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HomeMy WebLinkAbout1705DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 35. -4 -26 BOX 15 If 11' iij r „ Ll I Is' , 16 f '� 'e 1 �I I■ , , � �■ 1 Is 01705 Rev. 3/ 6 . P,UTNAMCOUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services, Carmel, N. 10512 . ` Epglneei Must Provide -- • .. •P.G H D 'Pemlt N CERTInCATE' 0 CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM _ T oBwlon c k o r YW Lated'at 01-\�KA I -T/,- ^ age Lut 19611 i�/IQN�DE E s 5'1''FiI..P/EGIv:' Owner /applicant NameTla\/P!'d* /� �J_l l'� V7D Formerly Stibdivision Name I Sabdy. Lot N�_ MaWng Address , V : n �a TZ0 ZIP i O 51 'Ti Date Permit'Iseued Separate Sewerage System 611f:by �Dt � ` I�G�/t;Ld(�H1F -�1 f' C� t,Ti> Ada . Qr) 'Consisting of Gallon Septic Tank and 6:-1 O P 400 7 Water Supply: Public Supply From Address or: Private Supply Drilled by M 11�1� I1.L) GAddress 'PI iWA0 AU1. t'>QiiW5 � N Building Type Has Erosion Control Been'.CompletedY -- Number. of Bedrooms T! —Has, Garbage Grinder Been Installed? 14D Other Ri ulrements I certify that, the aystem(s)�as listed serving the above premises weke constructed, essentially as shown on the p ns of the completed work ( copies of which are attached) and in accordance with the stindards,'rules'and regu _ tions, in accordance with the -ii " pl' " and' he.permit issued by the Putnam County. Department of Health. el Date ' ., ' Certifier! by P.E./�/� �, .'R�.A. Address ( (r Cico fdo._1S�J� — Any person_ occupying prom isei served by.the above 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 sewerage system shall become null and void as soon as a pubs': sanitary sewer becomes available +and the approval of the private'water supply shall become null.ina voitl, when a public wsisi supply'b.econtas available: Such approvals are subject to:modificattiion or cchaannge, when, in dhe judgment of the,Commissioner of Health, such revocation, modification or change Is necessary. Data CJ. �7" �9. By.- "r'��� �c �r Title"' -•—,�' . ely4` COQ. F O W GLL lrVr1C Lt.11 VV4 n r.r V".L DEPARTMENT OF HEALTH - Division _Of Environmental Health Services PUTNAM COUNTY DEPARTMENT OF HEALTH Office Use Only 11WELL LOCATION STREET ADDRESS: wNrvt r TAX GRID NUMSM - Steinbeck Estates, Farm —tb- Market Rd., Patterson, NY Lot. 22 =9' WELL DINNER NAME: monce Heights Deve1 ADDRESS: opment CORPO x .970 Camel, NY ,U PRIVATE 10 PUBLIC USE OF WELL 1- primary 2 - secondary &RESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIR /COND./HEAT PUMP ❑ ABANDONED ❑ BUSINESS ❑ FARM ❑ TEST/ OBSERVATION ❑ OTHER (specify) ❑ INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND -BY ❑ MOUNT OF USE YIELD SOUGHT 5 gpm. 1N0. PEOPLE SERVED 3 to 5 / EST. OF DAILY USAGE gal. REASON FOR DRILLING )0 NEW SUPPLY ❑ PROVIDE ADDITIONAL SUPPLY ❑ TEST /OBSERVATION ❑ REPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL DEPTH DATA