quick Disconnect
Adapter-
0
Bottom Pump
Bracket-
9 Base Plate
Lifting Cable
• Check Valve
• Vertical Pipe
Nipples,
NOTE: Standard overall
length of piping is 96"... can�J -
be cut down to 48 "minimum
length. It rail length longer A10-12,11/4"
than 96" is needed, consult A10 -20, 2"
factory for pricing.
( - ( For Use With
I I Pump Model
Ordering I EP03
Information
3885
3886
3887
40 1905 Goulds Pumps. Inc.
SENECA FALLS NEW }OFX 13140
SIMPLEX DUPLEX
11 " -1'/:' DISCHARGE
13" -2" DISCHARGE
W
LIFT CABLE-
96" LONG
96..
�-4Ct
Simplex System Consists of:
1 =.S -life Rail. ,y
1- Simplex Disch. Piping.
Simplex Discharge Piping:
H12S, 1'/." �t2
H2OS, 2"
. � p
IT' - 1i /:' DISCHARGE
Simplex is'h " -2" DISCHARGE
Includes:
•. Union • Pipe Nipples
• Tee Handle 6 Gate Valve
I
Duplex.System Consists of:
2 -Slide Rails
1- Duplex Disch. Piping.
Duplex Discharge Piping: +
H2OD, 2" I
r
21" -11/:' DISCHARGE
231h " -2 DISCHARGE
Duplex Includes:
• Pipe Nipples • Unions
• Gate Valves • Tee Handles
• Elbows • Pipe Tee
Duplex System `
Size
Simplex System ,b
Description
1 t /4 -,
Size
Qty OrderrNo:".
Description
2 A10 -20
1 H2OD
Slide Rail
Disch. Piping
1 t�4n
1 A10 -12
Slide Rail
1 H 12
Disch. Piping
'
2h
1 A10 -20
1 H2 OS
Slide Rail
Disch. Piping
I
Duplex.System Consists of:
2 -Slide Rails
1- Duplex Disch. Piping.
Duplex Discharge Piping: +
H2OD, 2" I
r
21" -11/:' DISCHARGE
231h " -2 DISCHARGE
Duplex Includes:
• Pipe Nipples • Unions
• Gate Valves • Tee Handles
• Elbows • Pipe Tee
Elleclivc .lu1y, 1905
SPECIFICATIONS ARE SUBJECT TO CHANGE WITHOUT NOTICE. PI]INTEO M U S A
Duplex System `
Size
Qty Order No.
Description
1 t /4 -,
2 A10 -12
1 H12D
Slide Rail
Disch. Piping
2!
2 A10 -20
1 H2OD
Slide Rail
Disch. Piping
Elleclivc .lu1y, 1905
SPECIFICATIONS ARE SUBJECT TO CHANGE WITHOUT NOTICE. PI]INTEO M U S A
Diaphragm
.Switches
• Pressure Actuated
Switch
• Liquid Level Differential
Permanently Set at 6"
e Rated up to 1 /2-HP or -
Control /Pilot Circuit up
to 230 Volts
• Mounting can be directly
on pump or independ-
ently suspended.'
4m. tudes.
Cast Iron Body,
15' Power Cord
Stainless Steel Strain
Relief, Fasteners, and
Bracket
A2 -1
Equipped with a three
pronged series plug (con-
figuration per NEMA 5 -15)
up to 1/2 HP, 115 volt single
phase operation. ,
A2 -2
Equipped with bare leads
for direct connection to a
magnetic contactor
(A3 -2012) or a starter
(A3 -5034) as a pilot switch.
A2-4
Equipped with a three -
pronged series plug (con-
figuration per NEMA 6 -15)
up, to 1/2 HP, 208/230 volt,
single phase operation.
Mercury
Float .
Switch
A2 -3
• Mercury Fluid Contacts
• Normally Open Design
• 150 °F (65 °C) Max. Temp.
:Includes: -- _.--.-.
Polyurethane Foam
Float.
15', SJO, Neoprene
Cord
Lead .Weight and
.-Mounting Strap . - - - -.i
• Suitable for Pilot Control
Duty up to 230V Max.
