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HomeMy WebLinkAbout1582DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 34.-5-22.23 BOX 15 11 ru ,. „ v r r I. I I As .L-v- :yj AM COUNTY DEPARTMENT OF HEALTH DIVISION:.OF_. ENVIRONMENTAL - .HEALTH SERVICES CE T ICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT SYSTEM PCHD CONSTRUCTION PERMIT # *P'' It -q-T Located at 52ifA-W e- V, A" i,. ,4 GTown or Village PATT- -k'g5 O r'i Owner /Applicant Name pQ-- JZ J Map _ Block Lot _-2_�- t Formerly I?A /Nk 5 g-AWE_ Subdivision Name 15tfAw P VA-LL, Fes( ATV-5 Subd. Lot # 13 Mailing Address 1Z-1 OCR 21D. M Zip J'pLS31 Date Construction Permit Issued by PCHD SJ # r %q % Separate Sewerage System built by 6,qVD1-F_7 lztD NaMdress 1�AA�� /�!!� l �53� Consisting of 12 Gallon Septic Tank and-432. L F a - - 2 f i d 1 DEA &<jngPrJa R-a . 1 .. • Other Requirements: 1 i .I 11 �i .A. Water Suouly: Public Supply From Address or: ) _ Private Supply Drilled by W IqL_ f SOXS Address 4 mi n Ak 7e ;ev_0, - - - Building -Type 5 a;/ Has erosion control been completed? -Y Number of Bedrooms 25 Has garbage grinder been installed? /V 0 I certify that the system(s), as listed, se built plans (copies of which are attach plans and th standards, rules and re lea Date: '24 Certified b Address Any person occupying premises served by the were constructed essentially as shown on the as- issued PCHD Construction Permit and approved Devartment of Health. P.E.) R.A. 1. K, 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 bject to modification or change when, in the judgment of the Public Health Director, such revocation,:mprdAcation opfhange is necessary. By: G� Title: 041411-A�& 82 Date: l a `% White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 PUTNAM ENGINEERING, PLLC 102 Gieneida Avenue Carmel, NY 10512 914- 225 -3060 Fax:! 914 -225 -2955 LETTER TER OF TRANSMITTAL Date: 011234/q G 1� X0-'1 We are sending you >L attached under separate cover, the following items: Shop drawings Prints Specifications Copy of letter Plans 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: ill GAL If enclosures are not as noted, kindly notify this office. n NORTHEAST LABORATORY OF DANBURY >.;.... ... , . �. CT Cep; .:P)EI ;9_444.... - ..... . ,.... ,.. _ w ... 39 -3 MILL PLmN ROAD - DANBURY, CT 06811- NY Cert: 11471 (203) 748 -7903 - FAX (203) 748 -0652 LABORATORY REPORT -- WATER SUPPLY TESTING REPORT TO: P.F. BEAL & SONS DATE SAMPLE COLLECTED: 8/13/98 4 PUTNAM AVENUE TIME COLLECTED: 1:15 P.M. BREWSTER, N.Y. 10509 COLLECTED BY: J.,SCOT DATE RECEIVED @ LAB: 8/14/98 TESTED BY: LAB #11471'& 11301 REPORT DATE: 8/21/98 SAMPLE SITE: SADDLE.R)fD!GE HONE , LOT 0, SHAWE VALLEY EST., BREWSTER, N.Y. SAMPLING POINT: HOSE BIB - TANK SOURCE: WELL -NEW TREATMENT: NONE TEST PERFORMED' RESULT: BACTERIAL: Total Coliform (Bacteria) 0. per 100 ml PHYSICALS: pH 7.42 Turbidity 3.4 NTUs CHEMISTRY: MAXIMUM CONTAMINANT LEVEL 0 per 100 ml no designated limit 5 NTUs Nitrite N <0.01 mg/L as N 1 mg/L as N 11301 - Nitrate N 0.42 mg/L as N 10 mg/L as N Alkalinity 71.0 mg/L no designated limits Hardness 150.0 mg/L no designated limits Iron 0.071 mg/L 0.30 mg/L [Note: Combined Limit for Iron plus Manganese = 0.50 mg/L] Sodium 4.4 mg/L 20 mg/L ** Lead 0.006 mg/L 0.015. * ** m1= milliliter mg/L = milligrams per Liter ND = none detected NTU =Units * *Notification Level ** *Action Level RESULTS BASED ON SAMPLES SUBMITTED: 8/14/98 SAMPLE, AS TESTED ABOVE: OTABLE or OT POTABLE (PER NEW YORK STATE DEPT. OF HEALTH SERVICES STANDARDS FOR POTABLE WATER) •NORTHEAST LABORATORY, 129 MILL STREET, BERLIN, CT 06037- (860)828 -9787 - FAX (860)829 -1050 TOLL FREE WITHIN CT: 800 - 826 -0105 •OUTSIDE CT: 800 - 654 -1230 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICE WELL COMPLETION REPORT Well Location Street Address: Ice Pond Rd, Shawe Valley Town/Village: Brewster Tax Grid # Map Block Lot(s) 3 Well Owner: Name: Address: Saddle Ridge Hanes, Inc., 15 Saddle Ridge Rd, Holmes, NY 12531 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 X Rotary Cable .percussion X Compressed air