WELD DEPTH 765 ft. STATIC WATER LEVEL 50 ft. DATE MEASURED 12/7/88 DRILLING EQUIPMENT O ROTARY x9k COMPRESSED AIR PERCUSSION ❑ DUG ❑ WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify): WELL TYPE ❑ SCREENED . ❑ OPEN END CASING. XB OPEN HOLE IN BEDROCK ❑ OTHER CASING DETAILS TOTAL LENGTH ft. MATERIALS: xkkSTEEL ❑ PLASTIC O OTHER LENGTH.BELOW GRADE t;3 fL JOINTS: ❑ WELDED :THREADED O OTHER DIAMETER 6 in. SEAL: CEMENT GROUT ❑ BENTONITE ❑ OTHER WEIGHT PER FOOT 19 lb./ft. DRIVE SHOE-32 YES O NO I LINER: O YES ❑ NO SCREEN DETAILS DIAMETER (in) SLOT SIZE LENGTH (ft) DEPTH TO SCREEN (ft) DEVELOPED? FIRST OYES ONO z .. -. SECOND - . GRAVEL PACK ❑ YES O NO GRAVEL SIZE DIAMETER OF PACK in. TOP DEPTH -ft. I BOTTOM DEPTH IL WELL YIELD TEST ; If detailed pumping METHOD: O PUMPED i tests were done iS in- O COMPRESSED AIR , formation attached? BAILED O OTHER ;OYES ONO It more detailed formation descriptions or sieve analyses 'WELL LOG are available, please attach. DEPTH FROM SURFACE Water Bear- 'n9 Well Dia- In FORMATION DESCRIPTION CODE. tt. it WELL DEPTH It. DURATION hr. min. DRAWDOWN ft. YIELD gpm. Surface 500 2 15 500 2 765 8 — 650 5. WATER X3: CLEAR TEMP. QUALITY ❑ CLOUDY HARDNESS ❑ COLORED ANALYZED? M2 YES ONO ANALYSIS ATTACHED ?)M YES ❑ NO STORAGE TANK: TYPE Diaphragm CAPACITY 86 GAL. 23 PUMP INFORMATION TYPE submersible CAPACITY 5 MAKER Goulds DEPTH MODEL 5FS05412 VOLTAGE2MHP '3 _ WELL DRILLER NAME MILL DRILL C. ADDRESS Putnam Avenue sr Brewster, NY . 1, Prt 9/88 E =. Eg i BREWSTER- LABORATORIES-... Box 224 - BREWSTER, N.Y. (914) 279 -4945 - WATER ANALYSIS REPORT - SAMPLE NO. 718 0 SOURCE: Stenbeck Estates Indian Hill Rd. Patterson, N.Y. 12563 COLLECTED: 12 - 9 - 8 8 BY: Mill Drilling, Inc. BACTERIOLOGICAL EXAMINATION Coliform'Count, MF Method NEW -WELL This result indicates the source of the sample was of satisfactory sanitary quality when the sample was collected. '12 -13 -88 0 per 100 ml. K-44 of omas eyer Director _.... - _P.,C�'N, COUN`L'Y DEPlt. �JF T,T'E -- DIVISION OF ENVIRONI ME.WAL HEALTH SERVICES won Lo e, 1,2i clf1 �S Owner or Purchas of Building C4 htn Co LT� Building Constructed `fin 544 AA TO #74 ",E1 ,Rb SGt6bIV /S10 ol Subdivision Name Section Block Lot Location - Street O-A-J:�z K0 Q,0 , Municipality R -2.S c � C4 ,n Building Type q Subdivision Lot # GUARANTEE OF SUBSURFACE SEWAGE DISPOSAL SYSTI1 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 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...pexiod• of ' two years in Mme ? ately_.folla vi n ...the -date .of -- approval:. of the "Certificate of Construction Compliance" for 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 occupant of the building utilizing the system. The undersigned further agrees to accept as conclusive the determination of the Director of the Division of Environinental 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. ff Dat this day of I� jQ U 19 � !Iqif U,� j . eras kCojitractor .