• Two Required for
Simplex System,(One
Pump)
• Three Required for
Duplex System (Two
Pumps)
LIQUID -LEVEL
CONTROL
SWITCHES
-7.
Ornnidirectional
Differential
Mercury Switch
.Mercury Fluid Contacts
• Normally Open Design
1'500F (6510C) Max. Temp.
- i Start /Stop Level -
Adjustable 5 to 23 in. .
• LIL and CSA Listed
• ABS Plastic Case
• 15' Cord SJOW— A /SJOW
with Mounting Straps
-.--*-One Required for•On/Ofi --
operation
A2 -5
With three - pronged series
plug per NEMA 5 -15,up to
'/2 HP, 115v. single phase
operation.
A2 -6
With three - pronged series
plug per NEMA 6 -15 up to
3/, HP, 230 volt single phase
operation.
A2 -7
With bare leads for direct
connection to a magnetic
contactor (A3 -2012) or a
starter (A3 -5034) as a pilot
switch.
A2 -8
.Reverse acting for pump -up
filling operation. (Normally
closed contact) Supplied
with bare leads.
Mercury
Differential
Switch .
A2 -9
• Mercury Fluid Contacts
• Normally Open Design
• Start /Stop Level
Adjustable from 6" to.32'
• Rated for % HP, 115 Volt
Single Phase Only
• Includes:
Polypropylene Float
10' Cord
Three Prong Series
-Plu g---NEMA 5-45 P..
SENIECA FALLS tJLW YOPK 13148 SPECIFICATIONS ARE SUBJECT TO CHANGE WITHOUT NOTICE. PRINTED IN U 5 A
HIGH LIQUID LEVEL ALARM PANELS
• -I TANK ALERT
� i js
-_.. ; 1 i
liUUt_U`)
r1111_IG'Itt 1110
ELECTRICAL
CONTROL PANELS
.A4 -1 Provides Warning of High Liquid Level Conditions:
115V, Single Phase, 60 Hz
NEMA 1 Steel Enclosure Standard
Includes: Alarm Bell, Red Indicator Light, Power On Light, Off -On /Reset
Switch, Terminal Block for Wiring Connections
Does Not Control Pump Operation
Alarm Bell and Red Indicator Light will Stay On Until Reset
Requires. Additional Liquid Level Switch, One A2 -3 or A2 -7
A4 -2 Provides Warning of High Liquid Level Conditions:
115V, Single Phase, 60 Hz
NEMA 1 Steel Enclosure Only
Includes: Alarm Bell; Red - Indicator Light, Power On Light, Off -On Switch,
Test Button, Float Switch with .12" Cable
Does Not Control Pump Operation
GSA Listed
ELECTRIC ALTERNATOR PANEL _ M
couios furs. INC. A5 -1 Provides fully automatic operation for two pumps in a Duplex
�u�.�t installation. Must be used in conjunction with contactors, or starters for
proper operation.
°t NEMA1 Steel Enclosure Standard
Includes: Alternator, Terminal Block for Wiring Connections
Will Operate any Voltage Single or Three Phase Magnetic Contactor or
Magnetic Starter Thru Pilot Circuit. 115V Single Phase, 60 Hz Power
must be Supplied to Panel
Requires Two Additional Contactors (A3 -2012) for Single Phase or Two
Magnetic Starters (A3-5034) =for Three Phase, for Duplex Operation
Requires Addition Liquid Level Switches, Three A2 -3 or Two A2 -7
l'.•, I • FllncliveJuly 1986
1 SENKA FALLS NEW YC(Y, 13140 SPECIFICATIONS ARE SU13JECT TO CHANGE WITHOUT NOTICE. PRINTED IN U S A
Size of Fittings, Inches
/z"
3/4"
1"
11/4"
1V2 "
2"
2Vh"
3"
4"
'V
6"
81,
900 Ell
1.5
2.0
2.7
3.5
4.3
5.5-
6.5
-8.0
10.0
14.0
15
20
450 Ell
0.8
1 "0
1.3
1.7 .