percussion Other (specify) Well Type Screened Open end casing X Open hole in bedrock Other Casing Details Total length 32 ft. Length below grade 31 ft. Diameter 6 in. Weight per foot 19 lb /ft. Materials: X Steel _ Plastic _ Other Joints: Welded _j_ Threaded Other Seal: X Cement grout _ Bentonite Other Drive shoe: X Yes No Liner: Yes X No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First Yes No Hours Second Well Yield Test Bailed X Pumped X Compressed Air Hours _L6_ Yield 5 gpm Depth Data Measure from land surface-static specify ft) 30' During yield test(ft) 440' Depth of completed well in feet 505' Well Log If more detailed information descriptions or sieve - analyses -__ are available, please attach. Depth From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface 10 Drillin in o e =den clay and boulders 10 H' o ' i0- -- -32- -Drr i' .. ._. .. __.._._.__.::..:...:. 32 505 If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type sub Capacity 5Z Depth 460 Model 5GS10412 Voltage 230 HP 1 Tank Type WX203 Volume 32 Date Well Completed 5/5/98 Putnam County Certification No. 002 Date of Report 9/11/98 Well Dr P NOTE: Exact location of well with distances to at least two permanent landmarks to be provide on parate she plan. Well Driller's Name Address: Signature: Date: 9/11/98 Per a White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 ,y 13,3:44AIA P02 GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM Location o Street 1 Subdivision Name Subdivision Lot Al 1 represent that i am wholly and completely responsibly 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"opprovad plan or approved ai andgnent thereto, and in accordance with the standards, ales and regulations ofthe Putnam County Department ofHealth, and herbby guarantee to the owner, his successors, heirs or assigns, to place in good operating condition any part of said system constructed by me which falls to operate for a period of two years immediately following the date of approval of the "'Certificate of Construction Compliance" fbi the . sewage treatment system, or any repairs made by me to such system, except where the failure to ray-the.willful or.negligent.act of. the. otcupant :ofthe- 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 ®r negligent act of the occupant of the building utilizing the system. C Dated: Month ( Day Year fin ot General Contractor wrier) - Signature - — - MZ- Corporation Marne (if Address: State Zi-��� i ' Title: _ Corporation Marne q-&K4s4 flie- :ion) P Form GS-97 e-- — (VI 5 PUTNAM COUNTY DEPARTMENT OF HEALTH �he e DIVISION OF EI N VIRONMENTAL HEALTH SERVICES �� 3�/9� FINAL SITE INSPECTION 2; _ - - v _ Date: g IP,��tedhy.�., r et~L- oeation• �4vi1�'I/.d 7_ . `•'x G 7C%' .. CSwner _" �� 7314A W,5- Town _PA-r-rgRse>& Permit # . "P — / / - 7 7 TM '�T — g gL , I Subdivision Lot # 3 "5)yAWO VAI1,C- y 1. Sewage System Area a. STS area located as per approved plans ................ :.......... b. Fill section - date of placement 3:1 barrier Lath.. Width Avg.Dpth c. Natural soil not stripped .................. ............................... d. Stone, brush, etc., greater than 15' from STS area ...... t� e. 100' from water course / wetlands .............................. II. Sewage System � a peptic to size - 1,000 ........1,25 .........other .............: b. Septic tank installed level ............... .............................., c. 10' minimum from foundation ........ ............................... d. Distribtuion Box 1. All outlets at same elevation -water tested ................ 2. Protected below frost ................ ............................... 3. i`linimum 2 ft.Original soil between box & trenche Junction Box - properly set..................................................... I. engt requiredt O Length installed) 2. Distance to watercourse measured OFt........ 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 -1' /2" diameter clean .................. 9. Depth of gravel in trench 12" minimum .................. 