(Owner) - SiqrAture Corporation Name (if --torp.) I a. N Address rev. 9/85 mk Signature Title Corporation Name (if Gbrp.) CCUUM,F-t I N 10512 ess ..I FINAL SITE INSrP=ION Date Im- ted 6_v TM OR SJBDIVISION LOT I .:'�1f' •,; s ]�'j i'7P,1 i .3cy -' Y .:__ ..: ,�:. .'... ,:.:. _ •.. ......... - .., .. a ,.... r ......r,. -.. - .... -, c,t1L t."c a_ SDS area lcct= as T aIIOrove3 laps b. F-� 11 section - Date of placa-ment 2:1 barrier. IGM W-= AVG _ DPTH c_ %turat soil nct stri d_ Stone, brush, etc., eater than 15' from SDS area_ e. 100 ft_ from water- course /wetlands. II _ S'Tr�u'= DISPOSAL SYS=. a_ Septic tank size - 1,000 ri, 25 b _ Septic tank ins =1 1 ed level ( I C. 10' mi.nimm f_an fcundation I d. Nc 90° be. ^.ds, clernout within 10 ft_ of 45° hend { { e. D I STRIHIITICI EGX . 1. ALl cutl--�-- . at same eleTTdt3on - water testea 2. Protect=---: belcw frost { I 3. Min. m 2 ft. crigiral soil bet can box and trencheis I I f JUNCTION EC;X = c'rccerly set I fit{ installed I I 2. Distance to wat- -course mel-sured 3. Instate✓ ac --rd? nQ to plan ( { 4 Distance center 't0 Canter .� 5. Slcce of t_encz accent bie 1 /10' - 1/32 " /foot. ( � 6.'10 fzt-f=�.n `_a Lne - 20 feet - fcurcaticn_s 7. Deat_-i cf trench < 30 .i_nczes . fran surface I �, 8. Ream allade:i fcr a mansicn, 50% I ( I °. Size or ar =�� 3/4 - lt" 10. Der,t_'1 of c =ve? in trench 12" m? n i:= I° � • L. Pine End Carte I h. OR ROSS. STSMS 1_ Size. or" .rc c- z-_m -:!: I i 2. Over tlaq t r k { 3. Alaxm, vi s-=-1 /audio 4. Pum easily accessible manhole to grade - 5. Fist bax 6. Cycle wi ` =sed by He= i to Der..artmp— t I es-i_=zted Ecw pier cycle IV. HOUSE a. E ^se looted ce_ acnroved plans _ b. of ber-o=sz { V. W7F-r,L I I a. WE:,-' lc—td as per acurove3 p Tans b. Di -lance fran SDS area me.----are—,q ft. C. C=.=inq 18" zhcva grade_ d. S`* =ace dr? ✓:ace 2rcur_d well accantable_ i I VI _ ME-laT , WOR .i A.Sn-l—Z a_ Ecees prepe_rly c_rcuted b. A1 TI pipes FarI a.!IV backfl C. All pices f_= us_:z with insid d. E`dcfill mateTiall contains e- C :=•-.ain drain installed ac f. C*-'tain drn cut=all prat g. Fxting dry?ns di_ =charae a h_ S=---ace water crot�tion a i_ •- -sian =LOl nrnvide!i of ba�c tones < 4" in diame rdinc to plan ta--7.1 & dir. to e`cist_ v fran SDS area to on siores greater than 15%- ,1--,' 0 PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES John`-M6 Simwns, M.D. Deputy` Cgmnissioner of Health LIT. - FIELD ACTIVITY REPORT - r ADORE4SS � : .R9 H 'T I I TI �� � � J'A Cle SO N -;:No. Street Town IM No MAILI_ NG ' ADDRESS P.O. Box Post Office Zip Code CHARGE Name and Title a / TYPE FACILITY TIME LEFT Sheet of _t Orig. Routine Orig. Complain Orig, Request Compliance T Complaint Comp Final Group Illness Construction Reinspection Field, Sampling Only _ Field Conference Other FT, Explain INSPE R-, TELEPHONE:. Signature and Title 3 PEE2SON `.IN CHARGE OR INTERVIE�TED e I.ac,° ..ledge this Field Activity Report. SIGNATURE° 6/86. TITLE: ° Putnam County Department of Health Division of Environmental Sanitation. AFFIDAVIT - - CORPORATE OWNER.A.PFLICATIQN , FOR PERMIT. APPLICATION SUBMITTED TO PUTNAM COUNTY 11EALTH DEPARTMENT, Tb: Commissioner of Health - In the matter of application for I, J 1 ,�_ ,�' (O �o��iv_T -� _ _ - — _ '_ _ -- _ — .