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Home My WebLink About1499DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 34. -3 -40 BOX 14 4� {- :: T. 01499 r PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE `SEWAGE TREATMENT SYSTEM Owner � G /_,ffi�� Address A X Located at (Street) r hoc_ VZ Tax Map 3 il Block _3 Lot 0(p (indicate nearest cross street) Municipality P, 7-- rggseW Watershed AA:ST ZZAkleµ SOIL PERCOLATION TEST DATA Date of Pre - soaking / 2 �� f ©3 Date of Percolation Test /�LL3z03 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 submitted for review. 2. Depth measurements to be made from top of hole. Form DD -97 3 3D— 3;00 4 5 Ila 3 z ;3s- -3 09 4 5 1 2 3 4 5 NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. s 1 min for 1 -30 min/inch, s 2 min for 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 DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. A I HOLE NO. G.L. 0.5' 1.0' 1.5' a',- 2.0' 2.5' 3.0' r: 3.5' 4.0' 5 /o 4.5' 5.5' 6.0' 6.5' 7.0' 7.5' 8.0' 9.0' 9.5' 10.0' HOLE NO. -- 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 �� 3 Cp Design Professional Name: Address: Signature: Design Professional's Seal 1�° A r)rd -R -! 2 ' a 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 �� 3 Cp Design Professional Name: Address: Signature: Design Professional's Seal 1�° A r)rd -R -! 'PUTNAM COUNTY DEPARTMENT OF HEALTH. N DIVISION _OE ENVIRONMENTAL, HEALTH_.SERVI.CES -_ ....._- .__..._ INITIAL INDIVIDUAL /COMMERCIAL SITE INSPECTION FORM. SECTION A. GENERAL INFORMATION Name of Project County Site Location 7W -3V- -3 -1(0 Building construction begun Extent -P -P 57-rV E j ay_ Is property within NYC Watershed ? ................. EZfYes 0 No SECTIO , TOPOGRAPHY (Please check all appropriate boxes) 1. .. ay � Rolling 0 Steep slope F7 Gentle slope a Flat 2. Evidence of wetlands Low area subject to flooding _ Bodies of.water 0 Drainage ditches F__] Rock outcrops 3. Property lines or corners evident .................. ............................... F__J Yes 4. Do water courses exist on or adjoin the property? ... S . l� F2�? :.. Yes 5. Will these affect the design of the sewage system facilities ?............ % Yes 6. Do watershed regulations apply in this development ?....... ... .............. F�Y e s 'B 7 Will extensive grading be necessary?.. . 21../.15- 4pW ............... .... 7.71 Yes _.._ .g; SECTION D. DRAINAGE 18. Will proposed grading materially alter the natural drainage in this or adjacent areas? Y y [-;No 19. Will groundwater F ndwater or surface drainage require special considerdtion? ..................... * No Y 20. Will gullies, ditches; etc., be filled and watercourses b.c relocated? .... 