10. Pipe ends capped..................................................... `?,uro orposed Systems_ I. Size of pump c am er .............. ............................... 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/Building a. house located per approved plans . ............................... b. Number of bedrooms .................... ............................... IV. Well a7-Well located as per approved plans .............................. b. Distance from STS area measured 100 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 plat f. Curtain drain outfall protected & dinto exist watercot g. Footing drains discharge away from STS area............ h. Surface water protection adequate ............................... is Erosion control provided .............. ............................... Rev. 1/97 Form WIMM COt *ff D13PAt; MEff of HEALTH Dlvb bm at BsihrMMEtd Red& Searvkea. Corset. N.Y. 10812 R abbe to Pewlde Fens t o M C23MVICATR OF CO CR DONnWCnM MUM FOR SHWAGR DMOSAL SYn= Paoalt # V sw. 'dr vm.Qe' Renewd_ ❑ RevNifts 0 [j Date of Ptevbsu Aptltovnl MOMS A..- 1 Town zip • - - - - - -- of 2,E] Gt BdWmg Type TAM Lot` Area 2' � � `� Fill Section 0* DepB Vdatoe NW&Q of Bedagifts Desip Flow G P D PCt1D No1M melon Is Regah'ed When Fm Is compieted Sepoeate Sewlser Syd= to osu t of Gallon Septic Tank na � Z W l DE AMoW710N TREfJG4 To be. emosetpd by 30 1W-- 7 5� I�dED Addwss Water Sop*. P&& SW* Fr Adder an X FAvate Sop* DAM by rl) � P�_Adihom Odw _ to 1�6AZM6 100.6. ova (�- 'Lp'j� SLEIA5• (�4N10VV— STONE WAy-s VgITWN (0 aF SSDS 1 represent'.that 1 am wholly and completely responsible for the design and location of the Proposed system(s); 1) that the separate few dl sal s stem above described will be constructed as shown on the approved amendment there to and in accordance with the standards, rules a ragu ns o nom County Department of Hulth, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Commissioner of Healthwill be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that YW bulkier will place in good operating condition any part of uld sawage disposal system during the sod of two (2) yews Immediately following the date of the iau- once of the approval of the Certificate of Construction Compliance of the o►_ anal m or Irs thereto; 2) that the drilled well described above will be IOa abed at stlaram on the a00roVad Plan and that mid well will I stall wi h the standards. rules and rpu aTt%ns of the Putnam County Dgmrtmaed of Health. Dates L 1 I.� .4 Signed P.E. -X— RA. %_ Add►e 1 ry Z � 'License No � Ted 'APPROVED FOR CONSTRUCTION: This approval expires t s orn the date a construction of the building has been undertaken and is revocable for ca se or ay be amended or modified when con esury by iionce of Health. Any Change o► alteration of construction require a new per�v Approved for disposal of, domestic' erw water supply only. Rev. rr/ 10/88 pato By Title DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 APPL;ICATION'"TO "CONSTRUCT° "'A° "WATER 'WELL" , _ " PCHD PERMIT AN! WELL LOCATION Street ddress Town Village City Tax Grid Number LAN 5__ 22 WELL OWNER Name rj a1 ing Address Private hjW 14) Public USE OF WELL 1 - primary 2 - secondary RESIDENTIAL 0 BUSINESS 0 INDUSTRIAL O PUBLIC SUPPLY O FARM t] INSTITUTIONAL O AIR /COND /HEAT PUMP 0 ABANDONED O TEST /OBSERVATION O OTHER (specify O STAND -BY AMOUNT OF USE YIELD SOUGHT M14 S gpm /# PEOPLE SERVED L ptA /EST. OF DAILY USAGE t-,00s�l O REPLACE EXISTING SUPPLY ® TEST/ OBSERVATION 13. ADDITIONAL SUPPLY tdNEW SUPPLY NEW DWELLING ® DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING WELL TYPE DRILLED DRIVEN ODUG O GRAVEL O OTHER IS WELL SITE SUBJECT TO FLOODING? YES A NO IF WELJ, IS LOCATED/ IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: - .Q1(�j Lot No. �?7 WATER WELL CONTRACTOR: Name IQ 13:05 Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES __NO NAM OF PUBLIC WATER SUPPLY: t�3 %A TOWN /VIL /CITY DISTANCE _ TO ..PROPERTYj FROM. NE_ARET...IATER MAIN_: A. ._.