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HomeMy WebLinkAbout1666DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 34.17-1-12' BOX 15 01666 I�yL T I ' ` •' Y :I I L L I} ` II 01666 i 'i�{I. ..M - Y •�.. HIV iii /.YW � i, '.: '..... . :.... -.. -.. - - ... .. �,. .. � - ..- .. .V ... _. . CITY, VILLAGE; "TOWN' & /OR`N.AME OF SUPPLY DATE'REPORTED SAMP.L, ING..POINT: lUTi!W: It i.Qm -,:oat BACTERLA_PER ,ML (Agar plate; count at-35 C): COLIFORM GROUP ,(Most probable No. /I Oml._) HARDINESS, TOTAL ` ppm :DETERGENTS - NITRATES (qs'N) mg j, .: IRON, TOTAL IpCJ. j, W l WELL COMPLETION REPORT PUTNAM COUNTY DEPARTMENT OF HEALTH 3/71 Division of Environmental Health Services COUNTY OFFICE BUILDING - CARMEL, NEW YORK Th[s._reoQ[l is to.be completed by- well_ driller: and - submittecj��o eCv rft _He,�Ith. �.r gn ti?g [ t2ithulahoratory .ce�ori;af: analysis of water �sample indicating water is of satisfactory bacterial quality before certificate of construction compliance is issued. REPORT MUST BE SUBMITTED WITHIN 30 DAYS OF WELL COMPLETION OWNER NAME Dominic Cotroneo ADDRESS Carmel, r)Y LOCATION OF WELL (No. 6 Street) (Town) (Lot Number) Corner Bullet Hole Rd, & Fair St, Patterson PROPOSED USE OF WELL BUSINESS DOMESTIC ❑ ESTABLISHMENT ❑ ❑ TEST WELL FARM 11 SUPPLY El INDUSTRIAL ❑ CONDITIONING ❑ ((Specify) DRILLING EQUIPMENT COMPRESSED CABLE 11 ROTARY AIR PERCUSSION ❑ PERCUSSION ❑ O� ER ) CASING DETAILS LENGTH (feet) 44 DIAMETER (inches) WEiuHT 6 PER FOOT 1.9 THREADED El WELDED O 'X YES. . ONO ' X CASING YES CnU ED? NO YIELD] TEST ❑ BAILED ❑ PUMPED HOURS G.P.M. L_ 1 COMPRESSED AIR 2 110 YIELD (G.P.M.) 10 WATER LEVEL MEASURE FROM LAND SURFACE — STATIC (Specify feet) 351 DURING YIELD TEST [feet) j total drawdown Depth of Completed Well in feet below Land surface: 200 SCREEN DETAILS MAKE LENGTH OPEN TO AQUIFER (feet)' SLOT SIZE DIAMETER (Inches) IF GRAVEL PACKED: Diameter of well including gravel pack (Inches): . GRAVEL SIZE (Inches) FROM (feet) TO (feet) DEPTH FROM LAND SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances, to at least two permanent landmarks. FEET to FEET 0 8 bank run ,_... .,._.._.......:..�_...... .. _.., _.� .. ..... __ .. a . ...._.... Boyd Arteslan Well Co., 1i R. R 5 -Route 52 Carmel, N.Y. 10512 8 24 clay 24 34 sandstone 34 200, ledge If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE DATE WELL COMPLETED 9/10/76 I'DAT F g PORT 1 S 11./ 16 WELL DRILLER �(5ignature) . Hol Phyllis & Dominic - Cotroneo Patterson Owner or Purchaser of Building Municipality McGlasson Builders Building Constructed by Fair St. & Bullet Hole Road Location - Street Sunny- Acres SUM..- Section Filed.Map #828 - Rock Frame 32 Building Type Lot GUARANTY OF SEPARATE SEWAGE SYSTEM. I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drair_age 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 guaranty.to .the owner,.his .succes- sors, 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 initial use-of the sewage disposal system, or any repairs :Wade by me to such system, except where the failure to operate properly is caused by the willful or negligent act of the occu- pant of the building utilizing the system. The undersigned further agrees to accept as conclusive. the de= termination of the Director of the Division of Environmental Health 'Ser - _tri!.eg. of the FUr�.�P. ua''21t- ��partT"�er�t of �iealth as `tG wlletiier' or° ilCit file 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 22nd day of December 19 76 Signature_ Title If corporation, give name and address) THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMPLETION WILL BE ISSUED. GUARANTOR IS REQUIRED TO FILE NOTICE, OF DATE OF FIRST USE OF SYSTEM. Division of Environmental Health Services, Putnam County Department of Health ­f ,� ....�.._ _. n►� r.,�°�� &...uor�lnrc Cct;r�ii�eor,...�.,,.,,�.�..� ,.... -. _....v,�:.._,...�_- �atcef�dn _- ._._,___... . _. .....�:- A,.,�a__,....,L.�,.._q �....� weer or Purchaser o : Bui d n g Municipal palit y McGlasson Builders' Sunny Acres Subd. Buildihg.Cdnstructe,d by SOction Fair St..