- • represent that I am an officer or employee of the corporation and am authoriied:. to act for �t_v 1�4 C`1 �" ���vGGd,l'j�iJ % (name of corporation) ~` _ having offices at - - — L_ _.�5. �l Whose- officers -are President (Name and-Address) _ T Vice-President � _ v_I 7 / (N�me and Adree sT Secretary J� _ GLo GGO -!m— -Z/ _ (Name and Address) Treasurer- (Name. and Address) and that I am and will be individually responsible for any or all, acts of the corporation with - respect to the approval r quested and all•sub- sequent acts relating_ttiereto. ' Sworn to before me this day Signed Of 198' Title �� otary Public I ' ANNE B. COARIOAN *"P;_ $W,1 r w.Y*t Mr CoiiM � �. w�►� u . Fief r n %a7� Corporate Seal PUTNAM COUNTY-DEPARTMENT OF HEALTH eer;to Provlde,Peemlt q �'� Dlvlelon o4 F vbronmental Health Servkee;. C"61. N.Y. 1051 ?. _ .. . - on CERTIFI ATE OF COMP CONSTRUCTION FOR SEWAGE DLSPOSAL SYSTEM PermiB : q " 9� f'A-TT (�.625aN � Snsdivlel - - Bwitni l (� PJ GL 4i-t t L ycabd.+Lot N 2 Tai M" Bloch 2 - Lot' Z lam. r Renewal_ O Revleion ❑ Owliee /ApplleintNoma D�'zl%V-0.I -Iv tzN"t Co i.."C►?, Date of Previous APO' '01' . B Address �?, Q Gl.l Town. .G,M2nti 1V gyp' sag. I tai; al`l i Luc. ht Area 1 r o ? 3 . c seeaoo oily Dept welam IVambee R®tlaoome Design• Flow G. P D O; PCHD Notldcatlon is Regnireal When Fill le completed sePor.te Sep: ®rsge System to consist of `° GaUon Sepelc Tank:*®iid q>�-S (sibT(U•1J �JS To be by - "i"o':.` �3 . �A tSTt'i2A!11N, ('r b Address Water SapplTs Ptmllc'S From Address fir" orl tom. Prlvete Sapply'DeWed by., 10 eA- !_Address' Other ReoaisementE; 1 l represent tml- am wl%olly antl comDletaly rosportsible for fhe tlss,gn and location of the proposed systam(s) 1) '.that the separafa sewage :disposal system above described will be constructed as shown on the ppproved,amendment there to antl .imaccortlance with,t'he standerds, rules an regu a ions o e, u nam County .Department of; Mealth,;and that on completion theieoi a Certificate of Constru�tion'Compliance satisfactory ` to - he Commissionor.of Healtpwill be :wbmitted ao the .Department and a written.puarant6e'will 68 t'urn� shed the owner his. successo $.; halrs or assigns by'th® builder that. se id buiide► v6i11 place.