(4... LOCATION SKETCH & SOURCES OF CONTAMINATION PROVID N SEPARATE SHEET (date) signa e) 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 thirt;- (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 provided by the Putnam County Health Department. During all well drilling operations, the applicant shall take appropriate action to assure that any and all water or waste products from such well drill' g operations be contained on this property and in suc a manner as not to degrade or oth 'w'.se &oninate surface or groundwater. Date of Issue: f Date of Expiration 19_ Pe it Issuing Official Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date Re: Property of PAM Located at �i'i�W �J�u_��/ �.�(1 (T) l 11 ,";�1-A Section 54'. Block S Lot Subdivision of Subdv. Lot # 3 Filed Map # ��02 Date 2121 I -7 Gentlemen: This letter is to authorize a duly licensed professional engineer or registered architect (Indicate to apply for a Construction Permit for a separate sewage system, to serve the above noted property in accordance with the standards, rules or regulations as promulagated by the Commissioner of the Putnam County Department of Health, and to sign all necessary papers on my behalf in connection with this matter and to supervise the construction of said system or systems in conformity with the provisions of Article 145' or 147, Education Law tart' Code. Countersigne P.E., R.A., # is Health Law, and the Putnam County Sani- 102 T--A Avg Address CAIL t-= 1- N`i (os 12 2 25 - 30 0 Telephone Very truly yours, Signed )4vv-� Owner of Property • Address y� � NY I Town Telephone 00 Z-AA6.X ' PC —: PUTNAMV• ���COIJNTY `� "�'TDEP�ARTI��E'iVT�� �:OF�� " •1�L�4.- L:�TH�• <•_ -- APPLICATION FOR APPROVAL OF PLANS FOR A WASTEWATER DISPOSAL SYSTEM 1. Name and Address of Applicant: 'oPM. BRi =Y�1 Sri r2 N �l 1 pSo 2.. Name of Project: 3. Location T /V /C: �i`i�FZSe�r`I 4. Project Engineer: �L�TN� r IG���� =�il�� S. Address: NY License Number: C(°-74j- ro Phone: 225 '306,0 6. Type of Project: Private /Residential Food Service Commercial Apartments Institutional Mobile Home Park _ Office Building Realty Subdivision Other (specify) T. Is this project subject to State Environmental Quality Review (SEQR)? Type Status (Check One) Type I.. Exempt Type II. Unlisted -X 8. Is a Draft Environmental Impact Statement (DEIS) required? ............. f�10 9. Has DEIS been completed and found acceptable by Lead Agency? ........... t4 1A, 0. Name of Lead Agency /A _ .- �....- ..:..._.�.. - . -. I. Is this project in an area under the control of local planning, zoning, or other officials, ordinances? ......... ............................... S. 2. If so, have plans been submitted to such authorities? S 3. Has preliminary approval been granted by such authorities? Date Granted: 4. Type of Sewage Disposal System Discharge...... Surface Water Ground Waters 5. If surface water discharge, what is the stream class designation ?........ _„ A -6. Waters index number (surface) ... ............................... .. T. Is project located near a public water supply system? .................. Nom_ GR9XMFM 11L& ,-J 8. If yes, name of water supply 1`1 Distance to water supplyl 01`95 19. Is project site near a public sewage collection or disposal system ?..... r4a QO*fA'Tl4R TF4► "J !0. Name of sewage system N Distance to sewage system 1= ! t . Date observed: 9 � 2-D 1 1 S 23. Name of Health Inspector: F311,1 4.16655- !4. Project design flow (gallons per day) ....... .............................. BOO u bra.-- is..state PoYlu�tant-. 01. scharge:.' EJ- i; m_i:na:�io�=:-Systemm- (SP©ES.) 26. Has SPDES Application been submitted to local DEC Office? ............... 2T. Is any portion of this project located within a designated Town or State wetland? .............. ............................... ... .............. YB 26. Wetland 'ID Number ................... ... ............................... N /,&. 29. Is Wetland Permit required? .............. ............................... W 'gD Has application been made tcTown,or Local DEC Office? .................. 