45.101 Yes F--] No SECTION E. REMARKS, 21. If a common water supply is proposedi. has an inspection been made of the existing or proposed source and facilities? ......................................... .................. I ..... . F Yes No Inspection data 22. Do adjacent wells and/or sewage systems exist? .................................................... F-;ryes F7..No 23. Additional comments 24. Site observer/inspector and -title L Y, 72, , 17 PI 25. Date(s)-of observation(s)inspection(s) TEST PIT PROFILES Hole # Lot # /f> Hole 4 'Lot # Hole # C- Lot Depth to water 4 ZZN 45 Depth to water A /�o A/� Depth to water.. AJP AIZ Depth to mottling 42,266 r Depth to mottling_ AmA16. ..... .. Depth to rock/imp. Depth to rock/imp. 6- Depth to rock/imp. )4hp G.L. 0f1'6;bUA& G.L. .01t161AIAL L4 G.L. 0 -A 6 IA. 1,0 -rraze -r51 0.5 .0.5 0.5 WV;-5 k 13 -r, 1.0 We 1 1.0 L'o 2.0 /extky 2.0 3.0- 3.0 4.0 41111.1y 731 -641L/A? 4.0 5.0, /--/o e -5A,,f. � 6-r, vel 5.0 6.0 .x- 1-611 7.0 2.0 3.0 4.0 5.0 6.0 6.0 7.0 7.0 8.0 8.0 8.0 9.0 9.0 9.0- 10.0 10.0 10.0 2 SECTION D. DRAINAGE 18. Will proposed grading materially alter the natural drainage in this or adjacent areas? Y y [-;No 19. Will groundwater F ndwater or surface drainage require special considerdtion? ..................... * No Y 20. Will gullies, ditches; etc., be filled and watercourses b.c relocated? .... 45.101 Yes F--] No SECTION E. REMARKS, 21. If a common water supply is proposedi. has an inspection been made of the existing or proposed source and facilities? ......................................... .................. I ..... . F Yes No Inspection data 22. Do adjacent wells and/or sewage systems exist? .................................................... F-;ryes F7..No 23. Additional comments 24. Site observer/inspector and -title L Y, 72, , 17 PI 25. Date(s)-of observation(s)inspection(s) TEST PIT PROFILES Hole # Lot # /f> Hole 4 'Lot # Hole # C- Lot Depth to water 4 ZZN 45 Depth to water A /�o A/� Depth to water.. AJP AIZ Depth to mottling 42,266 r Depth to mottling_ AmA16. ..... .. Depth to rock/imp. Depth to rock/imp. 6- Depth to rock/imp. )4hp G.L. 0f1'6;bUA& G.L. .01t161AIAL L4 G.L. 0 -A 6 IA. 1,0 -rraze -r51 0.5 .0.5 0.5 WV;-5 k 13 -r, 1.0 We 1 1.0 L'o 2.0 /extky 2.0 3.0- 3.0 4.0 41111.1y 731 -641L/A? 4.0 5.0, /--/o e -5A,,f. � 6-r, vel 5.0 6.0 .x- 1-611 7.0 2.0 3.0 4.0 5.0 6.0 6.0 7.0 7.0 8.0 8.0 8.0 9.0 9.0 9.0- 10.0 10.0 10.0 Sent By: LLL; 1234567 ; Sep -12 -02 8:46AM; AWO 29A Au&03 Vol Page 2/2 �aswa 'a,�a��,N q�u► Ida ags3o ams>�oxw►�a a�npagsB o; Isao ;saa,�ojd ufi�aap ay�io 410R.Modwa ajoo alp aq Ta► q'Sapm dos m sum.^ w sa;wtptq aogsauam Iuaabysgas wqi pos smodw "ogv aRs ao: Ponq P "t+iaa eq as pampjaW saaq aq mfoxd v iI W(DAN Pw ypa6111"J "d 93Pa QV 'HOQOd oql WW 2p; PPP Jo; MM 41VA s 10"um v MV-1003 9W t w&a $,U jupM gos aqs fsaml& pm dMAN `moppo alp ;a dap a; W peamm aoL ;Y •amadcu *W uo Pmmq (pa;asM to liner) fulwo 3a[osd d3WAX aql Gm. 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PD^ 311 1 1B P 0 4 46 - _DICE O 45 �S 9 K 60 c E PD �o I criers 84 ..� �D IANOVIEW4W leP, ®1 5� �++ .00 ! ! _! ! Ira 194 ! P t -%0 ----- P/0 23-2-9 - -- %--- �-- -�" 07 49� 265.56 y. \R° 1.68 AC. ��ti�sw 9 %4 , °p,. 