`in good?'o art ofy,inid 'sewage disposal> cystem'during:tha period „of two`(2) years immediateiy foilowln tliedate of ' the issu- ance >of the.approvai of the Cerbficate of Constructwn `Compliance of the;orngmal system or: enyYepgirs thereto_ 2) thaCthe drilled well described above will beIlocated,as showni;on the,approved'plsn antl that'said well will 0- install jq accordance with the it Ind s; rules .and' regu,a�f the 'Putnam County Department •of'hlealtii E . R.A. - 3 l ii i Ert�b :11-. , - "Add ass M _ License Wo _ K APPROVEb FOR revocable for caum requires a new pe 81 Date S. ti " i ONi0 • PUMM COUNTY DEP-ARZM= OF HEALTH - DIVISION OF ENVIRMMMAL HEALTH SERVICES INDIVIDUAL RUM SUPPLY & SUBSURFACE SESQGE DISPOSAL SYSTEMS :..., ._- .. REVIEWS= - CONSTRUCTION PM:ZN T . Iry CCMr < DATE BY: �• (%lame of Owner) (Street Location) © • DOCUMEIM ur -ZOT Pe_rnit Anplication Corporate Resolution Plans - Three sets Engineers Authorization Design Data Sheet (DDS) Deep Hole Lcg Consistent Perc Results (3) Perc.. -Hole Depth SZMDIVI I N Par` ' F., 11 CA ._- House Plates - Two sets Well ® pemnit; Fiu-S let-tar Variance Request Legal Subdivision Subdivision Approval Checked Ex- approval SSDS Add. Lots Check Wetland (Town /DEC Permit R & D) Data On DDS Plans & Permit Sam REQUIRED DETAILS ON PLANS Sewage System Plan - (north arrow) Serge System Hydraulic Profile - Gravity Flcw Fill Profile & Dimensions - Volire D or J Box;Trand-i /Gallery; PLmp pit derails Septic Tank - Size, Detail Well Detail, Service Line if over Const action Notes (grinder- rate). Design'Data: perc and deep results Two -Foot Contours Existing & Proposed Driveway & Slopes Cut Footi.ng/Gutte_r-,Curtain Drains (di scllharge OK) Perc & Deep Holes Located Representative of primary and expansion Expansion Area; shown; gravity flow,ssff. size If Pmved Pit & D Box Shown & Det_iled House - No. of Bedrooms Wells & SSDS's w /in 200 ft. of Pro_sed SysteTs Prope -rty Metes & Bounds House Setback Necessary (Tight lot) House Se=der - 1/4"/ft. 4110; Type pica No Bends; Max. Bends 450 w /cleanout Sr- 'PARATION DISTANCES SPFICIFIED ON PLM Fields 10' to P.L., Driveway, Large Trees,Top of fil 20' to Foundation Walls. 100' to Well; 200' in D.L.O.D, 150' pits 100' to Stream, Watercourse, Lake Unc. esr,.an 15' to Drains - Curtain, Leader, Footing 35'to catch basin, stormdrain,uiDei watercour_s 10' to Water Line (pits -20') 50' intermittent drainage course Septic Tanks 10' fran Foundation; 50' to well 1 - 1 W-1 1 i-- nr r ri= iii LAM ■ . . a required .0 f -' - 00: - • 1� mom mom i tF �; MIAM MI'MM SZMDIVI I N Par` ' F., 11 CA ._- House Plates - Two sets Well ® pemnit; Fiu-S let-tar Variance Request Legal Subdivision Subdivision Approval Checked Ex- approval SSDS Add. Lots Check Wetland (Town /DEC Permit R & D) Data On DDS Plans & Permit Sam REQUIRED DETAILS ON PLANS Sewage System Plan - (north arrow) Serge System Hydraulic Profile - Gravity Flcw Fill Profile & Dimensions - Volire D or J Box;Trand-i /Gallery; PLmp pit derails Septic Tank - Size, Detail Well Detail, Service Line if over Const action Notes (grinder- rate). Design'Data: perc and deep results Two -Foot Contours Existing & Proposed Driveway & Slopes Cut Footi.ng/Gutte_r-,Curtain Drains (di scllharge OK) Perc & Deep Holes Located Representative of primary and expansion Expansion Area; shown; gravity flow,ssff. size If Pmved Pit & D Box Shown & Det_iled House - No. of Bedrooms Wells & SSDS's w /in 200 ft. of Pro_sed SysteTs Prope -rty Metes & Bounds House Setback Necessary (Tight lot) House Se=der - 1/4"/ft. 4110; Type pica No Bends; Max. Bends 450 w /cleanout Sr- 'PARATION DISTANCES SPFICIFIED ON PLM Fields 10' to P.L., Driveway, Large Trees,Top of fil 20' to Foundation Walls. 100' to Well; 200' in D.L.O.D, 150' pits 100' to Stream, Watercourse, Lake Unc. esr,.an 15' to Drains - Curtain, Leader, Footing 35'to catch basin, stormdrain,uiDei watercour_s 10' to Water Line (pits -20') 50' intermittent drainage course Septic Tanks 10' fran Foundation; 50' to well 1 - 1 W-1 1 i-- nr DEPARTMENT OF HEALTH Division of Environmental Health Services TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 APPLICATION TO CONSTRUCT -A WATER WELL PCHD PERMIT #IL- WELL LOCATION Street Address TV A/ tZALC f r24AV Town Atillag" Tax Grid Number q-Z7i f2SO J )jq 115-63 oD -'2- — 24;, 1 WELL OWNER Name Mailing 0M20r- .5 DOM.OrMajif Address P 0, 5v)o G'70 rivate Coy L_10 6'0 n JELSJ 105i't. OPublic USE OF WELL primary 2 - secondary ;M RESIDENTIAL ® PUBLIC SUPPLY ❑ AIR /COND /HEAT PUMP ® ABANDONED ® BUSINESS O FARM 0 TEST /OBSERVATION O OTHER (specify ®INDUSTRIAL []INSTITUTIONAL O STAND -BY AMOUNT OF USE YIELD SOUGHT ; O gpm /16 PEOPLE SERVED 4 -(,/EST. OF DAILY USAGE i000 gal REASON FOR DRILLING NEW SUPPLY ❑REPLACE EXISTING SUPPLY O PROVIDE ADDITIONAL SUPPLY ® TEST/ OBSERVATION ®DEEPEN EXISTING WELL DETAILED REASON FOR DRILLING Wpw Wsiore Gf, WELL TYPE DRILLED ❑ DRIVEN ®DUG ® GRAVEL 0 OTHER IS WELL SITE SUBJECT TO FLOODING? YES y NO IF WELL IS LOCATED IN A. REALTY SUBDIVISION, NAME OF SUBDIVISION: 5-(0A 0 i3Kxh 14I Lt- Lot No.- -7-q WATER WELL CONTRACTOR: - Name --0 - 04. `li�vfft- i2midl�r Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES k NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY L DISTANCE, TO PROPERTY FROM NEAREST WATER MAIN: LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED ®ON REAR OF THIS APPLICATION SEPARATE ET GF -13 - ST (date) (si ature) 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 provi d b the Putnam County Health Departm t. Date of Issue: 19 dj�— Date of Expiration: 19 Perfnit Issuing UTTlcial Permit is Non- Transferrable White copy: H.D. File Yellow copy: Building Inspector 2/87 Pink Copy: Owner Orange copy: Well Driller .... wimM . OOUmy . DEPAR TMENT OF HEALTH :.DIVISION ;OF -: HEALTH SERVIC�:S.. DESIGN pATA SEU=' - SUEISUFACE SEWAGE °DISPOSAL SYSTEM FILE . NO Owner b: V E;.t op ,� T...:. Lzi , r LTD ;.:.... ,._Address �?:O t�D C 1_7 D _ 2N1 TD MAVZk.r�Z �7 2 Sec, �'�.. • Block `�- Lot �LG. Located at (Street). _ (indicate nearest cross street)r Municipality � �w n� �i 776uzson� Watershed G2o`r � SOIL PERCOLA CN TEST DATA RDQUMM TO BE SUBMITTED WITS. APPLICATIONS _ Date of Pre - Soaking ' ^Date of Percolation Test j 4- g 7 Holz IREM CLOCK 1= - PERCOLATION - :... .: _;,_ _.. PERCOLATION Run iEaapse Depth to Water Frcm Water Level ZZo....: _ ._: a:,.