2.0
2.5 ,
3.0'
3.8
5.0
6:3
7.1
9.4
Long Sweep Ell
1.0
1.4
1.7
2.3
2.7
3.5
4.2
5.2
7.0
9.0
11.0
14:0
Close Return Bend
3.6
5.0
1 6.0
8.3
10.0
13.0
15.0
18.0
24.0
31:0
37.0
39.0
Tee - Straight Run
1
2
2
3
3
4
5
Tee -Side Inlet or Outlet
3.3
4.5
5.7
- 7.6
9.0
12.0
14.0
17.0
22.0
27.0
31.0
40.0
Globe Valve Open
17.0
22.0
" 27.0
36.0
43.0
55.0
67.0
82.0
110.0
140.0
160.0
220.0
Angle Va4ue Open
8.4
12.0
15.0
18.0
22.0
.28.0
33.0
42.0
58.0
70.0
83.0
110.0
Gate en .
0.4
0.5
0.6
0.8
1.0
1.2
1.4
1.7
2.3
2.9
3.5
4.5
-
Check Vatie<(Swing)
4
5 I
7
9
11.
l 13
16
20
26
33
39
1 52
Check Value (Spring)
4
6
8
12
14
19
( 23
; 32
I 43
58
Example:
(A) 100 ft. of 2" plastic pipe with one (1) 90° elbow
and one (1) swing check valve.
90° elbow - Equivalent to 5,5 ft. of strai ht i e .
- - °Swing Ci'ieck Equivalent.to 13.0 ft. of straight pipe
100 ft: of pipe - Equivalent to 1,00.0 ft. of straight pipe
118.5 ft. = Total
equivalent
Pipe
Figure friction loss for 118.5 ft. of pipe.
(B) Assume flow to be 80 GPM through 2" plastic
PIPe•
1. Friction loss table shows 11.43 ft. loss per 100 ft. of
pipe.
2. In step (A) above we have determined total feet of
pipe to be 118.5 ft.
3. Convert 118.5 ft. to percentage. 118.5 _ 100 = 1.185.
4. Multiply 11.43
x 1.185
13.54455 or 115 ft. = Total friction loss in
this system.
10
25
12
65
0
PUINIIM OOUNII DITARRIENT OF IiEAU1I1
DIVISION OF ENVIRCNMENTAL 11EA 111 SUIVICES
y
DIMGN DATA SIiEF T- SUHSUFIICE SEWAGE DISPOSAL SYSTgt
U.mer Doualas Wallace Address 3 Grouse Lane, Huntington, NY 11743
J -,Y. -3 Led at (Street) ` Bullet ,Hole Road Sec. 73 Block. 3 Lot 7.1 '
(indicate nearest cross street)
11.1micipality Patterson Watershed Croton
SOIL .i'ERCOLATION TEST DATA RBW= TO BE SUDMI= 111111 11PPLICIYI'IONS
Late. of Pre - Soaking 9/15/87 Date of Percolation .Test 9/15/87
RULE '_
I itUDER CLOCK TIME PERCOLATION PERCOLATION
-Run Elapse Depth to Water. ]Yom Elates Level
tlo. Time Ground Surface In Indies Soil Rate
Start -Stop M.in. Start Stop Drop In'. Rin /In Drop
LOT 8 Inches Inches Indies
I i 1:21 =1:51 30 24 26 2 15.
5
2 1 1x23 -1:45 22 24 27 3 7.3
;.__.. _..2_.._ 1:48-2:10- 22 - _ _ ,.. . -., 24-- .. _...r� -27 . 3 _..w__, - 7.3
3 2 :11 -2:41 30 24 27 3 10
5
MIES: 1.. Tests to be repeatol'at same depth until approximately equal soil rates
are obtained .at each percolation test hole. All data t4' be suhmitted
for review..
2. Depth measurerents to be made fran top of hole.
z�v. 9/85
TEST PIT DATA RSQUIRM TO BC SUa-1171:ED W111i APPLICATION
DESCRLPTION OF SOILS EN 'CO(JRrERED IN TEST HOLES
DEP111 HOLE No.. 8A HOLE W. 8B. HOLE W 8C
............
G. L.
611,
Dark Brown
12"
Sandy
Loam
2411
3011
Light Brown
36!'
Sandy
4 2
.
Loam
4 8.
54,
Rock @ 4'
6011
6 f f
6
7211
7811
W.