59 $ F a 36 `r36 a,, ze6sz fie, . c ,` aAo� r4�g tee.61 30.91 AC. 34.84 , .: 2.63 A53 43i, ;6 �'''• �° �•'„`. I 2.70 AC. 46 °?81.12 39 .n�I C2i6'}r 58260 1.46 AGQ' � � ••'IiI 9 0 �" �S'23� 3,. _ i _ � a? = 4.00 AC. 4, , 35.63 AC. 1 ' • 3 �v 2.32 AC. 1 � 3r C � gyp, 3 s 25� 2P u,13� 4 2.49 A 9 6 1 B . 33J'}f,F 4" 2B 3; .ti ►�� `r,A X29 ? x.42 1.61 re 1.41 AG-0 �4` ° .0• 1y,C • �• Ac. x 9 feat QL \ 19 IT 8 r_. 27 �a` 6' • !�• t 26 21 20• 3.36 AC. 6 IIG ' 346.295 IS? 112 23 • - � � I.� AC. a • . � e 1 g %426 a %11 J ± 31 .59 AC. 295 2.49 • t 32 �s 1,•,et e' a 'el 6 A05•p5 38.70 AC. CAI. s. • 2 5 �.+� 33 1,92 a J= ` 27''an 3 AC. AC. 234 AC, it I! Vq At -' 34 24 • , 1.74 AC , „ . .46 ' crou 3< 1.91 At a �� 1►1,oe AC. 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CAL. �..7 t .j 14 75.97 AC. �� 1519 19• 230(9) !-IL" 10 BRUCE R. FOLEY ` Public Health Director - - LORETTA MOLINARI R.N., M.S.N. Associate' Public Health Director Director of Patient Services 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 (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Preschool (845) 278 -6082 Fax (845) 278 - 6648 Date: / / Z -7 Za To: S 1 S S �Z - "Dou La ©:55A Fax #: 7 73 — a 3 S 5- No. Pages (Including cover sheet) From: Gene D. Reed Putnam County Department of Health For your information /Please respond � -- . � , � • -- - . - - - - -- For your review As discussed Notes/Messages Attached as requested Please call .` In the event of transmission /reception difficulties, please contact this office at (845) 278 -6130 ext. 2261. Tf is f Y/ -4 ♦ WA 6. -6 /,<..,I., ile,� V, � JCi-C,k- IV% r-14 WA 6. -6 /,<..,I., ile,� V, � JCi-C,k- o �.1 SENDING CONFIRMATION DATE NOV -7 -2003 FRI 17:10 NAME : PUTNAM COUNTY DEPARTMENT OF HEALTH TEL 845 - 278 -7921 PHONE : 919147730355 PAGES : 4/4 START TIME : NOV -07 17:07 ELAPSED TIME : 02'49" MODE : ECM RESULTS : OK FIRST PAGE OF RECENT DOCUMENT TRANSMITTED... a r BB,UCB a FbIJW [.ORETTA MOLIIVA6tI RN., M.B.N. P`68d /limas bft m Ans W. Pa/11: 9-0 Dlnadr 16.emr of Peftw Sr'rior DEPARTMENT OF HEALTH 1 flows. Road ikewste , New Yolk 10509 4Aroaarwl nul9, 0115)774.6110 11.(149)271.7911 :hndq a...l... (at)IU.65S4 S11t MlI x71.6671 F.s09151171.60111 ary loft d6a (1111174-6 011 P—%d (Nn17NOtt F.(945)171.66N F Y Cpl V:.lt SCARFT .. _ 70• SI�i' Da � O•�A FnxIF• �773--03'S'S' .- _ ._.� ,_ From: f nw A. !MA—County Department of Health /or your infarmation _ For your review _ As discussed No. FaW q (Mcludiog cover sheet) / Please respond Attached as requested Flmm can Notealmessaxes �92G4 it •DEc6P5 CIAf /i /A R /lgle2Z5 /N /eA&f LS aux . PAr>•ER--' olt/ In the event of transmtulontreeeptlon difficulties, please contact this office at ("5) 278-6170 am 2261. o � BRUCE R. FOLEY LORETTA_ MOLINARI R.N., M.S.N, - Associate 'Public 'hiealth"Director ` " Director of Patient Services 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 (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Preschool (845) 278 -6082 Fax (845) 278 - 6648 Date: / % 11'2- !iL& a To: 51 SS Y Fax #: 773-0 From: Gene D. Reed Putnam County Department of Health ✓ For our-information For your review As discussed No. Pages i (Including cover sheet) ease respond /cort'� Please call Notes/Messages �► 11 g:. 