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Home My WebLink About1587DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 34. -5 -22.28 BOX 15 1 y ,., rr ,i y km! 01587 AM COUNTY DEPARTMENT OF HEALTH SION OF ENVIRONMENTAL HEALTH SERVICES TE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT SYSTEM PCHD CONSTRUCTION PERMIT # �— ICS° 7 Located at Z UfC- \/AJ L=04 �- Town or Village Owner /ApplicantName5A ax Map Block Lot' Formerly ��- Subdivision Name "44 rrGTATCS Subd. Lot # Mailing Address 5 5k'PPLr-- R1 Me l'h "I Date Construction Permit Issued by PCHD 51151 (T-7 Zip 1 253 1 Separate Sewerage System built by �A f IX :6 Address 65 SA e JQO C Consisting of 1,050 Gallon Septic Tank and SO4 L_ r___ ,50D i val L4019.�, � 0^041 — WAI'94 09ATNOJIV6 Xotb , PWI _- �; ILO F Water Supply: -caaA4 p 1 g75 Public Supply From_ Address or: X Private Supply Drilled by C'�5 Address -5eev'f."�i Building.T- erosion __..__..... _ .._...___ _..... ompleted ?qt�* _,p NC- LF- t ( Has control been c Number of Bedrooms _ Has garbage grinder been installed? l-lio I certify that the system(s), as listed, serving the built plans (copies of which are a , ' T-acc( plans and the standards, rules and re tuns of Date: Certified by the issued PCHD County Departn Address r l:Nrl 102 6�Cr�VPPA &(6� Any person occupying premises served by the above system(s) essentially as shown on the as- 4truction Permit and approved Health. P.E. ) R.A. License # ^,-- Q _ take such action as may be necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewage treatment system shall become null and void as soon as a public sanitary sewer becomes available and the approval of the private water supply shall become null and void when a public water supply becomes available. Such approvals are subject to modification or change when, in the judgment of the Public Health Director, such revocati m dification or change is necessary. B /=A� Title: A %1 �/'`- Date: y• �� White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 14 ill! 39 -3 MILL 1FLMri AbAb YDAn1BtiIIZY, (' 06811 (203) 748 -7903 - FAX (203) 748 -0652 LABORATORY REPORT -- WATER SUPPLY TESTING REPORT TO: P.F. BEAL & SONS 4 PUTNAM AVENUE BREWSTER, N.Y. 10509 SAP -IPLE. SITE: SAM[PLV'iG POINT: SOURCE: TREATMENT: TEST PERFORM EDD BACTERLA,L: Total Coliform (Bacteria) PHYSICALS: pH Turbidity CHEMISTRY: DATE SAMPLE COLLECTED: 6/30/98. TIME COLLECTED: 10:45 A.M. COLLECTED BY: C. BEAL DATE RECEIVED @ LAB: 6/30/98 . TESTED BY: LAB# 11471 REPORT DATE: 7/8/98 CT Cert: PH -0404 NY Cert: 11471 LOT #8, SADDDL- F- PtIDQ; E, S1 kiv '.7 ALLEY EST., r-'' Ew n- 1t,1'r-.Y... DRAIN VALVE AT WTER TANK WELL -NEW NONE Nitrite N Nitrate N Alkalinity Hardness Iron Manganese. Sodium Lead RESULT: 0* 5.82 19.0 <0.01 1.80 29.0 52.0 0.50 -<0.01 45.0 ** 0.008 MAXIMUM[ CONTAMINANT LEVEL per 100 ml 0 per 100.ml no designated limit NTUs 5 NTUs mg/L as N 1 mg/L as N mg/L as N 10 mg/L as N mg/L no designated limits mg/L no designated limits mg/L 0.30 mg/L mg/L - _ .. 