30. Does project require a DEC Stream Disturbance Permit? ................... �fl 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 or NO 32. Is project located within 1,000 feet of existence of abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site dr any other potential known source of contamination? ..............YES or NO DESCRIBE: 33. Is there a local master plan or file with the Tcwn or Village? ........... I::5; 34. Are community water, sewer facilities planned to be developed within 15 years? 35. Are any sewage disposal areas in excess of 15A slope? ........................ ~ 36. Tax Map ID Number ......................... ............................... 17. Approved Plans are to be returned to: ................ Applicant % Engineer :f the application is signed by a person other than the applicant shown in-Item 1, the application must be accompanied by a Letter.of Authorization. Failure to comply with this provision may be grounds for the rejection of any submission. % hereby affirm, under penalty of perjury, that information provided on this form is true to the best o f my knowledge and belief. False statements made herein are punishable as a Class A, Hildpmeanor pursdant to Section 210.45 of the Penal Law. IGNATURES & OFFICIAL TITLES: IDS 6L F_J,1&J®A A,115-- Al� AILING ADDRESS: 10�t2. f � I• •• X171' • •J� 1, 11 :17►• �: DESjCn*q DAM Sars'�"T -S0BSMCE S CE DISPOSSM SYSTEM FILE NO. Owner SI- {•1s�i�l� yai.t.e�/" �sT. Address Iccat—; at (S`: eet) $e--. �J� Bl=k 5 Lot Z2 . I {indicate ne =rest. cross stre°t) - E h 1n i ciratity nA�TT- `� Watershed G91 Tb SOIL P C MATICN TEST R U-rRM TO BE SMC-T= W4 APP=C�?'ICNS Date of Pre - Staking �' �� �l to Date of Pe- =laticn Test HOLE NCF2-rR CLOG PF :C)IA'7CN Run No. El=se Time Stares -S tcD Min. Deoth to Hater Ercm Graur_a Surface S tz_-t stop Levu Ia Inches Droo In Soil Rate M-:. zilln LYCD I_nG�:eS Inches Inches 24 ?G' /4 Z14 14.•7 2 1: 3o 2 03 33 24 ?ln 1/ 1/4 7-1/4 ��-.7 3 Z: o�j 2 38 i zalxz 13 . c 4 5 �oLE -T ..1 g- is, J ps (.- �..___- .._.._. .2S . 2$ 2 I: l0 1: 2s I S 2s zz � 314 3 128 1 :1 169 2�}- 2% 3�� `�.3 4 5 ' 1 • 2 3. trOTES: 1. Tests to be repeat.e:i at sz'ne depth until approximately 'egLu soil rates are obtained at each percalation test hole. Al.l.data try' be sutmitte3 for review. 2. Depth m zsurements to be made fran too of hole. . G.L. 21 31 at -91 61 71 89 91 10, lit 12' 131 ��15 � 24 -,w, -VC4-=' 501 L- INDIC.= •EVM AT Wr-=-, CE GRCGLN =-- IS ECG -N=M -7 + JN-DIC = - 5103° c�q•3J „Ci r - f` ll, �, , ! 24 l ' f pAeoVO ' - -. ,-.._.• -•_ 1150 fl ON, N. 5EF ?1L FANK Q : 11 w 1 • .o ; FX15TtNCs .m ” o 3 BED og o o� n .gyp d %' G�.7<Ary 04Y % 3 . 5 (7i STK•3 7� PAt h16.rFLF .. O yc' •.7LlrJ4T�W Via. (7"YG') � f c 1 � .Z' WIDE i�g56 (CDTION T2i•'�k.MfS I8 - •. r�t11`�''��• i - ' - 1 � - .. .'• r 1 rt.E1c NaT WELL L..CT("4 r r 1. • Putnam County Department of Health Division of Environmental Health Servioea Approved as noted for oonformanoe with app11 bl Ruloa a d Regulations of the Count alth Department. Signature 6�fiitle a 1 `2 5 4 5 6 8 q 1 l0 I I ; 12 15 14- 15 16 11 18 Iq 20 �S -g .-7 z 133 14-7 11 (0 1IZY7- C1 -2- -2-0 Z — — ��l YoZ� /z D -74Yz �P'�z l09 (ovz 59YZ �o (oa S4 Y 9 j 3.p zs I zcO /o4\1-z. /03 ,k rtment of Health tai, Health servioes • oonYormanoe With 3egulations of the th Department. "j l AP 18 Iq .!20 9-7 4� toZ'�z ion IiI 1E5 . ATE5 t, 1 1 i AS-BUILT: oz.. ALE I. This is to certify that the sevroge disposal system was 4y4 constructed as Indicated on this plan andbthat the system was Su^IONtaF Inspected by Putnam Engineering, P.L.L.G. before It was covered over. ! a f s f AWN OF PAT? E.R50N The system was constructed in accordance with oil standard „ A5 NOTED rules. and regulations of the Putnam County Department of Health and the New York State Department of. Health. �s y %r i� 2. The 5505 consists of the following IZSUgallon precast ;} concrete septic tank,4iZ•5 I.f. of 24" wide absorption f r trench ; additional requirements :f J- DATE f'Ra.leG7' FeR18E1Y !';,;, AUGUST 1498 , P.RO.IEGT MANAGER AS' BUILT DRAWIflG MINIBER ` i K�1 , DRAM BY .. GY ✓.r/ �.� I -.t GHEGKED BY PML' oz.. ALE 4y4 I Su^IONtaF ! a f s f AWN OF PAT? E.R50N ,_ �_. _ v: i+ - A5 NOTED �s y %r i