7� AA &/ I In the event of transmission /reception difficulties, please contact this office at (845) 278 -6130 ext. 2261. a SENDING CONFIRMATION DATE NOV -24 -2003 MON 17:16 NAME PUTNAM COUNTY DEPARTMENT OF HEALTH TEL 845 - 278 -7921 PHONE : 919147730355 PAGES : 1/1 START TIME : NOV -24 17:15 ELAPSED TIME : 00129" MODE : ECM RESULTS : OK FIRST PAGE OF RECENT DOCUMENT TRANSMITTED... a # r BRUCE R. MLEY LORMA MOLMARI RM. M.SN. P"& them D6rrWr A-1— Wbffr NroeD D&Wd Dbraw qj PMlw 6lvaau DEPARTMENT OF HEALTH I Geneva Road Browatar, Now York 10509 6Hrmm WHe&(143)211 -613P Pe(SM271.7931 1111nN arnke 5)111.6761 Wn: (UP271 -6671 ra(143)27l -6061 t'+,y 1wf—tw (147)371.6011 Prndlwl (143)37$606: Pc(143)771.6141 FAX RRFF.T Data To: 'Sa y. :n2 — Ds�s9 n.#:._ 7�= ��re� No. Pages i (Including cover aheet) We= GeQt II_ Putnam County County Department of Health Foryour Information /emeret \po`nd�emw�,y,� Foryonr review hed ae—ueateA-! As discussed Please call I • In the event of tranemdsiooheceptlon d0culties, please contact this otF7en at (843) 27961'30 e=t 2261. BRUCE R. FOLEY Public DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 LORETTA MOLINARI R.N., M.S.N. '"Associate -'PuNic'-_Health Director Director of Patient Services Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Preschool (845) 278 -6082 Fax (845) 278 - 6648 Date: .2- / / / A:52 �/ To: -515SX die G� 99� r .I From: Gene D. Reed Putnam County Department of Health Fax #: 7 7.3 — © 3-5- ,5 No. Pages (Including cover sheet) For your information - - Tease respond - - - -- - - For your review Attached as requested As discussed Please call Notes/Messages PF 2 k C c x/E In the event of transmission /reception difficulties, please contact this office at (845) 278 -6130 ext. 2261. SENDING CONFIRMATION DATE : FEB -11 -2004 WED 10:21 NAME . PUTNAM COUNTY DEPARTMENT OF HEALTH TEL 845 - 278 -7921 PHONE : 919147730355 PAGES : 1/1 START TIME : FEB -11 10:21 ELAPSED TIME : 00'29" MODE : ECM RESULTS : OK FIRST PAGE OF RECENT DOCUMENT TRANSMITTED... a BRUCE R FOLEY LOkMA MOLINARI R.N., M.S.N. M& &.M Drnd- At.O" pwra lAalth D&a D&,wro q? Yawet Sedan DEPARTMENT OF REALTH 1 Genova Read Brewster, New York 10509 ' n.ae.o..ar freae. pe)rra -euo as (145)"1 -7911 n.rma 8..k. (945)274.6519 WIC (4a3)rn -6676 Fo,(a4S)17a -6M s.df [..Me" (245)278 -eM rneeaaar (145)"14012 tx(a4n273-6649 FAY COVTR p_HEET Date: y q To:`Ss$1,Y'T)Sfr4. 055.4 Fax M: 17?— c23�i-' Awe) No. Pages % (Including cover sheet) From: CAne b. Reed _ Putnam County Department of Health ✓ For your information /Please respond `r For your review Attached as requested As discussed Please can Notes/Measages fog TZ S 77��P T5s=5_�nJ Ez7CA�Yr f��V�14Y 20�1— In the event of tnusmisaioNreception dffkuldes, please contact this office at (845) 27 166130 ext. 2261.