0.30 in°g/L _ . ... . [Note: Combined Limit for Iron plus Manganese = 0.50 mg/L] mg/L 20 mg/L ** mg/L 0.015 * ** ml = milliliter mg/L = milligrams per Liter ND = none detected NTU =Units * *Notification Level ** *Action Level The underlined result exceedsUSPHS, recommendations. RESULTS BASED ON SAMPLES SUBMITTED: 6/30/98 SAMPLE, AS TESTED ABOVE: 13POTABLE or CINOT POTABLE (PER NEW YORK STATE DEPT. OF HEALTH SERVICES STANDARDS FOR POTABLE WATER) *BACTERIA SAMPLE COLLECTED IN A SODIUM THIOSULFATE BOTTLE N Ju Laboratory Director °NORTHEAST LABORATORY, 129 MILL STREET, BERLIN, CT 060370 (860)828 -9787 - FAX (860)829 -1050 TOLL FREE WITHIN CT: 800 - 826 -0105 o OUTSIDE CT: 800 - 654 -1230 — . .. e NORTHEAST LABORATORY OF DANBURY CT Cert: PH -0404 : -39:3 M><LIG:PLA1x1ROA>D:.= . DANBURY; CT:- 06811 - re,.. NY°C6rtc 11471 LAW (203) 748 -7903 - FAX (203) 748 -0652 LABORATORY REPORT -- WATER SUPPLY TESTING REPORT TO: P.F. BEAL & SONS DATE SAMPLE COLLECTED: 7 /10/98 4 PUTNAM AVENUE TIME COLLECTED: 8:30 A.M. BREWSTER, N.Y. 10509 COLLECTED BY: P. BEAL DATE RECEIVED @ LAB: 7 /10/98 TESTED BY: LAB# 11471 REPORT DATE: 7 /10/98 SAMPLE SITE:' SADDLE RIDGE-HOIKE' S, INC., LOT ftS, SHAWE VALLEY EST., N.Y. SAMPLING POINT: HOSE BIB AT TANK SOURCE: WELL TREATMENT: NONE TEST PERFORMED RESULT: MAXEVIUM CONTAMINANT LEVEL CHEMISTRY: Iron <0.03 mg/L 0.30 mg/L Manganese <0.01 mg/L 0.30 mg/L [Note:Combined Limit for Iron plus Manganese = 0.50 mg/L] ml = milliliter mg/L = milligrams per Liter ND = none detected NTU =Units * *Notification Level ; ** *Action Level_ ' RESULTS BASED ON SAMPLES SUBMITTED: 7/10/98 (PER NEW YORK STATE DEPT. OF HEALTH SERVICES STANDARDS FOR POTABLE WATER) Laboratory Director *NORTHEAST LABORATORY, 129 MILL STREET, BERLIN, CT 060379 (860)828 -9787 - FAX (860)829 -1050 TOLL FREE WITHIN CT: 800 - 826 -0105 •OUTSIDE CT: 800 - 654 -1230 t PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT WeD ➢.I[,®eation>i•.- .; - -,.- Street- Elddress: Ice ,PdridRodd';" IShawe Valley Estates To*hNillage: Brewster Tax °Grid' #—-_`'_- , Map Block Lot(s) 8 Well Owner: Name: Address: Saddle Ride Homes, 15 Saddle Ridge Road, Holmes, NY 12531 Use of Well: I- 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 35 ft. Length below grade 34 ft. Diameter 6 in. Weight per foot 19 lb /ft. Materials: X Steel _ Plastic — Joints: _ Welded X Threaded _ Other Seal: X Cement grout _ Bentonite Other Drive shoe: __X Yes _ No Liner _ Yes .X— No Screen IIDetafls 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 6 Yield 15 gpm 5e— is Measure om land surface- static (spec; ft) 30.' During yield test(ft) 140' Depth of completed well in feet 205' Well Log If more detailed information descriptions or sieve analyses are available, please attach. Depth From Surfface Water Bearing Well Diameteron) ]Formation )(Description ft. ft. Land Surface 10 Drilling in ove burden clay and boulders 10 Hit rocc at 10' 10 35 Drillinj in roc l., set casing, grouted 35 205 Drillin in ro granite If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type sub. Capacity 7gpm Depth 160' Model 7GS05412 Voltage 230 HP z Tank Type WX250 /-)Volume Date Well Comp eted 2/9/98 Putnam County Certi fication No. 002 Date of Report 7/8/98 Well D ' r eal mu 'A z: trxact location of well with distances to at least two permanent landmarks to be provi wu on a separate sheet/plan. Well Driller's Name P. So 4, Inc. Address: 4 RA-mm Ave., Brewster, NY 10509 Signature: Date: 7 /8Zgg Perry X. Beal White copy: HD File; Yellow copy - building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 - �1 -17 03 4 4aPA PUTNAM