Dark Brown
Sandy
Lo
Light Brown,
Sandy
Loam
Rock @ 4.5'
Dark Brown
Sandy
Loam
Light Brown
Sandy
L oam,
Rock @ 4.5'
INDICATE LEVEL AT. WHICH GROUNUea= IS EMOWD= /A
INDICATE LEVEL To. waica WATER LEVEL RISES AFEM, BEING EMOUNMUD NZA
r)j-:� BOLE oBsmATioNs mop, BY: J. Eberle DATE: 12/8/87
DESIGN
Soil Rate used 17 Min/1" Drop:- S.D. usable Area Provided -6850, S. F.
11o. of Bedroans 3 Septic Tank Capacity 1000 gals. Type Masonry
h6sor"ption Area Provided By 429 L.F. x 24" width trench
Other 3 ft fill required
0941,
BALDWIN & CORNELIUS. P.C. S,
RD 6. ROUTE 22
BREWSTER, NY 10509
11115 SPIKE' MR USE BY I.LMLT11
—bh-AL
1980
01,
Soil Rate Approved sq-ftVgal. Checked by Date
d
•
ALARM
LIGHT
LS
GoNT2oL rs- nx6tlt P�lESt�Et1LE�
AcG1=ss . M.E-�:
Z� S�-l2 EE11ET� �/FS1T
L(L4pE L1-.
�C,LESS M.H
`
ZA .
!
dr
::
�A S
• '
•a.
_ GOiZiLC310P1 PRooF G- Elf�lfl
.� J .
•q
� .
— 1t1G2E�.CEtZ A2E.A
_ __ , - ..
_
1N�/.il�
`:
- :
-- ...�...
_
;•
.__. F'2EE8��D_24 He FLOW STOR--A,-.I`
:e
tNJ.��
"•
PRFtAST �otscs�TE
PUMP Pt-r
C�
E"
1t4StOE OtM.�PLG•t�(�
Vol..= 1$0 •GA -A4 F.
Qut-tP ON Ind b Z
-
•
••
t5o•z-z-oM el 05
P2EGcLST Gor1c.2 ETE.
•a: •o. •. t.�. v. •. ��•6•.
S$PT1G ^T".4t1K
DOG dtAU.
G.octtAS Su3M. SE•W4,e.E EFFLUtUA-r
ail
�loLC.1M� ot= DoSE =
PctMt9. NLOOEt_ 3885 WE
0 G�.t_.
MoTO� @ 3500• R..P.M. �_�' _ v
•
R4Tt� Fog �_ 4PM � �T•Dl-i . .
ELEVAT(Orq - PUMPED
SEWAGE O(SPOSAL SYSTEM '
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
DESIGN DATA SHEET -SUBSUFACE SEWAGE DISPOSAL SYSTEM FILE NO.
Owner'jD C9 V91- W 41% A. C_=: Address t C_ A NWJ,N.y
Located at (Street) Sec. Block Lot
(indicate nearest cross street)
2
3
E I
5
961 31 Z C 2_5
2'901 931 30 a s C3 C 5 42
3
4
5 lj 156
N=: 1. Tests to be repeated at same depth until appr
are obtained at each percolation test hole. All
for review.
2. Depth measurements to be made-fran top of hole. ""`wry
rev. 9/85 e liT
P. 1E_
Municipality
Qp�T W_
9,S'o r--A
Watershed
1
SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS
Date of Pre-Soaking _Ct —*(C)
Date -of . Percolation Test
LJ-9-cip
HOLE
NUMBER C=
TIME
PERCOLATION
PERCOLATION
Run
Elapse
Depth to
Water Fran
Water Level
No.
Time
Ground
Surface
In Inches
Soil Rate
Start-Stop
Min.-.
start
stop
Drop In-
Min/In Drop
Inches
Inches
Inches
1800 - ADS
15
20
2805 -FS 11
3811- qbl (p
4 Ailn - jbaa.
(0
oft
OIL
5822 -1 1$
2
3
E I
5
961 31 Z C 2_5
2'901 931 30 a s C3 C 5 42
3
4
5 lj 156
N=: 1. Tests to be repeated at same depth until appr
are obtained at each percolation test hole. All
for review.