& Bullet Hole Road Location Street Frame Building Type Filed Map #828 Block 32 Lot GUARANTY OF SEPARATE SEWAGE SYSTEM I represent that I am 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-amendment thereto, and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and hereby guaranty to the owner, his succes- sors, 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 initial use of 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 occu- pant of the building utilizing the system. The undersigned further agrees to accept.as conclusive the de- termination of the Director of the Division of Environmental Health Ser- vicas _of the Putnam y failu County Department_ of. Health.. as_ _t.o- whe.trer'-..or..no.t- -thy- r opy erate was caused by the willful or negli�ent act of the occupant of the building utilizing the systepK —) Dated this 22nd day of December 1976 Signature., Title If con ration.,_' give name . and address) THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMPLETION WILL BE ISSUED. GUARANTOR IS REQUIRED TO FILE NOTICE OF DATE OF FIRST USE OF SYSTEM. - - - - - - - - - - - - - - --- - - - - - - - - - - - - - - - - - - - - Division of Environmental Health. Services, Putnam County Department of Health Y� Siructure located. trom surv@q by surVeygr-, noteQ{-beior;Q-`1 W ®il 14cated a'y:' Sunmynrs surve,y -_ WellArlilecs•re,p7o7t._ :• Engineers •n.e,surements.D 1_ To ft K, . boxes, pits, gollenes 8i to to rat s:ln.ca ted oy't;ontractor_: - `•• -, .1 • Ong veer: • -' • z ,. w`eaitnaapi: FI@Ia ips itct.lo'n by: 1164lrn d@pi•Q•` dott@' 5 Ehg'vn@ -@ f AD dot, rl . NOTES VLt s ! , 1 E` N. i.^ O�V S r• A Y- s A A z H B H + �: A A K Q K Fa SAM SYSi M UE�L BlUI�" OWNER. 17�r� T'R OCATION Streot a �� U DIVISION: }� IIoGk`_ LOT••Pds ji7-_ tulidp :r sursSey'or ..vit _ a raver Date X130/„ i t $.GaleL� o::L6 2. 0V J;O;H N 7. H P R CONSULTING- P.- 3 f t Siructure located. trom surv@q by surVeygr-, noteQ{-beior;Q-`1 W ®il 14cated a'y:' Sunmynrs surve,y -_ WellArlilecs•re,p7o7t._ :• Engineers •n.e,surements.D 1_ To ft K, . boxes, pits, gollenes 8i to to rat s:ln.ca ted oy't;ontractor_: - `•• -, .1 • Ong veer: • -' • z ,. w`eaitnaapi: FI@Ia ips itct.lo'n by: 1164lrn d@pi•Q•` dott@' 5 Ehg'vn@ -@ f AD dot, rl . NOTES VLt s ! , 1 E` N. i.^ O�V S r• A Y- s A A z H B H + �: A A K Q K Fa SAM SYSi M UE�L BlUI�" OWNER. 17�r� T'R OCATION Streot a �� U DIVISION: }� IIoGk`_ LOT••Pds ji7-_ tulidp :r sursSey'or ..vit _ a raver Date X130/„ i t $.GaleL� o::L6 2. 0V J;O;H N 7. H P R CONSULTING- P.- DESIGN DATA SHEET - SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO..- 0wner��� ®v..,i.,.'� Located at ( Street ' Indicate Address e� o Z .'f' ock Loth rfearast cross s -re � � Municipality / A GC: so r, Watershed Cam' n� SOIL. PERCOLATION TEST DATA REQUIRED PTO BE SUBMITTED WITH APPLICATIONS Hold Number. CLOCK TII';E PERCOLATION PERCOLATION.: }dun E apse No'. Time Start =Stop Min. Depth. Lo a er a er . ve From Ground Surface in Inches Soil Rate Start Stop Drop in n - /in drop Inches Inches Inches 10! /, 2,0 7 W 0 4, ofic 5_ 3 0 4 /® ' Notes:. 1). Tests to be repeated at 8Ame depth until apppproximately equal soil rates are obtained at each, ^er : :olat:on test hole. All data to e submitted for review. 2) Depth measurements to be made from top of hole. 2. Notes:. 1). Tests to be repeated at 8Ame depth until apppproximately equal soil rates are obtained at each, ^er : :olat:on test hole. All data to e submitted for review. 2) Depth measurements to be made from top of hole. `PEST PIT MMA I'M C?UIRLD Mn nV - SU13P�I.T`1'1 n l.IJTFT APPLICATION DESCPfYTIO1`.1 Or'. 0OIL:�..I J' GUTdi' ►;TIED ,err ''i'EST HODS _Frml' IIOT,F' .,�r1.O. -.: - =. _T'?T T�' . *drJ�a - jF'r T'.•.:`� \ ...... _ .:...... r. G.L.. Te se) 6 ". Or q�lics 1211 30" 48" it S- 4. 60" 66" .� 8411 l7\'DICAT LEVEL AT WI°IICH GROUND WATLe IS ENCOUNTERED 'f1MT(<A.7_F 1,17. TG;I. TO:..WF1T: ^.L: in1.A 1.', rt TIE VET.. R.1.SFS .h` t 'FR FAT ?T14T(; FT COTINTERFT� TESTS' 4ADE BY �P.Y . � F .T 7 /i;/�t .. Deeo '�✓. �KP f r. to it - Provided '�� ' f Am, /g4le DESIGN Soil Rate Used 810 Min/l "Drop: S.D. Usable Area No. of Bedrooms 7X/ee - Septic Tank Capacity -. 000 Gals. Type &drso e Absorption Area Provided _ By 33LL. F. x24" ,/ . S vidth trenc . Other e., e "` dame John-H. PrentJ ss, P E, i na izre Address R.D. 6; Box-353 Carmel.. NY I05I2