COUNTY DEPARTMENT OF HEALTH P02 DIVISIOI--0 ,F- .F,NVIRONMENTAL. ;HFALTH:TSE-R- ICES-,v, -: GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM or Purchaser of e. O'ni.,o< A Building Constructed by zJ �Idllle Uek I IPtj Location - Street 34 S, a. - 2J/9) Tax Map Block Lot TownNillage .!5 v) e- . -- Subdivision Name Building Type Subdivision Lot I represent that I am wholly and completely responsiblq for the location, workmanship, material, construction and drainage of the sewage treatment system serving the above- described property, and that is, has been constructed as shown on the'approved plan or approved 'ainendment thereto, and in' accordance with the standards, rules and regulations of the Putnam County Department of Health, and hereby guarantee to the owner, his successors, heirs or assigns, to place in good operating condition any part of said system constructed by me which fails to operate for a' period of two years immediately following the date of approval of the "Certificate. of Construction,Compliance" for the sewage treatment system, or any repairs made by me to such system, 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 Public Health Director of the. Putnam County Department of Health as to whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant'of the building utilizing the system. Dated: Month G Day General C Tr (0 Ler, - j Corporation Name (if corora �Q Year _d Signati 1 � A Title: Vure Address: 6- L--e- �*' b L E R. � State Zip ec-'Sa,Me Corporation Name (if corporation) Address: State Zip Form GS -97 PUTNAM ENGINEERING, PLLC 102 Gleneida Avenue -.-,,Carmel, ,NY 10512,, _ t ...ru•:.... r ... _ .v... . -.... . < _ - .. . 914- .J225 -3060 .- Fax: 914- 225 -2955 LETTER OF TRANSMITTAL Date:: .. TO: Ptm*MG--V We are sending you attached under separate cover, the following items: Shop drawings Specifications Plans No. of CODies Prints Copy of letter Other: Description These are transmitted: -- For - approval _.. Approved-as submitted - Approved as noted _ As requested _ Returned for corrections For review /comment Resubmit copies for approval _ Submit _ copies for distribution REMARKS: Copies to: SIGNED: K— if enclosures are not as noted, kindly notify this office. `/ 1 �wr These are transmitted: -- For - approval _.. Approved-as submitted - Approved as noted _ As requested _ Returned for corrections For review /comment Resubmit copies for approval _ Submit _ copies for distribution REMARKS: Copies to: SIGNED: K— if enclosures are not as noted, kindly notify this office. L i ,m 50— .— WdD,- I it %J 07 Putnam County Deyl�twsnt of Health FLAN Di—cm Of ftVirOnoM4tol Eftelth BOX-11.0 Aiaw i7or 5v&v Ai & st- - SCALE: I 50 Approved as noted For conformance with- aPPIUMG Rules andMaiculations,of t3z6 is it' vq—, -,— ISo W em— t,— r -; ) AS-BUILT MEASUREMENTS (IN FEET) P2 e-mz a C L4rr 6 � fttmm CountY Department of Health PLAN Division of Environmental Health Serviosa 5CALE: I so APproved an noted for oonformanos with app a Regulations of the C th Depar"ut., A�w efr Signature & Ht-29 Data 1 2 5 4 5 6 8 q 10 II .12 15 14 15 16 17 1,5 lq 20 21 . 22 A (A Cq),- -75 81 14112 51. 57 63117- -70 -7(.Yi e33/1 79 83Y2- 87Y?- C12- 95� , 4 ioi 10& 44Y,• 55 (pi I- t, 72 &Z 6:5 Y2- (Oq -73 76 63 SBYz g3Ya 49 54A (10 ("q 70;1+ -7-7 A9 B ,,,zr