2. Depth measurements to be made-fran top of hole. ""`wry
rev. 9/85 e liT
P. 1E_
{
TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION
DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES
aDEPft
G.L. S m S d
2' 4% u'0 N L pry
31
4'
5'
6'
71 �C913 -wt t Ltd e����ovt
8' �"G-1 t� S P �. -{v r v Zrb of -4 -- -L '^t No e?-w
9' ).c�T $ov+e�e�a -A Env '1�•L. A.� v,c.) S�8`�
10, G'� \�-ip 'M X14-- �N, C
11'
12'
13'
14'
INDICATE LEVEL AT WHICH GROUNDWATER IS ENCOUNTERED
INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED
DEEP HOLE OBSERVATIONS MADE BY:
DATE:
DESIGN
Soil Rate Used /6 -ZO Min /1" Drop: S. D. Usable 'Area Provided Sdc-so
No. of Bedroatns 3 Septic Tank Capacity % �m d o gals. Type M r�soNa�/
Absorption Area ovided LA'L9 L.F. x 24" width trench
C�vsri me.) X6 �iuS1> tj 4r) . Car-S-77",
Other _1cDmc) GTw� e,►.,,r��'wuK__ �Rc� mo. ior2euc.\ le &41 5�2"�lbuca*'& .
Name .
P;ddress
Signature
SEAL
l
THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY:
Soil Rate Approved sq.ft /gal. Checked by
07-)
m
a.
3W
me s
zo
a 7i >�
Fill suitatae fo - 4-a�7- . ': ;;:a . _ , r,..,,x, ^ no m,^
��= and- prefe�a;�i�+ -no- here -tt�» �v •y L�:;;�it".�.•.'.�.<:;'; °�_
clay and silt particles that p ss a 200 sieve
and
no more than 1096 by weight, of the fill material should pass 'a
100 sieve.
Putnam County Department of Health
Division of Environmental 1-lealth Services
l
DEPARTMENT OF HEALTH
Division of Environmental Health Services
TWO COUNTY CENTER - CARMEL, N.Y., 10512 (914) 225 -3641
°' ` APPLICPiTION TO -CONSTRUCT- A` WATE'*° WELL
PCHD PERMIT # v
WELL LOCATION
Street Address
Bullet Hole Road
Town/Village/City Tax
P
Grid Number
WELL OWNER
Name Mailing Address
Douglas J. Wallace 3 Grouse Lanb, HuntinQtnn, Npw Ynrk
10 Private
0_Public
USE OF WELL
xl - primary
2 - secondary
I$ RESIDENTIAL
0 BUSINESS
13 INDUSTRIAL
❑.PUBLIC SUPPLY ❑ AIR /COND /HEAT PUMP
D.FARM ❑ TEST /OBSERVATION
C1.INSTITUTIONAL O STAND -BY
O ABANDONED
❑ OTHER (specify
AMOUNT . OF USE
YIELD SOUGHT
5 gpm /# PEOPLE SERVED 5 /EST. OF DAILY USAGE 375 gal
REASON FOR
DRILLING
0 NEW SUPPLY []PROVIDE ADDITIONAL SUPPLY
❑REPLACE EXISTING SUPPLY ❑DEEPEN EXISTING WELL
❑TEST /OBSERVATION
DETAILED
REASON FOR
`DRILLING:
WELL TYPE
DRILLED
�
DRIVEN
®DUG ® GRAVEL
® OTHER
IS WELL SITE SUBJECT TO FLOODING? YES X NO
IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION:
Burdick Glen North Subdivision Lot No. g
WATER WELL CONTRACTOR: Name To be determined Address:
IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES ___.X_NO
NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY
" DISTANCE- TO"PROPERTY- TROM-NEAREST WATER •MAIN: N/A
LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED
ON REAR OF THIS APPLICATION 5N_ S A$
10/25/88
(date) (signature
PERMIT
TO CONSTRUCT A WATER WELL
This permit to construct one water well as set forth above is granted under 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 applicant shall-
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 provid d by the Putnam County
Health Department.,
Date of Issue: 19�
rmit ssuing Official
Date of Expiration: 19
White copy: H.D. File
Permit is Non - Transferrable Yellow copy: Building Inspector
2/87 Pink Copy` Owner
Orange copy: Well Driller
li
nI
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