� Time Ground -Surface In Inches:.....:....._...._Soil Rate• Start Stop iMin. Start Stop Drop In Min/In Drop �-�' 2q Inches Tnches inches . , _. a ' a7 . 3 . ,: .. ?...... ... . 2 qs33 _ q Z 3 �1 s4t y;so._ .oq 3a Z7 _... _ u..... , 2 3. NOTFS: 1. Tests to be repeated•at same depth until approximately equal soil rates are obtained .at each percolation test hole. All data to•be submitti3d for review. . 2. Depth: measurements to be made fran top of hole. rev. 9/85 2 3 NOTFS: 1. Tests to be repeated•at same depth until approximately equal soil rates are obtained .at each percolation test hole. All data to•be submitti3d for review. . 2. Depth: measurements to be made fran top of hole. rev. 9/85 �, r • • op r• 2r • r W�r rc v • Dame L,4 u2rN7 EA,,G 1Al rz.&K,A)Cg Arx-a r-, lac, Signature Address "73 F-.qir- -/= ik.ev Q&-,V SEAL. o No. 5s124 I2.S'�,3 OFES51 ®�� THIS SPACE FOR USE BY HEALTH DEPARTM&W ONLY: Soil Mate Approved sgoft/galo Checked by Date 6R055 SECTION EAN FILL - SALT NAY OK LINTKEI\TED BUILDING PAPER /—q "� 1'EKFOKATED PIPE / ( PVC) SLOPE - Y92'l FT. a o 0 0 0 oDoNt o 0 ONGITUDINAI. bEGTION 051-1E0 GRADE A9- oullT �IMZN910NGHART N EAN FILL YER DI= 6AL1 HA'f UN- fKt5ATE0 BLDG. g 1 1 0.9' 12'h.3" PEIZ 4 124.5' 12'1.'+'' 9 131.7' 13g.D" MOOKATeP PIPC G 136.3' 141-0, vG.) sLOPE %g2'�FT. 1 121.11' 159.q' 8 1.15' 22 13I -O' ft' CRUSH ED ZTONE I WASHED GRAVED 11 IIG.O 10 110.0, 13q.6 II Ig0.0" 1320 Is I 13 1311 .5' 14°l.0• 19• 164.5' I4q.0 TH19 19 TOObW-11" THAT THe 9EWA6E t7l'W'~L 9YyTEM WAei 6ON9TKVGTer' Ay LAP ENO INOIGATEO ON THIh PLAN AMP THAT THC, OF EACH �j{vjT�M WAy 0-( MPi DEFOIZG LATERAL i-( WAIJ GOVEW-rO OVE10 - THE WADI GON9TI2VGTt✓O IN AGGOWLPANGAi WITH AI.- 9TANOA120 12VLE9 4 12eCsULA"TION90F THE PUTNAM GBUNTY r7eFAKTl..1L'.N'TOFHI%ALTH ANO TNT NEW YOI STATE 10tiPA2iM�NT OP HeALTH NO-W HOUSE LOCATION TAIK N P"M 'o NOT INSTALL TKC-NGHE9 IN WET SOIL". ",JV12-VEY OG " P12r✓r:Ar -t%*? F'OIz .IDES AND 0,OTTOM OF 7Kr-NCH PRIOR MAIKIO 4 JOANNA VALENTINI, DF LOT2q, 'INC + GRAVEL. PNDS OF ALL DISTRIBUTORS DATED f�" 11 "07, PP2EPAR�1� PIY GONTRAG BE CAPPED. '(OR-h LINE Q &W-AI, � WUTH . =At- ABSORPTION TRENCH NOT TO SGAL -E ,KN06KOLT 1 Ii I 11 - - 1 boy II 1 AY AD50RGT(ON TrteNCHES ONLY -3.5'DiA INLET`.. fINI6HE[7 GRADE' KeMOVABLE GOV6K boo j-- 2'WALLS NOTES: �\ F�EL.S R.o 1_ ti ONLY THE INLET, N 2'S PVC OUTLET AND TWO 60E \ FKOM PUMP 1 i zG.rt Tn f3E KUOGKeO u � �s• N I exlg 9 1WG 492 47.15, . ;s, � tZL'�i117�NGr; PI A 4'cDG�I•P. 1 12620 CAI. "PtIG 'TANV- �''d P.V.a(rfP.); �APFLE Plax I I to ' 9 q 1UNGTION ao4(r(f) y6 L.P. AO, TR -�NoH (tYP�); Y l a5 DUILT P S 0592) - 6558) _ - -- Z:5i GAI -_ - -- 6AFFLE Box Ipv= gpX tYP) JUNG ?ION